long overdue post

I would have been 32 weeks pregnant this week. Yes, even now, I still think about that milestone each Monday. I realize it's been several months since I last posted. To be honest, I have started posts quite a few times and never finished them. It's been too hard. It's true that time heals, but it never forgets. As the weeks pass, the pain numbs a bit ... doesn't feel as raw ... but it is still there. Even on a really good day, I still have that sadness in my heart. I wonder if that will ever go away. I'm guessing it won't. Maybe it will just continue to fade as the days fade away, and maybe someday I won't cry every time I hear that someone is pregnant or see baby pictures on Facebook. Maybe someday I will even be able to go to a baby shower again. I hope so. I don't like feeling sad. I am by nature a happy person. April 25th stole some happiness from my heart that will never be replaced.

Brian and I just got back yesterday from a wonderful long weekend in Wrightsville Beach, NC. We went there to celebrate our 11th wedding anniversary. My parents' dear friends, Julie and Roger, graciously offered us their condo at the beach for a getaway, and we had a fantastic time. There were definite moments of sadness when I thought about how big my belly would be getting at this point, how I would be feeling the baby kick often, and how this trip would have been a babymoon for us, but we still enjoyed ourselves and it was so nice to get away.

We have decided that we are going to do one more IVF cycle using my sister's eggs. Heather has graciously agreed to be our egg donor again. We aren't sure of the exact timing yet, but we are hoping it will be sometime in the next 6 months. I have decided that I am not going to post the details here like I did last time. Actually, I am going to continue to blog here, but I am going to make the posts private until I reach the beginning of my second trimester (assuming all goes well). As much as I appreciated all the love and support when things ended sadly, it was so hard to have to tell so many people our sad news. So, I think this is for the best. I have to be honest and say that I am terrified for this journey. Knowing how heartbreaking it is to miscarry, and knowing what an emotional roller coaster the whole thing will be, it somehow seems harder to do this a second time. But, we both desperately want a baby, and we want to give this one last try. I hope to update with a very, very happy post sometime in the not-too-distant future. :) 

what might have been ...

Today would have been the first day of my second trimester. This was supposed to be the week that we would be telling everyone our wonderful news. Instead, all I have left is grieving over what might have been. People keep telling me to stop counting the weeks. I can't stop. Every Monday is a reminder of what could have been, and I don't know how to stop thinking like that. This is already a very emotional week, and to make it even worse, Brian is gone for 8 days on a fishing trip in Canada. I know he is having a wonderful time, but selfishly, I wish he was here with me. It's just bad timing, I guess. I miss him so much, and I especially miss hearing his voice. He has been my rock through these difficult days. He is in a very remote area of Ontario, so he can't even call me to check in. This is the longest we've ever been apart in the 14 years we've been together. We have definitely never gone more than a day without at least talking on the phone. So, my emotions are all over the place right now.

I decided on Thursday that I am going to take a break from Facebook for awhile. Facebook is a constant birth announcement, or so it seems. I got home from a rough night at work on Thursday morning, and I decided to check Facebook for the first time in a couple days. Within 5 minutes of browsing my news feed, I saw two birth announcements and three pregnancy announcements. Those things have been difficult to see ever since we started this journey, but seeing all of that after a bad night at work was too much. As much as I enjoy Facebook and its ability to keep me connected with so many people, it's too difficult to see so many people enjoying the one thing I want the most but don't have ... a baby. I'm hoping this decision will make life a little easier for me right now.

One day at a time ...

muddling through the healing process ...

It's been two weeks and one day since my pregnancy ended. We are trying to find our way back to "normal". Some days are better than others. Mondays will always be hard, since they were my week marker. It's hard to believe that I would have been 10 weeks this week ... almost done with the first trimester. Mornings seem to be the hardest time for me ... I have been having vivid dreams that I am still pregnant, so waking up from those dreams is incredibly difficult.

I had my post-op follow up appointment with Dr. Nash yesterday. When he came into the room, he said that he didn't have any answers for me about the miscarriage. I assumed this was because the fetal tissue biopsy wasn't back yet. Sadly, he told me that the biopsy had been botched, and we would never have any answers. Apparently, fetal tissue that is being sent for biopsy must never have preservative added to it, because the tissue must continue to grow in the lab. For whatever reason, someone put preservative on my fetal tissue after the D&C, thus ruining the chance for the biopsy. Once the preservative has been added, nothing can be done. Dr. Nash was visibly upset about this, and he said that he personally spoke with everyone at the surgery center who was involved with my surgery. He said that no one is taking credit for the mistake. He believes that the preservative was not added at the surgery center (since they all know well not to do it), but that it happened at the lab at the hospital (the hospital where I work, ironically), where the tissue was sent for biopsy. I am very upset and disappointed that we will never have any answers about this miscarriage, however there is nothing that can be done at this point, and we just have to move forward. The appointment yesterday was pretty brief. He wants me to take a pregnancy test on May 20 to confirm that the pregnancy hormone is completely out of my system. That same day, I will begin 10 days of Provera, which is the medicine that induces a period. I will have a period about a week after the medicine is finished. About a week after my period, Dr. Nash wants to do a sonohysterogram (saline ultrasound) to make sure my uterus wasn't damaged from the pregnancy or D&C, and to make sure there is no residual fetal tissue remaining in my uterus. After that, we will sit down and have a long talk about where to go from here.

I am going back to work tonight for the first time in a month. I am thankful that I had the last two weeks off, because I got to spend some quality, healing time with my family. It will be strange to be back at work, knowing that the last time I worked, I was still pregnant. I hope I do ok. I cry a lot more these days (even when I try not to), and I hope I don't cry at work. We are just taking things one day at a time now ...

healing

The D&C went as well as it could. Every staff member I encountered, from the person at the front desk who registered me to the nurse who wheeled me out to the car at the end of the day, was incredibly kind and compassionate. Each and every staff member also mentioned how much they love Dr. Nash. I have to agree. He is the kindest, gentlest, most compassionate doctor I've ever met. He is definitely in the right profession and specialty. He truly cares about his patients. I went into the OR at 12:05 and woke up in the recovery room at 12:50. I normally have a lot of nausea and vomiting after anesthesia, but they proactively managed that very well, and I had none today. The cramping has gotten more severe as the night has progressed, but they told me that was to be expected. It is definitely bearable. They said I could bleed for a couple weeks.

Physically, I am doing ok. Emotionally, I feel very drained, empty, and sad. It's hard to believe it's all over. Dr. Nash reassured me today that there is nothing I could have done differently to change this outcome. He reminded me that most miscarriages happen because of severe chromosomal abnormalities that are not compatible with life, although it's possible that the subchorionic hemorrhage could have contributed to or caused this miscarriage. He said that the results of fetal tissue biopsy should be back in 4-6 weeks. This should provide us with some answers, especially if there were chromosomal abnormalities. I have a follow-up appointment with him on May 9 (two weeks from now). Since this is my second miscarriage (I had one 8 years ago), he may do some testing on me to check for blood clotting disorders and other issues that could contribute to miscarriages.

We will be spending the weekend with my family at the lake, so it will be comforting to be surrounded by loved ones in a relaxing place. Brian and I are both ready to start healing from this incredibly sad situation. Our journey has encountered a major bump in the road, but I am trying to have faith that we will still end up being parents, somehow.

it wasn't meant to be ...

The ultrasound this morning confirmed that there is no heartbeat and there has been no growth since last week's ultrasound. There is no doubt that I have miscarried. Over the weekend, I contemplated canceling the D&C and miscarrying naturally, but that can take up to a month. I just want this to be over with, so I am having a D&C with Dr. Nash tomorrow at noon. I will be asleep for it, thank goodness. The procedure should only take a half hour or so, and then I will be in recovery for about an hour and a half. Brian is taking tomorrow off to be with me, so that will be good.

We are both incredibly sad and heartbroken. I thought 2012 was going to be our year. Now, the rest of the year will be difficult as we reach all the milestones that might have been. I was so excited for Mother's Day this year, and now I just want it to pass by. It's hard to believe this is happening. I had to call my new OB this morning to cancel my appointment, and that was very difficult. The emotional roller coaster of the last couple months is one that I would like to never repeat, although I know that if we choose to do another IVF cycle, we will have to endure this roller coaster again. For now, we are going to take time to grieve the loss of our pregnancy and try to heal.

update about next week

The scheduler at Dr. Nash's office called me yesterday afternoon and said that the surgery center's schedule is full for Thursday. So, they rescheduled the possible D&C to Wednesday at noon, with Dr. Nash. They also rescheduled my u/s for Wednesday at 10AM with a different doctor (Dr. Nash won't be in town yet at that point). The more I thought about this last night, the more uneasy I got. If there is no heartbeat on Wednesday morning, then we will have to go straight to the surgery center, and I will have no time to mentally prepare myself for the D&C. I called Dr. Nash's nurse today to ask if I can have the u/s on Monday or Tuesday instead. She rescheduled the u/s to Tuesday at 9:30AM. I guess I am thankful for one less day to be in limbo ... alternately, this means I may have one less day to hold onto the hope that I am going to have this baby. I'm struggling a lot right now ... I am so attached to this baby, and it's not even an inch long yet. I just can't grasp the fact that this pregnancy could be ending next week. We waited so long for this. It just seems so unfair.

cruel twist of fate

I woke up today with a feeling of doom. I am not saying that I have ESP or anything like that. I just had a bad feeling. Brian met me at Dr. Nash's office, as he does every Thursday morning. Unfortunately, they were running behind and he had to get to work for a meeting, so he had to leave before I even got called back.

When the nurse took me to the exam room, she said that Dr. Nash would be doing a physical exam today, as well as a PAP smear and some cervical cultures. I was confused by this (he did all of these things the first time I met with him, several months ago), but I went with it. When he came in the room, he explained that he was doing all of this so my OB wouldn't have to do it in a few weeks. He joked that he is a full service doctor.

Speaking of my OB ... I was so excited yesterday. I called my OB's office to make my first appointment. They scheduled me to meet with a nurse next Thursday morning, to go over all of my information and history. They also scheduled me to meet with my OB on May 14. A little back story about my OB ... her name is Dr. Shepherd. I first met her in early 2009 during my maternal/fetal clinicals in nursing school. I had the opportunity to watch her deliver three babies. She was amazing, and I knew right then that I wanted her to deliver my baby. Unfortunately, she only accepts new patients when they are pregnant, so I have been waiting a long time to make that phone call.

It was time for the ultrasound. I always watch Dr. Nash's face as he is doing the ultrasound. As soon as he looked at the screen, I knew something was wrong. He had to adjust the screen several times. He's never had to do that before. I had tears in my eyes before he even said anything. He looked at me and said that the heartbeat was faint. I wish I had thought to ask what the heart rate was, but I didn't. *side note: I left a message for the nurse a little while ago to ask that question* I asked him what that meant, and he said it wasn't a good sign. He turned the screen so I could see it. My eyes were full of tears at that point, so I couldn't see the heartbeat. I did notice that my little peanut really looked like a baby for the first time today. It looked bigger, and I could see the head and little arm and leg buds. He told me that he thinks I may be miscarrying. He said there is a chance that everything could turn out ok, but he tends to err on the side of pessimism, so as not to give people false hope. As hard as that was to hear, I respect that he does this.

He said that he wants me to come back for another ultrasound next Wednesday afternoon at 1:15. He also tentatively scheduled me for a D&C on Thursday. He said he hates to do that preemptively, but he needs to put me on the schedule in case it has to be done.

I went into the appointment today thinking of two possible outcomes ... 1. everything looks great, see you in two weeks, or 2. there is no heartbeat, and the pregnancy is no longer viable. I never imagined that I would be kept in limbo for another week. I try to view life in a glass half full perspective, but today I am really having a hard time being hopeful. It hurts too much to be hopeful and then be devastated. I know that I need to think positively for my baby, though. I truly believe that positive energy can make a difference, so I am digging deep to find some. The odds have been against us so many times during this journey, and we have come this far. Maybe things really will turn out ok ... or maybe they won't. I still feel pregnant, so it's hard for me to imagine that things could be ending instead of progressing.

Dr. Nash is keeping me off work and on modified bedrest until next week's appointment. He assured me that there is nothing I did or didn't do that could have caused this or changed the outcome. He could still see the subchorionic hemorrhage on the ultrasound today, and he reminded me that it can sometimes lead to miscarriage. He looked so sad, and that made me feel so sad. Tears were running down my face as he finished up the appointment, and he gently rested his hand on my shoulder and just gave me a comforting look. He is a good man.

I guess I'm just going to keep doing what I've been doing, and hope that next Wednesday comes quickly (even though I know it won't). Life can be so unfair.

All is well. :)

Brian and I got to see the most beautiful sight today ... the tiny flutter of our sweet baby's heart!! It was amazing to see!! Dr. Nash found the heartbeat right away! We all (Dr. Nash included) breathed a huge sigh of relief. He said that everything looks perfect! He can still see the subchorionic hemorrhage, but he said that it is stable, and as long as the baby continues to grow appropriately, he is not too concerned about the bleed. He said that there was significant growth just from Monday to today. The bleeding has mostly stopped ... I am still spotting, but Dr. Nash said this is to be expected.

He confirmed my due date ... December 3rd! For some reason, the picture shows the due date as December 5th (my Dad's birthday!) ... I'm not sure why.

The black circle in the middle of the picture is the gestational sac. The bean-shaped item at the top of the gestational sac is our sweet baby. :)

Dr. Nash initially told me this morning that he wanted to see me in two weeks for another ultrasound. After my appointment, I called his nurse to find out if I need to be on any restrictions for the bleed (I was on bedrest this week). She said that she wants me to take it easy and not go back to work until next weekend. She wants me to come back for an ultrasound next Thursday morning to make sure the bleed is still stable. Then, they will release me to go back to work.

What a week it has been!!! We are so happy and relieved that we were able to see the heartbeat today. It's amazing that the heartbeat can be detected so early!

I will update again next Thursday after the ultrasound. :)

the roller coaster ride continues ...

24 hours ago, I would have never imagined I would be writing this post. We went to see Dr. Nash this morning. He did an ultrasound, and to my absolute surprise, we saw the gestational sac (bigger than it was last Thursday) and the yolk sac. He said that I am still pregnant. I have a subchorionic hemorrhage, which seems to happen in about 20% of pregnancies. From what I've read, the earlier it happens in the pregnancy, the better the outcome. He said that there is still a chance for miscarriage, but he was happy with what he saw on the ultrasound. I bled a lot yesterday, but today I am only spotting.

He wants me to continue to take my meds (estrogen patches, progesterone injections, prenatal vitamin, and baby aspirin), and he wants to see me for my originally scheduled ultrasound on Thursday morning. I am in shock, to say the least. I grieved what I thought was a miscarriage for the last 18 hours. I am having a hard time wrapping my head around the possibility that I can still be pregnant. I am trying to stay hopeful without getting my hopes up too high (easier said than done). This is all just so unbelievable.

Dr. Nash put me on bedrest until after the ultrasound on Thursday, to reduce the risk of the hemorrhage getting bigger. I am ready to get off this roller coaster. Please think lots of good thoughts for Thursday morning. I will update after the ultrasound.

in the blink of an eye ...

... it's all over. I miscarried yesterday (Sunday) afternoon. Maybe I will post more about the day when some time has passed. I have an appointment with Dr. Nash this morning at 7:45. I don't know yet if he will have to do a D&C. I am so crushed and heartbroken. I already knew that I wasn't good at getting pregnant ... it seems I'm not so good at staying pregnant, either ...

first ultrasound :)

The ultrasound went well. Dr. Nash said that he saw exactly what he wanted to see ... a little black circle (gestational sac). I was disappointed to not see the heartbeat today, but he said it is too early, especially since I probably implanted late. I will have another ultrasound next Thursday morning, and we are hoping to see the heartbeat then. I will breathe much easier once I see the heartbeat. It's so stressful to have this nagging thought in the back of my mind that we don't truly know what is inside the little black circle. I am trying to stay positive, but it's scary. I'm ready for next Thursday already! I have been feeling nauseous at the same time every day, so I have to believe that is a good sign that things are progressing well. It was exciting to see the little black circle. :)

I can't believe I'm really pregnant!!!

I had another blood draw this morning. I called this afternoon to find out the results, and my beta hCG went from 54 on Wednesday to 126 today! It increased by 133%!!! Yay!!! Another sigh of relief! :) The next step will be an ultrasound next Thursday (4/5) morning at 8:15. Dr. Nash will be looking for the gestational sac and the yolk sac (the earliest source of nutrients for the fetus). The yolk sac may not yet be visible next week. The embryo may also be too small to see at that point, although it's possible to see the fetal pole (first visible sign of a developing embryo ... it looks like a tadpole!) and possibly detect the fetal heartbeat. Those last two things often don't show up until week 6-7, though (next week will be week 5). So, things will still be nerve-wracking for the next couple weeks (and really, through the end of the first trimester). But, I am still trying to focus on one day at a time, because worrying doesn't do me or that little growing baby bean any good. I am on cloud nine right now! I will update again next Thursday after my ultrasound. :)

Definitely, officially PREGNANT!!! :)

Yes, it's true! My beta hCG went from 19 on Monday to 54 today!! It almost tripled in 3 days! They are happy if it just doubles, so Dr. Nash was thrilled!! I am over the moon and honestly still in shock. I can't believe I am finally going to be a Mama! I have waited my whole life for this, and there have been many times in the last few years when I didn't think I was ever going to experience this. None of this would be happening if it weren't for my amazing sister, Heather. She has given Brian and me the most incredible, selfless, miraculous gift of life. Thank you, Heather, from the bottom of our hearts. You will forever be "Special Aunt Heather". :)

I took this test this morning ... I've seen "Not Pregnant" more times than
I can possibly count, so this truly made it feel real. :)

I have to go back for another blood draw on Friday, to make sure my beta hCG is still going in the right direction. Then, I will have an ultrasound sometime next week.

Brian and I are going out to our favorite Italian restaurant to celebrate tonight .. no wine for me, of course! :)

I will update again on Friday, after I get the results of my blood work.

Oh, and please don't post anything on Facebook yet. I need to get through this stressful first trimester (only 8 more weeks!!) before I announce my wonderful news to the world! :)

Hooray!!!! :)

today, I am pregnant ...

What a long, complicated day it has been. I went for my blood draw this morning at 8:15. I have been told several times over the past few months that I would receive a phone call with my results by 3:00 this afternoon. It was a looooong day. As the clock approached 3:00, I kept waiting for my phone to ring. It didn't. I called the office at 3:00 to find out what was going on. I was told that the results arrive at the office between 2-3, and someone would be calling me shortly. Soon, it was 3:30, and there was still no phone call. I called the office again, expressing my concerns that the office was going to close for the day and I wasn't going to know my results. That time, I was told that my results hadn't arrived (implying that other people's results had), and someone would call LabCorp to find out what was going on. As the clock approached 4:00, I was on the phone with Heather. She decided to call the Akron office to put some pressure on. She spoke with Michelle (the nurse we have been working with the whole time), who told her that the results for everyone had been delayed today, and it could be 4:30 before the results came in. Finally, around 4:30, the phone rang ...

It was Michelle. She told me that I am pregnant, but my beta hCG (pregnancy hormone) level was lower than it is supposed to be. According to Michelle, 50 is the number they look for on this blood draw. My hCG was only 19. She said not to worry, because it's possible that the embryo(s) just implanted late and that's why the number is low. There are also a few other possibilities (ectopic pregnancy or chemical pregnancy/early miscarriage). I am choosing to focus my energy on the first option ... late implantation. The fact that my hCG is 19 means that the embryo(s) DID implant, and I am technically pregnant. I have to continue taking all of my medications, and I have to go back for another blood draw on Wednesday morning at 8:00. Then, I will meet with Dr. Nash on Wednesday afternoon at 3:00, to discuss everything. Wednesday is the big day. If my hCG blood level doesn't at least double by Wednesday, then the pregnancy is most likely not viable. So, for now, I am cautiously pregnant. Here is some good info on beta hCG, for anyone who is interested.

I somehow managed to keep myself from buying a home pregnancy test, until today. For those of you who have been following this blog since the beginning, you know that this is a very big feat for me. In the past, I always tested early. This time, I think I was just too scared to test early. After my blood draw this morning, I finally bought a home test. I stared at it in its package all day. After Michelle called to tell me that I am cautiously pregnant, I decided to have my POAS (pee on a stick) moment. Sure enough, the test was positive. The line is faint, but it is definitely there. The paperwork that comes in the box clearly states that any line, no matter how faint, means pregnant. So, I finally got my BFP (big fat positive)!!

I have been experiencing waves of nausea, cramping, and headaches the last few days. These are all signs of pregnancy. I am going to focus on the fact that I am pregnant today, and I will worry about the next step on Wednesday. So for now, I am jumping for joy inside, and daydreaming about the *now more real than ever* possibility that I am going to be a Mama.

... and now, we wait ...

The transfer went well yesterday. I took a valium pill at 10AM, and we arrived at the office around 10:30. At 11:00, Alex, the embryologist came and got us. He took us to a preop/recovery room, and we talked about the embryos. He said that one of the 5 eggs that they took from Heather did something very rare ... it began dividing on its own, as if there was a sperm in it, but without a sperm! He said this is called a parthenogenic egg, and it is obviously not compatible with life. Pretty wild! That is the one egg that they did not fertilize. They fertilized the other 4 eggs. By day 1 (Tuesday), one of the eggs did not divide any further, so there were 3 eggs left. I called on day 2 (Wednesday) to check on the embryos, and Alex said that one of the embryos had stopped dividing, meaning that we had most likely lost it. :( So, we went into Thursday knowing that there would be only 2 embryos.

Alex showed us pictures of the embryos. See below for the pictures. They are graded on a scale of 1-4, and 1 is the best. Ours are both grade 2. Here's a chart that describes the grading:

Grade 1	Cells are of equal size; no fragmentation seen
Grade 2	Cells are of equal size; minor fragmentation only
Grade 2.5	Cells are mostly of equal size; moderate fragmentation
Grade 3	Cells are of unequal size; no fragmentation to moderate fragmentation
Grade 4	Cells are of equal or unequal size; fragmentation is moderate to heavy

Alex told us that grade 2 is very good, and about 80-85% of the embryos they see are grade 2. In order for the embryos to be viable for transfer on day 3, they need to have 4-8 cells. One of ours had 6, and the other had 8. The cells are the large, circular shaped objects. The cytoplasmic fragments (bits of cytoplasm that break off during cell division) are the smaller, bubbly-looking objects. See below for the embryo pictures:

This embryo has 8 cells and 20% cytoplasmic fragmentation

This embryo has 6 cells and 25% cytoplasmic fragmentation

Alex told us that because we only had 2 embryos, they wanted to give us the very best chances for success. So, they did something called assisted hatching. The embryos are enclosed in a shell called the zona pellucida. The embryos have to break out of this shell before they can implant. In assisted hatching, the embryologist makes several nicks in the zona pellucida, which gives the embryos a jump start at breaking out of their shells. We will take all the help we can get!! After we talked about the embryos, he told me to change into a hospital gown and put on a cap. He told Brian to put on a one-piece white spacesuit-looking getup, along with a mask and a cap. Here we are in costume:

They took us across the hall to the procedure room. I sat in a chair with the traditional stirrups at the end. Brian sat to my left. Alex came into the room and said that the doctor (not Dr. Nash, unfortunately ... Thursday is his day in the Columbus office) would be in shortly. He would be inserting a speculum and then cleaning off and drying my cervix. Then, he would insert a catheter through my cervix to make sure there were no issues getting through. A few minutes later, Dr. Moretuzzo (the medical director of the practice) came in and introduced himself. He had Alex use an abdominal ultrasound wand to press against my abdomen, and they were able to see the catheter in my uterus on the screen. He had no trouble getting the catheter through my cervix, so he gave Alex the go-ahead to get the embryos. Alex went through a door to the lab, and soon, the flat-screen TV on the wall came on. A petri dish with my last name and date of birth appeared on the screen, and Alex came into the room to get a verbal confirmation that this was the right container. Then, he focused the camera on the embryos, and we watched on the screen as he sucked the embryos up into a small, flexible tube. Then, he brought them in and gave them to Dr. Moretuzzo. Alex used the ultrasound on me again while Dr. Moretuzzo threaded the tube with the embryos up into my uterus. When he could see that the tube was in the right place, he released the embryos into my uterus. Then, it was all over. They had me lay there for about 10 minutes, and then Alex brought a gurney in and had me scoot over to it and stay laying down. He wheeled me back into the preop/recovery room, and told me to lay there for about a half hour. After a half hour, a nurse came and told me I could get dressed. Once I was dressed, she wheeled me down to the parking lot in a wheelchair, and Brian picked me up.

It feels very surreal that it's all over. Dr. Moretuzzo told me that the embryos will continue growing and dividing rapidly, and on day 5 (tomorrow), they will be blastocysts. At that point, they will begin breaking out of their shells, and by day 6-7, the embryo(s) will hopefully start to implant into the lining of my uterus. My pregnancy test will be Monday, March 26, 10 days from today. I will have the blood draw that morning between 8-8:30, and I will receive the phone call by 3:00 that afternoon. Oh, how those hours will drag ...

So, now we just wait. I am on 3 days of modified bed rest now. I am supposed to take it easy, not exert myself or do anything strenuous, and lay down as much as possible for the next few days. I am supposed to continue to take it easy and not do anything strenuous until after the pregnancy test.

Thank you to each and every one of you reading this, for all of the love and support you have given me. It has carried me through the last couple years of this roller coaster journey, and I am hoping more than anything (I have never wanted anything so much in my whole life) to give you the most amazing blog post of my life on Monday, March 26th. Until then, please keep sending positive thoughts and sticky baby vibes. :) xoxo

Optimistic and excited!!

Heather's egg retrieval was yesterday, and they took 5 eggs!! We were so excited!! Heather doesn't remember anything about the procedure, and is doing really well. Brian also dropped off his piece of the puzzle :) yesterday morning. The embryologist worked his magic yesterday afternoon, and fertilized the eggs. Typically, one egg and one sperm are put in a petri dish, and they are left to do their thing. Since we didn't have a lot of eggs to start with, the embryologist did an extra step called ICSI (intracytoplasmic sperm injection). Each egg was injected with a single super sperm, which cuts out the process of the sperm making its way into the egg. This adds an increased chance for fertilization. I was happy to hear this, as we will take all the help we can get to make this a success!

This morning, I received a phone call from the embryologist. He said that we have 3 embryos!!! He said that one of the eggs wasn't mature, and one didn't fertilize. We are SO THRILLED to have 3 embryos!! He also told me that we will do the transfer on day 3 (also very exciting news!). The transfer will be Thursday morning at 11AM. Dr. Nash's office has a protocol that they use to determine how many embryos will be transferred. They go by the age of the eggs (so in this case, they use Heather's age, which is 31, not my age, which is 36). For age 30-35, they transfer 2 embryos. If they were going by my age, they would transfer 3 embryos. I asked the embryologist if we could transfer 3 embryos, and he said they are reluctant to do so because the chance of triplets is so high. So, I'm not sure what we will do. In any event, we are so happy to have embryos!! Now, we just have to hope that the embryo(s) (yes, I would be overjoyed to have twins!) implant in my uterus.

I had my first intramuscular progesterone-in-oil injection last night. Brian has to give me the shots because they go in my backside, and it's hard to twist around and give myself the shot. We were both very nervous about the shot (there is a picture below to show you how big the needle is!). Brian did a great job, and surprisingly, it didn't hurt very much (thank goodness!). :)

So, I will update again after my transfer on Thursday. Lots of positive thinking going on here!! :)

Heather getting ready to give herself the HCG trigger shot 35.5 hours before the retrieval

Heather "pulling the trigger", aka giving herself the HCG trigger shot 35.5 hours before the retrieval

Heather in the recovery room after the retrieval

Beautiful card from my parents that arrived in the mail yesterday ... inside, it says "It's that beautiful place between the way things were and the way things are yet to be."

Brian holding the progesterone-in-oil injection ... look at that 1.5-inch needle!!

hope is a beautiful thing :)

Well, the roller coaster has continued for the past week, but I am thrilled to say that things are very much looking up right now!!

Heather had an ultrasound last Sunday, and the doctor (not Dr. Nash) told her that she didn't see a whole lot. This was discouraging, because Heather had been on her meds for almost a week, and we thought for sure there would be a bunch of growing follicles in there. She went back on Tuesday for another ultrasound, and Dr. Nash saw 4-5 follicles, with one being bigger than the others. He told her that she wasn't responding to the meds as well or as quickly as they had hoped she would. We felt pretty discouraged at that point. Michelle (Dr. Nash's nurse) told me on the phone that day that it was possible that the bigger follicle would continue to grow while the others stopped growing, and only one follicle would really not be enough to continue this cycle. Heather was pretty upset, feeling like she was failing and disappointing Brian and me. If only she could know how wrong she was. Yes, we were discouraged about the follicles (which, of course, Heather had absolutely no control over), but we couldn't be more thrilled that she agreed to give us this amazing gift, and we would NEVER be disappointed in her or feel like she failed us.

I had an ultrasound with Dr. Nash on Thursday. He said that the lining of my uterus was looking great, and my ovaries looked nice and quiet (meaning that the Lupron injections are doing their job). I expressed some concern about the follicle situation, and he quickly reassured me. He said that in the past, there was a lot of focus on a magic number of 10 follicles or more when doing an IVF cycle. In more recent years, there has been a lot of research that shows that quantity is not nearly as important as they once thought it was, and quality is really what matters. He said that maybe she was focusing her energy on a smaller number of follicles, and they are going to be really high quality. I like that! He assured me that he believes that the follicles will all still continue to grow, and that this will be a successful cycle. I left his office that day feeling much more encouraged and optimistic.

Heather had another ultrasound yesterday (Friday), and we got great news! Two of the follicles are ready, and three more will most likely be ready by the retrieval date. Yay!! :) Her estrogen blood level is also increasing nicely and appropriately, meaning that the eggs are good. She had another ultrasound this morning, and we got the best news yet ... 4 follicles are ready, and there may be 3 more ready by the retrieval date!! Yay!!! :)

Heather has one more ultrasound tomorrow (Sunday) morning, and the retrieval will be bright and early on Monday (3/12) morning. Brian has to be at Dr. Nash's Akron office (where the retrieval will take place) on Monday between 7-10 AM, to drop off his piece of the puzzle. :)

The eggs will be fertilized by an embryologist on Monday afternoon, and on Tuesday, I should get a phone call letting me know the transfer date. It will either be Thursday (3/15) or Saturday (3/17), at the Akron office. Brian and I will be heading up to my parents' house the night before the transfer. I have to be on 3 days of strict bedrest after the transfer, so my parents, Brian, and I are going to head to the lake for a few days of relaxation.

My managers at work have been incredibly supportive and flexible with me, and I am so grateful. They have allowed me to switch my schedule around at the last minute for the next two weeks, and it has taken such a weight off my shoulders. Brian and Heather's managers have been equally supportive and flexible, and we are all very lucky to work for such great employers. :)

As far as the meds go, Heather will take her last injections of Follistim, Menopur, and Ganirelix tonight, and she will take her HCG trigger shot (which will trigger the follicles to "finish" and be ready for retrieval on Monday morning) tonight. I will take my last Lupron injection tomorrow. I have to continue the estrogen patches through the end of the first trimester (assuming I get pregnant!!), and I will start the intramuscular progesterone-in-oil injections on Monday (eeek!). Those would also continue through the first trimester, and possibly the entire pregnancy.

We are feeling very optimistic, and are hoping for the best over the next couple weeks. The official pregnancy test (a blood draw) will be on Monday, 3/26 in the morning. I will know by that afternoon if I am pregnant. I can't believe I am 2 weeks from hopefully being pregnant!!! It's so hard to believe that we are finally at this point in our long journey. I am trying to stay composed on the outside, while jumping up and down and squealing with excitement on the inside. :)

Se, we are accepting all positive thoughts and good energy sent our way over the next couple weeks ... I will update soon!! :)

Moving right along ...

I have been taking daily Lupron injections for 2 weeks and 3 days. The hot flashes, bone and joint pain, and mood swings have been interesting, but I dare say they haven't been as bad as I thought they would be ... maybe because my reproductive hormones were already diminished? The worst side effect has been terrible headaches. :( I had a baseline ultrasound and blood work last Thursday, and Dr. Nash said that everything looked great. On Friday, I added several more medications to my daily regimen ... transdermal estrogen patches, estrogen tablets that are taken vaginally, aspirin (to prevent blood clots from all of the estrogen that I'm taking), folic acid and vitamin B12, and a prenatal vitamin (I have already been taking those daily for the last 2 years). My Lupron dose decreased by half on Friday, when I added all of the other meds. I will continue these meds until March 8, when I will go for another ultrasound and blood work. My daily progesterone-in-oil intramuscular injections (ouch!) will begin on the day of Heather's retrieval.

Speaking of Heather, she had a prolactin blood draw on Thursday. She had a baseline ultrasound and blood work today. She found out today that her prolactin level is NORMAL (yay!!), and everything with the ultrasound and blood work looked great. She will begin her daily injections of Follistim and Menopur tomorrow, and she will go back for another ultrasound on Sunday. Then, she will have daily ultrasounds until her follicles are ready to go. At some point (I'm guessing maybe Sunday?), she will add a daily Ganirelix (a drug that is similar in function to Lupron) injection to her regimen. This drug will keep her from ovulating prematurely. I taught her how to give herself the injections this weekend ... she will do great!! :)

The tenative egg retrieval date range for Heather is March 8-10. Brian will also have to go to the Akron office the same day as the retrieval, to drop off his excellent and high quality swimmers. :) haha! Then, the embryologist at the office will work his magic and hopefully create some beautiful embryos. :) The embryo transfer into me will be 3-5 days after the retrieval. If the embryos are high quality and divide the way they should, the transfer will be 3 days after the retrieval. If the embryos are good quality, but don't divide as quickly as they should, the transfer will be 5 days after the retrieval. Apparently, day 3 embryos tend to have a higher pregnancy rate, but Dr. Nash said that plenty of women still get pregnant with day 5 embryos.

So, that's about it for now. I have been trying not to let myself get too excited, while still trying to stay optimistic. Brian and I talked about baby names the other day, which of course got me excited. But, I'm also very nervous and trying not to get my hopes up too high. It's a balancing act, for sure. I will update again soon!

Here we go ...

Heather had her prolactin rechecked last Friday. Her prolactin is actually too low now (go figure!!), so Dr. Nash is decreasing her daily bromocriptine dose. By the time she starts her injectible meds, her prolactin level should be normal. So, Dr. Nash said that we can move forward with everything!

I have to say that I thought I would be incredibly excited upon hearing these words from Dr. Nash. I suppose that I am excited somewhere deep inside, but more than anything, I am scared and nervous. I know that this is our last ditch effort ... our last chance for me to experience pregnancy and to have Brian's baby. This is a scary reality for me. We have so much vested in this (emotionally, physically, and financially), and I just can't stop thinking about everything that could still go wrong. I'm normally an optimistic person, but I feel like this infertility journey has changed that. That makes me sad. I am trying to work on it, but one disappointment after another can really damage one's "glass half full" perspective on life.

Anyway, Brian and I have an appointment next Thursday (2/2) to sign the consent paperwork and pay a very large sum of money. We have to pay the entire balance on that day, which is a bit terrifying. Once the consent paperwork is signed, I will stop taking my birth control pills so I can have a period. Then, I will start taking my meds. I have to take daily subcutaneous Lupron injections, which will essentially shut down my body's production of estrogen and progesterone. I'm not sure how long I will take those ... I am guessing I will take them until right before the embryo transfer. At some point, I will start daily intramuscular (big, long needle = OUCH) injections of progesterone in oil, as well as estrogen transdermal patches. Because the Lupron will stop my body from making estrogen and progesterone, I will be giving myself very specific doses of these hormones to prepare my body for pregnancy.

In a couple weeks, Heather will stop taking her birth control pills so she can have a period. Then, she will begin her injectible meds. She will be taking daily subcutaneous injections of Follistim, Menopur, and Ganirelix. Those meds will all help Heather grow multiple follicles, which will then be retrieved once they are mature.

If everything goes according to plan, the egg retrieval will be sometime around the first weekend in March, and the embryo transfer into me will be within a week after that.

So, that's the plan. I will update periodically over the next month. I can't believe this will all be done in a little over a month. It seems like there is so much to do, but I guess it will start moving very quickly very soon.

If all goes according to plan, we may be looking at an late November/early December baby. Now THAT makes me excited ... :)

new year, renewed hope ...

Happy New Year! I am happy to put 2011 (and for that matter, the last 4 years) behind me and start fresh. I believe that 2012 will be a good year.

A lot has happened since my last post. Heather and I are both now on birth control pills, which means that our cycles can be manipulated as needed by Dr. Nash. I had my sonohysterogram a couple weeks ago, and Dr. Nash said that everything looked great.

Unfortunately, we recently encountered a big and unexpected hill on this infertility roller coaster. This time, it involved Heather. I seem to have spoken too soon in my last post regarding her lab work. As it turns out, her prolactin (a hormone produced by the pituitary gland - in the base of the brain - that stimulates breast development and milk production in women) level came back high when she had her initial blood work. This level should be low in a woman who is not pregnant or breastfeeding. Dr. Nash had her go for a redraw, just to rule out lab error. Unfortunately, the level doubled during the two weeks between blood draws. This can indicate a tumor on the pituitary gland that causes an overproduction of prolactin. Of course, we all went into high alert when we found out there was the possibility of a brain tumor. We all did way too much internet research, which more often than not results in some misinformation and worst case scenarios. I learned that these tumors (called prolactinomas) are almost always benign (not cancer), and can usually be treated with medication (more uncommonly, with surgery). I also read about some other, much more scary brain tumors and diseases that can cause elevated prolactin levels. Needless to say, we were all very worried.

Dr. Nash scheduled Heather to have an MRI of her brain, which would give us some answers. The 1.5-week span between the first elevated prolactin level and the MRI results seemed to drag on and on. Finally, on December 19th, Heather and Mom met with Dr. Nash to discuss the MRI results. NO TUMOR!!! Apparently, there are some cases in which the elevated prolactin level truly can't be explained (for my fellow medical nerds, this is called idiopathic hyperprolactinemia).

Words can't begin to describe the relief we all felt. Dr. Nash explained that he will be Heather's doctor for this issue going forward. He started her on a medication called bromocriptine, which causes the pituitary gland to produce less prolactin, thus lowering the prolactin level in the blood.

Dr. Nash assured Heather that she can still be our egg donor, and that moving forward with this process will not cause any additional issues for her. High prolactin can cause issues with infertility, so we can't move forward with this journey until Heather's prolactin level is normal. Because of potential negative side effects of the medication, Heather has been gradually increasing her bromocriptine dose. She will be at her full dose in about a week, and after she has been on the full dose for a full week, she will have her prolactin level checked. If it is normal, we can move forward. If it is still elevated, I'm guessing Dr. Nash will adjust the dose accordingly until the level is normal. Heather will have to take this medication until we are done with the egg donor process, and then she can stop taking it until/unless she starts having symptoms of high prolactin (menstrual irregularities and/or milk production when not pregnant or breastfeeding) or wants to have a baby.

I never would have imagined that a hormone called prolactin would turn our lives upside down for a few weeks! I guess the upside is that this prolactin issue was only discovered (and subsequently treated) because of Heather's generous decision to be our egg donor. :) For now, we are waiting for her prolactin get back to normal, and then we'll be full speed ahead (albeit cautiously, since we seem to have a tendency for bumps in the road) with the next step in our journey ...