So things are still moving along.  We upped the dosage of the Follistim to 100 last night.  About three hours after the injections, I had severe cramping in my upper abdomen.  The pain was localized to right under my rib cage.  I don’t know if it was a side effect of the medication, but it passed after about an hour.  Ovaries are starting to hurt a little, but that is to be expected.  I definitely feel fatigued.  Yesterday, I cleaned the house all day, which led to a lot more bending and twisting than I think I realized.  Towards the end of the day, I could really feel it.  Today, I’ve pulled an all out 30 Rock marathon on the couch.  The dogs and I have hardly moved-justified by a rainy, dreary day outside.  It was awesome!

My husband, however, seems to be getting more and more nervous as we get closer to the retrieval, and some his actions are a little out of the ordinary.  See, my husband is a data collector.  He likes to get as much information as possible, do as much research as possible, and explore as many sources information as possible.  Having exhausted the Internet, doctors, and our circle of friends and family, he has now started approaching random women, in places like Walmart or the pharmacy, and asking if they have ever been pregnant.  If they have been, he asks them questions about their pregnancy, complications, and ways they handled it.  I can only imagine scrolling the pharmacy aisle for Nyquil and having some random guy approach me and ask if I have ever been pregnant!  WOW!  I told you this infertility mess can make you a little Cuckoo for Cocoa Puffs.

Apparently, however, he has come across some very nice ladies that have been willing to share their experiences (as well as some who have told him to get lost).  Crazily enough, many of them have had fertility issues as well.  Some even using the same fertility center as us!  This has led to my husband coming home with armloads of new supplements, vitamins, concerns, and theories.  So now our little vitamin shelf is  overflowing a multitude of supposed cure-alls for boosting our chances.  Waaaay to many for me to possibly take.  Each woman also had advice for him on how he could best support me during this process and what he could do to help me along the way.  So now he is making lists and plans- gearing up to for what is to come.  I just listen and smile-meanwhile giggling to myself at the mental picture and thankful I have a husband who is so caring, concerned, and willing to go to great lengthss to make sure this process goes as smoothly as possible.  And I want to send a little shout out to all those angel ladies willing to take time out of their day (or night) to patiently share their stories and advice with my nervous husband…..Y’all are awesome!

So, the next time you make that late night Walmart run for the latest installment of the Twilight Saga and a man approaches you asking questions about pregnancy, don’t fret.  Its not a weirdo…its just my wonderful, wacky husband…trying to get through this the best way he knows how-by trying to help me.

I went to the clinic today for the blood draw to check E2 Levels.  They want it at around 200 to 250.  If it is a lot higher than that, it means you are responding too much to the medication.  THe concern here is that on can get Ovarian Hyperstimulation Syndrome (hyperlinked to Wiki page), a painful condition which can cause hospitalization and cycle cancellation if severe.  If the e2 levels are too low, you are not responding to the medication enough.  If less than 75, the chances for a successful IVF cycle or pregnancy significantly decrease.  So your doctor does a delicate dance of trying to push your body with medication enough to produce lots of good eggs, but not so much that your system hyperstimulates.

My levels were at 178.3, just shy of the perfect 200.  This is no big deal at all, it just translates into an increase in the dosage of the injections.  My medication protocol is very conservative at this point.  I was on 75 menapur and 75 follistim.  On fertility forums (a great resource and support network for women going through this procedure)  I have seen women taking as high as 600 follistim.  Such high dosages generally correlate to issues surrounding egg quality (indicated by an AMH or Anti-Mullerian Hormone test)  and egg reserve (# of eggs you have left)-neither of which of are my particular issues.  As far as we know, my issue is purely mechanical-bad tubes-not hormonal.  So my medication protocol started out as more conservative to lower the risk of Ovarian Hyperstimulation Syndrome.  With my levels on day five being just shy of the 200, my doctor has upped my Follistim dosage to 100 and kept my Menapur dosage at 75.  We will continue this particular protocol tonight and tomorrow night, then I will return on Monday for another E2 and ultrasound….we will get to see how many of these bad boys are actually cookin’!  THAT I am excited about!!!!

Today is day 4.  The shots have being going good so far!  Both shots are to make lots and lots of those awesome eggs grow.  Definitely starting to feel some of the side effects.  It feels like I am carrying a bag of marbles on either side.  Not painful, just slightly uncomfortable and twingy.  The right side is acting up a lot more than my left, but honestly they could tell me to put my hand in a meat grinder-and I would do it with a smile on me face.

Here is another kicker….My doctor recommends not twisting, bending, or picking up anything over 5 pounds.  When I first received this medical advice tidbit, I didn’t think much of it.  Overwhelmed with all the information we were getting, this statement kinda slipped to the bottom of the pile.  But 5 POUNDS!!!! REALLY! I drink cups of coffee that weigh more than 5 pounds!  Well, not anymore-caffeine is on the banned list, but I do fill my token Handee Hugo’s Large Coffee Cup with water to trick myself into THINKING I am having my traditional morning cup of coffee.  Other things that I now realized weigh more than five pounds:  my favorite pair of boots, my sling bag that holds all this lovely paperwork from the doctor’s office, the large casserole I put in the oven tonight, that puppy that came to visit us at the office today-the list goes on!  5 POUNDS!

Tomorrow I go in for more blood work to see if my E2 levels are at least 200.  I wish there was an ultrasound so I could see how these little marbles are coming along, but that will have to wait until Monday.  Fingers crossed!!!!

So along the way, my husband and I have done some “crazy” (unless they had worked!) things to make this baby thing happen.   Now at the time, these were approached with utter seriousness- that “THIS will DEFINATELY work!!!” type mentality.  Looking back, however, some of them were quite humorous-or possibly ingenious and creative, for some of our wierd and wacky theories actually resulted in some improvement.  So for all you hopefuls and skeptics, when faced with the challenge of infertility, I recommomend trying ANYTHING once!  You never know what will be your magic combination.  Without further ado, I present the first entry of our special gag reel of some of our most, let’s say, interesting attempts at conquering our infertility issues. 

1) Pineapple cores by the bucket load– Apparently, the rumor is that pineapple cores, not the pleasant juicy part, help with implantation. For those of you wondering about implantation, after an egg is fertilized (generally within the fallopian tube) it floats around for a couple of days before finally implanting somewhere in the uterus.  This usually happens 6-11 days after ovulation.  Here is a lovely photo depiction, which also shows all the stages the fertilized egg goes through (everything that takes place in the fallopian tube in the picture will take place outside my body during IVF) ….. 

So THEY say, and I never have quite been able to pin down who THEY are, that pinepple cores help with the implantation process.  The word on the street is that pineapple contains bromelain, an enzyme that helps with implantation.  Now, nowhere could I find any actual research that proved this true, but did that prevent me from making a back ally deal with the Harris Teeter guy for all his pineapple cores?  Absolutely not.  See infertility becomes like a crack addiction- you’ll do just about anything to get that next fix, that positive pregnancy test.  Even if that means wolfing down those stringy, bitter, too-tough-to-chew pinapple cores.  And wolf them down I did-with relish and a side of bring it on.  In the end, the pineapple was not my magic ambrosia, but hey….some people swear by ’em.  And to you, oh pineapple core enthusiast, I say “Wolf on!”…… and “Sorry for your stomach ulcers!”

We got the ALL CLEAR!  YIPEE!!!!  My morning clinic visit went great.  The ultrasound showed no cysts and a my uterine lining was at 4 mm (looking for between 3-5 mm).  My E2 levels were at 34 pg/ml, which is perfect.  I could also see all the “potential” follicles that will most likely become the eggs that are retrieved.  See, near the beginning of your period, there are a certain number of small follicles that have the potential to be “the one” that grows large and releases an egg during that next cycle.  Eventually, one is primed for ovulation, and the other follicles disintegrate.  The ovarian stimulants I will be taking make it so none of the follicles disintegrate and all grow into “ovulators”.  I had 6 potentials on the right and 4 potentials on the left.  A “great number” according to the nurse, and the meds will most likely make even more develop.  So, needless to say, we are off to a great start!

Just took my first to shots, both in my upper arm.  Menapur and Follistim, which stimulate follicle development.   My husband did great with the administration, and has even set up a very well organized “Medication Station”.  The Menapur burned like crazy. The Follistim was a breeze.  That will continue for the next 7-10 days.  I will go in on Sat for some more blood work to make sure my E2 levels are rising.  Feels good to have gotten started.

Creepy fact of the day:  Follistim is made from genetically modified Chinese hamster ovary cells.  So I basically just injected hamsters….gross.

Okay!  So we are officially in our first IVF cycle now!  Period started this morning-so that may explain the massive headache last night.  Earlier than we were expecting, which is good considering patience is not my best virtue.  We head into the clinic at 8 am tomorrow for the first of MANY ultrasounds in the days to come.  Tomorrow is referred to as the baseline ultrasound. The purpose of the baseline is to check for any ovarian cysts or other complications.  Cysts=delayed or no cycle, depending on severity, so lets keep our fingers crossed that they are a no show.  The hormone level they check is my estradiol, or E2, levels.  The levels should be <50 pg/ml. Low levels are good, as research indicate low estradiol levels correlate with a better response to the ovarian stimulation medication. High levels indicate the potential presense of a cyst or diminished ovarian reserve (lack of good quality eggs).  I also get my finalized medication protocol with all my stuff laid out for me over the month. Shots begin tomorrow as well!!!

Tomorrow is a big day!  It is finally starting to hit me that we are doing this!  Someone asked me today if I was scared or nervous.  No.  I feel hopeful, positive, like I am about to get on a ride that might take me somewhere amazing.  It might not….but it might.   There is a reason to have hope.  I was scared 6 months ago when we didn’t know what was wrong, when everyone was telling us that there was nothing wrong.  Yet months dragged on and still nothing happened for us.  During this time,  I felt lost, like I was wandering around in the woods where no one could give me direction.  I once told my husband during that time that I would rather just be told that we couldn’t have children than continue fumbling around in the dark-wondering, desperately wishing.  At least then we could move on, move forward, dream new dreams.  The unknown wore my soul to the bone.  But now we have a plan, a map, a light to guide us somewhere.    We made it out of the woods….we KNOW what the issues are and we know what we have to do to get around it.  And knowledge is power-a reason to hope, and thats all I needed.  So heres to day Day 1!

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…..

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!