Egg Growth

I am less than a week away from my egg retrieval. I am really excited about this procedure which is unusual considering I hate hospitals and medical procedures. As a child, I experienced enough surgeries and I almost decided not to undergo any fertility treatment because of this. I had 2 eye surgeries at age 1 and 2 yrs. old to correct strabismus and then kidney valve reconstruction surgery at 10 years old. The kidney valve surgery may be the culprit for the damaged fallopian tubes. My mom remembers the doctors saying that I may have trouble getting pregnant. Which turned out to be true except God has provided the miracle of science to help us and for that I am grateful and very very excited. Today was exciting too because I had another ultrasound to determine my egg growth and progress. Earlier this week was discouraging because my estrogen was low, which is not a problem except for my bank account. I had to up my Bravelle to 5 units a day instead of 3. For 3 days worth of meds it cost me $962. I am hoping that will do it and I don't need anymore. Pray for that!

Normally vaginal ultrasounds are not exciting, but it was fun to see my little potential babies!! Who gets to see that before they find out they are pregnant. I will be able to tell my future children that I saw them at their egg stage, cell division stage, blastocyst stage and embryo stage. The cool part is they will be able to see that too as long as I get copies of the pictures! :) Now even though there are 8 follicles, I am not sure all of them contain an egg or will make it to the fertilization stage. Egg growth is measured by mm and the doc likes them to be between 18 mm and 22 mm before retrieval. A few of mine are 11, a few at 14 one at 16 and one or two are 8. I am hoping that they all do what they are suppose to do and grow! The weird thing is I can feel them growing. It is like period cramps and then lots of pressure!  Retrieval day is tentative for Wednesday, Oct. 5th!

First Ultrasound

Today I had my first ultrasound, blood draw and trial transfer for our first IVF cycle. It was a good appointment overall. I do have one ovarian cyst on my right ovary. It is no big deal, women actual get them all the time with each period, but some women get more than others and they can become painful and bothersome. I think that mine is no biggie and the doctor didn't appear to be concerned. The trial transfer went well too; much better than when we did an IUI transfer.

I was suppose to get another prescription for John for Azithromycin because he had a sinus infection last week and the pharmacy got confused and didn't send his for the retrieval because they thought he already had it. For some reason, John has to be on an antibiotic before he gives his specimen. Well, he lucked out and doesn't have to take the antibiotic because he already took it this month. The nurse was joking around about the guy being so lucky... he lucked out on his antibiotic and he lucks out on not having to do several injections everyday of the month. I told the nurse that John said he would stick himself in the stomach with an empty syringe and needle just so he had to go through it too! :) Which was very sweet of him and the nurse thought so too, so she willing gave me several extra needle/syringes for John! I won't actually make him do that, but it was nice of him to offer. Honestly, unless you are deathly afraid of needles, that part really is not a big deal at all. The bigger deal is getting a hot flash while trying to find your seat at a Red's game, or just randomly while I am watching T.V. Not to mention the headaches, exhaustion, lack of motivation (to pretty much anything but shop), weight gain and pain in my legs... all nice side effects of Lupron. I am almost positive that John also experiences these side effects from his job, except the shopping part. :) The nice thing though is the side effects really are pretty mild and so far I am doing great. I am getting more and more excited as I count the days to October 20th!

Baby Showers!

This past Sunday was a very busy day, but a very good day. I went to a friend's baby shower after church and it was awesome to be able to celebrate with her. I think of her as a very dear friend. We went to high school together, but then to different colleges and through the years have lost touch with one another. However, I will always think of her as one of my very best friends. It would be awesome if our children will be friends one day.

I am sympathetic to those who are like me and can't get pregnant or (worse in my opinion) suffer from miscarriages not wanting to go to their friend's baby showers. Though, I am different in that I love going to their baby showers and celebrating with them. Not only are they important to me, but their children are important to me. I want to share and spend as much time with them as possible. I want to have a close relationship with my nieces, nephews and friend's children and that starts when they are in the womb.

I had a foster mom friend of mine who has twin girls who are about 2 yrs. old. We would get the kids together when I also had foster children, twin boys. When my kids left and she still had hers, I told her that we were going to use a fertility specialist to help us get pregnant. She understood as she also has not been able to get pregnant. I mentioned to her that I would love to see the girls and she told me that she was hesitant to let me see them as she did not want it to be too hard on me to see them. WHAT? I can't believe she would say that to me. My response to her was I LOVE CHILDREN. That only makes me want to be around children more, not less. I enjoy the presence of children so much more now because I can't get pregnant. I do not cry over my infertility, it is what is... we will pray that God chooses to change it. In the meantime, to my friends, do not keep your pregnancies from me now that you know my situation. It will not make me sad. I will be extremely happy for you and rejoice with you in your gift from GOD. I will support you and buy you presents! :) When my turn comes, I want my friends and family to be there for me so why in the world would I not be there for you!

One of my weaknesses right now in my journey through infertility is I love to buy baby clothes, shoes and other cute baby things. I try to resist the temptation until I know for sure I will actually need those items. The beauty of my weakness is that those of you (my friends and family members) who either have children or are pregnant will only get more gifts from me because I can't help myself. The other temptation on the shopping front is an occasional "I can't get pregnant" Coach purse or pair of Ugg boots! :) See I take my sadness out on the shopping world, not my friends... haha!

I think this is the cutest picture ever! John and his nieces, Brooke & Addy!

Explanation of IVF

from http://cnyfertility.com/fertility-treatments/in-vitro-fertilization/detailed-explanation-of-ivf/


Detailed Explanation of IVF
Ovarian Stimulation  - This is the stage where I am at right now...
An IVF treatment cycle begins with the onset of a menstrual period. A week before the beginning of the next period a medication called Lupron is administered. Lupron prevents premature release of eggs from the ovaries. Lupron is a very small daily subcutaneous injection given just under the skin. Any part of the body can be used for these shots and the woman or her partner can administer them. Lupron is given daily for about three to four weeks. Because estrogen levels are low, side effects may include fluid retention, headaches or hot flashes.

About a week after taking Lupron your period will start. From this point on, Lupron will keep you hormonally “frozen” in that normal egg production is put on hold. A few days to a week from the start of your period, hMG injections will be taken along with the Lupron injections. Follistim, Gonal-F, Fertinex, Perganol, Repronex and Humegon are all collectively known as hMG, but you will only be injecting one of these medications. Lupron puts your ovaries on “hold,” – that is, prevents them from releasing the eggs before we are ready to collect them. At the same time, HMG stimulates development and maturation of multiple eggs in the ovaries. The objective of this medication protocol is to produce as many eggs as possible in a given cycle, and “tell” the ovaries to hold them until we are ready to collect them. On average, about 6 to 12 eggs develop.

Before starting HMG injections, an ultrasound will be made of your ovaries to check that no cysts or large follicles exist. Injections in the form of Follistim, Gonal-F or Fertinex are shallow injections whereas Pergonal, Repronex and Humegon are deeper injections. Some side effects may occur with hMG injections, such as abdominal bloating, weight gain due to fluid retention and pelvic or abdominal discomfort or both. These are signs of ovarian hyperstimulation and usually do not require any treatment. It is rare for a woman to be hospitalized for severe symptoms.
You will be taking Lupron and hMG injections every day for about ten days. During these ten days your progress will be monitored with ultrasound and possibly estradiol blood tests. Since the eggs are microscopic, they cannot be seen on ultrasound. However, we can see when the eggs are mature from the size of the ovarian follicles, or the fluid filled sacs within the ovaries that contain the eggs. These monitoring visits are brief and usually done in the morning

Once the eggs are almost mature you will stop taking the Lupron and hMG. You will then take a single injection of hCG hormone. This medication triggers the final stages of egg maturation. The eggs are nonsurgically removed from the ovaries 36 hours after the hCG injection. You should not have intercourse during the time between the hCG injection and egg retrieval.

Egg Retrieval
Egg retrieval is an office procedure during which partners are invited to be present. Using ultrasound as a guide, a thin needle is passed through the top of the vagina and into the ovarian follicles. This nonsurgical procedure is possible because the ovaries are located directly next to the vagina. The needle enters the follicles and removes the follicular fluid which contains the eggs. The fluid is then examined under a microscope to identify the eggs.
Egg retrieval can take anywhere from 15 to 45 minutes. Medications are used to relieve the pain of the needle, but many women cannot feel the eggs and follicular fluid being drawn. Most likely, you will feel a short menstrual-like cramp when the needle is passed through the top of the vagina – once for each ovary. Because of the pain medications you will receive that day, you should not drive. Egg retrieval is a very safe procedure and serious complications are rare.


Fertilization

The number of eggs retrieved will depend upon your age and response to hMG. But on average, 6 to 12 eggs are developed. As soon as the eggs are identified under the microscope, they are placed in petri dishes which contain a culture medium. The prepared culture medium is a composition that so closely resembles your own body’s fallopian tube secretion that the eggs, and subsequently the embryos, will develop in the petri dish just as they would in your body. The dishes are kept in an incubator at a constant temperature of 37ºC, 100% humidity and 5% CO2 concentration.

At the time of egg retrieval, the male partner will collect his sperm into a clean cup. The semen is then washed and processed to remove the seminal fluid to get the highest quality sperm possible. It takes about four to six hours after retrieval for the eggs to finally mature to the point that they are ready for insemination. Traditionally, sperm has been added to each dish containing the eggs and letting nature take its course by fertilizating overnight. However, we are using ICSI even in normal cases to ensure that the best eggs are indeed fertilized. The fertilized eggs, now called embryos, continue to grow in the IVF laboratory. In three to five days, you will return for embryo transfer.

ICSI
Intracytoplasmic sperm injection (ICSI) is a micromanipulation procedure developed to help couples with male factor infertility or previous low or failed fertilization. ICSI involves using a powerful microscope and an extremely small glass needle to physically inject a single sperm into the center of the woman’s egg. After egg retrieval, the eggs which are most likely to be successful ICSI candidates are chosen. While holding the egg in place, the glass needle containing the single sperm is inserted into the egg and the sperm is injected directly into the cytoplasm, thereby fertilizing the egg.


Embryo Transfer
Dr. Kiltz along with the embryologist will examine the embryos before transfer to determine the likelihood that any given embryo will implant. The quality of the embryos is very important. Several other factors may determine how many embryos will be transferred, such as your age, how many years you have been infertile and previous IVF cycles. Most couples with an average embryo quality usually select between two or three embryos to transfer. Generally, the pregnancy rate increases as more embryos are transferred, but so does the chance for multiple pregnancies. These issues will be discussed prior to your embryo transfer.

The actual transfer is a brief procedure. The embryos are “loaded” into the tip of a catheter along with a very small amount of transfer medium. The catheter is then gently passed through the cervical canal and into the uterus. Usually, you never feel this. The embryos are slowly expelled near the top of the uterus. This transfer only takes a few seconds. No rest period is required after transfer and you can go back to your normal routine right away.


Establishing Pregnancy
To help your body prepare itself for the embryos, you will be given daily progesterone to supplement your own. This additional progesterone starts the day after egg retrieval and continues for at least two weeks. Progesterone is a hormone which transforms the lining of the uterus to be an ideal receptor for the embryos.
After the embryo transfer, it’s now up to nature. The front and back walls of the uterus gently squeeze the embryos and keeps them in the uterine cavity. Your embryos cannot fall out, so there is no need to restrict physical or sexual activity. Even so, it might be wise to wait a few days before beginning any strenuous activity.

About two weeks after transfer, a blood test will be performed to determine if you are pregnant. This can be done at any lab of your choice. Your results should be available the same day. If the pregnancy test is positive, an ultrasound will be scheduled two weeks later to determine the implantation site and often detects a heartbeat. The heartbeat should be seen by four weeks after a positive pregnancy test. At this time, you will be given instructions regarding progesterone or other medication use.
Once a heartbeat is detected, there is a 90-95% probability that the pregnancy will continue to a live birth. There is only a 5-10% chance of miscarriage. IVF pregnancies are no higher a risk than natural pregnancies. At about 12 weeks into your pregnancy, you can return to your obstetrician for routine prenatal care.
If the pregnancy test comes back negative, you can stop the progesterone. Your period should start in a few days. You can begin another IVF cycle after one spontaneous menstrual cycle. Waiting will give your ovaries time to rest from the previous IVF treatment. There are several factors to consider before deciding on how many IVF cycles you may try before moving on to other treatments. These factors include your response, age, previous IVF cycles and the number of years you have been infertile. Just because you may not become pregnant after one, two or even three tries, does not automatically mean your chances of becoming pregnant are slim.

A Typical IVF Calendar (based on 28-day menstrual cycle)

First Injection

I did it! I successfully stuck myself with a needle in my stomach. Last time we did an IUI, John did it for me and it was only once for the entire month. I have to do this everyday. Oh boy... thankfully I am not that squeemish. I am meticulous and I had to read the instructions about three times before actually giving it to myself. Then I had to call my nurse to make sure I did proper storage of all medications. Whew... that is over. I am going to go take a bath! 

The injectable meds came today!

Today I got my medications and injectables to start the IVF process! YAY! and I'm a little scared, just of the unknown. Gotta keep reminding myself that no matter what God is in control.

I have to give myself a shot everyday for 5 days while simultaneously taking the birth control pill. I got to skip my period for the first time ever... Kinda fun, though I feel bloated.

Then shots for several more days; actually I will be giving myself a shot everyday for about 6 weeks until I find out if I am pregnant and then for a few weeks after that to sustain the pregnancy if pregnant.

On Wednesday, October 5th, I will be under a conscious sedation to retrieve the eggs (hopefully there will be a good number). Then on Saturday, October 8th, the doctors will transfer 2 blastocysts into my uterus. I will take progesterone injections for the 2 week wait. Take a pregnancy test on October 20th and hopefully it will be positive. If negative, we repeat with the frozen blastocysts.

This is the short version. I plan to post my thoughts, feeling and information about the procedures as they happen... more for myself to cover the journey, but also for any women (couples) out there in cyber world going through the same thing.

Why IVF?

I know IVF is a controversial method of conceiving a child. We chose IVF after much prayer and research on the process. We came to the conclusion that God was leading us in this direction for a few reasons.

[1] Medically.... it was the only way for us to have a chance at a pregnancy. Of course, I believe that God can do anything He wants and I could do 6 cycles of IVF and then boom after all that I am pregnant through the normal way! We know that God has given us doctors to help with lots of conditions, heart blockages, cancer, infertility etc. Some say well if God made you infertile you should remain infertile. Maybe so, but to those I say because you have a blockage in your heart means God allowed it so you should stay that way and die. No, you should have a surgery! :)

[2] Adoption vs. Fertility Doctors (IVF): When it came to adoption we could never agree on a country, domestic or international. You have to both be 35 in most countries, except Russia to adopt. As with all pregnancies there are many unknowns and the cost is 2 to 3x more expensive than IVF. I am 28 and John is 33. Great ages for IVF, bad ages for international adoption. We did foster care for a stint and were burned pretty bad by our agency. The plan to foster again is in our future plans, but we are taking a break from it only doing respite care at the time (short term placements). Infant domestic adoption would be cool, but God is not blessing that route right now. Maybe in the future!

[3] IVF decision: John and I agreed almost instantly on IVF. And all family members (from my in-laws, parents, grandparents, aunts, uncles, siblings, cousins and sibs-in-laws) are super supportive and excited for us. My grandfather is giving us a really nice donation in the thousands, my aunt and mom have given us a few hundred dollars and my sister even though she is pregnant herself and has 2 other children is making us a change-piggy bank. The bank loan we took out is the exact amount of the car we turned in off lease last August. We prayed constantly for God to stop it if it wasn't His plan.... He didn't. The opposite was true... paperwork, financing, and everything to date was super easy. John was at work about to fax the financing in to the loan company and he prayed "God don't let the fax machine take this if it isn't what we should be doing." The fax machine at his work hardly ever sends faxes through on the first try and doesn't work very well. He said the machine sucked the paper up so fast there was no turning back. LOL. I think things like this are from God. Does that mean we will get pregnant, only time will tell, but I believe God has provided doctors to help Him perform miracles. We see people who should die live everyday with cutting edge procedures.

The biggest decision for us was to decide when is a life a life...  We prayed about this too and did lots of research. We believe the answer to that is at implantation. Scientists may be able to help sperm and egg join, but only God can perform the miracle of implantation. And the other decision was should we spend this much money. Well, we decided it is like buying a nice car (which ppl do several times in their lifetime). A child is so much better and more important than a car. You could compare the price to a Camry or maybe a Lexus or BMW (depends on how many cycles and how much meds needed). LOL!

Overall if you are considering IVF for you and your spouse, it is a very personal decision and only you, your spouse and God can make it! :)

Not much can irritate me, but one thing that does....

What irritates me: When people say children are blessings from God and that somehow infertile people are not blessed by God because they cannot have children. That we must have some sort of sin in our lives which is the reason we can't get pregnant. They compare infertile-ness to other sins like bulimia. Uhh yeah... like we chose for it to happen.

Yes, children are indeed a gift from God! But those that are infertile are still blessed by God in different ways. We get to sleep in, eat out, finish a whole movie, stay up late, travel, spend our money on ourselves. We don't have to clean up messes, do tons of laundry, chauffeur kids around, etc.

God may have other ministries for us too. And I have to be thankful and content that my overall health is good, I have a loving husband and a great marriage, my families are amazing, we are blessed with great jobs and money to make a good living, a fun sports car just to name a few. God is good and I am blessed!

Of course, I would willing give up all of these selfish things to enjoy receiving and giving love to a child(ren) and growing them up in Lord.

I know that infertile couples often think that they did something wrong. I think the opposite. We did something right... In the example of my husband, John, he is such a caring, giving, loving person! He will make the best possible father because he strives to resemble his heavenly Father. I think that maybe it is our calling to adopt. God knows that we are up to the challenge and that the other "blessed" people with biological children are just not up to that same challenge. I want to adopt and foster children regardless of how many biological children that we have. In fact, we tried to adopt and would still if a birth mother chose us to raise her child. We have our info. into an adoption attorney, we are doing respite foster care and the IVF process. Not one of these is better than the other. IVF is not our first choice or our last choice. A child is our first choice. Because our child, would be our child no matter where they came from... my belly or another mother's belly!

I believe God gives us what we need in order to make us grow closer to him. To some that is singleness.... does that make them "not blessed", to some that is to be married, to others to have children, and to others still not to have children. I believe that I have grown closer to God though my marriage and now through my trial with infertile-ness.

We are all sinners and deserve nothing.... nothing but death in hell (sorry if I am blunt)... But there is hope... God loves us sooooo much that He sent his son, Jesus to die for our sins and that through our faith and belief in His resurrection we can have eternal life.... now to all who accept Jesus as our personal Savior and trust in Him to control or destinies.... those people are truly BLESSED!

Background

I haven't really decided on whether or not I am comfortable sharing my journey of infertility and IVF with the world... but here goes!

John and I were married 7 years ago, March 2004. John wanted kids right away and I was still in college and very much opposed to the idea. I was 21 at the time and kids were the last thing on my mind. I wanted to do other things and finish my degree. I struggled with the idea of starting a family for a long time, avoiding the questions of "when are you two gonna have a baby?" My answer was always, "I want to finish college first and have a career." In my head thinking, "I don't want kids right now, and stop asking!" I love kids, don't get me wrong and I love, love, love, love my nieces and nephew. We have 5 total with the combined family and 1 more due in January (my sister's first boy, after 2 girls).

Well... I don't know what it was exactly that made me change my mind.

Maybe it was....
I love my family so much. I am one of four and I like having big, loud, crazy family get togethers.
I want to have the loving support system of family.
It would be a shame not to pass on the biggest blue eyes (John's) that I have ever seen.
John will be the best father in the world.
My niece Brooke (now 7) is just the nicest, cutest, sweetest child in the whole world and it has been so much fun to watch her grow. When it is just the 2 of us together, people think I am her mother (probably because I look exactly like my sister). It makes me proud... let's hope I get one just like her!
I get a glimpse of what my kids will be like from my nieces and nephew and I want that too.
I want to teach, grow, love and nourish – must be that mother instinct kicking in.
I think that to experience parenthood is to more closely know and understand God (My Savior and Creator).
If I can be half the mother my mother was to me then my kids will have the best mother!
I will strive to honor Christ in my parenting and above all tell my kids about what Jesus Christ has done for us.

Anyway... I am sure there are many more reasons that I decided that I really want to have a baby, but more importantly I see the bigger picture and want a very large family, whether that is through adoption, foster care, or biological or all three!

We have been on a silent journey to conceive for a few years. I have never been on birth control (until recently, for IVF... more on that later) and have never had an accidental pregnancy in the last 7 years. (though I don't believe in accidents, all children come from God). After secretly trying off and on for 3 years to get pregnant and being unsuccessful, we just knew that just maybe there was something wrong with one of both of us.

So.... the easiest thing to do was to get John tested, so we did. The result... 0% of normal sperm. I guess they were chasing their tails and everything else that you don't want to hear. The reason... low testosterone. The fix... clomid 1/2 a pill everyday. He has been taking that for over a year now.

We tried to conceive for a while after that thinking that would fix the problem as all his stuff was now perfectly normal. YAY!

I guess it was my turn now for the fun, invasive, poking and proding from a RE (reproductive endocrinologist). I got put on meds and we tried an IUI (failed) and I had a laparascopy and hysterascopy. Basically discovering that both fallopian tubes were failures due to scarring I had from a kidney valve reconstruction surgery I had as a kid. One was collapsed unable to open and the other twisted, swollen and leaking dye. The chances of getting pregnant were slim to none with slim resulting in most likely a tubal pregnancy.

The good news... I am a GREAT candidate for IVF.
The bad news.... it is really expensive!
The good news.... my husband makes decent money.
The bad news... it is pretty invasive and still there are no guarantees of taking home a baby,
The good news... We trust in the Lord, Jesus Christ will all of our heart and know without a shadow of a doubt that God is in control of our lives and will ultimately do what is best for us. We have faith (not that we will take home a baby) but that God's plan will be done no matter what we do!
It is nice to be rest assured in that fact!

Photos of John and me!

I have long hair now.