Well, this blows.

I finally got in contact with our coordinator for the next transfer attempt. Seems the timeline is a little longer than I expected.

Yesterday I started birth control again. I'll take it for 3 weeks and then I see the doctor again on the 30th for another pre-Lupron scan. That's right. Lupron again. The Lupron is to prevent ovulation, but I don't see why that should matter since we're not retrieving any more eggs? I guess it's all for hormonal reasons and the doctor obviously knows more about this than I do. I'm just frustrated because I am very much a product of the Internet generation and I want things to happen immediately. Curse my super-effective ovaries and their 40 eggs that caused this delay.

These are not cute at all :(

After that I'll be on the Lupron again, but at a lower dose. Doesn't matter. That shot hurts like a bitch. And I think it is the one that gave me a funny taste in my mouth. But on the plus side, it's one of the few that my insurance actually pays for. Oh, and I had a skin reaction to all the cute band-aids we bought. My skin darkened in the shape of band-aids all over my stomach and legs. I don't have a latex allergy so I think it was to the adhesive. We've got to try and find hypo-allergenic band-aids before we do that again. So now my students will have cute band-aids.

I'm not sure how long we will have to do the Lupron but they gave me an estimate of April 23 for the transfer so we're looking at a January 2013 baby now. I'm glad it's not so close to Christmas, but on the same hand, I'm really bummed about the delay.

I know this sounds like I'm just bitching, and I am a bit. I guess the doctor doesn't get 70% success rates by being hasty, so I've got to learn to be patient.

This Friday is the end of the second grading period so I get to do report cards this weekend. So my next update won't be until next week. Until then, I leave you with this advice. If you have a Taco Bell in your area, you must get the new Doritos taco. And you must get the taco supreme with the sour cream and tomatoes. You will thank me later.

Day 1 (again) - March 4

Well, here we go again, I guess. Period started very suddenly on Sunday. It's about a week early by my estimation, but that's probably because of all of the medication. I'm glad because this means we can get started sooner. I called the doctor this morning but they haven't gotten back to me so I don't know when I'll be going in again. I assumed it would be tomorrow since that's day 3, but I don't have any injections to start so they might not need me on day 3. I'm not sure what the timeline for a frozen transfer is. I imagine I'll be going in sometime this week, but until then, I had already this filler post typed so I figure, why waste it? Enjoy.

Assisted Reproduction Technology Misconceptions:
A Critical Review of The Golden Girls

Sounds like a topic for a dissertation. Hell, maybe if that was what my dissertation was, I might have actually finished. Anyway, I fucking love The Golden Girls. I've loved it since I was a kid and between syndication on Lifetime and Hallmark channel, I must have seen every episode at least 20 times. I'm now waiting for Netflix to put it on instant streaming.

In season 5, Blanche's daughter comes for a visit and tells her mother she is planning to get impregnated by artificial insemination. The episode then depicted her path to motherhood.

Since we have been doing all this, this episode has really taken on new meaning for me. I find myself watching it with a different eye. It's still a great episode, but there are some problems with the information presented. I know, it's an entertainment show not an informative one. But I can't help but think that things like this are the reason why misconceptions persist. So I decided to evaluate the episode.

You can watch here. I tried to embed a YouTube video, but all videos with this episode have been removed. So I had to download it myself through...other means...and upload it directly to Blogger. Since this isn't exactly a high traffic blog, I figure it'll be safe for a while. I guess we'll find out.

"The Accurate Conception"

Season 5, Episode 3

Original air date: 10/14/1989

So, Rebecca lives in Atlanta but is visiting Blanche and the girls in Miami. And she announces that next Monday she is getting impregnated. Now, I'm working on the assumption that Rebecca is doing IUI and not IVF. I'm also assuming, even though the episode doesn't address it, that she has already done all the fertility testing and has been tracking her cycle for at least 2 months, so she knows she will be ovulating next Monday. It's a stretch, but OK, fine.

Rebecca says she is going to a sperm bank to get artificially inseminated. But she would have to go to a fertility clinic. A sperm bank doesn't do the insemination, at least according to what I found when I researched. They just provide the swimmers.

Now, the girls' reactions when Blanche tells them about it is hilarious and totally expected for 1989. Lol.

Blanche also is surprised that you have to buy sperm. She's probably be even more surprised to know how much it costs, too.

In the next scene, Rebecca comes in and announces that she has found a sperm bank nearby. She wants Blanche to go and see what kind of place it is. They all decide to go check it out. We had to go out-of-state for our sperm so we've never actually been to one. I don't know if they allow people to just drop in like that, especially if you have no intention of actually buying something.

In the next scene they arrive at the sperm bank. Oddly enough, the elevator opens right into the lobby.

When they meet with the doctor the scene cuts to the end of their conversation so we don't know what he told them the procedure was going to be. Blanche makes a classic comment about having a test tube baby. But the embryos are grown in a petri dish, not a test tube. They only use a tube when the eggs are extracted for IVF. And when we did IUI, we never once saw a single test tube.

In the final scene Blanche and her daughter make up and Blanche accepts what Rebecca is going to do. I assume she is going back to Atlanta and to her own sperm bank there. In later episodes it is revealed that she actually becomes pregnant and there is no mention that it took multiple attempts, so I guess we have to assume it worked the first time. Lucky her.

Things don't go this smoothly now in 2012 so I've got to figure in 1989 things didn't work out like this either. But hey, it's the Golden Girls.

A post like this only comes around once every 4 years or so...

I am feeling so much better. I am done with the pills that make me sick, so I should be ready to resume my attempts at eating chicken again soon. I'm still a little sore, but I only feel it when I stretch too far or when I'm trying to get comfortable at night. So I guess I'm on the mend.

We have been getting updates from the embryologists this week. We started with 40 eggs. 30 of those were fertilized, the other 10 failed. Our package included testing on 8 of them and originally everything looked good, but it turns out that 3 of them had chromosomal abnormalities. This is unusual in someone my age and makes me wonder what the hell else is wrong with me.  But I digress.

On the bright side, of the 5 good ones there are 3 boys and 2 girls. So we'll get our shot at a boy after all. Now, of the remaining 22 that weren't tested, 8 of them made it to the blastocyst stage and were frozen with the 5 good ones. The rest failed to divide and so they were destroyed. So that gives us a total of 13 little ones in the freezer. We're hopeful that it will be enough.

One of the interesting things we've learned in this process is that the technology exists to freeze sperm and embryos, but not eggs. They don't freeze the embryos right away, though. Like I said above, they wait for them to get to the blastocyst stage, which is about 5 days of division. This is a cool video my future sister-in-law found that shows the division.

 

Credit to http://stemcells.nih.gov/info/cellmovie.htm

After the 3 attempts we paid for with this package, it's about $2,500 for each transfer plus $300 for testing. It's crazy to think, but after all we've paid already, that seems like nothing. If somehow we went through all 13 embryos then we would have to start this all over again.  Of course we're hopeful we won't need to do extra transfers beyond what we've already paid for (and definitely hopeful that we won't have to do all this again), but the option is there and one thing we've become is more aware to options and having backup plans.

So now that's all done, I'm just waiting for my period again. It's hard to estimate when that could possibly be coming, but I would imagine it won't be for at least 2 more weeks, my slow cycle and all. Don't worry, though. I've got a few filler posts planned to fill the time.

Hello blog friends. Please excuse my lateness on this post. An IVF egg retrieval turned out to be harder on me physically than I thought it would be. But here I am now with all the up-to-date information.

Egg Retrieval - February 22

So, you remember how I've been worried about taking so much time off?  Well, our office manager is out for the next 2 weeks! So I was able to easily sneak in my 101 (absence request) with out her hawk eye scrutinizing it.

Wednesday morning we woke up bright and early. I was terribly hungry and thirsty since I wasn't allowed to eat since 9:00 the night before. We had to be at the office by 8:30 and since both of us are always early, we got there at about 8:15. We checked in and they gave me a hospital bracelet with my name, birthday and patient number. We waited a little while and they led us back to a little room we've never been in. It had 2 armchairs, a TV and a portable heart rate monitor. Cozy.

Our nurse-coordinator told me I had to undress completely except for my bra. I assumed I would keep my shirt on because the instructions said to wear a short sleeved shirt, but they gave me a spa wrap instead. And a robe! It was pretty funny. I also had a hairnet and non-skid booties. It was a very sexy outfit.

After that another nurse came in and started an IV (in my hand...ouch!) and hooked me to the heart rate monitor. Then it was just a waiting game until 9:00.

Close to 9:00 they came and got me and walked me to the operating room. It was down a hallway and in the hallway is the desk where all of the nurses sit and work. I gave them a Miss America wave as I passed in my sexy robe and hairnet. Then in to the operating room. I've had probably more than my share of surgeries but operating rooms are still pretty scary. They had me get on the table and put my legs in some giant stirrups. THEN they strapped my legs in, which really creeped me out. The nurse told me she was giving me an anti-nausea drug and a painkiller in the IV. Then she gave me the sedative. I don't know what it was, but it was very fast acting. Almost as soon as she finished plunging the sedative, the tiles in the ceiling started spinning and that's the last thing I remember until waking up in the lounge room again.

It turns out that the armchair I was sitting in before was ALSO a wheelchair! Crazy. I assume that I must have been awake enough to get into the chair because I don't think they could have lifted me off the table. But I don't remember. I just remember waking up in the room and asking how many they got. Vaguely, I heard someone say 40. 40 I thought? 40??

After a few minutes when I was more awake I asked "Did someone say 40?" And the nurse said it was indeed 40 eggs. Well, I was pretty impressed with myself but unfortunately, this disqualifies us from the study that was going to pay for the progesterone cream.

The doctor came in after I was thoroughly awake and dressed again. She said that because I had so many eggs it was a train wreck in there. My ovaries are leaking fluid, plus the inflammation and other affects from the hyperstimulation. So the bad news is that instead of doing the transfer on Monday like originally planned, she wants to wait until I heal up, at least a month. So I'm waiting for my period...yet again.

Now, for the aftermath. When we left I felt pretty good. I was hungry so we decided to go to Cheesecake Factory, which is my ultimate comfort food. But they didn't open until 11. So we went to Krispy Kreme first. This is how good I was feeling. After we got all of our food we went back home and ate. I wasn't really sleepy so I watched some daytime TV and just lounged. I even joked that I probably could have just taken a half day and gone to work for the afternoon. I didn't know it then, but this was because I was still full of painkillers. The next day was another story.

Actually, that night was another story. One of the medications I have to take is an anti-infection pill called Flagyl and it is well known for making people very sick. That night I barfed up all my avocado egg rolls and cheesecake and I barely slept because my stomach hurt so bad. The next day I woke up and everything just hurt. It wasn't even a pain I could easily describe because I have never experienced it before. The closest I could come up with is a combination of the stomach flu and bad period cramps with spotting.

Unfortunately I had not planned on this and had not taken the day off from work. So I had to go. And I went, and it was miserable, but I made it. I couldn't take the Flagyl again that night. I needed to keep some food down and I needed sleep. Thursday night was better and I felt much better on Friday, I'd say I was at about 80%. I could walk without pain and I was finally interested in eating something other than Ritz crackers.

That brings us to today. One of the embryologists called and told me that out of the 40 eggs, 30 fertilized properly and they did the genetic testing on 8 of them and it looks good so far. I feel pretty good, except when I take the Flagyl but I only have a few more days of that. So now it's just another waiting game. Waiting for my insides to heal and waiting for my period again.

Ovulation Trigger - February 20

Well, this is it. Tonight we do the last injection. The one to trigger ovulation. We have to do it at exactly 9:00, which is bedtime for us, so I figure I should blog before.

For an IVF transfer, you don't use the full amount you would during an IUI attempt. That's because you don't want the eggs to actually make their way down the tubes. You just want the follicles to release them and to give them one final boost before they are sucked out.

I'll be mostly sedated for the procedure. It's an anesthetic that apparently will make me not remember anything, but it's not a full sedative to where I would need a breathing tube and an anesthesiologist. I've had some interesting experiences with sedation. I fear the dentist so they have to sedate me to do anything other than cleaning and the aftermath from some of the cavities I've had filled have been pretty amusing.

So, since I probably won't be in any fit state to write about the procedure on Wednesday, here's what I know now. My doctor uses the method where the needle goes through the vaginal wall internally instead of through the stomach. After they knock me out, they'll put in the ultrasound wand, but with a needle attached to the end. I think they do an ultrasound on my abdomen as well and guide the needle to the ovaries. They suck the fluid from the follicles and the egg comes with it. They'll suck out as many as they can from the ovary and then switch to the other side and do the same. The doctor said today that I have more on my left side. The whole procedure shouldn't take more than 30 minutes and looks something like this:

After the eggs are sucked out, they embryologist takes them and then they do their thing in the lab in the back. They said they would call us Thursday to tell us how many were fertilized and to set the final date for transfer. Quantity wasn't my problem; I know I have a lot of eggs. I just hope a lot of them are viable and they don't find out that there's some weird issue where my eggs reject sperm or explode upon fertilization or something.

My doctor also said that I should start eating meat now. I've been a vegetarian since I was about 13, but I decided a while ago that I would eat chicken and fish during pregnancy and probably breastfeeding. I am aware that I can get comparable protein from beans and such, but I'm also a very picky eater and I hate beans. Yeah. Today I had a spicy chicken cup o' noodles and it was OK. My stomach feels a little funny, but I expected that. I'm going to try some of the chicken stuff from Taco Bell because I love Taco Bell so I figure working meat into something familiar and enjoyable would be a good way to transition. After that, there's a bunch of stuff I want to try once I get used to eating meat regularly. I became vegetarian before hot wings got popular and I love spicy food so I figure that's something I'll enjoy too.

I'm pretty nervous. But my girlfriend was able to arrange it so she can come with me after all. That makes me feel better, but just thinking that everything we've been working for comes down to this, it's scary. I hope everything turns out well. Tomorrow I go for bloodwork again to make sure the HCG is in my system and I also start the regimen of antibiotics so I don't get an infection. One of them is likely to make me very sick, so there's that to look forward to. But after that, it's game time!

Day 10 - February 17

Today we bagged up all the pens we had with a little bit of medication in them and packed them in an ice pack. We brought them to the doctor so they could condense them into this:

They do this by taking a disposable needle and injecting it into each pen and drawing up the rest of the medication. The catch is that this dulls the needle and there is no way to switch the needles on these syringes. So we had to do the injection with a dull needle. But it's three full doses. It's about 900 units, which is the same as one of the new pens we had for this cycle. So by saving the extras from before we saved ourselves over $700 because we would have had to buy a new pen. And we still have a little left!

The eggs are much bigger today. Some of them are about 10 mm (or 1 cm for those of you clever with metric conversions) or more and my estriadol and progesterone levels are going up. It looks like they're going to have us trigger ovulation Monday night and retrieve the eggs Wednesday morning. And they also have a tentative transfer date of next Monday the 27th, but that really depends on how they develop. We're a little disappointed because my girlfriend works Monday and Wednesday and there are no subs for universities. So it looks like my mom will be taking me to the next couple of appointments. We'll know the dates for sure when we go back this upcoming Monday.

We switched from the stomach to the leg for injections tonight. My stomach is a bruised mess. I couldn't get a good picture that didn't accentuate my fat roll, but I feel like a pincushion. Trust me. The doctor suggested that I might get better absorption in the leg and it wouldn't hurt as much. Plus my girlfriend is getting squeamish injecting into old bruises. For the first two shots I stood with my leg raised, but I have a terrible sense of balance so for the third one I sat on the counter (on a towel), which was better. Never a dull moment here, just dull needles.

Day 7 - February 14 (Happy Valentine's Day)

Today was a bit of a disappointment at the doctor. After the usual bloodwork we went back for the ultrasound. I've been taking the Luveris and Gonal since day 3 and since the doses are so much higher than before, I figured things would be coming along nicely.

Well, there are a lot of follicles but they're not as big as the doctor thought they should be. So I guess the ovarian stimulation is working, but not the part to fatten them up. The doctor increased the Gonal from 225 to 300 units, which means we have to open a new pen tonight. Each pen has 900 units so this one will be good for 3 nights and then I go back on Friday.

The original plan had a retrieval date of about the 19th, so Friday would have been the last ultrasound before we trigger ovulation and have the procedure done. But I feel like now that is probably going to be pushed back at least a couple of days. This creates a couple of new problems.

1. After Friday we will be out of the Gonal and if we have to do a couple more days of shots after that we're going to need more. They said that if we need to we can order another pen but they're going to try and consolidate the pens we have now. We have a bunch of pens from before that have just a little bit of medication in each one. The nurse said she could use a needle and put them together.

2. I've been having to take a lot of days off of work. I have over 120 sick days, but that's because I never took days off before. So now that I am, I'm feeling like they're going to start asking questions, especially my office manager, and I'm not ready to explain this to them. I'd rather wait until I'm actually pregnant and then explain how it happened. But since we have such a problem with people abusing sick leave, they look very closely at people who all of a sudden start taking time off.

I try to take half days whenever I can, but if the appointment is in the morning it's easier to get a full day sub. My appointment Friday is in the morning too, but I took my chances and just put in for a half day sub. I hope someone picks up the job because if nobody does, then they ask other teachers to sell their prep time to cover classes with no subs and I would feel bad about that because what they pay you when you sell your prep is hardly worth the missed time.

Plus, my students are starting to notice time time I'm missing. They were really sad that I'm missing their Valentine's party today so I feel bad about that too. I obviously haven't told them why I'm missing so many days so they don't understand and it's hard for me to get on their cases for attendance now.

It's easy to explain and justify missing days when you're already pregnant. And if you get pregnant the 'traditional way' you probably wouldn't have this problem anyway. But if you're considering IVF, make sure you have a flexible work schedule because you might not have control over when doctor appointments come up.

Day 3 - February 10

More bloodwork today. Now my hands are bruise twins.

It's been a rough couple of days. I've felt really crappy and it could be a combination of my period and finally feeling the mood swings of the Lupron. It's not even an easy feeling to describe. I'm tired, cranky and my head hurts just a little all the time. Today as I was driving home, I saw some girls walking and I just wanted to lean on the horn and flip them the finger. Absolutely no reason why. I didn't, but even after I had passed them, I kept thinking about it. It's strange, that's for sure.

Tonight we started the new medications Luveris and Gonal. These medications help to stimulate the ovaries to produce more follicles as well as to ripen the eggs faster. We used the Gonal before in the IUI cycles, but they have me on a much higher dose. Actually, as a result of the bloodwork today they had me start on an even higher dose than they originally planned. Tonight the Lupron dosage goes way down too. I assume since they're going to want me to ovulate in a couple of weeks, it's time to back off of the ovulation suppressant.

Here's what our medication setup looks like now.

The Luveris comes as a powder and has to be mixed. The Gonal has to be dialed to the dosage and then the needle attached. It took about 20 minutes just to get everything ready. We decided to have me lie down for this. For some reason, the damn Lupron hurts like a bitch for the entire injection. I thought I would have a tolerance for it by now, but no. The Gonal hurts going in, but not during and it's a fast injection. The Luveris wasn't as bad as I thought it would be considering a lot of fluid was being injected.

We decided I should use 3 of the same series band-aids instead of 3 randoms. These were from the Target kid's band-aid series.

Our next appointment is Tuesday. Not exactly how most couples spend Valentine's day, but it gave me a reason to take the day off from work again. Otherwise we wouldn't have had any time together on Valentine's day because she has class at night and we don't see each other until late in the the evenings on Tuesdays. Now, after the appointment, we're going to have a nice day together. Not quite sure what we're going to do because it's going to depend on the weather but whatever we end up doing, it'll be fun.

Day 1 - February 8

I actually should have gotten my period much sooner. Last Friday was the last day of the birth control and my period should have come sometime over the weekend. But it didn't. My period is never very regular and my cycle length has always been around 30 to 32 days instead of 28. But the doctor was worried because with all of the medication, everything should be pretty well regulated. So they had me come in for bloodwork and an ultrasound to see if there was a problem.

One thing about me, I don't handle stress and anxiety well. It's something I've worked on for years. I've tried medication, I've taken relaxation classes, hypnotherapy. You name it. But nothing has had a real significant impact. So when things don't go the way they're supposed to, I break down. I didn't sleep last night because of the worry. But the cats were good company.

I took the whole day off, even though I probably could have just taken the morning. I was going to take a day off this week anyway, so it just worked out to be today. I have over 120 sick days so I'm not worried about that. My girlfriend doesn't have that luxury and had to work today so I went by myself.

They had me do bloodwork first and I found out that my blog is misnamed! The poster I had been staring at says "wishing for baby" not "hoping for baby". Oh well. At least now they could never sue me for copyright infringement.

Oh hey, speaking of bloodwork...want to see something gross? Here's what my hand looks like every time I get blood drawn. It doesn't hurt as bad as it looks. It's just gross.

Anyway, after that they brought me back for the ultrasound. The doctor popped it in and the craziest thing...she could see movement. We actually saw my period moving and flowing inside. It was just taking it's sweet time, like always. But it was crazy to actually see that. She took a look at the ovaries and there were no cysts, which I was worried about. And there is a good bunch of follicles still on the ovaries so the Lupron is doing it's job of suppressing ovulation.

When the doctor pulled the wand out, she held it up for me to see the blood on the tip so she counted this as day 1 and we're moving forward now. I guess I just needed something to open the floodgates. On Friday we start the Gonal-F injections and the Luveris injections, both of which help ripen the eggs. Then I'll go back next week for more ultrasounds and bloodwork to see how they're developing.  So, more news next week, I suppose.

Week 1 of Lupron

Since I've never gone through menopause, I can't really say if the side effects really mimic menopause or not. I don't think I've had any mood swings. At least nobody has told me that I'm acting differently. I'm usually cold (temperature, that is) all the time so maybe that is balancing any hot flashes I might be having. Although the A/C in my classroom is not working and in the afternoon it never gets below 80 degrees so my whole afternoon is a hot flash anyway. I have noticed a very decreased "desire", which is very significant for me. I think I'd rather have the hot flashes.

The Lupron injections made me bruise up after the first shot. We switch sides each night so we're not sticking a needle into a fresh bruise. I made a valuable discovery this week. If I shave my hairy stomach, it doesn't hurt to take the band-aid off. I wish I knew that a year ago.

Friday was the last day of birth control so I should expect that hefty period any day now. Then we go in for an ultrasound and start the injections to plump the eggs up and another injection that I forgot what it does. I think it prevents ovulation, but I thought that was what the Lupron was for. Oh well, I'll ask the doctor again next week.  Anyway, that'll be 3 shots a night. Yikes.

Today we ran some errands in the morning and we ended at Barnes and Noble. We're both avid readers and we like to browse books...which we then go home and download to our Kindles. At B&N they sell Moleskine journals and I think they are so cool so I always check them out. They had a new display of different journals and one was a baby journal so I had to pick it up.

I probably wouldn't be very good at scrapbooking a fancy baby book, but I love to write so this will be perfect, I think. It covers from pregnancy to 2 years. I'm excited to write in it, but I think it would be bad luck to start before I'm actually pregnant, so I'll just be content with admiring the pages for a while.