Lupron Fears & Therapeutic Tears

So I just got off the phone with the pharmacy for my Lupron Depot 3 month injection. Ugh. Do you know how expensive those things are!? At least my insurance covered some of it, but then I did a bunch of bouncing around on the phone to get a very small, but also appreciated, co-pay assistance from the manufacturer. If you don't know what the Lupron Depot is, it's a treatment course for Endometriosis. It basically puts your body in a false state of menopause in the hopes of stalling the disease. It causes a lot of horrible side-effects, one of the most concerning for me is the very real bone loss effect. Need to up my calcium stat!

I'm in a great online forum and have support from ladies who've been on it before, but they do nothing to ease my fears. Everyone is different though, so we'll see how I do. Arrives tomorrow but no clue as to when I'm supposed to take it. Maybe CD1? How bizarre to live in a world where no one communicates anything and you really have to dig for all the resources and information yourself. So different in Canada from my experience. USA... figure it out!

Anyways, on a separate note, on of those mentioned ladies posted the following articles which caused tears to stream down my face. Sometimes it just feels good to be reminded that we're not alone in this journey, and that someone else understands. Infertility can be so isolating. I had a very frank talk with my friend who was just in town visiting, and we discussed it. How no one asks, and yet if they ask, it can be at such an inappropriate time. Or when they get an answer they don't know what to say. She admitted to it herself, and though she cares deeply she really doesn't know what to do. She tries, and I appreciate that much, but until you've lived it, I really don't think you get it.

So for you, my blog readers, a reminder that you too are not alone. That you're not the only one to not yet have their happily ever after, and not alone in worrying that day may never come. Hugs to you.

http://www.scarymommy.com/struggle-with-infertility-ttc/?utm_source=FB

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ps. hope you like the new blog style, I got bored of my old one ;)

Day 19 - Transfer Day!!!

So I woke up bright and early at 630am this morning in anticipation of my transfer. The crap thing about that, is that I couldn't eat or drink anything until after my appointment because I was going on anesthetic. Well my transfer wasn't until 1030am so I had a good 4 hours to suffer without food or drink. Small price to pay.

Okay so lets start with the adventure to get there...
Homme InFertile and I went to take the subway but there was a medical incident and the trains were skipping our station due to running on the express track. Greaaaaat. So we went about ground because after watching 3 express trains go by, we now didn't have time to do the whole 'ride uptown, transfer to express downtown' song and dance. But of course it's late rush hour (all hours are rush hour in NYC) and half the subway commuters had the same idea, and everyone was now looking for a taxi. One guy was waving people away as he didn't have his light on and clearly was off for the day or something. Well I ignore that and walk up to him while he's stopped at the light because there's no chance we're getting another taxi for a while, and times a ticking. He points across the park. I nod. He relunctantly unlocks the door and we clamber in. He was headed up to Harlem and we're headed to midtown hell... but we tried to tell him to just drop us on other side away from the park (we could catch a different cab there or subway, at least we'd be away from the crowd). Well he was mad at us, and refused to do that, and ended up taking us all the way where we needed to go, albeit begrudgingly. Anyways, fastest, craziest cabby I've been in in a while, but we literally arrived just on time. Phew. Homme InFertile tipped him well since he helped us out so big.

Now that we were there...
I feel like a regular at the fertility clinic. I'm sure everyone does... we live there through our cycles. But regardless it was like ya ya, I got this people...
Step 1 - change out of my clothes (watch out for the al-fresco situation)
Step 2 - paperwork and routine questions
Step 3 - get my IV administered (we used a new smaller vein since I've been poked/proded so much recently, but she was really gentle)

Step 4 - cry... not because I'm in pain, but because I felt such overwhelming anxiety, fear, hope etc. for this cycle. This was the moment I really felt like I was relinquishing control up to the universe and was having to just have faith.
Step 5 - Homme InFertile comes to join me/console me (he was looking something up for us, not ignoring me I promise)

Step 6 - Doctor comes in to make a plan 1 vs. 2* we'll come back to this
Step 7 - Anesthesiologist comes in, checks nothing has changed height/weight, tells me it won't be as involved med-wise as last times as I won't need pain meds.
Step 8 - Say by to DH, move to procedure room
Step 9 - Confirm my name, date of birth, and why I'm there
okay so this was different, but because it was a smaller vein, I could actually feel the cold/stingy sensation of the anesthesia. I remember telling them it really hurt and just as quick hand a hand on my arm soothing me saying I know then..
Step 10 - become really sle...e...p......y

Back to Step 6...
So this morning I was leaning towards just putting back in 1. Homme InFertile and I had had a discussion yesterday about if there was a really good looking naturally fertilized, maybe we'd try that since it'd be different (all our other transfers were with ICSI). Well that wasn't exactly the case.
Of our 7 ICSI embryos, 6 made it to blast. Of our 10 Natural embryos, only 2 made it to blast.
Well that threw a wrench in my plan. I now don't have as much faith in our naturally fertilized embryos. Crap. And we've done the ICSI route before. Crap. The easiest decision for me to make in that moment was to put back 1 ICSI and 1 Natural and just see what happens.

Of course I was then warned about the risks of multiples, but the doc understood given our history how this would make me feel the most secure in my decision. He also said something about my tall frame being capable of carrying twins and how he won't be quite as worried about me in that case, which made me feel slightly better. I really would prefer a singleton pregnancy, but this has been a long hard 5 years of infertility treatments, and I'm nearing my breaking point.

So 2 it is! We know that we are risking becoming pregnant with twins, and although I worry about pre-term labour and complications, if I had two bundles of joy to take home at the end of it all, well I'd count myself blessed.

Waking up in the procedure room...
So this was different. In the past, I've always woken up in the recovery rooms. Maybe they chose to let me lay there to help with implantation, who knows, but I actually really appreciated it. Of course, Homme InFertile was there to try and videotape me, but apparently I'm not as funny on this non-pain version of anesthesia. I was pretty much right away with it, just a little groggy.

that little window is the passthrough to embryologist

I continued to lay there, had some apple juice and we were given our picture of our little embryos. Hopefully our babies' first picture. We wanted to know which was which (#5 and #9) and the naturally fertilized one is the smaller one. The I got dressed and we headed out.

Lunch and Acupuncture time...
Now since I was beyond famished, we elected to stop for a nice little healthy lunch before my post-transfer acupuncture appointment. There's a Pain Quotidien right across the street from the acu clinic, and have great gluten-free and dairy free options for me, so seemed perfect. They messed up our order... twice. But once the food arrived, it was de-li-cious and we inhaled it in no time.

Then I crossed the street for my acupuncture. Listened to "Acclimating to your baby's signature" by Alaya and Oshira of Vibrational Child which ended up being the perfect selection. At first I wondered if I should have stuck to the Circle+Bloom IVF program that I've been doing, but I find Alaya's work much stronger. I dunno, it seems to have more impact for me and my mediation time during the session was just plain beautiful, no other word to describe it.

Home and resting...
Then we came home and it's just been chill time since. I had another small nap, but my mind was racing a bit with all the wonderful optimistic possibilities, that it didn't last long. Unfortunately Homme InFertile is finally falling victim to the cold I've had (which I still haven't kicked... you kidding!?!), so looks like it'll be a super lazy weekend.
Side note: On my personal blog, I wrote a little shpeel to family/friends about respecting our privacy about our cycle from here on out, and to not ask questions or ask for updates given they can't know when the good/bad news is coming and they could reach out at a very inopportune time. This is what I wrote in case you're struggling with a similar situation, having been open up to this point:

One thing that I'll ask at this point, since we're getting close to transfer. Please do not text or call for updates on how it turned out. At this point it will just be a waiting game for us, and a very painful stressful one at that. We won't know the outcome until the end of the month unfortunately, and once we find out the result (good or bad) we may need some time to process it. We know you are/will be excited to find out and waiting in anticipation, but know that if it is a negative outcome, we'll need some time to grieve, and untimely messages etc. may make that more difficult. If you don't hear from us early May, assume no news is bad news. If we have good news, we will be thrilled to share that with those closest to us one by one, and that may also take some time. So be patient with us. :)  Thank you though for all your support, positive vibes and kind words of encouragement up to this point. We love you all and are so grateful for how wonderful you've been in this process. 

Day 17

Fertilization update call came through today. Nurse Leslie informed us that all 16 embryos were still developing, and the 10th egg put to be naturally fertilized decided to catch up! So we now have 17 total! Crazy!

Of the 7 that were fertilized with ICSI:
4 are 10 cell embryos
3 are 8 cell embryos

Of the 10 that were fertilized naturally:
7 are 10 cell embryos
1 is 9 cell
1 is 8 cell
1 is 7 cell

Today I've made very slight progress. I showered and we went for a walk in Central Park with the dog. It was really cold out, but overall a nice day. Funny to think that when we move to Houston in September I won't have to deal with the chilly bone cutting wind of the NE Coast anymore. Instead, I'll just be sweating I guess...
I tried having a coffee today to help the whole bathroom situation move along. Not so helpful, but keeping the faith. In terms of my cold/flu... I'm definitely on the upswing, but just barely. So I'm still feeling quite under the weather, and now developing a cough (instead of the leaky faucet nose) but hoping I can heal up quicker now that my body actually seems to be recovering from the procedure. My body is working overtime that's for sure.

We got the call about our transfer for Friday as well. Initially the nurse had no idea we planned for me to be put under for the procedure. She had to hang up and talk to my doc. Kind of annoys me that if I weren't so on top of it and knowledgeable about the pre-anesthesia "shpeel" then I wouldn't have picked up on that fact and we would have been hooped. Anyways, I did notice, and she called back to confirm that's the plan and changed our time. So we go in at 930am Friday for a 1030am transfer.

All I need to figure out now is are we transferring 1 or 2 embryos... I literally cannot decide. I flip flop every five seconds. I know the doc would prefer to put only 1, and my DH would prefer to put only 1, but both support me putting 2. I'm trying really hard to listen to my gut but unfortunately it's like radio silence. Hoping to have clarity on this before Friday. 

Fertilization

So... time for the fertilization update. I got the call this morning from Nurse Leslie (who's the bomb by the way) and she started by reminding me that we retrieved 20 eggs... probably because some women are so loopy afterwards that they don't remember haha.

So they split the eggs evenly - 10 to do ICSI with and 10 to fertilize naturally.
Of the 10 they did ICSI with, once washed, 7 were mature, and all 7 fertilized.
Of the 10 they naturally fertilized, ALL 10 were mature, and 9 fertilized.

So we have 16 embryos!!!
HuuWHAT!?!?!!?

To put this in perspective, in the past we had 7 mature eggs, and 4 fertilized. I'm over the moon at the difference. Not sure if its my health, the supplements, or acupuncture that is to thank, but my guess it's a combination of all of the above.

Transfer has been scheduled for Friday and we are expecting an update about our 16 embryos on Wednesday. So now Homme InFertile and I need to decide in the meantime if we transfer 1 or 2... and this won't be an easy decision to say the least. I swear I'd be better off flipping a coin.

Basically in the past we've transferred 2 fresh day 3 embryos (bfn) and then 2 frozen day 5 embryos (bfn) so I'm scared to revert down to only transferring 1. That being said, this cycle has been so different than the past, and we'd like to believe it will work out, so do we really want any additional risks associated with carrying and delivering twins? We'd love to have twins, sure, but I worry so much about losing one or both, or them being pre-term and living in the nicu, or having massive delivery complications... just seems scary. But, at the same time women have twins without any issues, and some women carrying only one child end up with all the complications so it really feels like a crap-shoot.

I know I must sound like I'm spinning my wheels... I AM! I have no friggin' clue what to do. For now our plan is to wait and see how the embryos develop and if we have one embryo that is out of this world on Friday, maybe just transfer that one. But on the flip side, I'm tempted to transfer one natural and one icsi and just see what happens. Ugh. Wish there was a crystal ball to tell me what to do!!!

Sick + Cramping

I'm trying so so hard to fight off this cold. It's come to try and get me numerous times this cycle, but it had yet to get me down. Maybe because my friend was in town and I was in go mode, I dunno maybe that helped somehow, but after slowing down and resting, today it finally got me.

My nose was a leaky faucet all morning (it has since stopped), and now my throat is on fire. I'm doing everything I can to stay relatively healthy: lots of fluids (though that's also for OHSS), zinc, emergen-c, garlic, salt water gargles, but I wonder if its because of the intralipid infusion. I mean the whole rationale behind doing intralipids is an over-active immune system that fights off the egg from implanting.

So now I'm spinning my wheels wondering if I should just let myself be sick, or if I should continue trying to get better. Ugh. I'm confused and there's very little info out there. I go in tomorrow so will just ask doc/nurse then. For now. I'll treat the symptoms as best I can to feel relief, and just hope for the best.

Also, side note, I have some ovulation cramping going on. I'm assuming from the HCG trigger, but seems odd that I'm made to ovulate before the egg retrieval. I'm sure my cramping is partly due to how many follicles I have as well as the mild OHSS...

Faith.

Day 10 (8 stimms)

DAY 10 - day 8 stimms
Ganirelix done. Check.
Ultrasound done. - - -> My 21 follicles lowered to 17 (I guess some of the 5mms just dissipated). Disappointing, but still solid. Hoping all 17 hold strong.
BW done. - - -> Good to continue with same dosages, and am going back in Friday for another check up. I'll probably be ready to trigger Friday night it looks like. That'll make retrieval Sunday, Transfer Wednesday or Friday of next week.

I had another different doc today. I guess it truly does take a village. I liked her a lot better. Might try requesting her for my Friday appointment and retrieval. She just had a much warmer demeanor in my humble opinion.

Was so fun having my friend in town to distract me, but now she's left just as I was getting more uncomfortable and closer to the finish line. I am a bit relieved to have some down time. I feel like I'm just going to hermit it up for the next little while through our trigger, retrieval, and transfer.

We found out we might have to go back up to Canada while our new USA visas are processed, which is a bit of a pain in the butt. Maybe we'll do it during the 2ww. That'll make for a good distraction I figure. Problem is, if they want us going sooner rather than later the timing is tricky and may be a quick turn around situation. That's fine too, and maybe better if it means I can fly instead of having to drive. No chance I'd risk flying in the 2ww. No sir.

I go in for my intralipids tomorrow. Really nervous about that. No clue what to expect, and who in their right minds likes IVs? No one. I'm hoping Homme InFertile can join me and we can cuddle up and watch a movie. We haven't really had any alone/chill time since my friend was in town. I wanted to be respectful to her as she's single and I know it can be hard being around super lovey dovey couples (which we are, but just not in public). So soaking up some cuddles tonight. 

Days 9 (7 stimms)

DAY 9 - day 7 stimms
Just another day in stimming paradise... or hell... whatever way you personally feel about it. For me, I'm trying to feel as much gratitude for being in a position to be able to be as proactive as we are. I'm grateful for 21 follicles growing. I'm grateful for the financial ability to do a cycle. I'm grateful for being unemployed and being able to focus fully on fertility. It helps a little to think of all the things I'm thankful for as my belly becomes increasingly bruised and my ovaries more and more bloated/painful.

Today was Homme InFertile's Birthday. 31! Wasn't anything overly special, but he had been wanting to check out this place Katz in NY (a staple) so we did lunch there, and while he went bowling with my friend visiting, and his friend who's also unemployed until they start their new jobs, I went to acupuncture. She seemed impressed at how well I've been doing/feeling, so that made me feel even better about everything... if that was possible.

I called to schedule my appointments for the next day (bw/us and intralipids) and got a lecture on how I was supposed to book intralipids weeks ago. I don't want to go into the nitty gritty of the conversation, as I'm trying to let it go, but basically instead of simply telling me unfortunately at this point there wasn't an appointment time left for Wednesday, but I could go Thursday instead (which I would have been totally chill and fine with... my bad for not calling earlier), I instead was told that I wasn't being responsible for not calling weeks in advance, and that's generally when people book these, and there are no appointments for today. So naturally I freaked out thinking I wouldn't be able to get an intralipid appointment time for 2 weeks, and thus started to cry. See I believe the intralipids are what could make or break this cycle so my mind started racing a million miles a minute. I just wish she would have handled the conversation a little nicer and preceded the lecture with "I can fit you in tomorrow" at bare minimum. No one told me the precedent on timing to book intralipids, and all other appointments I have been making a day or two in advance. Without this knowledge, how was I supposed to know any different, especially after checking on Monday that they received my intralipid medication, and that all was good for Wednesday... which clearly it was not. Grrr. Very different "service" level in the U.S. from Canada. They try and make it as stress-free as possible, where as in the states, its all on you the patient at an already overwhelming stressful time. Kind of silly, but cultural differences I suppose.

Shake it off.

Later we went out to a nice dinner followed by Les Miserables on Broadway which was A-M-A-Z-I-N-G!!! So great!

I had to push my evening injections to 10:15pm (I normally do at 9pm) as I wasn't sure how I'd go about timing it, doing it in the bathroom at the theatre, not to mention bringing the injections and keeping them cold (the gonal-f needs to stay in the fridge). It was all too stressful, so I just did it a little later. RE said it was fine if they weren't exactly at the same time, although that is ideal. FX all is well. I'm sure I'm not the first patient to do an injection an hour off schedule one day.

Anyhoo. Shots were less painful than the previous day which was nice. I'm a pro now it seems, although I still friggin hate my ganirelix injection which I'm delaying taking as I write this. Boo.