18 Weeks

This week was a pretty good week! We hit our deadline at work, so things have been a bit calmer. I took Friday off because I had my level-two ultrasound scheduled (and I also really needed a break from working every second).

The ultrasound went fine. The doctor didn't see anything out of the ordinary which is great news! We met with a genetic counselor for almost 45 minutes beforehand and then the ultrasound itself lasted about 45 minutes. Of course, baby was moving around the whole time making pictures extremely difficult. He started out head down and then did a complete somersault to breech position.  After that, he decided to put his feet up by his face so we couldn't see his little profile. I can already tell he's going to be a handful!! 

Due to all his movement, we only got five pictures and the 3D one is not the best (apparently no one told him he was supposed to hold still for five full seconds for that one!), but here are they are (minus the one which confirms he is indeed a boy ... ha!):

I asked about his upper lip looking so swollen and the doctor said it was fine. He is still pretty small (9 oz) and has lots of growing to do, so I will try not to worry. The doctor said she was obsessed with a wonky looking pinky on her daughter and when she was born, it was totally fine. I'm glad I'm not the only mom-to-be that has these worries! I am definitely able to feel him kick now which goes a long way toward reassuring me. I still can't believe we will be halfway to meeting him in a little over a week! My bump is still tiny which makes it seem all the more surreal. 

Coming up, I have my normal doctor's appointment next week and then on Jan 5, we will have a fetal echocardiogram which is standard for IVF patients. I always look forward to another chance to see my baby :)

15-17 Weeks

I've become super delinquent with this blog, mostly because I've been working way. too. much. The deadline we are pushing towards is next week and we are almost there, so I think things will calm down after that. Thank goodness!

Our Thanksgiving break was very nice. We spent the day of Thanksgiving with Mike's family and ate lots of yummy food. The rest of the week was spent relaxing, shopping online intermittently, and putting up the Christmas tree. Some of the shopping included me caving and buying a few maternity shirts, although I really don't need them yet ... pants are what I need (mine are starting to feel a bit constrictive even though my bump is teeny tiny!), but buying pants online tends to be a nightmare for me so I thought I would go to the Mall of America at some point (hopefully AFTER the holidays).

First maternity shirt (from Target!) with bonus kitty sighting. Excuse the messy room! 

Last week we had real, custom blinds installed in the front of our house. I must be an adult because I was excessively excited about this. They were an investment, but look great! I also got to see my friend Adrian from Clemson who I hadn't seen since my wedding. He was in town for a work meeting. Christine, he hasn't changed at all! We were waiting for our table at the restaurant and he commented on how cute a girl walking by was! He also suggested Adrian as a name for the baby. Ha! Anyway, it was nice to catch up with him and he may be back in May for more work stuff. Depending on timing, he might get to meet the baby which would be fun.

Fancy pants blinds! 

We walked to US Bank Stadium. Adrian was very cold :)

In baby news, we got the results from a blood test I had at my appointment in early Nov indicating normal (low) risk for neural tube defects. Hurray! I think I'm starting to feel the little guy move a bit. I read online that it would feel like a flutter or popcorn, but for me it feels like an increase in pressure in my uterus. When I feel the pressure and I put my hand on my stomach, I sometimes feel a poke or two ... weird but cool ... and also very reassuring! This week I had an ultrasound to check on the blood clot from 11 weeks and it was totally gone. Great news! Even the doctor was surprised. She also found it amusing that I lost a few ounces over Thanksgiving ... oops ... I'm definitely not starving myself! I've only gained about two pounds so far. When I asked if she was concerned, she said that she wasn't, so that makes me feel better. I actually feel like I've gained two more pounds in the four days since that appointment! Weight gain that I can't control is still very uncomfortable for me, but I'm trying to take it in stride.

You can see some fingers and one of baby's little feet!

Don't worry! I didn't forget the baby in all my shopping :) I bought this coat for baby's first winter.

This coming Friday I have my level-two ultrasound. Expect lots more baby pictures after that one!

13-14 Weeks

I'm so glad it's the weekend ... what a completely depressing week (honestly, the first time I've really craved a glass of wine in three+ months). I could go on and on about how horrible and morally-empty Trump is, but I've been trying to bring myself out of my tears/rage cycle by focusing on Baby L. So that's what I will do here.

Last week/weekend, I headed to Louisville for a visit. I won't see my parents again until Christmas and then I'm not sure if I will be able to travel again after that. Mom may disagree, but I think she was slightly disappointed by the lack of a noticeable bump ;) Maybe at Christmas! I've read that you pop later with first babies and I'm relatively tall which affects things too. My friend Amanda at work is around my height and she said she wasn't showing until 20 weeks. I know that every pregnancy is different, so we'll see. My pants are getting a bit tight though, for sure. Anyway, the Louisville visit was really nice. I only worked half-days while I was there which allowed me to disconnect a bit and enjoy family time. My favorite thing.

While I was away, Mike was busy getting quotes for our upstairs bathroom remodel. I get stressed just thinking about the things we have to get done before baby and the holidays will slow everything down. Most of the quotes we got were totally outrageous ... the bathroom is not that big ... but we did finally find a company that seems more reasonable, so hopefully we can move forward with them soon. After the bathroom remodel, we will need to finish up the third bedroom which is currently being used as a workshop space with tools and wood scraps and sawdust everywhere. It needs to be emptied out, reframed (we want to move the closet), and drywalled. Once all that is done, I will at least feel ok about the state of the house.

On Wednesday, the day of doom and gloom, I actually got a very welcome call from the doctor. Our results from the genetic screening had come back and everything was normal: 1/10,000 chances for all the abnormalities they screen for. It's not a guarantee, of course, but still a relief nonetheless. She was also able to tell me the gender! Mike was already at work so I had this little secret all day. I bought an appropriate onesie at Target to surprise him with the news:

A little boy! We are both very excited. And now we get to start picking names!

Second Trimester!

In honor of the first day of our second trimester, here's a picture of baby from our screening ultrasound that we had yesterday. S/he looks much less like a blob now :) S/he was also bouncing around and got the hiccups while we were watching. So weird to see it happening when I can't feel any of it just yet!

10-12 Weeks

Work has been insane and I've been working for at least an hour or two every night which doesn't leave much time for blogging ... or anything else for that matter. But I made it to the weekend and I hope things will calm down soon.

We have had a lot going on besides work too. We told Mike's family the big news at his dad's birthday. Mike made a copy of an ultrasound pic and put it in his card. His mom and sister gathered to look at the card since Mike said that it was so funny his dad needed to open it right away. His sister got it first and then his mom and finally his dad after staring quizzically at the picture for a while. Ha! They were all very excited.

My birthday was next and it was a nice relaxing day. We had burgers for lunch (my hemoglobin is a tad low so I've been upping my red meat consumption) and I splurged on a milkshake. It reminded me of eating at Steak n' Shake in high school. For dinner we walked to a restaurant near our house and I got their delicious fall salad with apples and spiced pecans. Mike got me lots of goodies ... sweets, flowers, pumpkins to carve, and a big pregnancy pillow. And of course I got to squeeze in a nap between lunch and dinner :)

Last week on Tuesday, I had my first OB appointment. It went fine. Hearing baby's heartbeat was definitely the highlight. We talked about the different screenings that are available and we decided to do the first trimester screening which consists of a blood test and an ultrasound. I had that scheduled for this week, but had to reschedule to Monday because of work.

Last Friday, we started looking at daycares. Supply is low and demand is high in Minneapolis, apparently, so there are often long waiting lists. And prices are high. I was prepared for this to an extent having talked to friends at work, but there was still some sticker shock because the places we looked at were even more expensive than what they paid. The first place, Kindercare, was ok ... it felt old and very institutional. They did not mention a curriculum per se and I would hope that even as an infant the child wouldn't just be sitting/laying around all day. The second place, Primrose, is still being built so we met with the director at a nearby Panera. She talked to us for an hour about the daycare's goals for their kids, the curriculum, the food, the emergency plans ... we were very impressed. My friend Iris sent her kids to a different franchise of these schools and spoke very highly of them, so that was a plus too. Today we went to one last place called Towerlight which is on the first level of a senior living facility. The kids regularly interact with the "grand friends" which sounded interesting to us. The facility was nicer than we expected, but again, the curriculum was not discussed in detail which concerns me. This was the least expensive of the three although there was only a $2K difference between the this place and Primrose, the most expensive. A lot of details I know ... mostly for me to remember how stressful picking a daycare is! We are leaning toward Primrose at this point, but Towerlight is a close second. I think we will decide by the end of the weekend.

Last Friday, after the daycare hunting, I took a nap and when I woke up, I was bleeding again. I could not believe it. It felt similar to last time with no cramping. But it was just as scary. We called the on-call doctor and he said that if we had seen the heartbeat, the odds of miscarriage are just 5%. He said we could go to the ER to check on the baby or wait until Monday and come to the office. Obviously, there was no way that I was waiting the whole weekend to find out. We decided to wait until Saturday morning which turned out to be a good move since there was no wait in the ER. The doctor was literally in the room before I even had the gown on! They took blood and sent me for an ultrasound. What a relief to see the heartbeat when the baby popped up on the screen! The ultrasound tech said that I have a subchorionic hemorrhage, basically a pocket of blood, near my cervix. Being near my cervix it will likely bleed out instead of being reabsorbed. The doctor (who was not an OB) said my chances were 50/50 at this point which I was totally shocked by. When I got home, I did my own research and found that an SCH does not increase the risk of miscarriage by much. I think the doctor must have meant that of women who bleed during the first trimester, 50% go on to have healthy babies (which I have heard before). Holy crap, though ... way to scare me. Regardless, I will be glad to see baby again in just a couple days.

9 Weeks and Duluth Trip

Last weekend, we took a short trip to Duluth to see the fall colors. I still wasn't feeling great, but lodging was paid for and we were meeting another couple up there, so we went for it. Although I probably pushed myself a bit too hard on the hiking and paid for it later with a prolonged cold and sore calves, it turned out to be a really nice trip.

Our cabin had a private beach on Lake Superior

So much of our hikes was steps!

In front of High Falls at Tettegouche State Park

View from the top of the falls

Bouncy suspension bridge 

View from beginning of second hike

View from end of second hike 

Nice sunset on Saturday night

We also had another ultrasound on Wednesday. The nurse said the little guy or gal is looking perfect! You could see the little arms, legs, and the brain, and it is measuring 2.47 cm with a heart rate of 168. It was even moving around some! I was so relieved. I feel like now I might finally feel secure enough in this to start planning, reading, etc. I've also officially been discharged to my OB! I had blood work with them on Tuesday which all came back fine (except my hemoglobin is slightly low so I will be eating more hamburgers) and my first real appointment is in a couple weeks. Things are moving along!

Little cutie

8 Weeks

The pregnancy apps on my phone tell me that the embryo is the size of a kidney bean or a "big juicy raspberry". These two items seem quite disparate in terms of size and shape, don't they? I feel like all the pregnancy website/app companies should come together and agree on the fruits/vegetables that will be used to show human baby size progression. And why does it have to be food?! The last thing I want to do when visualizing the baby is to associate it with a food that I perhaps want to eat!

Not much to report this week. To be honest, it feels like time is creeping by. I still have a lot of anxiety about everything. I felt reassured last week after the ultrasound, but every day since, I wonder "what if something has happened in the x days since then?" Mike tells me that worrying so much won't help since it's out of my control, but it's hard to let go. I wonder if the anxiety will ever go away. I mean, even once the kid is out I'm sure I'll still be worrying about one thing or another!

I also have my first (hopefully last, too!) pregnancy cold. It sucks. Normally I would be in a NyQuil induced stupor each night, but instead I'm forced to suffer. I'm a super big fan of taking medicine in lieu of suffering, so this is really hard. I read somewhere that certain decongestants might be ok. If I'm not feeling better soon, I may call the doctor and check. At least I don't have a fever which could be bad for the embryo (silver lining?).

7 Weeks and a Heartbeat

I will be 7 weeks tomorrow. I'm physically feeling pretty good. My fatigue has increased and I find that I get dizzy when I stand up too quickly, but thankfully, nausea has been at a minimum so far. We had our second (more on that in a minute) ultrasound today and got to see the little flicker that is the embryo's heartbeat! It was strong at 146 bpm. I was amazed that we were actually able to HEAR the heartbeat too. It was so surreal. They said that everything is measuring well ... s/he is measuring a couple days ahead at 7w1d. I'm hoping this is not an indication of a large baby to come!

I did not post last week because we had a bit of a scare and I could not bring myself to write about it until I had additional reassurance from this week's ultrasound. On Tuesday, I woke up to red bleeding. Looking back, I don't know if I would call it "heavy", but it certainly was not just spotting. I called the doctor's office as soon as they opened and they were able to get me in for an ultrasound that morning. We were so scared. I was preparing for the worst while holding on to hope. I researched online all morning and it seemed like bleeding is more common in early pregnancy than I thought. I was not cramping at all and from what I read, this was a good sign. The ultrasound showed a gestational sac, yolk sac, and the embryo, but they couldn't see a heartbeat because it was a little early at only 6 weeks. They also saw the area of bleeding. I asked what was causing it and the nurse guessed that it was potentially some tissue breaking off from implantation. So we left reassured that our embryo was hanging on, but I was a nervous wreck all this week. The bleeding went from red to pink to brown and became much more like spotting over the course of a few days. Still, I panicked every time I had to go to the bathroom. What if it came back? Today, they were able to see the bleed again and they said it was much smaller and looked to be resolving itself. Thank God! 

I'm still nervous, but feeling more hopeful after today. I read that the risk of miscarriage is much lower once a heartbeat is detected. The next milestone will be the end of the first trimester which won't be until early November. I'm sure it will be here before I know it even though it sounds so far away now. Luckily, we don't have to wait that long before our next ultrasound: we go back in two weeks. I'm all for seeing the embryo as much as they will let me!

To end on a good note, here are some pictures from our ultrasounds. 

6 Weeks: The little bright line at the bottom of the yolk sac is the embryo

7 Weeks: The ring is the yolk sac and embryo is the little glow worm looking thing to the left :)

5 Weeks

Last night, I told Mike that I would be five weeks pregnant today and he said, "What?! How did that happen? How is that even possible?" I will admit to being similarly in denial although for a different reason: he was confused about what constitutes "day one" of pregnancy, while I am in shock that this is even real in the first place! I feel pretty normal ... maybe if you pressed me, I'd say that I'm a little more tired, have some occasional cramps, and don't have a huge appetite, but that's really it (knock on wood!). I wonder when it will start to feel real? Maybe after our first ultrasound? Once we start having to look at daycares? When my clothes don't fit anymore? Who knows the moment, but I'm sure reality will hit hard when it finally arrives. I already get anxious thinking about the whole process and all there is to be done, so for now, I will take it one day at a time.

Another milestone that I will thoroughly enjoy this week will be my freedom from the devil known as Endometrin. This is your warning to stop reading if you don't want to hear about things like suppositories and discharge! I'm about to go all TMI on you. Here we go ...

So I guess it's pretty typical after IVF to be put on some sort of progesterone supplement. From my reading, it sounds like there are three main types: oral, vaginal suppositories, and shots. Oral is the least effective and so is not used much. I've read that the shots are super painful because they are intramuscular and many women end up with soreness, bruising, and difficultly sitting. My doctor uses the suppositories (my brand is Endometrin). I am on three per day and if I only had to put up with the constant leaking throughout the day (which is pretty gross), I would a-ok. I mean, what's a little discharge after stomach shots and egg retrievals and whatnot? Unfortunately, Endometrin also causes spotting. Can I tell you how scary it was to wake up to spotting Friday morning before I got my results?! I was sure at that point that I wasn't pregnant. When the nurse called in the afternoon and gave me the news, I told her about the spotting (it had been light brownish) and she reassured me that it didn't sound concerning and that it was probably the Endometrin which can irritate your cervix. Whew! Then this weekend ... more spotting ... and this time it was PINK. Since the doctor was closed, I spent the weekend googling various combinations of "Endometrin", "spotting", "discharge", and "pink". I was mostly sure that it was the same issue as before, but the pink really threw me off. Today I called the nurse for further reassurance, and yes, apparently Endomerin can cause a whole rainbow of discharge colors. Ugh. Anyway, Thursday is my last day on those and if I could celebrate with champagne, I would. But I can't, so maybe I'll splurge and have a Fresca instead to commemorate the moment!

BFP

BIG FAT POSITIVE!

Positive results were via a blood test, but I POAS just for fun :)

We got the results yesterday and I'm still in shock. I was so sure they were going to be negative. What a crazy, happy surprise! 

Waiting

I am officially 7dp5dt. That's IVF lingo for "7 days past 5 day transfer". Our embryo is 12 days old (or maybe 13 since they count fertilization day as day 0). That assumes, of course, that our embryo is still alive and growing. I hope it is, but thinking about it too much leads me down the worst-case scenario rabbit hole.

So I've been trying to keep busy. That was easy last week since work has been super stressful. I never thought I'd be glad for stress but it does keep my mind busy! Just in case you were worried (as I was) that stress could affect IVF success, it doesn't.

But I can't stay busy all the time. It's after the lights are off, the house is quiet, and I'm laying in bed at night that the fun over-analyzing and fretting begin. To be honest with you, I have had no real symptoms to speak of ... maybe a couple small things, but really anything that I do feel could be attributed to all the progesterone I'm taking. I'm also taking estrogen, so to say I'm hormonal would be an understatement. In the past, any symptom would be googled and thought about and timed and counted. Now, since I'm feeling nothing, I'm thinking about the possible reasons for that. Trying to prepare myself for bad news. How will we move forward? What if I have polyps again and the little embryo couldn't implant (this one haunts me!)? Should I test early to prepare myself?

I have blood tests scheduled for Wednesday and Friday morning. We will not get the results until Friday afternoon after the second test. They do two tests just in case the first is a false positive. I'm getting more nervous as Wednesday approaches. I'm sure this week will be much more difficult than the last. But there's nothing to do now except wait and hope and pray and wait ...

Embryo Transfer

Today was our embryo transfer day! I slept pretty well given my nerves. I slept horribly Friday night so that is most likely the reason. At any rate, we were due at the IVF center at 10 with transfer scheduled at 11. Let me tell you, that was the longest hour ever!

Mike got to sport some cool booties

Per their instructions, I took the Valium I was prescribed once we arrived. I probably should have taken it earlier, though, since it didn't really kick in until after the whole thing was over, so I was a nervous wreck throughout. The doctor attempted to soothe me by saying it wouldn't be painful and would be over quickly, but it was more the realization that "THIS IS IT", the culmination of the whole physically, emotionally, and financially draining process, that had me on edge.

Before the transfer began, the embryologist came in to give us a progress report on our embryos and to tell us how many they would be transferring. I had thought earlier that we would be called during the week and given an update, but I was mistaken, so this was the first we had heard anything since our egg retrieval. Out of 28 eggs, 22 were mature, 20 fertilized, and 4-5 were perfect. She is watching the others for one more day and she expects 3-4 more to be at a stage where they can be frozen. So that will be a total of 4-8 frozen. And here, without further ado, is our single perfect embryo that was implanted.

If the embryo implants, the clump of cells at the bottom will become the fetus and the cells along the edge will become the placenta. The little cells popping out at the top are the embryo starting to hatch from its shell. It has to hatch to implant so this is a good sign.

Finally it was time!

The whole procedure lasted maybe 10 minutes, and was slightly uncomfortable, but not painful. It was very reassuring to have Mike with me, holding my hand. If we can't make a baby the "normal" way, then at least we could be together for this. This picture is hard to make out, but the little white dot above the cursor is the droplet of fluid containing our embryo inside my uterus. Hurray!

So now we wait. I have to call tomorrow and schedule two blood pregnancy tests two weeks from now. I'm sure it will be a long two weeks with lots of false and/or real symptoms, but what is two more weeks when it has taken us two years to get to this point.

Egg Retrieval

They got 28 eggs! Holy cow! I was pretty shocked to hear that when I woke up, especially since I had only had 14 follicles at my last ultrasound. Apparently, 10-14 is about average so I definitely overproduced. Unfortunately, this also puts me at a high risk for OHSS (ovarian hyperstimulation syndrome) where your abdominal cavity fills with fluid. They added an additional medication to my daily protocol, told me to drink a lot of Gatorade, and I have to go back on Friday for an OHSS check. I have been doing a lot of Googling about it (bad idea, I know!) and found myself in a total panic last night when I realized I was 6 lbs heavier than I was in the morning! Luckily, after a night of peeing, I was down 5 lbs this morning. Whew. I am still super bloated (I look several months pregnant) and quite uncomfortable. My ovaries hurt when I'm in a sitting position so I've been laying on the couch all day. I'm going to try to go to work tomorrow, though, so we'll see how that goes.

We should get a call from the embryologist tomorrow to let us know how everything is looking and when our transfer will be, although the nurse said before we left that with so many eggs, it will most likely be on Sunday. Depending on how the OHSS check on Friday goes, there is a chance that the transfer could be cancelled and all the embryos put on ice. If that happens, we would have a frozen embryo transfer in a month or so. Hopefully, it won't happen, but I'm putting it on my radar so that I'm not totally deflated if it does.

Nerves

Tomorrow is our egg retrieval and I am totally ready and not ready all at the same time. I feel super gross: bloated, sore, gross metallic taste in my mouth constantly from the antibiotics, bruised from blood draws and stomach shots (Mike went two for four for hitting blood vessels with Sunday's shots). So I am ready to feel better (especially the metallic taste needs to GO AWAY ... blech!). But I'm also super nervous. How many eggs will they get? How many will fertilize? What if I end up having low quality eggs? How will I feel after the procedure? What if I get OHSS? This is what will keep me up tonight. In the end, though, I know it's out of my control. I just have to hope and pray for the best.

The game plan for tomorrow is to leave at 6:00 am to arrive at the doctor's office at 6:30. Mike makes his contribution at 6:40ish then I go back at 7:00 with the surgery scheduled at 8:00. The doctor will aspirate all follicles greater than 18mm or so and then an embryologist immediately looks under a microscope to see if there is an egg or not. I think we should know by the time we leave how many eggs they managed to get. They said the procedure itself is pretty fast (15-20 minutes), but I have to recover from the anesthesia which takes about an hour. Fingers crossed we are home and relaxing by 10!

After the procedure, each mature egg will be injected with sperm via ICSI and then we wait to see whether they grow or not. Hopefully, there are several that fertilize and are growing at the expected rate. The quantity and quality of the embryos will determine when and how many embryos we transfer (1 or 2). The transfer will be sometime between Friday and Monday if all goes as planned. Any extra embryos are frozen for future use.

So that's the plan. I find that if I focus on the plan and what is the immediate next step, sometimes I can stop my mind from diving into "what if?" rabbit holes ... sometimes. We'll see if I can do that tonight!

All the Follicles

I had an ultrasound today and I have ten follicles close to or greater than ten mm in my right ovary and four in my left (such an under-performer!). I knew there was a lot going on in the right because I've started to wake up from achy pain in that area. The nurse was super happy with my progress (it's day six of stimming). The goal is to get them to around 18-20 mm at the time of retrieval so we are right on track. I cannot even imagine how I uncomfortable I will be then.

Speaking of retrieval, we are officially scheduled for Tuesday morning! Crazy. We have to be there at 6:30 am for Mike's appt at 6:40 and then I go in at 8:00. I won't go into details about the procedure because it sort of makes me cringe, but feel free to go here to read more about it and to see a lovely picture. Suffice it to say, I'm glad I will be asleep!

Things are going so smoothly that I feel like something has to go wrong soon. I mean, we don't have the best track record. I keep hoping things will go well while at the same time trying to temper my expectations. Even if everything goes perfectly from here on out, the odds of a successful pregnancy are only 60-65% at the highest. I guess I shouldn't say "only" since that's much better than the usual 20%, but it's not a guarantee. We could go through all this and fail in the end. It's sad to think about, so I try not to, but it's always there in the back of my mind.

Anyway, enough worrying ... one step at a time ... egg retrieval here we come!

Estradiol Levels

We started the stimulating meds on Saturday. The tentative plan was for the shots on Sat and Sun to contain four vials of meds and then decrease to three vials for Mon - Wed. I was scheduled for blood work this morning and blood work and an ultrasound on Wednesday. After the blood work this morning, I got a call from the doctor saying my estradiol levels were a little high ("which is perfectly okay!"), so they want me to decrease to two vials tomorrow and come in a day early for the ultrasound.

They told me that my estradiol level was 327 which means absolutely nothing to me, so I did some googling and it seems that most women are at or near 100 after three days of stimming. Of course, everyone has a different IVF protocol, with different meds, etc, so who knows what the actual "normal" level is. I can tell something is going on because I haven't been feeling great today: I didn't sleep well, my ovaries feel sore, and I've head a headache since the afternoon which just won't go away. If these are side effects of the meds and/or high estrogen levels, then I will have to live with them for another week since my egg retrieval is tentatively scheduled for Monday. Here's hoping at least the headache goes away before then.

On a side note, I also had my post-op appointment for my polypectomy this morning. (Yes, I had a busy morning!). The doctor I met with was the one who did the first surgery. He acted confounded by the quick reappearance of the polyps and wondered aloud whether they were "compressed" during his surgery. I could tell he felt a bit guilty. He was glad to hear that we are doing IVF and said good things about the IVF doctor. I mentioned the cost and he said my doctor is pretty affordable (as far as IVF goes) and then mentioned that his friends in GA had spent upwards of $120K on IVF cycles. Who has that kind of money laying around for IVF?! I guess it's a small blessing that the one place within an hour of us approved by my insurance is significantly more "affordable"!

Too Many Meds

The polypectomy went fine. Here's a pic of the polyp ultrasound image (actually mine this time!). The black spot in the middle, my uterus, is supposed to be a smooth oval shape instead of being reminiscent of a scary pumpkin mouth or the opening of a cave. Hopefully, it is much improved now!

I felt the effects of the anesthesia for a day or two longer this time, I think because I pushed myself a bit too hard, too quickly. Anyway, I'm totally recovered now and hopefully good to go for the transfer.

Not much went on this past week besides trying to get all my medication ducks in a row. I have a list of ten that I will be taking at various points in the process (in addition to prenatal vitamins and a baby aspirin, which apparently helps with fertility ... who knew?!). Some require prior authorizations which is a pain in the ass. Some have to be filled via the mail-order specialty pharmacy, while others can't be filled there at all. It's enough to make my head spin, but I mostly have it sorted out, I think ... I hope!

Next steps are my baseline blood work and ultrasound on Monday, and then I'm scheduled to start stimulation meds the following Saturday.

Rerun

Mike and I spent three and a half hours at the IVF center on Monday. We were both totally exhausted and overwhelmed with information when we got home. And there was one unexpected blip: the sonohysterogram showed that I have polyps again! Two months after having a polypectomy! I have no doubt that they are caused by the fertility medications, but whatever the reason, they have to come out before we can proceed. The doctor said that if I was able to schedule the surgery this week, I would still be able to move forward with an August IVF cycle, so that's what we are doing: I'm scheduled for (another!) polypectomy this Friday. At least I know what to expect this time, so I won't be as anxious.

We also have our tentative IVF schedule!

Aug 1: Baseline ultrasound

Aug 2 - 15: Stim-ing (i.e., stomach shots) and every other day appts for ultrasounds and blood draws

Week of Aug 15: Egg retrieval

4-6 days after E.R.: Embryo transfer

Then we wait ...

4th of July Up North and IVF Update

"Up North" is what Minnesotans call anything north of the Twin Cities. During the summer everyone goes up north on weekends to their respective cabins on various lakes. It's like a mass exodus. We went up north to Mike's parents' cabin for the week of the 4th. We had some rainy weather, the mosquitos were insane, and the fish weren't biting after the first day, but the company was excellent and we had some beautiful sunsets.

Regarding IVF, we got all the blood results and genetic testing back, so we have our official program start on Monday. The only issue found was that I'm slightly deficient in Vitamin D which is apparently typical for caucasian Americans. I started taking 2000 IU of Vitamin D3 but I was experiencing crazy fatigue (I felt like I was wearing a 25 lb blanket) and stomach upset so they dropped me down to 1000 IU. Anyway, the Vitamin D won't hold us back from starting so that's a good thing. 

I did find out today that we are only $500 away from hitting the lifetime max coverage on fertility medication which means we will be paying out of pocket from here on out. At this point, I'm guessing the medication will cost more than the actual procedure. I cried when I found out. The small amount of coverage for infertility is totally ridiculous. And apparently I was one of the lucky ones with my meager coverage! On the plus side, I can now just go to a pharmacy and get my meds and not have to deal with insurance. 

So Monday, our appt is supposed to last 3 - 3.5 hours and will mostly consist of signing lots of consent forms. We had to pre-fill out a few forms that asked us what should be done with our leftover embryos if: I die, Mike dies, we both die, we divorce, or I lose the ability to carry a baby. Strange conversations to have. We joked about leaving the embryos to my brother if we both die. "Surprise! You are the proud owner of Stacey and Mike embryos!" Haha! It makes me laugh just thinking about it (sorry, Brad!). I will also have another sonohysterogram to check my uterus (even though I just had one a couple months ago :-P) and a trial transfer where the doctor practices placing the embryo in my uterus. After the appt, we wait for a call from the scheduler to determine the actual timing of everything: stimulation start, egg retrieval, and embryo transfer. Then things get really real.

IVF Here We Come

It wasn't our month, again. Oh well. We are moving forward and have been busy this past week getting all the IVF paperwork and testing completed before we head to Mike's parents' cabin for the 4th of July. They did lots of blood work on both of us and I think we had about 10 pages of medical history forms to fill out. One option they provide is genetic testing to see if we are carriers of any genetic diseases. We don't have any indicators for genetic diseases, but I feel like this will give me more peace of mind during pregnancy, so we went for it. Goodness knows I don't need anything else to worry about! Once the genetic results come back and all the records have been sent over from this past year of trying, we will be scheduled for our "program start". This will be when we fork over some cash and officially get started. I'm semi-dreading the whole process, but we will get through it and hopefully have a sweet baby (or two!) at the end of it all.

Side Effects of Progesterone

About five days after ovulation (when it occurs), I have to start taking progesterone. I've never really been told why and I suppose I've never thought to ask since it's so much of an after thought to actually ovulating, but based on some googling, I think it helps to prevent miscarriage in the first trimester. Regardless of its use, it has some fun side effects, such as:

• Nausea
• Fatigue
• Headache
• Breast pain and enlargement
• etc..

If those side effects look familiar, it might be because they are also symptoms of pregnancy! When you get pregnant, your progesterone levels increase causing these early pregnancy symptoms. So every (ovulation) month, I get to enjoy the early symptoms of pregnancy without ever being pregnant (yet)! It's very frustrating. My level of symptom-spotting is way down from where it used to be, but the hope never really goes away ... which inevitably leads to hopes being crushed. Not a fun cycle month after month.

I'm not out just yet, but I'm trying to temper my expectations.

Total Shit Show

As predicted, today was a total insurance shit show. I needed one prescription today and I need the other on Wednesday. Regarding the one that I needed today and for which the doctor sent in a prescription on Friday, "Yes, I see the prescription, but there was no ORDER placed for the medication. The doctor can send in a prescription, but you have to call in and order it. It's for your own protection since you are the one paying for the medication." ARE YOU FUCKING KIDDING ME?! Excuse me for thinking that you work like every other pharmacy I have ever used in my life which fills a prescription upon receiving it. Seriously?! The doctor's office actually sells this med since insurances in general are stupid, so I went ahead and bought it there ... it was double my co-pay, but I don't even care. And the other prescription? "The preauthorization on that medication is still pending. We can't place an order until then. You can call your doctor and have them call and check on it." I did this. The nurse told me that the insurance told her that it could be up to 48 hours FROM TODAY for the PA to go through. Well, isn't that convenient. It will be approved on Wednesday right when I need it! Oh wait ... silly me ... THEY CAN'T GET IT TO ME SAME DAY. I'm predicting another shit show on Wednesday.

End rant (for today).

Actually, the doctor's appointment went really well and I hate insurance for ruining my day. He said everything looked good. We have a few follicles in the running and my lining is ready. The only bad thing is that Mike is out of town (Mike, if you are reading this, the doctor would prefer if you came home early!), so our timing could be slightly off. I am stimulating for two more days and then triggering on Wednesday night. The doctor wanted me to trigger tomorrow, but life and annoying work conferences happen. Regardless, he was still very positive about everything, probably since I looked so skeptical. He said something like, "Start your progesterone on Tuesday and then you'll keep taking it until you're 13 weeks pregnant." And then he sent me off with, "We'll see you after you have your positive pregnancy test to see how many babies you're having!" Ha! Well, fingers crossed that this is our month, but toes crossed that we don't have more than one!

And in case anyone is stilled enraged about insurance (*raising my hand*), here is a video of my favorite kitty :)

Back in the Saddle

I had my baseline ultrasound for this cycle on Wednesday. Everything looked fine (no large cysts), so we started our last try with injectables that night. I did have a good talk with the doctor while I was in there. The doctors at this practice rotate who covers infertility patients, so I often see a different doctor each time I go in. I hadn't seen this particular doctor since 2015 sometime. He opened with "Looks like you've been through a lot lately" which I actually really appreciated because half the time these doctors are so busy that I feel like they are catching up on my chart while they are in the room with me ("Now what cycle is this for you?", "Have we tried this med on you?", etc). Anyway, I told him that this would be our last cycle before moving to IVF and he agreed that that was the right decision. It was a bit of a relief to have someone affirm this path since I often wonder if I'm just being impatient and should give meds-only more tries. He did say that maybe having the polyps removed will make all the difference for us since sometimes polyps can act like IUDs. I'm not holding my breath.

So once again, I left their office with prescription in-hand needing medication same-day. Can you guess what happened? That's right ... me sitting in the car for an hour in the Walgreen's parking lot on the phone with insurance. This happened despite the fact that I called insurance several weeks prior to try to get everything sorted out so I wouldn't have to go through this again. I talked to someone who sounded very young and I guess he was, and inexperienced as well, because he had assured me that I had an unlimited override which, come to find out on Wednesday, I did not. Ugh. (To give him some credit, though, he did manage to get me reimbursed for that $1K I paid out of pocket). After having a meltdown on the phone, I was finally able to get my meds and go home. I had to call them back again, however, because I know I will be in the same situation on Monday. I eventually got someone from Fertility on the phone and they said that "Most doctors will just send in prescriptions beforehand." So there you have it ... they have built a system that requires doctors to write prescriptions for patients before they have even seen them. I am honestly out of words for how stupid this is. I called my doctor's nurse and asked if she could get him to write me a prescription for more medication and send it in by Friday so that they could ship it to me and it would arrive by Monday (my next appt). Supposedly, this occurred.  "Supposedly" because I tried to log in to the specialty drug website and my account could not be found. Monday might be another shit-show.

Another wrinkle to this cycle is that Mike is out of town for work from Sunday until Thursday evening. Last cycle, it took them two weeks of injectables to get my follicles ready, so I wasn't too worried at first, but the doctor is using what they know about how I reacted last time to speed things up this time. He said that it is better for the follicles to mature faster. I told him that Mike is out of town, so he is going to try to drag things out until then. A house without Mike also means that I will have to give myself shots for the first time. I am quite nervous about this. Mike said we will practice tonight while he's here and hopefully, it won't be as bad as I think. Regardless, I'm going to have to just suck it up and do it.

Polypectomy

Last Thursday, I had a hysteroscopy with polypectomy. To be honest, the build up was far worse than the actual procedure. I was scheduled for 1:35 pm and had to arrive at the hospital at noon. No food after midnight and no drink after 9:30. I was registered and back in the room by 12:30ish, I think. At first, they didn't let Mike come with me. I was feeling super anxious so I was not happy about this. After changing and submitting to the indignity of a pregnancy test (yeah right), they finally brought him back to the room ... at which point the nurse talked him into going to the cafe! She literally pestered him into going. After he left, she said something like, "Now you guys don't have to just sit here and stare at each other." What? Thankfully, he made it a quick trip and even brought me his bag of chips for after. If that isn't love, I don't know what is :)

Anyway, around this time, we were told that the doctor was running an hour and a half behind. For me, this was just extra time for my mind to run wild with anxiety. I asked as many questions as I could of the anesthesiologist and the doctor when I got my five minutes pre-op with them, but I was still a nervous wreck. I did my best to distract myself by watching HGTV.

Tired, hungry, anxious, and sweating profusely in that itchy gown.
The attached tube was blowing cool air into my gown.

My awesome non-slip socks

Finally, they were ready for me and the nurse walked me to the OR. Yes, walked ... I found it very odd. Once I was situated on the table, they started the IV ... the whole process of being put to sleep scares me ... and I remember giggling nervously, saying "This is kind of scary," and thinking that this must be how someone being put to death feels. I have no idea how that popped into my head.

Next thing I knew, I was waking up. Based on the texts Mike sent my family, the surgery lasted maybe 20-25 minutes. The doctor told Mike that it took him 19 seconds to remove the polyps (I had two). So specific!

Good riddance! Mike said the doctor told him they were only a cm or two.

I was in very little pain when I woke up ... some low back pain and some cramping, but not even close to the pain of period cramps. They gave me some pain meds in my IV, but I have not needed anything other than ibuprofen since then. I felt drunk and lethargic from the anesthesia that day and was lacking in energy over the weekend, but recovery has been surprisingly easy.

Another obstacle cleared ... now we wait for the next cycle to begin!

Polyp Update

I had the sonohysterogram yesterday and I definitely have a polyp.  

Not my polyp, but this is what it looked like

The doctor was already going to be at the hospital doing surgeries tomorrow, so they went ahead and scheduled me for the afternoon. It is a type of D&C and I will be put under general anesthesia. I'm glad because it is not fun at all to have instruments pushed through your (closed) cervix. I'm still recovering a bit from yesterday which was definitely worse than I remembered from August. My poor cervix will need a rest after all this.

I realized as I wrote that that my cervix will go through much more if we end up getting pregnant, but this is my limited frame of reference at the moment ...  Hopefully, I will get to look back on this later and say to past Stacey, "What a whiner you were!"

Benched

We have been benched for the month. I have a 3 cm cyst on my left ovary (similar to what happened in October). I'm sad, but secretly relieved that I don't have to deal with the insurance company (isn't that awful??).  

Since we have all this free time, I thought it was best to get the polyp situation figured out. The doctor today didn't see a polyp and seemed skeptical like the other doctor, so next week, I will have a sonohysterogram where they fill my uterus with saline and then do an ultrasound to determine whether the polyp is real or not. I had this same procedure in August as part of the diagnostic work up ... it was not super fun, but at least this way, the polyp question will be put to rest. If there is one, then I can have a procedure to remove it. If not, they can stop bringing it up every flipping time I'm in there!

Before I left, the doctor did say that we should still try on our own this month. I had to stop my eyes from rolling out of my head. Then I was reading an infertility article this evening ... something from Scary Mommy, I think ... to be honest, it wasn't that great of an article ... but this one quote rang quite true to me: "a part of me will always wonder what it must be like to simply have sex and get pregnant." Yes. Exactly.

Next

Another month down.  I didn't even have to waste any pregnancy tests this time ... although I was tempted.  On infertility forums there is always lots of discussion around implantation bleeding.  I've gotten to the point where I feel that this particular symptom is like grasping for straws ... one last-ditch, tiny ray of hope.  I wish I had never heard of implantation bleeding.

Also, on Friday, which was already my one sad day I allow myself, we got a letter from the insurance about that $1000 out-of-pocket that I spent.  I'll let this picture speak for itself.  Fucking insurance.

(Don't hate on the horse!)

I go back to the doctor tomorrow.  Mike wants to do one more cycle of shots before we move on to IVF.  We'll see if that happens this month or not.  For the past couple cycles, the ultrasound technicians have been measuring some little growth in my uterus, a polyp I think.  One doctor tells me he doesn't think it's a big deal and I shouldn't worry about it.  Another doctor says that I should definitely have it removed because it could cause issues with implantation.  Tomorrow will be a doctor whom I haven't met before, so I guess he can be the tie-breaker.

Spring in MN

Spring has finally arrived in MN!  It's so nice to be able to work in the yard and go for walks around the lake near our house.  Sunshine and warm weather really do help me feel more positive.  Here are a couple pictures from our walks this weekend.

Cedar Lake with the Mpls skyline behind the trees

 Sweet little gnome house along our trail

Spring naps!

Trigger Happy

My ultrasound yesterday showed a 22 mm follicle! Finally! The doctor told me to trigger at around 5 pm that evening. The trigger is a different shot which causes ovulation within 24-36 hours. So we actually get to try this month ... for the first time since November. Yay! I was so glad to get that call from the doctor, obviously because I will successfully ovulate this month, but also because it means I don't have to deal with the insurance company for a while. Double yay!

Of course, there is only a 20% chance of pregnancy even with ovulation, but that is much better than the 0% chance without. And it's awesome that this drug protocol worked because it means we could try this for a couple more months (if this isn't our month) before moving on to IVF.

Hope.  Such a happy thing!

New Insurance Part 2

So the "specialty pharmacy" that I'm supposed to be using now is a mail-order pharmacy.  I called them today because I needed more vials of the med (more on that below).  Apparently, the fastest they can get any drug to anybody is the next day.  I was literally losing it on the phone because this lady was giving me zero options other than a one-time override (keyword: one-time) that would allow me to pick it up at a brick and mortar pharmacy.  "Ok.  That's fine, but this is going to happen every time I get this prescription.  They prescribe it and I need it the same day.  You are telling me that I have to use your mail-order specialty pharmacy and that they can never get me these medicines the same day?!  How is it possible that NONE of your specialty customers has ever needed a prescription same day????"  

This whole call happened in the parking lot of the doctor's office.  Yep.  Another day.  Another round of crying in my car in a parking lot.  Anyway,  I went home to wait for the authorization call for the one-time override.  Mike was home by this time and I was so upset about the complete ridiculousness of this that all I could do was yell about it (probably the yelling that I had wanted to do at the insurance lady).  I decided that I couldn't wait and I called them back because while it's great that the situation is resolved today, I didn't want to have to deal with this every single flipping time I go to the doctor.  So I called the main customer care line and immediately started crying to the lady on the phone about this impossible scenario.  She quickly transfered me back to the specialty pharmacy (who I had just spoken with 30 minutes prior), but I got someone new this time.  I think her name was Lena. My sweet, sweet insurance angel Lena.  

Lena actually took the time to listen to my concerns and offer up some long-term solutions (what?!).  She said a member of the pharmacy team would call me and they could work with the main medical insurance plan to perhaps authorize UNLIMITED OVERRIDES!!!  She didn't make any promises but at least it's not a dead end.  Progress.

Yeah ... so more meds.  The ultrasound showed that my right ovary still has nothing going on and my left ovary now has 3 follicles of 13 mm.  So the follicle from last time didn't grow AT ALL.  Frustrating. But two new ones have popped into the running.  I'm definitely a slow responder.  So the doctor upped the dose to three vials per day for the next two days and I go back again on Wednesday.

New Insurance

The new policy year for my health insurance started April 1. While the medical coverage is the same, the prescription drug benefits are being handled by a new company.  I knew this.  I even went on their website to check if I could go to the same pharmacy for these drugs (which are considered specialty drugs).  The pharmacy was listed as in-network and the co-pay was the same as under the previous plan ($70).  Great!

So today, I bee-bopped into Walgreens to grab the two additional doses the doctor had called in yesterday.  I was looking forward to doing a little shopping after.  

"Your new insurance says that we are not an authorized location." 

"What?!  But I looked on their website ..."  Worry creeping into my voice.

"It's giving me a number for you to call.  We also have a discount program you could use.  These 4 vials would cost you $400 with that program."  She was trying to be helpful, but $400 is way different than $70.

"Uh ... ok ... let me go try to call them." 

I fast walked out to my car and called the number she gave me.  Apparently, it was for the specialty pharmacy for my insurance.  "Our office is now closed."  I was really starting to panic at this point.  I need these drugs.  So I called another number that I found on the back of my insurance card.  After several minutes of electronic prompts, I got a real human!  

"You have to get prior authorization for those drugs and you have to have them filled through our specialty pharmacy."

"Ok.  But I need these today."

She explained that I could get reimbursed this one time and that I should go ahead and pay out of pocket.  Whew!

Back into Walgreens I went (not bee-bopping this time ... I mean, $400 is still $400).  I tell the pharmacy tech the plan.

"Oh, you can't use the discount program with insurance.  It's one or the other."

"Ok.  How much will it be then?"

She literally whispered the number to me.

 "Oh my god ... (deep breath and resigned sigh) ... ok.  I have to get these."

So I swiped my AmEx and it was effing declined (!@#$%^) because the purchase amount was so large.  My phone immediately started buzzing.  Oh ... it's just AmEx asking if it's really me spending a cold hard grand at Walgreens.  So for the next several minutes, I stood at the pharmacy counter and said "yes" into my phone several thousand times until the automated voice was convinced that the purchase was not fraud.

Biggest purchase I will ever make at a drugstore complete, I went back out to the parking lot where I sat in my car and cried and called Mike and cried some more.  I know I will be reimbursed, but they're my hormones and I'll cry if I want to.

To make myself feel better, I bought myself this cat planter from West Elm.  And I totally deserve it.

Cycle Day 10, Shot Day 8

I went to the doctor on Wednesday and there wasn't much follicle activity going on.  Largest guy was 10 mm (a follicle needs to be 20 mm or a bit larger for ovulation).  The doctor decided to double my shot dosage and see me again on Friday (today).

They also took some blood to test my estrogen levels.  Let me tell you, this was the most painful blood draw ever.  The woman who usually does blood draws was busy and this other lady volunteered.  She put the tourniquet on WAY too tight and I definitely felt the needle go in.  I nearly passed out.  So that was fun.  Great start to the morning.

I went back in this morning after two nights of double shots.  Still not much activity, but the largest follicle from last time had grown to 13 mm.  The doctor asked if I just wanted to scrap the cycle or keep going.  What kind of a question is that? Obviously, if there is a chance, I want to keep going.  So we are doing three more days of shots and then I go back in on Monday.  She also wanted another blood draw.  This time I got the "right" nurse and it was much less painful, but since I almost passed out last time, I did the same this time too.  I'm not anything if I'm not consistent!

This will be the third time that I've visited the Walgreen's pharmacy in a week.  Every time I get this drug there is a copay of $70, regardless of the number of doses.  So if they had just prescribed all 10 shots to begin with I would have paid $70. Instead, since they prescribed three separate times, I've had to pay $210.  Annoying.  I will ask the nurse if they can do it differently next time (assuming we do these shots again).

For your entertainment, here is what it's like to be a human pincushion from the pincushion's perspective.

(He definitely made me bleed with that one!)

Mike's Birthday

A few days late, but ... Happy birthday to my wonderful husband, Mike!  I'm so glad to be traveling this crazy road with you.

Here are some pics from the combined Easter / Mike's birthday celebration we had with with his family.

First Shot

Injectables it is!  One shot per day for five days.  We had to do a bit of transferring between vials to mix the medication (a powder) with a saline solution.  We watched a video the nurse had recommended and that helped.  The shot itself was not fun.  The video said to inject slowly and Mike took that literally ... it felt like he was injecting for 5 minutes!  I survived although I was a bit woozy after.  Mike says he had fun.  I'm glad one of us did!

The equipment

Did they give us enough syringes?!