flicker

U/s today, at 6w4d. C went with me this time, as for once it didn't conflict with working. He was a little uncomfortable with the concept of the internal u/s, but seemed to get over it pretty quickly when the tech spun the screen around to show us the heartbeat. Our little one is measuring at exactly 6 weeks, a little beind but at this stage, even the teeniest mismeasurement can account for that. And Charlotte measured behind at the first u/s, but had caught up by the second one, so we're not concerned. The heartrate was a steady 115-120 bpm (the tech told us 115, then the nurse in our follow-up conversation said it was 120). There appeared to have been a second sac, but it was empty at this point, and impossible to tell if it had ever had anything viable in it.

Our next u/s is on 7/7, along with a final meeting with the RE who will "release" me to an OB. From then on, we'll be just another normal pregnant family. Hurray!

doubling well

For some reason, I can't cut and paste or save and insert the hCG graph from babymed.com/tools/hcg-calculator, but Friday (15DPO) was 174 and Monday was 534. That's doubling every 44.5 hours and right on the "max" (for singletons) line. So far, so good. I'm sleepy all the time now, and my waist has already nearly disappeared. I think I've gained a pound or so, but it's hard to tell since "normal" kind of disappeared as soon as I started lupron.

My first OB ultrasound is scheduled for 6/17, but my babysitters (my parents) just informed me yesterday that they'll be out of town that day. I need to reschedule or find someone else to watch Charlotte for a 7AM appointment. Maybe her old daycare isn't full that early on a Friday. I don't want to delay the u/s. I'm eager to see that everything is as it should be.

news

BFP !

11DP2DT- early-response test turned definitively positive 15 seconds after I put the cap on it. Can't post more now- juggling squirmy baby with other hand, but had to tell SOMEONE.

Ecstatic.

nothing new on HPT #2

Another negative this morning, but I noticed that last night's test had a second line on it... 12 hours post-use. I know. I know... after 10 minutes, the stick is meaningless. And this morning's was still completely negative 15 hours after use. We'll see how tomorrow goes. I'm not giving up hope just yet. It is, after all, still early.

have stick, will pee

No matter how well I know that it's just too too early for a +HPT, I could not resist that one leftover pee-stick that's been sitting in my linen closet for nearly two years. Of course, it was negative. It also expired nearly a year ago. My first +HPT for Charlotte came 9DP3DT, so my initial plan was to wait until Tuesday to test, at 10DP2DT. But I've been feeling *something* for a few days now- a sort of tugging tightness that washes horizontally from just inside my hipbone to the middle of my belly when I sit up abruptly. It's the same sensation I felt while testing out rocking chairs at BRU in late 2009, but not quite as intense. I was actually dreading a + today, believing one this early would surely indicate multiples. I want ONE. I'll take more if that's what happens, of course. But with all the potential complications, I'm hoping for a single healthy embie to have taken root.

I'll probably buy some more HPTs tomorrow, a multi-pack so I can test daily until it's too late to deny the results. Definitely Monday, if not tomorrow.

Meanwhile, I've lost 8 pounds since ER, most of that in just the four days immediately following retrieval. All fluid, I'm sure. I'm still quite bloated, but suspect that's just the enlarged ovaries which will take a while to return to normal. I'd gained about 10 pounds since starting lupron, so weight-wise things are going well.

Happy Memorial Day weekend, everyone.

all in

At yesterday's ET, I received a more detailed explanation of our fert report. Of the 28 eggs retrieved, 21 were immature. Of the 7 mature eggs, 4 fertilized and grew well. Not a bad fertilization percentage, but it appears we should either have waited another day before the trigger or given my body a few more hours between trigger and retrieval. The doctor who did the transfer was more in favor of increasing the trigger-retrieval interval, which kind of scares me... if it's off by even the smallest margin, the whole cycle could be destroyed by ovulation. I read in someone else's blog about an embryology lab that tries to mature eggs in vitro. I should have asked her about that, and I'll certainly do some online research if we should need another cycle. In any case, as I said to her yesterday, it's all moot because this cycle IS going to work.

Our four mature, fertilized embies looked great. We had one 4-cell with no fragmentation, two 4-cell embies with minimal fragmentation, and a 2-cell with minimal fragmentation. Assisted hatching was done to all four of them to promote implantation. Now we wait. Beta is schedule for June 3rd, but I'll POAS on 5/31, at 10DP2DT. I got my +HPT 9DP3DT, so that shouldn't be too early. Here goes the TWW!

fert report

I'm feeling deflated today. On the plus side, the bloating is down. I'm more comfortable than I have been in a few days, although I still don't need a belt to keep my "fat" pants up. Age seems to have caught up with me, though, as only 4 of my 28 eggs fertilized. I'm scheduled for the 2-day transfer, not the 3-day which would have meant an abundance of fertilized and growing embies to choose from. Everything that's left by tomorow afternoon will be transferred. The platitudes are flying... "It only takes one."

To further mess things up, the medrol was left out of my pharmacy order, so I didn't get to start taking it last night like I was supposed to. It wasn't on the packing slip, so I didn't realize it was missing until late last night when I sat down to take all the post-ER meds. There was nothing anyone could do about it until this morning, and by the time I had it I was told it was too late to "double-up" today's dose by taking one in the AM and another tonight. With only 4 (or fewer) to transfer, and the transfer a day earlier than I expected, I'm seriously concerned that this will lower my chances even more.

But, we have 4, for now. Barring a phone call telling me they all died, I have at least a little hope to cling to. Damn, this is hard.

a good day

Way to go, ovaries! I am once again thankful for this body that I have, and ever so grateful that our only real IF issue on my side of the equation is AMA. Tuesday's E2 was 3339. My lining was at 14.6mm. And they reported "more than ten" sizeable follicles on each ovary. Today, they retrieved 28 eggs- a comfortable number. The risk of OHSS is less threatening than last time (E2 of 3970 and 40 eggs retrieved) and no one even mentioned the possibility of "freeze all." Knowing that there's a trade-off between quantity and quality, I'm actually happier with 28 than I would have been with a higher number.

The retrieval itself went well. My veins have suddenly become difficult, though, so it took a couple of tries to get the IV started. The nurse actually gave up after one failed attempt and asked the anesthesiologist to do it. I really appreciated the warning that I'd feel the anesthesia entering my vein with a hand IV. I did, and it was very uncomfortable, but knowing what it was made all the difference.

Pain this time was manageable. It peaked at about an 8 on a scale of 1 to 10, but didn't remain there long. I knew from experience that heat helps immensely, so I requested a heating pad as soon as I woke up. I also learned last time that a lot of the discomfort could be alleviated by consciously relaxing my abdomen. I hurt so much in 2009 that I tensed up, afraid to move lest something exacerbate the pain. This time, I took a deep breath and then let go. The only bad moments come when I pee- it feels like a full bladder holds everything in one position, and when it's emptied everything shifts around in the freed-up space.

A new development in the ART department of the hospital... if there are few growing embryos and it looks like they'll transfer all of them, they do 2-day transfers. Otherwise, they'll do a 3-day. I'll get the call tomorrow with a fertilization report and will learn then whether our ET will be Saturday or Sunday. My fingers are crossed for Sunday, but as long as we have something to transfer, I'm happy.

the primes have it!

The tech yesterday wouldn't (wasn't allowed to) tell me how many measurable follicles she saw, but when looking at my left ovary, she did say, "We only measure the ten biggest. Then I count how many others are over 12." So, yesterday there were more than ten on my left and I think I counted 8 measurements recorded for the right side. I wasn't able to answer the phone when the nurse called, so I don't know the tally or what the bloodwork revealed. Regardless, I was told to trigger last night. Retrieval will be Thursday morning.

I asked C a couple of times yesterday if he'd be OK giving me the trigger shot. Each time, he said he was a little hesitant, but was sure he'd be OK. He'd seen the needles I use to inject lupron... not so bad, right? Then, at 8:52 PM, eight minutes before trigger-time, I finally showed him the HCG needle. "No way!" Luckily, my SIL was home and willing to do the deed, and lives nearby enough that the shot was only about 2 minutes late. I have to admit, that IS one intimidating needle... long and broad, and painful-looking. In a professional's hands, though, I felt almost nothing. In retrospect, I'm glad My SIL (a nurse) took care of it again. I would have liked to keep this cycle a little more under wraps, but she's good about keeping quiet.

So here we are, with transfer scheduled for CD13. I triggered on CD11. Retrieval is on the 19th of the month. That's a nice series of prime numbers... if I can't have an 18, I'll take primes. And I don't have to buy any more drugs for this cycle, having finished the stims with 450U to spare.

comments! Thank you!

I didn't realize that my settings did not carry over from my original blog, where I am notified each time someone posts a comment. So, I've gotten ten comments that I did not realize were here. I am so sorry for not responding! I appreciate your cameraderie and support, and want to thank each of you personally for your kind words. I'll do my best to get back to you all in the next few days.

still cookin'

I asked about Friday's b/w results when I revisted the RE's office on Sunday for another blood draw and an encounter with the fabled dildo-cam. As of CD7, E2 was 442. CD9 results included 6 measurable follicles on the right, 7 on the left, and an E2 of 1113. Once again, my Gonal-F dosage remained unchanged. I report back again first-thing tomorrow, CD11, for another blood draw and u/s.

At this rate, I'll be out of Gonal-F after Wednesday morning's shot. Unless you count the unknown amount remaining in each pen once the 900 known units have been dispensed. I'm not desperate enough yet to seriously consider administering 4 injections to achieve a meager 150U dose, but ask me again on Wednesday when it's that or spend another $600 for an additional pen. I hope it doesn't come to that, and I'm praying I'll be told to trigger tomorrow night for a Thursday ER/Sunday ET. I'm considering driving myself to the hospital for the ET if it lands on a week day so C won't have to take more time off. He's definitely going with me for the ER- I wouldn't want anyone else there.

As far as the trigger shot goes, I asked C to administer it when the time comes. His family doesn't know we're cycling this time. My SIL, a nurse who loves just half a mile away, gave me the trigger shots in 2009. My parents know because they're watching Charlotte every time I have an appointment, but I don't want to involve anyone else in this. So, when I go to the RE tomorrow, I'll bring a sharpie and ask one of the nurses draw a bullseye on my tush where the shot should go. C gave me my first IF injection, and if this cycle works he'll also give me my last.

CD7

I suspect I'm not responding as "vigorously" as I did 2 years ago to stims. CD7 b/w this morning resulted in no change in my Gonal-F dosage, and a day off from monitoring. I got the message from voicemail, so didn;t have the chance to ask what my numbers were. I'll go back on Sunday (CD9) morning for u/s and more b/w, but until then I continue at 225U Gonal-F twice-a-day, plus the 5U Lupron each morning. Last time, I was lowered to 187.5U Gonal-F on the evening of CD7, and had to return for on CD8 for b/w and u/s. I'm beginning to worry that I may not have enough Gonal-F to get through the cycle. At this pace, one pen lasts two days. I cracked open the third of five pens last night. There's a little left in each "empty" pen, but I don't trust the amount AND I am reluctant to stick myself 4 or 5 times to get one complete dose. My hope now is that I'll have plenty of growing follicles on the u/s Sunday. It didn't occur to me until now that I could not only respond less well, but perhaps not at all. All this money down the tubes, and there may be nothing to show for it. Yikes.

My fingers are crossed.

let the stims begin

Once again, my body amazed me with it's clock-like timing. A 29-day cycle ended Friday, so I scooted up to the RE's and started stims on Sunday night. Mothers Day... how appropos, no? We're following the same protocol as last time, so here's what we know so far-

CD22-29 (end of cycle)- morning: 10U Lupron.
CD1- morning: 10U Lupron.
CD2- morning: 10U Lupron; evening: 225U Gonal-F
CD3-6- morning: 5U Lupron + 225U Gonal-F; evening: 225U Gonal-F
CD7- morning: 5U Lupron + 225 Gonal-F; Report to RE for b/w which will determine next Gonal-F dosage.

Oh, the bloat. Today is only the third day of stims (second and a half, actually) and the bloat has already set in. I have be-bands at the ready to hold up my pants when buttoning them becomes painful. For now, I'm just to the point where I no longer need my belt. I've gained three pounds since starting Lupron.

As if life weren't exciting enough, I started a part-time retail job last week with a company I've worked for on-and-off for the last 8 years. Luckily, the manager is OK with giving me a week off post ER, but I had to guess when that will be. I'm on the schedule to work on 5/17, CD11. My ER was on CD12 last time. I know I'll be uncomfortable, but I hope that's the only problem with my schedule.

now, the "fun" begins

My body really did jump back into its usual rhythms once I stopped breastfeeding. My third cycle began yesterday, so I dutifully called the RE's office to report that CD1 had arrived. Of course, I didn't know for certain until early evening that AF was here, so my call landed on an unattended answering machine. I weighed my options- wait for the nurses to call me and schedule baseline u/s & b/w, which would probably be Monday, or just show up this morning and see if they would accommodate me. They took me right in and said Monday would have been fine, but since I was there... Hurray! Monday traffic would have been awful, so I saved at least 45 minutes by going today. Additionally, I didn't need a sitter since C was home. The two of them needed some daddy-daughter time anyhow.

So, I started my stims tonight- 225U Gonal-F. I'll repeat that dose each morning and evening until Friday, CD7, when I'll head in for b/w. Lupron decreases to 5U each morning starting tomorrow. Following the timeline of our successful IVF, that puts us on track for a 5/18 retrieval and 5/21 transfer.

Eighteen is my lucky number.

side effects

CD21 came and went, and I had blood drawn to check my progesterone level, which would indicate whether or not I ovulated. I did, so the lupron arrived and I started the daily shoot-up on Friday, CD22. The lab where my husband's blood was drawn FINALLY got all the correct results to my RE, so the rest of my meds were prescribed at last. They could not, for bureaucratic reasons, authorize the stims until we had documentation that my husband's blood is exactly as it was 2 years ago. Luckily, this time it was covered by insurance. I plan to dispute the charges for the second blood draw and the multiple wrong tests that were run. If the phlebotomist couldn't read the order, shouldn't she have called the doctor who sent the req?

So, three lupron doses down. I still hesitate a little before sticking myself, but I'm sure that will pass. I haven't noticed any physical side effects yet, but I think I got off pretty easy last time with just a general mind-fog. The stims, which haven't arrived yet, have already contributed their own side effects, though. I can't sleep and I think my blood pressure is up a bit... sticker shock. I don't remember what the prices were before, but how can a single drug cost $6,000? That's ONE item, of the five or six included in the order. I'm unemployed, having been laid off at the end of November. The small business we started a year ago was doing OK until fuel prices climbed past $4/gallon (diesel). We're shelling out over $1k/month for cadillac health insurance, but we still have to pay 50% for "name-brand" prescriptions. The drug order came to over $3300, after insurance. OUCH!

I'm focusing on long-term... we can pay it off in a couple of years, assuming no other major debts come our way. But the house needs a new roof and the car has 130,000 miles on it and the taxes/fees/permits/licenses/insurance on the business keep going up while the profits continue to fall. I started this cycle believing that if this doesn't work on the first try, we can give it one or maybe two more attempts before we're completely burned out. Now, I'm seriously thinking that this may be our last shot.

Stims will be delivered Tuesday. If I have any "leftovers," I'm afraid I won't be quite so generous with them as I was two years ago. Anyone know anything about selling unused drugs?

remarkably normal- hooray!

Ever since I started TTC, my cycles have been regular. I think I knew that before TTC, but never paid much attention. Now, though, I have an appreciation for the predictability. I'd made some hopeful predictions, assuming my body would resume it's usual rhythms, and thought perhaps AF would appear some time around 4/8. She was perfectly on time, so here I am on CD5 counting down to the real deal. On CD21, 4/28, I report to the RE's office for bloodwork (progesterone check, I think). If all is well, I'll start lupron the next day... expect AF to reappear 5/7. If the timing follows our previous (successful) cycle, ER would be 5/18; transfer 5/21; beta 6/4. There are so many "if's" in IF, but my body has been wonderfully cooperative so far. I'm unrealistically hopeful, what with the warmth and support I sense from the RE this time around and the fact that my body is so well behaved. June 4th is the anniversary of the day I first met C in person. What better gift than a positive beta to celebrate 7 years together? And then the realist in me steps forward and squashes all the optimism. This may not work. The odds are stacked against us. Our clinic's track record includes a 21.4% success rate for women in the age bracket below mine. My age is off their charts. But I think optimisti-me is winning still because I just have to respond to pessi-me with, "I am in the best shape of my adult life. I weigh what I did in high school and have been maintaining a very healthy lifestyle for years now (TTC/pregnancy/BF-ing, and now TTC again). This all has to help in some way, no?" I choose to tread the thin line of realistic optimism. Make no plans, but go ahead and speculate. Because this could work.

test results- good to go!

I met with the RE on 3/24 to learn the results of my clomid challenge and other bloodwork. Everything checks out A-OK. Hurray! The RE remarked that by my age (I will turn 43 next week), nearly half of all women fail to qualify for insurance-covered IVF because of their hormone levels. Mine are not quite as good as they were two years ago, but all well within the acceptable ranges. My information will be submitted to the insurance company today, so we should have an approval by Monday. Then, we simply wait for AF...

We discussed my plan, again, and concluded that we should not mess with what worked last time. She dosed me pretty high on the stims, then had to cut way back as the cycle progressed but we still ended up with 40 eggs and a worrisome E2 (3970 on CD11, I believe) that had most of the doctors screaming "FREEZE ALL!" after my ER. Considering my age, we just don't have time to waste a cycle or two trying to tweak the dosages to get the ideal balance between quality and quantity. I did ask about that trade-off... if there was one between quality and quantity, and she said that there is.

My worries this time around are not focused so much on whether or not we can succeed. Instead, I wonder how cycling and pregnancy will affect my ability to mother Charlotte. I worry about multiples, bedrest, and finances. Through it all, though, I have my sweet Charlotte who makes me laugh and fills my heart to bursting with love and pride.

testing 1-2-3

I'll meet with the RE on Thursday, 3/24, to learn the results of the "Clomid Challenge." When I was in the office for the hysteroscopy on 3/18, one of the nurses told me that my CD3 blood work looked great.

The hysteroscopy was quick and would have been painless if not for the speculum. I'm guessing that scar tissue from my minor tearing doesn't stretch easily and was to blame for the brief pain. Luckily, it eased pretty quickly, and the procedure itself was completely without sensation. All is well in my uterus, so once the CD10 bloodwork results are in, I believe the RE will submit the request for IVF to my insurance carrier for approval.

Meanwhile, I scheduled the mammogram, but not without some drama. The first time I called, I mentioned that I'd recently stopped breastfeeding. The scheduler said I could not have a mammogram until 3 months had passed since the last time I breast fed. Timing is completely unpredictable right now as I have no idea when AF will return, so a midMay mammo might not delay anything. But it might. So, I cheated a little, called back, and booked a mammo for 4/12. According to Dr. Google, the tissue of lactating breasts is more dense than normal breast tissue, and may therefore be more difficult to read on a mammo. I'd rather have fuzzy results than none at all.

Things are moving along quite smoothly. I hope my chat with the RE on Thursday ends with some specifics about an active cycle.

Project Sibling... the beginning

3/10/11- CD2, Met with the RE to discuss plans for pursuing child #2. We'll follow the same protocol that resulted in Charlotte, but first need to confirm that everything is functioning properly.

Pre-IVF plans=
*** Office hysteroscopy scheduled for 3/18
*** Clomid challenge, 3/13-17 (CD5-9) with blood drawn 3/10 & 3/18
*** Need to schedule mammogram
*** C needs to have blood drawn for STD testing (standard procedure when using DS)

We've been checking periodically with the bank to ensure that our donor remains available, and would have purchased vials already if availability had diminished. Luckily, that hasn't been an issue. Charlotte will have a full sibling if this works.