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 ...

The power of positive thinking ...

Sorry for the delayed update! Heather and I went to see Dr. Nash on 11/21. He is very nice, and we were quite impressed with him. We discussed the whole egg donation process. Heather and I both have to take birth control pills to sync up our cycles. Once we are synced up (hopefully by January), Heather and I will both take several different meds. Her meds will be similar to the injectible meds I took during the insemination cycles. The goal is for her to produce many mature follicles that can be retrieved and mixed with Brian's sperm via in vitro fertilization. My meds will effectively suppress my hormones and chemically prepare my body for the embryo transfer. The goal is to do the embryo transfer by February, which means we could potentially be welcoming a Fall baby!

Heather, Brian, and I met with a counselor who specializes in infertility last Saturday. This is required by Dr. Nash's office, for anyone who is preparing for in vitro fertilization and specifically using donor eggs and/or sperm. We talked about the complexities of using donor eggs, and the unique complexities of using a known donor (Heather).

Since I don't have periods anymore, I have to take 10 days of Provera, a pill which will make me have a period. I just started those yesterday, because Dr. Nash wanted me to wait a couple weeks to make sure I didn't start a period on my own. I didn't. :( Once I am done with the Provera and my period starts, I will start the birth control pills. Heather has already been taking birth control pills for a couple weeks. Heather already had bloodwork done. The bloodwork has to be timed correctly, and it must be drawn on day 2, 3, or 4 of the cycle. All of her blood levels look great, which means her ovaries are working well and she should respond well to the fertility meds. :) I will have the same bloodwork done after I start my period, although I already know how those levels will turn out based on all the lab draws I've had over the last year and a half.

After I start taking birth control pills, Dr. Nash wants to do a procedure called a sonohysterogram. He will insert a catheter through my cervix into my uterus, and inject saline solution. Then, he will do a transvaginal ultrasound to visualize my uterus while it is filled with saline. This will allow him to see any fibroids, polyps, or other abnormalities that could potentially interfere with a pregnancy. Hopefully he won't find anything abnormal.

I know this road may be bumpy, with plenty of potential detours, but I am feeling more hopeful than I have in quite a few months. I can't believe that this time next year, I might actually be a Mama!

I read several infertility blogs, and I came across a post that really spoke to me. I am going to change it up a bit to fit my situation.

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People keep asking me, "What will you do it if doesn't work?".

C'mon people, give me a break.

It IS going to work ... I've come too far for it not to.

And what kind of thinking is that anyway? What answer are you expecting me to give you?

Hope for the best, prepare for the worst.

I want it to work, more than I've ever wanted anything in my life. I am hoping for the best. I just really don't have the time or energy to prepare for the worst, to worry about what if it doesn't work. That whole way of thinking is completely counterproductive, in my opinion.

The power of positive thinking.

Please, stop asking me what I will do if this doesn't work.
It doesn't help me to force me to think about that.

Instead, please share in my joy and optimism.
Please think good thoughts for me.
Please wish and hope along with me.

I remain hopeful.
I remain positive.

In my mind, there is no other way to be.

Appointment is made!

After lots of thought and discussion, Heather, Brian, and I have decided to switch to a different reproductive endocrinologist. Dr. Nash (and his practice, Reproductive Gynecology, Inc.) comes highly recommended by several friends of Heather's and mine, and the best part is that he has an office in Columbus (where I live) AND Akron (where Heather lives)! So, Heather and I can go to whichever office works better for our schedules. This will make this whole process much easier. I am definitely sad to be leaving Dr. Schmidt's practice, but I think this is for the best.

Heather and I have an appointment together on Monday, 11/21, at the Akron office. At that time, we will find out more about how this will all play out. I'm excited, nervous, and a whole bunch of other emotions. It's hard to believe that this is really happening!!