Low Risk to More Risk

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Hi everyone!  I know, it’s been a while since my last post.  I think it’s obvious the baby is here, leaving me less time to write.  Lol.

Everything was going smoothly with all my appointments.  I was going every other week on Saturdays so I wouldn’t have to take time off from work.  That was my preference because I wanted to save my leave.  Well at 33 weeks, the nurse scheduled me for additional appointment the following week.  I thought it was weird because I previously scheduled all my appointments to the end – 40 weeks.  I agreed to come in for the appointment even though I was thinking they were mixed up on what week I was on.

Prior to that, my husband had been trying to get me to attend a co-worker’s new store open house.  I kept insisting that I didn’t think it was necessary to go to the open house.  I didn’t want to drive to town when I didn’t have an appointment.  So, when I got an additional appointment, which happened to be the day of the open house, I reluctantly agreed to go.  A few days before the open house, I began to question my husband about this “open house”.  I didn’t feel like he was telling me everything.  He told me to stop asking him about it, so I did.  But I kept thinking about it.  I thought his co-workers were going to have a baby shower at the “open house” but even I wasn’t convinced that was it.  I knew there was something going on but I couldn’t put my finger on it.

A few days before my appointment and the “open house” I thought about calling the doctor to verify that I was on week 34 and not 35.  Well, that didn’t happen.  I figured I’d just clarify with the doctor at that appointment and not worry about it.

The day of my appointment arrived.  At week 35, I was scheduled for an exam and ultrasound.  So, when I clarified it with the doctor, he agreed they made a mistake and I was 34 weeks.  But since I was there and undressed from the waist down, he decided to do an ultrasound.  During the ultrasound he noticed my amniotic fluid was high and was concerned about it.  He asked if we could go to Queen’s Labor and Delivery to complete a NST (Non Stress Test).  I looked at my husband because he wanted to go to the “open house”.  I was thinking we could skip the “open house” and do the NST.  My husband told the doctor we had something so we scheduled an appointment for the afternoon.

We left the doctor and headed toward the “open house”.  He told me it was at Manoa Marketplace.  As we were driving there I told him, “I know it’s been a long time since I’ve been to Manoa Marketplace but it’s it that way?”  I was pointing to the right as we were going left.  My husband shushed me and told me the “open house” was at Waioli Tea Room.  At this point I was super confused but I knew something was up.  We walked up to the front and were greeted by a woman who asked if we were here for a bridal shower or baby shower.  I looked at my husband and he had a big grin on his face.  We both laughed as he turned me to walk toward my group of friends.  SURPRISE!  It was definitely a surprise and a very enjoyable brunch.

After the brunch we headed to Queen’s Labor and Delivery for my first NST.  The NST was for the baby, not me.  If you’ve never had a NST, they do the same thing when you’re admitted.  Let me explain.  Due to the excess fluid, the doctor wanted to make sure my baby was doing well and he was not under stress.  Hence, the NST…Non Stress Test.  In Labor and Delivery, I sat up on the bed and lifted my shirt just to expose my belly.  The nurse placed 2 monitors on my stomach, 1 to monitor contractions and the other to monitor the baby’s heart beat & rate.  The nurse used wide elastic bands to obtain the right placement of the monitors.  It’s like a wrist watch.  The face of the contraction monitor is placed at the center of your belly and then they tighten the band.  The monitor for baby’s heart beat & rate is wherever baby is.  For me he was faced down so the monitor was below the contraction monitor.  Since my baby moved around A LOT, the nurse would often have to adjust the monitor.  My NST lasted about an hour and then I was free to go, not without scheduling my next one.

My first NST was quite painless.  One of the first things the nurse asked me is if I knew why I was there.  Lol.  I sure hope so.  I know there’s a technical name for excess amniotic fluid but I didn’t know it. (It’s call polyhydramnios.)  The nurse gave me water and the remote for the TV.  Ooh, I forgot!  Along with the 2 monitors the nurse gave me a button to press every time I felt the baby move.  The button reminds me of Wheel of Fortune where they are referred as “buzzers”.  It’s easy to grasp and great for pushing frequently.  Lol.

It was then that I realized my pregnancy was no longer “low risk”.  I had to do NSTs weekly until the doctor ordered otherwise.  Another thing to note about the NST, it varies in time.  For example, the first time I went it took an hour.  The next time I went it was longer.  The shortest time for me was half an hour.  The reason for the variation is because the nursing staff needed to contact my doctor to review the monitors and give the “ok” for me to leave.

Well, 34 weeks was just the start of what I call “pregnancy excitement” aka stress.  In upcoming weeks I experienced much more than I ever thought I would.  Twice a week appointments, twice a week NSTs, 2 more ultrasounds, and weekly vaginal exams.  The twice a week appointments, NSTs, and ultrasounds is how the doctor monitor my polyhydramnios.  I got quite use to it, although now that I think about it, it was pretty draining.  Having 2 more full fetal ultrasounds was nothing I expected but I was grateful for them.  Not only was I able to get more pictures, but I was able to see my baby more.  The ultrasounds looked at the fluid and the baby’s growth, including the heart.  One of the main concerns my doctor had about the excess fluid is the umbilical cord.  If my water broke the cord could come down before the baby which would result in an emergency c-section.  I was lucky to have the reviewing doctor present at each ultrasound.  He asked questions and watched the ultrasound technician take measurement.  Through discussion with us he determined that they did not know why there was excess fluid.  He noted that gestational diabetes was one common cause for excess fluid, which I did not have.  I never knew why I had so much fluid but I knew my fluid was about equal to the size of they baby.  I remember at 35 weeks the ultrasound gauged that the baby was 6 lbs 10 oz.  I thought, yikes!  Then at 37 weeks the ultrasound said 8 lbs 6 oz.  That created another concern for my doctor.  Of course the ultrasound has a range – room for error.

So, although my pregnancy began with little risk as time went on risk increased and the doctor induced labor.

Just as a side note….The only thing I will say about vaginal exams as a pregnant lady, is that’s they’re painful.  It’s nothing like a pap smear…at all.

Next post:  Inducing Labor


Endometriosis Diet

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Hope everyone had a wonderful Thanksgiving!  I still can’t believe it’s December.  It seems as though time is quickly floating by.  Soon it will be Christmas and then we’ll welcome a New Year!  Wow!

I’ve contemplated my purpose in writing about the “Endometriosis Diet” and am still unsure.  But, hopefully it will help someone or provide information to help someone else.  I’m thinking this is going to be a short post.  Hmm…think of it as a brief commercial break from the show.  Lol.

I got this book during the summer and thought it would be a resource and help for me.  I find it entertaining that endometriosis is referred to as a “disabling disease” in the book.  For me, I’ve never thought of endometriosis as being disabling.  I suppose for some it can be.  For me, it’s uncomfortable, painful, and not a fun experience.

Anyways!  The book pretty much has 2 chapters.  1 is an introduction that reviews all the foods to avoid and healthier alternatives.  The 2nd chapter contains all the recipes, although the recipes are divided up by meals.  When I first looked through it and read the suggested foods, it reminded me of my first acupuncture session.  It seemed so restrictive, I didn’t know whether I would be willing to give it a try.  So, I didn’t.  I know, that sounds bad.  But I needed to consider how much this would cost as well.  Many of the recipes included making things from scratch and then using that in a dish.  It was also time consuming.  At the time, I wasn’t willing to make that change.  Some of the recipes are appealing and I may give those a try, but I’m not going to only eat what the endometriosis diet recommends.  That may sound defiant but oh well, that’s the choice I made.  If you or anyone you know wants to borrow my book, let me know! 🙂

Personally, I felt that just changing my diet was not the only answer to controlling my endometriosis.  In previous posts, I’ve mentioned oils as a method for healing and helping.  So, I looked up the information and found that these oils are good for endometriosis: geranium, cypress, and clary sage.  I just recently got those oils and am looking forward to giving them a try.  Wish me luck!

FYI: The book is “Recipes for the Endometriosis Diet” by Carolyn Levett

Next post: In the Meantime


Considering the Options

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Well, understanding and considering all the options available to us takes a lot of time.  I don’t know if I can adequately express or explain the amount of time and thoughts involved in this process.  In my last post, I explained the options and costs:

1.  FET

2. IVF

3. Natural Cycle with meds

You know, my husband & I have spent many hours discussing the options…the costs, the time, the what ifs, etc.  You name it, we’ve talked about it.  Of course, this also includes the consequences of each option as well as reality.  One of the realities of each option is that it may not be successful.  It’s not being pessimistic, it’s being thorough.  Being thorough is necessary because if you can’t deal with an unsuccessful pregnancy, FET, or IVF cycle…it makes it more difficult to cope with.  It’s already hard as it is, you don’t need more pain to deal with.  You need to talk about the possibility of things not going the way you plan or desire.  Here’s the thing about being thorough, you need to consider all the options, whether you want to or not.  Of course, you always hope that everything works out good but that is not always the case…believe me, I know…just read my last few posts.

I never thought I would experience all 3 of the options available to us.  Honestly, considering these options with experience in mind, was just a tad bit easier.  Having had experience helped because I knew the processes and what to expect.  Two of the important factors for me were cost and pain.  Lol.  I truly had to wonder if I wanted to do injections again and actually, I was ok with it.  Most people cringe when I explain the injections to them, but in reality, it’s 10-12 consecutive days at the most.  In the big picture, I feel like it’s doable.  You may think I’m crazy but it’s really not that bad.

The prices for all the options was a hard decision for us.  Spending $4K is quite an expense, considering it’s not covered by insurance.  Plus it’s only a little bit more than a fresh IVF cycle (covered by insurance).  The other thing we considered is that a FET can be done whenever you want…with at least 2 months notice.  The embryos are frozen, you can thaw them anytime you want.  We have the option of thawing them for an FET cycle years from now.  I hope that makes sense.  The option is good, the price is ok – meaning affordable, and long term – it’s a good option because the embryos are still the age of retrieval.  So, for example, if I was 35 when they are retrieved, then they will be 35 five years later when if we decide to do an FET then.  Of course, I’m not that age, hence it’s an example.

With all that said, we knew and still know all the options for us.  It’s a matter of waiting for when we’re ready to do it.  It also matters what Dr. F recommends.  So, this means I will call on Day 1 and schedule a Day 10 exam.  Based on that exam, we’ll go from there!

Next post:  Day 10


Are You Serious?

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Where was I?  Oh yes, my next appointment.  I think I may have mentioned this but each time I went in for an appointment, I had blood work.  So, not only was I injecting myself, I was being poked in the arm every few days.

Anyways, getting back to my appointment.  I was still bleeding and I made sure to ask the doctor about the pain I felt over the past few days.  He attributed much of the pain to coming off birth control (having been on it for almost 2 months).  I just went with it, even though I felt like something was wrong.  What were they going to do?

The ultrasound revealed at least 10 follicles growing.  I can’t remember the exact number.  I was quite amazed to see all of that.  The doctor would call out numbers that confused me…I didn’t know what some of the numbers meant.  For example, if the doctor said “one twelve, two tens.”  What he was doing was counting the follicles and measuring them at the same time.  So, one twelve meant that there was one follicle that measured 12mm.  The same for two tens, that meant that there were 2 follicles, 10mm in size.  Make sense?

After the ultrasound, the doctor talked to us about the lining of the uterus.  It wasn’t doing what they want it to do…grow!  At my first appointment the lining of my uterus was thick, that was before I got my period.  At my second appointment the doctor expected me to get my menses.  At this third appointment I was still bleeding and the lining of my uterus was not cooperating.  So, the doctor discussed the option to freeze the embryos after the egg retrieval and transfer them at a later date.  It wasn’t part of the plan, but it made sense.  If the doctor transferred the embryos the probability for pregnancy would pretty much be zero.  The lining of my uterus was not thick enough to support an embryo transfer…they wouldn’t have anything to attach to.  It would be a wasted IVF cycle.  The decision wasn’t finalized, we just had a discussion about it.  We would have to see how the next 1-2 appointments go before deciding.

At the end of this, my third appointment I was given further instructions by my doctor and IVF coordinator.  I was going to start a second injection…Ganirelix.  If you’ve read some of my previous posts, you would have seen a picture of this injection.  It is in a clear glass syringe and pre-filled.  The purpose of this injection is to prevent ovulation.  Oh boy!  Now I had to keep track of both injections!  It’s not that hard, but 2 injections in one night?  Oh dear.  One is already enough.  Having to take 2 would be much more interesting.  Since my follicles were growing it was important that my body not ovulate on it’s own and release and unknown amount of eggs…hence the Ganirelix.

My next appointment (4th) was scheduled 2 days later.

Before I get to that appointment, I want to talk about the Ganirelix injection.  The Ganirelix shot was so sore!  I haven’t figured out why yet.  The box says that it’s the same sized needles as the other injections.  It hurt and caused bruising…not fun.  Since I had the other injection, I did that one first and then the Ganirelix.  I alternated sides, not injecting anything into the same side or near the same injection site.  So, I had to do the same thing…pinch the skin about 1-2 inches to left or right of the naval, alcohol prep it, and then inject.  I took a deep breath between the injections!  The Ganirelix injection needle hurt going in, but injecting the medicine didn’t hurt at all.  That shot was the most painful injection.  I knew that I had a limited supply of the Ganirelix injection, phew!  After that first Ganirelix injection, I wasn’t sure how I was going to make through 3 more!  Yikes!  Luckily, I only did one more Ganirelix shot!  It hurt the second time too!

There was something else going on…the lining of my uterus.  So, despite having to do all the injections, the lining of my uterus was going crazy!  I didn’t know what was going on!  At random, the lining of my uterus would shed…and I needed to be near a bathroom or my clothes would be completely soaked in blood.  I first noticed it at the end of my work day (in between my 3rd & 4th appointments).  I was in a meeting and I felt this surge of blood.  It was weird.  My meeting ended soon after and I went to the bathroom…where a huge chunk of the lining of my uterus came out.  This continued at random for 2 more days…with the same pattern, a surge of blood and then a chunk or more of the the lining of my uterus.  I didn’t know what to do.  I thought it was a side effect of the all the medications.  Since I was scheduled for an appointment the next day, I decided to bring it up then.

So, I did.  At my 4th appointment the doctor confirmed that it was most likely a side effect of the medications.  Just as I suspected.  When the doctor did the ultrasound I couldn’t keep up with the number of follicles, there were just SO many…I gave up counting.  I was reminded to take the injections one last time…one more Ganirelix and one more of the Bravelle and Menopur mixture.  It was at that appointment that the doctor decided we would freeze the embryos on egg retrieval day.  We would instead focus on the follicles.  On top of that, I was scheduled for an appointment…the next day.  That was not on the schedule.  I didn’t expect to have an appointment the next day but I just had to go with it.  Like I’ve mentioned before…flexibility.

I wasn’t too happy about having to postpone the embryo transfer because I knew that meant I would have to wait longer to know whether the IVF cycle was successful or not.  I was frustrated though, only because I had to wait.  I felt as though I’d waited for so long already.  I thought, “You have got to be kidding me!”  There’s really nothing I could do about it.  The follicles and the lining of my uterus were the new focus and priority.

So, that night after my appointment, right at 6:00pm I did my last 2 injections!  Well, not exactly…but close enough.  I knew I still had 1 more injection, the HCG shot.  The Ganirelix still hurt but I was relieved to be done with that.  Up to this point I had done 8 consecutive days of injections, 10 total injections.  The last 2/8 days were 2 injections each.

Ok, the next day I went in for my 5th appointment.  It was a Sunday and due to the time of my appointment, I was unable to attend church.  Just in case you’re wondering, we went after we came back.  Getting to the appointment was little different.  The building where the doctor is located is closed on Sundays.  So, we had to call so they could let us in.  I think it’s more work for the employees because they have to run around everywhere and be available for the next client coming in.  We made it and everything went smoothly.

The ultrasound went well and I still lost count of the number of follicles.  I didn’t care at that point, I knew it would be enough when it came time for the egg retrieval.  We left with more instructions and injections.  The doctor made me a special dosage of HCG and added a second injection of Lupron.  While he made those for me, my IVF coordinator talked to me about the antibiotic (Doxycycline).  My husband and I were given the same instructions to take one pill each that night and the next (2 days total).  It was an antibiotic to prepare us for the egg retrieval.  The doctor gave me the 2 injections with instructions to refrigerate them until it was time to inject them at 9pm.

Here is a picture of the antibiotic Doxycycline (left), and the alcohol prep pad.  I used an alcohol prep pad for each injection.  A little further down you’ll see the last 2 injections.

  

The HCG shot makes you ovulate and it is given at a specific time, 36 hours before the egg retrieval.  Lupron is used to treat endometriosis, which I have.  So, at 9pm that night the shots were injected one at a time.  I have to say, I think the needles were smaller.  I didn’t feel anything.  No pain, nothing!  That was awesome and such a relief after the Ganirelix injections!

Below you will see the 2 injections.  The injection on top is the Lupron and the one on the bottom is the HCG.  They are not labeled so I’m guessing here. But I’m pretty sure I’m right because the one on the bottom is a higher dosage (75 units), exactly what I was prescribed for the HCG injection.  The one on top is a thinner syringe that has 35 units.

The next day I went in again just for blood work.  I also brought in my HCG shot.  Since the doctor made one for me, I still had one at home.  He said I could give them mine, so I did.  That was one less medication to worry about.  The lining of my uterus stopped shedding.  I believe it was the Lupron injection that stopped the random shedding for 3 days.  That was a blessing and very helpful.  We took our antibiotics that night and reviewed the instructions for the egg retrieval.

As promised, here is the video!!  It shows how to mix the injections.  I’m just going to apologize in advance, it’s a long video.  I’m not a professional.  Lol.  I hope you have a better idea of how it’s done.

Thanks for reading and watching! 🙂

Next post:  Egg Retrieval Day


Ready, Set, Go!

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It was time to get started!!!

The IVF process, mainly the injections, remind me of riding in a bumper car.  You wait in line until it’s your turn.  Once you’re up, you get in the car, buckle your seatbelt and enjoy the ride!  Well, not totally of course, you get bumped and bruised as you drive around, sometimes not knowing where to turn.  It can be chaotic, painful, funny, and crazy…but luckily it’s a relatively short ride.

The night before my baseline appointment, I took my last birth control pill.  It was quite nice not having a period, especially when it’s associated with A LOT of pain!  The next morning I went in for my appointment, very curious about the lining of my uterus.  The verdict: thick.  I thought, great we’re going to have to postpone!  Well, to my astonishment, we carried on.

According to my calendar, I was scheduled to start the injections 2 days later.  However, due to the lining of the uterus, the doctor requested to see me again in 3 days.  So, I was not starting my injections until instructed.  He told me that I should expect to get my period within the next 3-4 days.  I was not looking forward to that!  It was a little delay in the process but I was still hopeful.

I went in 3 days later for my next appointment.  We got the green light to start the injections that night, with a minor change!  Hooray!  I was both relieved and nervous.  I felt a burden lifted because we were able to continue…nervous because it had been 4 months since the last injections.  The injections are not something I’ve enjoyed doing, but sometimes you just “do whatchu gotta do” (do what you need to do).  It was that same day, I felt I was going to get my period and just like the doctor said, I did.  It had been 4 days since I took my last birth control pill.

The minor change was an increase in dosage.  Remember now, I had all the medications and I knew what the prescriptions were.  So, I knew that I was prescribed 5 Bravelle (an entire box) for each injection.  The doctor changed the dosage to 6 Bravelle but kept the Menopur at 1 vial.  I was surprised by the increase but I trusted the doctor.  I knew everything would be ok.  I took a deep breath and set my phone alarm (for 5 days).

Like I mentioned, at the same time, I got my period.  I wish I had the eloquent words to explain the pain!  It was hands down one of the worst periods I’ve ever had!!  I couldn’t even walk.  I had such a hard time using the bathroom, didn’t have much of an appetite, and still had to do the injections.  So not fun!  I attributed a majority of the pain, to the endometriosis and to the fact that I was on birth control for almost 2 months!  Luckily, the pain subsided.  The bleeding however, was different.  It varied.  It started off heavy, went light and then came back heavy.  I thought it was weird.  Eventually, it lighten but I thought it would still be important to share that with the doctor at my next appointment.

Below is a picture of what I call my “IVF prep.”  Each night, for 5 nights @ 5:50pm my alarm would sound, reminding me to start preparing the injection for 6pm.  I gave myself 10 minutes to get the shot ready.  I learned after that first night, it wasn’t enough time.  I needed more than 10 minutes.  After each injection, I gathered everything I needed in preparation for the next injection to following night.  That might sound too organized for some or maybe even a bit obsessive…but who cares.  I know I’ve said this before…IVF is very structured.  You take the injection at the same time every night, without excuses.  The injection takes priority…that’s just how it is.

At the top of the picture are all the vials, 7 total.  The gray vial is the water.  The peach vial is the Menopur, and the green vials are Bravelle (6).  Below the vials is the syringe, followed by the 2 alcohol prep pads.  At the bottom left is the needle and on the bottom right is the Q-cap.  You’ll notice that there are 2 alcohol prep pads…this is because one prep is to clean each vial after removing the caps, the second prep is used to clean the skin right before the injection.  Also, you may have noticed a difference with the needle and syringe.  In my last post, the picture showed pink needles and syringes with needles attached to them.  I didn’t need those.  Unfortunately, I paid for them, which was a $4.80 loss but it’s ok.  (Let me know if you have any ideas or suggestions as to what to do with them.  I can’t return the syringes and needles.  It was all sales final.)  Anyways!  My IVF coordinator provided me with the syringes and needles that I used for the injections.  They are the same used for all the previous shots, which I was familiar with.  That was good for me!

The shots were pretty much the same as I explained before, except they were quite potent!  It took 2 injections for me to feel side effects.  I think the side effects contributed to the additional pain I felt during my period.  Because the dosage of medication is MUCH higher than when doing ovulation induction, I experienced more than I bargained for.  When I did ovulation induction with IUI I didn’t experience any side effects.  Doing the IVF injections, however, I had what my family calls an “OVARYACTION!”  Get it?  LOL!  The injections were not nearly as painful as the ovaries themselves.  I literally felt the ovaries growing.  Well, when I’m taking the highest dosage that should be given (according to the medication insert) I’m bound to experience something!  The crazy thing about it was I felt pain in the front and back of my body, in the same areas, all related to the ovaries.  If you think about it, my ovaries were highly stimulated to produce follicles and mature them so they hopefully contain eggs.  I hope that makes sense.  The pain from the ovaries came whenever.  It was never a set time, pretty much at random throughout the day and night.  So, although I originally thought the pain from period was from the endometriosis and birth control, I think it was actually from the medication – the injections!  (Not to worry, I’ll write more about this)

I did the injections for 5 days…then I had an appointment the next day!

In my next post I’ll add the video showing you how to prep the injection.

Next post: Are You Serious?


The Calendar, Timing, and Costs of IVF

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One of these posts, I’m going to catch up…it’s just not going to be this one!  I have SO many thoughts right now, I’m not quite sure where to begin.  I think I’ll start off with this…

I’m going to apologize beforehand, if anyone is offended by what I’m about to say.  I don’t intent to offend anyone.

One of the original purposes for starting this blog was to inform and help others.  I’m not trying, at all, to sugar coat the IVF process.  This is not something I’ve dreamed of doing, nor is it a result of something I’ve done wrong.  I get asked a lot of questions pertaining to the “hows and whys” I’m not pregnant.  People assume many things.  I’ve had some say that I’ve put my career ahead of my decision to have a baby/child/family.  I’ve had others wonder why I haven’t had a baby after being married for more than 7 years.  Yet others assume that it’s easy for everyone to conceive just by having intercourse.  If it were that simple, I wouldn’t be writing this blog.

Everyone’s experiences are very personal and individual.  I recognize that to some degree, if you haven’t experienced IVF, you will probably never fully understand what some women have to go through to become pregnant.  It’s difficult to explain how personal this is.  Even though IVF is a process, there is a tremendous amount of emotion, physical pain, and unexpected events that accompany it.  I hope that as I describe the steps and experiences I’ve had, that you will gain an understanding.  I don’t think I can really explain everything.  I’ll do my best.

The Calendar

Like I’ve mentioned before, there are a lot of dates to remember.  Since I already wrote about the birth control, I think I’ll bypass that this time.  My calendar contains at least 2 weeks of intense activity, meaning appointments, ultrasounds, blood work, and injections.  Of course, all of this activity is tentative and subject to change, depending on how the uterus and ovaries look.  So, you have to keep your schedule open during that time.  My calendar included specific dates for my egg retrieval and embryo transfer, which I will discuss in more detail in upcoming posts. Oh ya, I forgot to mention another important date.  The calendar gives an exact date for when I will be starting the shots.  One month prior to starting the shots (while I take the birth control), my IVF copayment is due.

The Timing

IVF requires frequent monitoring, which is why timing is so critical.  Although I followed my calendar, I understood that I could be asked to come in for another appointment, the next day.  I could have an appointment anywhere between 1-3 days or more, in other words, flexibility is a requirement! 🙂

Costs of In Vitro Fertilization (IVF)

Oh my, take a guess!  How much do you think IVF costs with or without insurance?  I’ve mentioned a range in previous posts.  Since this is our first time doing IVF, insurance will cover a majority of the costs.  Phew!  That’s definitely a good thing!

We had over a month to review the costs and make a decision about IVF before paying our portion.  There are a few options available to couples doing IVF.  For me, the copayment would either be $3,000 or $4,500 plus some additional fees that, if we consented, would be paid at a later time.  The options include the following:

1.  With or without ICSI.  ICSI stands for Intracytoplasmic Sperm Injection.  Choosing to do ICSI ultimately means that after the eggs are retrieved from the ovaries, each egg will be individually fertilized with a single sperm.  When I first heard of this procedure, I was amazed!  It’s very precise and pretty much guarantees that each egg retrieved will be fertilized, thus slightly increasing your success rate.

Choosing “without ICSI” means that the eggs and sperm are on their own.  They are placed together and then responsible for fertilization.  I’m not sure if you can still consider that “natural” but it kind of is.  It’s just not happening in your body.

The cost: Without ICSI = $3,000     With ICSI = $4,500

Without insurance, IVF would cost around $18,000-20,000.  That’s right!  Thinking things through is a MUST!  You want the best chances you can get with the least amount of variables or factors.

2.  Cryopreservation of the Embryos.  This is one of the additional fees to be paid at a later date.  Agreeing and paying for this means we would be freezing our embryos, which will cost $1,500.  There is also a fee for storing the embryos.  After the first year, keeping the embryos frozen will amount to $600/year, which equals $50 per month.

3.  Frozen Embryo Transfer Cycle.  If per chance we decide to freeze our embryos we have the option of doing a frozen embryo transfer cycle.  Say the IVF cycle did not result in pregnancy and we’d like another chance.  We can use the frozen embryos and have them transfered into the uterus rather than complete the entire IVF cycle again.  Or, say that the IVF cycle was successful and we wanted to increase posterity.  This same option would be available to us.  The cost of this cycle is $4,000.

These are all HARD decisions to make.  I’m grateful we had a sufficient time to review all of these options.  The first difficult decision, for me, in the IVF process, was whether to do ICSI or not.  The $1,500 additional charge was difficult.  Paying for it wasn’t the problem, not that we’re swimming in money!  I thought about this decision for a LONG time!  My husband and I had many discussions about it…still no definite answer.  We weighed the pros and cons, pondered, and prayed.  What was really going through my mind was this…is it necessary?  I didn’t feel comfortable paying for ICSI because I felt that it was for men with low sperm count.  From what I knew, there weren’t any issues with my husband’s sperm through semen analysis.  Then there were the “what ifs” that popped up in my head.  Like, what if only a few eggs are fertilized?  We were encouraged to do ICSI but in the end, it was up to us.  It took weeks for us to solidify our decision.

The second decision we contemplated was whether to freeze the remaining embryos or not.  My husband read a lot of articles that say that many couples become pregnant naturally after IVF.  We have NO idea if that would be the case for us.  How would we know?  We just speculated.  Regardless of that, we had to discuss and decide.  We didn’t need an answer yet but the time would approach quickly.

Decisions, decisions…

Next post: Our decisions


More Shots

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Well, after the first night of shots, I thought, “This is going to be interesting.”  I knew I would get through it, ok.  It wasn’t a preferred thing to do, at all.  Lol!

One thing to keep in mind and remember when doing the shots is that appointments are scheduled the day of your appointment.  So, for example, I had my day 3 scan and then after getting my tutorial about the injectable medicine, I scheduled my next appointment.  Well, I was kind of told when my next appointment was going to be, I just had to schedule the time.  Because the shots require a lot of monitoring, I would go in for an appointment every 4-5 days or less.  Also, since these appointments were a priority for me, as I think it would be for anyone in a similar situation, I didn’t mind taking time off of work.  I would receive the exact amount of medicine until my next appointment.

Ok, back to the shots.  The second night, as I agreed, I prepared the shot and let my husband inject it.  I cleaned the area and then pinched it so all he had to do was inject the shot.  My husband quickly injected the needle and pushed the syringe without hesitation, like he was giving me a flu shot.  Ouch!  It happened SO fast, my abdomen hurt.  I felt a pressure that was similar to a sting, but the pain was stronger.  As he pulled the needle out at an angle, he scratched the surface of my skin causing it to bleed (a little).  I was in such pain, I told him he was fired!  Lol!  I wasn’t going to give him another chance.  He asked for the opportunity to try again because it was his first time.  I understood that, so I agreed.  I explained how I felt and shared some things I thought would have to change in future injections.  It was a new experience for both of us, we were quite clueless.  We had a good laugh about the experience as we reflected on in it retrospect that night.  By the next morning, I had a bruise in my abdomen area from that injection.  It didn’t change my decision to give my husband another chance.

The follow night, night 3 of shots, went much smoother!  It actually turned out to be helpful for me to have my husband do the shots.  We communicated about the best way to do the injections and that made it much more bearable for me.  My husband got better and we had a system going.

I went in for my next appointment & scan.   It was close to the weekend and everything looked good.  I had at least one good egg, since the start of the injections.  I went home with more injections, except this time, my dosage increased.  I was instructed to use 2 vials of medicine in the same 1 cc of water.  So, my dosage doubled.  The injections went well.

Oh ya, before I forget, when Dr. Frattarelli was not available, I would see a Physician’s Assistant (PA).  She was very nice and knowledgable.  Ok, back to the scan.

The scan showed 4 eggs!  I was stoked to hear that information!  I thought we were close to achieving our goal of becoming pregnant.  I didn’t realize that 4 eggs meant I would be required to have the “multiple births” discussion.  I was required to give verbal consent to abort more than 2 embryos.  What that means is…if I became pregnant with more than 2 embryos, I would have to abort the rest of the embryos leaving a maximum of 2.  So, since I had 4 eggs, it was possible that all 4 could be fertilized.  That’s why I had to have a discussion.  I hope that what I’ve explained so far makes sense.  Basically I could have twins, at the most.  Through further discussion with the PA, I was informed that triplets (or more) were a (very) high risk to the babies as well as the mother.  I was also reminded of the many possible complications associated with multiple births and that the babies are at greater risk for developmental delays and other things.  Having the multiple births conversation was very hard for me, morally.  I completely understood the objective and reason for the discussion but it was still hard.  There was much more to contemplate than just yea or nay to the multiple births.  If I said no and didn’t consent, we would have to have protected intercourse for at least a week so I would not become pregnant.  I would pretty much just wait for the next cycle.  But I didn’t want to do that!  I had 4 eggs, 4 possibilities.  It didn’t mean that they would all be fertilized, but I still wanted to take advantage of that opportunity.  It was so difficult for me.  The idea that I may have to agree to abort an embryo did not sit well with me.

Before I left the office, I was asked to give my verbal consent.  I couldn’t give an answer.  I requested to talk it over with my husband and then call the office with my answer.  The PA agreed to give me the HCG injection just in case I decided to consent and continue with the cycle.  But, I was only to use it if I consented.  The HCG shot looks very similar to the Bravelle, it just comes in bigger vials and with a bigger needle (I’ll explain).  Anyways!  I left the office and called my husband immediately.  As I drove home, I explained my appointment to him and asked for his advice…I really depended on it!

Without hesitation, my husband said I should consent.  He then explained that it’s better to have the opportunity than nothing at all.  He calmly assured me that everything was going to be ok.  I respected his thoughts, even though it was still hard for me.  We agreed to consent and then I called the PA to let her know. I left a message for her to call me and she did a little while later.  I believe she was with a patient.  She returned my call and I happened to be running an errand.  We scheduled an IUI, which meant that I had to do the HCG injection, right then.  Good thing I was close to home!  I hurried home, quickly prepared the shot, and nervously injected it.  I got accustomed to my husband doing the shots that doing it myself made me feel anxious again.  I anticipated that I would be tense and was not looking forward to it.  But I didn’t have time to worry!  I had to do the shot, and fast!  The HCG shot came in a glass vial in a powder form.  A separate water vial was also included.  Since the Q-cap did not fit the vial, I was provided with a needle, much like the ones used to draw blood.  I attached the needle to the syringe and used the needle to draw up the water and medication.  I unscrewed the needle and used the same sized needle for the injection.  I prayed that I would be able to do the injection with minimal pain.  My prayer was answered!  I didn’t feel a thing!  The HCG injection went well!  I was VERY relieved.  That night I still had a hard time with the consent and abortion thing.  I did not sleep well.  I tossed and turned about the decision and still felt uneasy.

A couple of days later, we went in for the IUI.  We were given the option, prior to this, of whether we wanted to have timed intercourse or IUI.  We decided to do the IUI.  I wanted the best chances, every time and I knew IUI would give us that.  The IUI went smoothly and then it was time to wait.

Two weeks is a long time to wait…something I was and still am very familiar with.  When my menses came, I was SO devastated, emotionally.  I couldn’t fathom the idea that none of the 4 eggs were fertilized!  It boggled my mind because it didn’t make sense.  At the time I thought my life sucked and things couldn’t get any worse!  Plus, my menses was painful.  It was not a good month for me.  What was I to do?  Carry on.

Next post:  Carrying On…


Acupuncture

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What would you do, if what you’re already doing isn’t working?  Do you continue to do what’s not working or do you find alternatives or supports to help you?  Those were some of the questions I faced.  I had to ask myself these questions because that was reality for me.

Since the clomid cycles were not successful in achieving pregnancy, the next step was to obtain a referral.  So, I contacted my new OB/GYN and we reviewed the plan.  Oh, the “new” OB/GYN…I felt comfortable having the last OB/GYN help me through the rest of the process.  While waiting to hear back about my referral, I figured…this “western” medicine is not happening, we should try something else.  Hence, I went to acupuncture.

Acupuncture was not a replacement for modern medicine or “western” medicine, at least not for us anyway.  Acupuncture is something I consider complimentary to modern medicine, that helped provide more understanding and different approaches to an already complicated situation.

I went to acupuncture without consultation or a recommendation from my doctor.  I did not ask because at that point I thought….this can’t hurt our chances!  Why not try it?  Some of my friends advised me to see an acupuncturist but no one in particular.

My husband did the research and I made the call.  I set up my first acupuncture appointment!  He came with me to check it out.  Plus, I was nervous and didn’t want to go by myself.

If you ever have the opportunity to participate in acupuncture, I would recommend it!

At first, I was definitely skeptical!  I didn’t know what I was getting into nor did I realize the effect it would have on me.  I was a little freaked out because I wasn’t familiar with it, meaning I had a general idea but not the specifics.  I knew I was going to be poked with needles and thought it might hurt a little.

My first appointment was about 2 hours.  I read and signed consents.  Then I tried it out…I was invited to one of the rooms and asked to remove either all of my clothes or to remove my clothes from the waist up.  I laid on my stomach, put my head in the rest area provided at the end of the massage table, and covered myself with the sheet.  The massage table was covered like a bed, with a sheet to protect the table and a sheet to cover me.  When the acupuncturist came in I was asked questions pertaining to my history, infertility, and reviewed some of the things I could expect.

Next, the sheet was lifted to uncover only my back and arms.  My back was lathered with lotion and I moved on to cupping.  If you’ve ever done cupping you may have a different perception than me.  The fact is, I never saw the cupping process because my head was always face down.  I heard and felt cupping.  My husband, however, has witnessed cupping being performed on my back.  So, he assisted with my explanation of this.  Cupping helps the blood flow in your body.  It involves small glass cups that are placed on your back.  Prior to that, a cotton ball is lit on fire and swirled inside a glass cup, which creates smoke.  The cup is then placed on your back.  You can tell it’s on your back because the glass becomes like suction cups to your skin.  The skin surrounding the cup is sucked up into the glass cup.  The smoke removes the oxygen from the glass cup creating the suction effect.  The cup was moved around my back in a particular manner.  At times it stayed in a specific area for a few minutes.  It was at those times that I got a hand and foot massage.  Oh, I almost forgot.  While I was laying on my stomach there was also a pillow by my ankles holding my feet up a little off the table.  This probably sounds really weird and possibly harsh.  I hope I’ve explained this well enough for you to understand.

I had a least 3 cups on my back.  I have to admit, the first time I did cupping it was sore, and for good reason.  After the cupping was complete, the cups were removed.  My back was really tense.  That was also apparent when the acupuncturist did a back pinching thing.  I don’t know what the exact name for it is, but it hurt.  It starts at the tailbone.  You push the skin toward the spine and pinch it.  Alternating hands (thumbs & index fingers), you pinch the skin up following the spine, until you reach the neck.  It seemed to take forever, probably because I was in such pain.  The pain was due to the tightness of my back.  After the pinching thing, I got a back massage. When that was done, the sheet was lifted a little.  I was asked to turn over and lay on my back.  When I was ready, the sheet was draped over me.  Don’t worry, the acupuncturist was very modest about it and the sheets were not sheer.  The pillow by my ankles was returned to that spot and another pillow was placed under my head and neck area.

It was now time for the actual acupuncture!  I was instructed to breathe a certain way while the needles were being placed in specific areas.  If you don’t know anything about acupuncture or Chinese medicine, know that there a hundreds of points on the body.  I can’t tell you all of them, just know there are a lot! Lol!  One of the purposes of my first appointment was for the acupuncturist to assess how my body works and then identify the best way to help me.

My first experience with the acupuncture needles was not at all what I expected.  I knew that they were different from needles used to draw blood or give shots like TB, which are hollow.  I remember in high school a teacher had acupuncture done to her as part of the lesson in class one day.  It was mostly around her face and I was not bothered by it.  Anyways!  I was surprised that I couldn’t really feel the needles.  There were a few times that I felt a very brief pinch but that was it.  Since I was laying on my back I didn’t see where most of the needles were placed but I did feel them.  I remember lifting up my hand and seeing one between my thumb and index finger.  It was so thin I could barely tell it was there.  If it wasn’t for a thick cylinder metal piece at the top, I don’t know if I would’ve be able to see the needle.  The needles were about 2-2 1/2 inches long.  When the needles were in their proper places, I was instructed to close my eyes and rest for 20 minutes.  Just as a side note, I did not have needles coming out of every acupuncture point.  The needles were strategically placed.  The acupuncturist set a timer and then came in to remove the needles at the completion of the time.  I was instructed to take my time getting up and dressed, then meet the acupuncturist outside.

I got up, got dressed and we went outside to talk with the acupuncturist.  She gave me further instructions about a diet, book & article to read, as well as additional things I could expect in future sessions.  I still have the handouts I was given.  I thought the session went well considering it was my first time.  I scheduled another appointment for the following week.

As I write about this experience I realize that there are SO many things to share about the topic of acupuncture.  One post isn’t going to be enough!  Oh dear.

Anyways!  When I went home after the appointment I didn’t notice anything different until it was time to take a shower.  I saw the marks on my back from where the cups were.  My back wasn’t covered in marks, there were maybe 4-5.  They looked like bruises that were perfect circles, scattered around my back.  Lol.  It took a few days before it was gone, which I expected because of all the tightness in my back.

Acupuncture usually consisted of cupping, massage, acupuncture and rest.  My first appointment was the longest.  The typical appointment after that was about an hour, complete with validated parking.

Ok.  I had this thing…for 2-3 days after acupuncture, I would wear my hair down to cover my neck area.  I didn’t want people to think I was being abused.  Lol.  I don’t know why because I wasn’t being abused.  Well, a few months into treatment, a day or two after acupuncture, I made the mistake of going to Wal-mart with my hair tied up.  I forgot what I was shopping for but I remember walking pass the sewing section & noticing this tall, African American looking guy following me.  He looked like he was in his 40s. I didn’t know why he was following me.  I tried not to make eye contact and walked a little faster but, he caught up to me.  He said, “Excuse me, what is that on your back?”  It was then that I realized why he was following me!  I laughed to myself.  He spotted a mark from the cupping.  It was on the middle back of my neck, right above my shirt line with about half of a circle visible.  I explained to him how I got it.  He seemed surprised, nodded while explained, ok with it, and then walked away.  Thinking about that experience makes me laugh.  Hope you got a good laugh too! 🙂

Next post: More Acupunture


Still on Step 2

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Before I dive into the details of the HSG, I’d like to make a side note.

I really appreciate your encouragement, support, and positive energy! 🙂  I know some of you may not believe this, but I’m a pretty private person.  I don’t feel the need to share my life stories with anyone and everyone!  You may be thinking in disbelief, “yeah, right.”  But it’s true.  Writing this blog is quite the adventure for me…an important adventure.  As I’ve traveled this journey, I’ve learned a lot.  I realize that infertility is not a popular topic of discussion in many settings.  Nor is it always comfortable for those who experience infertility, to talk about it.  In upcoming posts, I will explain and hopefully clarify some of the feelings I’ve had throughout this journey.  Thank you for allowing me to share my journey with you.

Alright, back to the HSG test!  When the OB/GYN arrived, she introduced herself while she sterilized the area then put the speculum (which was also cold, it’s metal) in.  She slided the catheter into the vagina and pushed it up toward the cervix.  However, she couldn’t get it where she needed it to go.  She tried a number of times by pushing it and maneuvering it in the area between the vagina and cervix.  She took the catheter out and tried with a different catheter.  I believe there were different sized catheters available to the OB/GYN, as needed.  Even with a different catheter, she was unable to complete the HSG test.  The OB/GYN’s attempts to get the catheter to my cervix caused bleeding.  It was painful.  I figured it was temporary, which it was, so I just took the pain.  Since there was bleeding, she put a flat rectangular-shaped pad underneath me to soak up the blood.  It was not a lot of blood but it hindered her attempts.  She tried at least one more time without success and then decided I should reschedule my HSG test.  She removed the speculum and recommended I rest a little before I got up.  So that was it!

I was grateful and relieved the OB/GYN stopped the HSG test.  When I stood up, the radiology assistant (sorry, I can’t think of the appropriate title) felt really bad.  She apologized and asked if I was ok.  I told her I was fine.  She gave me a pad for additional blood and I changed.  On my way out she apologized again and gave me a $5 off coupon.  I was surprised and thanked her.

On the drive home, I felt good physically but my mind was full of thoughts.  It never occurred to me that I would have to do the test again.  I went in for my appointment with a purpose and expected to come out with an answer about my fallopian tubes.  Instead, I had a bunch of questions in my head.  My main thoughts were, “Why was there such a problem doing the test?” and “Is there something else going on?”  I didn’t have an answer to either of those questions.  What could I do?  Nothing really, I had to wait until my next cycle (between day 7-12) and do it all over again.  I was worried.  How would it go the second time around?  What would the results be?  I was not confident I could cope with the results.  It was frustrating but I decided to be patient and let it go.  I needed a plan for the next HSG test.

Next post: The 2nd HSG