A Stressful Trigger Day & Next Steps

Today was such a roller coaster ride so be prepared for a vent session and a long post.  Like I had posted earlier today, my ultrasound appointment was horrible and I just had this gut feeling about it the second I saw the look on Dr. Rhoton's face when she saw my pelvic fluid.  They always beat around the bush and they can never tell you definitive answers of what the plan would be when you ask.  Before even starting the ultrasound, I inquired about how Dr. Williams had said over the weekend that we were a candidate for a possible "freeze all embryos cycle."  I wanted to know what their magic cut off numbers were for labs and whatnot.  She just said "well lets take a look at your follicles and we'll see what your estradiol level comes back at."  This left me with a little ray of hope that maybe if my estradiol wasn't too high we still would have a chance.  I even joked with Laura, my lab tech, saying it was her job to make sure my estrogen level wasn't through the roof.  Laura seemed to be concerned with a magic number around 5000 so I thought I should be golden and for sure less than that.  I never even imagined that I would already be spilling fluid from my ovaries and THAT would be the reason they cancelled my cycle. 

Well I went to work after they found the fluid and I had a breakdown to Justin on the phone.  They warn you that none of these hyperstimulation symptoms will start until after you take your trigger shot that starts the ovulation process and I was scheduled to take that tonight.  I thought that I was going to have such a bad reaction and I was going to be throwing up, be hospitalized, or the absolute worst- DIE!  I was dizzy, crying, shaky, and a nervous wreck.  He was able to calm me down and reassured me that I would be fine but I am still anxious.  I will be staying with my mother in law for most of the day tomorrow to provide some distraction and rest from the crazy dogs.  

So Melinda said I have a new job to make sure that I am EXTRA hydrated with electrolyte replacements and eating salty foods the next week to help with reabsorption of the fluid.  She told me about these Propel drinks which will be great for me because they taste EXACTLY like gatorade but have 0 carbs and 0 calories and lots of flavors.  I have to have 4 bottles a day of Propel! (That's 2 Liters a day!) PLUS another 32oz of water on top of that.  I am going to be peeing every hour for sure and it needs to be clear. 

Later in the day, I found out that my estrogen came back at 3823.  I got so excited thinking hey! That's not THAT bad!  My LH and progesterone numbers were great as well.  Melinda said all the clinic doctors wanted to sit down and have a conference over what to do with the remainder of my cycle.  I guess they all discussed my case and determined that it is best for me to do a freeze all embryos cycle.  The reasoning wasn't so much my estrogen number but more because of my number of follicles I had formed and the fluid they found.  I can't believe I am up to almost 40 follicles now. I was expecting this so it wasn't that much of a shocker at work but don't get me wrong- I still cried and was upset. 

I learned that I needed to take Lupron as my trigger shot and I had to find a way to pick it up at the Shands Medical Plaza Pharmacy before they closed at 5pm and I was at work.  Luckily, Justin got out of work early and was able to go to the pharmacy for me but then they had an issue with getting the medicine.  I started crying again thinking I had to take this medication EXACTLY at 9pm and I had 30 minutes to get them to figure out how in the world they would give me my dose.  They had used their last kit to make the medicine earlier in the day when they thought I was needing a different dosage.  Because it was already diluted, they were telling Justin that they didn't have any more to make the dose I needed.  I am so thankful that Melinda was able to call them with like 5 minutes to spare and they were able to get it all squared away.  I still am unsure of how exactly they worked it out but I got my shot and I gave it on time! Phew! 

My trigger shot! 

So what is next?  I go in tomorrow for a progesterone level to make sure that I am about to ovulate.  I will still get these little eggie-weggies (as I like to call them) out of me on Thursday at 8am.  I think I have to show up at the office at 6:30am- eww!  They will fertilize as many as Justin has sperm for.  I'll go home and rest and they will call me the next day with how many embryos survived fertilization.  I will get phone calls on day 3 and day 5 of life to be updated on how many there are left.  Melinda says I should expect a decrease of 50-70% of our embryos by day 5!  It's crazy to think how much I have been through to see so many die.  They will freeze all the embryos that survive until day 6 of life.  Dear lord baby jesus please make this all worth it and have at least a handful to freeze!

Then I will take more Ganirelix after the retrieval to tell my body to immediately shut down and go back to normal.  Within 4 to 10 days, I will get a withdrawal bleed and then I have to wait for an official period to come on my own before starting birth control again.  This is the worst fear for me because my periods are so irregular and sometimes didn't even come.  Last time, it took a month of birth control pills to regulate my body and then I had a period 37 days later!  Sometimes I would go 3 or 4 months without one.  I am hoping from all of these hormones, I will still be regulated somewhat and it will only be a month between cycles. 

After 14 days of birth control, I can start the frozen embryo transfer process.  This is A LOT different than what I just went through.  I have to take all different medications!  I will be on Lupron for 10 days of more suppression and then do another mock transfer. Then I start estrogen patches instead of injections for 14 days of stimulation.  They slowly increase these over time and I will get to a point where I wear 4 patches at once!  My estrogen needs to be at least 150 to transfer.  That is way better than almost 4000 and they don't have to do daily labs or ultrasounds!  Then I have to start taking progesterone 3x a day for 6 days to prepare my uterine lining and one of those times daily will be the intramuscular oil shot in my butt!  Not looking forward to those.  The embryos end up getting transferred day 28 of stimulation.  The whole process is a lot longer and around 2 months time.  I guess the earliest that I could start would be the end of July with a transfer date sometime in Fall.  

This whole process is so devastating and I can only imagine how I would feel during a failed IVF cycle that didn't work.  There's nothing more frustrating than to think that everything fertility related to you ends up getting screwed up and never working out.  You really start to question whether you are doing the right thing by putting your money, time, and body through this when nothing positive comes from it.  I like to think of this as just a little delay and not a failed attempt but I still can't help but be upset and frustrated.  I will get over it and be back to my positive self tomorrow but as for tonight I am just going to be mad at the world and stay clear from anything baby.  Trying to stay positive and remember that I still have future babies in me right now and at least enjoy the last few days of being bloated. :)

Praises:  Everyone has been so understanding and supportive of my emotional meltdowns and for that- I am so thankful!  My medications for the rest of the year will be free since I spent so much money already this year.  I will have more time to work on the house and get it baby ready.  Lots of kisses tonight from my concerned puppies!

My Tuckeroo <3

Prayers:  That everything will go well with my blood sugars during retrieval.  One sperm for every egg!  A short menstrual cycle.  That we will find the money for our frozen transfer in a few months. (they can be up to an additional $6000!)

End of Stimulation

Well it's not looking good everyone.  I went in for my ultrasound at 7:30am with Dr. Rhoton and my follicles were so big that fluid was leaking into my abdomen already which isn't a good sign.  I went from 28 follicles to now 39 follicles.  I don't have very many symptoms besides some slight bloating but now I am very at risk for having all the hyperstimulation symptoms once I take my trigger shot tonight.  They are going to give me an injection of Lupron instead of HCG (the pregnancy hormone) which will decrease my risk of symptoms because Lupron immediately stops the stimulation process whereas HCG stays in your system for 10 days.  I haven't talked with the doctor's about my estrogen level or lab results yet today but I'm sure everything is going to come back sky high since I had another crying break down this am.  I am about 90% sure that they are freezing all of our embryos this round due to the fluid spillage into my abdomen.  When they take out all of my eggs on Thursday, the fluid will just increase and my symptoms could get worse.  I am happy to think all my follicles have matured but sad to also think that maybe if I just triggered yesterday instead of one more day of meds, maybe I wouldn't have had this issue.  I definitely didn't have any extra fluid in my abdomen yesterday.  Oh well, life is life and I'm going to do everything possible to get a healthy baby in the end even if it means I have to wait a few more months to transfer.  I'll post more later. My lining was about 9.5mm. Here's my follicle measurements now:

Left Ovary 5-31-2016

Left:

21x19 = 20

21x17 = 19

23x12 = 17.5

19x15 = 17

25x8 = 16.5

22x11 = 16.5

19x13 = 16

19x12 = 15.5

19x11 = 15

19x9 = 14

Left Ovary 5-31-2016

17x11 = 14

17x10 = 13.5

13x11 = 12

14x8 = 11

13x7 = 10

10

<10

<10

<10

<10

Right:

Right Ovary 5-31-2016

26x23 = 24.5

19x18 = 18.5

20x16 = 18

20x16 = 18

18x15 = 16.5

16.5

17x15 = 16

20x11 = 15.5

20x10 = 15
17x13 = 15
17x13 = 15

18x9 = 13.5

This picture best shows the leaking fluid which is the black square to the left of my ovary

15x12 = 13.5

14x12 = 13

13

12x11 = 11.5

12x9 = 10.5

10

8

I Have an Egg Retrieval Date!

This is becoming so real!  It's Memorial Day and I had to be at the fertility clinic at 7:30am for another set of labs and ultrasound with Dr. Williams before going to work.  I was so anxious and emotional yesterday thinking that my follicles weren't going to grow fast enough since they were only averaging 13mm and I wouldn't have enough medication to keep them growing.  I had an emotional breakdown and even cried in the parking lot of TJ Max for a bit. I knew my estrogen had to have increased because I was so tearful, but I am no longer bloated, so were my follicles really even growing anymore?


Well prayers were answered and my little follicles grew a ton during the past 2 days!  He measured 28 follicles instead of 27 but I am starting to wonder if he double counted any of these.  I was right and my estrogen jumped from 1688 to 3064!  No wonder I was crying.  My progesterone went from 0.5 to 1.1 and luteinizing hormone stayed the same at 0.8 which is all good numbers.  Here's my follicle numbers from today!


Left:

21x18 = 19.5mm

Left Ovary 5-30-2016

18x13 = 15.5mm

19x10 = 14.5mm

17x10 = 13.5mm

16x10 = 13mm

15x11 = 13mm

17x8 = 12.5mm

17x8 = 12.5mm

16x9 = 12.5mm

13x12= 12.5mm

17x7 = 12mm
15x9 = 12mm
14x9 = 11.5mm
13x10 = 11.5mm

Right:

19x17 = 18mm

Right Ovary 5-30-2016

19x15 = 17mm

17x15 = 16mm

18x12 = 15mm

19x10 = 14.5mm

16x12 = 14mm

16x12 = 14mm

16x10 = 13mm

14x10 = 12mm

13x11 = 12mm

13x11 = 12mm

12x10 = 11mm

12x9 = 10.5mm

10x9 = 9.5mm


I am so excited that I have follicles that have matured to the 18mm mark meaning they should have mature eggs in them.  The doctor said he wanted to give me one more day of Follistim at a lower dose, as well as Ganirelix & Menopur injections to give the remaining follicles time to grow and catch up to 18mm. This is perfect because this will be my last dose of Ganirelix that I have at home.  I will be triggered tomorrow with either HCG or Lupron and they set a final egg retrieval date of Thursday 6/2.  This is perfect because Dr. Christman, my doctor, covers Thursdays so he will do my retrieval!  Then the fertilized eggs will either be implanted on Sunday or Tuesday.  I'll have to call out of work for whatever day they choose but it will be worth it.  The only dilemma I have is that if my estrogen climbs too high tomorrow (I think over 4000 is their magic number), they could still want to do a freeze all the embryos cycle.  Can we all say some prayers that it doesn't and we can implant this week?  Thanks!!  I will post my numbers again tomorrow.

Sometimes Too Many Can Be a Bad Thing

Justin always wanting to snap a picture....daily lab work!

It was an exciting day for Justin to come to the clinic with me this morning.  He got to see my "beehive" as Dr Williams calls it.  I now have a total of 27 follicles (13 left and 14 right).  They just keep producing!  We received some unfortunate news that since I am responding so well to the medication, we need to prepare ourselves to possibly freeze all of our embryos and transfer them in a few months to give my body time to heal.  If my estrogen continues to drastically rise with so many follicles and I got pregnant, my risk of ovarian hyperstimulation syndrome would sky rocket.  After the eggs are removed, those follicles fill up with fluid which can spill over into your abdominal cavity causing pressure on the lungs, abdomen, and kidneys.  This causes nausea, vomiting, bloating, shortness of breath, decreased urination, and rapid weight gain.  A baby in my belly would make everything 10x worse and interventions to fix the problem probably more dangerous.  Sometimes these patients even have to be hospitalized to correct their fluid and electrolyte balance and a surgical drain can be placed to remove some fluid.  My heart would normally sink at hearing news like this but instead I remain positive and know God's plan is best. I am hopeful that the extra injections that I am doing will continue to simmer my body down. My estrogen only rose from 1451 to 1688 so that's not too bad.  We want it to continue to rise but not significantly.  I believe they look at this number and my symptoms to determine whether freezing needs to occur.  I know someone who had an estrogen level of 3000 and 30 follicles and they still let her transfer.  This helps me remain hopeful.  Knowing that we have so many people praying for us keeps me positive! I am so glad that I have chosen to be open about everything! Thank you!

They started measuring my luteinizing hormone (0.8) and progesterone (0.5) which were both good numbers.  My lining increased to over 10mm but I'm not sure of the exact number.  But I am glad that it's over 8mm now!  Here are my follicle numbers taken by Dr Williams.  He does the ultrasound a little differently than the nurse so we have to take the average of the 2 numbers to compare.

Left Ovary 5-28-2016

Left

15x12 = 13.5mm

15x11 = 13mm

14x12 = 13mm
14x9 = 11.5mm

15x7 = 11mm

14x8= 11mm

12x9 = 10.5mm

11x9 = 10mm

10x10 = 10mm

11x8 = 9.5mm

10x8 = 9mm

10x7 = 8.5mm

9x7 = 8mm

Right

Right Ovary 5-28-2016

17x8 = 12.5mm

13x12 = 12.5mm

15x8 = 11.5mm

13x10 = 11.5mm

12x10 = 11mm

11x11 = 11mm

13x8 = 10.5mm

13x7 = 10mm

12x8 = 10mm

10x10 = 10mm

11x8 = 9.5mm

10x9 = 9.5mm

11x7 = 9mm

9x7 = 8mm

Since I'm not at 18mm yet, I won't go back until Monday for a check.  I only have enough Ganirelix for 4 doses so that means I'll probably be doing egg retrieval Wednesday or Thursday.  Dr. Williams wants me to continue everything at all the same dosages.  He was in a much better mood today! haha

Prayers: I don't want any more follicles but I just want them to mature & grow! Praying my estrogen doesn't get too high and I can transfer embryos in me next week! 

"I don't know about you, but I'm feeling 22!"

Just thought I'd post a quick update! It's been 2 days since I had my last checkup.  Blood sugars are doing ok.  I have had quite a few lows but nothing too scary and they aren't getting super high yet so I'm happy.  Here's my numbers from today:

Estradiol increased from 446 to 1451! 
Uterine lining increased from 6mm to 7.5mm
And the biggest shocker for me was I went from having 4 large follicles on each ovary, to a total of 
22 follicles!!   Like the title?  Had to take the opportunity to quote my favorite Taylor Swift Lol

Here are my measurements in mm:

Left    

One side of my left ovary  

                        7.8

                        8.2
                        8.8
                        9.1 

                        9.3
                        9.5
                        9.6
                      10.1
                      10.6
                      10.7
                      11.1

                      12.9                           

Right

Can you see the follicle wrapped around another follicle?

                        7.8

                        8.9

                        9.2

                        9.4

                        9.9

                      10.2

                      11.0

                      11.1

                      12.4

                      14.5

So now that I have a follicle greater than 14mm, my body is trying to prepare me to ovulate all these eggs! So now I need to start injections of Menopur & Ganirelix (in addition to my Follistim) to help the eggs mature and prevent me from ovulating them too soon on my own. 

Menopur is a subcutaneous (in the fat) injection that contains a combination of follicle stimulating hormone (FSH) and leuteinising hormone (LH).  Fun fact!  It is extracted and purified from the urine of post-menopausal women.  Creepy! haha.  It will help my eggs mature.  I have to reconstitute it with normal saline myself!

Ganirelix is a subcutaneous injection as well that is an antagonist (hence the "antagonist" IVF protocol name) to suppress the LH surge and ovulation until the follicles are mature.

Melinda is out of town and the doctors were all out of the office today so my ultrasound was completed by the covering nurse, Ursula. She told me that on average follicles will grow about 2mm a day. If I have one that is already 14.5mm, it won't be long until I reach that 18mm mark! Maybe even by Sunday! I am worried that I will have to have the eggs come out before the original Wednesday plan. Dr. Williams is on call this weekend and I am not sure what would happen if this all occurs on Memorial Day. Maybe the meds they give me will slow things down a bit and I can at least wait until Tuesday. However, I am so ready to get these things out!! I feel like I am waddling when I walk and the constant tension by my ovaries is driving me nuts. I have already gained 3 pounds since starting meds and it's difficult to stand up from a chair. I have a pretty constant headache but luckily it's not bad enough where I have had to take any pain medication yet. Tomorrow is Saturday and another ultrasound and estradiol level. I believe they may even start measuring progesterone. Dr. Rhoton (the only female Dr which is how I describe her) was covering today and she said I should decrease my Follistim dose from 150 units to 125 units since my estrogen had such a big increase. I am excited for Justin to finally get to see my ultrasound in person tomorrow! I will post then :) Goodnight everyone!


Prayers:
-Everything will go smoothly even if I have to take out the eggs early.
-Continued growth and lots of mature, useful eggs!

Slow and Steady Wins the Race!

Hey everyone! I have started my stimulation monitoring and everything is going good so far!

Tuesday May 24th (Day 4 of Stimulation)- I started my morning by waking up to a big rash on my face! I thought to myself, could this be my acne getting way worse from the medication?  Turns out, I think it was a bug that attacked me in my sleep!  I have like 10 itchy bumps on my face around my eyes, cheeks, and forehead.  The mosquitos have been getting in our house from opening the doors so much for the dogs.  I need these to go away pronto!

Putting on makeup to cover my rash

Next, I had a 7:30am lab draw and estradiol resulted at 279.  I started out with my estradiol at 28 so this was a big jump!  They wanted to see me the next day for my first ultrasound and another estradiol check right away since I was >200.  I am at risk for Ovarian Hyperstimulation Syndrome with my Anti-Mullerian Hormone (AMH) high at >9 meaning I have a lot of eggs left from hardly ovulating with PCOS over the years! They decided to keep my Follistim dose the same at 150units tonight.  I am feeling my ovaries grow daily with them always feeling tense and twinges similar to a typical ovulation feeling.  I started getting extra emotional today and crying at anything sappy or baby related that I saw.  Haha!  A normal woman's estradiol typically will only get to around 350 during their cycle.  I am sure my emotions are only going to get worse as my estradiol could get to a level of 2000-3000 by the end of the stimulation!

I spent some time today trying to research meals that I could eat for lunch and dinner since I feel so restricted by this pregnancy diet.  Here's a list of what I have come up with so far as far as the main dish goes.  Can anyone think of any good ideas that I forgot? Leave me a comment!

Justin and I had a great laugh this night with all my emotions and my crazy appetite.  We decided to go on a Bonefish date because I hadn't been there in awhile and it's my favorite spot.  My hormones told me I wanted bang bang shrimp & the 3 course Tuesday special of bread & pesto, caesar salad (yes I was going to risk it), steak, mashed potatoes, broccoli, and a brownie & ice cream! This was like 175 carbs but I really didn't care as I had been so good lately haha!  I thought I was doing good by taking my insulin before eating.  Well of course I took all of my insulin at once except the dessert and then they took forever to get the rest of my food out so my blood sugar got low.  I had to have 3 juice boxes to get it up and I had to ask my waitress for my dessert before my steak lol!  She probably thought I was crazy.  Then of course I took more insulin for dessert and my juice boxes and I still woke up with my blood sugar getting to 400 in the middle of the night!  #diabeticproblems  #nomorebonefishforme  Lol lesson learned control my portions!!!  Justin and I talked about how we wouldn't be able to be wild and crazy anymore if we got pregnant and how I was craving going to Vegas with him and staying out late and partying. haha  I guess he took that seriously and thought I was in the party mood so he changed the radio station to 105.3 when we got in the car.  Well that proves how my mood changed in about 5.2 seconds as I was then yelling at him "Why do you keep changing the radio every time we get in the car?! Where's my Jesus music?!" and then he was referring to me that Christy the boring librarian was back.  We were dying laughing.  I guess I will be having many personalities during this journey.  Lol!

Wednesday May 25th (Day 5 of Stimulation)- My appointment wasn't until 8:45am today since I didn't have to work.  I had my first stimulation ultrasound and it was so neat to see all of my ovarian follicles.  Dr.  Williams had to do it since Dr. Christman is only in clinic Mondays and Thursdays.  Let me tell you! It made me appreciate Dr. Christman so much as Dr. Williams just didn't have the best bedside manner.  I had heard this before but I wanted to form my own opinion.  He didn't take as much time to explain things, it felt really rushed, and he made me feel bad for asking for a copy of my pictures.  Maybe he just wasn't awake yet haha  Thankful for Melinda to answer my questions! So my uterine lining was 6mm (up from 4.5mm) and they would like this to get to above 8mm.  The doctor said things were moving "slow" and that I would be on stimulation meds for awhile.  Sometimes it can be up to 12 days!  My left ovary had 4 large follicles measuring: 10.5mm, 9.5mm, 9.5mm, 8mm, and then more <8mm.  My right ovary had 4 large follicles measuring: 9.5mm, 9.5mm, 9mm, 8mm, and then more <8mm.  I read online that they typically don't trigger your ovaries to ovulate until they reach around 18mm.  Each follicle doesn't guarantee that there is an egg in it and sometimes rarely a follicle can have 2 eggs.  I asked if I needed my medication increased and he said they are really hesitant to increase anything in me because of my hyperstimulation risk so unless today's estradiol is low, they would keep everything the same.  Melinda called and said things are looking good and my estradiol resulted at 446.  They are keeping my Follistim dosage the same and I won't have to go in for more labs and ultrasound until Friday.  I will post then how things are coming along!  It's so crazy to think that next Wednesday (in one week!) I could be having my egg retrieval!

1st stimulation ultrasound on 5-25-2016 (Day 5). My left ovary. You can see 6 follicles here.

Prayers:
-Continued growth of my lining and follicles
-One viable sperm for every egg (I am so anxious about this!)

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Garage Sale, Acupuncture, Mock Transfer, & 1st Injection

We had so much stuff!

It's been an eventful last week!  On Saturday, we were super excited to raise another $900 at our garage sale. We had a great turn out and almost sold everything.  We still have a handful of items that I will post on Craig's List to continue to pay off our fertility loan.  I still feel like I am recovering from the late night hours of staying up sorting clothes and pricing. THANK YOU to everyone that took the time to sort through their things and donate to us.  I am SO appreciative!

All of my medications

On Wednesday, I was supposed to pick up all of my medication at Shands Hospital's Medical Plaza Pharmacy where they do special orders, etc.  I got really frustrated to hear that they had given away the last vial of Follistim to another patient.  There was a national shortage so they would be unable to get my vial before I needed it on Saturday.  They said I could get my doctor to change the vial dosage but that would require another insurance authorization and the supplier to send the medication in 48hrs.  Of course, being a nurse and patient myself, I know how difficult it normally is to get a rush authorization so I was panicking.  It typically takes them a week to authorize my insulin pump supplies so how could they do this in 2 days?!  Well luckily I got in touch with my nurse Melinda who has a specific insurance contact and they authorized my meds within an hour.  The pharmacy had the different dosage I needed in stock so it all worked out.  God is so good :)

I have a better idea of how much this whole process will cost now that I picked up my medicines.  I just had to write the biggest check ever and I felt like I was signing my life away.  Thankful it is less than $15,000 and insurance paid for some meds and ultrasounds!

Acupuncture needles in my hand

Meds = $1211.10
Acupuncture = $225
IVF c/ ICSI = $10,893
Assisted hatching of eggs + freezing of eggs = $1165
Total = $13,494.10

On Thursday, I started my day with my first acupuncture appointment.  A friend who recently did IVF recommended them to me and our fertility clinic had pamphlets all over the office so I decided why not?  They use a protocol that has been proven through research to increase your chances of a pregnancy through IVF by 12%.  All of these women post online about how they use it to regulate their cycles so I thought maybe it would do some good.  I was shocked that it didn't hurt at all.  I had needles coming out of both ears, my forehead, stomach, hands, legs, everywhere!  My next treatment will be in a few weeks before the embryos are transferred into me and another one a few hours after.  If anything, it just relaxes you a lot!  I was anxious about my upcoming mock transfer appointment and my blood pressure was really low after acupuncture so it must have done something!

Next on the agenda was an appointment at the fertility clinic to do my medication teaching, first pelvic ultrasound, mock transfer, more consents, and labs.  The ultrasound was awkward but cool to see.  I liked how they have the monitor on the wall for you to see everything the doctor does and follow along.  The ultrasound showed the birth control did its job and everything is suppressed enough to start my meds.  No cysts or fibroids noted and my uterine lining was great at 4.5mm!  You can only see the outline of my uterus on the right side of the picture.  They made me have a full bladder for the mock transfer so I was like hurry this up! haha They inserted the catheter they would use to transfer the embryos and took measurements for where they would exactly place them.  Dr. Christman said that it was the easiest mock transfer he had done in years!  I am hoping that is a good sign and that everything will go smoothly in a few weeks.  My labs resulted at estradiol 28 and leutinizing hormone (LH) 1.5.  This means I can proceed with the Follistim and I wont need Menopur just yet because my LH was >1.  I had to make a calendar in order to keep my protocol straight and let's be real- it was just fun! I am so ready to get this started!

1st Ultrasound 5-21-2016

My IVF Calendar

Here's a picture of me doing my first Follistim injection tonight.  Luckily all of my injections are just subcutaneous (in the fat) so it should be really easy for me.  Follistim is a follicle stimulating hormone that helps healthy ovaries develop and release mature eggs.  Side effects are headache, stomach pain, bloating, redness/pain at the injection site, breast tenderness/pain, or dizziness.  It comes in a pen form like some insulins but it is a little different with the way you set it up.  I will continue to take nightly injections until I get labs checked again on Tuesday.                                          

24 Hours of Continuous Glucose Monitoring 5-21-2016

I am interested to see which meds will increase my blood sugar levels.  I had another good day today! No sugars above 140 again!  I am having the hardest time resisting all of these foods they say you can't have when you are pregnant.  I am wanting a soda, feta cheese, and a cold subway sub so bad!  Why do  you always crave things when you can't have them?  I haven't had a subway sub in probably 2 years. My doctor is making me start all of the pregnancy restrictions now.  My appetite has been through the roof so I need to distract myself from eating too much haha.  I think I would have more motivation if I knew I had a baby in my belly.  I also can't lift more than 10 lbs while my ovaries are growing.  This will be a fun few weeks at work!  Prayers for healthy growing eggs and little medication side effects :)

Until next time.....
Christy!

Anniversary, A1C, Antagon protocol, and Aspirin!

Well we all know how much anxiety I always have over getting my a1c checked! (average blood sugar over the last 3 months)  I always try my hardest to control my diabetes and when you have a new endocrinologist who is way more strict, my blood pressure goes through the roof until my results are in. Haha You can either leave the office super happy and celebrating or they make you feel not good enough and leave it up to you to fix it without much guidance.  I wasn't supposed to check labs until the end of May but I wanted to get results before they started my hormones and made things even harder to manage. I am glad I did because what did I get??? A 6.9!! As you all remember that my fertility dr's were happy with anything less than 7.2 so I am satisfied with that number. I had even compromised with my endo dr to be less than 7 and it is! Let's hope she remembers our compromise. I just sent her a message to let her know my IVF schedule so I feel much better now that everyone is on the same page.

So how did I get there you ask?  I recently came across a book recommended in one of my diabetes facebook groups called "Sugar Surfing" by Dr. Stephen Ponder.  It talks about using a continuous glucose meter (CGM) to your advantage for when to give yourself insulin, etc.  It has been so insightful!  I literally told myself for years,"I have all the tools, why isn't this happening?! I just wish those people with super low a1cs could just tell me how they do it without being low all the time." Well this book has taught me a few things.  I learned tricks like giving your insulin several minutes before a meal and waiting for your sugar to drop a point or two on the CGM before eating so that way you know your insulin is working which will in turn reduce after meal spikes (my biggest problem). I didn't have a blood sugar over 140 my first day after reading the book!  He also writes that controlling after meal spikes is really a huge reason why your a1c never falls less than 7 (my issue!). It has only been a few weeks since I read the book so I am hoping for an even better a1c in 3 months :)

I spoke with Melinda yesterday and I was able to get my IVF schedule.  I will be on the antagon protocol and start taking a baby aspirin to prevent blood clots today!  Justin will have to take Doxycycline antibiotics for 10 days as a standard precaution against any infections.  I will have a "mock transfer" appointment on 5/19 where they do more labs, an ultrasound to make sure my ovaries are suppressed enough, and measure me to find the perfect spot to implant embryos.  On Saturday 5/21, I will start subcutaneous injections of Follistim and Menopur (Follicle stimulating hormone/Luteinizing Hormone) which will make those eggs grow! This is when I have to go in for every other day and then daily ultrasounds to see how big the follicles are.  Once they reach 14mm, I will start Ganirelix injections which will prevent me from ovulating on my own too early.  Around June 1st, I will have my egg retrieval and take an HCG shot to trigger my eggs to ovulate the day before. Depending on how the fertilized eggs look will determine whether they implant them on day 3 or day 5 of life.  We are looking at a pregnancy test in the middle of June!  I am sure this is going to all go so fast.

Well I would say today has been full of good news and a great start to our 3 year wedding anniversary!  I plan on spending all day pricing garage sale items and then going out to eat somewhere that has a yummy prime rib just like on my wedding day.  Looking forward to what this year has in store for us :)

Praying for a Miracle

After meeting with the fertility doctors and psychologist today, I realized a big way that I alleviate some of this infertility stress is by talking and getting my feelings out with others. So I decided to start my own blog to keep those of you that care updated along the way and help you understand our journey.  By all means, I am not writing this to make everyone feel bad for us, but almost using it like a coping mechanism for when things get tough and a way of expressing excitement with good news. I appreciate your encouragement and positive thoughts! Thanks for listening! 

Today was a big appointment day so prepare for a long post.  We started out with another sperm analysis for Justin (I'll talk about that at the end) and then saw the fertility psychologist. They make every couple speak with a psychologist before signing consents for IVF.  She was really nice and knowledgeable about the IVF process and explained what we could expect to feel during each stage of the IVF process. My favorite part was when she warned Justin to not tell me that I am acting crazy when I am being all emotional from hormones (it'll just make matters worse). He said he'll just make sure to do the laundry and put dishes away that month to not set me off haha score for me!

We then met with Dr Christman, our fertility doctor or officially titled "reproductive endocrinologist."  We often secretly call him Santa due to his name and joke that he will make us a baby by Christmas.  He has a great bedside manner, makes everything comical, and is a math & statistics genius. I swear I can ask him a question and he can give me the stats or do all the calculations in his head in a second.  Makes me feel like he knows what he's doing & super smart. haha He also has a brother who had infertility due to a varicocele so he's very knowledgeable in what Justin is going through.  He is great! 

Dr. Christman started out by saying he spoke with the director of anesthesia about how we should handle my diabetes during egg retrieval.  He described me to the anesthesia doctor as a "conscientious" pediatric nurse who is always fine tuning her diabetes. I laughed when anesthesia responded as "well if she's that OCD, then there shouldn't be any problems!" Hahaha I'm glad I have that reputation already. We all knew that description is accurate so I couldn't say anything! So they aren't worried about me getting low blood sugars at all, they will use my own glucose meter and continuous glucose meter during the procedure and Justin will follow along with my sugars on his phone and it will be great! He gave us a consent form over 20 pages long to sign discussing things we hadn't thought about like what would we do with our fertilized eggs if one or both of us died etc. They will discuss our case this Friday with every fertility doctor in the clinic and come up with a team decision for a protocol for me to follow with medication dosages etc. We think it will be the antagon protocol due to my PCOS.  It typically includes small amounts of steroids of dexamethasone which could raise my blood sugars a lot. Dr. Christman said I didn't  have to take them if I thought my sugars would be too crazy because he doesn't even know if they help at all- it's just something they have always given since IVF started and the cases that haven't gotten them, did just fine. That made me feel better!  

We discussed putting in 1 or 2 eggs and the current literature only recommends one for my age if you get a great looking fertilized egg. You have around a 40% chance of that egg implanting and if you add another one, your pregnancy chance only increases to 50%.  They get nervous about multiples but he understands that we don't have tons of money so we may decide on two and he wouldn't think less of us haha!  They won't be able to tell us what we can implant until the day of based on how many have survived and how they look.

I am really stressing about telling my diabetes doctor that I am officially starting IVF in a few weeks. I have only seen her twice and she's older and way more strict so I am praying that she won't make me feel like crap. Fertility is ok with an a1c level of less than 7.2 for IVF and diabetes Dr wants it less than 6.2. I told her that I have never been that low in my life and she needed to be okay with fertility's plan which was my old diabetes Dr's magical number too. My last a1c was 7.0 and I am due for another one at the end of May. I have been trying to manage blood sugars while on birth control which I am afraid will make my a1c higher when I check it. I am leaning towards checking it next week but I am so nervous! Praying for less than 7.2! 

We then got Justin's sperm analysis back. It was AWFUL!  I literally don't know what to think anymore.  The Clomid he was taking made it increase to a total of 8 million just in January and now they only saw 5-6 single sperm per "high visual field" on the microscope (whatever that means) and only one of those moved at all. SAY WHAT?! How can this happen? It has NEVER been that low. Just a few weeks ago we had 1 million total. So I don't know exactly how many they have in this specimen but it was frozen in case it's even worse in a month at egg retrieval.  Justin is already not drinking alcohol or caffeine, wearing boxers, taking a multivitamin, and avoiding heat.  The only thing I wonder was could his increase to 8 million be when he stopped taking his Valium for his vertigo syndrome a few months ago?!  He recently doubled his dose of Valium due to more dizziness and it's been all downhill on his counts from there. We are going to try stopping it again to see if that helps but seeing as sperm take 72 days to regenerate, I am not sure we will see a difference in enough time. At this rate we are praying that we have just enough sperm to fertilize all the eggs I produce.  With IVF with ICSI, they chop off the sperm's tail purposefully so it doesn't move around once it is placed in the egg and then the DNA will break down in the egg to fertilize it. So I guess they don't need fast movers then. If we don't have enough sperm, I guess I could freeze my eggs and always fertilize and implant them later but who wants to do that?! 

So that's how we left that appointment: annoyed, anxious, praying for a miracle a1c and enough spermies for each egg! 

Next step: Getting my a1c, hearing back on Monday from my wonderful friend/nurse Melinda what our official protocol will be with calendar and meds etc., and sorting through all these amazing garage sale donations. Stay tuned!