Follicle Check Ultrasound #2 Results

Hello hello! I had blood work and an ultrasound this morning, both of which went well. The phlebotomist had to take blood from the top of my right hand again (thankfully, she tapped a different vein) but it was otherwise painless. As for the ultrasound, there has been definite growth! The follicles are now all in the 15/16/17 mm range. The nurse actually used the word "beautiful" when I asked her how they look, so that's always good! Uterine lining looks great, too. They want the eggs to reach the 23-28mm range so we're getting there! A few more days should do it -- Grow, eggies, grow!

And in this case, the thing is growing mature eggs :)

We added in the Ganirelix shot last night, so for the remaining days of follicle stimulation, I will be taking those three med injections. I'm definitely beginning to feel the "growing pains" that my ovaries are going through but aside from lots of aches, twinges, and a general heaviness in my lower abdomen (which has made walking around at any other pace but leisurely relatively uncomfortable), it's not been terrible and hey, I'll take it.

So, in short, things are looking great! We are definitely encouraged and feeling like things are going smoothly and as well as we could have hoped. That being said...we do have to remember that just because things are going well doesn't mean we're guaranteed success. I don't say that to be a downer but rather to guard my own heart. This is a reality of the "trying to conceive" process and it's hard to accept when you're so invested in the outcome, but there you go. We just take it one day at a time and continue to hope for the very best, and thankfully, the positive trajectory of the process thus far has helped us remain positive and kept our outlook bright. We are certainly grateful for that!!

If you'd like to do a little light reading/watch a few informative videos on the actual IVF process (specifically the retrieval and transfer processes), here are a few links:

http://www.shadygrovefertility.com/ivf-process-getting-started

http://www.advancedfertility.com/ivfprocedures.htm

https://www.youtube.com/watch?v=eO27B563GYg

http://video.nationalgeographic.com/video/ivf-sci

Lastly, a post wouldn't be complete without me thanking you all for taking the time to read my updates, but especially, for supporting us and loving us through this process. We're glad you're here and we're grateful for your optimism and well wishes. xoxo

Updates, Day 5 of Injections and First Follicle Ultrasound

*** Note: Now that we're in the thick of things, these updates are going to become more frequent, as I have ultrasounds scheduled every day this week and through the weekend. And if all goes according to plan, the egg retrieval will be NEXT TUESDAY, with embryo transfer slated for Sunday, August 16. Wow. We're getting closer! ***

First things first: we started the injections this past Friday (July 31) and so far, so good! Mild headaches and nausea, some fatigue and some bloating, and my ovaries are beginning to ache but nothing crazy and no heart related symptoms as of yet. And I hope that continues to be the case! I know that as the medication builds up in my system, the symptoms are likely to become more pronounced, but for now, each passing day feels like a small victory. J has been such a trooper with giving me the shots -- the first, as predicted, was the hardest but now he can get them prepared in about 15 minutes and when he actually gives the injection, there is no hesitation. He told me that while he feels badly about causing me discomfort, giving me the injections helps him feel involved which is so important. I'm proud of him for working past his needle phobia and so very grateful for his help!

Icing my injection sites post-injections: Day 1, 2, and 3

Which brings us to today. After getting home around 9 pm last night from my after-work acupuncture appointment up north and getting my day 4 injections, I had blood work done first thing this morning at 7am, went to work for about an hour and then had my first ultrasound appointment at a local gynecology office that our clinic partners with for during-the-week ultrasound appointments (thank GOD -- we will travel up north this weekend for an ultrasound but I'm so thankful I don't have to make that drive every.single.day). The blood draw was a challenge, per usual. No good veins in my arms so after applying a heat pack to the top of my right hand, she finally struck gold. As for my ultrasound, I heard back from my nurse and the results are in: after 4 days of 75 iu's of Menopur + 100 iu's of Follistim, I have several follicles that are around the same size and are right where they should be size-wise at this point, so she said things are looking great! I get to skip my blood work and ultrasound tomorrow (yay!) so the next time I do those will be Thursday, August 6. I'm so pleased things are shaping up nicely!!

The only bummer I have to report is my lab results didn't come back -- and they were ordered STAT. So, the clinic is not pleased. If my labs don't come back every day, that can actually be dangerous because they won't be able to monitor my hormone levels to watch out for OHSS (ovarian hyperstimulation syndrome) and that's really bad -- lab results also help the doctor determine medication dosage. So, starting Friday, I will have to drive all the way up to Carmel every day for my ultrasounds and lab work. Huge bummer -- it will mean I have to take even more time off work and it's just an additional hurdle and hardship. So much of this process is out of our control and that can be difficult. I guess we do what we have to do and I'm just extremely thankful my boss is willing to jump these hurdles with us when they're tossed our way.

Because I didn't get my lab work back, tonight's injections will be the same as they have been. But beginning tomorrow, we'll add another med to the rotation. In addition to the Menopur and Follistim, we will add in a Ganirelix injection. So, that is where things are likely to get more uncomfortable. I know it's all necessary in order to grow those eggs but I'm definitely anxious about adding in a third medication. One day at a time...and also, grow, eggies, grow!!

Thank you all for your amazing love and support as we continue down this path! We love you!

It's GO time!

J and I are in the throes of moving to our new place and it's been quite the hectic week! Most of our stuff has been moved from point A to point B but it's the little stuff and the cleaning that we've got left -- and we shall deal with it tomorrow. What we'll also be doing tomorrow is beginning my injection medication. I took a break from schlepping boxes and instead, spent the first half of today up at our fertility clinic getting my baseline ultrasound and having a consult with the nurse. I'm pleased to report that my ovaries are, and I quote, "beautiful" and the ultrasound tech told me that my follicles are all looking as they should at this stage and each one seems to have an egg in it, which is great news! The one "benefit" to having PCOS is that there are typically more eggs to work with so we are definitely hopeful that we have at least one golden egg which will be the key to building our family.

The schedule is definitely intimidating. We will start the Menopur and Follistim injections tomorrow (Friday) and we will continue with those two for four days. On Tuesday, August 3, I will have an ultrasound to see how things are developing. At that point, they will have an opportunity to adjust my med dosage if needed and also, a third medication (Ganirelix) will be added to the mix. I will continue taking those three until I take HCG and lupron prior to egg retrieval. After that first ultrasound on the 3rd, I will have blood work done almost daily and an ultrasound nearly as often. Most of the ultrasounds and blood work will be done in town at a gynecology practice they partner with, but some will have to be done at the clinic in Carmel, which is about an hour and a half away. Additionally, I will also need to find time for my acupuncture treatments. In short, it's going to be an interesting few weeks! I am very grateful that my boss is being so accommodating, but it will still be a challenge. My schedule (which is definitely subject to change) is below. At this point, assuming all goes well and to plan, it appears my egg retrieval will be on Tuesday, August 11, embryo transfer will be on August 16, and first pregnancy test would be 10 days later on August 26!

I can't believe the time has finally arrived for us to get this show on the road! I would be lying if I said I wasn't nervous about taking the medication (and I did voice my concerns with the nurse today) but she said the doctor has started me at a relatively low dosage and the clinic has a low incidence of severe Ovarian Hyperstimulation Syndrome, so that was definitely encouraging. She told me to expect the injection sites to be quite sore and even bruised, to feel very moody, very bloated, very uncomfortable, and to expect headaches and fatigue and some nausea. All of that, while unpleasant, I can handle -- it's the heart palpitations and tachycardia issues that we sincerely hope don't come in to play. J is pretty nervous about giving me injections but he's been reading over the instruction pamphlets so I think he'll do just fine. I'm sure tomorrow's injections will be the most nerve wracking but after that, it'll become much more routine....or at least, that's what we hope! 

Please say a few extra prayers, send up good thoughts, or whatever it is you want to do to put positive energy and vibes into the universe on our behalf as we enter in to this process tomorrow -- just think, if we're successful, this time next month, we could have VERY good news to share!! 

Thank you all for your continued love and support -- this is a huge deal for us and having you all on our team truly means the world <3

Update: I just learned that tonight is a blue moon! The last one was in August of 2012 and the next won't be until 2018 -- there's something about the rarity of the event and the fact that we're starting our medication tonight that makes me feel an extra boost of positivity. Once in a blue moon...

The Fertility Diet

*Side note: we're moving to our new place in T-3 days...things are about to get crazy!

I've been asked to adhere to a strict fertility diet, which will (supposedly and hopefully) help my system grow healthy, good quality eggs. And, since we're spending a small fortune on this venture, it behooves of me to follow their guidelines. Which, as you'll see, outright contradicts itself at one point. Before we started eating this way (Jason is so kind to eat what I'm eating {well, mostly} so I'm not alone in this sad little diet plan), we treated ourselves to burgers and fries and ice cream. It was a good day. So, what exactly am I eating these days?

• Mostly organic or locally sourced, to avoid excess nasty hormones/pesticides entering in to my body, including: chicken (as often as I can find it), eggs, fruits and veggies. So, our grocery bill has seen an uptick these last few weeks. 
• BPA-free canned goods (which includes pasta sauce in glass containers). 
• Wheat-free as often as I can (and since I'm already eating mostly gluten-free these days, that's not hard).
• Less dairy, especially what is considered "cold dairy", ie ice cream (boooo), yogurt (although Kefir brand is okay, because it's so high in active cultures...spoiler: it's gross), and milk (we've temporarily switched to almond milk for cereal). I've been eating small portions of cottage cheese, though, for the benefit of the protein.
• Lower sugar fruits, to try and help control my insulin resistance issues due to the PCOS: blackberries, raspberries, nectarines, cantaloupe, watermelon.
• Leafy greens, such as broccoli, kale, swiss chard, red leaf lettuce.
• Prenatal vitamin every day and lots of water.
• No caffeine, no alcohol, and no soda (I don't drink caffeine and I don't drink soda so again, easy peasy for me).
• Cut down on the sugar intake in general, so sweet treats are far and few between these days.
• Salty snacks and Gatorade (when I start taking the meds) to help absorb the excess fluid in my body due to the bloating from the medications...and this is where the diet contradicts itself. I've read other IVFer's blogs online where they've eaten Chinese food to help ease their bloating and it really helps! See, ordinarily, if you're not horribly bloated, all the sodium would CAUSE bloating, but since my body is going to be so bloated from the hormones in the meds, the high volume of sodium will actually help ABSORB the water and thus decrease the bloating and most importantly, help keep Ovarian Hyperstimulation Syndrome -- which can be seriously serious, especially for women like me with PCOS -- at bay. I'll be drinking a lot of fluid to help pee it all out, too. So, once I start on the meds, I've been given the green light to eat a crappy, high-sodium meal now and again. Hooray!
• Specific approved "fertility diet" foods include: broccoli, strawberries, oatmeal, salmon, tomatoes, spinach, brown rice, pineapple (limited), kale, sweet potatoes, melon, walnuts, eggs, hummus, chicken, olive oil for cooking, and avocados. 

And there you have it. A typical breakfast for me is gluten-free oatmeal with cinnamon, a tiny bit of brown sugar, walnuts and almond milk. Lunch has been hard boiled eggs, rice cakes with peanut butter, a nectarine, blackberries, and cottage cheese with pickled cucumbers, onions, and tomatoes, and sometimes hummus with raw veggies for a snack. Dinner ranges from a lean meat (chicken or turkey), rice or potatoes, and a veggie, to a gluten-free pasta dish with a veggie and salad. If I have dessert, it's a gluten-free cookie or popcorn.

I know this may seem restrictive and it certainly is, but I'm willing to do whatever they suggest if it will help our success rates. In all honesty, I've been eating pretty close to this way for a long time now, in conjunction with the recommendations my heart doctors (lean meats, no caffeine) and other infertility doctors have made (low sugar, no soda, leafy greens) over the years, so this isn't too hard for me. But of course, now that I've been on this diet, I've been craving bagels and cream cheese, Mexican food, pizza, etc. I've already decided that my salty "cheat" meal once I start the meds will be Thai food. Yummmm. Counting down the days!

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What's next? I stop my birth control this Sunday and await my cycle. On cycle day two, I head up to the clinic for a baseline ultrasound and then begin injection medication on cycle day three. Which means we are mere days away from officially starting this process. For reals. Wow.

Holy moly, this is really happening!!

Gearing Up! aka Sh*t is getting real

So, stuff is happening. We were approved for our loan (hooray! And also, holy crap, that's a lot of money) and we will hopefully sign paperwork for said loan tomorrow when we are at the clinic for our medication training. I will also have an acupuncture appointment right after the training, so I am definitely looking forward to that.

Speaking of the medication.... The good news: I applied for and was accepted in to a discount program for two of the most expensive meds I will be taking. In all, the discounts will save us close to $900, so that's awesome! The not-so-good news: I've had issues with the pharmacy company. Lots of issues. I spent no less than 5 hours on the phone with six different reps over a two-day span. It's a very long story and I won't bore you with the details, but long story cut very short, my meds were supposed to arrive yesterday but they didn't because my order fell through the cracks. More than once. And I had to keep calling to ensure that my order moved forward through the process, step by painstaking step. The meds were FINALLY shipped yesterday afternoon and they arrived this morning. I am just thankful that our clinic has had enough experience in working with pharmaceutical companies to know to request an order far enough in advance so that if they drop the ball, it's not a game-killer. {FYI, I spoke with a quality assurance person yesterday and we will be receiving a substantial Walgreen's gift card in the mail for my trouble. So, at least there's that.}

Behold, the bounty that is my medication:

Yes, this is all for just one cycle. And notice my Sharps box? Professional.

Even though I've seen other people's IVF medication pictures online, the sight of all of my medication makes me a little bit nauseous (okay, maybe a LOT nauseous), because I can't *quite* believe it's all going to go in ME. And yet, I knew this was part of the process. Even though I honestly don't want to do these injections and wish I didn't have to, I'll do it. I'll dose myself (and J will dose me, too) with however much of this stuff I'm required to take for however many days (usually 8-12) and we will hope my body can handle it. Each dose of medication will bring us that much closer to our goal. And THAT is what I'll focus on with every injection, every blood draw, and every ultrasound leading up to egg retrieval and then leading up to embryo transfer, and beyond. Our family is worth it. One step closer...

Mind Your Mind

I ran across this quote quite randomly yesterday but I loved it, so I saved it to call upon when I'm not doing the best job tending to my negative thoughts.

"Energy flows where your attention goes. What you think about will come about. Mind your mind."

Mind my mind. What a novel idea. Negativity will NOT be the underlying story of this process. Positive energy will. I started saying the following to myself, chanting it to myself when I feel less than optimistic: My body is a sacred vessel. I know that sounds uber religious of me, but I need to believe it. I need to believe that my body isn't broken, that it can do amazing things. It can grow our very own little miracle, if given the chance, and a chance it shall have.

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Updates:

1) Thursday, July 2, Dermatology appointment -- all moles and freckles are fine! The splotch on my nose is...a sun spot. So, facial sunscreen will become part of my morning routine. There has been a lot of chatter about good sunscreen vs. bad sunscreen so I did some research and found that the bad sunscreen has been shown to mess with hormone levels (mainly estrogen and progesterone) which is most definitely NOT what I need. So I found a good sunscreen option in Burt's Bees and am enjoying the delightful hibiscus and apple scent, while appreciating the benefits of the SPF 30.

2) Friday, July 3, acupuncture appointment -- my acupuncturist, Kate, is awesome! We spent a good while talking about why I was there, what I hoped to get out of acupuncture, and my fertility history. This particular acupuncture clinic specializes in fertility acupuncture, and it's the only one of its kind in the whole state. So I feel very fortunate that it's right across the hall from our fertility clinic! Kate will work in tandem with Dr. C, formulating my acupuncture treatments around where we are in the IVF process. The larger picture will be to try to calm any anxiety, encourage uterine lining growth and egg follicle growth, while combating any negative side effects from the medications (excessive bloating, headaches, abdominal pain, etc). I had my first treatment after my consultation and was so relaxed by the end, I couldn't believe it. I only felt two of the needles go in but the rest were virtually painless. I have another appointment on the 17th, and then during the follicle stimulation phase, per IVF treatment protocol, I will be seen two more times. Then I will have a treatment on embryo transfer day, with the final one in the week following. We feel really good about adding this to our process -- if the only thing it does is help me relax and keep my head in a good place, it will be money well spent.

3) Meds ORDERED!! -- thankfully, my period arrived on Thursday and I started taking my second and final birth control pack last night. So, as instructed I called the clinic this morning to order my meds. Of course, I had to leave a message (I have yet to call and actually speak to a nurse right away) but the nurse returned my call just about two hours later. Sherri (Dr. C's nurse) will place my medication order with the pharmacy and I will await a phone call directly from the pharmacy itself, at which time I will be required to make the payment for them in full. They are ordering five injectable meds: Follistim, Menopur, Ganirelix, HCG (hormone trigger shot I'll use 36 hours prior to egg retrieval), and progesterone shots. I just read through the side effects for each and let's just say I stand to be quite uncomfortable. It will ALL be worth it if it gets us our family!! I also had to make an appointment for J and me to get injection medication training, which will be Friday, July 17 at 10 am, which is also the same day as my next acupuncture visit. After spending an hour learning how to inject myself with hormones, I think relaxation will be in order...

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Things are happening and it seems a bit surreal. In reality, we've been inching our way towards this process for years, at times kicking and screaming -- we just weren't ready to give IVF a try when we were 26 and even though we're actually worse off now financially than we were then (by a lot, actually), we feel so much better about the whole thing. We've made peace with it, and we're actually getting excited about it! Even though it's scary, and even though there are so many unknowns yet to be figured out, and so much of this is wait and see how my body responds, and SO MUCH MONEY is being spent that we don't have, the fact that this could lead us to our family gives us the strength to keep soldiering on. For the first time in years we feel hopeful. We feel like there could be a miracle for us just around the corner, and we just have to keep moving steadily onward.

J has his oral exams tomorrow and will defend his doctoral dissertation on July 20 (!!). That following week, we will move in to our new home and I will start taking my meds -- yes, the very same week. In fact, this time next month, we could be readying for the egg retrieval. Seriously, it's that close. Yes, things are indeed happening. And we are so SO ready!

Ready to get the ball rolling

Unbelievable as it may seem, we are just mere weeks away from officially beginning this IVF cycle. But I guess in some ways, it's kind of already beginning - my meds are being ordered this week (well, they will be ordered if and when my stupid period arrives...I'm still waiting...more on that in a minute), and I have my very first acupuncture appointment on Friday! There is a lot of good data surrounding undergoing acupuncture in conjunction with IVF treatments (increasing the odds of success and decreasing the miscarriage rate) so while it will be yet another expense, we feel it will be well worth it if it helps. Kind of neat to be blending the old art of Chinese medicine with advanced fertility technology! Plus, if it helps me relax during this process, I'm all for it! I just have to make sure they only use manual stimulation needles, not the electric ones because the electrical impulses would interfere with my pacemaker settings -- but they're aware and I was assured that they mainly use the manual stimulation anyway, so that won't be a concern. I'm a little nervous but excited too - we're on our way! I've included a few links about IVF and acupuncture below if you're interested:

http://indianareproductiveacupuncture.com/ivf-support/ 

http://americanpregnancy.org/infertility/acupuncture/

http://www.fertilityfactor.com/infertility_acupuncture.html

http://www.webmd.com/infertility-and-reproduction/features/ancient-art-of-infertility-treatment

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J had his semen analysis last Thursday and the results came back today. His numbers were high (364 million sperm per milliliter -- normal is considered between 40 - 300 million, so he's a bit above that). The rest of the analysis fell within normal limits, except for one thing: motility. The way the sperm move is a bit sluggish (which could be due to his high numbers) so Dr. C is recommending that we do ICSI (where they inject the semen directly into the egg) for half of the eggs they retrieve while allowing the other half to try and fertilize "on their own" in the petri dish. This will be yet another expense but if it's what needs to be done, then it needs to be done. We certainly wouldn't want go through all of the process only to find out none of the eggs fertilized and it could have been prevented. The ICSI may need be necessary anyway, if my eggs prove to be hard to penetrate, so if that's the case, all will have to undergo the ICSI procedure and not just half. We will just have to wait and see.

As for my lolly-gagging period. I called the clinic earlier this morning and spoke to a nurse. I told her that in the past when I've been on birth control pills, my cycle usually starts by Tuesday once I started taking the "sugar" pills (I've always been a Sunday starter with the packs), so it's alarming to me that it's Wednesday, and my period is still MIA. The nurse said that this can happen as your body adjusts to the pill and that it could just be delayed in starting, or it could be that my uterine lining has been really thinned out by the pills (which can happen) which means there's not much there to shed. She suspected that it would arrive by this weekend (I really only need to bleed a day for it to count as a cycle) but if not, I'm to call on Monday and let the doctor decide what to do next. She brought up that I may be required to take meds to bring on a period (which would take another 10 days!) or the doctor may decide to just have me start my next pack even without a bleed. I told her that it was VERY important to us that we don't get off track here, which is what would happen if I had to take a 10-day medication to bring on a cycle, because of J's teaching schedule. School starts August 24 and after that, his availability would be very limited. I definitely panicked a bit and she said not to worry, that the doctor would probably just have me start the next pack and she said again that it's likely my period will arrive by the weekend. Deep, cleansing breaths. Seriously, how are people supposed to remain calm during this process?

Lastly, and totally unrelated, I have a dermatology appointment tomorrow to check out a suspicious blemish on my nose. It's been there for over a year and it's not a pimple and it's not a mole or freckle (from what I can tell) so I'm trying not to panic...but it's me and let's be honest: I'm prone to panicking. We only have one dermatology practice locally and they have a 6-month wait for new patients (!!) so I put a call in to IU Health in Indianapolis and they had a last minute cancellation for tomorrow afternoon. So, I took it. I also have some other moles I should probably have examined just to be proactive and responsible, so it's a necessary appointment but I'm very nervous. If anything derails our IVF process, I will go ballistic. And, I really can't handle another health crisis, so let's hope it's nothing serious. My co-worker looked at it today and she thought it may be basal cell carcinoma (she has a lot of experience with skin issues) but assured me that they can remove stuff like that pretty easily these days. Even though I don't wear a daily SPF on my face (yes, I know I should but I don't), I am not a sun worshiper, I've never been to a tanning bed, I don't smoke and never have, I don't even sit out in the sun to just "soak up some rays" with any frequency, and I tried to wear sunscreen as much as I could growing up. But regardless, something is on my nose. Positive thoughts!