Screening Tests!

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I realized after I completed my last post, I didn’t tell you my due date!  Well, here it is: July 30.  The ultrasound revealed that I was pregnant with 1 baby.

Alright, moving on to screening tests.  Oh ya, I forgot to mention that on January 1st, my insurance changed making it necessary for me to find an OB/GYN.  I searched and got information from family and friends.  I wanted someone nearby but that option was not available.  I didn’t prefer having to drive to town but it was better than the doctor that was only available every Tuesdays.  Plus, starting a job, I didn’t have time to take off nor did I want to take unpaid leave.  I was looking for a doctor that was available on the weekends as well.  So, we decided to see on of my sister-in-laws OB in town.

At my first appointment, the nurse asked me a lot of questions and I filled out some questionnaire as well.  When I met with the doctor, we went over all the information and he asked if I wanted to participate in a screening.  I told him that it didn’t matter because either way, we would be keeping the baby.  The choice was up to me.  So, I agreed to complete the screening.  I thought it was only one but as we talked about it more, I understood that it was 2 screenings.  He gave me the time frames for when they’re completed and then said he would send a requisition to Queens Medical Center (QMC) because they do the screenings.  I agreed and that was it.  I left and had lunch with my husband.  While we were eating I got a call from QMC to schedule my 1st screening.  I was really surprised at the  prompt response, very impressive.  I scheduled my first screening.

First Screening

I really wish I could remember the names of the screenings but I can’t.  All I know is the first screening was an ultrasound and blood work for down syndrome.  I completed it at 11 weeks, almost 12 weeks.  I thought everything went well.  It was pretty cool that I had my own bathroom, adjustable lighting, and a curtain for privacy.  Also, the jelly they use for the ultrasound was in a warmer.  Lol.  It was thoughtful, rather than it be cold.  I liked the fact that the technician gave me a USB to put all the ultrasound pictures on.  She reminded me to bring the USB to the second screening as well.  Having the USB is really cool and quite up-to-speed with the technology available now.  I’m grateful to have that, in addition to the 8 pictures the technician put on it.  Also, the technician printed out all the pictures she placed on the USB and gave them to me before I left.  I remember her telling me that now I will have the pictures forever and I can put them on facebook or wherever.  I told her her I was happy to have them but probably won’t be placing it on facebook.  Lol.

A week or 2 after my first screening, my OB/GYN called and shared the results of the first screening.  He explained that I was low risk.  Phew, that was a relief.  After all we experienced trying to become pregnant, I figured I wouldn’t get too much relief when I actually got pregnant.  So, hearing the doctor tell me the results showed I was low risk, was awesome.  I was so relieved and at the same time, still not convinced that my pregnancy would be smooth sailing.  Nevertheless, I was grateful.

Second Screening

At my second screening, my husband came with me.  It was around week 18-19.  I knew this screening would be looking at the physical development of our baby.  For instance, a cleft lip.  Also, the screening looked at kidney function, blood flow through the heart, the blood flow from the umbilical cord to the baby, etc.  I gave the technician my USB and she loaded the pictures on it.  It was so interesting to me to watch the things she looked for.  One of the coolest things I saw was my baby’s nose and lips.  I know you may be wondering why I think that’s so cool, but I find it neat.  I knew she was looking for any physical concerns like a cleft lip.  This was the 3rd ultrasound I’ve had during my pregnancy and it was neat to see the growth.  But seeing my baby’s nose and lips was cool because at that point I knew our baby was still very small but the technician could zoom in for a closer look, something that would not have been as successful in previous ultrasounds, for obvious reasons.  Of course, there are a lot of cool things to see during an ultrasound.  I remember while my ultrasound was going on that the lab technician came in and drew my blood.  Either she was really good or I was too focused on the ultrasound to feel anything.  Lol.  I think she was good because she drew my blood from a different arm and found my vein right away.

Towards the end of the ultrasound, the technician asked if we wanted to know the gender of our baby.  I told her we did and then she proceeded to move the probe all over my stomach.  She did mention that she would try her best.  I knew that meant cooperation from the baby would be necessary.  Lol.  As we looked at the screen, it didn’t take long for her to scan our baby’s gender.  The technician said, “Well that’s pretty obvious, no questions there.”  I tried not to bust out laughing, instead I let out a little chuckle.  I immediately turned and looked at my husband.  We smiled and then I looked back at the screen.  We’re having a BOY!!

At the end of our ultrasound, the technician wanted to try the 3D probe.  We agreed.  For those of you that aren’t familiar with the 3D probe, it’s a little more rounded with something that looks like a ping pong ball at the tip.  Not sure if that helps.  The 3D probe was quite entertaining for us.  The technician tried so hard to get a good picture but our baby didn’t make it easy for her.  Each time she got a good view, he would move his hand and block his face.  We just laughed.  She printed pictures for us, 11 pictures to be exact.  Soon after, we left.

I was relieved, not because we’re having a boy, but because we were able to find out the gender of our baby. For my husband and I, we didn’t have a preference.  You know, when you wait so long (or what feels like so long) you take what the Lord gives you/trusts you with.  I was also relieved to be able to refer to my baby with a gender.  I read that it’s important to talk to your baby early in pregnancy and all this time, I’ve referred to the baby as it or baby.  Now I could say he!  Lol.  It seems so minor but it was definitely a relief for me. 🙂

Next post: Weight Gain

Frozen Embryos

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After all the excitement, stress, and relief of finding out how many eggs were fertilized we were now waiting for the next pivotal step…knowing the # of frozen embryos.

Since the change in plans with the embryo transfer, we were hopeful that there would be a sufficient # of embryos for freezing.  Because the embryos need to meet a certain criteria before freezing, they are given a few days to grow before they are rated, measured, and frozen.

So, as a little reminder, there were 10/12 eggs fertilized.  Five days later I was notified by phone that 6 of the 10 eggs were frozen.  (More on that # in a later post.)  I felt blessed and relieved because I knew 6 was more than sufficient.  You may be wondering if I had to pay $1,500 for freezing, after all, we agreed to freeze any remaining embryos.  Nope!  We didn’t have to pay for the freezing, yet.  If our IVF cycle went smoothly or as planned, we would be paying for the freezing immediately after the embryo transfer.  Since our embryo transfer was postponed, we did not have to pay for the freezing.  Once we do the transfer we will pay $1,500 to have the remaining embryos frozen.

I’m not sure how many embryos will be transfered, nor do I know how many of the embryos will survive thawing.  Only time will tell.

Well, I received a calendar specific to the embryo transfer (ET).  I was surprised to find out that the ET was scheduled for July 25th.  I assumed that I would be doing the ET on the next cycle.  I was disappointed that I had to wait 2 months but after I thought about it and looked at all the medicines I still had, I knew it would take more than one cycle.

I was instructed to call on Day 1 and see the doctor on Day 3.  He wanted to see how the lining of my uterus looked.  So, of course, when I go in for my appointment, the lining looked great.  Lol.  And as usual, I had blood drawn.  The doctor also put me back on the birth control (active pills only) to maintain the lining of my uterus.

Two days later, I was informed (by an IVF coordinator) that my thyroid was low and I needed to take a blood test.  I, in turn, informed my PCP and did a blood test that same day.  The results revealed that my thyroid was in fact low…meaning I needed to increase my dosage.  How frustrating.  I knew it was related to the medications and changes my body experienced because of it.  The main reason for the frustration is that it usually postpones everything.  The thyroid is a priority but it can be frustrating when progress depends on it.  If you have to take thyroid medicine, you’ll know what I mean.  And, if you change dosages you pretty much lose a month.  The thyroid medicine takes 4 weeks to know whether it’s the right dosage or not.  If not, it needs to be adjusted and then another 4 weeks.  I hope that makes sense.

Since my ET was scheduled for July 25th, I had time to take care of my thyroid.  It was good and I was able to get my thyroid within the normal range. 🙂  In the meantime, I was still taking the active birth control pills.  During this time, emotions are quite calm and relaxed because there’s a lot of wait time.

A month before my scheduled ET, I followed my calendar and went in for an appointment.  I was surprised to find out, upon arrival that I was not on the schedule.  It was definitely a miscommunication.  Apparently they were awaiting the results of my thyroid test, which I received but had not given to them.  So, that day, I called my PCP and asked that the results be faxed to the fertility specialist.  My PCP’s nurse called me requesting that I sign a consent.  I was like, seriously?  I drove to the clinic, signed the consent, and it was faxed.  As soon as my IVF coordinator received my tests results, she called me.  She emailed me a new calendar (2nd) and scheduled my next appointment…exactly a week later.  My IVF coordinator informed me that the doctor would be doing a scan and SIS – test.

Blood is drawn each appointment and you squeeze the stress ball.  At one of my appointments, the lady who drew my blood asked if I wanted to take a stress ball home.  I reluctantly agreed.  It’s quite funny, I think.  Here is a picture of the stress balls.  I hope you get a great laugh, like I did! 🙂

Next post:  My SIS

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…

My Research & Self-Diagnosis

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Ok, as promised I’m finally going to share what I my body was really experiencing.

Remember now, I still felt like there was something wrong with me…I just didn’t know what it was until I started reading.  I did clomid and simultaneously searched for answers.  So often you hear others say, “Everything happens for a reason” or “Things happen for a reason.”  That just ate at me.  My reasons were a little different.  I was looking for WHY…why is nothing working, thinking that would solve my problem.  Knowing the cause of such difficulty brought temporary relief.

I borrowed a couple of books from my local library and began to read intently each moment I could.  I would come home from work and just read, sometimes getting a late start on dinner.  I would read late into the night, well late for me, often times going to sleep way past my bedtime.  I felt that educating myself on the topic would broaden my perspective on the whole process and increase my understanding…so I didn’t look like a deer in headlights.

As I read, I noticed a lot of the books were similarly structured but their explanations were very different.  I would only read through the IVF chapters and then skim through the rest.  I didn’t want to read about adoption, surrogacy, donors and the sort.  I knew that was not the direction I wanted to go, nor was I prepared to pursue those options (& still not).

Book 1: “Having a Baby…When the Old-Fashioned Way Isn’t Working”

I read a book by Cindy Margolis, a former model.  She experienced multiple IVF cycles and had a surrogate help her have 3 children.  The junk part was that after reading the book, I found out she and her husband are now divorced.  I find it interesting that they separated because they both contributed to the book and expressed their thoughts.  As she shared her story she emphasized that they went through this process together and how important it is to have supportive family, etc.  I thought…that sucks!  I’m sure there’s a lot more to the story.  To some degree I was unable to relate because I didn’t have the same concerns she shared.  I did however, understand how she felt.  She expressed feeling awkward around friends, thinking that it was her fault that she was not pregnant, and strong desire to have a baby.  She told her story and expressed the idea that it was not her fault and she was not going to let it bring her down. I’m glad I read it.

The book I found to the most informative and helpful is “What to Do When You Can’t Get Pregnant” by Daniel A. Potter, MD & Jennifer S. Hanin, MA.

Book 2: “What to Do When You Can’t Get Pregnant” (2005)

This book is truly amazing!  It’s so easy to follow!  I opened to the first chapter (page 1) and read this, “Nearly 15 percent of reproductive couples (men with female partners age 20 to 45) suffer from infertility.”  So, although I felt SO alone in my journey…I was in fact, not at all lonesome.  I didn’t like the term infertility because it sounded like I was unable to have a baby…ever.  I was wrong, of course, about that term.  The book explained, “Infertility is a medical condition.  A condition so misunderstood that it touches both genders equally.  A condition so common that it affects 80 million people worldwide.  In this country, infertility is growing at an alarming pace.  Over 16 million Americans have been diagnosed as infertile, and experts believe the actual number is easily triple that” (pg 2).  I really had no clue that there were so many people dealing with this!  I was somewhat relieved but I still didn’t know what was going on with ME.  Of course, I was only at the beginning of the book! Lol!  I continued to read and obtained more interesting facts.  The book also describes the menstrual cycle, including fertilization.  I found this to be much more complicated than I thought!  See, although I was still keeping track of my menses the chances to become pregnant each month was much smaller than I thought.  The book contains a few illustrations as various processes are described and explained.

I found the answer I was looking for when I made it to chapter 4, entitled “What Your Doctor Might Find in You.”  I began to read about endometriosis…and a light bulb went off in my head.  It’s like the book was reading my mind.  Lol!  Here is what I read (on pg 64-65)…I’ll apologize now, it’s kind of lengthy.

“Endometriosis is a progressive disease where the tissue lining your uterus (endometrium) implants and grows in your abdominal cavity. …When you menstruate, the foreign tissue in your pelvis also bleeds (since it’s actually uterine lining), causing irritation and inflammation that can lead to scar formation and distortion of your pelvic anatomy.  This anatomical distortion can cause infertility.  Strangely enough, severity of symptoms seen with endometriosis doesn’t correlate with severity or stage of the disease.  Some women have little or no pain from severe endometriosis, while others experience immense discomfort before or during their period from mild disease.  Symptoms of endometriosis include the following:

  • Extremely painful menstrual cramps (dysmenorrhea), especially if this condition develops after years of pain-free periods
  • Discomfort during intercourse (dyspareunia)
  • Pelvic, back, or side pains before or during periods
  • Rectal pain or painful bowel movements, diarrhea, constipation, or other intestinal upsets during menstruation
  • Frequent and painful urination during periods
  • Infertility

The book continued, “How Common Is Endometriosis?”  Endometriosis is one of the most common gynecological diseases, affecting more that 5.5 million women in the United States and millions more worldwide.”  The book also mentioned some suggestions and treatment options to help alleviate the pain, but clearly stated that there was no cure for endometriosis.

I TOTALLY believed I had endometriosis!  I remember telling my husband, “I think this is what I have!”

I thought everyone had cramps, until I read the book.  I had been experiencing painful periods for a while but my cycles were pretty regular.  I experienced 4 of the symptoms the book mentioned – extremely painful menses, pelvic & back pain, painful BM, and infertility.  This was my WHY!  I realized that all these symptoms were hindering our attempts to become pregnant.  As I thought about my self-diagnosis, so many more things began to make sense!  I thought, no wonder clomid didn’t work, even with the IUI.  Speaking of IUI, I said I would talk about the sperm being “washed.”  Here is the explanation provided by the book, “What To Do When You Can’t Get Pregnant” (pg 100).

“Why Wash Sperm?  Semen is mixture of sperm cells, seminal fluid, and debris (dead sperm, white blood cells, mucous, and fat globules).  You probably didn’t realize it, but semen contains prostaglandins that cause menstrual cramping.  While sperm behaves fine in the vaginal environment, if your doctor injects raw sperm directly into your uterus, you would experience severe pain.  So the goal of sperm washing is to separate healthy sperm from toxic seminal fluid.  One method of doing this involves a specialized lab tech who layers sperm on top of a nutrient medium and spins it in a centrifuge.  Spinning forces sperm cells to the bottom of the tube.  Once spun, he draws this purified sperm into a syringe so your doctor can inseminate you.”

I hope this makes sense!  It made sense to me.

Anyways!  Getting back to my self-diagnosis…I’m going to explain the symptoms I had.

  1. Extremely painful menses – Having cramps everyone month was a given.  The pain was really inconsistent each menses.  I think maybe a handful of times, total, I didn’t have any pain.  Otherwise, I had very painful menses.  Most of the time I just tried to take the pain, but I couldn’t handle it all the time.  I preferred not to take anything for the pain and I wouldn’t unless I had to.  It was SO bad at times, I had to take an OTC pain reliever.  The pain was very sharp, intense, and constant.  It’s not the funnest thing in the world, that’s for sure!  For me, the majority of the pain lasted for at least 1 day and sporadic pain the next day.  When I refer to my menses, I’m talking about years of pain, …before I started (& during) this journey.
  2. Pelvic or back pain before or during menses – Ooh, this in combination with #1…not good.  One of the BEST purchases I ever made was…a heating pad!  Most of the time, I experienced horizontal lower back pain near my tailbone.  Using the heating pad helped minimize the pain.  It also helped me sleep better at night.  This usually lasted 1 day, sometimes 2.
  3. Painful BM, constipation, etc – I think this is pretty self-explanatory.  I didn’t know before reading the book that this was such a problem for me.  I just expected it every time I got my menses.  I didn’t take anything for it but I did do some deep breathing to relax.  This lasted the entire time I bled, which was about 4-5 days.  I don’t have any good suggestions for this.  Just recognize that it’s a symptom.
  4. Infertility – Uh, this was quite obvious to me.  Becoming pregnant wasn’t happening for us so I understood this to be a factor in our inability to conceive.  I’ll talk more about this when I get to the referral.

I was never asked about my symptoms from any OB/GYN nor did I divulge all kinds of information.  I was pretty much just asked: how long I bleed and how many days my cycle lasted.  I’m not saying it’s anyone’s fault…but when I got my referral, it made a big difference.

I really hope this helps you understand what I was going through and the all frustrations I had.  I received tremendous understanding and knowledge reading the books.  I’m glad I did.  My research didn’t end there.  I still read about it and other related topics.  Knowing more allows me to make better decisions and understand what to expect.

Next post: Acupuncture