Trigger Happy

We got the OK to trigger tonight for a Friday morning retrieval!  Ganirelix at 9 tonight, Lupron #1 at 10:30 tonight, and Lupron #2 at 8:30 tomorrow morning.  And then back in for one final blood draw to make sure everything is working.

My estrogen today: 3,999.  That’s up about 2000 in just 2 days.  That’s doubled in 2 days.  Yikes.  My ultrasound showed that 8 follicles are ready now (18mm+) and 6-7 more that should be ready to go by Friday.  I will be so happy with 10 good eggs, although my estrogen suggests a lot more than that.  We’ll see.  We’re guessing it will be between 5000 and 6000 by retrieval.

I’m ready.  I’m sore and full and moody.  My head is achy and, as usual, I am exhausted.  But we’re so close!  The worst part is almost over. 🙂

In Terms of Arnolds…

When we had our first meeting with Dr T and he told us that I am an excellent candidate for Lupron Trigger Protocol, he told us he would be throwing everything he had at us.  And we, being excited and hopeful, said, “WOOOOOHOOO, IVF!”

My estrogen hit just over 2000 yesterday. ?!?!  It’s expected to hit 3000 by the time I go in for monitoring tomorrow morning.  Lord have mercy, I am SOOOO UNCOMFORTABLE!  I’m still at a doubled dose of gonal-f and menopur.  He’s still trying to bulk up the smaller follicles.
At my appointment yesterday, my nurse guessed that I’d have between 10 and 12 follicle for retrieval.  That’s much better than 7 and they’re not done growing yet.  In terms of Arnolds, this is how they looked yesterday:

The left is rather unimpressive.  Happy to be here, but only sporting 2, maybe 3 13mm follicles.

The right, however, is a beast.  10+ nice size follicles with many smaller ones as well.  It means serious business. 😉

So I inject again tonight and the plan is to trigger tomorrow and then go in for the retrieval on Friday.  Hopefully tomorrow’s blood work will support that, because I am ready for this to be over.  I’m thankful that we get the opportunity, but IVF is no fun.

We might actually have some embryos this weekend!! 🙂

2014!

Well, 2013 is officially behind us and I am so excited!  2013 was a big year for us.  I finally got a diagnosis, had my lap and lupron, had 3 more IUI’s, started looking into adoption/foster care, moved to North Carolina, sold our house, and finally got IVF coverage.  A year ago I wouldn’t have been able to fathom all that happened this past year.  It was a hard year, but it was so productive.

Our current timeline looks like we’re about 4 weeks out from my egg retrieval and 7 weeks out from our first transfer (give or take a few days here and there).  I’m not nervous yet.  Just excited.  All 6 of our IUIs filled me with complete dread.  My goal is to go into our transfer feeling calm and positive.  So far, so good. 7 weeks to go… 🙂

We had our IVF education class on Tuesday.  It was basically going over all of the various medication and how to inject them.  The class consisted of us and another couple who were obviously new to fertility treatments.  Jeremy and I sat and took it in.  There wasn’t much that we already didn’t know.  The other couple took notes frantically on everything the video was saying.  I feel bad for them because the video did a good job at scaring you with medication side effects.  I wanted to hold their hands and tell them it’s all going to be ok either way.   They looked nervous.  Did I look that was when we first started?  Do I still?

The one difference we learned at this class is that they don’t want subcutaneous injections injected into my belly like I usually do.  They want it done intramuscularly into my upper arm.  When I asked her why, she told me they’ve found they get better responses to the meds that way.  Good enough for me.  Follistim, menopur, and ganirelix acetate in the arm, progesterone and lupron in the butt, and then baby aspirin to fight the clotting.  Excellent.   Jeremy didn’t realize that progesterone in oil injections are daily.  Poor husband.  If you remember, Jeremy doesn’t like needles.  I made him promise when we moved here that he would suck it up and give me my injections because our clinic is a good 40 minutes away.  I used to drive to Dr. B’s for my lupron and novarel injections, but that’s not really an option any more.  Hopefully after the first few, he’ll be a little more desensitized. 😉

That’s all for now.  Just waiting for my period to start. WOOO, periods!! 😉

36: IVF, Here We Come!

Today marks our 36th month of trying.  That’s 3 years.  I haven’t felt the need to discuss the past couple because it wasn’t like we were going to magically get pregnant naturally.  lol.

Anywho, we met Dr. T this evening.  It’s true what they say that everything seems to move a bit slower down south.  Our original appointment of 3:30 got pushed to 4:30 and we didn’t actually see him until 5.  He was, however, quick and efficient, less personable than Dr. B, but I don’t need a new friend.  I need a doctor who can perform a medical miracle.  I need a doctor who has found a way to combat OHSS and a doctor who tells me my chances of conceiving are close to 70%.  I need a doctor like Dr. T.

Enter: Lupron Trigger Protocol.

In normal IVF, you take birth control for a couple weeks to settle everything down.  Then you move on to heavy injectables that stimulate the ovaries into creating ridiculous amounts of follicles (and therefore eggs).  You then use an hcg trigger to trigger ovulation.  Then you go in for your retrieval where the doctor sucks all of the eggs out of the follicles, combines them with some sperm in a lab, and transfers embryos back into you 3 to 5 days later.  Any leftover embryos are then frozen.

With Lupron Trigger Protocol, you still take birth control for a couple weeks and then move on to really heavy injectable to stimulate the ovaries.  Instead of triggering with an hcg injection, you trigger with…. a lupron injection.  It still causes ovulation, but it effectively squashes your estrogen and uterine lining.  The eggs are then fertilized and the resulting embryos are frozen.  During the next cycle, you take a couple low dose estrogen injections and then have a frozen embryo transfer (FET).

The reasoning for this is 1) The lupron trigger eliminates (or so Dr. T says) the chance of OHSS because it lower the estrogen.  We saw last summer than I react well to lupron.  We don’t need to be afraid of really beefing up my ovaries. Excellent. 2) Dr. T believes that the estrogen numbers with fresh transfers a couple days after a retrieval are too high for optimal embryo health.  I can see that.  Waiting until the following cycle allows him to create the perfect embryo environment.

This plan sounds awesome to me.  Every time I end up with OHSS they tell me that it will have no effect on our chances of conceiving, but I have a really hard time believing that.  I worry every time that it’s going to impact us because my body is angry and in pain and that can’t be conducive to baby making.

Lupron Trigger Protocol used to be done with fresh transfers until they realized that it didn’t work very well when it came to maintaining a pregnancy.  They’ve done a great job at tweaking it and the miscarriage rate is as good if not better than an hcg trigger fresh transfer.  Dr. T has put our chance of conceiving around 70%.  Dr. B had only given us a 40-50% chance.

Another excellent thing?  Because we’ll be able to push the meds and retrieval process so hard, we should end up with a good number of frozen embryos.  A frozen transfer with this clinic is only $1000.  That’s what we paid per IUI in Chicago.  We could end up with our entire family in one go.

So what’s going on in the meantime?  This month, Dr. T wants to schedule a saline ultrasound.  I’ve never had one.  I’m not looking forward to it.  😦  He also wants to do a couple other blood tests because a lot of my original tests from Dr. B are over a year old.

After that?  We’re ready to roll as soon as my period starts in January.  Wooo hooo!!

IUI #4/1

Welllll, IUI #4/1 is done!  It actually happened on Thursday, but things have just been a little busy.  Plus, the novarel trigger really knocked me on my butt.  I’m EXHAUSTED!  Not to mention, ovulating 5 eggs is a little painful.

For the first time ever, they had to warn us that we’re high risk for multiples (they estimated my estrogen was over 1000 — easily 4 mature follicles) and that Dr. B usually recommend selective reduction if there’s more than 3 babies.  Yikes.  Crossing fingers and toes that’s not a decision we’ll ever have to make.

Other than that, it seemed to go well.  I usually cramp like crazy during and after an IUI, this one, however, was surprisingly peaceful. 🙂  I’m thanking the lupron/lap for that.

I’m going to start testing out my trigger on Sunday when I start my progesterone supplements.  

How am I feeling now?  Remember last Halloween when I was on bedrest after IUI #2? I had managed to produce just 2 follicles, but had some pretty uncomfortable Ovarian Hyperstimulation.  Take a guess as to how great that’s going now with 5 follicles.  Yep.  It’s BBAAAAACKKK…. 😦  It hurts to move and to breathe.  They told me to stay off my feet and keep them propped up over the weekend.  Also, to go to the ER if I start to have trouble breathing.  YAY!   It’s just a bummer because OHSS is usually something that is mostly attributed to IVF.  I’m just one of the few lucky IUI OHSS cases.

No matter what, though, this has been our absolutely best shot yet.  We’re torn between being crazy, super hopeful and very very cautious.  I’m calling this IUI #4/1 because while it is our 4th IUI, it’s our 1st post endometriosis IUI.  

I’m 25 years old.  My body is clean of endometriosis.  I just produced 5 follicles and at least 4 of them were mature.  I have a ridiculously good chance of becoming pregnant with not 1, but multiple babies.  I think I have a right to be excited.  I’m working on it.

Off to drink my gatorade and keep these feetsies propped.  My pile of pillows is seriously 2 feet high…. 😉

** As a side note to anyone who reads this blog via facebook — Sometime next week I will stop posting blog posts to facebook in case this cycle works.  So, I would suggest that you hit “subscribe” and have these exciting posts delivered straight to your inbox.  🙂

Summer 2013. As told by bloodwork.

What a crazy summer.  The lupron debacle is (hopefully) over for good.  It was really ok until the end.  Now for a very long story time, yes?

The hotflashes, fatigue, and headaches were consistent starting at the second injection and only got worse as time went on.  Two days after my third injection, we met with Dr. B to discuss the plan.  I assumed 4 weeks from them we would be ready to start trying again.

We went into that meeting with him happy and hopeful, but came out of it confused and disheartened.  More than once during that meeting, Dr. B asked us if we could afford In Vitro or if we could get our insurance to cover it.  We were confused because he had always told us that IVF wasn’t necessary for us, that I would be fine once the endometriosis was cleared up with the lupron.  He claimed that our best bet would be IVF.  While that’s probably true, IVF isn’t on the table.  It is not an option for a number of reasons, mainly because if we’re going to pay for it out of pocket, we’d rather pay for an adoption.  They’re similar enough in price, but at least with adoption you’ve got more of a guaranteed that you’ll actually get baby.  No IVF.

That being covered, he also told us that it could take 6-8 weeks for my period to come back.  WHAT?!  And no, he wasn’t comfortable starting it again with medication.  Ugh.

Next? The heart, the thyroid and the clotting.  He wasn’t quite sure how actually sustaining a baby once I actually managed to get pregnant would go.  He suggested we meet with an oncological hematologist to be sure.  Yikes.

Then we left.  And I went and drank a large amount of rum while I tried not to have a complete melt down.  It helped.

A week later, we met with Dr. P, a oncological hematologist.  LOVED HIM!  He explained that my thyroid is fine.  Right now.  But, it might not be strong enough to sustain me AND a baby.  Clotting?  Also fine. Right now.  But it might prove to be a problem when a baby pops into the equation.  HOWEVER, he assured us that while neither of these things are curable, they are treatable.   He said with all the information that he had in front of him, he would encourage us to keep trying and to just keep in mind that it would be wise to monitor my blood and thyroid frequently throughout any subsequent pregnancy.  Whoosh.

The heart is another problem.  I seem to have every dna marker that could come with a genetic predisposition to heart disease.  I have sets from both parents which is interesting because my mom’s side of the family doesn’t seem to have the extensive heart problems my dad’s side does.  That being said, he told us I *could* potentially develop heart problems in my 40’s.  That’s just 15 years from now.  BUT, he also said, I could be perfectly healthy then as well.  It’s a guessing game.  

The heart business threw me for a loop.  He made it clear that everyone, if their bloodwork was analyzed to the extent that mine was, would come up with some kind of marker that suggested an early or painful death.  I’m just unlucky enough to have had mine done at such a young age.  I realize that.  I realize it’s not a death sentence.  I realize that I can take care of myself and be just fine.  But it also, over the course of a couple weeks, threw my life and the life I want to lead into perspective.  More on that in a bit.

One week after my last lupron injection, potentially 5 weeks before I should have had a period, I had my first post-lurpon period.  Now, I spotted and bled my way through lupron, which is unusual, but does happen.  This, however, was a full period.  The nurses at Dr. B’s were shocked and had to ask me if I was sure… Still in the lurpon rage, I snapped that I knew what a period looked like.   They told me to come into the office in 2 weeks for an ultrasound and bloodwork.  Yippie.

On July 22, I walked into the ultrasound room only to find the tiniest little follicles you ever did see.  Not enough to count.  Estrogen?  Still in the low 50’s.  “Come back in 2 weeks,” they said.  Great.

2 days later, I had my second post-lupron period.  I called in again.  They said they had no idea what was going on.  Dr. B said this never happens.  He thought my body was trying to fight the lurpon, but didn’t have enough estrogen to get anything done.  Come in for an ultrasound and bloodwork in 2 more weeks, they said. =/  

2 periods in 3 weeks, 3 months of lurpon, and general anxiety took its toll.  I had to drop my summer class.  I just couldn’t do it.  Thankfully, my school understood and allowed a very late withdraw.  I felt like a huge failure for a couple weeks.

On August 6, this past Tuesday, I went in for what promised to be another let down.  The cramping was back, as was the spotting.  Period #3 was on its way just 2 weeks after the second.  No follicles.  Nothing.  I suck.  Estrogen?  Lower than low.  At this point, we’re 5 weeks past the 3rd injection.  

And then they called.  “Your hormone levels are so flat,” they said, “that we don’t think you’ll get another period for quite some time.  Dr. B thinks it would be best to start injectable medications again.  Do you have any gonal-f?”  I only have  2250 units in my fridge.  That’s 5 boxes.  YES!

And so, as of this past Tuesday, I’m finally back in the game with 112.5 units of gonal-f injected into my menopausal tummy every evening.  Finally.  And Dr. B didn’t want to intervene.. 

Today’s ultrasound?  MANY 8mm follicles and estrogen that’s already up to 157.  I can’t tell you which cycle day this counts as since things were so wonky.  I can, however, tell you that when my estrogen is usually at 157, it usually indicates one 19mm follicle.  So the mystery at this point is… how many follicles are going to end up surviving?  My bet? 3. OMG.

We’ll find out on Monday.  Have a nice weekend.  

It’s good to be back. ❤

4.5 Weeks to Go!

I know I’ve been noticeable absent over the past 5 weeks.  I’ve been just living and being.  While I definitely don’t feel 100%, I don’t feel as bad as I was expecting to at this stage in my lupron therapy.  I had my second injection 3.5 weeks ago, which means my 3rd and final injection is on Monday afternoon.  The hot flashes, headaches, general lack of energy, and epic lack of focus have been my main complaints.  I don’t find myself being too much more moody than normal, and if I am, it’s usually because I’m not feeling well.

I still feel astronomically better than I felt when I was taking clomid last summer and a fair amount better than I did before my lap in April.  And I think that is absolutely ridiculous.  I’m looking forward to getting the lupron out of my system and just being healthy for a while.

What have I been up to lately?  We’ve had lots of house guests who have kept me nice and busy.  Jeremy’s aunt and cousin came for a few days at the end of May and his brother and his brother’s girlfriend were here visiting over this past weekend.  Getting ready for and spending time with everyone has been a huge help in making these past 8 weeks fly by.

We also put up our fence!  We had a little bit of help from one of our neighbors and Jeremy’s dad, but we put the whole thing up mostly on our own.  It’s not perfect, but it has made for some very happy hounds. We still need to trim the posts down.  It looks a little ridiculous right now.  It’s been so nice to have them out with me while I garden.

Speaking of gardening, I’ve put so many new flowers into my garden and a lot of the older ones are blooming.  It’s just beautiful!

I’ve been waging war against both the bunnies and the slugs, and for the moment I think I might actually be winning.  Lots of plants have been eaten right down to the ground, but I’m crossing my fingers they come back now.  My wildflower patch has just started blooming, so I’m expecting some beautiful pictures in the coming weeks.

I started teaching last week and it has already proved to be an experience.  It’s only 3 hours of actual teaching per day, but that on top of the lesson planning and grading AND the theory of writing class I’m taking AND the lupron has me feeling pretty run down at the end of the week day.  But, I love my students.  I’m especially fond of the 9th graders.  I hear most teachers hate teaching the younger high school students, but I just love them. They leave me with a smile on my face almost every day. 🙂

I have few other projects to share as well as an update on how our due date day went, but I’ll leave that for another post. I’ve got papers to grade! YIKES!

I’m getting antsy for these next 4 weeks to be over!!

10 Weeks to Go

10 more weeks on Lupron (Well, 9.5 now, but you know).  Ugh.  The first two weeks seemed to go really fast.  Now, however, it’s really dragging.  However, I was the matron of honor in a friend’s wedding over the weekend, so that was an excellent distraction.

Remember the bridesmaids dresses she picked out for her wedding from this post?  Last August, I really thought I’d be very pregnant by now.  These bridesmaids dresses reflected that.  While I’m definitely not pregnant, this dress did an awesome job of covering up the Lupron pouch I’ve started developing below my belly button.  It made me feel a little more comfortable in my body, and we all looked fantastic! 🙂  It was a gorgeous wedding!

The highs I was feeling are quickly going away.  Now, I feel perpetually irritated.  At everything.  I hear that’s pretty normal though.  In a week and a half, I get injection #2.  I’m both looking forward to it and dreading it.  Looking forward because it means 2 out of 3 injections are done.  Dreading it because that’s when menopause symptoms really start to kick in.  Yuck.

 

11 Weeks to Go!

Week one down!  Last week flew by and I’m hoping that means the next 11 will as well!

This past weekend was weird.

Saturday, after sharing the same car for the past 6 years (a basic two door Toyota Yaris), Jeremy and I bought a second car.  We went round and round with what we wanted to buy.  Originally, we thought a cheap beater would suffice to get one of us to and from work.  However, it was proving really difficult to locate something decent that we could pay cash for. 

After some long discussion, we decided to take out a car loan.  But then came the decision as to what kind of car we wanted.  We could get a small, 4 door sedan that wouldn’t cost us much and would be easy to get a car seat in and out, but the dogs wouldn’t fit.  Or we could get a small SUV that would comfortably fit us, the dogs, and a baby or two.  Ugh.  Haven’t we done this before?  Didn’t we just buy a house with plenty of room for babies?!

We decided to go the responsible and hopeful route and bought a used Honda CRV so that we didn’t have to buy something bigger in a year.  It has so much space… =/  The dogs fit in the trunk which leaves the entire back seat open for… something…

Don’t get me wrong, I love this car.  It feels like such a luxury to have power doors, windows, and cruise control! 🙂  It just reminds me greatly of what we don’t have to put in it.  Much like the house.
Interestingly enough, 7 months ago, after we found out we were pregnant, we discussed trading our car in for something more family friendly.  We decided we could push it out and buy a car in May.  This May.  I didn’t think about that fact until we had already signed all the papers.  Hmm..

Mother’s Day wasn’t as brutal as I thought it was going to be, although it still wasn’t pleasant.  We didn’t see anyone and I think it was just as well.  I was pretty weepy off and on all day.  I had a couple friends wish me “Happy Mother’s Day” and acknowledge our baby and as sad as it was, it was so much of a relief to have our baby mentioned and remembered.  It hurt a little less to know I wasn’t the only one thinking of him or her yesterday.  🙂

I’ve packed my subbing schedule this week, so I’m expecting it to fly by as well.  10 weeks will be here before you know it!

29: 3 more months

We saw Dr. B today.  We were expecting him to fill us in on what kind of IUI we’re doing next, give us some pretty pictures, and send us on our happy way.

OF COURSE, that didn’t happen.  He has decided there’s a good chance that there may be more endometriosis lurking under the surface and he only gave us a window of 1 to 2 months before it comes back.  His solution?  Lupron.  For 3 months.  He thinks that will give me a 1 to 2 year window of being relatively endometriosis free.  What is lupron?  It’s an injection that shuts your reproductive system down to allow the endometriosis to heal.  It’s a whole lot like menopause.  It’s also used to treat cancer.  

I wanted to start crying right then and there.  While it might be an effective way to treat endometriosis, I’ve heard nothing but bad things about the side effects.  All I can think of is how completely horrible I felt when I was taking Clomid last year.  This will probably be worse.

He made the case that my quality of life will improve significantly if the lupron can successfully eliminate the endometriosis symptoms I’ve been living with.  It’s pretty impossible to argue against that.  It’s true.  I always feel bad, something always hurts, and I’m always just exhausted.  But this drug scares the bejeezus out of me.  Googling it brings up nothing but horror stories.  However, I know women who have taken it and, other than some God awful symptoms, been fine afterwards.

So we told him if our insurance will cover it, we’ll do it.  What else can we do?  I trust Dr. B.  I know that he knows what he’s talking about.  I made him promise me an IUI right away after we’re done with it.  No natural cycle.  This needs to be over.  I’m going to hot flash my way through this summer… again..  fml.

And so, I will be more than halfway to 26 by the time we start trying again and close to halfway to 27 before we have a baby at this point.  Our earliest due date?  One year from now.  I would like to start drinking heavily now….

Also, the birds who live in my yard are very fertile.  A-holes…