Infertility

Yes, I know I promised this post months ago. The nausea of pregnancy has been exactly what I was expecting, and therefore I have had zero energy to blog. Most of you who read this blog have already heard this, but I'm writing it down more because I haven't written it in my journal and want to remember it. It is going to be a LONG post.

We stopped using birth control in June 2007. By December 2007, I knew something was wrong, but because of our ages, no doctor would talk to us until we had been trying to conceive for a year. We started talking in vague terms of how many infertility treatments we would undergo before trying to adopt. I have family who had gone through in vitro fertilization (IVF) and it seemed so overwhelming and expensive that I would do anything before that. We agreed we would look into any treatment up to IVF. When a year had passed, we were referred to a reproductive endocrinologist (RE) by my OB/GYN. By the time an appointment was available and our schedules didn't clash, it was December 2008. Our RE was great and I loved the small clinic setting.

The first visit was an in-depth conversation of which the major points were recorded. It was actually kind of funny that our RE was very interested in the fact that my mother and both brothers are colorblind. He found it important enough to record that I was "aware of the genetic correlation to colorblindness." After the initial consultation, our RE ordered a battery of tests and told us that he was "confidant that, with the right timing, we could have a baby in 2009." All of the tests were initial and were not expected to give any real answer. To our and our RE's surprise, one of the tests revealed a serious problem and the result was that IVF was our only option. Since IVF was required, no further diagnostic tests were done. At first, it felt like a death sentence. It was the death of the family we had imagined and hoped for, and the death of the idea that we could choose how many children we had. It was also the death of the idea that I could become pregnant for free :)

We prayed over the decision to pursue adoption or try IVF. For those unfamiliar with IVF, it is expensive (over $10,000), invasive, time-consuming, stressful, emotional, and requires a detailed schedule. After all of that, even the best cases have a 30% to 50% success rate. We finally decided that we needed to try it. As long as I could plan this, I was going to make it as easy on everyone involved as possible. Our RE did the IVF procedures every other month, and we needed some time to save money and plan things. We finally decided that we would do it in September, which meant I went to the RE office to pick up a schedule. The schedule was a full page long and spanned from August 2 to December 10. It was overwhelming. I stared at it the whole way home, not actually seeing it, and then put it away for months while we waited for August to come. The first step was going to a class where we would learn about the process and sign forms. There were 30 pages of consent forms. During the class, a nurse went over every possible procedure and most possible complications. Then she went over the costs and the various forms of insurance available for the possible complications. The weirdest thing about the forms was when Greg and I had to stipulate, if there were any embryos left over, what to do with them if one or both of us became mentally incapacitated or died.

Once the forms were signed and check was written (largest check I've ever written!), we ordered the prescriptions. Here is what everything looked like when the first package arrived:

The first picture is just the needles. The second picture is the medicines, but I ended up needing two more boxes of one.

I had to start taking low-dose aspirin, pre-natal vitamins, and a drug called Femara (for five days). The self-injections were hard. I was nervous about them, but I figured as long as Greg wasn't anywere near me I would be okay. The first one was more emotionally taxing than I expected, and it took a toll on me every time I had to switch or add medications. The first two weeks of drugs (Lupron/leuprolide) sent me into menopause. The idea is to suppress everything so the RE can start things exactly when he wants to. Menopause is NOT fun, although I think my mom enjoyed having one of her daughters partially know what it's like. I experienced nausea, hot flashes, extreme fatigue, general ditziness, and, according to my boss, looked like "death warmed over." The nurses all said the next two weeks (Follistim/follitropin beta injection and reduced dosage of Lupron/leuprolide and a low-dose HCG) would be better, just a "little uncomfortable." The purpose of this step was to make my eggs mature at the pace they wanted them to and could monitor. I also started every other day ultrasounds. My ovaries swelled from approximately the size of a golf ball to the size of an orange. It was very, very painful. When I went in for my last ultrasound and the RE said we could schedule the egg retrieval a day early, I said "Thank goodness" before he could even finish his sentence. The one larger needle was used for the last shot, a high dose injection of HCG, which needed to mix powder and water. I would ovulate exactly 36 hours later, so the egg retrieval was scheduled for 35 hours later and I was to arrive an hour early.

I was told to expect somewhere between 8-14 eggs to be retrieved, and warned that all of them may not be mature. The egg retrieval is classified as minor surgery, so I was taken into an OR and put under general anethesia. I do pretty well under anethesia, though Greg will testify that I have a hard time waking up and ask the same thing over and over and over again. Immediately after surgery, we were given a report of the number of eggs retrieved. There were 17 eggs and 13 were mature. The next day we received a fertilization report and I began progesterone supplements. Of the 13 embryos, 12 fertilized. Two days later, we received another fertilization report. Most of the embryos were in fair condition, but a few were good or excellent. We decided to transfer the embryos on day 3 and grow the remaining embryos to 5 day blastocysts before cryopreservation(freezing). The day 3 transfer was done on September 25 and was also done in an OR, but I was not under anethesia. I had to remain down for 15 minutes and then was ordered to take it easy the rest of the day. We transferred two embryos, and three others survived to day 5, so those embryos were cryopreserved.

Thus began the excruciating two-week wait. I took a pregnancy test the morning I was supposed to have the blood test done, and it was positive, but I wasn't sure I could trust it. I asked the nurse about it when I went in and she said I could trust it, and they all started congratulating me. I started crying. I went to work for a little while and then left waiting for the official call from the RE's office. They called and confirmed I was pregnant and scheduled my first ultrasound for two weeks later. At that ultrasound, there were two sacs, but only one heartbeat. The other embryo had stopped growing at 5 weeks. I continued the progesterone supplements and low-dose aspirin until December 10, after my first OB appointment. The embryo with the hearbeat was strong and is still strong and growing at 18 weeks. There's our story for my records. I will post a picture and more updates soon!