IVF DIARY VOL I: 10 – 16 JULY 2015

IVF_Diary_Vol1a.pngMedication(s) administered and dosage(s). Ovulation Control Pill (OCP) Reclipsen 0.15MG-30MCG x 1

Medical procedures undertaken. Nil

How do I feel today?  Fed up of spotting!  I haven’t felt ‘hormonal’ the last week like I thought potentially the birth control pills might do.  Overall feeling not too bad.

What are my symptoms? The first few days after I started the birth control pills I got a bit bloated and a bit constipated…which for someone with Irritable Bowel Syndrome (The diarrhea type) one would think it would make a nice change from going to poo three times a day!  Fortunately, things have got back to normal in that arena.  My boobs are a little tender and have stayed the same size since my period started (a bit bigger).  Then there is the extra bleeding also, my period lasted a couple of days longer than my normal 2-3 days…and I have been spotting since then, so wearing a panty liner is a must right now.

How does Chris feel today? Chris is still very busy at work at the moment 😦 He is trying to get as much done in prep for the when we start ‘stimming’ (aka injecting the drugs) so he can focus on us.  (Aww bless him, he’s a sweetie)  We did have that big discussion about how many embryos to transfer and what our decision will be.  It made for an interesting dinner table conversation!  We weighed up the pros and cons, but he did say that ultimately he would stick with whatever I decided because it is my body and health that would be at risk.  So we haven’t completely ruled out transferring two just yet.

Any results? NA

What’s next? Just four more days of birth control pills.  I’m looking forward to not hearing my ‘alien’ alarm on my phone that reminds me to take them at the same time every day.

Weight. Funny story and probably too much information – Now, I have been weighing myself as soon as I wake up to make it a fair comparison.  One morning, after weighing myself I went downstairs, started to prepare breakfast when I realised I needed to go to the toilet (at last hooray!!).  And as I mentioned earlier, having been constipated for a while, I did an enormous poo….so much so that in the interest of science, afterwards, I dashed back upstairs to weigh myself again.  Can you believe it?  I weighed EXACTLY the same 127.2lbs….and I got on and off I three times to be sure it wasn’t stuck.  So now I just don’t trust those scales!!

Waist.  NSTR

Boobs. NSTR

Hours of Sunshine 🙂 Seriously, still not enough….the weather has not been great recently, but last night whilst I played softball I soaked up the evening sun and it was glorious.  I hope this weekend brings us some better weather!

150716_IVF1_Stats

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

The pain of unexplained infertility

Unexplained infertility eats away at you, month by month, day by day, hour by hour.  The pain grows exponentially, as the odds of a successful pregnancy diminish.

At first, you thank your lucky stars (or your god), that there is nothing seriously wrong with you or your husband.  You both passed all the fertility tests with flying colours.  Your Reproductive Endocrinologist should be giving out gold stars each time you brave another fertility test because your stats are great and you are top of the class.

But you are defined as infertile, and yet at the same time, they cannot find any medical reason as to why you are unable to conceive.  This is not through any fault of the doctors; learning to accept this fact is difficult.  Beginning to understand the wonders of conception and how many stars have to be in line for a baby to be born makes it a little easier to swallow.  But that doesn’t make it any less bitter.

You beat yourself up over the seemingly small things…

  • Should I have just had that glass of wine?
  • Am I too fat? Am I too skinny?
  • I forgot to take my pre-natal multivitamin – will my eggs mature this month?
  • Will that cup of coffee harm my little bean?
  • Did I exercise too hard?  Should I exercise more?

The ambiguity of it all drags on you, it weighs heavy on your heart.  You can’t help but believe it must be something you are doing wrong.  Even with the strength of your friends and family around you holding your hands, it feels like the road is getting darker, narrower and scary as hell.

You can’t move on, you can’t stop, because you might just be at the false summit and your success story is just around the corner.  You don’t know how long your journey will be…the blisters are beginning to burn and you just can’t figure out why it’s happening.  Giving up is not an option.

You cannot lie, although your friends will give you kind encouraging words and strong hands to keep you going up that mountain, there are no words that can ever compensate for why this is happening.  God’s will…or….it is meant to be….just does not compute or make sense.  The pain will continue to grow, you will cry, you will question yourself….but you will keep swimming.

“Just keep swimming. Just keep swimming. Just keep swimming, swimming, swimming.  What do we do? We swim, swim.” (Dora, Finding Nemo 2003)

Funny conversations you probably only have when suffering infertility #1

confusingThere are probably a few conversations we will only ever have as a direct result of suffering from infertility.  This particular conversation ended up to be completely random as I feel more comfortable talking about my period with my husband now, so here is how it went….

(Scene – In car on way home from Softball game)

Dani (nonchalantly and randomly not expecting a response from Chris) : “I hate my period, why does my period have to be so sucky?”

Chris: “Does your retroverted uterus effect your period?  If it wasn’t upside down, would that mean your period will happen faster?”

Dani: “Hmmmm well I already suffer from twice as much blood as the daily average, but in half the amount of time, so I don’t think gravity has much of an impact on my blood flow!  But it is a good point…I wonder if gravity impacts periods and whether an upside down uterus means that blood has to be squeezed out rather than gravitationally slowly falling out as it de-lines.  Is this potentially why my period is twice as heavy each day but over and done with in 2 or 3 days?”

Dani picks up iPhone and asks Siri: “Does gravity affect menses?”

Siri replies with several websites, mostly focusing on women in space travel.  It is FASCINATING!!!! So what do you think?  How does a woman have a period in space?

Here is an article from www.thestraightdope.com that fully answered our question and more…EVERY DAY IS A SCHOOL DAY!!!!!

Dear Cecil:

Without gravity, how do female astronauts menstruate while in space?

Cecil replies:

For a while there, Gayle, the question wasn’t how women would menstruate in space but whether it was too risky to find out.

Although the first female cosmonaut, Valentina Tereshkova, had flown inVostok 6 in 1963, women were excluded from the U.S. space program during its early years. The official reason for this was that, as a matter of policy, U.S. astronauts were drawn from the ranks of military test pilots, and all the test pilots were men. If you ask me, though, the real reason was American male panic about women and their mysterious inner workings. Several plane crashes in the 1930s had involved menstruating female pilots, and experts — male experts, of course — suggested that putting a woman with “menstrual disturbances” in the cockpit was an invitation to disaster. Eventually the more hysterical fears receded, but some space medics still harbored serious concerns about menstruation when NASA began planning to put women in space in the 1970s.

From a certain point of view, I suppose, these concerns weren’t completely crazy. When a woman has her period, normally the menstrual flow is forcibly expelled from the cervix. However, given the low-gravity environment of space, some scientists wondered about the possibility of “retrograde menstruation,” the backward flow of menstrual blood up into the fallopian tubes. This occurs sometimes on earth and is thought to lead to endometriosis, a disorder in which tissue that normally lines the uterus grows where it shouldn’t. Prior to the 1983 space shuttle flight by Sally Ride, the first U.S. woman to exit our atmosphere, consultants told NASA that female astronauts should take hormones to manage their menstrual cycles to reduce flow volume and ideally avoid having a period while in space.

Unsurprisingly, to women anyway, most of the anticipated problems never materialized. There’s no evidence retrograde menstruation occurs in space, and even if it did, it probably wouldn’t cause endometriosis: reverse flow seems to trigger this condition only in those who experience it chronically. Returning women astronauts who’ve menstruated in space report that everything worked the way it usually does. The mechanics of a zero-G period haven’t been fully explicated in the scientific literature, but according toPrinciples of Clinical Medicine for Space Flight (2008), astronauts have “access to multiple sanitary products for menstruation, including pads, mini-pads, and tampons in plain and deodorant versions,” and presumably capillary attraction accomplishes what the lack of gravity can’t. (We might have predicted as much, since bedridden women usually menstruate OK.) Incidentally, for times when going to the bathroom is impossible for an extended period, such as launches, spacewalks, and landings, “crewmembers of both sexes have available a maximum absorbency garment (MAG) that can retain up to 2000 ml of urine, blood, or feces.” Not your ideal working conditions, but a small sacrifice to make for the world’s coolest job.

Female astronauts do face some challenges in space. Internal medicine specialist and space buff William Rowe notes that women are more likely to develop decompression sickness during their periods. That’s a problem mostly during space walks, so he suggests any excursion by a woman be timed for a different part of her cycle. Before you peg Rowe as a chauvinist scumbucket, note that he also thinks women are, on the whole, better suited than men to a low-gravity environment. In a 2004 article in the Journal of Men’s Health and Gender, he argues that for long-term space exploration an all-female crew might be the best bet. His reasons:

(1) Menstruation rids the body of iron. That’s a good thing, because space flight can reduce one’s production of a protein that normally sops up excess iron, and “increased free iron can be extremely toxic.”

(2) Women produce a lot more estrogen than men, and they also have lower epinephrine levels. For reasons we needn’t get into, these factors reduce the likelihood of heart attacks and other cardiovascular problems while in space.

(3) Some of the Apollo 15 astronauts experienced pain and swelling of their fingertips while on the surface of the moon. Rowe hypothesizes that this is less likely to happen to women because “estrogen reduces vascular smooth muscle tone.”

It might also be pointed out that women on average take up less room in cramped spacecraft cabins, consume fewer resources, and are more inclined to ask for directions when lost. Finally, to be blunt, who would you rather have up there: female astronauts who, worst case, are hormonally challenged on a fairly predictable schedule once a month, or male astronauts subject to random testosterone attacks any time at all?

We have a start date for IVF!

Today the nurse called me with our IVF schedule…wooohooo!

It looks roughly like this:

Our rough schedule

Our rough schedule

So our first day of stimulation injectibles will be Friday 24 July.  Chris and I both go in to the clinic to fill out the rest of the paper work, pay the $$$, get a lesson on how to do injectibles, receive our medication plan and I will have my first monitoring appointment with ultrasound/ blood work.

I also asked the nurse about the vivelle dot (estrogen patches) and why insurance only covers 8 patches and not the whole 24.   Apparently the use of the patches is “off label” so it is not covered under infertility coverage, therefore I would need to pay for the rest out of pocket.  BUT she did say that usually insurance will cover 8 every 30 days, so I can refill the prescription in 2.5 weeks and the insurance will cover 8 more patches, then I maybe lucky that by the time I need the last 8 it might be another 30 days.  But either way, now we know why and will expect to pay out of pocket for the patches if needs be!

So….just another 11 days of Birth Control Pills! I really hope these don’t mess my hormones up too much :-s

IVF Diary Vol I: 04 – 09 July 2015

IVF_Diary_Vol1I’m starting my IVF Diary today.  I’m going to be tracking a few things about my first IVF experience over the next 6-7 weeks .  I’ll be blogging too, but I want to capture the experience like this….in a kind of organised manner, to help give me some sense of control over something, because I fear that I will have to let that go!

Medication(s) administered and dosage(s). Ovulation Control Pill (OCP) Reclipsen 0.15MG-30MCG x 1

Medical procedures undertaken. Nil

How do I feel today?  I was feeling grumpy, then a bit teary eyed today.  No one asked me if anything was wrong, but I reckon some people probably thought I got out of the wrong side of bed today!  Which perhaps I did because it’s the first night I slept all the way through without needing to pee or wake up from night sweats….and then the alarm woke me up and I really didn’t want to get up.

What are my symptoms? It’s period time, so I am bleeding pretty heavily today with some gross and huge clots (sorry if that’s too much info, but this is what this diary will be – blunt and honest! It’s not going to be all fairies and sunshine).  I also have normal period pains and feeling of emptiness in my tummy like I want to do a huge fart or burp (It’s the kind of feeling I get when I am really hungry)

How does Chris feel today? Chris is very busy at work at the moment, but when I asked him he how he was feeling, he said he hasn’t thought about IVF today! 🙂

Any results? NA (but the nurse finally told me today that my blood test results for HiV, Hep B, C and Rubella all came back just fine even though I called her last week to check up on them and the results came back 2 weeks ago!)

What’s next? Hoping that my body can handle these Birth Control Pills!

150709_IVF_Stats

09 July 2015

Weight. NSTR

Waist.  NSTR

Boobs. NSTR

Hours of Sunshine 🙂 Not enough….0.25hrs (I walked to the shop)

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

Double Trouble: options for elective single embryo transfer

Double trouble can only mean one thing – twins!  A couple of weeks ago our friend recently gave birth to two handsome little boys – fraternal twins.  I visited them after they were just a few days old, and as I held one of the boys I tried to imagine how it was possible to fit two of these little babies in anyone’s tummy!  I know they are curled up pretty tight in there, but seriously – it must be magic!  I am so amazed at how my friend carried these two boys to full term and not break her back!  I am also super impressed that she avoided a c-section, despite one of her boys being breach – what a super mum (mom).  And I am under no false impressions that it was easy!  So all this got me thinking about our first IVF cycle and the number of Embryos we will transfer…and our chances of twins.

Now…Chris and I have already discussed and agreed that we are OK with multiples…we had to make that decision when we had our IUIs, in fact for one of my IUIs I had three follicles, so there was always a chance for triplets! Yikes Treble Trouble.  But being OK with multiples is not the same as actively desiring multiples.  For IUI, it was kind of out of our hands how any eggs would fertilise and implant, it was still very natural.  But for IVF, we kind of have a choice.  Our clinic typically transfers 2 embryos for women <35 and first round of IVF, but of course, we can choose to just transfer 1.

I read somewhere that 29% of IVF patients said that twins were a desirable outcome.  Why?  Well it’s kind of like BOGOF (buy one get one free).  IVF treatment doesn’t come cheap, both financially and emotionally, so I can understand this logic.  But for me this is all about probability and gambling….not with money, but with needles and drugs.  Sure it costs $$$$s but fortunately we have it covered by insurance. It’s the emotional and physical cost that I am particularly nervous about.  I have no clue what it will be like, so I feel like for our first IVF round we can’t make a firm decision just yet how many embryos we will transfer. I want to wait and see what all these hormones are like first and what our doctor’s prognosis will be when the time comes.twins

However, that doesn’t stop me looking into it now.  Whilst I was surfing the web for more info on this subject I discovered an article that my RE had commented on regarding the a study that had shown single embryo beat double embryo transfer.  Her point of view on the study was very vanilla and cautious! Random. I also found that the CDC provide a good little list of things to consider for elective Single Embryo Transfer.

So for now this topic lays to rest until we get a bit closer to transfer day.  But until then, I’ll keep educating myself on what it might be like to be a mother of twins as well as help out our friend however we can with their teeny bundles of joy 🙂  So it’s not just double trouble – it’s also double the adorable 🙂

Starting my IVF diary

I have been thinking about writing an “IVF Diary”.  Something a bit more formal and structured than my blog.  I will of course post my IVF diary on my blog and keep posting other things, but I wanted to create a bit of structure to my diary to help me.  Plus, I am all about the data (did I tell you I’m an analyst??!), I can’t help but think of it as s kind of data collection plan. Soooo this is what I think my template will be, but I would really like some input from anyone who has been through this before.  I’ve crawled some blogs to try and figure out what would be useful to monitor:

Day X, date, cycle #, cycle type

Medication(s) administered and dosage(s).

Medical procedures undertaken.

How do I feel today?  (i.e. my emotions)

What are my symptoms? (i.e. my physical reactions)

How does Chris feel today?  (i.e. his emotions, if he is willing to share them that is)

Any results? (i.e. blood tests, ultrasounds)

What’s next? (any thing significant in the next 24-48 hrs)

Weight. (has it changed?)

Waist size.  (has it changed?)

Boob size

Temp?? (should I do this or is it pointless because meds screw temps up?)

I want to start this week so I can capture a baseline of some of these stats before I start Birth Control Pills next week, like weight etc.

Do you think I have missed anything???

No returns policy

There isn’t much I have purchased in life that I have not been allowed to return, with the exception of swim wear, knickers, sale items and earrings.  But today I purchased enough medication for our first IVF cycle….and it comes with a big fat no returns policy! There is no turning back now.  The whole order cost us $770 (which is the co-pay at 10%, so complete cost of the medication is $7700!! Ouch.) and should arrive in a couple of days.  I guess we are really doing this then….

Reflections on the future – using someone else’s ten lessons learned on Infertility

A friend of mine recently sent me a link to a Huffington Post Article “Ten things I would tell my past self about infertility”, written by Kathryn Kefauver Goldberg (she has written other posts too).  Not only was it an interesting article, but my friend told me “I can be your number 9”.  Number 9 in the list of ten things was:

9.  Find one person to whom you can talk uncensored.  Check in with yourself about what and who feels good.  This might be a friend, a counselor, a support group — anyone who can support you unconditionally and isn’t invested in the outcome.

Well of course, my friend already is my number 9 🙂  I’ve got this one nailed already!  So what about the other 9 suggestions in the list of Ms Goldberg’s lessons learned?

1.  Recognise that the limbo of infertility puts you in an impossible situation.  This is something we are totally dealing with right now, with the added limbo on whether we stay in the US or move back to Europe.  Fortunately, one of those limbos has been taken away – I have been offered an indefinite contract, so I don’t have to leave the US in December!  We have choices.  But we don’t have choices when it comes to whether we get pregnant or not!  So we are handling it OK right now, better than last week.  We will just take one to two weeks at a time.  It’s pretty hard work on the abdominal muscles all this limbo business, but you get a good work out, and your muscles only get stronger as time goes on.

2.  Feeling sadness will not define your path.  I have had a pretty tough few weeks on this front, and I have questioned my ability at work, if I am coping.  I even asked myself if I was depressed.  I don’t believe I am depressed, but just sad.  Being sad is OK.  How do I know I am not depressed?  Well I just googled it, and I am not depressed, I don’t fit the descriptions.

3. Define and honor your limits.  Here Ms Goldberg talks about pressure to try everything on the medical front.  It can be quiet easy to go far without questioning medical treatment, for example agreeing to ICSI, agreeing to freezing embryos, agreeing to participate in research etc.  We have made sure we talk about it together, but I am not sure Chris and I have the same feelings on how far we go on our path.  I think I will feel what I will feel, in the future and I can’t predict that right now, so I don’t want to put a maximum number of attempts, money or time on our path.

4.  Listen to your doctor and trust your gut.  I’m not very good at questioning a doctor, after all they are supposed to be the qualified ones, right? But I do get gut feelings about people and I have a positive gut feeling about our doctor, even if she seems a little crazy sometimes.

5.  Have rote answers prepared for nosey questioners.  I have talked about this on two occasions recently, but I think it depends on the situation.  It’s a careful balance.  This week I caught up with some friends I haven’t seen for a year, and I totally lied to them about what we are going through (I didn’t lie directly, I just avoided the opportune moment to talk about it) and I wish I had just been honest because I know they would have been great about it.

6.  For every medical procedure you go through, find a soothing activity for your body.  Ahhh a couple of massages I think might be scheduled.  Maybe we need to think about this more.

7.  Take care of your heart.  This is more about protecting yourself from emotional overload moments, like going to baby showers.  Well I have decided to tackle these head on.  Infertility doesn’t define the me and the type of friend I want to be to my friends.  I won’t let it, and it’s worked so far.  I will take care of my heart, but I know Chris has got me on this one too.  He’s like my cod liver oil or what ever is good for your heart – he is my added protection layer for my heart.

8.  Invent a project.  Well I have decided to take another online course starting in a week.  This will be my project.  It will be a useful distraction, I hope, rather than be an added stress.

10.  It will be OK, though your definition of OK will change.  I tell myself this a lot. Everything is going to be OK.  And if I ever doubt this, all I need to do is listen to Chris’s playlist of movie’s all time greatest dramatic soundtracks, like the one below.  And everything is going to be OK again.  This is my future.

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 😐