ICLW March 2011

Happy ICLW!!! If this is your first time stumbling upon my little place in web space, welcome! I'm a 30 year old NICU nurse, and mom to a 4-year-old piece of work! DH is 34. We suffer from MFI, endometriosis, and hydrosalpinx (removed in Nov). Our little boy was the most awesome result of our first cycle. Briefly after IVF #2 we explored adoption (and were getting ready to do our homestudy) until our insurance changed and we were given the gift of another IVF cycle covered by them. If you checked us out last month then you might remember that we were in the middle of IVF #3. The update on that is that we had a BFN (Big Fat Negative) on 3/11. We believe we have enough left in our savings and insurance cap combined to do a FET (frozen embryo transfer) this year. We are moving right into that, and I'm currently on birth control pills to get me ready for this. By next ICLW, I should have had my transfer!

For a little overview of our blog and where to look if you want to know about something specifically, we started the blog with the adoption adventure back in May 2009. Insurance changed July 2010, hydrosalpinx issues and info start around October 2010, and IVF consults start about the same time. I hope some of you will stick around and follow us on our journey to complete our family. :)

Fertilization Report

First, let me tell you that I haven't had any more of the issues where I almost pass out. Yay! I am still very tender with pain wrapping from my abdomen around to my back, and what feels like trapped air in my diaphragm and shoulders. I thought the trapped air was odd as it's not like I had an ex-lap for retrieval, so I called the doc yesterday evening and he said it's abnormal, but not unheard of, just rest. So when I talked to my nurse this morning and was still having some of that pain (it's not as bad as it was last night when I almost ripped the countertop out of the wall in our bathroom-it felt like around AF with my endometriosis), she suggested I just rest and if I could not work tonight, that would be best. We've had too many people staffing at work right now and people were getting floated, so I made the decision to call out. I will lose 12 hours of time, but I'm not worried about it if it means that I'll feel better come transfer day.

Which leads me to my next bit of news. For a little bit of history, when we did IVF #1, we had 18 eggs, 11 were mature enough for ICSI, and 8 fertilized, none made it to day 5, so we had a 3 day transfer, and had Jack 9 months later. IVF #2, we had 9 eggs, 6 were mature enough for ICSI, and 3 fertilized-all abnormal with multiple nuclei and we did not transfer any back. IVF #3 gave us 20 eggs as you guys read yesterday, 15 were mature enough for ICSI, and 12 fertilized!!!!!!!!! This is the best we've ever had!

My transfer is tentatively scheduled for Sunday morning. They won't know for sure until this afternoon how many retrievals they will have for Sunday AM, and the transfers are always after the retrievals, so not sure what time yet, I'll know more tomorrow. The thing is that the lab at this clinic comes in and looks at the embryos on Sunday morning and emails reports to the nurse between 7-7:30AM, and that is when we'll be called to be told if our retrieval will be postponed until Tuesday. We've never had anything make it to day 5 for freezing, so I can't imagine they'll push us until Tuesday, but if they recommend it, we will just have to trust them. If there aren't any retrievals for Sunday morning, we could be scheduled for a 9am transfer, which means we'd have to be there by 8am, and my nurse admits we could be driving there when she calls to tell us we're being postponed. We just have to be flexible and roll with the punches. Easier said than done with someone who likes to have everything planned out, but we'll do it.

How am I feeling at this point in our cycle? Positive. I feel like this could work, I've got many supportive friends who feel like this could work and are very excited for us. I have to admit that I'm excited, but I also admit that being excited when nothing is for sure scares me. I guess that is what hope is.

Happy ICLW & Day 10 IVF *edited*

My current followers will have to bear with me for a few minutes.

Happy ICLW!!! If this is your first time stumbling upon my little place in web space, welcome! I'm a 30 year old NICU nurse, and mom to a 4-year-old piece of work! DH is 34. We suffer from MFI, endometriosis, and hydrosalpinx (removed in Nov), and we're going through IVF #3 now. Our little boy was the most awesome result of our first cycle. Briefly after IVF #2 we explored adoption until our insurance changed and we were given the gift of another IVF cycle covered by them.

For a little overview of our blog and where to look if you want to know about something specifically with us, we started the blog with the adoption adventure back in May 2009. Insurance changed July 2010, hydrosalpinx issues and info start around October 2010, and IVF consults start about the same time. I hope some of you will stick around and follow us on our journey to complete our family. :)

Now, for the first part of today's IVF update. We're on day 10 of stims. My ultrasound this morning showed quite a few follicles-I couldn't count after 3 shifts in a row, and Dr. M was just happy we had a bunch. We are "triggerable" today based on my ultrasound. Most of my follicles were like 16mm-20mm with some smaller ones lagging behind. That said, I explained my situation with Parent's Day on Wednesday and they were willing to schedule me for a late retrieval, however, if I was the only retrieval that day, I'd have to be there at 8am for a 9am retrieval. To be honest, this clinic is HUGE in our area, and I had never considered the fact that I could be the only retrieval for that location on any given day. So, this still has the potential to get fouled up. That said, Dr. M said he could also possibly plan for a trigger tomorrow night with retrieval on Thursday which would work out perfectly (I think...who will give me my trigger shot if I have to take it tomorrow night when I'm at my agency shift at a hospital where I'm not staff brings up any number of questions like who will give it to me, what part of my body am I willing to expose to an almost complete stranger, who should I trust enough to stab me with a needle?!?!?)...Dr. M said that the only way he would have no choice on whether to trigger me tonight would be if my estradiol was skyrocketing, and then it would be out of his hands and we'd have to trigger tonight.

So, while I say Thursday would be perfect, it would only be perfect in that it would not require me to do much but call out of work for Thursday night. The trigger part would be a minor fiasco, however, if we do retrieval at 9am on Wednesday, that part would be a major fiasco while the trigger shot would be cake. Such is life right?!?! I'm anxiously awaiting the phone call from my nurse. I'll post later!

*edited to add* I spoke to my nurse, and my estradiol was 2800, so we can put off my ER for Thursday. I've got someone to watch Jack all lined up, and I switched the nights I'm supposed to work at my regular job so that I'm not using up time I could save for a potential maternity leave. It means losing a couple hundred dollars working at another hospital (I was supposed to work a different hospital on Tuesday night, but since I switched days at my regular job, I'll have to cancel that shift), but it's worth it in the long run. Yay for ER Thursday!!!!!

Day 3 IVF Cycle

So I started stims on Friday evening. I can't say I'm feeling much of the effects of them, perhaps because I failed to decrease my lupron dose and didn't realize it until I'd already taken today's dose and was on my way to have my labwork drawn. It was definitely a "smack my head" kind of moment, and I got really panicky. I thought, "You dumb ass, how in the world could you screw up something so important?!?!?!" I told the medical assistant who drew my labwork so she could note it in my chart, and her comment to me was, "Well, at least we know you won't ovulate early right?" And I thought to myself, are you kidding me? I just ovulated on BCP's AND lupron, and last time we cycled, I had bad cramps the day before my retrieval and I was worried that I was ovulating before they could do the retrieval. We still don't know for sure if I did, BUT, that was the cycle where they went into do the retrieval and got back a few hundred cc's of blood from my pelvis. I am REALLY hoping that nothing will happen before they go in to get those eggs from me.

No worries at this time though, I WILL take only 5 units of lupron in the morning, and tonight, I am to increase my follistim to 100, and keep menopur at 75 until my next appointment Tuesday morning at 7:30am for ultrasound and bloodwork. My estradiol today was 106 (up about 40 points from 2 days ago).

New Blog Design and UPDATE!!!!!!!!

Hi everyone! I decided I was going to be upbeat about this cycle (if it kills me I WILL BE UPBEAT darnit!) and regardless of the outcome I am determined to have a good outlook on the rest of the year. How I will do that if we get a BFN is beyond me but I will do it, probably with the help of a really good therapist who specializes in infertility stuff, but I am sure I won't need them...right???!!!

Anyway, as my excitement began to take hold of me with this cycle, I stumbled upon the opportunity to get my blog made-over by a fellow IFer. I love it, she did a great job and was so easy to work with, great at communicating with you and fast too! If you need a bloggy makeover, please go visit Aly here!

Now, my period (herein referred to as AF) arrived on Sunday-day 1 of this cycle. I went today (day 3) for bloodwork. It came back ok and I started on BCP's (birth control pills). I know, seems odd doesn't it that I would be on birth control pills while I am TRYING to get pregnant??? It helps with suppressing my body, I can't explain how, but it does and I just accept that (believe it or not I don't HAVE to know everything whether it seems like it or not). Then my nurse told me that I will start on lupron in 2 weeks (approx. January 25th)!!!! I can't believe it. I mean, duh I am doing an IVF cycle, but they never give me dates for lupron AND stims!!! That's right, I will start stims in 3 weeks (about Feb. 1)!!!! If my memory serves me correctly, I was on stims for about 10 days with our first cycle (the other lupron one)...actually, it may not have been 10 really because I was going into OHSS and I remember at one point they had me so low on my stims that they had to stop them because we couldn't go any lower and I ran the risk of my cycle being cancelled, so it may have been 10 days from start of stims to egg retrieval (ER). Either way, I'm thinking we'll be looking at ER about the end of the following week so about the 11th of February. This is awesome as I will be off that weekend and I work the following weekend so I will only have to worry about working one day that next week (during the weekdays) which allows me to be more flexible with my schedule. My boss has been great with working with me during my cycles and letting me switch to other nights instead of taking time off (which would use up more of my time and I'm thinking if I don't miss anytime between now and the possible delivery I should be able to get paid for about 10 weeks off). The problem is that I will have to work 3 in a row right after the embryo transfer (ET). I will call out for at least the first night after my transfer, and depending on how incredibly freaked out I am at that point, I may call out for the second one. Actually, if I have a pretty good idea of when my transfer will be (which I probably won't), I may ask if I can work the night or two before my transfer instead of my weekend, but it isn't as likely that my boss will say yes to that because the weekend is a big deal for staffing.

Ok, I've rambled enough. I'm excited. Lord help me. Could you please pray that everything goes smoothly this cycle. That would be great, I just don't want threats of my cycle being cancelled and all that this time around. It would be a really nice change.

Final Post-Op Appt.

I had my final post-op appointment today. I got to see pictures of my endometriosis, rectum, uterus, ligaments, abdominal wall, etc. I have lots of spots of endometriosis on my abdominal wall, but none look too bad (this is to me who is pretty clueless when it comes to looking at endo) except for the one on my rectum. It is a nodule, and I have scar tissue (presumably from the last time I had the endo scraped out) all over my rectum and uterine ligaments, and it is causing my rectum to change shape due to the scar tissue making adhesions. So I questioned him as to why the hysterectomy was the recommendation instead of just scraping again, and as it turns out, the scraping would take place at the same time, but in order to keep it from being a continuing problem (with recurrences within 5 years), the hysterectomy is needed. If I decline to do this and allow it to continue to build scar tissue, I will likely face bowel problems, incontinence, and possibly urinary incontinence as well. So...let's try to get pregnant!

I did ask if I could schedule a c-section and have the hysterectomy afterwards, and he said that they only do the hysterectomy afterwards if it is emergent with uncontrolled bleeding-type situation. As it turns out, the 6 week recovery time my mom talked about is correct if you had to be opened up and have the hysterectomy, however, nowadays we are lucky enough to have the option to do this laproscopically once the uterus has shrunk back down to it's normal size post-delivery. He said it would basically be the same procedure I just had in November, 1 week recovery time, but I'd be more sore just because they were doing more inside of me than just removing a tube. They'd be removing a uterus, a tube, and an ovary, and scraping out the endo. Sounds good to me!

I really expected to get another bit of bad news today, but it didn't come thankfully. He said he'll see me when I am ready to have the hysterectomy and good luck otherwise. I placed a call today to our financial coordinator at our IVF center to make sure our prior insurance authorization for the cycle was still good (since it's been almost 4 months since our initial consult), and I'm waiting to hear back from her. Period is expected this coming Sunday, and sometime next week I will start on birth control pills if all goes as planned. I talked to my IVF nurse to make sure there was nothing on their end that I needed to take care of before Sunday and there isn't, they will be expecting a call from me on Monday. I'm excited to get started, yes I said that.

I am excited, but I am also scared. I prayed on the way into work tonight that our )His and our) plans be the same for growing our family, and that if it isn't, I pray that He help me find peace with that. I prayed that if He has a plan for us to get pregnant that it be a healthy pregnancy. Please continue to pray for us on this journey.

Scared

I think this is what I am feeling most these days. We have about two weeks before my next period is due, at which time I will start on birth control pills. About 3 weeks into that, I will start on lupron. I figure I should be on the stim drugs by sometime the second week in February, and be having my retrieval and transfer mid Feburary. If timing goes as it did with our first cycle (and we have some normal embryos to put back), my first beta would be about the time of our anniversary. This bothers me simply because our last cycle, we started a couple of weeks later in the year-our transfer was supposed to be on March 6th, but we were called on our anniversary (March 5th) and told that all of our embryos were abnormal. It ruined our anniversary and quite frankly, ruined a few months for us. I don't want to delay my beta, or get it too early, so I guess we'll just have to deal, and to be honest, I hope that it's going to end up being after our anniversary.

I don't know if I don't feel as hopeful this time because I found out about the hydrosalpinx, which, if I had left it could have decreased our chances at pregnancy, and increased our risk of miscarriage, but we had it removed so we could have the best shot. By having it removed, we risked my ovary and we cannot be sure how it will respond during the next cycle to the stim drugs. I just continue to pray that when it comes time for all of this, that my right ovary pulls it's weight and makes at least as many or close to as many follicles as our left does.

Finally, I haven't met with my surgeon for my final post-op appointment and I guess I get nervous that "something" will come up and delay us further. One of my friends said all I can do is pray about it and take things as they come, and she's right. But I'm a planner, and my plans at least where this is concerned always seem to get mucked up. Perhaps that's because I'm planning things as I want them to be, and not as they are MEANT TO BE. I realize this is something I struggle with-giving up that control and leaving it in God's hands. I am trying and I continue to pray for his help with this. Another friend reminded me today when she was over visiting that we can always adopt if it doesn't work, and while that is in the back of my mind, it's a huge undertaking, an enormous financial risk, and just really hard to plan. To be honest, I can't even think that far to adoption at this point, I'm so stressed out that I can only think as far as a beta. I've just made things harder on myself trying to think about when we would go to Disney, whether my OB would be ok with scheduling a c-section and doing my hysterectomy at the same time, etc. I have to just let it go, and focus on what is in front of me which is my final post-op appointment next Monday, my kidney ultrasound (I get these occassionally to monitor my kidney stone issues) this Wednesday, and my appointment to follow up on the ultrasound with my urologist next week. Then once I've gotten through all of that, it will be go time. My visiting friend asked today if we're doing the IVF/ICSI cycle for sure, and yes we are, I didn't go through surgery for no reason! It is a definite, hopefully for January start. My emotions (and sanity) are on the line and I don't even have the extreme hormones rushing through my body yet!

Please pray for everything to go well with my upcoming ultrasound (I don't want stones before I get pregnant or while I am pregnant, this is so important) this week, my last appointment with my surgeon next week, and for everything to be a "go" with this upcoming cycle in two weeks! Thanks for your support!

Update

Shawnee's best friend as you might remember me mentioning in my last post, had her little boy today, a few weeks early. He is healthy and from what I hear, beautiful, and weighing in at 6 pounds. Please pray for them both and pray that she has the support that she needs during this time, and for post partum depression to stay away as this time is trying enough for her and I believe any person in her situation having lost her best friend could be high risk. Please also continue to pray for Shawnee's family, other friends, and coworkers.

On a positive note (depending on how you look at it), my wish came true and my period came yesterday!!! Of course, having planned on hopefully starting our IVF cycle this month, I was low on supplies, so I was feeling a bit evil this morning as I went to the grocery store to pick up more things. I thought to myself, "this had better be the last time I have to buy this crap for a long time!!!" I bought enough to last me through this cycle and next, and hopefully not anything after that...is that having high hopes or what?!??!

One of my friends asked me yesterday if I'm excited about the upcoming IVF cycle. I really was a couple of months ago, but everytime I get excited, something happens-I break my arm, I have surgery, I have to wait for 2 cycles...it's hard to keep up the excitement, you know? So my answer was to ask me in about 3-4 weeks, then we can talk about being excited. At this point I would have to say that I probably feel apprehensive just because I keep waiting for something else to come up.

My final post-op visit with my doc is on January 3rd which is awful because my son's allergist appointment that I really feel like I need to be there for is at the same time across the street from my doc. My doc doesn't have morning hours to see patients, and so I have to be at his office at 1, and Jack's appointment is at 12:30, the doc is always running late, and it takes months to get appointments with the allergist so I am not rescheduling. My appointment should have been the week prior, however, he didn't have any vacancies that week or on January 10th and I'm hoping my next period will be here by the 9th, and I really need to see him before we start so I can be sure nothing is going to change his mind about us proceeding. What a mess! I plan on calling the week of Christmas to see if he has any cancellations for that Monday the 27th, and hope I get lucky so that I can also go to the allergist appointment with Jack.

Wish me luck, and please pray for Nikki and Shawnee!

2 Week Post-Op Appt.

I was all geared up for this appointment today. Yes! The doc can look at my incisions, see I'm healing and give me the blessing to start our IVF cycle. Of course, that wouldn't be how my appointment went.

We were pressed for time since the doc was running late and we had to pick Jack up from school. He started in talking about the endometriosis he found. I was supposed to be able to see pictures, but the pictures hadn't made it over from the hospital where I had my surgery yet. I had relatively superficial endometriosis on my abdominal walls which he said may or may not cause me pain (it really doesn't), but that the endometriosis nodule that I have on my rectum causes it to tent up toward my uterus, and he is sure I am in pain (I am around my periods especially when I go to the bathroom-I hold my breath and try not to scream). His honest recommendation is for us to go ahead, get pregnant, have this last child, and then have a hysterectomy leaving maybe one of my ovaries in so I can still have the hormones, etc. I'm not real upset about this as I look forward to not having to deal with periods anymore, and no more shooting pain my rectum when I go to the bathroom. The only reason it does upset me is that it requires major abdominal surgery. My mom advised me to have it done during my maternity leave since it will require an 8 week recovery period, so then I'm thinking maybe just do a scheduled c-section and have them do the hysterectomy then. This will of course probably screw up our Disney plans, but we could always do it last minute if I was healing well and felt up to it, or we could plan it for late Winter/Spring 2012. This is all IF we get pregnant, which is a big IF. If we don't, I may wait after our IVF cycle to see if it happens on it's own (despite it being unlikely) if I'm not willing to give up just yet, and if it doesn't then schedule the hysterectomy.

That was the surprising news of the day. The other not great news was that Dr. Moro wants us to wait until I get my second period post-op to proceed with our IVF cycle. He advised me that the first will be unpredictable, I won't know when it's going to come, and it will be messy. The second one will be predictable in that it will come about 28 days later. At that point, we can proceed with our cycle. This does not make me happy. I want it when I plan it, and it's all jumbled up now. So, I guess I'm asking for prayers that the first period comes very soon (like if you could pray for tomorrow, that would be awesome, but I know God doesn't work like that) so we can get this show on the road. I guess we'll be looking at the second period sometime in January with any luck, so the procedures part of the IVF cycle maybe in February?

The good news is we can use our healthcare FSA I just enrolled us in to pay the copay!

Follow Up to Question

Believe me guys, if you follow my blog and I have a way of contacting you, you'd be on the email so long as I have it. No worries there. It wouldn't be fair to tell you about all of our IVF stuff, and NOT tell you the results! It could be a depressing email you end up receiving, and a rather short one at that, but you'd know one way or another. I have no idea what I'm going to do. I don't have a large family-I think if I don't count the young children in the family who could care less if I was pregnant anyway, I might have 20 people to tell. All I would have to do is tell my mother, and the rest of the family would know in minutes. If you're reading this Mom, it's meant in the nicest way-you'd be so excited you wouldn't be able to keep it to yourself.

Maybe I'll just email the followers I have contact info for, and tell my family until it's noticeable at work that I'm sick. I do have a couple of close friends at work, and a couple of close coworkers who have been really supportive that I would probably tell, but I know I can trust them to keep quiet. That's probably 4 people on a unit of 100+. And dude, if you have me on Facebook, PLEASE do not mention the IVF or maybe pregnancy on the wall, just message me. It's easier that way!

In other good news, I think the bleeding may be stopping. It may only be for a few days since my next cycle is due to start end of this week, but I'll take what I can get at this point! Here's hoping my next cycle is nice and quick so we can move along to IVF!

Follow Up and IVF Talk

We met with Dr. M this afternoon. I decided I wanted to talk about what I thought to be positive info first-the SA results. So last cycle we had 9.5 mil sperm and this time around 14 mil. Great! Then last time we had 31% motile sperm, this time 42%. Great! However, of the washed sperm, only 1% were motile- 500,000. I can't remember what it was last time but he said it was less this time than it had been previously. He would consider these SA results perhaps slightly better than last time. So perhaps not as positive info as I thought!!!

Then we moved onto the elephant in the room-the stupid hydrosalpinx. I always thought our little boy was a miracle. Now I know it! I pulled up research articles that had been published and with a hydro, chances of pregnancy are cut in half and that is with IVF, and if you consider that the fact that anyone gets pregnant on any given month, that's crap. Dr. M hit the nail on the head when we were discussing whether or not to correct this problem before proceeding with our cycle when he said, "If you don't fix it and the cycle doesn't work, you will think it was because of this." Damn if that isn't right! Sure, it could just be a failed cycle, happens all the time. But if I didn't have the hydro corrected I KNOW that I would think it must have been that, and even if I wasn't totally convinced of that irrational thought, I would always wonder "what if?"

So, the decision has been made and Dr. M is completely backing us. I will call my OB/GYN in the AM and try to get a surgery date set up ASAP to have this thing either removed or at least have that tube tied. Which brings me to my next issue to deal with emotionally and physically. The consequences of taking care of this issue. I asked about something I had read online on a forum about hydros where multiple people said that they not only had to have their tube removed but the corresponding ovary as well. This is a problem! So we discussed that and Dr. M didn't really feel that that was a necessary evil, but he did bring up something I had not considered. I figured if they had to remove the ovary then obviously I would have less eggs to retrieve when it came down to it. I just sort of figured that if the ovary was left in we would have those eggs as well. Not necessarily. The fallopian tube and ovary share a blood supply, so if we clamp the tube, we may be risking any follicles and resulting eggs from that ovary. It is an unfortunate situation, but I think I'd rather risk losing the response from that ovary than having fluid leak into my uterus and giving us dismal odds at pregnancy.

I will have the surgery, and per Dr. M request that Dr. A or whoever ends up doing my surgery try to preserve my right ovary as best as possible. Dr. M said that we could contact him as early as a month post-op to setup our mock transfer appointment and begin an IVF cycle. He tends to be a little more aggressive than some docs, he said that others would recommend waiting at least 8 weeks post-op to see if you get pregnant on your own. But given our male factor infertility issues, I think getting pregnant on our own may not be very feasible.

Please pray that we can get scheduled quickly and that the surgery is as atraumatic as possible!

HSG results

Hydrosalpinx (big ugly dilated looking thing on the left side of the screen) on the patient's right side, and an occluded tube on the left (my left tube is patent and resembles the tubes on the picture below).


Normal HSG with both tubes patent

I had my HSG this morning. It was not painful initially until they injected the dye, and then it was very painful. Alot of cramping which persisted until about an hour and a half after the procedure and oddly enough radiating down my leg. I didn't freak out about that too much since I used to have extremely painful periods and would have that same leg pain, it was more of an annoyance than anything really. I came home, put my heating pad on my belly and took some motrin. I laid there wishing I would just throw up since the doxycycline is not sitting well on my stomach and unfortunately I still have alot of doses left to take!

Last time I had an HSG (2006) it showed my right side was blocked or a hydrosalpinx. I was sent for an ultrasound which didn't show much so we continued on with my cycle. It was explained to me at that time that they believed it was a blocked tube or they would have expected to see more of a dilated tube on ultrasound. If it had been a hydrosalpinx, there would be a lower chance of pregnancy, and a higher risk of miscarriage if pregnancy did occur. This was because in a hydrosalpinx there is fluid that leaks from it which can make it hard for an embryo to implant, and could contain debris or other harmful things which could be detrimental to a fetus. Luckily, I got pregnant, and delivered Jack at 37 6/7 weeks. No complaints here!

So today when I went in, I prayed that our HSG would be no different than it had been last time. Well, I could see on the screen that my right tube looked bigger. Uh oh. I heard Dr. M and the radiologist talking about a hydro. Great. I got dressed, went out to meet Dr. M and he showed me my pictures which indeed showed a hydrosalpinx on the right. He said they are sure it is a hydrosalpinx. I asked what that meant for us and he reiterated the things we already know about a lower chance of pregnancy, higher risk of miscarriage, and then added, "but you've gotten pregnant with it before and had a full term baby." So he thinks I should be ok. I felt torn leaving him because I could in theory be ok, but what if I'm not. Our plan was that we weren't going to do this again if this cycle fails. Do I want to risk it on this problem tube?

I came home and looked up a few things on it, specifically pregnancy rates, etc in some studies. 40% in the control group vs. 19.65% in the hydrosalpinx group...50% less chance. If you think about it, we did get pregnant before, but would I have allowed them to try a cycle on me if I knew it was for sure a hydrosalpinx???? Probably not, I probably would have elected to have it removed or ligated. Archie and I were discussing it when I got home, and he doesn't want to delay our cycle further, if we do, we'll be looking at procedures around Christmas this year and that's no good. I understand his thought process for sure, I don't want to delay it either, I'm excited and ready to go now! But I also don't want to waste what might be our last cycle.

After obsessing over this quite a bit, I called our IVF nurse (Sonya) and told her I was sorry to bother her with the thoughts in my mind, but I just don't know what to do or think about this. She asked if Archie had done his analysis and I told her he was going to do it tomorrow (appt in the AM). She told me that we have to have a follow up appointment anyway, so to call and schedule the appointment for next week, and we could discuss it further with Dr. M then and if we still didn't feel good about proceeding with our cycle we could decide about how to take care of it at that point. There are a few different ways to "take care of it" including tying the tubes, ligating or removal of the tube completely. Some of it can be done laparoscopically (sp?) and we could probably proceed with our cycle in December.

If you remember, I had planned this whole thing with the thought of using the last part of my maternity leave for a Disney vacation for Jack. If we don't do this until January, I will be pregnant when we go to Disney or we'll be going at Thanksgiving time (my holiday to work next year). I know we shouldn't plan like that, but I was planning like that because I am an infertile and since I can't get pregnant on my own, it is a perk to knowing when you may or may not be getting pregnant. So sue me!

I guess we'll see what Dr. M has to say next week. I'm a little depressed about it definitely being a hydrosalpinx, but I'm trying not to let it put a damper on things.

Identified Adoption

Wow. I am actually at a loss for words. My friend was just over. Her son and my son are best friends, and she is moving with her son, and her one year old daughter to New York in a few short weeks. I've been sad for my son and to a lesser extent sad for myself that we won't be able to visit as much as we had been. Really I'm more sad for my son just because this is his best friend-anytime we do something fun, he always wants to know if this friend can come with us. He asks about him all the time when it's been a few days since we've seen him and so now I am trying to prep him for that friend leaving and us not seeing them for months at a time. He knows that A is moving to New York. He knows it will take us about 8 hours to drive to Niagara Falls to see them. But those trips will be so worth it because none of us have been to Niagara Falls, so we will plan to make it like a 4 day vacation and actually see some sights while we are there. I don't think it's really hit him yet though.

Anyway, these friends came over to hang out for a little while today. My friend looks at me and Archie and says, "I have to ask you guys a question." I'm thinking to myself, well, I know she's not asking if there is any way she can stay with us when she comes back to visit because I told her earlier today she would always have a place to stay with the kids. So what in the world does she want? Maybe she wants us to help her move to NY. Ha!

She told us that her younger sister is 12 weeks pregnant and not in a position to keep the baby and her sister knows this. Her sister has been talking about placing the baby for adoption. My friend told her she knew the perfect people, told her who we were, and that she would talk to us. My friend "C" thought that this would be great because then she could see her neice/nephew, but her sister was wondering if we would be open to her being able to see the baby. I explained that when we were planning to go forward with adoption we did want an open adoption and that it would be fine, but that honestly I had no idea how identified adoptions work, what was involved. I had no idea what we would have to expect cost-wise, and that in a month and a half we would be doing another IVF/ICSI cycle and if it worked there would be no way we could afford to adopt. I told her that most likely we couldn't afford whatever an identified adoption would cost at this point anyway, but I would look into it.

Anyone out there in blogland that can shed some info on this subject, I'd like to hear from you. "C" seems to think that her sister can just have something notarized that says she gives custody to us, but I told her it's not that easy and to be completely honest I would want the legalities iron-clad. I told her you could either go through an attorney or an agency, but that an agency may be better because they provide counseling for the mom and that is important. Help!

It's funny because a year ago I would have died to have this chance. It just so happens that this coincides with another IVF cycle for us that we are lucky to have insurance mostly covering, and so financially that is the better option for us. Go figure!

Ok people, spill it on the identified adoption. I need to know so that at the very least I can pass the info and options onto C's sister. Thanks!

Interesting Reading

Today I was looking through my packet for the new fertility clinic. One of the things they give you read in that packet is about twins. It's basically meant to educate the patient as to the risks of twins, as well as try to dissuade them from putting back more than one embryo. Those of you who have been following me for a while or know me, know that when we did our last cycle, I had a hard time wrapping my head around putting more than one embryo back.

I asked Dr. M what he thought about just putting one back. His response was that he felt that we should put two back in the hopes that we would end up with one baby. Twins were my fear then as they are now. We did not have good quality embryos, and I have a friend who also did not have good quality embryos, and it didn't matter, she still had twins! Little did we know that it would not be an issue as we wouldn't have any normal embryos develop last cycle.

I'm reading this information about twins, the fertility center's take on it, etc. Of course, fertility clinics don't want high amounts of multiples because it's not healthy for the mom or the babies, and they want their end results to be live births. Anyway, it turns out that this fertility clinic that my doctor is now a part of recommends elective single embryo transfers. They recommend transferring one embryo back for women who are younger than 37 (I am), people in their first IVF cycle or ones with a prior IVF pregnancy (me), normal uterine cavity (mostly me), and 1 or 2 Day 5 blastocysts available for transfer...I have never been able to get my embryos to day 5...they all fizzled out and ceased to develop further, hence the reason we never had any snowbabies-nothing made it to the point where we could freeze them.

It sounded good in theory. I want to ask Dr. M what he thinks about it if we were to have decent embryos this next cycle. At least I'll know where we stand and what to expect. I doubt we'll have decent embryos since we never have before, and since in his words my egg quality has greatly declined. But it could happen right?

That brings me to the next thing I'm wondering about. If we had any embryos that made it far enough, would we freeze them in case we did another cycle? Last time we said we would. But last time we also had a greater amount of money available to us through our insurance to pay for frozen embryo transfers. This next cycle is going to use up that money. All things to think about I guess, and things to ask about.

Anyone have any other ideas of questions I should ask Dr. M on Thursday? Now that it's come time to ask them, I can't think of many!

Anticipation

Wow, it's been almost a month since my last post. Not much has been going on. I feel like I've been less affected by pregnancies around me for the most part which is good. As I think about the fact that we'd like to be doing another cycle in as little as two months from now and how I feel like that cycle will go I have a whole mix of feelings.

I feel anxious about whether we'll be able to get the copay together in a month. That's right, a month. They told us to call about a month before we want to cycle, and if we want to cycle in November, that means we need to see Dr. M in October. That's a little scary simply because I haven't talked to that man since I got clarification of "genetically abnormal" after our last messed up cycle. I have alot of questions for him, and to be honest, I am not sure I want the answers to some of those questions. I am anxious because the fertility clinic mine merged with has a higher rate of multiples. I know we will be able to handle it because others have, but I also know what that means as far as increased risk for me and the babies.

I feel like if we can get the copay together in a month, and can get through the tough initial meeting with our doctor, that this could actually work. Dr. M has already said that he couldn't repeat our last protocol given how bad the cycle went, that we would likely go back to our first protocol which resulted in the little boy we love more than anything. I actually believe this next cycle could work. That scares me because I haven't even started the cycle and already I'm emotionally invested and I tried so hard to avoid getting my emotions going during our last cycle. I actually did a decent job of staying relatively unattached to any hopes last time until our fertilization report. It was all downhill from there. I guess perhaps feeling optimistic already is better than feeling bad about the cycle. I do believe to an extent in psyching yourself up.

My last feeling is generally one of excitement. That in about a year we could have another baby or two is so exciting. A little scary about the thought of having double the temper tantrums, double the whininess (or triple as the case may be with 3 kids), the financial impacts, etc, but with double or triple the trying times a parent experiences also means double or triple the most awesome moments in life. It's funny, Jack will be so whiny some days and I think, "are we really thinking we want more of this?!?!?" And then in the next moment my heart melts at something he says or does, and I cannot wait to have soooo much more of that. It makes all the hard times infinitely worth it.

How in the world infertiles don't end up psychiatric inpatients with all of this stress and all of these feelings is beyond me. Somehow we seem deal with all of it, not always in the most constructive ways, and for sure we've all got battle scars somewhere whether they be physical or emotion, but somehow we all find a way to cope. That in itself is amazing.

New Blogsite

Hey all,

It is bad enough that I feel guilty for feelings I sometimes experience on this rocky infertility road, but it's even worse when people can pass judgement on you when they've never even been in that situation, and when they don't even talk to you or ask questions to try to understand those feelings you have. People talk to others about your feelings, judge you based on your innermost private feelings, and you don't even have a clue that they are doing so or have a chance to defend yourself. People who really know me know that I'm a pretty open book, pretty honest, sometimes to a fault. If you ask me a question about something I'm going through I'll tell you, just like if you have a problem with something I say on my blog or don't understand why I said something, talk to ME. I'll respect you more for it, and I'd appreciate some respect in return.

I know who some of my followers are, but I don't know who all of you are. I emailed those that I could contact via email and let them know that I began another blog, simply for more privacy where my feelings are concerned. I provided the address of the site to them, and I do not have it listed on my profile. If you want to continue to follow my blog where more private matters are concerned, please email me at sweetrn621@msn.com for the blog address. Please tell me how you found my blog or know me. I know many people started following my blog during our adoption process. Adoption is not off the table completely, but is currently on the back burner due to another opportunity for IVF to be mostly covered by our insurance (a huge financial difference when compared with the costs of adoption). If it fails, we will at some point proceed with adoption. This blogsite will continue to have random things posted, but not most of the deeply personal things we are going through.

Thanks for your understanding and I hope to see you on my other blog!

Even Little Decisions Are Hard to Make

Here we are, mid-August. I was just going through my planner to update a new one with birthdays, etc., and came across appointments we had for interviews with different adoption agencies, and before that, appointments for trial transfers, high risk OB's, and dates to start fertility drugs. It obviously conjured up memories...no way to avoid them I suppose.

I also got my twice yearly email that the consignment sale I always go to is nearing again. Each time it comes around I think about selling my maternity clothes, Jack's clothes he has outgrown. Each time I feel pulled between making room in my house, making some money from it, and the "what ifs". What if I do get pregnant? What if I get pregnant and the baby is a boy? What if that baby is born around the same time Jack was so we could use those clothes again? And each time I decide not to sell those things.

The other morning I was laying in bed, cuddling a small warm body, soaking up his little boy smells while I waited for him to wake up. I was thinking about how "comfortable" we are right now. With only one child, we can afford to do more day trips, we can make quick (sort of) trips to the grocery store, financially we're just more comfortable. He's 3, and relatively independent. I don't have multiple kids to buckle in, keep happy during the car ride, gather up tons of stuff just to go to the store. I don't have to worry about buying diapers, breastmilk storage bags, wipes, frequent doctor's appointments. It's "nice" I have to admit. The next moment I am asking myself what the heck I am thinking? Are you serious? You've spent the last 2.5 years trying to get pregnant again. You've had one failed treatment in that time, and started and stopped the adoption process. All things that took alot of time, dedication, and emotions to get through and you are questioning if it would be "easier" and "more convenient" to just give up? You never "give up". I was mad at myself for even thinking about it. Such is the mind of an infertile I suppose.

I am 95% sure we will try another IVF cycle. If we didn't try another cycle, I'd always be asking myself, "what if". When I think about doing another cycle, I ask myself "what if?". What if it doesn't work? What if it works too well and we end up with multiples? Haha, want to talk about being financially UNcomfortable, lol. What would I do about work? Childcare? Schooling? What if we had twins in the NICU?

One of my friends told me the other day she was pregnant. I am truly happy for her. In the midst of our conversation she was talking about being sick again. I laughed because we had just covered my crazy thoughts and how being sick again wasn't even really on the list of "what ifs". If I am sick again and it's like it was before, there is a plan in place for it. I am a planner, and I need a plan. I think that is why I am so hesitant. Anyone who does IVF (Octomom included-dummy that she is) knows that there is a risk of multiples. I think that just freaks me out the most because it is the one thing I am having the most trouble planning for. It brings up things like bedrest...I'm already probably going to only have about an 8 week maternity leave thanks to being out forever for my wrist. How the hell would that work? Could I find work I could do from home while I'm out? No idea. Sure couldn't while I was out with my wrist. If I had multiples and had a c-section, I'd have to be out of work for 8 weeks at least anyway, there goes my maternity leave, and that is fine if my babies are at home, but what if they're in the NICU-it's not even like I could go back to work to save maternity leave for when they come home.

Could I sit back and not do another cycle? Well, God knows we haven't stopped trying to conceive since we started a couple of years ago...and it hasn't worked. And I'm 30 now. We know my eggs are not great anymore from the last cycle we attempted. It's not going to get any better the older I get. I think Archie and I would always wonder what if. And it's not like we'd have to put out a huge chunk of money this time that would be a significant deterrent. Just our emotions, and thoughts that are at risk if we don't do it. And as much as we've wanted it I guess we will try...now to decide about whether or not to sell the baby and maternity clothes in the meantime...

Welcome!

Hi all!

So I started this new blog because my last one it turns out was circulating around work, and I had not mentioned names of people, but had described my relationships with them and in an effort to be a little more careful so that I can feel like I can openly discuss my feelings and not have EVERYONE there know my business, I've moved. I don't mind people from this blog looking back at that one, but I do mind some of the coworkers reading this one. If you happen to be one of my few friends at work that I have shared this new blog with, please be careful to delete it from the history on work computers, or just check it from home. I work on a unit of about 104 people, and I heard that about roughly half have been checking up on it. Hence, my new blog. Welcome!

In case you are just now finding my blog, here is some back story. Originally I started blogging after we had a hellacious IVF cycle early last year. We had done a different protocol than we had originally when first cycled. Our first IVF/ICSI cycle was a lupron protocol. This last one we tried the Antagonist protocol because our fertility doctor felt that they could more easily control my risk of ovarian hyperstimulation syndrome (OHSS) with it. With our first cycle we had 18 eggs retrieved, 11 were mature enough for ICSI, and 8 fertilized. We put two embryos back on day 3, and let the rest grow until day 5 hoping for some blasts to freeze. They all teetered out. Our second cycle we had 9 eggs, 6 were mature enough for ICSI, and 3 fertilized. The day before our scheduled transfer, we were called and informed that all 3 were "genetically abnormal" as they all had multiple nuclei. Our cycle was cancelled. Happy Anniversary to us, yes, it was cancelled on our 4th wedding anniversary.

We moved onto domestic adoption, chose our agency, and had begun fundraising to help us with the costs. We had a great turnout at our first fundraiser, and an awful turnout at the second which cost us everything we had raised the first time around. We got a letter from our fertility clinic telling us that they were merging with another major clinic in the area. After contacting them we found out that we'd pay far less to do another cycle with them than we would for adoption. Then we got more information from our insurance that actually will allow us to another full cycle with just the copay coming out of our pocket. So, this is our current plan for hopefully later this year. If it doesn't work, I think we will call our little family complete and continue to feel blessed that we have our one little boy to love.

Cats and Babies and Disney, Oh My!

The pool opened on Saturday!!! We went on Sunday for about an hour and Jack played in the pool with his dad. My mom and I sat on the edge of the pool and dangled our feet in. It wasn't too hot thank goodness.

My sister called me late Sunday night in tears to tell me that her cat was dying. She was 16, and her brother (my Toby) passed away in 2007. They were very sweet, social, and loveable cats. My sister hadn't seen Cuddles in awhile (she had been living with my sister's friends), and was really hoping she'd hold on long enough for one last visit in August. Unfortunately she called me today and told me that she went to sleep last night and passed away. I feel so badly for her because I know she loved Cuddles, and I know how hard it is to lose a pet. I also know that she probably feels somewhat guilty for not having seen her in awhile.

Today we had my mom over for a cookout. It was hot as Hades outside, but we had a nice visit. We watched The Blindside after lunch and it was a great movie. It helped that Michael Oher is on our hometeam-the Baltimore Ravens, and we are huge fans.

Archie and I talked a little more this evening about another kid. It's scary, I realize it's going to be alot more work having two. However, by the time another kid comes, Jack will be almost 5, so he'll be rather independent, and I think he'll be a really helpful big brother. He's so sensitive to other people's feelings, and just a true sweetheart. Granted he's mine, and I may be a bit biased, but I have never ever met a little boy so sweet and caring.

We had planned to take Jack to Disney World next year either in April or later in the fall. This is all up in the air based on what household/car things come up between now and when we book the trip (when we know what our taxes look like early next year). I'm leaning more towards the fall-late September or early October. I just think with April we run into kids on spring break, and to be honest, if we take a vacation in April, I'll be wanting one in summer too. But, if we book Disney for October, we might do a beach weekend in the summer and really look forward to our BIG vacation.

Anyway, enough rambling, back to our conversation. So I was telling Archie that I had originally thought maybe October for actually doing the cycle, but that would put me at delivering (a hopefully full-term baby) around July. And if I'm only going to be able to take 8 weeks, I'd like to be able to go on a vacation while I'm already off so I'm not using any extra time outside of maternity leave. Then we talking about the good part being that I'd be off most of the summer which would be awesome, but I'd also have a baby stuck to me in the heat and humidity which may or may not be well, sticky. Then I was toying with the thought of another cycle November/December, but that puts me hugely pregnant in the middle of summer. I might look cuter in a maternity bathing suit to be honest, LOL. But I imagine it's pretty awful to be huge and pregnant in the heat of summer. But there is always the pool! And, we could do a Disney trip in early October before I go back to work. This sounds like a good idea to me now, but my only other experience with a newborn 24/7 was with Jack and he was a super easy-going baby. He slept well (nap-wise), was a happy baby and just a complete joy. I think there is probably a slim chance I could get that lucky twice right? Most of my friends and at least in my family it rings true, that the second is more challenging than the first.

The Disney trip could be wonderful (good news is that Grandmom is going too probably, so everyone can get a break at some point), or it could be a mess. If it was hard because I made the decision to do our cycle late in the year so that we could do Disney, I would feel soooo bad. I do not want to do the Disney trip pregnant given my history with Jack. Being sick all the time is no fun, and now that we know about my cystinuria and the chance I may need a long term IV for fluids if I am like that again, it's just not worth possibly wasting the money. I think Disney after the baby is here would be a nice treat for the big brother, and if I had a really cranky little one in tow, I would just do maybe half days with the family and then hang out poolside or in the hotel room with the baby so we don't rain on Jack's parade. I just pray if we have another one, it's as easy at least in the infant stage as Jack was.

If you pray, please pray that I heal quickly so I can return to work soon. Please pray for my sister as she grieves the loss of Cuddles. Pray that we can pay down some of our debt before we try another cycle. Thanks!

Wrist Update and Good News!!!!

The doc removed my stitches on Monday. I have to say that I was really surprised at how neat my incision looks. It is a very thin one, not raised at all. I guess it was surprising because of the other scars I have from when I had a pin put in my leg (broke that when I was 14). One on my buttocks is huge and raised, and then I have one on my hip, and one above my knee where the screws were to hold the pin in place, and those are actually a little sunken, but wider looking incisions. It was just not what I expected.

I have a green hard cast until June 7th at which point I will go into a removable fracture brace and start physical therapy. They had a physical therapist come in and do a little mini eval at my appointment the other day and I am losing range of motion in my hand which I suppose is to be expected when you've had limited use for 9 weeks. I am under orders to lift nothing heavier than a coffee cup. That's proving to be difficult.

In other news, our insurance's fertility coverage is going to change effective July 1st. Our coverage right now is that you are allowed 4 IUI cycles with $100 copays, and up to 3 IVF cycles or a maximum cap (for IVF only) of $30,000. We have a seperate med cap of $10,500. Basically as it was, we had done two IVF/ICSI cycles which we had used just under $25,000 of our IVF cap and just over $3,000 of our med cap. We had never done any IUI's as our sperm motility and count were not sufficient, and would have been a waste of time and money.

As you know if you've read some of the previous posts, I questioned our fertility doctor about whether our semen analysis last time would have been good enough for IUI and the thought was that it would have possibly worked, so we were going to explore that once we paid off half of our credit cards. Well, upon reviewing our upcoming changes in our coverage, we've come to new conclusions.

With our new coverage, any reproductive medical procedures including IUI's, IVF, meds, etc will be covered under a $40,000 cap. We will still have a $1,000 copay per IVF cycle, or $100 per IUI. Where previously our office visits, labwork, and diagnostic radiology were included in our cap, they now will be billed seperately which is good. They will not be reclassifying things that have been done previously, so they will not be going back and changing how much we've used so far. So, as of July, we will have used $28,174 of our $40,000 cap. That means we have enough for another IVF!!!!!!!!!!

So, when will we do this? I'm not sure. I've been out of work for 10 weeks already, and probably by the time I go back, I will have been out 15-16 weeks. Our short term disability works like this-you use your own time (vacation, sick, personal time) for the first month that you are out. Then your short term disability kicks in. It's different for maternity than it is for an injury. So at this point I am getting paid 60% of my base pay (no differential) by the short term disability, and I am using 12 hours of my own time to supplement my paychecks. I had something like 260 vacation hours, 70 sick hours, and 20 personal leave hours saved before I broke my wrist. By the time I go back to work, I might have 60 hours left.

For maternity leave, you use your own time for the first month, then if you had a vagina delivery short term disability pays you 60% for two weeks, and if you had a c-section, they pay you 60% for four weeks. I have no reason at this point to believe I would need a c-section as Jack wasn't a c-section delivery. So if I calculate how many hours I need to take a full 12 week maternity leave based on a vaginal delivery, I would need 384 hours. It would take me a year to save up 182 hours. So if I wanted to be sure I had that much time saved up, I wouldn't attempt to do another cycle for year and a half. I could do what many women have to do and just take 8 weeks. That would mean I'd need 240 hours which I could conceivably have in another year. So I could do another cycle 3 months after I return to work! We will probably shoot for the end of the year if I had to guess.

I've been asked if we will still try for an IUI first. My answer to that is that I'm not sure. It would really depend on what our labwork and semen analysis showed. I only have one patent tube which makes me think that maybe it wouldn't be as good of a chance, and I don't want to waste what money we do have available through our insurance on a shot in the dark. I am also nervous and scared to try IVF again given how horribly I dealt with our last cycle being a huge flop. I tried so hard to not get emotionally invested, let my guard down when our fertilization report came back ok, and then got smacked with the bad news. I felt like I was insane afterwards. I guess if we do that I will have to psych myself up that it will work (we will be going back to our protocol we did on our first cycle that was successful!), and I will not let my guard down. I have alot of questions for my doctor before we make any decisions, and we would have to have some more routine pre-cycle testing done before we could make a decision between the IUI and IVF anyway. The office told us to call a month before we want to do another cycle, so maybe in September we will get started.