Tomorrow = BEST day or WORST day

How do you prepare yourself for what is to possibly be the happiest day of your life or one of the worst days of your life? I don’t think you really can. Emotions have been high for the last 10 days. As I pace around the house, I would do anything to be able to fast forward time to tomorrow afternoon. At least I’ll know the answer. I can’t sit still, I’m so fidgety. Good thing Nick is at work or I’d be driving him crazy too.

I sit here pondering about what it'd be like to wake up one morning and think, “Hmm, I haven't seen my period in a while." Then take a home pregnancy test and be surprised. "Wow! We're expecting!! No wonder my period is 7 days late!" How wonderful that must be instead of feeling like a ticking time bomb through every grueling minute of our wait to find out if our thousands and thousands of dollars spent will result in happiness.

So, I just keep waiting and waiting for the time to pass...

SECRET MISSION

The infertility department isn't "open" on the weekends at Mayo, but they are for those doing IUI's or IVF since you still need to come in for blood tests and ultrasounds according to your cycle! So, it's like “mission impossible” when you go in on Saturday or Sundays because the lights are all off and there's only a nurse and doctor there. It's like it's a secret meeting or something. You feel as if you’re trespassing!

Nick would have to meet a guard in another building to be escorted to the special place for sperm samples, because it wasn’t open. Then we’d go to the Infertility Dept. and wait around in the dark. It was just crazy! You feel like you’re in a ghost town, but rather a ghost clinic!

For both of our IUI’s at Mayo, my cycle landed them on weekends. (Which worked out nice for Nick’s work schedule.) And during our IVF cycle, we had some ultrasounds on the weekend as well. So, we did a few of these “secret missions.” And they were sort of fun!

LESSONS LEARNED FROM INFERTILITY: (MY CONTINUALLY GROWING LIST)

I’ve learned that unintentional hurts come from loving but uninformed acquaintances.

I’ve learned that nothing is really as scary as I imagine it to be.

I’ve learned not to take everything so seriously or personally.

I’ve learned to stop planning so much for the future and enjoy the present by living in the moment.

I’ve learned that sometimes just putting your feet on the ground and one in front of the other, is enough.

I’ve learned that a lot of goodness can come from the unknown.

I’ve learned that people who are there for you the most, oftentimes are the people you’d least expect.

I’ve learned that the people you’d expect to be there for you the most, oftentimes are there the least.

I’ve learned that life offers far more good than the bad.

I’ve learned that the friends you thought would be there for you may let go of you, which makes you feel unworthy and unloved.

I’ve learned that even though you want no one to have to go through this – it helps to know someone who is. Because then you don’t feel so alone. Anything to help you not feel so lonely.

I’ve learned that even though I might not want to attend a baby shower – I still want to be invited. Because it hurts much worse to find out about it later.

I’ve learned that you can keep going long after you think you can’t.

I’ve learned how to react and respond to people who say insensitive things.

I’ve learned that I have more patience, strength, and resilience that I ever imagined.

I learned I’m glad I didn’t track of the number of hours total that I’ve waited for doctor appointments, the number of miles driven in the car to appointments, or the number of hours on hold on the telephone.

I’ve learned that two people can look at the exact same thing and see something totally different.

I’ve learned that I have a lot to be proud of.

I’ve learned and gained a deeper love, devotion, and appreciation for my husband due to the trials we’ve faced together.

I’ve learned to stop looking at the piles and piles of hospital/clinic statements, bills, and prescription sheets.

I’ve learned that no matter how bad your heart is broke, the world doesn’t stop for your grief.

THE IVF PLUNGE!

I found this online and wow…what a wonderful writing by Laura Mitchell. It is so true!! Hilarious! :)

"The IVF Plunge" Copyright © 1997 Laura W. Mitchell

The latest.... The greatest.... Come ride the spectacular new roller coaster, now open at an IVF clinic near you! Take...THE IVF PLUNGE!
Thrills! Chills! Stabs! Jabs! Laughs! Screams! What makes THE IVF PLUNGE so unique is that it is actually several rides in one! But not all riders will experience all the rides - automatic track switchers randomly select cars to go on any particular sequence. In addition, selection of a clinic also results in different protocols, behavior, treatment, cost and support. So THE IVF PLUNGE is never the same ride twice!

For more details, read on....
Some riders will experience thrills on the INSURANCE ride! Swinging you around, upside down and inside out, a brass ring of coverage will be tantalizingly close, only to be snatched away at the last minute! For those riders who manage to snatch the brass ring, a FREE RIDE on THE IVF PLUNGE is available! (Provided they meet certain restrictions.) Riders who don't grab the brass ring get a consolation prize - a ride on the CASH attraction! Whether maxing out the credit cards, taking a second loan on the house, or sponging off of future grandparents, this is a ride that you will remember for the rest of your life as you struggle to pay off the debt!!
A new attraction for PCO (Polycystic Ovarian Syndrome) sufferers has recently been added - called DAY ONE. This ride starts with the well-known classic DAY ONE - a big draw in the INFERTILITY group of attractions - and ratchets the anticipation UP!!! Will YOU meet the cut-off date??? Then of course there is the Day 3 FSH - do YOUR ovaries have what it takes?

The first part of the main ride is familiar to those who've been to the INFERTILITY attractions before – OPKs (Ovulation Predictor Kits)! But the intensity is GREATER - the highs are higher and the lows are lower and the kits are even HARDER to read!! But it all pays off as you move into....
MEDICATIONS! This is the most intense part of THE IVF PLUNGE, described by visitors as the ride from hell!! Whether your shots are sub-cutaneous or intramuscular, you won't want to miss the artificial menopause brought on by lupron, and don't forget THE HORRORMONES! You think you've done injectibles before? You think you're a pro? THINK AGAIN!! With HIGHER levels of injectibles, and DAILY monitoring, this is where the nightmare becomes reality! Then who can forget the terror of HYPERSTIMULATION, one of those random side trips! Another random side trip, POOR RESPONSE, has a chance of ending your ride early!!! Just another sense of anticipation! Can YOU make it through this part of the ride?

If so, it's on to RETRIEVAL AND TRANSFER. This ride is unique in that NO TWO PEOPLE EXPERIENCE THE SAME THING!! Some will sail through with arms raised, careening into the next sequence. Others will be shunted off due to poor egg or sperm quality, incomplete fertilization, or fragmented embryos! Your heart will be in your mouth as you await the phone call telling you how many embryos made it! And will you be sick with anticipation, or is that a reaction to the anesthesia???

Then the TWO WEEKS FROM HELL. Words cannot describe this phenomenon! With daily intramuscular shots of progesterone in oil, this is probably the most painful part of the ride! The highs and lows are even more intense, as you are surrounded by well-meaning but offensive friends and relatives saying "Well?" and otherwise telling you what you SHOULD have done. NOTHING you have experienced in the two week wait of prior cycles will prepare you for this!! You will laugh, cry, scream - all at the same time!

You will feel suspended in time as you wait for.....THE TEST. The most anticipated part of the ride!!! Some random number (depending on clinic stats) will PASS!! Those lucky riders will go on to the PREGNANCY ride, a swirling maelstrom of emotions, changes, and risks! Those who receive a negative beta-HCG are not left out though. They will descend a huge drop of what will seem like ten miles in about 10 seconds!! The misery and tears will be just the beginning, as pregnant women and women with babies and adorable toddlers will be EVERYWHERE! But never fear, because for only thousands of dollars you can once again -Take THE IVF PLUNGE!!!

"The IVF Plunge" Copyright © 1997 Laura W. Mitchell

INFERTILITY: THE ULTIMATE WAITING GAME

I wait in the waiting room for countless appointments. I wait for test results. I wait for treatments. I wait for my cyst to go away so we can continue on to the next treatment. I wait for Nick to be back in town, so he’s around for my next treatment according to my cycle. I wait for my insurance to go through because my bill was charged wrong again. I wait on hold on the telephone with the doctor. I wait on hold on the telephone with my insurance company. I wait on hold on the phone while ordering my fertility drugs from a specialty pharmacy out of town. I wait for my fertility drugs to arrive. I wait to find out if my follicles are big enough. I wait in the pre-op room for surgery. I wait to find out if our embryos are fertilizing. I wait for pregnancy. I wait for my period not to come. I wait…

MY MIRACLE NURSE - MY SISTER

She loves to inflict pain upon others. (Just kidding!)


My miracle nurse is my sister, Jesse. She's been my best friend for my whole life. (Along with my other sisters!) Who would have thought through all our trials and tribulations that we'd grow up to experience this together. I say "together" because I know she felt many emotions along with me through the entire process. And I say "together" because she was there with me every step of the way. But honestly we've pretty much done everything together our whole lives, so why stop now?

I know I couldn't have gone through IVF without her. What a blessing to have a Mayo nurse for my big sis. And to live just a few blocks away from her to help me with all my shot medications. We went over everything over and over to make sure we understood it all. Wait, who am I kidding, it was more like she went over and over it to make sure she understood it all as I stood there scared out of my mind. With each injection, she double and sometimes tripled checked the amounts.

Jesse, thank you for helping me, for supporting me, and for always loving me. Thank you for listening, giving me advice, and telling me when to chill. Thank you for letting me love your children as if they were my own. Thank you for drying my tears and holding me until they stopped. I can't thank you enough for helping to get me pregnant. I love you! Thank you for being my big sis, my friend, my heart...

I wish I could truly express how much you mean to me. This poem makes me tear up every time I read it. It's how I think of you, Erin, & Corrie!

My Sister by Lisa Lorden

My sister is my heart.
She opens doors to rooms
I never knew were there,
Breaks through walls
I don't recall building.
She lights my darkest corners
With the sparkle in her eyes.

My sister is my soul.
She inspires my wearied spirit
To fly on wings of angels
But while I hold her hand
My feet never leave the ground.
She stills my deepest fears
With the wisdom of her song.

My sister is my past.
She writes my history
In her eyes I recognize myself,
Memories only we can share.
She remembers, she forgives
She accepts me as I am
With tender understanding.

My sister is my future.
She lives within my dreams
She sees my undiscovered secrets,
Believes in me as I stumble
She walks in step beside me,
Her love lighting my way.

My sister is my strength
She hears the whispered prayers
That I cannot speak
She helps me find my smile,
Freely giving hers away
She catches my tears
In her gentle hands.

My sister is like no one else
She's my most treasured friend
Filling up the empty spaces
Healing broken places
She is my rock, my inspiration.
Though impossible to define,
In a word, she is...my sister.

Only your sister would give you a shot in your buttcheeks. Now that's true love!

FINANCES: The Infertility Gamble

The financial burdens from infertility are indescribable. The results are not guaranteed, it’s a gamble. And many couples have zero coverage for reproductive technology. While others I’ve heard of having $25,000 lifetime coverage. As you can tell, it greatly varies across the entire country.

I’m currently on COBRA health insurance, from my last job. We were blessed enough while going through our first initial attempts at our IUI’s to have some insurance coverage, which helped out tremendously. But was still very expensive. After my 5th failed IUI, we found out my insurance had switched to cover an $8000 lifetime max toward any ART (Assisted Reproductive Technology), with a $3500 medication lifetime max toward ART. We were overjoyed! This meant we could go ahead with IVF, as before none was covered. Of course we’re already past those lifetime maximums, but we’re not complaining. It’s better than nothing!

After 18 months of COBRA coverage, you are kicked off and need to find an individual plan. We were under the impression that when my COBRA was done in May, I would have to find that individual plan. Which then means that you can’t have a baby for 18 months, in order to have full delivery coverage. (It’s sort of considered a “pre-existing condition” otherwise. Fortunately, we received great news that there’s a portability clause, which allows me to stay on the same plan with similar benefits, and it’s cheaper. We can still have my delivery covered when the baby comes in October. What a blessing we’ve spent so much time worrying about!

Obviously the expenses would be so much easier if the results were guaranteed. But they’re not. Most clinics have a 50% success rate with IVF. It’s a gamble. It’s throwing your money out there and taking a chance. But honestly we made the decision that we’d spend anything to have a chance to at our baby.

WAITING TO BE EXPECTING

Can you find the "baby" in this photo? I love this picture!

We’ve been “waiting to be expecting” for longer than we’d like. And these next particular 12 days of “waiting to be expecting” are by far, the longest and hardest we’ve ever experienced.

I think nearly all would agree that the most agonizing time of any IVF cycle is the two-week-wait after your Embryo Transfer. After your IVF transfer, you have to wait 12 days before you go back in for a blood test to reveal if you are pregnant or not. The constant poking and prodding is replaced by a big void you have to fill while under instructions to rest and relax. Talk about cruelty. It’s about the worst thing you can do to a wannabe parent! It’s like someone telling you, “Just wait 288 hours and you’ll know.” What? 288 hours. That’s like forever! And relax…yeah right. The thing that would relax me the most right now is to drink a few glasses of wine, but that’s obviously not an option. So what now? I just pray and pray and pray and find myself hoping these little babies really will make a nice cozy home in my uterus.

You try to completely trust in your body and God. That together they’ll make these babies survive implantation. I prayed and prayed, but I found this difficult because this time I was desperately praying for what I was wanting so badly, not for what God wanted for me. If we could be assured that once, just once we’d become pregnant, this waiting game would be a little less stressful. But of course there are no guarantees and no magic ball showing the outcome. So we just keep playing the waiting game until our day comes.
After IVF, you are advised to stay away from doing any activities involving twisting or not to lift anything over 25 pounds. Every sudden move I made, I thought maybe I shook those babies right out of place. I thought maybe I should just lay around in bed all day in order for maximum results! I’m not even kidding when I say I didn’t want to pee too hard, laugh too hard, or sneeze too hard! One day, my niece, Cora, jumped on my lower stomach while I was laying on the floor. I imagined the embryos shooting right out from my uterus, through my vagina. Ahh, scary! I sure hope those babies held on tight!

Now that I think of it, someone should really invent a way to be frozen in time, just sleeping or something, and then be woken up right when it was time for the results. How sweet would that be!? But since that can’t be done, I guess we just continue our 288 hours of “waiting to be expecting.”

EMBRYO TRANSFER

Nick in his special scrubs! Ready for the Embryo Transfer!



After our Embryo Transfer! Come on babies...make a nice home!


We had our Embryo Transfer this morning at Mayo. And amazingly not much nerves...mostly excitement!!!!!

We left early because we had to drive in the freezing rain! (Seems there always bad weather when we need to drive there!) We checked into the hospital at 8:30am, I took a Valium, and relaxed in the room. (The Valium actually didn't do anything to me. They said some people get loopy and some don't, but I didn't feel any different. Guess I can handle my drugs! HA!) We watched a movie, "The Proposal” to pass the time. At 10am, they wheeled me down into pre-op and Nick got to come along in his sexy scrubs, booties, cap, and mask! I was so glad he was able to see the rooms I was in on Tuesday and experience this with me. The Embryologist said our embryos were right on schedule and growing great.

They were all the same group of nurses and doctors that were with me on Tuesday. I have a "grandpa" crush on my favorite doctor there...meaning I wish he was my grandpa. He is such an amazing doctor and it doesn't hurt that he has a wonderful accent! The nurses had told me how wonderful he was and that once you're his patient, he treats you like family! They weren't kidding - he held my hand, was very supporting, and gave me kind words of encouragement. The procedure went great. It was painful, as the “clamp” had to be in for a while and they sort of scraped the area out. I was taking deep breaths pretending I wasn’t there. Anything to keep from moving my body. I didn’t want to harm the embryos! Another not so fun part was my full bladder. By that time I hadn't urinated in over 4 hours and had to go bad! But you need a full bladder for the procedure to go smoother.

They injected 2 embryos (no chance of a future octomom here!), which is the highest that Mayo will put in for someone of my age. It was pretty incredible to watch the ultrasound on the screen and watch the catheter go in and once it reached it's destination - out popped the 2 little round embryos. Incredible! Not many people get to see their babies at that stage. I couldn’t believe this was happening. These are our babies! I already feel so "attached" to these little embryos. I pray they burrow into my uterine lining to stick around and grow strong.

So, back up to the room at 10:50am and I was on bed rest for 1 hour. I was determined to make it without having to pee. But about 35 minutes into it, I was about ready to explode, so I had to use a bedpan. The pressure was just too much, I couldn’t take it anymore. I was stabbing myself with my nails trying to get pain elsewhere so I wouldn’t wet myself! I called Jesse quick to ask her how it worked because I was scared! (What a wimp!) I really didn't want to but I had no other choice. But now I can say I've done that. Everyone needs to say they've used a bedpan at least once before right? Isn't it on everyone's lifelong to-do-list? HA!

This time they made me leave the hospital in a wheelchair. I enjoyed being pampered by Nick and waited for him to get the car to pick me up. The men at the door were funny. When Nick pulled up, they said, "Your Camry has arrived." Then they wheeled me out. I could get used to that service. HA!

There are some interesting rules I need to follow during all of this. Such as: no hard working out or twisting of the waist (no golf, tennis, bike riding, etc.) We gotta protect those embryos! No lifting more than 25 pounds, no using any lotions/perfumes, no alcohol, no being around chemicals/toxic fumes such as paint, glue, etc., No sex until after the pregnancy test! And if positive, then no sex until after the ultrasound 3 weeks later. (Gee, this is a nice break. HA!)

I'm feeling pretty good...just super tired...a little cramping and my butt hurts from the progesterone shots. I've been relaxing the rest of the day while Nick worked from 3-7pm. I napped twice! My body is so worn out...but I'm not complaining. Naps have now become a part of my daily routine. I am excited to hopefully get some energy back and feel a little more normal. For the next few weeks, there's no exercising or twisting (this includes vacuuming...woo hoo!) and no lifting over 25 pounds.

Today is one of my dearest friends, Keri's birthday. She joked it would be good luck for us! I sure hope so! Now the waiting game begins. Come on babies...love your new home!!

Being wheeled to the car after the embryo transfer.

OUR FERTILIZATION RESULTS

More great news! I called the "Mayo Lab Talk Hotline" and received a wonderful message from the Embryologist. Out of the 14 eggs they retrieved yesterday, they inseminated 12 with Nick's sperm (I sure hope it was Nick's anyway! HA!) 10 out of the 12 fertilized normally...which is awesome! So, they froze 8 embryos yesterday on day 1, which will be stored at Mayo for 3 months and then transferred a cryostorage company in Minneapolis. And the remaining 2 embryos are waiting to be transferred back into me tomorrow morning!! We go in at 8:30am for our Embryo Transfer. Just a Valium and bedrest for 1 hour, then we can go! :) Then the wait begins!!!!!!!!

I can't believe we have 2 "babies" waiting for us tomorrow! And 8 "frozen babies". I sure hope they behave well in their embryo daycare! It's weird you have to pay for daycare for embryos!!

So, 2 embryos could mean 2 babies...twins! (With IVF, it's around a 20% chance for twins.) And if those split naturally - then that's 4! Yikes, let's just hope for 1 or 2. We're so excited with anticipation, faith, and hope! We know God has great plans for our family and we pray and hope that this is it!

EGG RETRIEVAL

Nick and I "all smiles" on the Egg Retrieval Day!


Looking sexy before surgery!


Looking a little groggy after surgery!


Today was the Egg Retrieval day! We have great EGGSpectations for today! Ha Ha! We drove through the bad bad fog to Rochester and checked into the hospital at 7:30am. We waited together in the room for about an hour, then I was wheeled down to wait in pre-op for another 40 minutes by myself watching all the "sick" people getting wheeled into their surgeries. It made me actually thankful for the reason I was there. I looked absolutely stunning in my hospital gown, sockies, and cap. Ha Ha! The head of the "Reproductive Endocrinology and Infertility Department" came and spoke with me. I was relieved to know he was doing the egg retrieval! He is such an amazing man. The moment he looks at you and starts speaking, you just feel the love. He makes you feel cared for and peaceful. Everyone who helped me today was so friendly and nice, which helped me stay calm!

It was interesting being wheeled into the operating room with all the people with their masks on. I felt like I was on a TV show or something. The worst part was when they put the IV in for general anesthesia and that wasn't even too bad. Just a few second of pain! I didn't necessarily like being strapped onto the table like a crazy person, but then they put a nice heated blankie on me and I didn't care anymore. They put an oxygen mask on me and said, "You don't look very sleepy, so we'll give you a little more." I started to count the people in the room. I think I got to 8 and then I don't remember anything else until they told me it was all over and everything went fine.

The "surgery" probably took around 25 minutes. I was wheeled back up and got to see Nick! Yippee! All I had was slight cramping, but honestly I have worse cramps that that every month with my normal period. I had to stay and rest for about 1.5 hours after. They need to make sure you can eat, pee, and walk fine. All was well and we were outta there a little after 12pm. I've just been taking it easy today. Besides some slight pressure down there, I'm feeling just fine!

Amazingly I wasn't scared today. I was nervous last week, but today I was excited and anxious to get this part over with! I was shocked I felt this way and was so brave! We feel really at peace and are hopeful and excited for the Embryo Transfer on Thursday. I just have a good feeling about all of this!!!

In case you forgot what the Egg Retrieval involves, here is a quick summary:
The surgery is performed to move the eggs from the ovaries. A needle is passed through the top of the vagina through ultrasound guidance to get to the ovary. The fluid in the follicles is aspirated through the needle and the eggs detach from the follicle wall and are sort of sucked out of the ovary! The fluid with the eggs is passed on to the embryology laboratory where the eggs are identified, cleaned, and placed in dishes. Those are kept in IVF incubators under a controlled environment. Then, since we are doing the ICSI IVF, today the sperm were directly injected into the eggs.

Also, this morning Nick got to give another semen collection to be injected in to the eggs today. Although they already have a backup frozen sample, “Semen Cryopreservation” in case if something happened to be “wrong” with this sample.
We are actually doing a different form of IVF. “Regular” IVF is where they put the sperm and egg next to each other and let them do their thing. But, we’re doing the ICSI IVF which is where they will directly inject the sperm into the egg. (And this one is more expensive….of course!) ICSI is “Intracytoplasmic Sperm Injection” and it can dramatically improve the likelihood of fertilization when there’s a male factor of low sperm counts, low sperm motility, or abnormally shaped sperm. So, just hours after the retrieval, Nick’s sperm will be individually injected into my eggs. How romantic!

I also start on my last set of antibiotics today. Twice a day for the next 5 days.

The doctors took out 14 follicles and right now, they are "hatching." So, tomorrow we call in to find out how they are growing and how many fertilized embryos we have! Just think, all our future babies could be growing in dishes RIGHT NOW!! Absolutely amazing!!

Come on strong spermies, good fertilized embryos, and a warm, hospitable uterus!

PROGESTERONE OIL SHOTS

Tonight begins the progesterone shots in my butt. (Nice visual, huh!?) These are the long needles that are intramuscular. Two days of a half dose of 25mg and then after 50 mg for the rest of the injections. This progesterone is a thick oil, so you can feel it going in! I guess it'll be sore and feel like the pain of a bruise. So, we'll see how they go! Jesse will have to teach Nick to give the shots because we'll be outta town next week.

The rationale behind the supplemental progesterone is that following egg collection, ovarian hormone production may be impaired because many of the hormone-producing cells are removed at the time of follicle aspiration. In addition, the use of medications, such as Lupron that I took, may diminish ovarian steroid production following egg collection. So, basically - you take progesterone to keep the uterine lining healthy for good implantation. It keeps your uterus healthy and hospitable! If we're pregnant, we’ll end up taking this for a total of 10 weeks.

Your body naturally produces progesterone. Getting a steady stream of progesterone during pregnancy is vital for these reasons:
1. Makes the uterine lining develop and secrete fluids after being primed by estrogen.
2. Maintains the functions of the placenta and fights off unwanted cells near the womb that could cause damage to the placenta or fetus.
3. Keeps the uterine lining in a thickened condition.
4. Stops the uterus making spontaneous movements.
5. Stimulates the growth of breast tissue.
6. Prevents lactation until after the birth (with estrogen).
7. Strengthens the mucus plug covering the cervix to prevent infection.
8. Strengthens the pelvic walls in preparation for labor.
9. Stops the uterus from contracting thus keeping the baby where it is.

THESE FOLLICLES ARE BREAKING MY BACK!

On Monday afternoon I started having intense pain in my mid-back. Any way I laid didn't seem to help with the pain and I couldn't get comfortable at all. I’ve never felt anything like it. Even just laying flat on the floor didn’t help at all. I took some Tylenol and that helped for bit. I woke up with the back pain still the next morning.

Nick and I thought it must have something to do with the fertility meditations. But after talking with a nurse at the Egg Retrieval, she said it's probably because of the increased number of follicles taking up all that extra space and pushing, causing the pain. Remember that with all the medications, I have many more eggs than normal. I had around 18 follicles and in a normal cycle without medications, you only have 1. So, my ovaries were working overtime!

Turns out she must have been right because after the Egg Retrieval, the pain was immediately gone! :) Awesome! I’ve never experienced anything like that! It seemed like a miracle!

Here's an example of an ultrasound photo of someone going through IVF. That's a lot of follicles!!

TIME FOR OVULATION!

Yet another trip to Mayo today for a blood test and ultrasound today to check on the follicles and see if they are mature enough. We were hoping to hear that the follicles were big enough and that we could trigger ovulation tonight with the hCG injection. The hCG (Human Chorionic Gonadotropin) is a hormone that supports the normal development of an egg in a woman’s ovary. It basically stimulates and kicks in ovulation which releases the eggs.

We really wanted the hCG shot to be tonight, due to the fact that that would work best with Nick’s work schedule this coming week. And because we were almost out of some of the medications and would have had to get it last minute from the specialty pharmacy in the cities. Or maybe at Mayo, but we would have had to pay full price, because my insurance didn’t cover the medications from there.

The blood test needs to be done before 9am and our ultrasound was at 10am. So between those times, we went to our newly found favorite quaint bakery, and ate there for Sunday brunch. We also sported our Minnesota Vikings gear, ready for the big game later that afternoon.

We met a new doctor today who did the ultrasound, and she was wonderful. She gave us great news and said my follicles are lookin’ great. I have about 18 or so, with 9 or 10 that are big enough, so we’ll see how many they “use” for embryos. (Normally you have 1 follicle in a normal cycle with no drugs - so with 18 - my ovaries are working overtime! No wonder I have such pressure and bloating!)

There is one follicle that has blood in it, but I guess that can be common and so they don't use that one. My uterine lining is "beautiful,” in the words of the nurse! The doctor also checked the computer system quick around 10:30am to see if our blood test results were miraculously in, as she said they sometimes aren’t there until 1pm. She didn’t expect them to be in, but they were there! The results were great. So, she told us right then and there that we’d be triggering with the shot tonight. It was exactly what we wanted to hear and we didn’t even have to wait long for the results. Wonderful!

So - we'll take the HCG shot tonight, which will trigger ovulation! As they say, "timing is crucial" so we take the shot at 9pm tonight. And retrieval is approximately 34-38 hours after.

The hCG shot is given intramuscularly, which means “super long needle that goes right into your muscle above your butt” and involves all that crazy mixing of vials. I can’t shoot myself in the buttocks, so that means someone else has to give me the shot. And that will be my Miracle Nurse, my sister, Jesse. I don’t think anyone has seen my butt as much as she has! HA!

BUMPS IN THE ROAD

Throughout our infertility, there have been many bumps in the road - above and beyond the typical ups and downs from the monthly disappointment of negative pregnancy tests.

We spent countless hours on the phone with my insurance company for appointments and services charged wrong. With referrals over to Mayo, oftentimes it would get mixed up and I’d get charged “out of network.” And then trying to figure out medications. Many of the infertility drugs are “specialty drugs” and aren’t available in many areas, so they have to be ordered from specific pharmacies that were covered under my insurance. That equaled a lot of time on the phone with pharmacies, clinics, and the insurance company!

Along with figuring out where to get the medications shipped from, more than once they arrived frozen to our house as our IVF was in the dead of winter in Minnesota. This proved to be difficult as oftentimes you’d receive the medication just as you needed it very last minute, since you didn’t know if you would need it and it was too expensive to just have on hand “in case.” Then we’d have to hustle to try to get another delivered on time, without being frozen and unusable!

Then there were painful procedures that weren’t supposed to be, such as my first IUI that went horribly wrong. Not to mention the crazy acupuncture experience I had! There were also times that I had cysts in my ovaries from the strong medications, therefore our treatments would get pushed back in order to allow time for the cysts to disappear.

One time I was even told to take the wrong dose of medication. But it didn’t seem right to me, so I called the clinic to check and I was correct. It’s important to be on top of what you’re putting into your body and understanding what it is and what dosage it should be. Trust the doctors and nurses, but trust yourself too!!

Another stressful experience was finding out the cost of IVF was going up in 2010, right as we were doing our IVF. We were fearful that we’d have to pay the large 20-some-percent increase (thousands of dollars) since ours would be done in January, just a few weeks after the new year. After weeks of calling, emailing, etc – we finally find out that we’d still be charged the 2009 rate. Wow! I could have done without that stress!!

All of these bumps in the road were things we weren’t expecting, but as if we had ever expected to experience infertility in the first place. So, you just deal with it, move on, and keeping looking ahead. Nothing is perfect…I know! But I try to think that all of these experiences just strengthened us and made us even more appreciate for our future children!

ESTRADIOL BLOOD TESTS

On Wednesday, January 13th, we went to Mayo for an estradiol blood test. This checks the ovaries response to the stimulation. They also want to make sure that the ovaries aren’t being over stimulated, which can cause OHSS (ovarian hyper-stimulation syndrome), and is very dangerous.

I called lab talk to receive my results in the afternoon. My level was great and I was given instructions to lower my dosage of both GONAL F to 75 units and continue on MENOPUR at 75 units. I also am to continue the LUPRON at 10 units.

Today, I went for another estradiol blood test and ultrasound. There are 10 follicles on the right and 9 on the left. Everything looked good, but the follicles still need time to grow.

So, back to Mayo on Sunday for yet another blood test and ultrasound. We’re hoping the follicles are mature enough so we can take the hCG shot on Sunday night!

THE ARRIVAL OF FROZEN MEDS

Here are two photos of how my drugs would arrive in a cooler!




Ahh, the joys of doing IVF in the frigid Minnesota winter…

There are a lot of medications that have to be taken at the same time, so I have learned it’s a good idea to set alarm reminders on my cell phone. For someone who doesn’t even like taking ibuprofen when I have a headache – these past 3 years of infertility drugs has been a big change for me. I’ve also been taking pre-natal vitamins daily…”just in case.”

I order most of my drugs from a specialty clinic in the cities as they’re not available in the town where I live. They come via UPS. It’s interesting because some need to be refrigerated, so most arrive in a cooler. I don’t know why, but I feel like it’s an illegal drug deal or something! During IVF, the shipments were bigger and my largest one had 12 prescriptions delivered at once! Woah!

Ordering these medications is stressful. Just thinking about the cost is enough to make anyone sick to their stomach. As I wait for the drugs to arrive, I pray that they don’t get lost along the way, because we can’t afford any mistakes. Fortunately the pharmacy I’ve ordered them through has been a Godsend. They are so nice, helpful, and knowledgeable. They actually return your phone calls and follow through! Wonderful! I’d recommend them to anyone and everyone!

During my first IVF cycle, while I was taking LUPRON, I knew I was going to run out of the drug, just barely, according to the dosages. I called the pharmacy and it was scheduled to arrive. For the scheduled days that the drugs arrive via UPS, I have to stay at home and make sure I’m there when they arrive. They tell you they can arrive any time between 9am and 5pm. Wow…what a specific time slot! Ha! This makes it extra difficult in the frigid winter months here in Minnesota. As all mediations have restrictions, these have specific requirements of between what temperatures they can be stored. Many also list, “DO NOT FREEZE” in capital letters! So, as I wait all day, I begin to think about how long they have been in transit and outside in this very cold, 8 degree day.

I was getting anxious and when they finally arrived a little after 5pm, I was relieved. But as I opened the box, my relief quickly turned to anxiety. It was exactly what I had feared - the liquid medication was frozen! I was freaking out knowing that even if they told me it was still okay to use – there’s no way I would! I was paying and going through way too much for this whole process and I wasn’t going to mess it up with a bad drug.

I called the clinic and they were great. The pharmacist tried to contact the drug company to check to see if I should still use the LUPRON or not. Of course it was too late in the afternoon and they were closed because I hadn’t received my drugs until 5pm. So the pharmacist said he’d call me back tomorrow after he found out. And he did! The drug rep said not to use it as there were no studies as to if it still worked after being frozen. They told me they’d try it again and mail another in a cooler with an unfrozen ice pack. This way, if it were to get too cold, it should freeze the ice pack, instead of the medication.

I prayed this would arrive unfrozen as I don’t know what I would have done otherwise as this drug isn’t available where I live. Where would I be ale to get it last minute? Where would I have to drive? I received that package the next day, and it arrived just fine…with no trace of being frozen…just in time for me use it in my next shot because I had just run out. Praise the Lord!

SUPER SCARY SHOTS

I’m not afraid of needles. I donate blood as often as I can. It doesn’t really bother me. But that’s when a trained professional is doing it. Give me a needle and tell me to poke myself and I may panic. Especially when it’s something this important that I don’t want to take any chances of messing up!

Even though I’ve gone through the shot class at Mayo and watched the video at home, it still just scares the crap out of me. I’m constantly scared that I’ll put the needle on wrong, mix it up incorrectly, or inject the wrong amount.

This is a whole different thing. These fertility drugs are extremely expensive and the vials come in very specific amounts, so there’s no room for error. Otherwise you might not have enough medication for the next day. And unfortunately, these are specialty drugs that aren’t available in the town where I live. So you just can’t get them last minute.

These 2 new shots are quite scarier than the LUPRON. I can handle the LUPRON because you simply draw the air into the syringe, insert the needle, push the air in, draw the units back into the syringe, remove the need, and inject. Easy. Something I can handle.

But the GONAL F is a “pen”. The dosing adjusts with the turn of a dial, which, as it says, makes it easy to inject your precise medication dose for every injection prescribed. But it still doesn’t seem so easy to me. I’m still paranoid I’ll do it wrong. What if I set the dose wrong? What if when I load the new dose in, it doesn’t really all go in? I don’t trust it when you can’t see how much you put in like you can when it’s a vial. And besides the fact that you have to put a new needle on each time. Wait, I guess now that I’m writing it down, that putting the new needle on each time part doesn’t seem so scary. I need to stop being so scared of doing it wrong.

And for the MENOPUR medication, it involves two vials, one of which is sodium chloride and the other the MENOPUR tablet. It involves mixing these together with the use of more than one needle. This medication also comes with a Q-Cap. It is the only available vial adapter for needle-free reconstitution. It’s really quite interesting. The Q-Cap helps to eliminate stress, anxiety, and accidental needle sticks. This involves way too many steps for me still which therefore, still scares the crap out of me.

So, with all these shots, I am so very thankful to live just 2 short blocks away from my sister, Jesse, who happens to be a nurse at Mayo. And she gets everything together and injects the shots for me. Luckily for her, this stint of 3 shots per day only last for the next 10 days. So, I should be able to relieve her of her duties after these 10 days are up. We bundle up every night in this cold Minnesota winter weather a little before 9pm to head over to get shots from who I call, my Miracle Nurse…Jesse!

The shots go just fine. 150 units of GONAL F and 75 units of MENOPUR. All are given into my stomach. My only complaint is the MENOPUR shot, which is painful. It feels like someone is pinching your skin as hard as they possibly can. I can feel the medication going into my body and spreading out in different directions.

So, I guess I'd say I'm afraid of the medication...not the needles!

INITIATION OF STIMULATION

Today starts the stimulation phase of the protocol! Awesome! So far so good and right on schedule. What a relief! This now means I’m adding two nightly shots to my still morning shot. So, now we’re up to 3 shots a day!

Since my ovaries have “shut down,” as they are supposed to, my dose of LUPRON now goes down to 10 units daily. I start two more shots at night, GONAL F and MENOPUR. GONAL F (Follitropin Alfa – pronounced “foll-ih-troh-pin) is a follicle stimulating hormone (FSH) that makes the follicular cells in the ovary grow, which then stimulates egg development and the female hormone estrogen. This basically means it helps the ovaries to make more eggs. (The follicles are what contain the eggs.)

MENOPUR (Menotropins – pronounced “men oh troe pins”) is a human menopausal gonadotropin which is an ovulation drug. It’s an equal mixture of the follicle stimulating hormone (FSH) and luteninizing hormone (LH). These are both important for the development of the follicles (eggs) produced by the ovaries. MENOPUR is used to stimulate the development of multiple eggs to be collected for IVF.

I take these 2 shots daily at night (with the LUPRON in the morning for a total of 3) until the week of January 18th.

DOWN REGULATION CHECK

I stopped the birth control pills on January 1st and got my period on January 5th. Today is the “down regulation check,” which is an ultrasound and a blood test to check ovarian suppression. (“Ultrasound” sounds like fun, but of course these are vaginal ultrasounds, so it’s a not as enjoyable if you know what I mean!)

So, I braved the snow, wind, and icy roads by myself to get to Mayo this morning for an ultrasound and blood test. My ultrasound showed a few cysts, which is weird since that's one of the reasons they put you on birth control (it's supposed to help so you don't get any.) The ultrasound nurse asked me, "Do you have a history of endometriosis?" I thought to myself, "Oh no, this doesn't sound good." I said no and asked why. And then she said I had a cyst. I know if you have a cyst it could rupture and of course that's not good. (I've had cysts multiple times in the past and when that occurs you have to stop the medications and wait until it clears the next month or 2.) I met with a nurse quick and she told me the doctors would meet up at noon to discuss the ultrasound with my blood test results. If the cysts were too big, we'd have to wait it out and try again next month. I had to wait until 3pm to call the "lab talk" line, where they leave you messages. And yes - great news - they said it is still a go. The blood results were good, cysts were small and they're not worried at all. So, tomorrow starts the next phase – stimulation! More drugs = more side effects! Oh joy!

THE LOVE OF MY LIFE

My husband is absolutely amazing. Besides his obsession with golf and his small touch of OCD – he’s absolutely perfect. Perfect for me! And anything else that sort of annoys me about him really isn’t his fault – it’s a result of something I’m ultimately just annoyed with about myself. Nick is so supportive, loving, giving, and understanding. He’ll do anything to make me feel better. Like running out late at night to pick me up some ice cream while I was in one of my “moods” and craving ice cream RIGHT NOW!

He loves me when I’m happy. He loves me when I’m sad. He even loves me even when I’m hormonally imbalanced because of all the medications. He holds me when I’m crying and squeezes my head when I have a headache. He gives me shots in the butt even though it scares the crap out of him. He gives me a backrub without even having to be begged…sometimes! I’m convinced any other man would have left me by now, and I take comfort in the fact that I know he never will. We’re in this together…for better or for worse.

I’m thankful for a husband who is full of faith and prays for God’s will. I’m thankful that God has used this in our lives to make us stronger as a couple and more faithful in our relationship with Him. I’m thankful for my husband who will never leave my side…my husband who loves me for me and who lets me feel how I need to feel. I love you, Nick!

MENOPAUSE UPDATE

Menopause is still going okay! The side effects have been “okay” - nothing a strong woman like me can't handle...ha! The "hot flashes" have moved to my ears! A few times a day my ears just start burning like crazy. It's the weirdest thing! I can feel the follicles in my ovaries, lots of pressure and bloating. I even stopped going to workout at Curves because I'm afraid they're gonna blow. And I've still been very tired. (I'm happy to report Nick has given me a couple back rubs because my lower back has been quite sore!) There's other symptoms that I won't discuss, most of which involve interesting mucus (too much information!) since you probably don't want to hear about them anyway. But yes, I’m happy to report that I’m surviving menopause….so far…

PATIENTLY OR NOT-SO-PATIENTLY WAITING

Can you imagine having to pretend for 2 weeks of every month for 39 months in a row that you’re pregnant? 39 months…that’s 1220 days. That means for a total of approximately 20 months of my life, I’ve had to pretend to be pregnant without ever being pregnant. With that many months of being pregnant, I could have popped out 2.22 babies by now!

Oftentimes, at this point of the month, I’m afraid to hope because I don’t want to be more disappointed. You put up a guard because without one, the crushing disappointment is often too heard to bear. I often wonder if I have the emotional resilience to survive another failure and start over again the next month.

But then I get my period, which as contradictive as it sounds - is almost a relief. I’m so anxious, but then have a sense of peace because at least it’s a definite answer. And I can try to look forward to the next month. Nevertheless, I seem to find enough renewed strength and hope to at least try. Even though “trying” can mean very different things in every different month!

After the two-week-waiting game, (I’m so sick of playing this game!) starts what I call the “almost-two-week-at-least-you-know” phase. A little under 2 weeks that you definitely know you’re not pregnant. It’s about two weeks of being able to do what you want. Get in that hottub, drink that wine, and indulge in some extra caffeine.

I’ll patiently wait, I’ll not so patiently wait…no matter what, I’m waiting…

INFERTILITY IS…

Infertility isn’t just “We can’t get pregnant”, for me it was and is:

• trading intimacy and passion for shots, ultrasounds, and results
• people minimizing how i feel
• suffering the two-week-wait over and over and over again (39 times so far!)
• “pretending” I am pregnant during that two-week-wait (which ultimately equals out to half of every month!) just in case you really are, because you don’t want to harm your “maybe baby” in anyway
• making myself question my self worth and faith
• avoiding baby showers, pregnant women, and the baby aisles
• putting off vacations because we’re saving money for more treatments
• sitting in a room full of pregnant women while waiting for my infertility appointments
• taking a pregnancy test and never seeing a positive sign
• taking pre-natal vitamins every day for over 3 years, just in case I was pregnant
• taking time off work to go to appointments
• quitting my job to try to reduce stress and so you had more time for appointments
• quitting my job also because it was too heartbreaking to be surrounded by children all day long
• having my period come one day late, taking a pregnancy test, and finding out it’s negative, only to get my period the very next day
• spending thousands and thousands of dollars on fertility treatments
• gambling on treatments that may or may not work
• sitting at home waiting for my specialty fertility drugs to arrive via UPS so they don’t get too hot or too cold waiting outside the door
• finding out my unmarried close friend is pregnant and she wasn’t even trying
• finding out a family member is pregnant from another source
• hearing about yet another abortion of a beautiful, innocent baby (makes me sick to my stomach)
• having my doctor become part of your intimate sex life by telling us when and how often to have sex
• having that scheduled sex month after month
• arguing with my spouse because both of us are so tired and aren’t in the mood, but you’re ovulating so you HAVE to have sex or another month is wasted
• waking up after 3 hours of crappy sleep after falling asleep upset because I haven’t had sex yet like we were supposed to
• taking my basal body temperature daily to find out those peek ovulation times
• thinking that taking my body temp daily is not very fun and realizing that peeing on those ovulation sticks are much more enjoyable. (Because at least you see a positive sign at some point which gives me hope that I might see a positive on a pregnancy test someday!)
• realizing that honestly the daily body temperature and ovulation sticks both suck and deciding to stop doing both!
• spending a lot of time daydreaming about: when that day will be that I finally take a positive pregnancy test, the names of your future children, and where they might go to college.
• imagining and scheming up the most creative way to tell others when I finally am pregnant
• not going to my 10 year high school reunion because I’m afraid of answering all the “children” questions

MENOPAUSE AT THE RIPE OL’ AGE OF 29!

Getting the Lupron shot all ready!


This week I started the LUPRON (Leuprolide – pronounced “loo pro lide”) shot, which basically puts me into menopause. It over stimulates the body’s own production of hormones, which causes my “lady parts” to shut down.

What is Lupron?
Lupron helps shut off my body’s natural stimulation from my pituitary gland to my ovaries. Pituitary suppression is important for recruitment of multiple follicles or eggs. The more eggs I can grow during any given IVF round, the higher the chances of success. By desensitizing the pituitary's signals from the brain, Lupron blocks the natural tendency of the brain to allow only one dominant follicle to grow in each cycle. Also the medicine’s purpose is to prevent me from ovulating unexpectedly during the stimulation injection part of our cycle. Basically from here on out my entire cycle will be ruled by hormones that I'm injecting rather than the ones my body produces naturally.

Therefore, I’m going through the lovely side effects of menopause. I’ve had hot flashes during the day and night sweats while sleeping. Hot flashes are such a crazy thing. There’s really nothing to compare it to, really. You know how it feels when you’re outside on a really hot day in the summer? And you can feel the heat burning at your skin from the outside going in. To me, a hot flash felt just opposite, like this heat was literally burning, coming from your insides trying to get out. These hot flashes turned out to not be too bad for me since it’s mid winter. I like to think of it as free heat! And the night sweats aren’t too bad either. I’d wake up so warm and have to throw the covers off of me. Once again, this was fine for us because I was a personal heater for Nick!

I’ve also had mood swings, but I think I’ve had those for the past 3 years straight anyway, so I guess it’s not too much of a shocker (poor Nick!). Mostly I've been really tired. Naps are fun! I’m enjoying having these in my daily schedule. My lower back is really sore too, so I've been bugging Nick for a massage. Hopefully he gives in one of these days.

We’ve been taught how to give shots through Shot Clinics at Mayo, but Jesse’s still here to help me! I figured I better get the guts do it myself, since next week it’ll be up to 3 shots a day and would be a little inconvenient to go to Jesse’s at different times of the day to have her do all of them!

So I gave myself the LUPRON shot for the first time on Tuesday. This shot of 20 units is to be done at the same time every morning into the subcutaneous tissue in the stomach. (Subcutaneous tissue is the third of the three layers of skin. The subcutaneous layer contains fat and connective tissue that houses larger blood vessels and nerves.) It takes me a minute to talk myself up to go through with it, but then I think of what Jesse told me, “Pretend you’re a diabetic and if you don’t give yourself the shot right now – you’re gonna die.” Works like a charm!

P.S. The shots are going amazingly well. It's red and itchy after each injection but nothing drastic. A little bruising too, but nothing to complain about. It's actually getting easier to stab myself!

I take this injection daily until January 16th, which is two days before my retrieval.

Who knew I’d go through menopause at the ripe old age of 29? Seriously? Wow!

Ready for the shot. (I didn't smile while actually doing it!)

OVERWHELMING MEDICATIONS!

Here are photos of my dear sister helping me look through, count, double-check, and organize all the needles, syringes, and medications for IVF. It was overwhelming!

TEARS & THE HATRED OF INFERTILITY

I wonder how much my tears would all add up to? I’ve had tiny tears, sobbing tears, tears so gigantic I couldn’t seem to breath, angry tears with fists and kicking legs (okay, so yes, I admit I still have tiny temper tantrums), hopeful tears, happy tears, sad tears, and empty tears. Empty tears are ones that I wanted to cry, but there weren’t any left to let out. I cry for my baby I’ve never held; my husband who not only bears his own pain but tries to be strong for me; and for feeling weak myself.

I hate is a strong word. But yes, I hate infertility. Infertility is the most depleting experience I’ve ever faced. It’s slowing draining the life out of me. I wish I didn’t have to go through this and that no on one ever did. In fact, I don’t even wish infertility upon my worst enemy.

I’ve had friends/acquaintances who have gone through infertility at the same time as me. And after they’ve become pregnant – their contact with me lessens or stops. I often wonder if they totally forget those “infertility feelings.” How awesome would that be!?!? But then, the more I think about it – the more I know I don’t want to forget. That’s one reason I began journaling and writing. Even with all the heartache – I don’t want to forget the pain, because it’s made me who I am today…and I’m okay with that.

It’s heartbreaking watching friends and acquaintances have two children between my infertility of three years. I find myself thinking that if we got pregnant the first month we tried, right now we’d have a 2 ½ year old running around right now. Today I’m having a pity party. And I think that’s okay. I’m tired of people telling me HOW and HOW NOT to feel. Today I feel like having a pity party, so that’s what I’m gonna do…

GETTING PREGNANT: THE “UNCONVENTIONAL” WAY

People become pregnant by having sexual intercourse. Or at least that’s how I always thought I’d get pregnant. I thought I knew how to make a baby! People jokingly asked me if we were “doing it right.” Ha, ha, very funny. (not really!) So naturally I started questioning myself. I’ve only had one sexual partner, so honestly, I did start to think that maybe we were having sex “wrong.”

Without getting into detail (and here’s one of those parts I mentioned that you might not want to hear), we tried it all. I’ve layed in bed for up to an hour after, just to try to keep it all in. I’ve propped my butt up on pillows to keep it all from sliding out. I’m surprised we didn’t hang me up from the ceiling by my feet to let gravity take it’s course. (Trust me, I did momentarily contemplate it.) We tried at different times of the day.

It wasn’t until the “conventional” way didn’t work for us, that I realized I may be one of those people that would have an “unconventional” story. After two of my IUI’s, from the reproductive female nurses at MAYO, I was really hoping I could finally tell people that I got pregnant “from a woman without even having sex.” What a story for the baby book! Ha! After those failed and going on with our first round of in-vitro, I then found myself hoping that I could tell people that I got pregnant “from a man who isn’t my husband without even having sex.” Ha! Even better!

IT’S NOT ALL ABOUT ME

Today I’m realizing it’s not all about me. Maybe I don’t need to understand. I need to TRUST! Jesus gave up his life for me, so why am I not trusting my life to Him? (It sounds so simple, but why is it so hard to believe 100% of the time!?)

There’s always going to be seasons of hope and seasons of despair. We never know when they will happen or how long they will stay. But we can always be sure that God will work it for good. I’m looking to the future with anticipation and excitement. I’m trusting in God’s time and plan for our lives. I’m not ruining today anymore. I’m enjoying the time I have TODAY, as there’s no guarantees for tomorrow.

Anyone can give thanks and praise God during the happy times. It’s natural! But if you can give thanks and praise God during the sad times as well, then you are a shining example to everyone. I want to reflect and shine my light to others. I want people to say, “What’s Amy got? I want some of that.”

Well, I’ll tell you my secret – and it’s not even a secret at all. I’m a child of God. A child of God who wants to do His will and show others that God loves them too. This world and the people are too incredible to have happened my chance. We were created in His image. I pray and hope that everyone in this world has a chance to hear that they are loved by God. I’ve been blessed to be raised by loving, Christian parents. I’ve been blessed to have a member of supportive churches my entire life. But my greatest blessing is through Jesus. And because of that I have inherited eternal life and no one can take that from me.

So, it’s not about me. But it is about how my life can shine to show others the light of God! As the saying goes, “Your life may be the only Bible some people read.”

MEDICATIONS HAVE ARRIVED!

Here they are! The medications have arrived. We're ready for IVF!


Now that is what I call a lot of needles and drugs!!

I BELIEVE IN MIRACLES

Nick and I, together have found hope in God’s time and His plan for our family. It is this hope that keeps us on our path. Even though at times we may waver, we soon find ourselves right back where we need to be. We’ve been tested to our limits, but we have survived. We’ve been strengthened together as friends, lovers, and future parents.

We’re proud of ourselves amidst this crazy ride. I’ve heard PRIDE described as: “Personal Responsibility for Individual Daily Effort.” It has taken that daily effort, those baby steps. We’re proud that we’ve taken it one day at a time, moving forward even when oftentimes, we so desperately wanted to stop. We’ve gone through and sacrificed a lot in order to make our family. But, we’d do it all over again….no questions asked. We’ve stood in faith for all these years and we’re not stopping now. And we know God will faithfully and lovingly answer our prayers according to His will.

A blessing from our infertility is that we’re stronger both individually and as a couple. We’ve leaned on each other and our faith and relationship with God has strengthened. The next steps are yet to be made, but we are certain that our love for each other and our future children will never diminish. So, we’re celebrating that love for each other, our love for our Lord, and our love for our future children.

If you told me in the beginning of our infertility that I would grow to feel a sense of purpose, pride, and passion for infertility– I would have thought you were crazy. But it’s true. As the years have passed, we’ve changed. Infertility resides in our hearts. Infertility is a part of who we are. And we’re okay with that.

I believe in miracles. And I know someday I’ll be a mother.

KEEPING IT ALL TOGETHER WHEN SPERM AND EGG STUBBORNLY REMAIN APART

There’s a book titled, “Infertility Sucks! (Keeping it all together when sperm and egg stubbornly remain apart.)” by Beverly Barna. I haven’t read it, but I can imagine it’d be a great one.

I came across the title online and it made me start to think about how Nick and I have kept it together. So, I’d like to tell you know Nick and I kept it all together during a time it felt like it was all falling apart…

Just like any other couple, we were quite unprepared for the journey of infertility. But I suppose you can’t ever really be prepared for something like this. We would have never chosen this for ourselves – but who would?

Many people just consider infertility to be stressful because someone can’t get pregnant. But there is so much more! Infertility tests and treatments are very physically, emotionally, and financially stressful and can oftentimes become entirely unbearable. Ultimately, it can put a great strain on your marriage and can cause a couple to grow apart. It can even cause a loving couple to separate or divorce.

The month after month of disappointments takes a toll on every aspect of your life. And who better than to take it all out on than your spouse, right? They’re there, they are part of what you’re each going through, so, it mine as well be them!

The infertility medications can make your hormones all out of whack. I had mood swings like you can’t even imagine. Poor Nick. I know there were many times I didn’t treat him well. And I don’t blame it ALL on the medications, I know there were things I could have stopped myself from saying and ways I could have stopped acting. I take responsibility for my “diarrhea of the mouth.” I’ve said things I’m definitely not proud of…things to intentionally hurt Nick so possibly he could maybe, just maybe, for a second feel just an ounce of the pain I felt. But after I said those things, I apologized. And I think he understood. He forgave me. I apologize a lot lately. And thankfully he forgives me a lot.

We keep it together by knowing that we’ll never be apart. Marriage is a lot about compromise. It should be full of a lot of giving and just a little taking. It’s about trust and support. It’s about working through the good and bad. It’s about always communicating. It’s never giving up. We remember our vows we made to each other on our wedding day, and we know that together, with God, we’ll make it through anything. Marriage is about love…unconditional love…and I know our love will never end…

NOTE TO SELF

I try to tell myself these things and make myself believe them, but of course it is way easier said than done. Hence, here’s my little note to myself…

Enjoy the time you have. Don’t waste it “over-wishing” you had children or being sad you don’t. Or else you might miss all the great things that are happening right in front of you. Try to enjoy what you have and where you are in life. You have control over your own happiness, even though being happy at certain times may seem impossible. Don’t minimize the heartache infertility causes, but do know that you can’t let it overcome you.

Don’t loose track of where you are coming from and where you are going. You’re learning a lot about yourself and you are standing on stronger emotional footing because you’ve allowed yourself to confront the horrible, scary stuff! Don’t deny your emotions. Allow yourself to feel scared and cry when you need to because it’s preparing you to be strong and positive when you really need to be.

Don’t worry too much about if you’re being selfish. It’s not selfishness, but self-preservation. Do what you need to do to make it through this. Sometimes you will want to talk about it and other times you won’t. This is okay. Just take it one day at a time. And someday soon you will find yourself smiling at little children the same way you hope to smile at your own someday.

PLEASE BE PATIENT WITH ME, GOD ISN’T FINISHED WITH ME YET!

I know I may have hurt you along the way. Infertility doesn’t just affect the husband and wife. It affects their family and loved ones as well. I’m truly sorry if I’ve hurt you along the way. I’m sorry if I’ve ignored or neglected you. I’m sorry if my own pity party has triumphed over the good or bad things happening in your life. I never meant to hurt anyone. I just wanted to survive this…

You’ve seen our tears. You’ve filled us with hope and prayers. And most likely, at some point, you’ve felt a piece of the giant holes in our hearts. We know it hasn’t been easy, we know we haven’t always been the happiest to be around, and we know at times, we’ve neglected others.

For those of you who have cried with us, prayed with us, and loved us – we can never repay you. For those of you who have cried for us, prayed for us, and loved us – we can never repay you. This experience is quite the defining chapter of our lives. We’re learning a lot about ourselves, each other, and our relationships with YOU!

So, please be patient with me…God isn’t finished with me yet…

WHAT IS ICSI – INTRACYTOPLASMIC SPERM INJECTION?

This information is from www.advancedfertility.com

ICSI is an acronym for intracytoplasmic sperm injection - which is a fancy way of saying "inject sperm in the middle of the egg". ICSI is a very effective method to fertilize eggs in the IVF lab after they have been retrieved from the female. A common reason used for performing ICSI is for a male factor of the sperm concentrations of less an 15-20 million per milliliter, sperm motility less than 35%, and very poor sperm morphology.

• IVF with ICSI involves the use of specialized micromanipulation tools and equipment and inverted microscopes that enable embryologists to select and pick up individual sperm in a specially designed ICSI needle.
• Then the needle is carefully advanced through the outer shell of the egg and the egg membrane - and the sperm is injected into the inner part (cytoplasm) of the egg.
• This will usually result in normal fertilization in about 75-85% of eggs injected with sperm.
• However, first the woman must be stimulated with medications and have an egg retrieval procedure so we can obtain several eggs for in vitro fertilization and ICSI.

How is ICSI performed?
1. The mature egg is held with a specialized holding pipette.
2. A very delicate, sharp and hollow needle is used to immobilize and pick up a single sperm.
3. This needle is then carefully inserted through the zona (shell of the egg) and in to the center (cytoplasm) of the egg.
4. The sperm is injected in the cytoplasm and the needle is removed.
5. The eggs are checked the next morning for evidence of normal fertilization.

Photos below are an ICSI fertilization procedure in progress.


About to inject the egg with a sperm
Holding pipette on left
ICSI needle on right
Sperm head visible in needle at far right, just below X
Polar body of egg at 7 o'clock



Needle is advanced to the left
Shell of embryo has already been penetrated by needle
Membrane of egg (oolemma) is stretching and is about to break
Sperm head is visible at tip of needle



ICSI needle has penetrated the egg membrane
A single sperm is being injected into the cytoplasm of the egg

WHAT IS IN-VITRO FERTILIZATION (IVF)?

This information is from www.americanpregnancy.org

In-Vitro Fertilization (IVF) is a process by which egg cells are fertilized by sperm outside the womb, in vitro. IVF is a major treatment for infertility. The process involves hormonally controlling the ovulatory process (injecting super stimulation drugs), surgically removing eggs from the ovaries and fertilizing them in a lab with sperm. The fertilized embryo(s) are then transferred into a woman’s uterus with the intent to establish a successful pregnancy.

There are basically five steps in the IVF process.

1. Monitor and stimulate the development of healthy egg(s) in the ovaries.

Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during on the woman’s cycles. This is often referred to as ovulation induction. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. Egg development is monitored using ultrasound to examine the ovaries and urine or blood test samples to check hormone levels.

2. Collect the eggs. (EGG RETRIEVAL)

The eggs are retrieved through a minor surgical procedure which uses ultrasound imaging to guild a hollow needle through the pelvic cavity. Sedation and local anesthesia are provided to remove any discomfort that one might experience. The eggs are removed from the ovaries using the hollow needle, which is called follicular aspiration. Some women may experience cramping on the day of retrieval, which usually subsides the following day; however, a feeling of fullness or pressure may last for several weeks following the procedure.

3. Secure the sperm.

Sperm, usually obtained by ejaculation is prepared for combining with the eggs.

4. Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.

In a process called insemination, the sperm and eggs are placed in incubators located in the laboratory which enables fertilization to occur. In some cases where fertilization is suspected to be low, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.

5. Transfer the embryos into the uterus. (EMBRYO TRANSFER)

The embryos are usually transferred into the women’s uterus anywhere from one to six days later, but most commonly it occurs between two to three days following egg retrieval. At this point, the fertilized egg has divided to become a two-to-four cell embryo. The transfer process involves a speculum which is inserted into the vagina to expose the cervix. A predetermined number of embryos are suspended in fluid and gently placed through a catheter into the womb. This process is often guided by ultrasound. The procedure is usually painless, but some women experience mild cramping.

A blood test and potentially an ultrasound will be used to determine if implantation and pregnancy has occurred.

YES, I’M TRYING TO GET PREGNANT AND I’M ON BIRTH CONTROL!

I’ve been on birth control pills since November. Which may seem crazy, but they want to totally be in control of my cycle. This month they had me skip the “inactive/placebo” pills, so I won’t get a period.

It seems extremely weird and contradictive to be on birth control while struggling with infertility. Just another one of those things you need to laugh at.

IVF ORIENTATION

In October of 2009, we had our first IVF meeting with our Mayo doctor. We had our Orientation IVF visit on December 4th, where we had individual meetings with one of the team doctors, an embryologist, a reproductive endocrinology nurse, and the business office representative.

With the doctor, we discussed the consent forms and went over the risks, complications, and side effects that can occur, etc. Next was the embryologist who told us what they do and talked to us about being in a research study which would study early human development before implantation. This means we’ll “donate” any cellular material that is going to be discarded. We chose to be involved in this if the opportunity presents itself. Another research study is to determine more information about hCG from 0-12 weeks of your pregnancy. If we are pregnant, we’ll probably chose to not be involved in this study, as it means I would drive to Mayo daily for blood tests and ultrasounds for 18 days. All of that is for free but of course not the time and gas money!

Next, we met with a nurse, who gave us one-on-one instruction for self-administration of the medications, step-by-step instructions for the treatment cycle, and went over our binder and outline of medications and prescriptions. This happened to be one of Jesse’s work friends and she was awesome! Plus she’s been through IVF herself and could relate…that makes all the difference! And finally, we went to the Business Office Representative to discuss the costs and arranging admission to the hospital for the egg retrieval and embryo transfer. One step closer…yippee!!

“TO IVF OR NOT TO IVF?” THAT IS THE QUESTION!

IVF is a time of hope for many couples. This may be the time and way that a couple becomes pregnant! A lot of time and money is invested into each attempt. But of course that comes with the uncertainty as to if it will be successful or not. Therefore, it is also a time of fear. There’s no guarantee that it will work, so going through these tests, medications, etc. is an emotional time full of hope and fear for most couples.

Undergoing IVF treatments is very rigorous. The woman undergoes many medications and shots with frequent appointments. There are many steps and each step coincides with the next. If one step along the way isn’t “right,” it may stop or slow down the whole process. (You need to take drugs to make more follicles, but it can result in too many follicles and over stimulation and then you have to stop all medications. You may get all the way to the fertilization after the egg retrieval and none of the sperm and eggs fertilize together to form an embryo.) Each successful milestone is just one step closer to the hopeful pregnancy.

With all the hype in the news, many people assume that IVF is a sure thing. But in fact, the odds of success are fairly low. Generally speaking, it’s a 50/50 chance. So, if it fails, which there is that 50% chance that it will – the blow can be devastating.

Probably the biggest factor of IVF is the financial strain. One cycle of IVF is extremely expensive. Especially if you do not have any insurance coverage for ART (Assisted Reproductive Technology), choosing to pursue these medical options is very difficult. Many have to pay for a large part of all of the costs out of their pocket. Many couples cannot afford to try for one cycle, yet alone multiples times.

IVF also raises ethical issues. Therefore, it can also be difficult for a couple to tell others about their decision to proceed with IVF as any people can form judgmental and uninformed responses. It’s a gray area in many ethical ways, and many of our moral leaders don’t yet even know how to answer the questions that have arisen from this technology. For many couples, IVF may be the only way they will ever be able to have their own biological baby. This is a huge decision. Try to put yourself in their shoes for a bit. How would you feel? What would you do? You have no idea how many times I've questioned myself as to if I'm trusting in science too much and not God enough. It can just tug your mind and heart in such crazy directions!

A couple who goes through IVF has a hard, expensive road ahead. They need support. The hormones, heartache, and financial burdens are enormous. They wouldn’t be going through this if there were any easier way. And the fact that they are willing to endure so much is proof of how much they truly want to parent a child.

Acknowledge that this is one of the biggest challenges life may bring someone. It’s effects shouldn’t be taken lightly...

KNOWLEDGE: AN IMPORTANT ALLY

Knowledge is an important ally on this journey. Even though the doctors told us and explained what was going on, usually it was so much information thrown in our faces at once, that we couldn’t take it all in. Or it was explained in such long, technical terms, we didn’t really understand what it all meant. I’ve never understood why most doctors talk to you like you have a computer dictionary in your brain, instead of just using normal words like a normal human.

Don’t be afraid to take notes during appointments. (I regret that.) If you don’t understand, ask him/her to explain it again. Ask for printed information, search online, and talk with people who have been through it. But remember that in the medical world, research is always updating and changing medical practices. So, just because you talked to someone who went through IVF 10 years ago, it may not be the same in today’s time.

Although, even if you’ve done all the research you can, I’ll give you a fair warning that you’ll never truly understand it all until you’ve been through it yourself! But I guess that’s true with any aspect of life! Experience is the best ally!

There are so many different doctors and clinics that practice varying techniques for infertility. Even when doing the same treatment, they can use different procedures, medications, etc. So, when researching online, it can be difficult because just because one clinic lists how they do it, it doesn’t mean the next clinic will be the same. But it gives you a good general idea and starting place, nonetheless.

Oftentimes, I feel that that I know more of what’s going on than the doctors do. Remember that this is your plan, you have a say in your treatment. Fight! No one will fight harder than you for you. So if something doesn’t sound right or feel right – speak up. You you’re your own body better than anyone else. Don’t be afraid to take control. Ask questions. Be annoying. (I like to think of annoying as “being prepared.”) Call. Do whatever you need to do. This is your body and your life. And that is worth speaking up for!!

INFERTILITY: THE THIRD YEAR: - Hope or Denial?

October 2008 through October 2009

Our third year started with renewed hope…or maybe it was just denial. We started doctoring at the Mayo Clinic in Rochester. I thought, if the “world famous Mayo Clinic” as they call it, couldn’t get us pregnant, than who could? We might as well give it all we’ve got. We went through more testing there with a more specific sperm analysis called “morphology.” The morphology came back with interesting results. Nick’s sperm count wasn’t necessarily “low,” but other issues were recognized with the motility. They look closer at "perfect" sperm. All of that was really confusing to me, but from what I understood, we were at around the 3%, where the chance of conceiving on our own was very slim.

I endured tests and more tests. We wondered if there would be an end in sight. We did 2 more IUI’s with no success. This year was difficult with fitting in treatments. Time just didn’t always work out for us. We’d be out of town during ovulation, peak times, etc. So, we’d be forced to take another month off. We voluntarily took some shorter breaks in-between treatments to regroup and rejuvenate.

At then end of the third year, when we started the process for in-vitro, I felt bewildered that we had really been on this journey for this long. I never imagined it would get to this point. I naively thought we’d be one of those couples who would start going to the doctor and naturally get pregnant by ourselves during the in-between times of non-treatments. I don’t know why I even thought that would even happen to us since I actually only personally know one person that has happened to!

So, now it’s been over 3 years since we started this infertility journey. Wow! We’ve done all we can medically available up to this point. Now on to the next step..in-vitro! Since it had been 1 year since Nick's last sperm analysis, they requested another. Apparently it was also a newer, updated "test." It can study more into the specific appearance of the DNA and how it binds to protein. (Blah, blah, all of this stuff I don't understand at all!) This time the results were different! The sperm seemed to have "improved." In fact, they told us that we may not have to go ahead with the IVF-ICSI, as we had discussed, but just to go ahead with the IVF. But after some more thought, our RE (Reproductive Endocrinologist) suggested that we still go ahead with the IVF-ICSI, just to maximize for best results! (The techniques for IVF and IVF-ICSI will be explained in a future post!)

We are optimistic that IVF should be successful for us! If we haven’t been able to get pregnant due to the sperm not being able to get into the egg, then this should work! Mayo stats show that it’s about a 50% chance we’ll become pregnant. And if we are pregnant, then it’s around a 20% chance it will be twins.

HOPE FOR TOMORROW

I don’t know how long our infertility journey will be. I don’t know the direct path that will take us there, but I know someday we’ll arrive. And God will guide us there, never leaving our side.

We’ve learned we’re more certain of God’s love, more grateful for very blessing, and more full of trust for His plan for our family. Throughout this whole experience, we’ve experienced questions, loneliness, doubts, and hurt. But more importantly, we’ve experienced answers, support, strength, and hope.

Remember that you are loved. You are blessed. Keep the hope as it is a foundation. And keep the faith as it draws strength. I pray you always hold hope close in your heart. And remember that while your arms may be empty today, there is always hope for tomorrow.