IVF Aftermath. IVF is a Mind F@!%

IVF is a brutal process, both physically and emotionally.

Physically:
It begins with the baseline bloodwork and the visits for bloodwork ramp up in frequency from there.  Getting your blood drawn every day is not nice.  I had my blood drawn 6 times in a span of 7 days.  Ouch.  Overall, throughout the cycle I had blood drawn 8 times in 3 weeks, not counting my IV and IVIG infusion.

Shots are never fun.  I administer them to myself since my husband, like many men, is squeamish around needles.  Squeamish is putting it mildly.  He passes out at the site of a needle, gets light headed talking about shots and literally shutters when seeing my shot sites on my arms and stomach.

Internal ultrasounds.  Yup, I am going there.  In an IVF cycle you are getting more action from the ultrasound probe than your husband.  Seriously.  My husband knew to stay the hell away from me during IVF.  I've been poked and prodded enough thank you very much (and the worst is to come... egg retrieval)

I am covered with bruises, both visible and perceived.  Both of my arms are covered in bruises.  My stomach is bruised from injections.  My lady bits feel bruised from all of the internal ultrasounds.  No lies.

Enlarged, throbbing ovaries.  I never thought I would feel like my ovaries would attack my other organs until I went through IVF.  There were times when I could feel my ovaries responding to the stims and envisioned them gobbling up my appendix or something.  They felt like they were moving throughout my abdominal cavity and were threatening to bust out of my abdomen altogether.  (I am exagerrating here.  My ovaries are quite well behaved compared to other women undergoing IVF be geesh I could still feel them plumping up)

Egg retrieval is surgery and do not forget it.  I was sore and I was uncomfortable.  It is surgery people. (Confession:  I have a HIGH pain tolerance and wasn't too impacted by this surgery when compared to other people.  I had to force myself to take it easy.  Still, though, it is not pleasant)

Time.  By this point a tremendous amount of time has been devoted to IVF.  Early mornings at the Doctors office followed by a full day of work and awaiting nightly shots is physically exhausting.  Shaving your legs daily, in preparation for your ultrasounds, is utterly draining, honestly.  I don't want to shave my legs for two weeks after everything is said and done.  Then there is all the time off you need for surgery and transfer.

Emotionally:
IVF is a rollercoaster of emotions.  One day you are extremely optimistic, the next day you are in the depths of despair.

You question everything and every decision.  Should I...?  Would it be better if...?  I should have... 

Every appointment has the potential to end in disaster.  Ever phone call could spell out misfortune.

Hormones can play havoc, plain and simple.

Follicle concern.  How many follicles do I have?  Are they similarly sized?  Are they growing as expected?

Uterine Lining.  Is it thick enough?  Is it too think?  Will this be an issue?

Surgery can be scary, especially for your first egg retrieval procedure.  How will my recovery be?  Will I be able to handle the pain?  Will I be able to go back to work?  At the top of you mind however is the ever present question of: how many eggs?  How many are there?  I wonder how many eggs we are working with.  I wonder how many will be mature.  I wonder how many will fertilize.  I wonder if this will work.  Will this work?  Why am I doing this to myself?  This had better work.

How are my embryos doing?  Will I have a 3 day transfer or a 5 day transfer?  Will there be anything left to freeze?  What are our odds?

Egg transfer.  You arrive.  They prep you.  You drink plenty of water.  All the while you are constantly wondering: what are we working with?  Are the embryos on-track based on their day of development?  How many cells do they have?  What sort of fragmentation do they have?  Are they symmetrical?  What are the odds given how they look?  Where is the Doctor for pete's sake.  Just tell me already.  Sheesh.

The two-week wait is brutal... brutal.   FOR ME, THIS IS THE WORST PART OF ANY TREATMENT CYCLE.   I hate this part.  You have hope, doubt and fear all at the same time and all in the same day.  Some days are better than others and some days are tolerable.  Just get through it.  You will get through it.  That's what I tell myself.

To sum it up:  IVF is a complete mind fuck.  It takes otherwise rational human beings and turns them into a neurotic mess.

IVF is a brutal process, both physically and emotionally.  AND I WOULD DO IT ALL OVER AGAIN IF GIVEN THE CHANCE TO HAVE A BABY.  Without a doubt.  No hesitation.  I am five days out from my egg retrieval and I am certain that I would do this again.  In a heartbeat.  Mind fuck or not.  Yes.








  

The silver lining is gone

The silver lining I spoke of in my last post is gone.  Our other embryo didn't make it to freeze.  

Surprisingly, I am okay with that.  I guess it is because we will get to do another fresh IVF cycle sooner than later.  We get a do-over.

What I am not okay with is the thought that if that embryo didn't make it to freeze how are the embryos they transferred on Monday going to make it?  

Admittedly, I'm in a glass half full type of mindset right now but I wasn't this way all day.  I woke up feeling better about everything.  Maybe writing the blog post last night helped.  Maybe not.  Who knows?

I often wonder how far we will take this IVF stuff.  I think I've previously written that I couldn't envision too many more IVF cycles but now I am not so sure.  You could call me a flip-flopper.  Should I blame the seasons on that?  Doctors giving me hope?  Hormones?  All of the above?

How much trying is enough?  How do you decide that?  I thought I went through a sense of acceptance last summer but that was before working with the reproductive immunologist.  That was before we had a sort-of-diagnosis and something to go on.  NOW how do we decide when enough is enough?  It's like I am on another carousel ride, seeing the same scenery all over again.

Can we fast forward a few days and just get this over with?  Am I or aren't I?  If so, will I be able to keep it?  If not, can I survive another miscarriage?  Can I endure being childless?  Where do we go from here?

I'm always ahead of myself.  This two-week wait is just the worst.  Thankfully tomorrow is my "Friday" so I can keep myself busy and keep my mind off of the wait.  Ugh.  

Optimism is Gone

Well...  We had our egg retrieval and embryo transfer.  Technically we have a little bit of optimism left but not much.

The optimism was sucked out of the room when they told me that they retrieved only 9 eggs.  I say only 9 eggs and that the optimism was dashed because I had 16 follicles.  SO I REALLY EXPECTED TO GET AROUND 15 EGGS AND I WAS THRILLED ABOUT THAT.  But instead we had 7 EMPTY follicles and only 9.  Had I only had 10-12 follicles I would have been adequately prepared to get only 9 eggs... So that is why the optimism has left the building.

Then came hope.  We hoped that of the 9 eggs 6 would fertilize and qualify us for a 5 day transfer.  NOPE.  We had 5 fertilize with ICSI which meant that we were automatically assigned a 3 day transfer... You know since they want to have something left to transfer and not "poop out in the dish"

The new hope... Good quality 8-cell, 3 day embryos like we transferred last time.  NOPE.  On Day 3 we had three 6-cell embryos and two 4-cell embryos.  Not bad but not ideal.

So yesterday we transferred two 6-cell embryos with slight fragmentation.  I am not optimistic about our odds.  As far as I can tell our chances of one of them taking are about 30%.  Not great, but not terrible either.

The kinda-silver-lining is that we may have one that may make it to freeze (that other 6-cell embyro).  The less than ideal news with that is there is only one.  If we are going to invest in another cycle I would to transfer two.  Especially considering the $4,000 out of pocket IVIG infusion I have to do prior to each transfer.

Beta is June 8.  I won't be waiting until June 8 to test though.  I will try to make it to Wednesday, June 3 to test.  I doubt I will make it that long.  I will probably be able to make it to Monday, June 1.  I did test yesterday just to be sure that the HCG trigger shot is out of my system.  It is.

The Optimism Continues

It's been awhile since I've written.  Over the years this blog has changed.  Initially it was about expressing my emotions while on this baby quest.  At some point it switched to more note taking.  In the last year or so, I've been using this blog as a way to capture details of my cycles which admittedly come in handy when needing to provide specifics (and a timeline) to medical professionals.  This was never my intention, but at the same time I cannot see myself pouring my heart out here like I have in the past.  Especially in a meaningful way.

I suppose that since last year, after a failed fresh IVF and a failed frozen egg transfer, I have been slowly coming to terms with the fact that we may never have a child.  Last summer I was a wreck about it when beginning to come to terms with that possibility.  Now, though, I am more at peace with whatever happens.

However, since seeking out an RI, finding gene mutations and uterus challenges, I have continued to be optimistic.

I'm optimistic that this treatment plan will help us.  It's a strange sort of optimism with a side of worry.  For the first time in a very long time I am more worried about miscarrying than conceiving.  It's a tough feeling to accurately describe.  I am so optimistic that I'll get pregnant but also that I'll have something to lose again.

As difficult as these once buried emotions are, I welcome them.  Ugh.

Where are we now?  In the midst of IVF stimulation.  I did my IVIG infusion towards the end of April.

I started my stim medication yesterday - Gonal F.  I'm also taking Lovenox.  So far so good with the Lovenox.  I was quite scared to inject the Lovenox given the discomfort and bruising that many women experience.  I guess I'm lucky since it really hasn't been that bad.  Hopefully it stays that way.

On Wednesday, I go in for blood work and will go from there.  I'm expecting/guessing that my egg retrieval will be on May 20.  Eeeeek!  Yippee!  It's about time!!!!!!!

Oh yeah, I'm also doing a low carb/high protein diet to help improve egg quality....  I'm bathing my eggs in protein which is supposed to be good for them.  I suspect that my "poor egg quality" (as the doctors put it) in my first cycle (4 embryos from 17 eggs) may be because of the lack of protein in my diet.  Who knows though?  I guess if we have better results from this cycle the diet worked.

I cannot say that I am a fan of this type of eating but I've been doing my best to limit my carbs and increase my protein.  It's funny that I am doing this diet considering I've never modified my eating              habits for fertility before.  I honestly find this diet a HUGE challenge.  I'm not a big meat eater.  I've joked that I barely eat meat and now here I am eating meat at every meal.  It's tough.  It's also tough that I have completely cut out bread, potatoes and most sugar.  Did I mention that this is TOUGH.

Hopefully this diet gives us great results, if not, my misery will have been for nothing.  I have had digestive issues (stomach ulcers, IBS, lactose intolerance, etc.) for many years and this diet is not helping these issues in the least, nor is it causing me to lose any weight.  If anything, I've GAINED weight.  Blah!

If this diet works it will have all been worth it.  Even if it doesn't work it was worth a try.  Sacrifice is part of this process and part of being okay with the outcome - whatever it is.  It will be okay.  Everything will be okay.

Shopping for my someday baby

I'll admit it.  I spent an inordinate amount of time researching strollers & car seats for my someday baby this weekend.  My secret board on Pinterest was reviewed and added to.  I could have and should have accomplished other things with my time but I suppose it was nice to dream for a little while.

It was strangely satisfying, a little bit sad but also a sign of my optimism right now.

I've been here before.  Heck, I even bought a crib that is sequestered to my basement as I type this.  I hope to not be let down like last time.  Although it is nice to feel optimistic again for a change, I do hope it can stay this way.

I'm nervous, anxious and excited to be on the cusp of beginning another IVF cycle.  This is a good mental place to be in when beginning something so time consuming, emotionally draining and with a certain level of physical pain associated with it.  I am in the right frame of mind to begin the grueling two month IVF schedule.

I am calm and at peace which is just so lovely.

IVIG wheels are in motion

The wheels have been placed in motion for IVIG and now I finally have a little less to worry about and fewer phone calls to make.  Unfortunately, IVIG will be an out-of-pocket expense but we are incredibly fortunate to have infertility coverage so IVF will be covered.  I really cannot complain, especially being as fortunate as we have been in these last few years.  I would hate to imagine what our out-of-pocket expenses would have been if we didn't have coverage and if we didn't have the coverage we probably wouldn't be on the road we are finally on.  We have saved an incredible amount of money with our infertility coverage so I just need to suck it up.   

Is it ideal to pay out pocket? No.

Will it be a strain?  Yes, to an extent.

Will I regret the decision to follow the doctors' recommendation?  Never.

I owe it to my future-self to try.  I need to be able to look back, 10 years from now, and be satisfied
with the steps we have taken to have a family.  I want no regrets.  I want no "we should haves" or "we could haves."  You cannot put a price on peace of mind.

Thankfully, right now I have peace of mind.  I feel well cared for among the entire team of doctors that are looking after me.  I feel supported by my family.  I feel supported by my husband.  Overall I feel good about where we are and where we are headed.

I can finally breathe easy for a few days until I need to figure our IVF schedule and where IVIG falls into the mix.  It's hard to know when to schedule IVIG when there are so many factors at play in IVF that put a wrench in a treatment schedule.  It's a tough spot to be in but that is a worry for next week, not this week.  One thing at a time.  One day at a time.

Today I am Zen.

Nurses are Fantastic!

Nurses keep me informed.  Nurses keep me educated.  Nurses keep my spirits up.  Most importantly though, nurses keep me sane.

Admittedly, I was freaking out yesterday.  I was unsure of some test results that my doctor did not go over with me specifically but included in my patient letter.  There was extreme skepticism about the treatment plan actually working especially because I have no idea of the likelihood.  I was also worried about the financial aspect of IVIG. 

Thankfully many of the things I was freaking out about have been explained to me by a nurse who listened to my additional questions and put me at ease. She was able to give me the assurance that the Doctor did not give me last week at the end of our phone call.

Most importantly the nurse made me realize that I need to slow down.  Part of my anxiety has been tied to my desire to start a fresh IVF cycle next week.  I don't think I have enough things in order to proceed with that plan.  This is good and bad.  The timing of a Feb-Mar cycle would have been ideal with our work schedules however there are still many phone calls to make, most specifically about IVIG.

In addition to the financial aspects of IVIG the nurse reminded me that it takes 6 weeks for your TSH levels to go down after a medication increase.

So I am going to put aside my wish to start IVF sooner than later.  This will give me time for my thyroid medication to work and to make the 400 phone calls I need to make to try to get IVIG covered by my insurance and set up for infusion.  Before yesterday it was my hope that I would only need one IVIG infusion (if be willing to accept the full financial responsibility) but since speaking to the nurse I have a feeling I will be doing at least a few of them so it is worth my while t try to get them covered by my insurance company.

So I'm off to make more phone calls.

I'd also like to mention that I was able to join some closed/secret groups on Facebook that I think will provide great resources in the coming months.  Most importantly I was able to join the Reproductive Immunology Group, thanks to a nice new friend, but also a Lovenox Group and a MTHFR Group.

I need to remind myself that this is a marathon and not a sprint.  I just need to stop and breathe.  Having this new job has been so unbelievable when it comes to my stress level.  I am very fortunate in so, so many ways even if we are enthralled with infertility challenges and now three gene mutations and an immune disorder.