Monthly Archives: February 2012

Thumper

14 Tuesday Feb 2012

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Okay…this will be quick because currently the white of the computer screen causing me to feel like Thumper and his 10 little brothers are having a Mexican fiesta behind my forehead.  Thats right…a headache, and one of the serious migraine proportion.  One of those headaches where the only respite is to lie in a dark room void of all noise, including the sound of the light breeze outside my window.  And that is exactly what I have done…for the past 5 hours.  It must be a side effect of the birth control pills, which I had assumed, out of all the intense medications I will soon be taking, would be the least of my worries. I guess not!

But on a more positive…this means I’m one day closer to getting this party started.  My hunch is that tomorrow will be Day 1.  So party on Thumper and all your friends…party on….but here, let me introduce you to a little friend I like to call Exedrin Migraine…..

My Last Birth Control Pill…Off to the Races

12 Sunday Feb 2012

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So..this morning I took my last birth control pill.  “Wait! What? Birth control pills-that seems backwards?”  I thought so too!  Before beginning your official IVF cycle, your doctor may prescribe you 10-14 days of birth control pills (BCPs).  The purpose of this is to “quiet down your ovaries” before beginning the battery of medication that is ahead.  There is a lot of different research on the advantages and disadvantages of BCPs before a cycle, and each patient’s protocol is different due to their particular circumstances.  One advantage involves the number of eggs retrieved (remember we are going for A LOT).  Research suggests that BCPs keep the body from focusing its energy selecting a “dominate” egg for the next cycle.  The BCP keeps the everything quiet. Therefore, when you start the ovarian stimulation drugs (All that lovely stuff in the picture I posted), LOTS of eggs become dominate at the same time.  Think of it like a horse race.  During a normal cycle, one egg breaks out of the gate a lot sooner than the rest, therefore becoming the dominate egg (You should bet on that one!!!).  The rest just hang around the gate, wondering what happened.  The BCPs help make it so the gate opens at the same time for everyone, once that gunshot called ovarian stimulation medication goes off….and then, as they say, its off to the races.

Anyway…I took my last BCP this morning. Now we wait for my period to start-usually within 2-3 days after the last pill.  When I start my period, that is officially Day 1 of my IVF cycle. The horses are leaving the stable and saddling up….the race is about to begin!

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Hello Medications!!!

11 Saturday Feb 2012

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WOW!  Look at all this! This is all the medication I have to take during my IVF cycle.  My body is going to be a wonderland of hormones.  I am sure at some point I will cry at the State Farm commercials.  Who am I kidding?  I already do! Maybe now it will be the commercial with the dogs barking the theme to Star Wars?   My husband gets the awesome job of managing all this, mixing the medications, and injecting me in various parts of my body for the next three weeks.  Who said IVF wasn’t sexy!!??  On a side note..the owls are not part of the medication regime…but they sure are cute.

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IVF 101 for all you landlubbers!

11 Saturday Feb 2012

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So one of the first questions I get asked is “What is IVF?” and “What does an IVF cycle entail?”  Well, as a recent landlubber myself, unfamiliar with the Sea of Infertility, this has been a “just trying keep my head above water” process that I am just beginning to understand.

IVF stands for In Vitro Fertilization, “in vitro” meaning “outside the body”.  In its simplest form, IVF involves taking as many mature eggs as possible out of my body, my husband’s sperm out of his body, putting them all together in one big happy dish, and hoping sperm enter the eggs and fertilizes them.  Once fertilized (not all of them will), the embryos hang out and grow for either 3 or 5 days (more on that later).  At this point, they bring me back in, sedate me, and put the embryos back into my uterus. Then ya hope like hell that those little suckers implant and BOOM… you’re pregnant. That is IVF.

Now as to the IVF Cycle…that looks somewhat different for each couple, depending on their issues, advantages, and challenges.  The cycle refers to the process surrounding the IVF procedure such as medication, stimulation, and monitoring.  Mine is following a pretty traditional cycle protocol.  My issues are tubal, which is great news when it comes to IVF, because IVF bypasses those pesky tubes altogether.  The eggs come out of the ovaries, fertilize in the dish, and a put back in the uterus.  No tubes needed.  Yeah for me! An IVF cycle generally last 4-6 weeks, depending on a lot of things.  It begins when you start your period on the cycle that you have designated as your IVF cycle.  Then you generally follow the following steps:

  1. Call your fertility clinic and tell them you have started your period.  THis is considered DAY 1
  2. Day 2:  Come to clinic for a base line ultrasound to make sure your uterus and ovaries are looking good and fancy. Certain hormone levels are tested. We hopefully receive clearance to proceed.
  3. Begin taking fertility medications and injections after your visit on DAY 2. WAIT Till YOU SEE HOW MUCH!  I am doing an antagonist medication protocol (more on the different protocols later).  So I start off with multiple injections that cause more than the normal 1 egg to grow (we are shooting for 12-20 eggs!).  So 2 shots a day of Folistim and Menapur for at least 9 days
  4. Day 5.  Return for ultrasound and blood tests for estradiol levels.  See how many follicles are growing.  Follicles are sacs surrounding the eggs in the ovaries that are being primed for this cycle. The estradiol levels indicate if you are responding well to the ovarian stimulation and if the lining of your uterus is growing nicely.  The lining is what that little sucker is going to stick too when it is put back in.   Medication is adjusted accordingly.
  5. Day 7:  Another ultrasound to monitor the follicle growth.  At this point, you can see how many potential “good follicles” you have coming along.  Now the concern becomes that you will ovulate too early and have to cancel the cycle (once the eggs bust out of the follicle..they are useless for IVF).  And so enters the 3rd injection in the rotation, Ganirelix, which prevents the body from ovulating prematurely.
  6. Day 8-12?  Ultrasounds and injections continue each day until and adequate group of egsg reaches maturity (Generally when they become > or equal to 18 mm.  Enter the 4th injection, and hCG Ovidrel, which tells the body to complete the egg maturation process and prepare for ovulation.  All other injections cease.
  7. Next Step:  Egg Retrieval (ER).  This happens around 36 hours after the hCG shot.  I go to the clinic, undergo sedation, and have a needle inserted into each ovary to aspirate the follicles and take the eggs out.  They let us know how many eggs were retrieved. Fingers crossed!
  8. Next Step:  Petri Dish Fertilization…Is there any other kind?  My husband gives a semen sample and it is placed with the eggs. Magic ensues.
  9. Over the next few days, the clinic will keep us updated on how many embryos were fertilized and how many of them are growing.  Each embryo is graded for quality.  It is possible to lose some along the way.  The center will then make the decision on whether or not to do the Embryo Transfer (ET) back into my uterus 3 days or 5 days after the retrieval (More on the Pros and Cons of 3 day versus 5 day ETs later).  Progesterone shots begin.  Progesterone supplements makes sure the potential pregnancy doesn’t end early due to low progesterone levels.  These people cover ALL their bases.
  10. I am sedated either 3 or 5 days after the retrieval and the embryos are placed back into my uterus, where they will hopefully implant over the next couple of days. We select how many embryos to be placed back in.  If there are any left, they are frozen to be used in the next cycle if this the cycle does not result in a pregnancy.  We are shooting to transfer two, with the hopes that one sticks.  I wouldn’t mind if we had twins.  What do you think?
  11. 9-11 days later-after being on 5 days of bed rest, we pee on a stick and  find out if I am pregnant!!!!Or have a blood test at the clinic…whatever floats your boat!

So there you go…IVF and the IVF cycle in a nutshell.  If you have any questions, please feel free to ask!

Here is a link to a great animation of the process.  On a side note, in the beginning when you see the egg released from the ovary and picked up by those finger-like fern objects-thats was was clubbed and blocked on my tube.

Through the Looking Glass…..Flashback to 2009

11 Saturday Feb 2012

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Ahhhh….I can still remember the day when we decided to have children.  We had tossed around the idea for about a year, but wanted to wait until life was more “settled’.  Is anything ever more “settled”?  My husband (29 at the time) was neck deep in his pursuit of a Ph.d. in Chemistry.  I (30 at the time) was forehead deep working full-time as a counselor and getting my Masters in Social Work.  Needless to say, we were busy-and worried we had too much on our plate to start a family.  Eventually though, the thought of adding a new addition, a little combo of us, began to materialize into a reality.  Around January 2009, we decided to make it happen.  We had it all planned out.  We would wait three months, get pregnant THAT month, and have our child about 2 months after I finished school.  Picture perfect! Easy Peasy!

Looking back,  I just want to snicker, pinch those rosy cheeks of our 2009 selves, buy them a strawberry ice cream cone, and permanently affix those rose colored glasses to their forehead.  Little did we know the uphill battle that lay before us…

*I would like to make a disclaimer here…This blog will not be for the “faint of heart”. I long ago became accustomed to all the gross, embarrassing terms that come with discussing infertility…. so as a blog reader, I want you to be prepared. So lets get it out now…sperm, sex, semen samples, cervical mucus, uturus,  testicles, spotting, peeing on a stick, and periods.  Go ahead…giggle, blush, and say, “Eww..that is soooo gross!”.  I sure did! But, as those of us going through infertility issues know, these terms soon become as commonplace and conversational as talking about the weekend forecast. This is about to get real people! But seriously, I’ll try to keep it at a minimum…..*

Around July 2009, we started to get the first inklings of insecurity and concern about this whole process.  We would joke about how society spends so much time when you are growing up teaching you how NOT to get pregnant-that when you finally start trying, you don’t know how to do it right!  Everyone said, “Just relax!  It will happen when it is supposed to happen.  Stop trying–and I bet next month you will be pregnant!”  (All of these have since become phrases that make me want to pull my own eyelashes out when people say them, which they still do…ALL THE TIME!).  We purchased the LH strips, which test for a hormone surge that occurs right before ovulation.  We timed everything perfect.  I took basal body temperatures…checked cervical positions. We did it upside down, right side up, backwards, and tilted. Anything we could think of, and still…nothing.

Around February 2010, we started getting the battery of tests that come with determining infertility issues.  I initially came back perfect.  I had a normal length, regular cycle, was ovulating, and had no blocked tubes (so the initial dye test showed).  My husband tests came back showing  a low sperm count, around 10 million.  He was then diagnosed with a varicocele vein, which is a twisting of veins in the testicles that effects the flow of blood and damages sperm.  He underwent surgery to correct the issue in March 2010.  We tried for another 6 months with no success.  It was during this time where we began to truly face that having children might not be possible.

Eventually, we moved up the ladder to a fertility specialist in early 2011.  We tried Clomid cycles.  We tried two IUIs (Intrauterine Inseminations), one with ovarian stimulation and one without.  Negative!  My husband’s sperm count continued to decline.  We were ultimately, with a lot of research and tests, able to pin the decline on toxic metal exposure from his chemistry lab research.  Solution…Husband out of the lab., Ph.d on hold.  Just a little extra side of stress to go with our main course of stress! Changes in lifestyle and diet helped him detox the heavy  metals, and in the months to follow his count went from 4 million to 250 million (which is nearly unheard of)-with excellent  motility and morphology.  YIPEEE!!! PROGRESS!!! We celebrated this as a personal victory against the cosmos.  Yet still…months went by with no pregnancy. No one could find any issues with me, but I had this little voice in the back of my mind whispering that something was very wrong…..

Bills were starting to mount up.  This fertility mess can be EXPENSIVE-and our insurance didn’t cover anything in the “Assisted Reproduction” category.  Dejected, frustrated, and bordering on throwing in the proverbial towel, we decided to get one last opinion in October 2011 from a different fertility specialist recommended to us by a few close friends. It was here our journey took a new turn.  Within 2 weeks, the new specialist had pinpointed the issue.  After undergoing a surgical procedure called a laparoscopy (a small camera is inserted into an incision in bellybutton to get a look at the reproductive system), I was diagnosed with a unilateral hydrosalpinx.  I will go into further detail about this particular issue later, but ultimately a hydrosalpinx occurs when the distal end of the fallopian tube closes in on itself, preventing the egg from entering the tube after ovulation.  Also, the blocked end causes fluid to flow back into the uterus making it a toxic environment for embryos.  Therefore, even when I ovulated from the “good’ tube side the chances of getting pregnant were slim to none.  My new doctor immediately performed a salpingectomy, removing my left fallopian tube.  The right tube had a lot of scarring, which he cleared out the best he could.  At our post-surgery consult, he recommended moving straight to IVF in order to maximize our chances of conceiving.  After a lot of praying, scraping together of finances, and unconditional support from our loved ones….Here we are!  One tube…Rockin it out! IVF….Here we come!

Wow!  That was a long one…but I am actually impressed I was able to compress it down as much as I did.  I will go into much more detail about certain things in the future, but I have always believed knowing the  backstory is important.  You can never know where your going until you know where you’ve been…all that good stuff.  I look forward to the day where this chapter of our lives is behind us, where it all takes on that clouded looking-glass quality that comes with time and distance from heartache and worry.  Right now it feels so raw, so real.  Each day is consumed with it, this possibility of impossibility.  I try to breath…I believe we will come out on the other side of this stronger, closer, never taking for granted this miracle we call life.  I fix my mind on an image of us swinging on our back porch, watching our children play under the sycamore trees.  I will sip my sweet tea, squeeze my husband’s hand, wistfully smile, and say,”Remember those years where we thought they would never get here?…Well, look at us now.”  And that, my friends, is the beauty of hope……

What’s in a Name?

10 Friday Feb 2012

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Nuit-The Sky Goddess

So why “Gambling with the Moon”, you ask?  Well..the moon, in all its beauty, has always symbolized woman.  Birth…growth…cycles…rebirth.  Fertility. Our process of trying follows the moon on its journey.  She is our timekeeper, yet the real reason behind the name comes from a story as old as time itself.  In Egyptian mythology, Nuit was the Goddess of the Sky.  The story goes a couple of different ways, but ultimately her and the Sun God, Re, had a falling out.  He cursed her with childlessness, proclaiming that she would never be able to give birth during any month of the year.  Nuit, desperate and distraught, turned to Thoth, the God of Wisdom and Words, for his help.  Thoth agreed to help her.  Using his divine powers of persuasion (and possibly some strong cocktails) , he convinced to Moon to gamble with him using some pretty high stakes.  See, back then the Moon was just as bright as the Sun.  For each round that Thoth won gambling with the Moon, he would win a little of the Moon’s light.  Eventually, Thoth won enough of the Moon’s light to add five extra days to the year, giving Nuit the loophole she needed to give birth to her children.

So now we are beginning our own gamble with the Moon, moving Heaven and Earth, as we try to win just enough light bring our own children into the world.

Love Always,

The Moon Gamblers

About this Place

10 Friday Feb 2012

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2/10/2012

Well…Here we are.  In the next few days my husband and I will begin our first IVF (In vitro fertilization) cycle. It has been a long journey to get here, and we are excited/nervous for this next step to begin.  In March, we will have been trying grow our little family for three years (More on the back story later!).  For those us going through struggles with fertility, we know this large increment of time, the year, becomes an abstract, nearly meaningless concept. For you I say…we have been trying for 36 cycles.  36 go-arounds on the rollercoaster of trying at all the right times, 36 two-week waits to get that “Positive”, 36 big, crushing “Negatives”, and then digging down deep to find the courage to start again the next month-36 times.

Our first IVF cycle will officially begin sometime during the next week.  I am starting this blog in order to help me process the experience (and give me something to do during that dreaded two-week wait for the results!), as well as a way to keep our friends and family updated on what is going on.  A part of me hopes that others going through this experience will somehow find their way here.  My wish is that it can be a source of comfort, camaraderie, humor, and information to them; as so many of their stories have been to me along the way.

So….Here we are, and here we go!

*From here on…the most recent posts are listed first…If you want to follow this blog. Press the follow button at the top left of the page and you will be emailed when there are new posts!