update on fertility journey

The month of April marks 2 years since I began blogging and 5 years since our first miscarriage. You could read through the last 2 years of posts to see most of our story, but I thought I would post an update here for those who might be new to the blog.

Husband and I were married September 2007. Hard to believe we are about to celebrate 10 years of marriage! Two years into our marriage, I decided to go back to school to earn a masters degree in counseling. That was in September of 2009. In December of 2011, I graduated and in January of 2012 we decided we would start building our family.

I found out I was pregnant in March of 2012. We were so excited to share our news and wanted to come up with a fun way to surprise our families. However, in April we found out that instead of sharing the news of our pregnancy, we had to share the devastating news of our loss. It took several months to cope, but we were soon ready to try again.

In November of 2012, there was another positive test, but December brought news of our second loss. In January of 2013, I was at the doctor’s office to discuss my second miscarriage when I found out I was pregnant in her office for a 3rd time! Yet our 3rd miscarriage followed in February. When I should have been having my first ultrasound on February 6th (also my sister’s birthday) I was instead at the doctor’s office to check to make sure my hcg (pregnancy hormone) levels were decreasing.

I was at a mother’s day service in May 2013 with my mom and sister and tears were streaming down my face during a worship song. I wanted so badly to be a mother. Little did I know that at that very moment, I was pregnant for a 4th time. Yet, in June of 2013, I had my 4th miscarriage. It was our 4th miscarriage in just over a year. It was the fourth time I fell in love with mine and Husband’s child and the 4th time my heart ached, reeling from loss of our child.

We were then referred by my doctor to a Reproductive Endocrinologist. We had our first meeting with Dr. G at the end of June. We set up a hysteroscopy for August of 2013 where a polyp was found in my uterus and removed.

The next year that followed our 4th miscarriage was one of the toughest years for me personally and for our marriage. I isolated myself and stopped sharing my feelings with Husband. It was bad. In April of 2014, I finally reached out for help for the depression and anxiety I was experiencing. I was in denial that I needed help, because I’m a marriage and family therapist and should know how to handle this…right?!?!?!? Wrong.

Starting in September 2014, we then did 3 rounds of clomid. One round in September, a second in October and a 3rd round in November. All with negative results. Because I basically have the eggs of a 45 year old at the age of 31 (at the time) IVF with genetic testing was the recommendation for us moving forward. Before starting the IVF, Dr. G wanted to do another Hysteroscopy to make sure everything in my uterus was looking okay. That was in December 2014. Things were good and we were all set to go.

Stimulation shots began in February 2015. 6 eggs were retrieved that March, 4 fertilized, but just 1 was healthy. That one egg was a baby boy and was transferred April 15, 2015. We found out two weeks later that the embaby (embryo/fertilized egg) did not attach to my uterus. I began the blog the day we found out. I also set up a counseling appointment the next day, as I did not want to slide as low as I had been exactly one year before.

In July, we felt like we were ready for round 2 of IVF and got the stimulation meds going. I counted over 50 shots I gave myself in a matter of 12 days. At the end of August 4 eggs were retrieved and 5 days later we found out 2 had fertilized. Those 2 embabies were both healthy when the genetic testing came back and were both boys! We transferred one embaby in September 2015 and got a positive pregnancy test! We had ultrasound after ultrasound, but what we thought was a heartbeat was not. We had 5th miscarriage at the beginning of November.

We were heartbroken for a 5th time. Our 5th life was lost, but Dr. G had a plan. He felt we were at the point of either a Reproductive Immunologist or a gestational carrier (surrogate). There are just a handful of reproductive immunologists in the US. I finally followed up with one in New York. When I spoke on the phone with Dr. B, he was fairly certain that I had what was called “silent endometriosis.” I stalled on the paperwork because I knew once it was all turned in, the process would go quickly. Sure enough, I was correct.

I completed all the paperwork for the RI in May 2016 and the next morning I had 3 emails in my inbox. Within a few days, I had hooked up with a lab in Massachusetts and had 20 vials of blood sent there on dry ice overnight. It wasn’t until late July that all the results were in. There were about 5 things that popped up, but all were treatable and secondary issues. Dr. B in New York was still sure about the endo, while Dr. G in Houston wasn’t quite convinced. The only definite way they can diagnose endometriosis is via a laparoscopic surgery.

Husband and I went to Manhattan for a pre-op appointment with Dr. V, an RE who specializes in silent endo, and then I had the 2.5 hour surgery the next day in Hoboken, New Jersey. You can read about that process here and here. Stage 3 endo was discovered. We had a great time exploring NYC and I ended up walking over 8 miles the day after surgery. My surgeon was not pleased, but when in New York…

We began stimulation medications for a 3rd round of IVF in October, retrieval was in November. Only one embryo was healthy after genetic testing. It is a girl! We were so excited because we thought this was finally it. Remember, we still had one boy embaby and now a girl. We transferred the boy embryo in December 2016, just days before Christmas. In fact, I was on bed rest right up until Christmas Eve. I was feeling pretty heavy about this most recent transfer. From the moment in the OR while Dr. G was positioning the catheter and then embryo as both husband and I watched on the monitor, I had this feeling of unease. It just didn’t feel right.

I insisted on a pregnancy blood test a week after the transfer. We are now in the last week of December 2016, just before New Years. My hcg came back at 16. Very low. I was told by my favorite nurse to go home, think positive and pray. I went in the next week and had another blood test. Hcg was at 1. I’d had a chemical pregnancy, resulting in our 6th miscarriage.

A few weeks later, I was experiencing so much grief that I was unable to make it through an entire day without the appearance of tears. I took a leave of absence from work and 4 weeks after that I decided to resign from my job as an adolescent therapist. It all became too much. I am hopeful that with a bit more downtime, I will continue to heal, but I feel like my heart will never be quite whole again.

Husband and I decided together that we would put off IVF round 4 and transfer our remaining embaby girl when I feel more at peace.

And here we are. Year 5 of trying. Almost down to the day that we found out about our first miscarriage and 2 years ago this month that I began this blogging journey. We prayerfully continue to push forward, because moving backwards is not an option for us.

Please join us on our journey.

ivf cycle 3, day 20

This cycle will never end.

Today is the 18th and final day of injections. Hallelujah.

I went in for my 10am appointment. I was called back fairly quickly and my blood was drawn, but they had me hang out in the conference room for a few minutes to wait for a specific exam room to open up. This room had an older machine, but it gives a better view. The nurse was telling me that because we are at such a crucial point, they wanted to make sure there was little to no doubt as to my progress (or my body’s progress…its not as if I really have any control over this).

I went across the parking lot to the hospital after my appointment to squeeze in baby snuggles with my cousin’s daughter who was born yesterday. I was at work around 11:15. Things went smoothly today, despite having to recommend residential treatment to a patient who has been unable to maintain sobriety from pot. I went back to read this paragraph again. It starts out with a sweet baby and ends with a teenager smoking weed. This is my life.

As soon as work ended today, I left to go to my church for a women’s ministry event. Had a great time visiting with some pretty amazing women and learning more about different ways to get involved with missions in my community.

So anyways…back to IVF…It was about 4:40pm this afternoon and I became nervous that I had not received a phone call from the doctor’s office. The office closes at 5pm and I wanted to make sure I was given instructions on the next step. I was told that the nurses were talking to the doctors and the surgery center to set everything up and that I would receive a phone call from a nurse in a few minutes. Sure enough, about 2 minutes passed  and my phone began to ring. I was informed that I would definitely be triggering tonight and that the retrieval had been scheduled for Thursday.

Before leaving the office after my appointment this morning, I requested the earliest procedure time so that Ross would be able to make his way back to his job site 3.5 hours away. The nurse told me that there are a number of procedures already scheduled for Thursday and that mine would not be until 12:45pm. The surgery center is about 45 minutes from our house without traffic. It has taken us up to 1.5 hours commute time during rush hour traffic in the past. We need to be there by 11:30am, which means we need to leave the house no later than 10:30am. Also, I cannot eat or drink anything after 12am tomorrow.

The Ovidrel trigger shots (there are 2) will need to be given at 1am Wednesday morning, as the trigger shot is administered 35.5-36 hours before the retrieval time. I went ahead and set an alarm to wake up at that time earlier this afternoon, but seeing as how it is 11:21pm here in Texas as I type, I will likely stay up, though, of course, I am more tired tonight than I have been in about a week. I think part of that is knowing that it is finally time to trigger and the wait is almost over. There has been so much build up to this moment.

 

 

 

ivf cycle 3, day 19

And…………….One more day of stimulation shots. Went in for ultrasound and blood work this morning and was notified this afternoon that the doctor wants me to stim another night and come back tomorrow for another scan. When I said yesterday that this cycle seems to be going longer than the previous 2, I didn’t mean for it to go longer. It is looking like Thursday will be retrieval day. Taking a deep breath now…

After the doctor appointment, I went to work. I was there a few hours before going back to the hospital to visit my cousin who had a scheduled c-section this morning. I went back to work and about 10 minutes after getting to the office, I received a phone call from the nurse telling me that I would need to stim one more day. I have just 2 vials of Menopur at the house and take a total of 7 each night. They had enough at the office to get me thru tonight and I will go back tomorrow. It is likely that I will trigger tomorrow night, but not definite.

Again, timing is everything.

Went back to work to finish the afternoon group that I was scheduled to lead. Left work about 5:45pm and went to my monthly support group meeting for infertility that lasted 6-7pm. I have spoken to the leader of the support group, who is a marriage and family therapist and specializes in infertility and 3rd party reproduction. There has not been a peer led support group in my area in over a year and I have expressed interest in starting it up again. I sent an email a few weeks ago to Resolve.org and the responded with a video that I would need to watch about what to expect about leading the group. Tonight, at the end of group, I asked those present if they would be interested in attending another group each month. The response was overwhelming, so I plan to take an hour to watch the video and find out the next steps.

I’m exhausted today. More that I have been in the last week or so. I don’t know if it is the hormones again or if it is the stress related to IVF. I am a part of an online support group, which has also been pretty neat. Tonight they asked for prayer requests and then you would be responsible for praying for the person in the thread above you who shared a request. It is great to get together with the support group here locally, as some of them I have known for just over a year now. Then to be able to check Facebook after leaving the group to find prayer requests opened up to the group is so encouraging.

I thought this update would be different today. I thought I would be typing about the trigger shot I had taken and about the upcoming plans for retrieval day. That is not the case tonight. I’m not overly upset about it. Just tired. Tired of all of this. Yet, I know it will be worth it in the end. At least that’s what I keep telling myself.

ivf cycle 3, day 18

I arrived on time (chronically late) to my doctors appointment on Friday at 10:45am. There were about 12 other women ahead of me. Apparently, Fridays are usually very busy. I have been spoiled this cycle because I have not had to wait long at all when I have gone in for my appointments.

Today is the 16th day of shots, for a total of 47 injections so far. This cycle seems longer than other cycles. Dr. G told me that he was a little nervous on Monday when he scanned me because I had been on a pretty significant dose of medication for a full week at that point and he was not seeing much progress. A nurse scanned me Wednesday and then Dr. G scanned on Friday. He was please with the progress, but wants to see me again tomorrow (Monday) morning for another scan. On Friday he thought it was likely that we would trigger Monday night and then the retrieval will be Wednesday morning. The “trigger” is 2 shots of Ovidrel that I will take at an exact time they tell me. This tells my ovaries that it is time to ovulate and release the eggs that have been growing in the follicles.

There are currently 5 follicles they are keeping their eye on, but likely only 4 will be ready for retrieval. There are 4 in my left ovary measuring 15.71, 12.45, 10.38, and 10.40mm. There is one follicle in the right (yes, they finally found my right ovary), but it is just measuring 8.45mm. This was on Friday and the follicles grow about 1mm per day. Again, they want the follicles to measure between 18-21mm.

I remember sitting down with Dr. G back in July and expressing my concern with the possible dilemma of having the endometriosis being removed and then all of a sudden having an increase in eggs. Y’all, I’ve heard there are actually people out there that have up to 30 follicles growing eggs. Dr. G said we would likely not run into that problem, but if we did, he would only fertilize the healthiest eggs. Reminder: 1st cycle they retrieved 6 eggs, but only 1 ended up being viable and 2nd cycle they retrieved 4, but only two were viable. One embaby was transferred September 2015, but I had a miscarriage at the end of October. The 2nd embaby is still frozen, but will be transferred in December, if all goes well.

Also, if you read my previous post, you know that I forgot to do the injections one night. The nurse was able to get back to me that same morning and let me know that all is good. Dr. G teased me about it Friday morning. I was so embarrassed, but he said it would be fine. Whew! They were glad I took them as soon as I woke up and remembered, rather than later.

The weekend has been nice and relaxing. Celebrated a friend’s birthday Friday night. Waited around the house Saturday morning for Fed Ex to deliver medications and after that went out to get some errands done. Church this morning and then went to look at some tile for our living room this afternoon with my mom. Ready for the upcoming work week. Makes it a bit easier when I know that I will be working just 4 days rather than 5. I’ll update again after the doctor appointment tomorrow.

 

 

 

ivf cycle 3, day 9

I had my third appointment at the doctor today. All the consents were signed on my part. Husband had consents signed, notarized, scanned, and emailed to the doctors office, but there is one left we will have to take care of tomorrow and then I will take it in on Monday when I am at the office for yet another doctor appointment. 

I didn’t go in to work on Tuesday. It was the first time in almost the 5 years since beginning this journey when I took a day off work without anything significant happening. I just could not get out of bed. I hadn’t received bad news. I hadn’t had a miscarriage. I’d had no procedure.

I just wasn’t up to it. 

My doctor has been out of town on business, so the nurses have been taking great care of me the last week and a half. Nicole, Megan, Teresa, Sharon, and Rachel are amazing women. I teared up at the appointment on Wednesday and was searching for validation with the crazy feelings I’ve experienced the last few weeks. Teresa was amazing and simply told me that I had been through a lot. That was all I needed. She didn’t tell me it would be okay. She didn’t attempt to brush off my tears. She grabbed a tissue, walked around the nurses’ desk, and hugged me. 

I’m not entirely sure if she was prepared for my full-on hug. Maybe she meant for it to be a reassuring pat on the shoulder, but in that moment I needed a hug, so I went for it. 

After that appointment I went to work. Y’all, I work with some amazing people. They checked in with me, asked how I was doing, but when I teared up again, they backed off. It’s also nice that I work with other counselors and therapists. 

Work has been good the last few days. Chipping away and the ever increasing mound of paperwork while getting the opportunity to train new hires and student interns. I love my job. Even on the crazy days. 

I spent about an hour on Thursday trying to refill a prescription for my main stimulation med, Menopur. I also contacted my sister in law who is a pharamacist to ask if she could help me out with some pharmacy math. With her help, I was able to determine that I would not need a refill for a different injection until after the weekend. It’s good to know people. 

So, back to today’s appointment: I arrived on time. Almost. Signed the consents and they pulled me back for the lab work soon after. I entered the exam room and waited just a few minutes until a nurse came in for the ultrasound. She had a hard time finding my right ovary, which is odd because that is normally the easier of the two to find. She had no problem at all finding my left ovary, which is typically more difficult to locate. The same thing happened on Wednesday, but it was still early enough in the cycle that it wasn’t a big deal. However, today it was just a little odd. Another nurse entered the exam room and was able to find what she was pretty sure was my ovary. Great. Just over a year ago when we were doing our second round, they couldn’t find the left ovary. Now the right. 

Pictures were taken and everything was wrapped up. I went to work for the rest of the day. I received a call and voicemail from one of the nurses, along with a text message to check my patient portal. Dr. G reviewed the labs and ultrasound results and wants me to go from 6 vials of Menopur to 7 vials each night. I have another appointment scheduled for Monday at 10am for more lab work and an ultrasound. Dr. G should be in the office. 

Husband was able to get off work early and made the almost 4 hour drive back home and actually beat me to the house. While I had a fun date night in mind, we ended up ordering take-out and watching a Dateline re-run. 9 years of marriage. That’s what it’s all about.  🙂 

The neatest thing happened though. While shifting through a variety of infertility bills and insurance claims that had arrived in the mail, husband tosses a package my way and says: This came for you. 

I had no idea what “this” was. I opened the envelope and found a book inside. There was no explanation. I thought my best friend sent it, but, after texting her, she completely denied having anything to do with it. She shared that she loved that someone sent it to me. The book is called “In Due Time” and had a handwritten message from the author with my name in the address. I did a little investigating and found the author on Facebook and noticed that the author and I have just one friend in common. My very thoughtful cousin. I sent her a text to verify and thank her. I also messaged the author and quickly received a response as well as an invite to an online support group. 

It’s amazing how blessed I feel tonight. 

ivf round 3, day 7

Not much to update. Went in this morning for blood work and ultrasound. In addition to regular labs (progesterone, estrogen, and LH) they also checked for anti bodies and my thyroid level. 

It’s funny, a while back I read on another blog that she watched as they stuck her with the needle for the blood draw. I have no problem giving myself shots, but I cannot bring myself to watch a poke for labs. 

They sent a text message this afternoon to check my patient portal. The regular lab results had been posted, but not the thyroid or anti bodies. In the message, the nurse shared that everything looked good and that I’ll go back Friday and again on Monday for more labs and ultrasounds. 

It is looking like the retrieval will be the weekend of the 12th. What a fun way to spent a Saturday or Sunday. It could possibly be Monday or Tuesday, the 14th or 15th. It’s a day by day thing, which can be frustrating. It is what it is. 

I had a pretty rough day yesterday. Very overwhelmed. Called in for work and took the day off. Went on a walk with my dog and then enjoyed some coffee at the house. Caught up on some tv shows I’d missed and then made spaghetti with gluten free noodles. My mom came over to visit. We spent a few hours talking and watching tv. 

Today was a much better day at work and I was able to catch up on some things, which helped reduce my stress level. Husband will be home this weekend! Looking forward to having him home. 

ivf round 3, day 5

Added the second shot today, for a total of 3 shots each day. Lupron in the morning and evening. Menopur in the evening.

The 6 vials with the peach lids is the actual medication. There are these wafer type things in them and as soon as saline (last vial/gray lid) is added, the wafer dissolves. All six are mixed together into one shot.

I dressed up as a bee for work. It was a fun day, even if it started off over-sleeping, rushing around, losing my phone, finding my phone, working all day, and then straight to trick or treating. It’s been a tradition for the last 4 years to trick or treat with our best friends and their kiddos. I stopped by the house to get Pepper and took her with me. We are both wiped out and ready for bed. Good night! 

ivf round 3, day 3

Shot number one is done. 

teaching visit

Yesterday morning I went in for a teaching visit with one of the nurses. It just happened to be one of my favorite nurses too! I really like working with Teresa. She has a very calm voice and always explains what she is doing and why. We sat down in the conference room and she began going over the protocol I will start next week if everything looks good.

I have an ultrasound and blood work scheduled for Monday morning August 10. That will also be the last day I take my birth control. As long as things are looking okay on the 10th, I will start on the 13th with a micro dose of Lupron twice a day about 12 hours apart. This is an injection I am getting from a compounding pharmacy here locally. The rest of my medications will be shipped to me overnight from a mail-order specialty pharmacy. I continue the Lupron thru Friday the 14th and then add two more injections on Saturday the 15th. That will be a total of 4 injections each day. 2 in the morning and 2 at night. In addition to the 20 units of Lupron in the morning, I will add 150 IU Bravelle mixed with 1cc of saline. Then in the evening, I will inject 20 more units of Lupron and a second injection of 300 IU Menopur mixed with 1cc of saline. All of the shots will be administered around my belly button. I had a little bruising the last round of IVF and that was just 2 shots a day, so we will see what happens this time around.

I will continue this protocol through Wednesday the 19th and will go in Wednesday morning for another ultrasound and blood work to check on the progress of my follicles. At that appointment, they will either keep all the dosages the same, or make any adjustments they feel are necessary. I have a calendar with specific and detailed information on each day as to what to take and when.

In addition to the injections, I’m also talking a large dose of Folic Acid, Vitamin D, Co-Q-10, baby aspirin, and prenatal vitamins. I typically take all my pills right before bedtime and it feels like I’m taking in a second supper! With the different dosages of vitamins, it usually adds up to 8-10 pills.

The retrieval is scheduled to take place Thursday the 27th. Hopefully all will go well and that date will remain the same. The only side effect I experienced last time with all the medication was bloating, which is common because your ovaries are working over-time to produce so many eggs at once. I will have to stop doing cross fit while I take the stimulation drugs because of the chance of my ovaries twisting during this time due to how large they become and from what the doctor has told me, this is very painful. Plus, the only way the ovary can be untwisted is by surgery and your IVF cyle will be cancelled because of the process of how everything has to be timed just right.

It’s a lot of information and I am still trying to wrap my head around it all. I’m so glad that the clinic I to to has such a supportive staff and that they welcome questions or concerns at anytime. I’ll update again after my appointment on Monday!! Have a great weekend!