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Tuesday, October 14, 2008

Recent History--part three or IVF 1, 2 & 3: a whirlwind of activity

By the time April rolled around, when the doctors said we could start IVF again, I was nervous, excited, and scared. After attending an orientation class at our IVF clinic, shown how to give myself injections (I left sweaty hand prints on everything I touched when I was holding the needle), we were ready to go.

After an excruciating time getting the medicines (a topic for another blog post), we were on the road. Now, I would never say I was a morning person, so dragging my fat butt out of bed at 6:30am to give oneself multiple injections left a lot to be desired. Then again, so did not having a child. So out of the bed I came, bleary-eyed, to the vials and needles that I had set out the night before and began mixing, flicking and poking my way to what I hoped were super follicles.

I was really unclear as to what was supposed to be happening. Actually, I knew what was supposed to happen, I just was unable to see danger signs.

The first danger sign was that after a week of stims on the doctor's "second-most aggressive protocol" my estradiol levels (a measure of developing follicles) were in the 200's. So the nurse in charge (NIC) of my chart, bumped me up to the "most aggressive" protocol. Fine.

I went in for an estradiol check a few days later. "We're moving up, slowly, but it looks better." I was up to 350.

The next day I had more bloodwork. I was up to around 450, I think. "Here we go," said NIC. "Come in on Saturday for another estradiol check and an ultrasound."

Since it was on a Saturday, my husband came with me, and I "forced" him to come in the back room with me for the ultrasound. I had given him the rundown about my new-found relationship with "Mr. Wand," but I thought that formal introductions were necessary, given the intimacy of the relationship. After modest introductions, Mr. Wand disappeared into the recesses of my body cavity and the probing began.

Ultrasound techs cannot give info about what they see, at least at my facility, so we waited for the phone call later that afternoon.

I remember that I rushed to the phone with a pad and pencil to write down any further instructions. The Saturday nurse read me my estradiol number: 451. One follicle detected. "Great," I thought, "I have a visible follicle." Unfortunately, after 10 days of stims, 1 follicle and a non-doubling estradiol level does not a protocol continuation make.

I have to admit I was taken completely by surprise when the nurse said that we were going to have to scrap the cycle.

Really? Scrap the cycle? Just like that?

Unfortunately, this news came the day before the most coveted of holidays for infertiles: Mother's Day.

I spend most of Saturday crying. Trying to pull myself out of the funk, I suggested that Sunday my husband and I go out to eat.

Haahahahahahahahahahaa! Wrapped up in my own grief, it had completely escaped me that on Mother's Day, hundreds of mothers would descend upon eateries around the area, smartly dressed children in tow. We ate dinner quickly and returned home.

For IVF attempt #2 I was a little more knowledgeable. We started that protocol in June. It was slight variation on the original theme of pump-her-with-as-much-hormones-as possible.

This time, however, we had better results. My estradiol levels were climbing. They were finding follicles. Good reports were coming back. We were actually given a day to have the trigger shot and a retrieval day!

Times were scheduled. Appointments were made. We were ecstatic!

The retrieval went well: out of the 8 follicles seen, 6 eggs were recovered. The next day we were told 4 fertilized. A transfer day was set. Things were moving so fast now!

Two days later we went in for the transfer. Of the 4 fertilized eggs, 1 had quit dividing after the 1st day, so it was not a candidate for transfer. Of the other three, one had only progressed to three cells, so its future was not in my uterus either. The other two showed more promise: they were still dividing, although one embryo was only at 4 cells while the second one was at 6 cells. I wasn't sure how many cells there were supposed to be at this stage (I had instituted an internet "blackout" for myself to try to limit my stress level), but six cells seemed about right from what I remembered from my readings.

While six cells may be close, eight is actually the number one is going for. Well, perhaps my little guys were just slow-pokes. Surely bathing them in the temple that was my newly reconstructed uterus would give them just the chance they needed.

I NERVOUSLY set about for my two-week-wait. I fidgeted, I daydreamed, I did relaxation exercises, I spoke to my therapist, I spoke to my husband, I tried to concentrate at work. I did, however, realize that the day I went in for the blood test, that I would not be at work that day. I was holding it together, but barely. Bloodwork at my clinic is always drawn between 7 and 8:30 am, so I had half a day to kill before the blood test came back.

I went home. I watched crappy TV; I waited for the phone call from NIC. When the phone rang, my heart stopped beating. I held my breath. "I'm sorry, I have bad news. You're not pregnant." I thanked NIC for calling, I hung up the phone and called my husband. I don't think that he could understand a word I said, but he got the gist. He was kind and sent flowers at home for me. But I was inconsolable. See, we had broken a cardinal rule of IVF, don't tell your family unless you are ready for them to ask questions. They knew what day I should have the answer. They called. My husband called them back when he got home from work. That was the day before my mother's birthday, July 16.

IVF # 3 I was ready for. We had taken a month off, to rest and recuperate. By now I had dealt with my pharmacy long enough to know the protocol; I had the drill down pat. I knew who to call and where in order to get all the meds that were prescribed for me.

I also knew what my estradiol numbers should look like. I knew what to expect if the ultrasound techs found follicles (a lot less poking around and a lot more typing on the screen).

So it came as no surprise to me when my third IVF cycle was canceled before retrieval. I called my husband and told him as much when I got back from that morning's ultrasound and bloodwork. "You see," said the ultrasound tech to the tech-in-training, "when the patient has been on fertility medicine for a number of days, it will be easier to see the ovaries. They'll have a number of follicles on them." I guess he didn't know I had been stimulating for a week and a half.

That was where we left off in September of 2007. By this time I had been combing the internet for solace. A little preganant had just had similar results with her latest attempt at stimulation. Her doctor had recommended using donor eggs. I wasn't sure if we were on the same journey...

1 comment:

Lisa DG said...

I so appreciate you sharing your story. It is heart wrenching, mostly because I have walked in your shoes. I am trying to decide if I will use egg donors now- or rather, when do I make the decision to stop trying on my own.

I guess I have been wondering- what makes it our children anyway?

This is the first post of yours I have sat down to read fully, and I came to you by way of another blog. I figure this is as good a starting point as any. By perusing your more recent posts, I see you've come a long way since this one. I am looking for women who have made the plunge, and how they chose to do so.