Update, getting closer!

After blood work today estradiol came in at 1083 and luckily the ganarelix helped my LH drop back down, so it was .7 which is good because if it gets too high it could cause me to ovulate. We dont want that yet. I let the phlebotomist try to draw from my arm today instead of my hand. That was kind of nice because it hurts way bad to get it from your hand, but she did really well! Then ganarelix as soon as I got home again.

The nurse dropped my Follistim to 250 and added menopur 75iu. So if you are keeping count that would be a total of 4 needles that I have had stuck in myself today. One by a nurse and 3 by myself. great. Tomorrow I go in AGAIN for Blood work and an ultrasound, luckily they just opened a practice in Westboro, so I don't have to drive all the way to Lexington! woo! fx for an ER on monday maybe!

Monitoring!

Today I went in for BW and U/S (Blood work and ultrasound)

The u/s tech said my lining was 10mm and a triple stripe, which come to find out is very good (I never had lining issues so I wasnt as knowledgeable about this area of fertility)
Turns out I have 5 12mm follies on the right 3 14mm and one 12mm on the left, and a bunch of 10s and 11s. I need them all to be around 20mm. My estradiol was 1449 and my LH was 9, because my LH level was creeping upwards I had to give myself my Ganarelix shot in the car on the way to Wrentham outlets. It wouldnt go through my skin, it was SO gross. So I gave myself another 300IU of the follistim and tomorrow I will have more BW in the morning, but not another u/s. And another ganarelix shot right after the BW.

This is follistim, I have been doing 300iu a night for 7 nights.

This is the ganarelix, the needle is a tad thicker than the follistim, which could have been my injection issue.

Thats all for now I suppose, I didn't get the vera baby bag we went to the outlet for :( they didnt have it yet, maybe I'll just end up paying full price. Boo. But its just so cute!!

IVF Numero 3

I was suppose to have my third IVF cycle at the end of June beginning of July. But health insurance is dumb and said my BMI was not good enough. So I hopped on the treadmill, and had to change insurances, since I lost my job (thats a whole other story) and lost some weight and was able to start at the end of July.

We are using the Antagonist protocol again.

 

But with new insurance comes new meds. Insurance was giving us crap about the meds, they approved IVF but not the meds (at first), not really sure how much sense that makes, but I tend to not ask questions about the thought process of an insurance agency b/c they are ALL a mess. 

This time I have Follistim, Ganarelix, crinone, novarel trigger, menopur and estrogen patches.

The crazy thing is , I started stims on July 26th. It is the SAME day just a year later that I started stims for Josh and Zoe's cycle. This time I started with 300IU of Follistim, I am on day 6 unsuppressed tomorrow I go in for monitoring again. On Tuesday my Estrodiol was already in the 400s so I'm hoping this will maybe go a tad quicker this time, and maybe we will get some more eggs!

I'll update tomorrow if I get any fun information!!  

Fingers crossed and saying prayers that this is successful, I pray everyday that God will bless me with twins again. 

I'm bad at this...TAC surgery rundown!

I really should update you about my LAP TAC.

Surgery went FANTASTIC, April 15th, yes I was in Boston on tragic boston marathon day! Praise the Lord we were out before all the craziness.

So surgery was scheduled at 7am, we arrived around 5:45. They called me in to get all set up, I asked if my mom could come with me, they said they would get her later. I was given a jonny and told to sit on the gurney. I put on my jonny sat on the gurney and burst into tears. The last time I was in this situation I was losing my babies. I couldn't handle it. The nurse came in and saw me crying and immediately got my mom. So sometimes I guess it does get you what you want when you cry!

The "IV wizzard" got it on the very first stick! I was SO happy, since this is honestly the source of most anxiety. as I was getting all ready they let me bring my little Josh and Zoe hats into the OR with me, taped to my jonny. An OB who was working that day asked me if she could please stand in on my surgery so she could see it done and learn more about it. I am so glad that I could lead to this OB knowing more and more babies being saved through the TAC!

The doctor was late, but the nurse anesthetist was AMAZING she stuck with me, and calmed me, and gave me some "happy juice" early. She told me I was going to be the most amazing mother, and my children would be blessed to have me. I loved her. what kind words. I was finally wheeled into the OR at 7:24 I saw the heavy duty yellow and black stirrups for my legs and said "Oh my goodness, these are so fancy! I should just have these in my house, I spend so much time in them" and with that, I was out. HA.

At 7:48 the doctor called my mom and told her I was done, He said it was one of the most textbook LAP TACs he had done. I woke up all by myself in recovery. I asked for my mom, my throat was KILLING, honestly, it hurt worse than my belly! Dumb breathing tube! I asked the nurse how many times I had asked her what time it was, she chuckled and said "a few". For whatever reason I like obsess about how long my surgeries take, after both Egg retrievals I asked Bill like 47 times how long it took. I used the bathroom, proved I could eat and drink and got dressed and went home. Except we stopped at Panera on the way home, because duh, we needed soup. Hahaha.

And here is the "damage", honestly, I would do it all over again, the incisions and scarring are minimal and I was really only couch ridden for like 3-4 days. Heck I made guacamole that night!



I few weeks later I had some baseline testing done, and I finally got to see my TAC in place!

The line right above my thumb is my TAC the circle looking donut thing with the hole in the middle in my cervix, the TAC goes all the way around. 

Now my scars are barely visible and I am excited to give this puppy a try!!

What is a TAC??

TAC = Transabdominal Cerclage

How did you know you had an Incompetent Cervix:
I knew I had IC because I went in for my A/S and they checked my cervix with a trans vag u/s. I had the typical U shaped funneling of my cervix, with "silent" contractions. meaning the cervix was funneling from the inside out, and it was too far gone to do an emergency transvaginal cerclage (TVC). It looks like this:
And my little Josh was kicking the bottom of the U.
After I lost J and Z I decided there was no other answer for me than the TAC. So on April 15th I had it placed Lapriscopically. 

Having a TAC placed essentially cures incompetent cervix. it has over a 90% success rate (a traditional vaginal cerclage has about a 55-60% success rate).

Here is a picture of the various cerclages. 

 

A TAC is a band of mersaline tape (one 8" piece of this material can hold the entire weight of an adult!!!) placed AROUND the very top of your cervix (in my case lapriscopically, others have a c/s type incision). The TAC prevents the membranes from even beginning to funnel and "holds" the cervix shut.  A typical cerclage (TVC) is sew THROUGH your cervix at the base, since the doctor needs to access it through the vagina.

So typically a vaginal McDonald cerclage is placed around 12-14 weeks gestation (or in an emergency situation) while it canbe successful, what usually happens is that your membranes funnel to the point of the cerclage, at which point the cerclage can either hold and be fine, rip through the cervix completely (and deliver a premature baby) or funnel to that point and get an infection which then makes you pprom which results in preterm delivery.  

Will it allow you to TTC sooner?

After having the TAC done my doctor suggests you wait 2 cycles before getting pregnant. In my case we had intended to do our next IVF cycle in July, so this works out just fine for us. We could have had the surgery earlier and TTC-ed sooner, but July works out better for our jobs and for EDD as well.

Often times OBs see this as an "extreme" measure to be taking and try to counsel patients out of it. They see it as too invasive when a TVC could work. I'm not playing with the word could here, I'm going as dang extreme as I can. With as difficult as it is to get the baby in there in the first place I dont have a real margin for error (not that people who get PG the "normal" way should EVER have to endure this pain, but you know what I mean).

Please feel free to ask any other questions. I dont mind answering at all!!

Here is a video of the surgery being preformed by the doctor that did mine:

https://www.youtube.com/watch?v=cnmkaquk5AY  

J and Z birth story

December 4^th, 2012 was supposed to be one of the very best days of our lives, instead it was one of the worst.

            We went in to the doctors to find out what gender our miracle babies would be. Bill really wanted at least one boy, he was so scared of being over protective of a little girl, let alone two. There they both were, as perfect as perfect could be, beautiful hearts, perfectly formed spines, bones, lungs and brains. We were so so proud. Then she told us Baby A was a boy! Baby B was a girl! It was everything I could have ever hoped and dreamed for.  Bill and I were SO excited! Then the u/s tech decided to do an internal to just put mine and the doctors mind at ease and check my cervix. It was measuring at .75cm, a “normal” cervix should be over 3cm long at that point in pregnancy.  I was instructed to go immediately to the hospital to L&D.

When we got to the hospital I was put on a stretcher in triage flat on my back for 4 hours until they found a bed to move me to. I prayed and prayed and prayed the whole time I was there, and all through the night. When I finally was moved to my room they put me on the bed in trendelenburg position, my feet were raised up above my head to decrease pressure on my cervix. Bill and I really got to a new place in our marriage since I needed him to help me use a bed pan throughout the night. The next morning we were visited by the most horrible high risk OB (MFM), he suggested we terminate, that was SO not an option for us, he said he would not do a cerclage b/c my cervix was too far gone. We went down for an ultra sound to see if there was any change. The ultra sound tech took to many measurements of Josh and Zoe, she kept saying how perfect they were growing, I just laid there sobbing.  Our OB came in and watched some of the ultrasound, he asked by I was crying. I told him “Because they are absolutely perfect and we aren’t going to get to keep them”. My cervix had now shrunk to .35cm a pessary was suggested along with progesterone. It was our only hope. We did both and stayed in the hospital on bed rest until Saturday afternoon.

I was so happy to be home and in my own bed, but I got up to use the bathroom and felt like I was leaking. The OB on call told me to come in to the hospital. They checked my cervix and said it looked like I was dilated a little, they took a swab and went to check to see if the liquid was in fact my water. When two doctors and the nurse came back, we knew that was it, my water had broken and there was nothing more we could do. Bill and I clung to each other and sobbed. Why after all we had been through to get pregnant with our miracles did this have to be happening to us. We both would have given anything to keep our precious angels.

They brought us back to a L&D room, We just sat on the couch and cried for a few hours until my contractions picked up. I love my babies so much, and my body was failing them.  My nurse told me she had been through this three times herself. She said she has three angels in heaven and four kids on earth. Having her with me was such a blessing. She got my IV in on the first shot, and offered me pain meds or an epi, which I declined. I tried to watch SNL to take my mind off of what my body was doing. The OB came in and placed a med called Miso internally, though she said I probably didn’t need it, I was dilating with a bulging bag of water. I was contracting every 2 minutes, strong contractions, the kind that make your body shake. Bill was right there with me holding my hand, telling me how strong I was. The nurse went to get a few things and told me to call her with any pressure or any changes, a few minutes later my water broke. I called the nurse and she came running to the room and called the OBs. By the time the OBs got there it was time for me to push, I just laid there yelling “NO NO NO NO my baby my baby whhhhyyyyy” The pain was bad only for a moment, I was just so upset to be pushing out my baby, when he needed to be in me so much longer. Baby Joshua David was born at 1:30am (only 45 min after getting the miso) Dec 9^th 10oz 11inches. He was so handsome, he has his mommy’s nose and lips and daddy’s eyes and flat feet. Zoe Faith was born along with Joshua’s placenta at 1:38am Dec 9^th 9oz 10inches. She was moving her perfect arms and legs just too early for her to breathe on her own. She also had her mommy’s nose and chin, and daddy’s pouty lips. I soaked the OB sitting at the foot of my bed when Zoe’s water broke. It took an hour and two more tablets of miso, which they told me needed to be placed rectally, I said “Uhh no thank you”, for Zoe’s placenta to come, they were setting up an OR for a D&C I am so lucky I didn’t need one. I ate a little and got up to use the bathroom around 4am with the nurses help. I passed out in a wheel chair for about 3 minutes. Bill said it was one of the scariest things he has had to witness. I woke up on the bed where they let me sleep until around 8 the next morning. numerous social workers came in to talk to us about funeral arrangements, I was so numb. We were finally discharged around 4pm Sunday, lonely and heartbroken.

Joshua and Zoe’s middle names have significance. Joshua’s middle name is David because in the story of David in goliath in the Bible, David has to have strength and trust in God to overcome a scary and difficult ordeal of fighting goliath. Our little angels had to face a scary and difficult time as they went to heaven, we as parents need to have the same faith and strength as David to get through this. Zoe’s Middle name, Faith, is because we need to have faith in God that he will see us through this pain, we need to believe through faith that our perfect little babies are in heaven being cradled by God and we need to have faith that one day Zoe and Joshua will have siblings to watch over here on earth.

We are so blessed with  amount of support we have had these past few weeks, the number of prayers for peace, and comfort in this pain has helped us through.