Well, that sucks

We are not pregnant.

We've been suspecting that result since about Sunday/Monday when I was still testing negative on the home pregnancy tests.  Technically, it could have just been too early (and doctors are NOT fans of the HPTs for this reason during IVF), but one couldn't argue with the stark white result window of a First Response Early Result test (of which we purchased nine to use over several days).

I pretty much resigned myself to the fact it was all a bust after the last BFN (big fat negative) on Tuesday, and said I wouldn't take any more tests until my official one on Saturday.  T and I made a plan to go out for a nice dinner on Saturday.  We could either get shockingly good news and celebrate, or they could confirm our suspicions and we'd order a nice bottle of wine, with plans to finish off a second, third and fourth bottle at home.

Then my lovely period started this morning.  It is actually unusual for it to start during IVF because I'm on progesterone and estrogen, which should "trick" my body into thinking it is pregnant.  Normal protocol is for the blood test to come back negative, then the doctor has you stop all the drugs.  Periods then come a few days after that.  But, of course, I go buck the norm and end everything earlier than expected.  The doctor had me come in for a blood test mid-morning to get full confirmation, and my beta (measure of the hcg pregnancy hormone) was a nice round zero.  I at least got my wish for the wait for results to not be so long.

So, here we are.  Definitely worn out, definitely a lot poorer, and definitely appreciating each other, T's daughter, and our furbaby.  We're working on scheduling our "WTF" appointment (one of the acronyms set in the IVF world -- T had no problems figuring out what that one meant) with the doctor in the next couple weeks.  He is, of course, testing my progesterone and estrogen levels to see if that was an issue.  We won't know much more until meeting with him -- and I'd actually be surprised if we really learn anything there, but we shall see.  

T and I are more of a"birds of a feather" couple, than "opposites attract", and both of us find solace in action and plans, rather than wallowing in self-pity.  Therefore, we're laying the groundwork for another IVF cycle and we're not sure yet if it will be again here in the US or perhaps abroad.  Stay tuned...

From T...

My wife has asked me to write a little something as a guest spot for her blog.  At first I thought it might not be a good idea, but when she told me that I didn’t have a choice it started seeming like a better option.  If you’ve read her blog up through now you know how fun/exciting/intense/horrifying this whole process is.  I would like to say that as the male it’s been a walk in the park, but sadly that’s not the case at all.

The hardest part about this whole thing has been trying to keep up with the lingo that accompanies this.  Apparently there was some secret meeting where all of the women got together and decided to come up with a special IVF language.  No men were allowed and no translations were made public.  Here is an example of a sentence using IVF language: “My DH and I are now 8dp5dt with our first beta this weekend hoping for a BFP!”  If you were able to read that cohesively then you are either a woman going through IVF or a woman thinking about going through IVF.  I am quite sure that our doctor would have no idea what that even says.

Another huge challenge was having to drink non-alcoholic beer during the Super Bowl.  That’s all I am going to write about that as it’s still too hard to think about without bursting into tears.

You would think that poking your wife in the rear with a needle would be fun.  It can feel a bit like revenge for all of the times that she was right about something and you didn’t want to admit it.  Outside of that it is not a lot of fun at all and I dreaded it each time I had to do it.  Fortunately she got switched off of that pretty quickly so I got let off of the hook.  Of course now when she is right about something (usually involving the female anatomy or past conversations we’ve had that I’ve forgotten) I have no sense of payback.

As much as I can complain about any part of the process up until now, at least there was always a next step and a light to keep working towards.  We’re now at the point that everything that can be done has been, and we get to wait and see if it all worked.  Having no next step and nothing else we can do is horrifying to say the least.  I’ll save the details for my wife to write about, but let’s just say the fear of the unknown is beginning to have a stranglehold on us both.  We certainly have our fingers crossed that this is a miracle and does work, but at the same time we’re beginning to research next steps and potential other options.

After all of that complaining the obvious question is would I go through it again knowing what I know now?  The answer would be a resounding yes.  Having said that, if this doesn’t work this time around we may decide to choose a different path depending on what we hear back from our doc.  As a bit of a gambler I think this has definitely been worth the $15,000 wager we made.  This is high stakes poker to be sure, but the potential payout will keep us coming back every time.  Especially with my wife.  I love and admire my wife so very much.  She's the bestest there ever was in fact.  I am so terribly lucky to be with her every day of my life.

no more shots!

So my crazy itchy feet won out, and the doctor switched me to a progesterone gel (versus the progesterone in oil injections). The hope is that not having to deal with the sesame oil allergy will help me get some sleep at night.  My first night last night was already much better (as in I wasn't crying), so I think we're on the right track!  The downside is that the gel goes in my hoo-ha (ick, ick) and it is about twice as expensive as the shots. 

We know have a shelf in our pantry and a shelf in the fridge devoted to more than $1K worth of drugs we didn't use, including the PIO shots and leftover stims.  I guess this is pretty common, and we'll have to figure out what to do with them going forward.  It's illegal to sell them and we can't return them to the pharmacy, but ideally we can ultimately donate them to someone (if we don't do IVF round 2 before their expiration dates).

I've definitely enjoyed my lounging around time, but I'm actually excited to go back to work tomorrow (I will regret saying that, I know).  At least it will get me back into normalcy while we wait on pins and needles for the results.

Not much else to say for now, but T has said he's planning to "guest blog" sometime next week to give the male perspective.  That could either be very funny or very scary, so be sure to check it out.

Have a fantastic week and weekend!

Artie and Herkie got in my belly!

Today was definitely a good day.  My biggest issue at this moment is trying to get the dog to not lay on my belly while I'm on bed rest.

We were so excited to not get any call all morning to tell us not to come in.  By the time we rolled into the doctor's office, I had to remind myself to not get too excited, as our embryos might be viable, but not the best quality.

Not the case.  Artie and Herkie are both graded 4AA which is essentially the BEST a blastocyst (5 day embryo) can be graded prior to hatching.  4 means the blastocyst has expanded, the blastocoel cavity is larger than the embryo (good expansion) and the shell is thinning (ready to hatch).  The first A means that there are many tightly packed cells and the second A means that there are many cells in a cohesive layer.  Here is a picture!

My mom thinks the smaller one (likely Artie) inherited my short people genes and the larger one inherited T's tall people genes.  While that is a joke, it is entirely crazy to me that we can see our unique personal genetic creations at this stage of development.  All of those traits have already been decided are in this picture.  After all the disappointments and stress of IVF versus natural conception, this is at least one area in which we have the ability to see something that is so entirely sublime and almost magical that not everyone gets to experience.

I realized I never gave any updates on the dreaded progesterone in oil (PIO) shots.  These are the ones that are the bane of any IVFer.  The needles are literally half the size of my face, and they go squarely in the glute.  The doctor drew nice targets on my back for T to use.  They are also fairly time consuming.  I ice my ass for about 5 minutes, the shot itself takes awhile (oil does not move as quickly as other shots) and then I use a heating bad for about 20 minutes afterwards.  I do these each day and if I'm pregnant, we'll continue through the 12th week.  My husband has gotten to be a pro, but we've already had to recruit my sister-in-law for some times he'll be out of town.  It is definitely the height of vulnerability to drop trough in front of someone with a 1 1/2 inch needle and an evil grin.

The other weird side effect is that I'm slightly allergic to the oil used (sesame oil).  I use sesame oil in cooking, but apparently the concentrated form can trigger allergies.  Basically my feet itch so much that it feels like they are on fire sometimes, mostly at night and early morning.  This apparently isn't unusual, and my doctor wants me to tell him if it gets worse, but it is at the point where I'm slathering my feet with petroleum jelly at night, wrapping them in plastic and then putting on heavy socks to just be able to sleep.  Thank goodness my husband and I are on forced abstinence anyway after transfer, as I don't think he is finding me attractive at all!


So now we really have nothing to do but wait for our first blood test in a few weeks.  Obviously, there is no guarantee of success, but I feel so much better that Artie and Herkie at least had a chance to snuggle up inside me, rather than never surviving the lab.   I've promised to keep them as warm and safe as I can.  In the meantime, I'm going to definitely enjoy the doting my husband is bestowing on me.  :)

No news is good news, until it is good news

In a long-planned celebration of his return from the dearths of sobriety, my husband (who I've decided to refer to as "T" from now on, as one runs out of ways to refer to him - and I refuse to use "DH") is on a day-long drinking extravaganza with his guys.  We normally have his daughter on Saturdays, but decided to switch to tomorrow since we didn't know in advance the state of mind I'd be in today.

I dropped T off at his friend's house mid-morning (there was no way in hell I was letting him near a car today) and went off for one of my awesome little pleasures -- seeing a movie by myself.  I know some people think that is weird, but I honestly love nothing more.  It's a good excuse to see movies that T has no desire to see ("The Vow" was today's outing) and I can stuff my face full of popcorn and candy with abandon. 

I settle into my seat at the 11:05 showing surrounded by goodies, and reach for my phone to put it on vibrate.  I set it on the armrest while I search my purse for my work blackberry to do the same thing.  The previews had now started, so I was raring to go.  All of the sudden my phone lights up and vibrates, and my clinic's name pops up on the caller ID.

I almost immediately burst into tears.  I spoke to a nurse yesterday to get another prescription for the vaginal pill I accidentally took the day of retrieval.  She reminded me that they'd call me if there was an issue, but if I didn't hear from them, I'd show up on Monday for the transfer.  I was very hesitant and reminded her how worried I was given all of our hope was in Artie and Herkie only (most people have 6 or more embryos dividing away in the hopes that 1-2 are good enough for transfer).  She said not to worry (easy for her to say) and that they would call if there were issues.

And they were calling.  I debated sending it to voicemail, but realized I really needed to hear it live.  I picked up the phone and whispered for the caller to hang on a second, and literally sprinted out of the movie theater, leaving my purse and popcorn and candy and drinks behind.  I reached the hallway where you walk in and sat on the floor to prepare for the bad news.

And then she says she knew that I was worried, and she was just calling to say that BOTH embryos look great.  They are exactly where you want embryos to be on Day 3.  Which means they probably look something like this (these are not ours):

Good day 3 embryos have 7-9 cells that are ideally fairly uniform in size and not fragmented.  Apparently Artie and Herkie are right there.

I blubber thank you to the awesome nurse about 50 times and run back to my seat (that mother-daughter pair behind me looked like purse looters to me).  I know all phones should be put away at this point, but I hunker down, half-crying, and manage to text T.  He responds immediately to tell me that he is smiling big time and very happy.  I'm sure the drinking that had already occurred didn't impact that giddy feeling at all :)  I'm honestly on this euphoric high that I can't get off of right now.

That being said, there is still a ways to go.  Embryos can arrest on day 4 or 5 before transfer and we still may not make it that far.  And of course, embryos that are transferred may not result in a pregnancy.  But we are not at those days.  We are at day 3, and day 3 is pretty freaking awesome.

As a side note -- THANK YOU to all of you that have reached out with your texts/emails/calls to provide support.  It was a huge debate to start this blog to begin with, because neither of us was sure that we wanted all sorts of people in our biz-nass.  But I can't even tell you how much it has meant to T and me that we have so many friends and family rooting for us.  And please know that we return the favor for all the events in your lives as well.  We love you immensely.

Artie and Herkie

Out of our six eggs retrieved, four had polar bodies (which signifies a mature egg able to be fertilized) and two actually fertilized.  Now we sit and wait and pray for those two to grow into viable embryos to transfer. 

Sigh.  I obviously would be lying if I said I wasn't insanely disappointed, but as my husband keeps reminding me, two is better than zero.  Two is better than zero.  Two is better than zero.

We have named our two potential embies Hercules and Artemis (Herkie and Artie to their friends).  Hercules and Artemis in mythology were both known for their strength --  sometimes quiet strength and sometimes in-your-face won't-go-down-without-a-fight strength.  I think we need a bit of both. 

We need to have Herkie and Artie start dividing cells - become 2-4 cells by tomorrow and 7-10 cells by Saturday.  We want the cells to be fairly uniform in size and not fragmented.

No news is good news.  If we get no call from the clinic, then we'll do the transfer at 1pm on Monday afternoon.  If the embryos do arrest or otherwise don't grow, then they'll call and cancel the transfer and we'll have to decide what to do next. 

Go Herkie and Artie :) 

A comedy of errors

Retrieval Day!  Should be pretty straight forward.  We just get up, hubby prepares his "donation", drive to the clinic, take out some eggs and we're good to go!

Except...firstly, my husband picked up all necessary drugs from here on out at the pharmacy yesterday on Monday.  I didn't go with him as I was pretty dogged down at work, and he's been such a fabulous at-home pharmacist thus far.  He walks through everything, including telling me that I would need to take a vaginal suppository this morning, as well as some Valium.   Hmmm, neither was on the list previously given to me by the doctor's office, but okey-dokey.  Left both bottles by my nightstand so I'd be good to go.

Take the suppository about 6:30am (2-3 hours before our 9am appointment).  I'm then happily laying in bed watching TV with the lovely husband, when I ask him what the circled "T" on the prescription bottle meant.  "Transfer Day", he says cheerfully.  Ummm....today is not transfer day, it is retrieval day.  #!@%^%!!^#!!!!!!!!!!!!!  Screw it, I mean SHIT!!!!   I frantically go online to figure out exactly what I took, and apparently it is some progesterone supplement.  It can be used to trigger a period.  DOUBLE SHIT!!! (There may have been some f-bombs dropped as well). 

I call my (not open yet) doctor's office, send multiple emails, and finally get a call back from the doctor telling me not to worry.  As far as screwups go, it was apparently an easy one to cure.  They basically would just need to scrub out my lady parts before the retrieval could actually occur.  Crisis averted!

We get to the clinic and get all set up.  I get all set up with my IV and really don't remember much until I'm back in recovery.  The husband and I are just chilling out waiting to be released, when the lab tech comes frantically looking for my husband.  Apparently, the semen sample we dropped off in the morning had ZERO sperm in it.  Per the tech, this occurs sometimes just due to the pressure associated with the day.  He first wants to try to get another sample there in the clinic, and if that doesn't work, they'd have to call in a urologist to try to extract some surgically.  Panic attack, breath, breath, further panic attack.

The husband is led to the "collection room" to do the deed again and comes out with a sheepish look on his face afterwards.  A few minute analysis does confirm that there are indeed sperm in this second sample, so we should be fine there.  My husband said the pressure of the "double" day, as well as the array of Playboy magazines in the room were a bit much.  He's not really the Playboy kind of guy, so he said he found himself flipping through and stopping at the articles before he could really force himself to "get to work".  I guess I should be happy about that :)

We're finally released at that point.  The doctor retrieved six eggs.   Not the best performance, but not the worst.  Based on my internet research (so it must be true), about 60% of females have 9 or more eggs retrieved (with 40% getting more than 12).  About 20% are in the 6-8 range.  Ultimately, it is the quality of the eggs that matters more.  A person could have multiple eggs, but they don't fertilize, don't mature, don't grow right, etc.  So ideally my little 6 eggs are of decent quality.

We'll know tomorrow how many fertilized.  As long as we can get 1-2 good embryos, we're set for embryo transfer on Monday afternoon.  Until then, it is couch time with the hubby for the rest of the day.  I'll certainly never turn down that.  Happy day after V-day to us!

I'm a stimmin machine

We had a bit of a worry after the Friday morning appointment.  Even after cutting down on my Repronex, my follicles were still larger than desired at that point, and my E2 level was up to about 1200 (looking for about 400 at that time).  The docs cut down on my Follistism, so at this point all three drugs I've been taking were cut by half.

Normally, my next appointment would have been on Monday, but the clinic wanted me to come back on Sunday morning, so they could check on me sooner.  So while I was worried through Friday and Saturday that my cycle would be cancelled, I was definitely happy that the clinic was on top of things.  Obviously that is their job, but it is nice to know that you are being well-monitored through this whole process.

So I got to take my sweatpants-garbed self to the doctor at 10am today -- and the doc was pretty happy with what he saw!  I don't have a huge quantity of follicles (we're looking at about 9 right now), but they are the sizes they should be at this point in the cycle.  He still had to see how my blood work came back, but said he expected no changes or issues, and they would likely trigger me tomorrow!

The retrieval occurs 35 hours after trigger, so the likely scenario is taking the trigger shot tomorrow night (Monday) and then doing the retrieval on Wednesday morning.  The embryo transfer (putting the eggs back) takes place five days later, so Monday morning I'd be back and ready for some babies.

I go back to the doctor tomorrow morning, so we'll the know definitive schedule at that point.  Fingers crossed for a smooth week!

25 shots and counting

I took my 24th and 25th shot this morning.  I feel like my abdomen should buy me a card.  "Thank you for 25 good pokes in the belly.  Cheers to more in the future." 

For those keeping track at home, that's:

19 Lupron shots
4 Follistism shots
2 Repronex shots

...with about 6 of each kind to go, and a trigger shot thrown in.  All together, I should have about 45 injections under my belt (or more literally, above my belt) when they go in to retrieve the eggos.  And then I'd start the good ole shots in the ass.  But more on that in future days.

In terms of pain for the current meds, it goes Follistism < Lupron < injecting liquid fire into your stomach, then having Chuck Norris roundhouse kick directly into the puncture site < Repronex

(I'm not a Repronex fan, in case you didn't pick up on that.)

A little background on these drugs for those budding pharmacists out there:

In the stimulation stage, the doctor is looking for drugs that trigger growth of follicles in the ovaries.  This is naturally done in a woman's body by gonadotropins (hMG), which are produced by the pituitary gland.  The two types are luteinizing hormones (LH) and follicle stimulation hormones (FSH), which work as a kind of tag team to optimally develop the follicles.

Since my docs have shut my body down, they now need to replace these hormones and even maximize them to promote growth of enough follicles to retrieve.  They can either use drugs that have naturally harvested these hormones, or ones that have genetically created the hormones in a lab.

Repronex is an example of natural hMG and is basically highly purified gonadotropins extracted from the urine of post-menopausal women (all together now -- EWWWWWWWWWW!!!!!).  Repronex contains both the FSH and LH hormones.  Follistim is a genetically manufactured drug that contains FSH.  These two will work in tandem to replicate what my pituitary gland would do in a normal cycle.

Anyway, as far as shots go, the Repronex is pretty rough.  My husband gets to play chemist and prepare the shot by mixing sodium chloride with the medication in solid form, so it can dissolve completely.  This results in about 1ml of liquid to inject.  The needle is larger than the other injections, and it honestly feels like you are shooting fire into your abdomen.  At first, I thought I must be having an allergic reaction, or something, but internet research shows that I'm in good company.  That must be what it feels like to shoot up pee, I guess.  I don't recommend trying it on your own.

I had another ultrasound/bloodwork appointment today.  This is the first one post-stimulation, so I was definitely excited to see the result.  The goal was to have a higher estrogen (E2) level, but not too high, and some growing follicles, but not too large.  My ovaries are apparently akin to a pork loin on a smoker; low and slow is the way to go.

I had follicles ranging from 7-9mm on one ovary, which is pretty ideal.  On the other ovary, I did have a follicle measuring over 10mm, which was a little advanced for this stage.  My E2 level also came back at 521 pg/ml, which is pretty high for Day 3 of stimulation (they were looking for 100-200).  The combination of the two resulted in them decreasing my Repronex for now (yay!!! Let's hope that helps the pain!).  I'll go back on Friday morning, and we'll see if that made a difference or not.  The major issue that could arise would be hyperstimulation, so the doctor is extremely careful to not have my follicle size or E2 levels skyrocket.  They weren't too concerned right now, but if it's not aligned on Friday, I could be at risk of having eggs of lesser quality (think pork loin cooked too fast and too hot), or even having the cycle cancelled.  So fingers crossed this change helps!

3 nights in paradise or a mini-drugstore, hmmm....

So apparently, for about $3,000, you can have three nights here:

Or you can have this (pardon the dark picture, but I already put everything away and didn't want to get back out to retake :) ...

I know what I would pick!  Oh, wait...oops.  Until we have a baby, my mind is not always going to think we made the right decision.  And this doesn't include the other bazillion dollars we paid to the fertility clinic today.  We've paid for some medications/injections prior to this, and we'll pay for some more in a few weeks, but this was definitely the major sticker shock day. We are officially poor!

When we were building our house last year, at every step my husband would proclaim, "It's starting to feel like a real home!"  It got to the point that his daughter and I would say it in unison any time we walked through the door of the house in progress.  This whole attitude is repeating itself again with IVF.  Every time we reach another step of note, he says, "This is getting exciting.  It just feels so real now."  Which is likely very true, but just kind of humorous to hear repeatedly. 

Anyway, the "steps" that triggered this ecstatic reaction today was (1) my baseline ultrasound and blood work and (2) the purchase of the stimulation injections or the "stims".  In IVF message board lingo, I'll be "stimming" my little heart out starting Monday, as everything looked a-ok at my baseline appointment.

Since I've been in suppression stage until now, the baseline appointment was to check that the suppression worked and my levels were at a low enough level to start the stimulation.  The blood work checks my estradiol or E2 levels among other things.  This is essentially my estrogen level, which should be low given the estrogen suppression shots I've been taking.  They want the levels to be below 75 pg/ml, and mine was 32 pg/ml.  Good to go!

Due to my estrogen being nice and suppressed already, they cut my dosage in half for the remainder of the cycle.  I'm definitely hoping this helps with the side effects, which have been pretty miserable.  I've had a horrible cold for the last couple days, and after further research and a note to the doctor, it appears that is a side effect.  My poor co-workers are bearing the brunt of that godawful noise coming from my cube.  I'm getting some hot flashes, but nothing too major, but also having consistent headaches.  I suppose my potential future children will give me headaches, so all good preparation, right?

Luckily, my sweet husband is doting on me quite a bit in the midst of my hacking and headaches, and is making a lovely shrimp linguine for us right now.  As hokey as it sounds, he has been the most amazing partner through this.  While I would likely be upset if he was anything but, given this is a true partnership undertaking, I have seen/read instances where the husband is definitely not quite as great.  And therefore I know I'm extremely blessed, especially since I get to keep him no matter what the outcome.  Thanks, lovey!