Getting ready to go public!

*8 weeks*

I've been feeling pretty good lately. Still freaking tired all. the. time. Oooh man, the exhaustion has been kicking my ass. The queasiness comes and goes. The idea of beef makes me feel yucky, and last night the mushrooms Ben was cooking smelled awful to me, so I had to pass.

We're on our way to *finally* being publically pregnant. I set the wheels in motion on Sunday, when I emailed the girls, saying "let's get together next Sunday" claiming cabin fever, boredom, la la la. It worked like a freaking charm. Maybe they're on to me, which wouldn't surprise us at all, but there were about 30 emails in my box by the end of the day Monday from everyone going back and forth, making arrangements, and ultimately deciding on a Saturday night get-together at Roxi & Neil's in Plainfield. I threw my two cents in Monday evening, and then today I had another almost 30 emails in my box! Everyone's super excited to be getting together, and we're desparately trying to peer pressure Andrea to come up from Champaign...

Ben and I are taking weekly photos of my tummy, which wasn't exactly flat to begin with, but we wanted to document the changes. Last week was our first photo shoot, and we'll do it again tonight, and every week, on the week (just so we can remember to do it). I'm not seeing or feeling tummy changes yet - my pants still fit, though I do need a new bra, but that's another story... But I can't really "suck it in" the way I used to be able to. I feel kind of full and sort of constipated all the time. I'm not constipated, but I just feel like I am, if that makes sense... Anyways, hopefully I'll post my tummy pics from weeks 7 and 8 soon!

And thus begins the nausea...

*7 weeks, 2 days*

Yeah, I thought I was in the clear. I was feeling pretty confident that I just might be safe... I was wrong. On Tuesday night, Ben had to go and make beef stroganoff, which I usually love, but the smell, taste, texture, everything just turned my stomach. I felt HORRIBLE! I mean I felt gross, but I also felt so bad, because he always labors over dinner for me, and then I didn't eat ANY of it. I couldn't. Even now thinking back makes me a little queasy...

Wednesday, we had another ultrasound. On the way to the doctor, the queasiness started again. Deep breaths, lots of water, small bites of my strawberry breakfast bar... and then it passed. The appointment went well. We went in for the ultrasound and the bean was measuring 6 weeks, 6 days, plus or minus 2 days. I'm going with plus based on human calculation error, and the fact that we know without a doubt (based on the date of my egg retrieval and fertilization) that I was 7 weeks, 1 day. She said it looked good though. The heartbeat was 129, right smack in the normal range (between 90 to 160). It's so weird seeing that little bugger and the flicker that is the heartbeat. The image changes every time we see it, and it's starting to look a teeny bit more like something....

Click on image to enlarge

Click on image to enlarge

Don't get too excited that it looks like there's two somethings in there - the blob on the left is the baby and on the right is the yolk sack.

Heartbeat

*6 weeks, 4days*

Yesterday we passed another hurdle - we saw the baby's heartbeat AND the baby! It was the coolest thing! The baby looks like a little blob, but you can totally see that it's there now! The ultrasound (u/s) tech said everything's measuring as it should, and from the picture, you can definitely tell the sac is growing. The heartbeat was just a little flicker on the screen, but it was clear as day. The u/s tech said that usually it should be 100bpm, and it was "in the 90s" which she said was fine for six and a half weeks. She didn't see concerned, so I'm not letting myself be concerned. We go back on Wednesday for another ultrasound, so hopefully the heartbeat will be even stronger.

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I asked my nurse Gabby how long they keep me for monitoring before releasing me to my OBGYN, and she said until 8 weeks. 8 weeks seems so SOON! I signed paperwork for them to send my records to the OBGYN I was seeing before the IVF started, Dr. Carroll, but now I'm not so sure. I like that it's easy to get in to see him because he keeps a small practice, but what happens when it's time for me to deliver or he needs to take a vacation the week I'm due?? I guess I need to research my options, and make a decision FAST!

I think Ben and I have decided that we're going to share our news with the world (or at least our friends and extended family) around 8 weeks. Thank goodness, because I really didn't think I could make it to 12 weeks with everyone asking questions and knowing what's been going on. I hate lying to people, especially about this. When parent's on my caseload ask if I have kids, I hate saying "we're trying" - NO, WE'RE NOT TRYING, I'M PREGNANT!!! It's so frustrating. And I really hate lying to my co-workers and my closest girlfriends. It's killing me!

A little bit more real

*5 weeks, 4 days*

Yesterday was our first "big" doctor's appointment. We had our first ultrasound - or "early ultrasound", as they call it. You have to keep in mind, most people are just now figuring out they're pregnant. They've missed their period, peed on a stick, and are anxiously awaiting their first doctor's appointment. Not so with IVF.

The purpose of having the first ultrasound at 5wks, 3dys is to make sure the gestational sac is growing adequately and also see how many embryos have implanted, if more than one was transfered. Since we only had one embryo transfered, the likelihood of twins is just as likely as anyone else having identical twins naturally. I don't think they can really tell at this point, since the fetus or fetuses are not yet visible in the sac.

The gestational sac will become the placenta as the fetus develops, so they need to make sure it's growing as quickly as it should. They measure it in days. It could be growing behind (say, at 5wks) or ahead (which would mean the date of conception was miscalculated - not an issue with IVF). If the sac was growing behind where it should be, there would be concern that it wasn't a viable pregnancy. I know way too much about this stuff...

So like I said we had our appointment yesterday. It was so bizarre to see that little black hole in my uterus that is my baby's home for the next 8 or so months. Nothing spectacular. If I didn't tell you where to look, you probably wouldn't even know what you were looking at. The first thing I asked the ultrasound tech was how it was measuring. She said the computer does all the calculations, so she would let me know. She did also say that it looked exactly how she would expect it to look at this point, so that was a relief. When she was done and the computer did it's calculations, she told us that, yes, the sac is measuring perfectly at 5weeks, 3days!! Wooo. Total relief.

Click the image to enlarge
Like any pregnancy, there's always the change of miscarriage. It's no more or less likely after IVF, but I think it's a greater fear for me because of our fertility problems and how long it took us to finally get pregnant. But every appointment is a milestone. The last few have been betas - how much pregnancy hormone is present, is the number doubling, do I have a healthy progesterone level? Check. Then this ultrasound - how big is the sac, is it growing the way it should? Check. Next week - can we see a heartbeat, is this pregnancy viable? That one's a biggy. I think it'll feel even more real, and seeing a heartbeat will be an even greater relief.

As each day wears on and I still feel tired and sore, even though I may complain about my back hurting, I'm grateful for that pain. I know that it means that little beaner is still snug in there.

RPS?

*We're 5wks today!*

RPS is the online community's abbreviation for "real pregnancy symptoms". I'm still feeling generally pretty normal, but today my back is KILLING me. It's a weird sort of back pain that I don't think I've experienced before, so I'm thinking it's a RPS. On the other hand, I stopped my arthritis meds as soon as I found out last week that I was pregnant, and I've been surviving on tylenol alone. This weather would normally wreak havoc on my body - what, with three big snows in under a week - but I'm pretty sure this back thing is not my lack of meds. I am actually feeling a lot better without meds that I had expected. From what I've read, the pregnancy hormone is supposed to reduce inflammation during pregnancy, therefore putting arthritis into remission. I'm HOPING that will be the case for me, but this sore back is making me wonder.

Other than that, still not really feeling pregnant! It occurred to me at one point today that the thought "oh yeah, I'm pregnant" didn't really cross my mind this afternoon, and suddenly I was like "oh yeah! I'm pregnant!" It's really the weirdest thing. I hope it feels more real when we go for the ultrasound on Friday, and I'm sure it will. I'm super excited to see the image of what will be our bean, our baby, but I'm a little nervous to see how many of what will be... A bunch of the ladies on my message boards are thinking twins because my hormone levels are pretty high compared to the norm. If that is the case, it would be fluke identical twins, since we only transferred one embryo. I guess we'll find out soon enough!!

Lookin' good!

*4weeks, 6days*

Beta #3 was today - 1827! My nurse now is Gabby, and she said that based on my numbers things are looking good. I'm scheduled for my "early ultrasound" this Friday the 8th. There won't be a heartbeat yet, but we'll be able to see the gestational sac that will become the placenta. We'll be able to see if my one embryo will become one fetus or two. We are really excited for this first ultrasound. I think it will make things seem more real. We're both still in shock, and we need to be able to move beyond the shock and start planning for the next 35 weeks and then the next 18 years!

I'm still feeling pretty normal. I have been feeling really tired lately and have had sore boobs for the last few days. I'm also having some achy abdominal cramps that, from everything I've read, are normal, but damn, they're annoying. I can't complain though - I'd really rather be tired and crampy than nauseous and vomity.

Are you serious?

Around 2:20pm on Wednesday, January 30th, I got a call from my nurse, J.J. She told me "I have good news! Congratulations, YOU'RE PREGNANT!"

What? Who? Me? Pregnant? Not possible. Not after all of this. I was in shock. I still am.

I was at work when J.J. called. I had to respond stupidly to her until I could get away from my desk and the listening ears of others. She told me my beta came back at 271!! I honestly don't remember much of what she told me, because I was in such shock. No sex yet, no hot showers or baths, keep taking the progesterone, estrogen, & aspirin, back on Friday. I think that was the gist.

She asked me if I knew, and I said no - I was just playing dumb because I was at work! I thanked her profusely, and then wandered around for a few minutes to calm myself down. I was literally trembling!

I wanted so badly to call Ben then and there, but I couldn't possibly tell him over the phone. It needed to be in person. I killed as much time as I could at work, before leaving to stop at CVS to pick up a pregnancy test. I peed on that stick when I got home, and the word "pregnant" popped up in under a minute!

I waited and waited for what felt like an eternity for Ben to get home from work. When I heard the garage door open, I was ready. He walked in a said hello, and came into to the family room to me looking up at him and handing him that little wand with a yellow bow on it. He looked at me like a deer in headlights and kept asking "are you serious?" I hugged him and said yes, and he stood there in shock.

The whole thing is quite surreal, and we are definitely still in shock. I went back on Friday, February 1st for my follow up beta. Beta numbers are supposed to double every 48 hours. My 1st beta was 271 and my 2nd was 619 - it more than doubled, so things are looking good! I go back for a 3rd beta on Monday, February 4th.

By my calculation, my due date is October 7, 2008, and as I write this, I'm 4weeks, 4days. The nurse said they'll do an "early ultrasound" around 5wks, 3days - we probably won't see a heartbeat yet, but we'll be able to see the sack or sackS. Now that's a scary thought!

So I said it, and I'll say it again, and soon enough, I'll shout it from the rooftops! I'M FINALLY PREGNANT!!!!

Can miracles happen?

We started our second round of IVF in December 2007. I started taking the birth control before we left for Punta Cana and started the stimulation process right after Christmas. During IVF, there is frequent ultrasound (u/s) and bloodwork (b/w) monitoring. I would frequently be at the office in Oakbrook Terrace every day or two for u/s & b/w, occasionally going downtown to the River North office on the weekends for tests.

I felt like the cycle hadn't gone well. The first part of the stimulation seemed to be off schedule, thought my nurse, J.J., didn't seem concerned. The drug protocol was different - it was supposedly for "poor responders". They were trying to get me to produce more follicles, since they'd only gotten two mature eggs the first time. From what I could tell at my u/s appointments, the protocol didn't seem to be working. I went to the River North office on Sunday January 13th for my last b/w & u/s before the retrieval. The nurse told me there only appeared to few a few potentially mature follicles, and gave me the option of canceling the cycle. She seemed pretty sure that I should, but I told her that Ben and I had talked about it, and decided that no matter what, we'd already come this far, we would complete the cycle.

On Tuesday, January 15th, I went in for my egg retrieval. We had no idea what to expect, and honestly, I wasn't feeling very positive. The retrieval went well. I had the same anesthesiologist again - LOVE HIM! After the retrieval, we were told they got five eggs, and one was mature. For a protocol that was supposed to make me produce MORE, I got a worse result!

I wasn't feeling good about the whole thing. When I spoke to the nurse the next day, I asked her if we canceled the cycle now, would it be used against the six attempts our insurance covered. She said it would, so we had no choice but to continue.

My friend Anne had been telling me about this book called "The Secret". The day before my transfer, she gave me a copy of it, and told me that I had to think positively. I started reading the book, not sure I really believed the whole mantra of "thoughts become things", but it had to be worth a shot.

I had the embryo transfer on Friday, January 18th. I told Ben all we could do was hope and think positive thoughts. I had one good looking 8-cell embryo transfered. They had used ICSI - a procedure where one good sperm is cleaned and inserted directly into the egg. They also used assisted hatching - a procedure where a small hole is made in the "shell" of the embryo to allow for easier hatching in order to more easily implant in the uterus. The procedure went well. I made it a habit to repeat to myself on a regular basis "this will work, this will work" and "stick, bean stick" encouraging that little embryo bean to latch onto the wall of my uterus.

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After the transfer, we tried to put it out of our minds and keep busy with other things. The day of the transfer, we went out to lunch at Rock Bottom and saw "Cloverfield" on opening day. We laid pretty low, and I kept busy at work.

In the days leading up to my beta test, I was searching for symptoms of pregnancy. I had this monster zit. I was having problems with IBS. I was feeling tired. But were these things really out of the ordinary? I couldn't be sure. I became very nervous the two days before the beta, not sure what I would do if the test was negative, and running the scenario through my head of if it was positive.

I worried all the time, not just during this cycle, but in general - what would we do if IVF didn't work. I've said before that insurance covers a max of 6 IVF attempts. Well, really they cover four attempts, and add an additional two if pregnancy goes to term in one of the first four tries. If this cycle didn't work, we would take a break and treat whatever might be causing the problem. I may have surgery again to remove any additional endo that may be in there. We may need to start thinking about egg donors, surrogacy, or adoption. These things terrified me, and I wasn't ready to go there just yet.

My beta was scheduled for Wednesday, January 30th. A few of the girls on my IVF message board had betas on or around the same day as me, so that really helped make it to that point. I avoided peeing on a stick, because I couldn't stand the disappointment or the possibility of a false positive. I had my b/w done at 10am by the phlebotomist would I LOVE - she gets me on the first stick almost every time, and is very conscious of the fact that my veins suck. I would expect a call later that day.

The beginning of IVF

We took the summer off trying to get pregnant, and just relaxed. There was a lot going on in our lives, mostly revolving around Julie & Scott's wedding, which was a great distraction. But at the end of the summer, we decided it was time. I called FCI, and we got started.

First of all, a brief explanation of how IVF works. An IVF cycle occurs in five parts:
1) Suppression: Birth control pills help suppress and control the body's normal cycle. Suppression gets your body ready for what's next.
2) Stimulation: Drugs are given to stimulate growth of follicles in the ovaries. Each month a woman's body is supposed to produce one follicle, containing one egg. Stimulation increases that number and typically FCI said they would hope to get 10-12 mature follicles.
3) Egg retrieval: A high dose of hormone is given 36 hours before the retrieval to finalize the development of the follicles, and then the eggs are retrieved under general anesthesia. The mature eggs are then fertilized "in-vitro" and monitored for embryo development.
4) Embryo transfer: Up to three fertilized eggs, now embryos, are transfered back to the uterus under ultrasound guidance.
5) Two Week Wait (2WW) & Beta: The two week wait is the time between the embryo transfer and the beta, or blood pregnancy test that measures the level of the pregnancy hormone, HCG.

And so it began in August 2007. I went on birth control just before Julie & Scott's wedding. Before we got to the stimulation part of the cycle, I got canceled because I wasn't suppressing well enough. We were disappointed, but ready to try again.

In October 2007, our second attempt underway, things looked good! Suppression worked well, and stimulation was doing its job. On October 21, I had my egg retrieval. I was nervous, but felt pretty good. The anesthesiologist was awesome! I warned him that I have bad veins, and he got me easily in one stick. I remember waking up from the procedure in tears and thanking everyone in the room, which they told Ben was a side effect of the anesthesia. I went back on October 24 for the embryo transfer. They had gotten six eggs, two of which were mature and fertilized, so on the day of the transfer, they put two embryos back. One was a great quality 8-cell embryo (8-cell is ideal for transfer) and the other was an okay quality 6-cell embryo.

The 2WW was torturous, and I was relieved to finally have my beta on Monday, November 5. I had a gut feeling the weekend prior to the beta that I wasn't pregnant, so when I got the call that the test came back "positive, but not a good positive", I was devastated, but not surprised.

My test results came back with an HCG level of 6.71. Technically, anything over a 5 is positive, but I wasn't having any delusions that it would be viable. I went back a few more time that week for follow up bloodwork (b/w), until the number was below 1, and then it was done. They termed it a "chemical pregnancy", meaning that the embryos had just never nestled in. I had been pregnant in the sense that I had two embryos, pieces of both Ben & I joined, inside of me, but they just hadn't attached to my uterus the way they should have.

We took some time to ourselves to process the loss. We had just gotten Toby, our blue point himalayan kitten, so he was able to give us some joy. I told Ben that we deserved a break, and I *needed* a break. It was then that we booked our trip to Punta Cana, Dominican Republic. I think it was exactly what we needed to relax and clear our minds, and gave us time to just focus on us and our relationship for a change. I think that trip did the trick...

Miracle makers

Fertility Centers of Illinois (FCI) was recommended to me by one of the therapists I work with. She had tried for four years to get pregnant, and on her first attempt at in-vitro fertilization (IVF), she finally succeeded and her little girl has to be close to a year old now.

We first met with Dr. Aaron Lifchez at FCI in March or April 2007. We discussed our history of infertility treatment, and told him that we were ready for the next step. He had us obtain copies of my OBGYN medical records and also required that I have my rheumatologist and a hematologist sign off that I was medically stable for addition fertility treatments in terms of my rheumatoid arthritis and spherocytosis (a blood disorder that basically causes chronic anemia).

Once he had everything in hand, Dr. Lifchez sat down with us again and told us that IVF was probably our next best option. We would be skipping a step in the ladder of fertility treatments - that step being intrauterine insemination (IUI), or artificial insemination as it's better known. He said that because of my history of possibly having a blocked tube on one side and possible anatomical problems on the other side due to the cyst I had removed in November, he did not feel that IUI was a viable option for us. I was ready for the next step, however we hit a minor snag financially.

In terms of cost, IVF is generally inexpensive in Illinois, since there is a state mandate requiring that companies of 50 or more people provide fertility coverage, including up to six attempts at IVF. So in that regard, we are lucky - we have only had to pay co-pays and towards our deductible and out-of-pocket max. However the hard decision came when I lost my short-term disability coverage (and therefore maternity leave coverage) at work, due to budget cuts. They offered us an optional plan, which I applied for, but got denied due to my medical history of arthritis.

Ben and I had to think long and hard about what to do. Would we be able to afford to have a baby without maternity leave coverage? Certainly not, because without my salary, we couldn't pay the mortgage! But we looked at everything on the table... we agreed that we would both save as many vacation, personal, and sick days as possible, and make due with what we had. Finally we decided - we would do IVF!

It's been a long road...

Ben and I started trying to get pregnant in February 2006. Whoever thought it would be such a long road!? I think most people think that all it takes is a few attempts at unprotected sex, and BOOM - you're pregnant. What most people don't realize is that it also takes a body and reproductive organs that are able to play ball!

I started charting my basal body temperatures and trying to figure out when I was ovulating based on those temps and using ovulation predictor kits (OPKs) in April 06. It didn't take long to realize that something wasn't right. I went to see OBGYN Dr. John Carroll in August or September 06. I showed him my charts and told him I didn't think I was ovulating. He agreed with me.

After obtaining my GYN medical records and getting our ducks in a row, Dr. Carroll did a hysterosalpingogram (HSG), which is a procedure in which dye is injected under the watch of x-ray to check out the anatomy of the uterus and fallopian tubes. My HSG was somewhat inconclusive. It appeared that one tube was wide open, but that the other may have a blockage.

Dr. Carrol than started me on a drug called Clomid in October 06. I started off at 50mg, and was monitored by transvaginal ultrasound (u/s) mid-cycle to determine if I was producing eggs for ovulation. The Clomid seemed to be working, as I started producing eggs and was finally ovulating.

During the second round of Clomid in November 06, Dr. Carroll found a large cyst on my ovary that he recommended we remove as soon as possible. A week later, I underwent a laparoscopy to remove the cyst. The cyst was large and turned out to be an endometrioma, a cyst that results from endometriosis (endo).

A week after the laparoscopy, I landed in the hospital for five days with a serious infection that caused me to need a blood transfusion and tube put in to drain the infected abscess. During my hosptialization, Dr. Carroll told us that the results had come back on the sperm analysis (SA) that had been done, and everything with Ben's swimmers looked great! He also gave us our options on how to proceed. We could either continue on Clomid for a few more months, or take some time off to do a drug treatment to reduce any residual cysts that may remain from the endo. I told him I wanted to keep at the Clomid.

Four more months passed on 100mg of Clomid, and I did not become pregnant. It was in April of 2007 that we decided to move on to the next step...