Just for an instant...

Hello all!

A little update for you, when we last left off I had a beautiful blastocyst transferred and we were amidst the dreaded two week wait to see if it implanted and if I was pregnant or not.

I started out this wait suuuuper cocky. A blast, of COURSE this is it, we have never had one this advanced! I was so cocky I tested at 2dp5dt (2 days past 5 day transfer) in other words, I should seek some sort of psychiatric help...lol. Clearly, it was negative, that poor little nugget didnt even have a chance to check out its surroundings yet! So I tested again at 6dp5dt (6 days past 5 day transfer, also could be called 11 days past ovulation) 2 perfect lines showed up. POSITIVE!! One more faint than the other, as it was so early. Two days later, I took a digital test "Pregnant" showed up on the screen! What a beautiful word! Our family would be growing! A sibling for Colin!

The next day (tuesday) I started bleeding, Thursday was my blood test, still more bleeding, I knew it wasn't good, deep down I hoped it wasn't so. My Beta (blood test) came back at 52, I was pregnant, but juuuuust barely (50 is considered positive). Repeat beta in 2 days - beta 2 came back at 62. The numbers were growing, but not doubling as they should be every 48 hours. People told me "stranger things have happened" I read story after story on "Dr. Google" about low betas. I tried to have hope. But really I was pissed. I knew it was over, why couldn't my body even miscarry correctly?! Two days later beta 3 came back at 6.5. At least I had an answer, I had officially miscarried, or had a "chemical pregnancy". You would think this would be the end to the maddness, nope, my numbers need to be >1 so beta 4 happened 2 days after that it came in at 1.2. For real, so beta number FIVE will be coming. You should see my arms and hands, its not pretty.

People have asked if I'm ok, honestly, I was sad and pissed for a few days, but after having lost Josh and Zoe, this loss, though sad, was sort of put into perspective by my past. I'm just ready to keep going.

#realtalk #pityparty  I'm so friggin over this. Sorry, I will do what I need to do to have a sibling for Colin, but good gracious, can I catch a break ONE time. When we had our transfer I told Bill "this isn't going to work, it was too easy, everything went too smoothly". Man I hate it that I'm always right ;)

So what now?
On the 17th I go in to see my RE for what we in the infertility world call the WTF appointment, as in wtf went wrong and wtf are we going to do about it. This is also when I will have beta #5. We will be signing consent to have a frozen embryo transfer (FET). We have one embryo frozen waiting for us. Here is how this works (the short version) 2 weeks of suppression (so I dont ovulate), blood work and ultrasound, 3 days of progesterone (possibly intermuscular shots in my hip/bottom) then a transfer. All things considered, it's an easy cycle. However we could do all this prep work and show up for transfer and the embryo could have not survived the thaw. In which case we would have nothing to transfer and just wait to move on to another fresh cycle. We will just continue to say our prayers! For now we will call our little snowflake Olaf

 

Send some love our way, and we will continue to keep you posted <3 

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PUPO! (Pregnant until proven otherwise)

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We are PUPO - pregnant until proven otherwise! ^^^ Hello there little baby!! Today this little friend came to stay in my uterus! Say some prayers that he/she is snuggling in tight!!

The expansion grade scale ranges from 1 (least expanded) to 6 (completely hatched).
Grade 1: the fluid-filled cavity takes up less than half the space of the embryo.
Grade 2: the fluid-filled cavity takes up more than half the space of the embryo.
Grade 3: the blastocyst cavity has expanded into the entire volume of the embryo, pressing the trophectoderm cells up tightly against the inside of the zona.
Grade 4: Expanded blastocyst, where the blastocyst has increased beyond the original volume of the embryo and caused the zona pellucida “shell” to become super thin.
Grade 5: Embryo has breached the zona and is hatching out of its shell
Grade 6: Embryo is completely hatched.
So the embryo is given a number grade (1-6), followed by a letter grade for the inner cell mass and then the trophectoderm (A,B or C).
For the inner cell mass:
A: Many cells, tightly packed
B: several cells, loosely packed
C:  very few cells
The trophectoderm grading goes like this:
A: many cells, forming a cohesive layer
B: Few cells, forming a loose layer
C: Very few large cells.
- See more at: http://fertilitylabinsider.com/2011/12/understanding-the-gardner-blastocyst-grading-scale/#sthash.xHvBQGol.dpuf

What you're seeing here is 1. the early beginnings of a baby and 2. More technically - an expanded blastocyst grade BA. Here's a little bit about that that means!

Expanded blastocyst - The fluid filled cavity volume is larger than that of the early embryo and the zona pellucida (outer shell) is thinning.

The ICM grading is as follows:
A ----- Tightly packed, many cells;
B ----- Loosely grouped, several cells;
C ----- Very few cells.

The trophectoderm (the inner shell) grading is as follows:
A ------ Many cells forming a tightly knit epithelium (layer of cells that make up the outer surface of your body);
B ------ Few cells;
C ------ Very few cells forming a loose epithelium.

So what? Welllll that means, basically, that it is in good shape, and a better quality than any of the embryos we have ever had!
We also have one to freeze for sure and maybe 3 more!! holy wow! That has never happened!! Frozen embryos means that if this doesn't take, or we want baby #3, then we don't have to do all the shots and procedures right away.

A little about the procedure - warning if you don't like mild gynecological talk don't read this, though it is a blog about making a baby after all!
I had to arrive an hour early to start drinking water and get checked in. You must have a super full bladder in order to do the procedure, it helps push your uterus down so its more accessible. (Here's the warning part) They brought me into the room to get set up, checked my arm band 2374634 times so I actually had my own embryo implanted then they get you in the stirrups. Now remember I have a TAC (transabdominal cerclage) this is tied at the top of my cervix, because of this my cervix doesn't "rise and fall" like most women. It just stays way way up high, which is fine b/c now it holds in a baby so I'll take that "pitfall".
My RE had to use like 4 different kinds speculums (this sounds like a Harry Potter word) and an extra long catheter to finally reach my cervix. OUCH! He then threaded the catheter through my cervix and into my uterus. The nurse yells "patient ready", embryologist yells "embryo ready" we see it on the screen above our heads and then she runs into the room with another catheter. The embryologist's bonnet was fabric with eggs and sperm on it, amazing. We watch the little white blip that is the embryo float into my uterus.
They took everything out and I went to lay back and settle in for my 15 minutes of laying flat when the nurse told me they don't do that anymore! My how things have changed, they also said I have no restrictions and can pick up Colin any time I want. I will have a blood test later to determine if the embryo "took" (if I am pregnant or not).
Then Bill and I went out for a nice lunch together! (Thanks Mom for watching Colin!)

At this point in the process Bill and I have decided that the blog should go dark for a while. Until we are ready to announce a pregnancy or until we begin another IVF cycle (both will take a while) Until then send some prayers our way!!

Grade 1: the fluid-filled cavity takes up less than half the space of the embryo.
Grade 2: the fluid-filled cavity takes up more than half the space of the embryo.
Grade 3: the blastocyst cavity has expanded into the entire volume of the embryo, pressing the trophectoderm cells up tightly against the inside of the zona.
Grade 4: Expanded blastocyst, where the blastocyst has increased beyond the original volume of the embryo and caused the zona pellucida “shell” to become super thin.
Grade 5: Embryo has breached the zona and is hatching out of its shell
Grade 6: Embryo is completely hatched.
So the embryo is given a number grade (1-6), followed by a letter grade for the inner cell mass and then the trophectoderm (A,B or C).
For the inner cell mass:
A: Many cells, tightly packed
B: several cells, loosely packed
C:  very few cells
The trophectoderm grading goes like this:
A: many cells, forming a cohesive layer
B: Few cells, forming a loose layer
C: Very few large cells.
- See more at: http://fertilitylabinsider.com/2011/12/understanding-the-gardner-blastocyst-grading-scale/#sthash.xHvBQGol.dpuf

Grade 4: Expanded blastocyst, where the blastocyst has increased beyond the original volume of the embryo and caused the zona pellucida “shell” to become super thin.
Grade 5: Embryo has breached the zona and is hatching out of its shell
Grade 6: Embryo is completely hatched.
So the embryo is given a number grade (1-6), followed by a letter grade for the inner cell mass and then the trophectoderm (A,B or C).
For the inner cell mass:
A: Many cells, tightly packed
B: several cells, loosely packed
C:  very few cells
The trophectoderm grading goes like this:
A: many cells, forming a cohesive layer
B: Few cells, forming a loose layer
C: Very few large cells.
- See more at: http://fertilitylabinsider.com/2011/12/understanding-the-gardner-blastocyst-grading-scale/#sthash.t16rla1O.dpuf

Grade 4: Expanded blastocyst, where the blastocyst has increased beyond the original volume of the embryo and caused the zona pellucida “shell” to become super thin.
Grade 5: Embryo has breached the zona and is hatching out of its shell
Grade 6: Embryo is completely hatched.
So the embryo is given a number grade (1-6), followed by a letter grade for the inner cell mass and then the trophectoderm (A,B or C).
For the inner cell mass:
A: Many cells, tightly packed
B: several cells, loosely packed
C:  very few cells
The trophectoderm grading goes like this:
A: many cells, forming a cohesive layer
B: Few cells, forming a loose layer
C: Very few large cells.
- See more at: http://fertilitylabinsider.com/2011/12/understanding-the-gardner-blastocyst-grading-scale/#sthash.t16rla1O.dpuf

A transfer you say?

So this cycle has been different than any of my previous cycles. On saturday morning, 3 days after my egg retrieval I got the call that they were canceling my transfer and pushing us out to a day 5!
What this means - the longer the embryos can continue growing in the lab, the better chance we have at picking the strongest one. 5 days is the max amount of "lab time".

This is what embryos look like as they grow. Colin was an 8 cell, and Josh & Zoe were 7 and 9 cells.

The embryologist called me today to tell me about my transfer for tomorrow. I asked her about how many we had and their grades. We still have 7 (SEVEN!!!) 

This is how we (we meaning I have no part in this at all...) grade embryos
So the top ABC - this tells about the symmetry of the cells
The next row says 1234, in my practice they use GFP- good fair poor. This talks about the fragmentation or space and "extra" stuff in the embryo.
And of course the higher the cell count, the better.
Got it? Easy Peasy right?? HA
Anyways, lets keep this in mind - Josh and Zoe were 7BF and 9BF, Colin was an 8BF(one of the 8BFs in this cycle didnt make it).
We currently have 2 10BGs (AHHH) and 5 8/9CFs. One of the BGs will be transferred tomorrow at 12:15!
Say a little prayer for us that transfer goes smoothly!!
Tomorrow I will show you our little "embie" and I will explain the transfer procedure. I feel I have bombarded you with enough info for one post!

Oh and because some people have been asking, we will being doing a SET (Single Embryo Transfer). The doctor is too worried for me to carry twins again (even tho the TAC can handle it) but really the end all be all is the fact that insurance will only approve the transfer of one embryo graded better than an 8bf in patients under 35. So unless I want to pay for IVF (which I don't) then one it is.

Fert report!

I always want to sing "creature report, creature report cre-ture re-port!" but with "fert"

ANNNNYwayyyys
Out of the 15 eggs they retrieved 14 of them were mature and 8 of them fertilized.
So to break that down even further, ICSI (intra cytoplasmic sperm injection) is done to fertilize our eggs. The embryologist took a single sperm and injected it into a single egg 8 of them managed to successfully fertilize and begin to grow.

On transfer day they will pick the embryo with the most cells and the best letter grade. If it's below an 8BF then they will allow us to transfer two. 

So we will watch and wait, the embryologist will call me tomorrow and tell me how many cells each egg is and we will probably transfer on Saturday.

end of super short post!

Buck buck buckkkkk

Today was egg laying day!!!
Or retrieval if you want to be all technical

We left bright an early so we could beat the traffic! When we got there they of course took my vitals. My BP was so outrageous number like 146/96 or something (needless to say I was petrified). The nurse was amazing, as they usually are, and she promised we would take our time and do the IV right.
She wrapped my arms in warm blankets and then took about 15 minutes to feel all possible places to put the IV. I appreciate her taking the time and not just jumping on what she "thought" might work. She decided to try for my hand but promised to not force the plastic cath if it wouldn't go. She got it!!! She got it on the first try and the least painful IV I have ever had!

Yes, I took a picture! Its a big deal!!! We waited a little while until the person ahead of my was out of the OR. It was finally my turn, I walked in and sat on the OR table, scooted down and they strapped my legs in the stirrups. They strapped my arms in and started to administer the meds to make me go to sleep.

I came into the recovery room with O2 still on, first time for that. Bill was there, I didnt talk to him so I didn't say silly things. First thing I did say when I finally felt more coherent : "How many did we get?"
My good nurse laughed at me and said we got (drumrollllll)

15 eggs!!! WOOOO
Tomorrow they will call and give me the "fert report" and then I will have a transfer friday, saturday, or monday (it will probably be saturday) Until then, we wait!

Thanks for all the prayers!!

Pulling the trigger

Today was another day of monitoring. So here we see my two ovaries almost touching each other (they aren't really suppose to do that in real life) and in the middle, the shadowy ball is my uterus. Fun huh? The ultrasound tech said she wasn't sure what they were going to do with me since I had a batch of follies in the 18ish mm range and then a bunch in the 15-16mm range (we need 19-22mm). I finally got the call today at 4pm, as I was beginning to freak out about being forgotten about...
Turns out they wanted me to trigger!!! WOOOOO!!! So what a trigger shot does, is it tells the body to release the eggs, basically I take HCG to make me ovulate. I HAD to take it at 8:30 on the dot, 36 hours later (wednesday 8:30am) I need to be in the OR to have my retrieval  

Here is my trigger shot!

I have to draw up 1cc of diluent and mix it with the powdered HCG with that giantass needle you see there. Then I get to unscrew said godzilla needle and put on the little subq one. Way easier! However this time the needle caps wouldn't come off and I was afraid of yanking them and stabbing my finger so I ended up bending one of the little subq needles, good thing they send 2!

So if you happen to take a moment on wednesday morning, just send a little prayer my way for an easy surgery. Also that they can get the IV set on the first shot, without blowing out multiple veins and me having a crying hysterical moment when they cant do it but keep trying. Honestly, getting an IV is the worst part of this whole entire process. Needles in my belly all day erry day is no big deal its blood work and stupid IVs that are the big problem.

Until next time!

Do you want to see my follies??

If you sang that title to the tune of "Do you want to build a snowman", then you win.

So here they are so far!





It appears that I have around 18 follies all in the 12-14mm range (goal is 19-22mm). We are trucking right along! I'm def starting to really feel the fact that my ovaries have literally 17x the amount of things in them on any normal month.

This med I am taking - Ganarelix

See that large yellow sicker on it? If you cant read it, it says "May cause headache". Yeah, as in perpetual headache that sleeping wont touch. Caffeine is a no go, and I am suppose to stay away from pain killers as much as I can.
The nurse said I might be ready for a trigger on Monday, which would make my retrieval on Wednesday morning. Monday morning I have more BW and US, that will tell me our next course of action.

On the docket for tonight

Some Ganarelix and of course my Follistim! Both injected subcutaneously into my abdomen by yours truly! I'm starting to feel more like a pin cushion, and my poor belly is bruising up.


So lets back up a tad, on Tuesday I went in for bw and an u/s. As we can see to the left, while 2 is better than 3 pokes, its still one to many! I had 4ish small follicles all measuring about 9-10mm (we need to get to 19-20ish mm).













Bill and I went to the Museum of Science in Boston to see the Pixar exhibit, so that was fun. And of course the 1 minute I was in a tunnel is when the Dr called. BOO. So more bw today, but no u/s, only one hand poke today! I said 'lets just cut to the chase, stab my hand' so she did. We have to watch my LH hormone to be sure it doesn't make me "lay my eggs" too early. Because it was at a 5.4 today they decided to have me introduce the Ganarelix. This will allow the Follistim to do its job but hold back the LH (oooOOooo science-y).
I head back in Friday for an u/s and more bw. Hopefully I have MY u/s tech that I love, and I can snap a few pics of my large ovaries starting to fill up!

It's like Christmas, for infertiles

 This will be quite the picture heavy post! I like pictures! I'm sure you do too

Look what came today!!!!!

WOOOOOOO!!!! A BOX OF NEEDLES!!

So here are my meds, the boxes on the left are patches and suppositories, all the boxes on the right are injections :( womp. (And bananas, because they are the only thing Colin eats, every time)

First is follistim - this is the "fresh" med that had me in a panic the other day about prior approval. This med wil make my ovaries hyper stimulate, it will make me make lots and lots of eggs as opposed to a natural womans cycle which is usually one or two eggs. This is a vile that I insert into a "pen", draw up the meds and use a new needle cap every day.



This is Ganarelix, it's "nice" because the syringes are already filled!

This med makes sure that my body doesn't release LH. If that hormone is released then I will ovulate too soon, this holds off that hormone until we tell it to do its job.

Menopur is another stimulation medication, however this med helps to make eggs a better quality and also make more of the follicles mature. you draw up the med using a "q cap" then switch the end of the syringe to a needle. This med is my least favorite. It burns going in and gives some resistance when injecting. blek.
(If youre following, thats 3 injections a night so far...)

This here is Novarel and Lupron - one of these will be my trigger shot, the shot I will use that makes my body release eggs at a certain time. This is all very timed out. I take it 36 hours before my retrieval, and I need to be in the OR ready to go exactly at that time, or we could lose all the eggs. Talk about stressfullness!

Last we have Crinone and Estadiol. This comes after the retrieval. progesterone and estrogen help the pregnancy to "stick" and keeps all my hormone levels in check.

Now wasn't that fun!?!

Its so weird to be excited to give yourself a shot. I just want to get a move on!

Thanks for reading! xoxo

Suppression check

This morning I went in for my suppression check. That consists of blood work and an internal ultrasound to determine that my hormones and egg production has been at a stand still due to the introduction of birth control.

So blood work, it needs to be drawn by 7:45am in order to be picked up by the courier. The lab opens at 7, so I figured I would get there around 7:10/7:15 to let all the people who have to get to work have a turn first. I arrived and 15 FIFTEEEEEEN people were ahead of me. So I was a tad nervous about that, the phlebotomist said that he would make the courier wait for everyone to have their draw completed tho. So that was nice. What wasn't nice were the THREE tries it took to hit a vein. I might need to be "that" patient and request the phlebotomist that hits my difficult veins on the first time every time. I just feel like a jerk. But I cant do 3 tries every day ouch.

After that "shit show" I headed down to ultrasound to check on my little ovaries. We started internally, but that wasn't working, so we went abdominal. All the medical things today. sheesh.





The dr called and said we had the hormonal go ahead to stop the bcps and start stims on friday, the 10th.
Then I got a call after 5 today from the fertility pharmacy, they said that my insurance is requesting prior authorization for my gonal f (the stimulating hormone) I am suppose to start it on the 10th if I don't have Auth by the 9th I will have to pay OOP.... $1500 for 1 pen. I need at least 5.

I can buy one at a time and if I get authorization then I can be reimbursed. But I'm sorta freaking out about them approving it. We never had this hoop to jump through before...I suppose I'll be doing some harassing tomorrow!



And last but not least --- my kid at the beach! Just cuz he's cute.

Popping in from vacation to saaaayyy

We just got the call...insurance approved our IVF!!!

I go in on monday for BW and US, then my stims (injections) will start on the 10th!

Our pharmacy order is going in today and will hopefully be delivered next week too. I cant believe this is all starting again. Its crazy. I'm sorta freaking out about the whole 2 kids thing. Colin is so so special, and not that this new baby wont be, but how will my feelings be?
I'm trying to keep in mind the love and bond I have with my siblings and how much I want that for Colin.
Anyways, this is a short update. More another day!

Happy 4th of July!!

Moving right along.

That beotch AF came around ON MY BIRTHDAY. fresh. But hey silver lining,  started the process of making a baby on my birthday? Started my birth control. Still weird that I have to take BCPs to have a baby, but such is the process.
Appointment updates  - monday physical fingers, toes etc crossed that my weigh in goes ok. Then wednesday I have a Hysteroscopy in Lexington. After I get that done they will put in to the insurance to order meds and start a cycle. I have to call them on the 30th to see if it has been approved. Then hopefully I would have a suppression check on July 6th and start stimming meds that night. Then about 10 days of those meds and I am ready for and egg retrieval (ER) followed by a 3 day transfer(3dt) (3 days after ER).

So here we go!! Now just to survive the last week of school!!!!

The waiting game (one of many)

Kind of a random post

One day 7 of Provera, IVF nurse said AF (infertility lingo for period) should be here around day 5...WTF body, the ONE time I actually want that bitch to show she's no where to be found? Nonsense.
As soon as I get it, I need to do 7am CD3 BW, so if I get AF on wednesday or thursday then I will need to travel to Lexington to have blood drawn. Saturday is my birthday, that's not really where I wanted to spend my whole morning, but such is the life of an infertile! And sometime after that I will have my HSC Oh all while winding down the end of the school year, moving my classroom, and changing grades. WOO!

In other news, I have lost 13.6lbs so far, I would love to lose another 5 before my physical on the 22nd. That way I get to hear less from that jerkface RE.

OH this is important!
I saw my OBGYN (who invented PAPs anyways??? blek.) He is the one who we were seeing with Josh & Zoe (he came to the hospital on his day off after I delivered to make sure I was "ok"). I love him, the office staff and the general feel of the practice. I know they actually care about me. He said "we will see you in a few months when you're pg!!" And I said wait wait wait no I have to go into Boston for my MFM. So we got to chatting....They are 15-20 min from my school and 15 min from my house. They are directly across from my delivering hospital, which has a stage 3 NICU.
OB said that I could tell him what I needed as far as ultrasounds and appointments were concerned and we would do exactly the same protocol as with Colin, which is an ultrasound to check cervical length ever other week from week 14-26. He said I dictate my care, what I say goes ( I mean clearly within reason). Also, this will make my delivery so much easier. Last time we were in Boston for 5 days, then Colin was in the NICU for 8. 
Traveling back and forth was so terrible and I felt like we didnt spend as much time as we could have there with him. (usually 14-16 hours, still didnt feel like enough). Everything will be harder with Colin at home, making all those trips aren't easy anymore, its not just Bill and I. On the other hand my MFM specializes in TAC pregnancies but is 2 hours away and appointments take at least 2 hours (at best). I feel very bad, like I'm saying I dont care as much about #2's care, but really I'm trying to reduce my own stress for the pregnancy and I have more knowledge now on how things "should" go. I also know that if problems start to arise, then I can always go back to Boston to see my MFM. This was a super hard decision for us to make, and as usual it can change at any moment.

So for now....we wait.

Weeee'rrreeee BBBaaaccckkkk!!!!!

I know I have some new followers, so I'm going to take this cycle really slow and do my best to explain everything.
So update on me ---
RE wasn't a giant asshole today! So that's a win. He said Colin was adorable, which I think is required for him to say...but since he is in the business of making babies it felt like a compliment? But I digress...
We worked backwards, and determined some dates. We need to not be pregnant before Aug 1st in order to be eligible for short term disability when I am on maternity leave (semantics...).

We will start provera (a drug that brings on a period) tomorrow (unless BW [blood work] showed I ovulated recently, HA). 12 Days of provera, then CD3 (cycle day) BW, and a hysteroscopy (camera inserted into my uterus) Below is the pic I snapped of one from last time...

Then 2 or 3 weeks of BCPs (birth control pills) then a suppression check (this determines that my hormones are in check and that we have control over them, it ensures my body isn't ovulating on its own). Then I will be starting stims (2-4 injections into my stomach a night in order to make my ovaries hyper stimulate, grow large quantities(15+) of eggs) on July 10th -ish. Followed by a retrieval of the eggs 10ish days later, and a transfer of embryos 3 days after that. And a beta (blood pregnancy test) Aug 4th -ish. I need to have a PAP and a physical before my suppression check (scheduled for Thursday and the 22nd).
So They took 9 viles of blood and a urine sample today. That was so fun, but YAY they got a vein in my arm instead of my hand!
We had the # of embryos discussion, turns out my insurance only covers the transfer of one embryo in women under 35, with 8 cells or more at an A or B grade. (Josh and Zoe were 7 and 9 cells with B grade, Colin was an 8 cell B). So while it makes me nervous, its sort of "nice" that it take the decision out of our hands.
So thats where we are at. As always ask any questions! 
And for your viewing pleasure... My goober! Colin!

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.