IVF DIARY VOL I: 01 AUG 2015


IVF_Diary_Vol1a.pngMedication(s) administered and dosage(s).
2 injections: (AM) Cetrotide 0.25mg, (PM) Ovidrel – HcG trigger shot (yippeee!).

Medical procedures undertaken. Ultrasound and Estradiol blood test, Chris came along this time.  The ultrasound was very uncomfortable with all the pressure building up in my ovaries.  Today’s appointment was with one of the senior doctors who I had not yet met.  The ultrasound seemed to be just a brief check that everything was to his satisfaction before he decided when I will trigger – Monday or Tuesday; this time the nurse wasn’t recording the follicles.  The doctor asked me what I was planning on doing this weekend…I said “nothing!!”.  He said he thought that was a good idea, perhaps I could just about manage some shopping (Chris was behind me shaking his head, miming ‘Nooooooo!!’).  But really, I’m not a shopping kind of gal anyway.  He also told me I should drink lots of water or gatorade (2-3 litres) to keep myself hydrated.

How do I feel today? I am super pleased no more menopur or cetrotide injections!!! Those medications are just AWFUL.  Just one injection this evening, and I will be drug free until Monday! I’ll take that 24hr break!

What are my symptoms? I struggled with falling asleep last night because I like to sleep in the ‘recovery position’ and that was almost impossible as my ovaries are very painful.  I even woke up once from the pain.  Today I am still ‘waddling’ and feeling just a little bit sorry for myself.  It’s a pain I have never experienced before.  It is kind of like the pain after being punched in the stomach and been winded (if you know what that feels like!!), I also just feel generally ‘heavy’.  It has been a glorious sunny day, my mum is visiting, we had plans to spend the day on the beach and all I really wanted to was lie on the sofa and watch TV.  Not really like me at all 😦

How does Chris feel today? He is pleased the injections are over (well for now anyway), he is sad that my tummy hurts.  He bought me some flowers to cheer me up today.  He also bought me some cat fishing bait for when I am in bed on monday.  What is cat fishing bait I ask you?  Well it is a roll of crepe paper party streamers…I think his idea was that I can ‘bait’ the cats to sit on the bed with me and keep me company.

Any results? Today the smaller follicles on the left had caught up, but they are now at 16-18mm, which is just where they need to be.  There isn’t an official count, but I know that there are at least 15 follicles in total.  I have nothing to compare it to, so as long as the doctor is pleased I’m pleased!!! I don’t know my estradiol results yet.

What’s next?  Chris will administer the Ovidrel trigger injection at 10PM this evening in time for my egg retrieval procedure on Monday 7AM! Nice and early :-s

Weight. NSTR

Waist.  Despite my little bloating around my ovaries my waist has amazingly stayed the same size throughout the stimulation phase.  I think I am lucky, but I have been good about not eating too much crap despite my cravings.

Boobs. NSTR

Hours of Sunshine 🙂 I managed to get out for a short walk to the beach and around the neighbourhood – about 45 mins to soak up a little bit of sun.

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

IVF DIARY VOL I: 30-31 JULY 2015

IVF_Diary_Vol1hMedication(s) administered and dosage(s). 3 injections: (AM) Cetrotide 0.25mg, (PM) Gonal-F 300iu and Menopur 75iu.

Medical procedures undertaken. Ultrasound and Estradiol blood test, my mum came with me, that was really nice.

How do I feel today? I pretty much cried at work today because my team gave me a good luck/thinking of you card, with a very generous gift – a voucher for a very fancy restaurant in our neighbourhood…to help us chill out!  How amazing is that?

What are my symptoms? My stomach is still painful from the injections and I feel like I am waddling a little bit from the bloating 😦

How does Chris feel today? He is out having a drink with some work colleagues at the moment, so I think he is probably feeling OK right now!!  I just couldn’t face it this evening.

Any results? Today I had 7 follicles on each side, so it looks like the left ovary caught up, but I am not sure why I had 9 two days ago and today there were 7!  Most of them were 13mm-16mm and the two newbies were 6-8mm I am not sure how they track them all, there are so many to count and measure.  Whatever…it looks like I’m reacting to the drugs according to plan so that is all that matters.

What’s next?  Tomorrow morning I have another monitoring appointment, hopefully the last one before they give me the go ahead to ‘trigger’ and I have egg retrieval on Monday. Yippeee!!

Weight. NSTR

Waist.  NSTR.

Boobs. NSTR

Hours of Sunshine 🙂 No sun today 😦

150731_IVF1_Stats

150731_IVF1_Follie

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

IVF DIARY VOL I: 27 JULY 2015

IVF_Diary_Vol1fMedication(s) administered and dosage(s). 2 injections: Gonal-F 300 iu and Menopur 75 iu.

Medical procedures undertaken. Ultrasound and blood test.  Also had a quick pre-surgery health check up.

How do I feel today? I have found it really hard to concentrate at work today.  I don’t know why.  I have a really big project deadline coming up…of course it is due the week of egg retrieval and transfer.  Couldn’t have planned it any better?!?! (a bit of sarcasm there).  I have pondered about working from home, I have also pondered just calling in sick.  But I checked out our sick leave policy for the first time in my life!  If I am off work for more than two days I need a doctors note, and if I am sick for more than 6 days in a year it cuts out of my annual leave entitlement :-s  so as I will probably be taking 3-4 days of sick leave for the procedures next week, basically, I need to not call in sick! (I had one sick day earlier this year).

The doctor who did a quick pre-surgery health check up was very young.  So young that she actually said “Love it” to me when I said I had no questions.  I feel old.

What are my symptoms? Lot’s of peeing!  I’m trying to avoid headaches so I’ve been drinking more water, it has mostly helped, but I am having the odd headache here and there.

How does Chris feel today? “Feeling good because we are on track and injections are going well” (he hasn’t killed me yet basically)

Any results? My follicle count this morning is currently at 8 at various sizes from 4-8mm…apparently I am progressing how they want me to progress and were pleased with this.  Well I’m pleased if they are pleased!  I will stay on same dosage of Gonal-F (300iu) and menopur (75iu), but adding cetrotide to the list of injections.

What’s next?  Eeeek, I start the Cetrotide injections tomorrow morning, increasing total number of injections per day to 3.  Seriously going to run out of space on my tummy soon!  But I am excited because this means we are almost half way through this stage of injections.

Weight. OK so I panicked with my 1.6lb increase yesterday, but some of that had disappeared by this morning, so it must have been a combination of weekend munchies with some bloating from the stimulation.

Waist.  Still feeling bloated.

Boobs. NSTR

Hours of Sunshine 🙂 Well the sun didn’t come out in Virginia today, so there was no sun to be had 😦

150727_IVF1_Stats

150727_IVF1_Follie

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

IVF DIARY VOL I: 22 – 24 JULY 2015

IVF_Diary_Vol1cMedication(s) administered and dosage(s). 2 injections: Gonal-F 300 iu and Menopur 75 iu

Medical procedures undertaken. Baseline ultrasound and blood test.

How do I feel today? I think every emotion under the sun has run through me!

We knew we had to deal with the financials today, but wasn’t sure what to expect so I turned up with cheque book and credit card in hand!!! Well it was all much quicker than anticipated, my insurance company has provided a letter promising to pay everything….yes everything including the ICSI! (well, everything except for the 10% co-pay of course).  I signed something saying that I would be responsible for the $14,000 bill if my insurance decided not to cover it for any reason.  So in the end, we didn’t need to pay anything upfront and we expect to see a bill of our $1,400 co-pay in 1-2 months time.  That’s great because it gives us more time to save some more and helps me feel a little more relaxed about things.

Chris surprised me with a big Zippy hug after he had stabbed me with the needles this evening.  Hiding in Zippy’s mouth was a bar of cadbury’s chocolate! Awww it was a nice perk me up.  Of course I only had 3 squares as my weekly treat!

Zippy!!!

Zippy!!! What’s in your mouth?

What are my symptoms? Just period pains.  I am actually quite surprised how heavy my period is considering I had only a 14 day cycle!

How does Chris feel today? Chris is currently writing his own separate post today about his experience this evening after he stabbed me…4 times…..with 2 needles.  You are going to want to read this!  Let’s just say there were some comedic moments.

Any results? The way I get all my results is rather handy.  I call a secure answer phone service after 4pm the day of my monitoring appointment and the nurse leaves a message with all instructions for dosages and the date/time of my next appointment.  I can call the nurse any time I like if I have questions.  I like it this way because I won’t have to worry about missing a call.  I actually didn’t get any info about my blood test results today.  But I do have an app on my phone that tracks all my results, but it updates late in the evening, so I will be a bit behind in reporting blood test results.  My ultrasound went well – my ovaries are ‘quiet’ as the doctor explained as she wants them to be.  I have several follicles between 5-6mm in size in each ovary ready to be stimulated.  For my next diary entry I’m going to figure out a nice visual way to track my follicle growth and numbers over time.

What’s next?  My next monitoring appointment is Monday morning, until then I keep going with the 2 injections a day of gonal-f  300 iu and menopur 75 iu.

Weight. NSTR.

Waist.  NSTR

Boobs. NSTR

Hours of Sunshine 🙂 We decided to get to the doctor’s nice and early this morning so we wouldn’t get caught in rush hour traffic, so we had breakfast outside starbucks, playing crib and basking in the glorious sunshine.

150724_IVF1_Stats

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

Last chance saloon…well kind of

Last chance for natural conception

Today it dawned on me that as a result of my last cycle being shorter than expected, I am probably going to be away for a work conference right at peak ovulation time. DOH.  This is going to be our last chance to conceive naturally before we start IVF. (Yes I still have hope that we can beat the odds!)  Soooo, what’s a girl to do? I’m thinking an ice box and turkey baster will be required.  Wait.  That’s NOT natural!

I can just hope that I ovulate later than expected or have another short cycle!

OR Chis will just have to drive 4 hrs to DC and stay with me for one night and then get up super early and drive 4 hrs back before work. Ummmm, do you think I will be able to convince him to do it?? I’m pretty sure he will be not be down for that.

Love you honey!!!

Love you honey!!!

Oh well. It will be what it will be.  Nature is unpredictable anyway.

Lost blood work frustrations

When I first had all my infertility testing back in December last year, my doctor gave me TWO orders for blood work.  The first order was to test my cycle day 3 hormone, FSH LH etc.  The second order was to test for baddies that can affect the health of a pregnancy, such as HIV, Hep B & C, syphilis, in addition to having an immunity to Rubella and Chicken Pox (I’ve had these jabs, so I hope I have immunity!!) which are all a legal pre-screening requirement for IVF.  I received my results for Day 3 tests, but never saw my results for HIV etc.  I just assumed all was good, and never thought anything more of it until…..I met my IVF nurse the other month.

After much hunting, it turns out they never drew blood for my second order.  I KNOW I gave them that second order, so I am really annoyed.  It was only last month I received the bill for this blood work back in December, so I had no clue they never did the tests.  The bill I received for $500 I thought would have covered all these tests.  But it turns out it costs over $1000 for both orders of blood work!! So, frustratingly, the nurse had to send me a new order which took almost a week to get to me in the post (I forget how snail snail mail is here, I should have just picked it up from the office).

This time I went directly to the lab who does the analysis rather than to hospital to have my blood drawn.

Now, you would have thought that going straight to the specialists who take blood day in day out would be good at it.  But oh no.  Not this one.  After one vial of blood was collected with the needle still in my army, the nurse was like… “Come on….where did it go?  Why is nothing coming out? Hmmm…” as he wiggled the needle and I tried very hard not to shout out ‘OWWWWWWW THAT FRICKING HURTS!!’ Thankfully after what seemed like forever “Oh!! There’s the vein!”.  But I won’t be totally mean about this nurse.  He was entertaining, and did immediately recognise my accent and asked where in the UK I was from.  I congratulated him on his talent for recognising a British accent and we talked about how surprising it is how many people have no clue where I am from.  He even understood what I meant when I said “Cheers” as I left.  So I’ll let him off the hook.

So after all that, let’s hope I do have immunity to rubella, otherwise I am going to have to wait ANOTHER cycle to start IVF.  Now that will make me pretty mad 😐

Surprise surprise!!!! IVF!

Well my blog post title has given the game away, so in summary…our next step will be In-Vitro Fertilisation!

This morning we met with our RE who reviewed our progress so far, or lack there of.  Our tests were all normal, the three IUIs all went according to plan (except of course for the pregnancy part), I responded well to the letrozole with 2-3 follicles, Chris had awesome sperm.  We remain unexplained, but she does still suspect endometriosis.  If my period pains were so bad that they affected my life and I wanted that to change then she would recommend a laparoscopy.  This surgical procedure comes with risk, side effects and can take several months to return to normal, so if my periods were so bad this would be the way forward, however, in my case the benefits are unlikely to outweigh the downsides.  So she recommends we move straight to IVF.  She explained the overall process:

Week 1 to 2 – after menstruation I start birth control pills for about 14 days, these help to control my hormones

Week 3 – start injectable medications to control ovulation and stimulate follicles to grow – many many more than the 2-3 that were stimulated with letrozole in order to get the best chance of retrieving some ‘good eggs’.

Week 4 – continue injectable medications…have ultrasounds every other day to monitor follicle growth, along with blood work to monitor hormone levels.  When the follicles are ready, we will inject the hCG Ovidrel trigger and 36 hours later I go for egg retrieval surgery.  Under sedation my eggs are extracted from my ovaries.  Chris provides his sperm and my eggs are fertilised in-vitro.  After the eggs have been fertilised, the embryos grow for a few days under close watch.  Then if they survive, one or two embryos are transferred directly into my uterus.

Week 5-6 – start injectable progesterone until the big pregnancy test either says – “woohoo you are preggers”! then I stay on progesterone, or…”booooo it’s a BFN my friend”, then we will…..well, let’s not go there right now.

This is everything I expected her to say, except for two things slightly different.

  1. First, I need to go for a hydrosonogram.  This procedure will produce a 3D ultrasound of my uterus.  I will have this last test because I have a severely retroverted uterus they could not see it very well on the HSG X-ray, they want to double check that there is nothing preventing the implantation stage.
    My HSG X-ray with my retroverted uterus (it's hard to see because it's hiding behind the catheter)

    My HSG X-ray with my retroverted uterus (it’s hard to see because it’s hiding behind the catheter)

    I have been promised this does not hurt quite as bad as the HSG.  THANKFULLY!!!!

  2. Secondly, she thinks it would be a good idea to do Intra-Cytoplasmic Sperm Injection (ICSI) because we are ‘unexplained’.  ART_logoThis is a procedure where a single sperm is selected and injected directly into the egg rather than normal IVF where the sperm is placed near the egg.  This procedure is an extra $2,420 so we need to check whether our insurance would cover this or not.

Talking of costs….it is going to cost $9,075 for the IVF which includes office visits, endocrine monitoring, ultrasounds, retrieval, transfer and first pregnancy test.  Plus, it is an additional $400 for the anaesthesia. Medication will be approximately $4,000 to $6,000.  Then the ICSI procedure is $2,420.  Cryopreservation is $1000 then $60 a month for any embryos frozen.  Yikes!!!!  But we roughly knew this anyway, it’s just a bit scary seeing it listed out like this.

So for now, we start the negotiating with our insurance and the diary planning. It’s looking like a late June start.

Ultimately, today I walked away with this one key figure she gave: for us – a 50% chance of success.  In my mind that is pretty amazing.  I’ll take that.  I’ve always been a glass half full kind of girl, lately it’s been half empty, today I think I’ve been topped back up 🙂

Thank you for all your support and kind thoughts so far, I’m feeling pretty encouraged this will work!

A new day, a new cycle and new worries!

Yesterday sucked.  Today sucks still, but not quite as much as yesterday.  Cycle Day (CD) 2 and tomorrow is start of Letrozole!  Wait – tomorrow??!?! Wow, where is the time to breathe?  I don’t even have a prescription yet.  The nurse didn’t mention anything about my medication for a new cycle.  She just told me that if I was pregnant I was to call in and arrange a blood test and keep taking the progesterone, but if I was not pregnant, to stop the progesterone and my period would come (late, not to worry, that’s normal because of the progesterone) and then we would follow my doctor’s plan.  At the time, this all made sense.  But my period came full flow three hours after I took my pregnancy test (seriously, what a waste of a test!!!).  My period wasn’t late, and suddenly I realised I don’t have my prescription ready for CD 3.  In addition I realised that CD11 for my first ultrasound was due the day I was planning on returning from Paris for a work trip. Uhoh.  And if all went to plan as the last round of IUI, we would be doing the IUI either the Saturday that my brother is visiting from the UK (sorry bro, you’ve come all this way and we just got to pop to the doctors for half a day) or potentially the day I will be travelling to DC for work (sorry bro, was supposed to be taking you to DC with me for some site seeing). Aghhhhhhh!  Too much to think about. How much of my best laid plans could I reschedule?

All of this came quickly.  I thought about it yesterday, but was in no state of mind to deal with it.  So I dealt with it all today…I decided to still go to Paris, just come back one day early (fingers crossed my flight isn’t delayed by more than 24hrs), we have a plan for when my brother is visiting, and I can delay my DC work trip (My boss has been helpful in this respect).

Today I called the clinic to schedule my CD11 ultrasound, check about medication, how I go about refills and to check the status of them passing on our medical records to our insurance company.  It turns out some of my prescriptions were on refill, but not the Letrozole (the nurse asked me if I still wanted to carry on with it – I guess so??).  The nurse said she would arrange it immediately.  However, when it came to my medical records, there was no note to say that my medical records had in fact been sent to my insurance company.  However, there was a note to say that they needed to do it… But not to worry, because I can always check again when I come in for my CD11 ultrasound.  Well I do worry because I still do not have approval from my insurance company to have IUI treatment – and there is nothing I can do but let them figure it out together.  We can afford the IUI, we have the savings for it, but we would rather know now than later down the road what we do and don’t have to pay for.

On a more positive note, today is our 3 year wedding Anniversary.  We celebrated this evening and I enjoyed a lovely big glass of Merlot.  Good timing 🙂

Happy Anniversary Mr F!

Happy Anniversary Mr F!

Infertility Tests – wands, needles & fishy dye

I scheduled my initial round of infertility tests as soon as I could, but due to work commitments and travel back to the UK for Christmas the tests ran over two more cycles.  Over December 14 and January 15 I had a vaginal ultrasound, cycle day 3 blood work and HSG.  Chris booked his sperm analysis in January.

Vaginal Ultrasound. An ultrasound wand was placed in my vagina to check if I had follicles in my ovaries.  And I had many!  The ultrasound also showed that I was just about to ovulate from my left ovary (which is the ovulation pain I had been feeling earlier that day – it’s nice to know that I can tell which ovary I am ovulating from!!).  The doctor confirmed everything looked healthy and normal. Woohoooo!

Cycle Day 3 blood work.  I was horrified at the amount of boxes that had been ticked on the blood paper work….I calculated at least 4 vials of blood.  I am not good with needles.  I cannot bear to look at them without feeling faint.  Just before I deployed to Iraq I had to ensure all my vaccinations were up to date (all four million of them).  The army nurse asked me how I wasDani thought with needles.  I replied ‘not particularly good’.  He said ‘well now is the time to overcome your fear, I’ll tell you when you can look away’, and then immediately proceeded to jab me four times, after he just laughed, ‘see?  I told you would overcome your fear!’.  I walked away dizzy and attempted to find the toilet to be sick.  I also have donated blood once, and passed out after giving 1/2 a pint.  Apparently even when I voluntarily want to give my blood away my body won’t let me!  This time, for these particular blood tests, the nurse was lovely (despite him coming to the conclusion that I ultimately kill people for a living), he put me at ease straight away.

A big difference between the UK and the US, is that here in the US it is possible to get your blood test results online before your doctor sees them and discusses what they actually mean.  I am not a doctor and I can barely pronounce the name of the tests, so using the internet to help me decipher the results was a TERRIBLE idea!  In the UK you call up your doctor and then a receptionist will tell you if the results were normal or you need to book an appointment.  I am not sure which way round I prefer!!  Anyway, my results were normal.

Hysterosalpingogram also known as a HSG.  I’m not sure any human being would want to have this test performed out of choice. This procedure is where dye is injected through the vagina into the uterus and by using x-rays to see if the fallopian tubes are blocked. I was given an information sheet about the procedure, I felt prepared, and took the 800mg of Ibuprofen as prescribed an hour before.  My friend accompanied me as it recommended that you have someone drive you home afterwards. I am very pleased she was there with me, I couldn’t have gone it alone.

I was a bit nervous, naturally, but it wasn’t until the nurse asked me ‘Are you familiar with the procedure?’, I said, ‘yes, I read up’.  The nurse looked a little worried ‘uhoh you haven’t been reading the internet have you?’.  Now that part made me nervous!  I had not thought to look up the procedure online because the info sheet given to me was sufficiently detailed.

The procedure was very uncomfortable, and painful at parts, it felt like my insides were on fire and I had immediate cramping.  I could just about see the screen with the x-rays on it and could make out that my tubes were flowing freely.  Great news!!!! But the doctor asked me ‘did you know you have a retroverted uterus‘? Nope, no I did not know that.  Well everyday is a school day after all.   The only question I had on my mind at that point, was  what does all of these results really mean?  What will Chris’s results be?  I felt sad and guilty that Chris would be feeling more pressure about his sperm analysis.

Google – Jekyll & Hyde?  After my final test, I went home intrigued, and googled “HSG”.  I am so glad I did not read any forums before going for this procedure, there are some sad and terrifying stories out there.  The nurse was right to look so worried.  A lesson was certainly learned here – I’m going to  keep trusting in the people I am paying lots of money for to look after me.  Maybe I’m being naive, but google isn’t always your friend.