Transfer Day - Fertilization Report Day 4

Today was the big day for us. We went into the clinic, me toting my full bladder, for the embryo transfer. We had two "great looking" embryos put back. They were at the morula stage, which is exactly where they should have been today. Above is a picture of a morula stage embryo (image kindly borrowed from the web). We still have 3 or 4 more embryos that continue to grow and divide, so there is a good chance that we will have some to cryopreserve. They will call us on Tuesday with the final cryo report.

I am now at home starting my two days of bedrest. I can sit up, but my legs must be up and stretched out on the couch. I am not allowed to do any cleaning, lifting, vacuuming, nor anything of the like, during my wait for my pregnancy test. Matt is already taking great care of me...he is out getting groceries and buying more wood for the woodburning stove.

I must go back to the clinic this week (Thursday?) for blood work to check my progesterone levels. They want to make sure they are at the appropriate levels to sustain a pregnancy in case I am pregnant. I then go back on December 17th for the official beta HCG pregnancy test. So, lots of excitment prior to the holidays. That day is the same day that we will hit the road for Chicago. If I do get a positive pregnancy test, I believe they would have me do follow-up HCG tests at a lab in the Chicago area. We will see when and if it comes to that!

Below are pictures that were requested by my friends. I went out shopping yesterday for an outfit for transfer. I knew that I wanted the "grow" t-shirt, as it is only appropriate for supporting our embryos as they come home. Well, I ended up getting the full gear for bedrest, too (socks and sweats...and the scarf to get me to and fro the clinic). So, friends..enjoy!

Thanks again for all of the support and encouragement during this cycle as it has meant so much to both of us. And, keep us in your happy thoughts and prayers over the next 10 days! For now we are thrilled to once again be at the stage that we have our minis back "home", and we can just sit back and hope for the best!

Fertilization Report - Day 3

Well, I am "stuck" at home today while everyone else is out at the Army v. Navy football game...boooo! Still, I know it was the right decision for me to stay home and rest. I am feeling better again today, but I get pain in my ovaries when I go to sit down or stand up. A little tender with walking still, but overall...I am in much better shape today!

Received the daily embryo update from the nurse, and we have SIX that continue to divide and grow. We are set for our embryo transfer TOMORROW at 10:15am. My instructions are to empty my bladder at 8:15 am and then drink 18 oz. of water at that time. We are to arrive at the clinic by 10 am. We will probably be transferring back two embryos. I am hoping that we still have some good ones left over to freeze...3 to cryopreserve would be great. Wishful thinking never hurt, right? All I know is that the minis will be "home" tomorrow. I will be on bedrest all day tomorrow and all day on Monday. After that, I can resume all normal "light" activities. Sadly for Matt, though, I will not be allowed to vacuum!

We will update everyone tomorrow after transfer and also when we get a cryo report! Send some happy thoughts our way...

Fertilization Report - Day 2

The nurse called just a minute ago, and ALL SEVEN of our embryos continue to divide and grow. That is FANTASTIC news! We know that we will NOT be doing a three day transfer, which is great! When they call tomorrow they will have a much better idea when transfer will be. We know that it will take place either Sunday or Monday for sure.

I take my last antibiotic today, and I also started with the crinone (progesterone) gel and the medrol (anti-inflammatory steroid) this morning. The crinone gel will be used every day until the pregnancy test. With a positive pregnancy test, I would need to continue the gel through the 12th week (something we have sadly never seen before). The steroid is just a five day course. I can tell you that it tastes horrible! I need to remember to take it very quickly as to not have the taste left on my tongue! The gel and steroid are both taken in addition to my daily prenatal vitamin. Estrace will be added the day after transfer.

I am feeling better today. Not great. Not my usual "normal" self. But, better! I will take that for now. I am guessing that I will be in good shape by Sunday. Sadly, I think that I will not be attending the Army / Navy game tomorrow...the game that we have been looking forward to for so long. I just don't think I will be comfortable enough standing / sitting / walking for that amount of time. Matt and I think it would probably be best for me to stay relaxed in a warm environment. (Sigh)

And, so we continue on....

Fertilization Report - Day 1

Still having a bit of a rough go this time around. My arm hurts, but I think the swelling has gone down for the most part. I am having bad aches and pains, I did not sleep well at all, and I am just trying to muscle through. Nothing that I am feeling is out of the realm of the common or ordinary, but it still doesn't mean that it is fun. Onto the good stuff, though...

My IVF nurse coordinator Kat called, and she said that of the 11 eggs that were retrieved, 7 fertilized normally. They had one that fertilized abnormally, so it is "out". There is still a chance that one or two more could fertilize late, and there is always the chance that a few could drop out of the race altogether. So, we wait again until tomorrow's report. Seven is a good start, though, so we are feeling optimistic at this point. We are hoping that the embryos continue going strong so that we will qualify for a 5 day transfer on Monday. That will mean things are looking good, and it will also give my body more time to heal prior to the transfer.

ER Day

Just stopping by for a minute before I lay back down. They were able to get 11 mature follies / eggs today. I will get the fert report in the morning to see how many fertilized. Feeling a little rough. They had a problem with my IV...anesthesiologist had a tough time finding a vein. He eventually did after about five tries. Well, when he went to "put me to sleep" I wasn't feeling anything, and my arm hurt. Turns out the IV wasn't really all the way in my vein, so a ton of fluid just went into my arm. He had to start a fresh IV in my left hand. Anyway, my right arm is all swollen with fluid now and feels sort of funny. Can't wait for that to clear up. Even though they gave me anti-nausea meds, I ended up feeling sick when we got home. Barely ate a half bowl of soup and then just slept for 2 hours. Doing a bit better now, but still in some discomfort.

Actually, starting to feel sick again...so, must go..

Monitoring Appointment #3 - Triggering Tonight!

I went in for my third (and final) monitoring appointment this morning. I guess the upped dose of Follistim did the trick, because I will be "triggering" tonight. I do not know exactly how many potential follicles I have, but my best guess would be a minimum of ten. There is still time for more to grow and mature, so we just never really know what we will get until the day of retrieval. When the nurse gave me all of my instructions today, though, she said that this was a "good" cycle...whatever that means!

I must set my alarm for just before midnight tonight, because the Ovidrel (triggering meds) injections must be given at an exact time. I must give the injections AT midnight because my egg retrieval is scheduled for noon on Wednesday, exactly 36 hours after the trigger. The Ovidrel will help the follicles reach maturation points and then be ready to be released (ovulation).

Starting today, I must take a five day dose of an antibiotic. I am now done with the lupron (suppresion) and Follistim (stimulation) injections. Yay! I am not allowed to eat or drink anything after midnight on Tuesday, given that the ER is done under light anesthesia. On the day of the retrieval I will take a pillow, blanket, and warm socks with me(they really are patient friendly at this clinic!). I also have to take some additional meds with that will be administered via my IV (one is an antibiotic due to my history of endometriosis and adhesions / the other is an anti-nausea med). I have to arrive at the clinic on Wednesday at 11:30am. Matt must be there for his "big show" (sperm collection) and to drive me home. We will be there for at least 3 hours. It is a big day...and it is now right around the corner!

The date of our egg transfer (ET) will be dependent upon the number of follicles that fertilize and produce embryos, and then how those embryos are progressing. If we have a decent amount of embryos that are progressing normally, then we will be able to do a 5 day transfer. If there are not a lot of embryos that survive and progress well, then a 3 day transfer will be in order. We will just have to wait and see how it all unfolds.

Monitoring Appointment #2

Early morning RE appt. the day after Thanksgiving! It is nice because Matt has the day off and was able to go with me. The best news is that I had my regular RE today, and he was able to quickly locate both ovaries. I have at least 7 medium size follicles that are looking good, and at least 9 other follicles that have the ability to catch up. Dr. Van Deerlin feels that we will have a "good harvest". He is upping my Follistim dose in hopes of getting the smaller follicles to grow, grow, grow! Of course, I do not have enough meds to get me by...and the specialty pharmacy is "closed" today...so, I am hoping that we can still work out a delivery of my refills by Monday. That would certainly be nice! I am waiting to hear back from my IVF nurse to see what the protocol is in this situation. I am sure it will be fine.

I go back to the RE on Monday morning for more monitoring. We are getting closer. I will trigger in the first half of the week (probably) and should be having ER by the end of the week. This could all change on a day to day basis, though, so stay tuned!

Monitoring Appointment #1

Today was my first monitoring appointment after starting the stims. I would like to tell you exactly how well or how poorly things are going, but I truly do not have a clue! The RE measured three follicles less than 8mm in my right ovary, although there were other smaller ones around that he didn't count / measure. He rooted around for about 5 minutes searching for my left ovary, but he was never able to find it. Fun, huh? TRUST ME when I say that it was not for a lack of looking for the damn thing. He pointed out my uterus (the lining is at about 6 right now, which is good). He pointed out the blood supply to my right ovary. He pointed out the right ovary. He "swept" the wand (as much as you really can, since it is an internal u/s) straight across from my right ovary, and he pointed out the blood supply to my left ovary. And....still, no left ovary. He pointed out my intestines. That was pretty much it for the show. This is only the second time that a RE or tech has not been able to find an ovary of mine. Apparently the large intestine can get in the way??? Who knows for sure. I know the ovary was there the other day when I had my baseline done! I am sure it will be "back" next time. So, for now, the RE is just guessing that I have at least 6 "measurable" follicles. When you can't find the follicles, guessing is all you can do!

I will know more once my blood work results are back this afternoon. The b/w measures my E2 (estrogen) levels. It will give a clearer picture of whether or not I am responding appropriately OR slowly to the stims. If I am on track, then I will just continue with 150 IU shots of Follistim every evening. If I am responding slowly, then I will probably have to up my dose of Follistim. Regardless, I am scheduled to go back on Friday morning for my next monitoring appointment. Hopefully it goes better than this one, and hopefully we have some good results!

UPDATE: No phone call from the nurse = no change in meds. I can only assume that all is on the right path at this point. I will continue at 150 IU nightly injections of Follistim and return to the clinic on Friday for monitoring.

Hoops and Hurdles - Let the Real Game Begin!

Well, we are finally here! I had my RE appointment this morning where they did b/w and u/s. The u/s showed that my uterus is fine and that both ovaries are still free of cysts. I have a minimum of 14 "follicles in waiting". These are all the reserve follicles that will be "stimmed" by the meds. I will begin my 150 IU follistim shots tonight. I will go back on Tuesday of next week for monitoring (b/w and u/s) to see how things are progressing. From that point, the monitoring will really pick up.

Above is a picture of the follistim "pen" that is used for dosing and injection. It comes with a pre-filled cartridge, and I just have to dial-up the correct dose, attach the needle, and shoot up. I am thinking that I will use my thighs for these shots, since I have already been doing all the lupron shots in my belly. This will give more surface area with which to work.

Hoops and Hurdles

Not much to report, but today I did drop down my lupron dose from 10 units to 5 units. One step closer to stims! Friday is coming....

Hoops and Hurdles

Done with BCPs! Finally! Continuing on 10 unit shots of lupron every morning for the time being. Slowly, but surely, getting closer to the "real steps" of IVF.

Added note:
I have been doing lupron shots for one week now. On the day of my u/s appt. the nurse gave me my initial lupron shot, just as a demonstration for the IVF nurse coordinator in training. I have one bruise on my stomach. That bruise??? You guessed it...from the shot the nurse gave me! You would think she would be better at giving shots than me, but it seems that I am just a pro at this point! ;)

Florida, updates, and what-not

Matt and I are back from our Subaru sponsored trip to Orlando, FL. We had a GREAT time! We were given multi-day passes to both Universal Studios and Islands of Adventure. We took full advantage of both parks by riding several rollercoasters (Doctor Doom's Fearfall, The Hulk, Dueling Dragons), going on interactive rides (The Simpsons, Spiderman, Men in Black), taking a "river trip" with an unexpected drop (Jurassic Park), and experiencing what a real tornado might be like (Twister). The first night we had a group dinner at Jimmy Buffet's Margaritaville. The food was great, and the entertainment was a blast. They hired caricature artists to draw pictures of anyone who wanted them...or anyone who was coaxed into having one done (which would be us). Ours turned out really well (as you can see above), and we plan to frame it and hang it in the basement. Matt's brother Scott and his wife Renata came up from Tampa on Friday afternoon to join us for lunch at the Hard Rock Cafe. Good food and drinks there (Twisted Mac n' Cheese. Yum!). On Friday night we had an excellent meal at The Palm restaurant with one of Matt's dealers and his wife, in addition to Matt's boss and his family. The poolside at the hotel called out to us on a few occasions, as did the beachy drinks that they offer (Purple Haze...mmmmmmmm). On our last night, we were taken to see the Blue Man Group at Universal Studios. It is an amazing and highly entertaining show. It was better than we could have even imagined. We finished the evening off with a meal that included: lobster mashed poatoes served in martini glasses, sushi, beef tenderloin, pecan encrusted grouper, salads, a lobster pasta, and a dessert bar with cheesecake and pound cake served with a variety of fondue sauces. WOW! I think I gained five pounds with that meal alone! Well worth it, though.

We are back home now and back to the real world. Today I had my appointment at the RE's office for my u/s. My ovaries are both clear of cysts, and they are showing about 17 follicles under 10mm just hanging out. My uterus looks good. All was fine and right as usual. The IVF nurse (and an IVF nurse in training) reviewed with me all of my meds for this cycle. I started with my first lupron injection this morning, and that went off without at hitch. I will proceed with these shots throughout the majority of my IVF cycle. As of today, I only have 5 more BCPs to take...yay! On November 19th I drop down my dose of lupron from 10 units to 5 units. After that, my next appointment with the RE is scheduled for November 21st. On that day I will have my baseline u/s and b/w and will then begin stims shots. It was nice to have had that little FL getaway prior to all of the chaos of IVF really starting. I think we are very relaxed and prepared...so, bring it!

VOTE...VOTE...VOTE...VOTE...VOTE...VOTE!!!

Today is THE day, so get out there and partake in your civic duty!

Meds are being shipped!

It is all starting to feel real again. Aetna called this afternoon to say that all of my authorizations have been finalized, and they are ready to ship my meds. They will all be arriving tomorrow. Now we can enjoy our trip to FL without anything hanging over our heads. Once we are back...the crazy ride begins! Well, at least another part of it.

The Official M & M IVF Season Begins!

Well, we are finally here again. Time to start up the maniacal IVF process. It all begins today. Here is a timeline / overview of how things will go:

• Monday, October 27: begin taking BCPs
  
• Monday, November 10: appt. at SJFC for u/s. begin lupron shots once a day. bring all meds to appt. for instructions and shot demonstrations. (waiting on Aetna to call this week to finalize med order and have them delivered prior to this appt. but not during our trip to FL...fun!)
  
• Saturday, November 15: last BCP taken
  
• Friday, November 21: u/s and b/w appt. first "monitoring" appt. start stims shots this evening, and continue with lupron shots.
  
• Monday, November 24: beginning this day, monitoring appts. will be every to every other day to see how follicle growth and hormone levels are progressing.
  
• Monday, December 1: ER (egg retrieval done under a light sedation / anesthesia) will be during this week. the date of ER is dependent upong monitoring and follicle progress. male partner provides "sample" at this time to be used for fertilization. crinone gel use is started for female partner the day after ER and is used to supplement progesterone production to help sustain a pregnancy IF one occurs.
  
• Monday, December 8: ET (embryo transfer after fertilization and embryo development occurs) will be done around this time. it will occur 3, 4, or 5 days after ER (dependent upon how many eggs fertilize and how the embryos are progressing). ET is followed by 2 days of bedrest to help increase chances of implantation (sorry, but it is for the female partner only!)
  
• 7 days after ER b/w is done to check progesterone levels (must be adequate to sustain a pg IF one occurs)
  
• 14 days after ER b/w is done to check beta / HCG levels (official test for pregnancy)
  

Thanks to everyone for your support and encouragement during this process! We appreciate it, as always!

Hoops and Hurdles

CD one has finally arrived! I need to call the IVF Nurse Coordinator at SJFC tomorrow morning to get my BCP prescription called in. They will also inform me what day I need to start the pills. During the first half of next week I will be waiting for a call from Aetna specialty pharmacy. They will be finalizing the ordering of the rest of my meds for my IVF cycle and then shipping them out. That is where things stand for now!

On a completely random and unrelated note, but to save "post time", I am adding a link to some pictures from the early fall. We forgot to share the pics from our trip to OSU for the Buckeye football home opener!
Here you go: OSU photos

World Series 2008 - Game 3

Well, it wasn't rained out...although it came awfully close! We arrived at the park close to 7pm and waited in the car until there was a break in the torrential downpours. At our first "break" we ran for the park and headed for cover. We passed the rain time drinking Coors Light under cover with 45,000 of our "closeset friends". Finally by 10pm the rains had stopped and the festivities and game got under way. Can you say late start?!?! Oh well, it was worth the wait just to be a part of that fan crazy Philly environment. What a sports town! (I say that as both a good and bad thing, as Matt and I were actually "booed" earlier in the day at Costco just for wearing Ohio State clothing.) The rains never came back, and the full game was played. The Phillies started strong with a couple of homers early in the game. That lead did not hold, though, and the Rays came back to tie up the game 4 - 4. In the bottom of the ninth, luckily, the Phillies scored an ugly run that won them the game. Nobody ever said winning had to be pretty! So, the Phillies currently lead the series 2 - 1. Game 4 is tonight, and we will be watching that one from the comfort of our living room.

Here is a link to the rest of our photos from the game:
World Series 2008, Game 3

Another Hair Cut...

Well, one of these days I really will grow it back out again. I keep threatening that, anyway. I went in and had more cut off today, though. I am happy to report that the damage has mostly been cut out of my hair at this point. I really just needed to have it thinned out and have some shape put back into it so that I COULD actually grow it again. I think I am there...for now...maybe...

Hoops and Hurdles

Well, another hurdle has been cleared! We HAVE been approved through Aetna to do our IVF cycle at SJFC. What a relief! Now we just wait for SJFC to submit the paperwork to get authorization for the meds. Once that is done and authorized, SJFC can order the fertility meds through Aetna's own specialty pharmacy. So far, it looks like we are still on track to start the BCPs and lupron with my next cycle toward the end of the month.

Updated note: I spoke with the IVF Nurse Coordinator at SJFC. She said that I need to call them on CD1 of my next cycle, and they will call the prescription for the BCPs into a local pharmacy. It will be two weeks from that point in time to when I start the lupron, so during that two weeks they will coordinate with the Aetna specialty pharmacy to order the rest of my necessary meds and set up an estimated timeline. Aetna will then ship the lupron and all the stim meds for my IVF cycle directly to me. Simple enough, I guess. All I do now is wait for my CD1, which should be sometime around the 26th of October.

A Good Taste of the Blues - shared by Matt

I had a unique experience this week as I attended a private jam session performed by Buddy Guy, one of the greatest Blues legends of our time. Buddy was in Philly this week to record a live session for WXPN, a local radio station. I was invited by my friend Brian Cavalucci who works with Subaru's ad agency, Carmichael Lynch. There were less than 100 people invited to this event. Seats were right in front of the stage and Buddy came out and jammed for just over an hour. Of course, that description does not do it justice. Buddy doesn't just simply jam. His songs tell a story, and, between songs, he tells stories. He speaks of influencing Clapton and Hendrix and jamming with Muddy Waters and Howlin' Wolf..all legends in their own right. Buddy is a legend, and certainly of a different time, and I am honored to have met him.

The following is an excerpt from his website. Enjoy!

“He was for me what Elvis was probably like for other people… My course was set, and he was my pilot
- Eric Clapton

Any discussion of Buddy Guy invariably involves a recitation of his colossal musical resume and hard-earned accolades. He’s a Rock and Roll Hall of Fame inductee, a chief guitar influence to rock titans like Hendrix, Clapton, Beck and Vaughan, a pioneer of Chicago’s fabled West Side sound, and a living link to that city’s halcyon days of electric blues.