Sunday, November 30, 2014

Day 7 - On the Low Side.

I went in again this morning for more blood work.

There are two main things I need to accomplish to graduate from the stimulation phase to egg retrieval.  I need an estradiol level greater than 1,000 and at least 5 mature follicles (10mm or greater).

The results of this morning's blood work showed that my estradiol level was 427 and the nurse explained that this was on the low side.  Since the nurse spoke so rapidly yesterday, I asked her to recap my follicle results.  She reported that I had three that matured to at least 10mm and were big enough for retrieval.  My ovaries sill have some work to do and I am to continue on my three-a-day protocol.

Since my numbers were low, I get to skip a day of monitoring and am due to report back the day after next for blood work and another ultrasound.  On the bright side, today marks only 6 days of the stimulation drugs and on average, it takes about 10 days to reach the pinnacle. 

Despite knowing I was only half way though the average number of stimulation days, hearing "on the low size", caused me to panic.  Of course my fingers ran off to Dr. Google.  My research put me at a slight ease as I learned many women are slow developers and that numbers could double overnight.  But then I also read that some women have to cancel their cycle because they never reach optimum ripeness.  So once again, anything goes.  I have no choice but to do my best to remain optimistic.  I figure I might-as-well until someone gives me further reason not to.

Grow, girls, grow! 

-nineteen eighty

Saturday, November 29, 2014

Day 6 - Three-a-days.

After you've been on the stimulating injections for five days they have you come in and do a round of blood work and an ultrasound to see how your follicles are doing.  I did as such and received a call back from the nurse this afternoon.  She reported that my follicles were looking good and growing.  My blood work, which also tests estradiol, progesterone and lutenizing hormone levels, also looked good.  She gave me some of the numbers associated with the results but rattled them off so quickly they didn't register.  Whenever they call they seem like they are in such a hurry.  I hate that.  I am sure a list of other broads to call, but this process is anything but routine for me.

Since things looked good she told me to add the Ganirelix injection to my daily routine, bringing me up to three injections a day.  The purpose of Ganirelix is to prevent me from ovulating prematurely.

Lastly, I was directed to return tomorrow morning for blood work.  I will have to continue to report daily for the next five days or so until everything looks nice and ripe.  Reporting daily is going to be a royal pain.  It takes about 40 minutes to get to the Fertility Center from home.  It's in downtown Pittsburgh so if I don't get street parking I have to park in the garage and pay.  This is why I can't stress enough to consider convenience when selecting a Fertility Center.

Despite my gripes about being on this roller coaster, I can already tell you it's worth it.  I know Tower and I will have a good life whether we have a family or not.  But I believe in no regrets so you got to try your darndest - which is what has brought me to here. 

-nineteen eighty

Friday, November 28, 2014

Day 5 - Just be Normal.

Surprise, surprise I was a bitchy Betty again today.  I think I've cried the past three days in a row.  Awesome.

Tower had to go down to the Fertility Center to do his Cystic Fibrosis test.  We will get the results in about 10 days.  By the time we get the results it will be too late to change the way we are doing this cycle.  If he tests positive for the Cystic Fibrosis gene and we need to do a second cycle, we will have the option to do genetic testing of the embryos before implantation.

It is becoming kind of a pain of the ass to get my shots in at a specific time.  Tonight I had to pre-mix my Menopur before leaving the house and inject myself in the car on the drive to meet friends for dinner.  On the bright side, I am definitely getting more comfortable with the process.  I am taking great care to follow my protocol to a T while maintaining as normal of a life as possible.

I have not cut out caffeine or vodka yet (nor have they told me to).  I am not an over indulger in either, but a little nip of both on the semi-regular probably keeps me more even-keel than without it.  I have been making play dates with girlfriends to engage in the occasional vent session and just as important - to hear what's going on in their lives - the drama and dates.  I am also proud to report that I am keeping up the workout regime I had in place before beginning this process.  For me sweating is so key in maintaining my mood.  It also helps me feel better about injection filled gut.

........keep on, keeping on.

- nineteen eighty

Thursday, November 27, 2014

Day 4 - Ima Bitch.

I can be a bitch on my best day.  But - damn, these hormone injections have taken my bitchiness to a whole new level.  Today, I was just evil to Tower.  God Bless him.  This is not an easy process for either partner.  The money, time, and needles that goes into this is enough to send anyone into a tizzy.  Add the injections and you don't even recognize yourself anymore. 

Speaking of needles, Tower and I got into today because he says I "chased" him with a needle.  Hardly, you wuss!  You see, he hates needles.  In my effort to keep him engaged in the process I simply held the poke up for him to see and said in a calm playful voice, look at this, do you think you could do this.  Admittedly, sometimes I play up the suffering so he sees what an amazing and determined women I am for enduring this for the sake of our future family.  See, I told you I was a bitch - a greedy one at that.  : )  But truth be told, I am glad we both are having irrational moments through this process so that we counter balance each other.  With that said, if we were keeping score on the irrational moments I'd totally be winning.

The stomach continues to feel tight and bloated.  Not fun.  It's darn right hanging over my pants.

-nineteen eighty

Wednesday, November 26, 2014

Day 3 - Two-a-days.

Today I started my protocol of twice daily injections of the Follistim and the Menopur.  I had to watch another video this morning to learn what to do with the Follistim.  Unlike Menopur, which you have to reconstitute and draw into a syringe, Follistim uses a nifty pre-mixed injectable pen.  Both get injected in my stomach below the belly button and I alternate between my right and left sides.  The injections need to be about 12 hours apart and so I've decided on 7:00a/p.  I am scared I am going to forget about this new daily ritual, so I've set an alarm on my phone.

It's hard to explain but I can definitely tell that something is up with my belly.  It feels bloated and tight and honestly my jeans were snugger today.  Also, I don't know if it's possible for the hormones to have already taken over, but I got irritated this morning at something that I normally wouldn't even have registered with me.  I could feel myself getting upset and the tears started so I decided I better go workout to try to release some of the tension.  I ugly girl cried hard the entire 15 minute ride to the gym but was fine for the rest of the day.


-nineteen eighty

Tuesday, November 25, 2014

Day 2 - First Injection.

I went for my baseline blood work and ultrasound and immediately afterward I headed into work.  Anytime I go in for blood work or an ultrasound the nurse will call with the results between 1:00 - 3:00p.  On schedule, the nurse called and let me know that everything looks good and there were 8 to 9 follicles visible on each ovary - which is very good.  In fact, it's even slightly better than my first ovarian reserve count. Small victory!

The nurse also gave me the go ahead to do my first evening injection tonight and begin my twice daily injection protocol in the morning.  I prepared the syringe along with the web video and without too much hesitation, let it rip.  The poke is actually very smooth and painless and the medicine did not irritate or burn.  All good and I am so glad to have the first needle behind me.

Now off to celebrate over a Margarita with Tower.......might as well.  I'm going to be cut off in a couple weeks.

-nineteen eighty

Monday, November 24, 2014

Day 1 - Janky Genes.

I started my period this morning so it is time to finally get this show on the road!  I called the nurse line and left them a message - yo!  Aunt Flow is in town.  They returned my call fairly quickly and scheduled me for my baseline bloodwork and ultrasound for tomorrow (day two).  The baseline testing needs to be done on day two, three, or four of your cycle.  I was feeling nervous, yet excited that this journey is about to begin.

Then.....about an hour later I received another call from the nurse.  She said, I don't know how we missed this but your Cystic Fibrosis genetic test came back and you carry the gene.  Fuck, really- you are just telling me this now.  She proceeds to ask me if my husband was, he wasn't....well, then we would really recommend that you wait to proceed.  Fuck!  I had just wrapped my head around the fact that this process was starting.  Not to mention, I just spent $5,000 on medications.  She goes on to say, that it is our choice but they need to their due diligence and explain the risks.  She also recommended that Tower be tested for the gene and we schedule a genetic counseling session.  

As it turns out, a Caucasian person has a 1 in 29 chance of carrying the gene.  If both Tower and I carry the gene, then our child would have a 25% chance of having Cystic Fibrous.  On top of that, we have a 45.6% chance of this IVF cycle working out.  It's just like playing roulette in Vegas - do you want to place your chips on red or black, baby?!?  I hate that.

Tower and I decided that we would proceed with this cycle.  If things would have worked out naturally for us, we wouldn't have this tidbit of information.  And as it is, I am uneasy with the amount of science that goes into this.  Raised Catholic, I'm uncomfortable with playing God.  In the meantime, Tower will get tested and if this cycle doesn't work out we will know more going forward.

- nineteen eighty

Saturday, November 22, 2014

Box o'IVF meds.

Tower picked up a huge box, containing my medication today.

The box.

Stimulation Medication - these medications work to directly stimulate the ovaries to produce follicles.  I was prescribed both Follistim and Menopur.  For approximately 10 days, I will inject the Follistim in the morning and Menopur in the evenings into my belly.

Holding Drug - this will prevent ovulation while continuing to stimulate my ovaries with the stimulation medication.  I was prescribed Ganirelex, another injectable, and this will start around day 5 of my cycle.

HCG - this medication is known as the "trigger shot", meaning it induces ovulation within 35 hours.  It was was prescribed Ovidrel and you guessed it - it's another injectable.

Progesterone - this medication is used with a treatment cycle to support the endometrial lining.  There are actually several different types but for the sake of no more needles I selected Endometrin which is a vaginal suppository.  This is used after the embryo transfer.  If the transfer is successful, use will continue until week 12 of the pregnancy. 

Our out-of-pocket grand total for this was $5,183!  It's shockingly expensive and you better believe they make sure it's paid in full before they give you the goods.  This is after assistance from our insurance company, which after a $3,000 deductible pitches in and cover a percentage of the cost.   Fuck, that's a lot of money.  When I whined to the pharmacist she reminded me of how lucky we are because people that pay completely out-of-pocket are slapped with a bill in the range of $6,000 to $7,000.  And let me remind you this, is just for the cost of the medication.  The IVF procedure is whole other bill.

We were also lucky enough to have $450 to apply towards the $5,183 in meds from a health savings account, Tower's company provides.  If you are looking into fertility treatments do your due diligence and look into starting a health savings account or a flexible spending account beforehand.

The hugely frustrating thing about the meds is that the Fertility Center gave me a list of medication options under each one of those categories.  It was incumbent upon me to do the research on each of them and chose which ones I wanted to use.  Additionally, I was provided with a list of specialty pharmacy to call and price out the said drugs.  Unfortunately, you can't just go to the Walgreens down the street.  This is so dumb - the process is so confusing and stressful as it is.  I would be so much more comfortable if they selected the medications.  Especially if the recommendations were based on success rates.

I took the easy way out and called just one pharmacy on the list, I selected them because they were local and we could pick up the medications.  Believe or not, said pharmacy has a dedicated line to a fertility department and those people know their stuff.  They were able to quote me the prices off the top of their head and because they were local were familiar with what most people who go to my doctor select.  They also were able to explain which ones were easiest to administer.

The other thing that I am shocked about is that the Fertility Center does not give you any instruction as to how to administer the drugs.  Instead they directed me to this website to watch freaking videos.  Dumb.  And I am scared.

- nineteen eighty

Friday, November 21, 2014

IVF & Me.

It has taken me exactly one year to get this point.  Tower and I just celebrated our one year anniversary, which means we've officially been trying to start a family for 12 months.  I'm 34 and he's 37 so given our age we decided to hit the ground running. 

The first couple of months of trying consisted of monitoring my cycle with the p tracker and clue iphone apps.  After that didn't work, I graduated to the ovulation predictor kits (OPKs).  According to the smiling pee sticks, I was ovulating and my cycle was on point.  Yet, still no success.  A few months later, I met with my gynecologist and she ordered the typical protocol for someone who is trying to conceive.  This included blood work to test my follicle stimulating hormone and progesterone level,  and a hysterolsalpingogram (a test to determine if both Fallopian tubes are wide open for business).  Tower was also summoned to get his swimmers tested.  Everything for both of us was normal.  I was then referred to a Fertility Center in Pittsburgh.  More testing ensued; more normal results.  The only exception was that from my hysterosalpingogram, my doctor could not say with 100% certainty that both of my tubes were open.  I found this super annoying because the doctor who conducted the test, said they both looked good.  GAH!!!!!!  

Another one of the factors my doctor looked at was my ovarian reserve which measures your antral follicle count.  My understanding of this is that it's a measure of the quantity and quality eggs you have left.  My count was 12 and they really want you to have at least 9.  I passed and am in a normal range for my age, but did not achieve rock star status. 

So based on a possible clogged tube and not achieving rock star status my doctor recommended IVF.   I'd rather be able to do this naturally but on the other hand I feel blessed that it's an option for us.  It is SO expensive but with the resources and insurance available to us, we are going to be able to finagle it.  I could wait and continue to try naturally, but I ain't getting any younger and I also have Ulcerative Colitis, an auto-immune disease.  While the auto-immune disease shouldn't impact my fertility - you just never know.  

I wish I would have started documenting this process earlier because there has been a lot of other steps to get us to this point.  But in summary, by now I should basically have a reserved parking spot at the hospital.  I highly recommend when selecting a fertility center you really consider the convenience of their location.  You will be there ALOT!  Especially, when you really get into a treatment cycle. 

I will try to go back in fill in some of the pre-treatment cycle blanks as I continue down this path.  I wanted to share this story because we are part of a generation in which women are waiting to start families and I want to share the possible side effects of postponing motherhood.   It is nothing to be ashamed of as so many amazing people of all ages struggle with infertility.  Additionally, when I looked for blogs on the subject - I didn't find any that were frank nor candid about the cost or injection process.  All of which has stunned me. 

At this point, we just wait for my cycle to begin so we can start.

- nineteen eighty

I've decided to use nineteen eighty, my birth year, as my pen name because during this whole process I have recited my birth date countless times.  Anytime I call anyone about anything related to this, I must state my first and last name and birth date before they will give me any information.

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