I wish just once I could share good news.  Thursday was the big day for egg retrieval surgery.  I took my last injection (hopefully ever) Tuesday night.  The "trigger" shot is the final step in preparing the eggs to be retrieved; it's supposed to mature and ripen them.  Immature eggs are incapable of being fertilized and are essentially useless.  Retrieval must be exactly between 35 and 36 hours after the trigger shot.  Too soon and the eggs will not be ready and are useless.  Too late and I will naturally ovulate and lose them all.  We arrived at 7:15 am and I was prepped for surgery starting at 7:30.  This time I was placed in a private room and had an absolutely wonderful nurse, Paula.  From the start she made me feel welcome and comfortable.  She went above and beyond to review my medical record with me just to give me the piece of mind that she knew who I was.  It really did help....I didn't feel like another number to her.  Even though I had gianormous veins, she had some difficulty starting the IV, mainly because I'm a needle phob and a complete baby.  I  moved and we had to start over....15 long minutes later I was starting my IV antibiotics and fluids.  My surgery was set for 9:00 and was taken into the room a little after 9:00.  I guess the doctor wasn't quite ready so I was lying on the OR table for like 15 minutes just staring at all the equipment and trying not be be a bundle of nerves.  Even though it was my second time, I was still nervous...not about the physical stuff but that I wouldn't have good results.  I just wanted to get it over with so I knew.  Within a matter of time I was put to sleep, woken up and learned I had 10 eggs retrieved.  Not too shabby, although I was still hoping for more than last time since I was on a higher dosage of hormones this round.  Upon waking I had more abdominal pain than last time and it caught me off guard.  The nurse explained that the needle (what they use to extract the eggs) tore some tissue in no man's land and I needed a stitch or two since I didn't stop bleeding.  Due to the anesthesia I was quite loopy and my emotions of the whole thing finally got to me.  She and I talked a bit about how hard IVF is and how it wears you down...how hard it is to desire something you simply cannot have.  She told me someone close to her was going through the same thing and that made me feel like she somewhat gets it.  She asked if she could say a prayer for me that we will have our baby.  I was completely touched and wished more nurses were this great.  

The following day (yesterday) I called out of work.  To be honest, if I didn't lift anything too heavy I probably could've worked but mentally I couldn't take it.  I knew at 8am I'd be getting a call from the lab to go over our results....how many of my 10 eggs were actually mature and how many fertilized.  It's a BIG deal.   Last time our numbers were SO great and I knew that there was a chance they wouldn't be this time....I just didn't expect them to be as bad as they really were.  Of 10 eggs, only FOUR were mature and could be used....only 40%!  That's awful.  I am wondering what happened...should the doctors waited one more day for the eggs to get bigger or is this just a fluke?  I just don't know.  Of the four only two fertilized.  Only two!  That's even more awful.  I knew that we have trouble getting the embryos to grow and the likelihood of them making it to transfer, dividing correctly and staying alive is bleak.  At least last time we had more than 3 times that amount to play with.  I am so upset but if we make it to transfer tomorrow I need to try to remain as stress free as possible.  This morning we received a phone call that the lonely two are doing ok.  They check only once a day to see how and if they are dividing and are alive.  Too much poking at them isn't good.  One embryo is 2 cells and the other is 4.  Those are normal numbers, but looking back at  last time it was the third day (tomorrow) that all went to hell.  Most just stayed at 2 cells.  I am hoping and praying with all my heart that they make it over the next hurdle.  I want at least two to transfer, to increase my chances.  If one or both dies, I can't bear the thought of not even having a chance.  

I Would Die For That

http://www.youtube.com/watch?v=AnqJCLMIc2k

This is just what a small glimpse of how we feel.

DAY 9:

  Today is my 9th and final day of stims.  I will definitely not miss my nightly cocktail of injections.  After tonight I have two more shots to give myself.  My morning injection is a drug that makes sure I don't accidentally ovulate and lose the eggs I have worked so hard to make.  I've been doing these morning injections for the past 4 days and tomorrow is my last.  My belly is sick of being a pin cushion.  Then tomorrow night I will inject my "trigger" shot which ripens the eggs for my retrieval on Thursday.  Thursday is the big surgery day for egg retrieval.  In the grand scheme of things, being on injectables for 9 days seems relatively short to do such a big job.  I've been following up with the the doctor every other day and now that I'm closer to retrieval I go daily for monitoring (more bloodwork and ultrasounds).  They found 8 follicles which contain hopefully mature and beautiful eggs.  For my age and problem, 8 to 10 is average.  I'd like more, but as long as they are all good quality I'm going to be happy with what I've done.  I can honestly say I couldn't have done more: avoiding caffeine for 7 months, alcohol, eating organic when I can, exercising, multiple vitamins and supplements, and even acupuncture. I am nervous for retrieval...not so much for the physical pain of surgery, but for the outcome.  In infertility treatments, passing each step is a milestone.  I've made it past the biopsy for co-culture, I've nearly made it past the medication phase, then comes the egg retrieval, then the ICSI for fertilization (where they inject the sperm into the egg in the lab), waiting for the embryos to grow, then embryo transfer, and then hoping and waiting to see if I'm pregnant.   I seem to pass each hurdle so well, until the time when the embryos are supposed to actually grow. I think what will make me the most nervous the next few days will be seeing if our embryos grow this time. It was SO disappointing last time when they said everything with my cycle was picture perfect....until the embryos just didn't grow. Waiting for my daily phone call from the embryologist at the lab was so nerve wracking and I'm dreading it again.

I'm going to rant and rave for a bit.  Today we just went grocery shopping.   I swear every time I go to Wegman's they have a pregnant women's convention.  Then I get home and put my groceries away.  Most people have a vegetable drawer.  I have that too, but I also have a fertility drawer where my medication that cost thousands of dollars sits.  It's just not fair.  Most people this weekend will be enjoying their holiday.  I'll get to be recovering from surgery and pining away about the outcome of my potential babies.  Most people will be spending Labor Day with their families while I'll only be dreaming of the family I can't have. I work in a medical office building and get to see pregnant women waddle down the hallway to the antenatal suite all the time....some with children in tow.  I just want ONE....they have two, three, sometimes more.  I've only seen the inside of that room in my dreams.  Even if this IVF does work out, it's unlikely I'll ever be able to give my child a sibling.   Since we started this journey, by no exaggeration I have counted over TWO dozen of my friends and family that have gotten pregnant in the time it's taken us to try for just one...some are already on their second.  While I'm happy for everyone else, I am so heartbroken for myself and wonder when it will be my turn.  I'm sick of watching everyone else get so easily what we can't.  I'm sick of hearing pregnancy and birth announcements while I sit here and inject myself with medication for a small chance of getting pregnant.  It's so difficult to watch yet another pregnant belly grow as I watch needles being stuck in mine.  This past weekend, we went out with friends and what was part of the topic of conversation....?  My husband happened to start a conversation about his job regarding unwanted children.  He works for the court system and sees SO many parents neglecting their children or giving them away because they can't care for them.  While he was telling stories, I was trying not fume inside that my fate is this. I was trying not to cry at the fact that people who don't even want children or can't care for them can have them while we can't.    

I started the injections Sunday night.  By now I'm a pro and can do it without cringing.  Every night at 9pm I religiously give myself two to three injections in my stomach.  I'm on a hormone cocktail of Gonal F and low dose HCG...both help to stimulate follicle growth (where the egg grows).  In a typical cycle without hormones, females have many follicles that develop each month but only one wins out to beat the others and grows an egg.  The rest are immature eggs incapable of being fertilized or never grow an egg and are discarded naturally by the body. The hormones I'm taking will help all those normally discarded follicles to grow a nice mature egg inside.  In an IVF cycle by the time all is said and done, each ovary will swell to the size of a grapefruit.  I can tell you from experience that this is quite uncomfortable and sadly the closest thing I've ever felt towards pregnancy.  I can somewhat vouch why pregnant women complain about their bodies but I would gladly trade places with them.  Most women who get pregnant easily and naturally will never appreciate how lucky they really are. 

I started out with a glitch in this cycle.  I received expired medications from the pharmacy! It's a good thing I happened to check the expiration date.  This is likely very atypical so those going through IVF shouldn't freak out....just remember to check your boxes and vials.  On my first day of injections I noticed it expired that day.  If the medication is expired or not kept refrigerated, it could severely compromise the results. It was a mix up at the pharmacy and likely the medicine was still actually good.  They still sent me a new vial, free of charge but I did have to take the expired medication for one day until the new one arrived.  Since it wasn't the most important medication to stimulate egg growth and it was only one day, it was likely no big deal.  So many things can go wrong in a cycle and so many things can cause anxiety that I'm trying not to let this freak me out or cause my stress to elevate more than it initially did.  

Tonight will be my 4th night of injections....typically most women "stim" for 9 days, so I'm about half way there.  In a few days I will start a third injectable medication to make sure my body doesn't accidentally release the eggs (ovulate), causing the procedure to fail.  This morning was my first appointment with the clinic after starting medications.  Again, I had a few glitches.  I normally have gianormous veins.  But today for some reason....not so much.  She stuck me a few times and dug around for a bit until she finally got some blood.  Now both my forearms look like I have track marks on them and are bruised...and I have roughly 3 to 4 more times I have to give blood within the next week. Ugh.  With it being summer, it's hard to hide and I don't like people (patients) asking questions at work.  Work is my ONLY time NOT to think about our problems with not being able to have children.  My ultrasound wasn't that great either.  I only have 7 developing follicles...that's HALF of what I had last time.  I know NO IVF cycle is the same and to never compare, but it's hard not to be disappointed in my numbers.  The less eggs = less potential babies.  Only about 2/3 of retrieved eggs are actually mature.  If I do the math, that's about 4 to 5 eggs we have to work with.  From those, typically only a third will become fertilized which leaves me with only 1 to 2 potential embryos.  Considering our problem with the embryos not developing, that doesn't leave us alot to work with....last time we had EIGHT and look what happened?  I understand this can change for the better or worse, but it's still difficult to not think about the outcome.  With this being our last chance to have a family, I am SO incredibly nervous.  One key thing I've learned is that it's the quality of the eggs, not quantity.  For now, that is all that's keeping my chin up. 

So for now I'm busy with appointments and trying to juggle work.  I had acupuncture yesterday, I had an appointment today with the clinic, tomorrow I have acupuncture again, Friday I have another appointment at the clinic and that's only this week....  Even though I'm nervous as heck, I'm doing rather well overall.  I'm thankful for the support I receive from my friends and family and only hope that support will continue and  multiply should this fail.  I can't imagine what a wreck I'll be....it's hard when no one understands completely or has been in my shoes.  It's easy to imagine how one should deal with this....until it's you.   

It's hard to believe we are at it again.  Trial number 2...and hopefully our last.  We are hoping and praying for success this time around since financially we are unable to pursue our journey past this round.  This IVF is a bit different this time around.  Our doctor recommended trying something called co-culture.  It's where they take my uterine cells, grow them and later allow the embryos to grow on top of them.  Last Monday I donated 10 vials of blood to this cause and this past Wednesday I had a uterine biopsy to collect cells.  I'd imagine they are growing in the lab right now.  The biospy was quite unpleasant and downright painful to say the least.  But I've had practice since I had a few others before.  At least it was quick.  In case you're wondering, to collect the cells they insert a long catheter through the cervix and into the uterus.  Even though I've had biopsies before, this was the first time I could stomach looking at the instrument used to collect the sample.  

Tomorrow I go for initial bloodwork and internal ultrasounds to get a baseline of my hormone levels and egg development.  Sunday is the big day I start injections (between 2 to 4 a day for about 10 to 14 days).  Last time I didn't have too many awful reactions to the hormones except a few hotflashes, bruises,  and abdominal pain and swelling.  I am hoping for the same or better this time around and am praying my body will respond to the medication to produce lots of good quality eggs.  Initially, I'll follow up with the clinic every other day, but closer to the end I'll be headed there daily.  It's ALOT of appointments and not always easy to juggle my work schedule.  I would suspect in about 10 to 14 days I'll be headed for surgery to retrieve the eggs.  

In addition, this time around I am trying acupuncture.  I've had three consults at great clinics and ALL doctors recommended I try it.  Acupuncture helps to stimulate blood flow to the ovaries to provide them with nutrients needed to grow healthy eggs.  I've been going weekly for the past 5 weeks but will start going twice next week and the week after.  Unfortunately this is running us a few extra hundred dollars but it's a chance I need to take.  If we fail, I want to be able to have the piece of mind that I did everything within my control to improve our chances.  

I wish I could say I was optimistic.  I've had too many letdowns and heartbreaks to be.  I am hopeful though, but am realistic.  I knew last time I'd be upset if we failed, but I didn't realize HOW upset.  It's worse than anything I could have ever imagined.  This time more is at stake since it's very likely it's our last.  If this fails, we will never be parents and that's a BIG deal for us. I'm hoping with every ounce of my being that it'll finally be OUR turn.  

Sacrifices

I always knew that being a mom I would have to make some sacrifices.  I knew I'd have to give up the freedom to be able to meet with friends at the last minute, staying out late on a weekend (then again I don't do that now!), having the amount of "me" time I have now, sleep, among many many other things.  I knew it wouldn't be easy but am still convinced that the rewards of parenting far outweigh all the negatives.  I didn't bargain that trying to get pregnant for the past three years would require just as many sacrifices.  While I don't think any new parent can truly grasp the difficulties of parenting, the past three years have really prepared me for my soon hope-to-be job as a mom.  

Awhile ago someone said that they didn't see Chris and I sacrificing alot to be parents.  Those that are close to us and know our struggles will likely tell you differently.  This statement really shocked and bothered me because I know the hell we've been through for the past 35 months.  Each couple that struggles with infertility has their own different struggles, but I bet and can guess by following others' blogs and chat rooms that our sacrifices are similar. I'd like to provide some insight on some of the things we have sacrificed.

Privacy:  Letting a team of complete strangers (doctors, nurses, etc) into on our private life isn't exactly easy.  They know everything about us....what we eat, how many partners we've had, how many times we have sex in a month, when I get my period, our entire medical history, not to mention "baring" all at appointments. Any woman will tell you gynecology appointments aren't a day at the amusement park.  The best way to describe my appointments are like gynecology appointments on crack.  They are much more invasive, more painful and much much more frequent.  

Time:  For us, trying to get pregnant is a BIG time commitment.  Like most of you, we didn't just get to have sex a few times and end up pregnant.  I've used ovulation kits for months, timed sex around ovulation, failed 3 IUIs and one IVF.  During treatment cycles I have to go to the doctor around 3 to 5 times a week.  Many are last minute and unpredictable since it depends on my body. Juggling my work schedule is stressful.  To date, I've had at least 50 appointments.  It's also a big time commitment in terms of being informed.  I've spent countless hours reading books (about 8 total), researching the internet for information and researching clinics and doctors.  

Sex life:  As taboo as it is to talk about, I'm gonna do it.  Yeah our sex life has suffered.  Sex is no longer an intimate experience as a couple... it is strictly about baby making.  When you have doctors telling you "when" and countless tests and instruments up that part of your body, you don't exactly feel sexy.  I hate when people tell me that "practicing to have a baby is the best part" so we are lucky.  Any good thing done long enough gets tedious.  Chocolate ice cream is delicious, but when you eat it every day it gets old.  What's worse is that for us it a futile effort, putting more pressure and stress on us when the doctors give us the green light.  I can guess for most infertile couples, sex causes some stress and arguments.  

Body:  I feel like a piece of meat...like a science experiment.  I can't count the number of times I've had blood taken, injections filled with hormones, and painful procedures.  My body no longer feels like my own.  

Indulgences:  I've given up alcohol, all caffeine, have been trying to eat mostly organic, and am taking about a dozen supplements daily just to try to increase our chances.  I LOVE coffee but haven't had any since January 26th.  I don't cheat...even a little.  When your desperate for something, you'll do anything. I've also been pretty diligent with taking care of myself by getting the right amount of sleep and exercising regularly.  All these things take time to do well.

Sanity and state of mind:  I will admit I'm depressed alot of times.  I'm doing my part by acknowledging it and getting the proper help.  I withdraw and isolate myself from people sometimes.  I cry alot.  I get angry alot.  I am sad alot.  I cried four days straight at a pregnancy announcement.  It took everything I had to pull it together.  I felt like a monster being so angry that it's not me too.  Anyone that's been depressed will tell you it's something you can't help.  While I have a good life and am blessed with may great things, it still doesn't fill the void I have.  It makes me feel ungrateful for what I do have.

Self esteem:  My body isn't doing what it's naturally been made to do.  We fail month after month.  I can tell you I feel less of a woman and strangely an adult as a result.  I'm sure my husband will tell  you the same thing about his masculinity. I see others getting pregnant and having families so easily.  Why is it SO difficult for us?

Money:  Assisted reproductive technology is expensive.  The average IVF is about $15,000.  We make a decent living, but we have school loans, car loans, and a mortgage like everyone else.  Recently I tallied our bills since starting this journey.  I stopped adding at $26,000.  For us, that is ALOT of money.  Because we were blessed with some donations we ended up paying about $21,000 of our own money thus far.  That could have been saved for daycare, for our child's college fund, for needed baby gear.  If I'm lucky enough to have our next IVF work I will be struggling to pay our IVF debt and buy baby gear at the same time.  It won't be easy.  I worked hard to have a good education so I could make a decent living and I feel it's been a waste of time.  Most people are lucky enough to not have to deal with this.  A year ago, before the doctors broke the news that IVF was a must, we went on vacation to Utah.  We didn't plan on needing IVF...who does? Earlier that year we had just failed 3 IUIs and we needed a much needed get away.   I am not ashamed we spent our money on that.  Anyone in our shoes probably would have done the same for sanity sake.  Vacations, clothes, and home repairs are a thing of the past.