Tuesday, July 7, 2015

Wrap Up

I wanted to do a post to wrap this blog up.

After the miscarriage last fall we were losing hope. We started looking into adoption seriously but decided to talk to one more doctor and do a round of donor IUI or if that was not possible do donor sperm.

We started talking to the new doctor in January and more tests were ordered. An advanced semen analysis and a DNA fragmentation.  The Semen analysis came back at a count of 800,000 38% motility, 1% normal morphology, with major defects. The DNA fragmentation came back at borderline.  That was done on 2/23.  On 2/26 we went out of town.  On 3/10 I found out I was pregnant.

Today I am 21 weeks and 1 day pregnant today with our little girl. So far she is healthy and growing on plan!  If you want to follow the pregnancy progress check out my new blog, 40, Fat and Pregnant

Thursday, September 4, 2014

Tequila Rose

Life is what happens when you are making other plans.

We decided to take a short break from medications and procedures and go on vacation.   I was kind of annoyed because my period was due the last day of our vacation. Well, it didn't start that day, or the next day, or the next day.  Two days after we got back from vacation (this past Monday) I took a pregnancy test and it was positive. So I took 3 more, all positive including a digital.
 


We were excited and scared and freaked out. It was amazing that his had happened. After all of these procedures and medications and time and money, this had happened naturally, out of the blue.  It was a holiday but I called the doctor anyway and he ordered a blood test. I joked that we'd name our daughter Tequila since she was likely conceived on our vacation in Mexico. 

I went and had the test but didn't hear back until Tuesday morning. Tuesday morning I took another test and it was lighter, which indicated to me that something was wrong, it should have been getting darker.  I got the call later that morning, the numbers came back low. My HCG was 25 and my progesterone 10.9.  They put me on Progesterone in Oil shots and scheduled more blood work for Wednesday (today).  

I had the test today and got the call, HCG has dropped to 9 and progesterone was up to 18.8 from the supplements.  

I'm in the process of miscarrying the pregnancy.  I barely even knew it existed and now its going to be gone.  I'm trying to look on the bright side that we went from completely infertile to a natural pregnancy.  That is really amazing.

Digital tests require an HCG of 50 to register pregnant but later that same day a blood test showed 25 and 48 hours later 9, that is a pretty fast drop.
Based on my last period I am 4 weeks and 4 days pregnant today.

I was taking 200mg oral progesterone from 10dpo. Yesterday added 50mg progesterone in oil injection and 2 100mg endometrium suppositories. I'm supposed to stop all progesterone and wait for my period to start.

It's been a rollercoaster ride of emotions this week.

Tuesday, June 24, 2014

IUI Cost

So far, IUI #1 cost about $640 and IUI#2 cost $670.   So far my insurance has been paying for my ultrasounds all but $30 which is great this cost is for medications, ultrasounds and procedure.

IUI #2

Had IUI #2 today.

My ovulation predictor was positive on Sunday.   I went in yesterday for an ultrasound and had a follicle on my left.  Since he is trying to lengthen my leuetal phase he had me do an injection of 2,500 iu of HCG yesterday. I'll do another on Wednesday, a third on Friday and the last on Sunday.   On Friday I will also start Endometrium, a progesterone suppository.

The sperm was not nearly as good today.  There were very few motile, he let me look in the microscope.  He made sure I knew how small the chances of success were before he did the IUI.

Since I'm on the HCG a home pregnancy test won't work (would be false positive) until 5 days at least after my last injection.

I'm not going to get my hopes up this cycle like I did  last time.

Thursday, June 19, 2014

This month's cycle

When I went in for my last ultrasound he found a cyst, which is basically when a follicle does not collapse after a cycle. They usually continue to grow and can become painful until they are either reabsorbed or in my case usually burst.

When you have a cyst they can't put you on Clomid because the cyst can become dangerously large. So I was instructed to get a blood draw on CD10 (yesterday) to check my estrogen level. It came back at 134. That's about the same level it as last time I had a cyst.  I had some sharp pains yesterday and figured the cyst had burst. He had me come in for an ultrasound today and confirmed that there was free fluid, indicating the cyst had burst.

I have 3 follicles now, 2 on the right and one of the left.  We will not be doing Clomid this cycle because of it being so late in the cycle. We might be able to do an IUI anyway though, depending on if the follicles mature properly.  I go back on Monday morning for another ultrasound.

Oh and there were 3 people in the room today staring at my crotch during my ultrasound. Doctor, intern and nurse. It's a good thing I'm not modest.

Tuesday, June 10, 2014

The Fat Lady Sang

This IUI cycle is over, the fat lady sang yesterday.

I go into the doctor for an ultrasound on Friday to make sure all of the follies from this cycle emptied before starting meds for a new cycle.  We also will be discussing timing this cycle a little more closely as it may have been about 12-24 hours too late this time.

Monday, June 9, 2014

Some lessons and the signs

So a couple of biology/anatomy/physiology lessons before today's update.

More about the IUI process
During an IUI the washed semen is placed, using a catheter directly into the uterus, bypassing the cervix.  The timing of this is critical.  The sperm needs to be waiting for the egg when its ovulated from the ovary but washed sperm has a much shorter life than raw sperm, 12-24 hours as opposed to the 3-5 days of raw sperm.   The woman has an ultrasound which measures the size of the follicles in the ovaries and determines if they are large enough to induce ovulation.  Typically doctors want the follicles to be around 20mm before triggering.  The trigger is a 10,000iu shot of HCG which quickly finishes the egg maturation process and incites a "forceful" ovulation.   The HCG shot is normally given 24-36 hours before the IUI procedure.

Basal Body Temperature Tracking
Basal body temperature (BBT) is the lowest body temperature attained while at rest (usually sleep).  A woman's basal body temperature fluctuates in a predictable pattern throughout the course of her menstrual cycle.  Many women track BBT as a way to pinpoint ovulation and predict the onset of their period.   At the beginning of a cycle the temperature is typically low, usually rising slowly up to the point of ovulation where it drops down usually for one or two days before making a quick rise.  These changes are triggered by hormones, the surge of luteinizing hormone (LH) at ovulation causes the drop and then the rise of progesterone after ovulation keeps the temperature high.  The body temperature usually starts to drop a couple of days before the onset of the period.  If pregnancy occurs the temperature remains high.

The Two Week Wait (2WW  or TWW)
Trying to conceive (TTC) is all about the 2 week wait. Its called a 2 weeks wait even though it can be slightly less or slightly more.  Each woman cycle varies slightly in length and can vary from cycle to cycle.  The cycle is broken down into 4 parts, the follicular phase where the ovaries are maturing an egg (or multiple eggs if on fertility drugs), ovulation where the ovaries release the egg, the leuetal phase where if an egg is fertilized it will start to become an embryo and implant into the uterus and menstruation.   The IUI procedure starts the two week wait and marks the beginning of the leuetal phase.  In most women the leuetal phase is about 14 days.  During that two weeks if the egg is fertilized then a lot is going on.  HCG, which is what is measured by a home pregnancy test is not produced by the body until after implantation.  Once implantation occurs then HCG is produced and the amount doubles approximately every 48 hours.   It typically takes about 4-5 days after implantation for the amount of HCG to reach a level it can be measured on a home pregnancy test.



The update
So now that you've had your lesson of the day here is what's going on with me.  My leuetal phase is typically 12 days long.  Today is day 12 for me.  I took a home pregnancy test yesterday and it was negative and my body temperature had dropped for the past two days.  Both of these things indicate that we are likely out (not pregnant) this cycle. It is of course not over until the fat lady sings but all biological signs point to that being the case.

Thursday, June 5, 2014

The wait

Just a quick update to say no news!  Just waiting.

I tested out my trigger shot and as of last night the hcg tests were almost completely blank so that is out of my system now meaning that any pregnancy test I take will have accurate results.

 I went and got progesterone blood work done yesterday and it came back this morning with a level of 27.8 which is great!  Anything over 10 is good. That was a relief because I'd been worried that the supplement dosage I was on was not enough.

I had a temp drop yesterday on my basal body temperature testing and then it spiked back up today, that is a good sign (and making me obsess more).

Wednesday, May 28, 2014

Inseminated!

We are inseminated!!!  
I was SUPER nervous waiting this morning for them to process the sample, then we waited what seemed like forever but was about 40 minutes and at that point we had decided they didn't find any sperm and were waiting on the doctor to tell us. Then they called us back and the embryologist said "come look at the microscope" and my heart fell to my knees.  Then she's like, There are good swimmers in there!  
They said they don't do an actual count but  '2.5 mil after wash" was written on the thing beside the microscope with our name on it, so I'm guessing that is their estimate which is WAY better than we ever had before.  So I'm hopeful. The doctor seemed very happy so I'm happy now too. 
I'm a little annoyed though because they don't schedule a beta, just said to do home pregnancy test.

What's next?  If an egg gets fertilized then it takes 5-7 days for it to implant in the uterus and start growing. Another 3-5 days after that HCG levels ( HCG is secreted by the growing embryo) should rise to a point a pregnancy test would showt positive.  On Saturday I start a progesterone supplement to help sustain an embryo.

Between now and then I mostly wait. I can test out my trigger.  The trigger is a shot of HCG given before IUI to help mature the eggs and ensure strong ovulation.     testing out the triggrt means taking pregnancy test now until it's negative so that I'll know the result on the one in 3 weeks is a true result and not leftover HCG from the trigger shot. 


Tuesday, May 27, 2014

IUI Eve

Went for my follicle check today and had 3 mature ones, doctors office went ahead and gave me HCG trigger shot and I go in at 7:45 tomorrow for a date with the turkey baster. Hubby has to do his collection at home and we bring it in, hopefully there are lots of swimmers.

Thursday, May 22, 2014

IUI

On Sunday I started Clomid, 100mg once a day.  Today was the final dose,  I go in Tuesday for an ultrasound and then should trigger and do the IUI late next week.

While the Clomid is MUCH easier than the IVF drugs it triggered the worst migraine of my life today with tingling hands, dizziness and excruciating headache.

Thursday, April 10, 2014

What's next

It's been about a month since my last post.  We have been taking a break while we figure out what we wanted to do.  Earlier this week we talked with our doctor and have decided to do an IUI with hubby's sperm only, no backup.  We know this has a quite low chance of success but we want to give it a try before moving on to donor.   So at the start of my cycle I will go on Clomid then will have ultrasounds to confirm ovulation and then we'll do the IUI.

Speaking of next cycle, I am still not back to normal after IVF. My cycles are usually 27-29 days and I'm on day 36 now and no sign of AF.

IUI= Inter Uterine Insemination.  The ejaculate is washed of all seminal fluid until only sperm is left and then its placed directly into the uterus that the time of ovulation.

Wednesday, March 12, 2014

Options

Saw our RE today to talk over what happened with the IVF and discuss options.

He is afraid, based on our IVF that the issue does not lie with just one of us, but both of us.
Our REALISTIC options are as follows
1. Donor IUI (low cost, 20% chance of success each cycle)
2. Donor egg with combo of hubby's sperm and donor sperm (high cost, 40% chance)
3. Adoption (high cost, success rate unknown)
4. Embryo adoption (mid cost, 40% chance)
He think embryo adoption is the best way to go and gave us some literature on it..
He does not think that we have any realistic chance doing an IUI with hubby's sperm.
So now we will research and talk and come to a decision about how we want to proceed.

Saturday, March 8, 2014

IVF Cost

Since I did many searches for IVF cost before we began I thought I'd share what we ended up paying.

Total spent: $24,355.10 (Testing, Procedures, Medications for 2 cycles and another complete cycle)

Breakdown:

Medications: $7,012.69
Cycle 1: $3,711.76
Cycle 2: $3,300.93

IVF Cycle Cost with Clinic: $12,355

Testes biopsy and storage:  $2,300

TESE: $2,002

Miscellaneous Doctor Appointments/Services:  $438.94 (Urologist co-pay, Reproductive Endocrinologist co-pay, ultrasound for cyst not covered in cycle cost, surgery center co-pay )

Lab/Blood Work: $152.35

A little more info on the medications. I did a LOT of research and calling around before ordering my medications. The pharmacy that the IVF clinic usually uses that they recommended quoted me $4500 for my set of meds for the first cycle.   For the medications I needed it turned out that Walgreens Specialty was going to be cheapest using several discount programs.   I ended up saving over $800 for the first cycle by going with Walgreens and using discount programs.

The discount programs I used were: 
Heart + (https://www.ferringfertility.com/savings/heart/)
Fertility Pharmacy Care Card (http://www.newlifeagency.com/surrogate_maternity/fertility_pharmacy_care_card.cfm)
Follistim Manufacture Coupon (I got mine on eBay,shhh, don't tell anyone)

Here is the breakdown cost of all of my medications for both cycles
MedicationQuantityCost
Azithromycin6$10.00
Clindamycin Suppositories3$10.00
Dexamethasone30$10.00
Dexamethasone30$13.92
Dexamethasone30$10.00
Estradiol Suppository14$42.00
Estridol Valerate5$144.31
Folic Acid30$2.36
Folic Acid30$8.86
Follistim 300 IU7$1,834.00
Follistim 300 IU7$1,834.00
Follistim 600 IU2$748.00
Follistim 600 IU1$524.00
Ganirelex7$738.50
Ganirelex7$738.50
Ganirelex1$115.34
Ganirelex5$0.00*
Lupron1$199.00
Menopur4$300.00
Menopur5$150.00*
Novarell (HCG)1$79.90
Progesterone IM20$10.00
Progesterone/Estridol Suppositories30$45.00
Provera5$10.00
*I was lucky enough to have someone give me some leftover Ganirelex and was able to buy some Menopur at a reduced cost

Here is the simplified version
MedicationCost
Azithromycin$10.00
Clindamycin Suppositories$10.00
Dexamethasone$33.92
Estradiol Suppository$42.00
Estridol Valerate$144.31
Folic Acid$11.22
Follistim $4,940.00
Ganirelex$1,592.34
Lupron$199.00
Menopur$450.00
Novarell (HCG)$79.90
Progesterone IM$10.00
Progesterone/Estridol Suppositories$45.00
Provera$10.00
Savings: 
Follistim Manufacture Coupon: $300
Fertility Pharmacy Care Card: $600

Thursday, March 6, 2014

Improved count!!!!

For those of you following along at home the reason we were doing IVF is because hubby had basically zero sperm, highest count ever was 14 (not million, just 14). He had varicocele repair surgery just over a year ago but the only improvement was going from zero to the 14 or so.  When we started going down the IVF path he stopped the soy based protein shakes he was drinking twice daily, started taking Fertility Blend and CoQ10 and increased his caloric intake (he'd lost a LOT of weight in the past 2 years).

We have an appointment next week to talk to our RE about our options post IVF.  Hubby did a semen analysis yesterday in prep for that meeting. So nurse calls me today with results of yesterday's test. Get this 1 MILLION!!!!!  I know that most people would be devastated at a sperm count of one million but we are elated!  That opens up the possibility of IUI for us, maybe, hopefully.

This is the best news we've gotten in awhile!

Saturday, March 1, 2014

Post Egg Retreival Recovery

I wanted to write a bit about my recovery from the Egg Retrieval. As you might have read a couple months ago from my cancellation I don't like not knowing what to expect. I did quite a bit of research and most women said they felt okay in 2-3 days unless they got Ovarian HyperStimulation Syndrome (OHSS). Since I was at low risk for that I didn't worry to much about that.

My egg retrieval was on a Saturday morning, and I'm going to call that day 0.   On Wednesday before my retrieval I had 17 follicles, 14 of which were larger than 10mm.  That is a pretty average number, and my E2 was around 1300 (high E2 makes OHSS more likely).

Day 0 (Saturday)- Returned home around 9:00 am and I went straight to bed and slept about 2.5 hours.  Pain was moderate all day but I slept off  and on.  I stayed in bed all day/night. Bleeding was moderate, quite a few clots, about like a period flow.

Day 1 (Sunday)- Felt pretty good in the morning. Got up, made breakfast, read the paper.  Up about 2 hours before pain started to escalate and went back to bed. Got up a couple more times but stayed in bed lying down or reclining most of the day with the heating pad on my abdomen. Bleeding was still present with some clots but less than previous day.

Day 2 (Monday)- Got up around 7, showered and dressed and worked in my office for a couple hours, went into work around 12:00p.  Still bleeding some. Severe diarrhea in the AM, slight nausea. Pain was moderate, got severe with bowel movement.

Day 3 & 4 (Tuesday and Wednesday)- Worked full days both days, pain mild for the most part, moderate if I got jarred or had to bend at the waist. Bleeding stopped.

Day 5 (Thursday)- Pain was moderate, worse than the previous days and diarrhea was back

Day 6 (Friday)- Pain moderate to severe.  Left work at 2:30 and came home and rested lying down until 5, went to a birthday party. By 9 pain was getting bad, got home around 10 took 3 advil and immediately went to bed and less than 5 minutes later I was writhing on the bed in pain.  Dinner had given me gas and there was no room inside my abdomen for both my swollen ovaries and gas. The pain was so bad I thought I was going to pass out. After about 15 minutes I was finally able to pass some gas and started feeling better.  Hubby brought me the heating pad and I was able to fall asleep after about an hour.

Day 7 (Saturday)- Full week since ER.  Pain is mild to moderate today, tending towards more soreness than actual pain, potholes hurt and I feel bloated today.

I attribute Friday's pain to a few factors, the clinic recommends intercourse the night before a embryo transfer and since we first thought it would be Thursday and then Friday we did it two nights in a row, I think that caused irritation of my swollen ovaries. Second factor is that I wore too tight jeans to work on Friday and I think that irritated my abdomen all day. Thirdly was the gas.

So once again, I am in a place where what I expected was not what happened. So if you find this blog I hope some of this info can help you!

Friday, February 28, 2014

Nothing to transfer

I just got the call from my RE that none of our embryos made, they all stopped growing (arrested).   I'm doing okay right now, I had my breakdown last night and pretty much got it out of my system.  I'll post more later.

Thursday, February 27, 2014

Day 5

I didn't sleep well and woke up early. I'm not a good waiter.  The nurse usually calls about 9:30a, so once I got to work I tried to concentrate but had a really hard time because I kept glancing at my phone, stomach churning

Right at 9:30a the call came and it was not good news. The embryos have not really changed much since day 3. Today if they were growing properly they should be blastocytes with hundreds of cells and they are still in the cleaved embryos' with only a few cells.  I talked to my doctor and he confirmed what I thought that things are looking pretty grim at this stage.    I asked him if he ever transferred embryos that had not made it to the blastocyst stage and he said yes but they have to be growing.  So right now I am trying so hard to hang on to my very fragile hopes upon at least one of these growing in the next 18 hours.  The doctors said he would call me around 9 or 9:30 in the morning with the news.

 I'm a person who hangs on to hope when all seems lost but this past year as beat me down, I'm feeling very fragile and despondent.

Tuesday, February 25, 2014

Day 3 Report

So the day 3 report was not as good as we were hoping for but not as bad as we were dreading.

We have:
2 grade 2's one is 6 cell and 1 is 8 cell
1 grade 3 with 3 cells

Grading Key:
Grade 1- No cell fragmentation
Grade 2- Some cell fragmentation
Grade 3- A lot of cell fragmentation

The nurse said there is very little difference in pregnancy rates between grade 1's and 2's.  

Based on this we have decided proceed with Plan B which is to do a fresh transfer on day 5 (Thursday) of the two grade 1 embryos. They will call me on Thursday morning and let me know how the little ones are doing, if they are slow to grow then we could be pushed to a day 6 transfer (Friday).  If we do it on Thursday my transfer time is at 12:30pm. 

I'm feeling slightly overwhelmed at the moment.  

Oh, and I've nicknamed our two grade 2's Will and Hester and our grade 3 is Chester.   The names are from the children's book McBroom's Ghost which I loved as a kid. 


Monday, February 24, 2014

Waiting and recovering

I emailed the nurse today because I'm still having some bleeding and quite a bit of pain.  She told me to rest, hydrate and take over the counter pain meds.  I worked for half a day today and am now sitting in the recliner with the heating pad.  Tomorrow morning we should get our day 3 status report, to say I'm anxious for the results would be a bit of an understatement.