19 Week Ultrasound and 3D Images

These are some my favorite ultrasound images from the pregnancy. One good thing to come out of having so many complications is that we had a lot of ultrasounds done. I think maybe close to 20!

Sunday Evening

36 Weeks

Oh bother. Has it really been almost 7 months since I have blogged??? For shame. The truth is, I am fairly superstitious and I was afraid to write here for fear of further disrupting an already disrupted pregnancy. Knock on wood. It has been one hell of a wild ride.

In a nutshell:

On Memorial Day I started hemorrhaging; lots of blood and awful looking clots. It was absolutely terrifying. I thought I was having a miscarriage. I called the fertility clinic and luckily my doctor answered the phone (a miracle!) and he told me to lie down and NOT MOVE until I came into the clinic the next day, which amounted to 24 hours of sheer hell. When we finally went in, we got an ultrasound and THANK GOD the baby was ok. The twin was most definitely not developing anymore but we still had one viable little peanut. I often cry when I think about it...my husband and I collapsing onto each other with sheer relief and cautious joy.

And that was just the beginning.

It turns out what I had was called a Subchorionic Hematoma. I will let the experts describe it:

SCH or Subchorionic Hematoma is a gathering of blood between the membranes of the placenta and the uterus. A more technical name is the chorion. Some doctors will also just refer to it as a blood clot.

The incidence of subchorionic hemorrhage (subchorionic hematoma) is 1.3% of all pregnancies. In pregnant patients with first-trimester vaginal bleeding, the incidence increases to almost 20%. Bennett et al⁹ reported a spontaneous abortion rate of 9.3% in patients with first-trimester vaginal bleeding who had a live fetus and subchorionic hematoma. Overall, hematoma is associated with a 4-33% rate of miscarriage depending on the gestational age when the complication occurs.

Mortality/Morbidity

• The presence of sonographically detected subchorionic hemorrhage (subchorionic hematoma) increases the risk of miscarriage, stillbirth, abruptio placentae, and preterm labor.
• The rate of spontaneous abortion directly varies with the size of subchorionic hematoma and the mother's age. The rate of spontaneous abortion is inversely related to gestational age. The frequency of fetal demise is higher with retroplacental hematoma than with marginal subchorionic hematoma.

Scary stuff. My hematoma was not small and was, in fact, almost the exact size of the placenta. That, coupled with the fact that I still had the extra twin sac, led my doctor to advise me, in his exact words, to do "a whole lot of nothing" for a while. A while turned into about 2 and a half months. I was basically on house arrest with very limited activity. No walking any distances (so no shopping, etc) no baths (again) or sex (still) or really much of anything. Blah.

But the truly hard part was the very tangible and real possibility that I could spontaneously abort at any time, especially if I wasn't careful. It's hard to explain just how stressful that is. You always hear how miscarriages happen because of a chromasonal defect, that it's the body's way of telling you this baby is not meant to be. What you don't often hear is that you can cause a miscarriage by, say, going grocery shopping or taking out the garbage. Holy crap. The fear can consume you and it almost swallowed me whole.

A couple of weeks later, I had to rush to the ER with more bleeding. I was told by the ER doctor that I could be having a miscarriage. That turned out not to be true, but it was awful to hear nonetheless. Soon after, I had a pretty big panic attack and realized I was getting nowhere fast with all the pressure. But with no way to reduce my stress (no exercise! no cooking! no acting gigs! no warm and frothy bubble bath! no soothing glass of red wine! no comfort sex with my husband!) I was getting increasingly tense and uneasy both emotionally and physically. I had my panic attack in my ear doctors office. I was seeing him because I had what I thought was an awful ear infection. After he talked me down from my panic ledge, he told me I MUST, come hell or high water, find a way to relieve my stress. Then he told me I didn't have an ear infection. What I had was TMJ from clenching my jaw from, you guessed it, stress.

So, how do you reduce your stress when you are stressed about having to reduce your stress? I still don't really know. But I can tell you what worked for me, at least enough not to explode. I started controlling my breathing, listening to meditative music and lighting candles. I stopped beating myself up and, most importantly I told myself and the little creature growing inside me that we would be okay. We simply would because, well, we just would.

Because I said so.

And then...

In mid August I got sick. We were up in San Francisco attempting to have the one and only get-away in a very difficult year and on Day One I started feeling crappy. Long story short, we saw a doctor who told me I probably just had a cold but took a flu swab just in case. The results wouldn't be confirmed for three days and he told us to try to enjoy our vacation in the meantime. Well, I tried but by day 3 I was tired of trying so we headed back down south. We checked into a hotel in Monterey for a night and in the morning I started bleeding. Again...terror. A crazy run to another hospital, more waiting, fear, the works.

It turns out I had a rather bad UTI which was causing me to bleed. Another enormous collapse of relief.

While we were driving away from the hospital the doctor from SF called and told me I had H1N1 as well as the regular flu. He was shocked because he had NEVER seen that before. Go figure. Pregnant women have died from the swine flu or, more accurately, from the pnenmonia they get from the swine flu due to pregnant women's limited lung capacity. I lied awake that night, restless and afraid, praying we would be alright. That night will never leave me. I am sure I will never be the same.

It took me a full month to recover from both flus and the UTI, which takes us to September and a diagnosis of....

Anemia!!

It was actually a relief to find this out because I think it had a lot to do with my weakened immune system. Once I started taking iron supplements I had a lot more energy and (knock on wood again) have not gotten sick. Phew. I started walking again and feeling good. What a relief! I started feeling like I had some measure of control over the extra weight I was gaining from inactivity. I didn't go on a diet or anything but I was able to keep from gaining much weight the whole month of September. I felt GOOD. :)

But October brought more bleeding and a three day stay in Labor and Delivery with pre-term contractions. And then another trip to L&D a week later, as well as the most painful and itchy rash covering most of my body.

HOW MUCH CAN ONE PERSON TAKE??????????????????????????????????????????????

Apparently a lot. I'm still here! Baby is still here! My marriage is not only intact but better than ever!

It has been over 2 and a half years since we started TTC, a year and a half since we began fertility treatments and almost a year since we started the IVF process. I have gone through 10 IUI's and one IVF. I have been on stimulants or natural hormones consistently since last January. In the past year, I have been through several procedures including 2 surgeries. I've had 1 trip to the emergency room and 3 trips to Labor & Delivery. I experienced the loss of a twin, a subchorionic hematoma, eczema, foliculitis, anemia, the swine flu, seasonal flu, a severe UTI, a panic attack, TMJ, restricted mobility, an ear infection and now, sciatica.

I have not been able to exercise, have sex or take a bath since January.

This Thursday, we will celebrate our 37th week of pregnancy, which means we will have reached full term. Everything else will be icing on the cake. We are having a little girl and her name is Elena. She is a trooper, a beautiful survivor. I love to feel the weight of her little body rolling under my expanded flesh. Holding her for the first time will be the sweetest moment of my life. Sometimes I find it hard to believe that day will ever come.

It's Sunday evening, December 6, 2009 and I have been lying in bed all day with an awful case of sciatica. I am in considerable pain and can barely walk. This does not make me happy but I no longer question the difficulty of this pregnancy. It seems to come with the territory. We will survive. We will be okay. More than okay. We will thrive. And how do I know this?

Because I said so, dammit.

*Knock on wood.

Update

Baby A and B-Five Weeks

My first ultrasound showed two gestational sacs so I was thinking TWINS!! A bit of  shocker but I embraced the notion of double cribs, a 2 seater stroller and NEVER sleeping for the first 6 months. We went back a week later and, while I am happy to report that one of our little Peanuts of Pure Love's heart is happily beating away, Baby B is simply not there. The sac is there, and it's still growing, but it's empty. I was unnerved by the news. It's hard to feel joy and loss at the same time because you feel guilty either way. 

If I hadn't done IVF, I probably wouldn't have done an ultrasound so early on in the pregnancy so chances are I wouldn't have known Baby B ever existed. I have heard that 70% of pregnancies begin as twins. I find that hard to believe but the point is, most women never know because by the time they get their first ultrasound, the other one is gone. This doesn't make it any easier to go trough but I take solace in knowing that nature knows best and this is what had to happen so Baby A can thrive. Maybe they have even joined forces. 

Baby A-Six Weeks

Beta Numbers

A beta pregnancy test is a blood test administered to determine the levels of the HCG hormone in a woman's body. Technically you are pregnant if your number is above 5 on your first beta, which is typically scheduled for 14dpo or 14 days past ovulation (the day of egg transfer with IVF) but it is my understanding that most clinics like to see a higher number by then. However, the most important indication of how well things are progressing is with the second beta, which they will normally do 2-3 days after the first. Your numbers should be consistently rising at the beginning of your pregnancy, not staying the same or dropping. 

It's too hard to tell if you are having multiples just by your beta numbers. Even though there is often a correlation between high beta numbers and multiples, it is not always the case. I have read where women with fairly low numbers ended up being pregnant with triplets and I've heard about people with high numbers having singletons, so you never really know.

Beta Levels in Early Pregnancy and Beyond

Weeks after LMP	Days after conception	HCG level for single baby (mIU/hCG)
3 Weeks	7	0 to 5
4 Weeks	14	5 to 426
5 Weeks	21	18 to 7340
6 Weeks	28	1,080 to 56,500

7 to 8 Weeks	35 to 42	7,650 to 229,000
9 to 12 Weeks	49 to 70	25,700 to 288,000
13 to 16 Weeks	77 to 100	13,300 to 254,000
17 to 24 Weeks		4,060 to 165,400

25 Weeks to Birth		3,640 to 117,000
4 to 6 Weeks Post Birth		Less than 5

Read more: "Beta Levels in Early Pregnancy" -http://www.stages-in-pregnancy.com/beta-levels-in-early-pregnancy.html#ixzz0EQFWQyIq&A

This past Friday my first beta was 333 and three days later it had, thankfully, risen to 1025. Next week is the real deal, however, when I get my first pregnancy ultrasound and hopefully we will see some real evidence of my little emby (or embies?) in the form of a gestational sac or two. :)

It's true, even when you finally get pregnant, the worrying doesn't stop, it just changes to a different kind of worry. And I imagine when the baby is born, a whole new set of worries begins. So I am committed to thinking positively and taking the very best care of my little guy or guys and staying strong and enjoying each moment. I worked very hard for this and I am going to make the most of it!

   

YAY!!!!!!!!

    

I'M PREGNANT!

BIG 

FAT

POSITIVE!!

               

Three...More...Days

Ugh. I've done the 2ww (2 week wait) many, many times but it's never been like this.  I am keeping myself busy with Lifetime movies and food (wait, did I say that?) and I'm shooting a film on Thursday (which may or may not have been a good idea) so it's actually going by fairly fast. I found a cool group of chicas going through the exact same thing on: 

http://forums.fertilitycommunity.com

I recommend hooking up with one of these sites! IVF can feel very lonely and isolating and hearing what other women are going through makes an enormously positive difference. The thread I'm a part of is for all of us April IVFs and it's fun to cheer each other on, especially when someone gets a BFP (Big Fat Positive, or even a Big F*ucking Positive?) Uh-oh...I'm addicted. The cute little emoticons don't hurt either. I especially like the little cheerleader with blonde ponytails and pink pom-poms. :) She's cute.

I'm delirious. (yay for me!!)

Channeling Tom Petty-Six More Days!

The waiting is the hardest part
Every day you go one more yard
You take it on faith, you take it to the heart
The waiting is the hardest part

Don't let it kill you baby, don't let it get to you
Don't let em kill you baby, don't let em get to you
I'll be your breathin heart, I'll be your cryin fool
Don't let this go too far, don't let it get to you

The Transfer

   A little loopy from the Valium.

Yesterday: Turns out I had two embryos who made it to the blast, and they were both good quality so we transferred both of them. Yay! The other three ended up not being good enough to freeze. Rats.

This was veeeery emotional for me and I cried during the transfer, which took three tries, btw. I finally saw the beginning of what all this fuss has been about. I get attached so easily and it's incredibly hard for me to think about this not working. I want to be hopeful and send loving energy to my two little guys, and I do. But at the same time I don't want to get my heart crushed if they don't stick around. The truth is, I will be devastated if they don't attach regardless of how I feel about them now, so I may as well love them and think happy, positive thoughts.

The transfer itself is fairly quick and easy. They had me take a valium when I got there to relax me and make the transfer easier. So we had to wait for that to kick in, which didn't take long. :) You also need to have a full bladder and for some reason all the water I had that morning disappeared. Guess I was dehydrated. But after three more bottles of agua I was good to go. After all the prep the actual procedure only took about ten minutes.

Since the transfer I have been in bed, per my doctor's instructions, and will be for another 24 plus hours. My husband has been very patient and helpful and brings me whatever I need. I never got that little bell but when I want something, I call him on our phone's intercom and he answers, "nurse's station." Hehe.

Staying in bed for a long period of time when you're not actually sick is harder than it looks. I'm restless and my butt and back are starting to hurt. Are my muscles going to atrophy!?!! Will I get bed sores?!?

I'm so dramatic.

Blast

I got a call from the center yesterday, or more specifically from ART (Assisted Reproduction Technology) and 4 out of my 5 embryos are doing well. Two have 10 cells, 1 has 8 and the other has 6. The last little guy only has 3. So we are waiting for the blast* and I am supposed to go in tomorrow, or even Wednesday (which would be day 6!) for the transfer. I think it's a good sign. 

I am hopeful and cautiously optimistic. Or cautious and hopefully optimistic?

I had such a good day yesterday. It was the first time I felt human in a very long while because I'm no longer taking the stims and I have recovered from the egg retrieval. What a great feeling!! I can't say I feel 100% like my old self, but it's the closest I've come since all this started. 

I'm going to take it easy today, eat lots of green vegies and plan for the 48 hour bedrest. Oh boy.

*"A blastocyst is an embryo which has developed to the point of having 2 different cell components and a fluid cavity. Human embryos, in culture in an IVF lab, or developing naturally in the female body, usually reach the blastocyst stage by day 5 after fertilization. Blastocyst transfer with IVF can give high pregnancy success with very low risk of triplets."

From The Advanced Fertility Center of Chicago

Their website is very informative, btw.

Shards of Glass, In Vitro

This is the spring of my discontent

There is somewhere I would rather be

In the room I will call your nursery

Today I bought acrylic paints

canvas stretched on wood

Now an easel sits where a cradle should

I wonder how you're doing

a tiny spot of paint upon the floor

An absence like I've never felt before 

For there are traces of your life, my love

in the hands of strangers

Your light? Your glow? 

I see it now and I ask you just one thing

Bring it to me, bring it home, bring your light to me

I have a cozy place to stay

a warm and tidy room

a center for your light to play

and wiggle in my womb

I miss you but how can that be?

I've never even met you

but when I do, and I know I will

I'll paint this little room

Colors of the sky, colors of my soul

the pink of sadness

greens of hope

and all the shades of gold

There is a pretty orange tree outside 

your nursery window 

We can watch the blossoms bloom

next spring 

If only you will come to me

Just come home to me.

-April, 2009

Progesterone Injections

Every evening, right before bed at the same time every night, I have to have a progesterone injection. This is not fun.

First of all, the needle is pretty frickin' huge. I think it's about three inches long. This would have seemed impossible had I not gotten so much practice with the smaller FSH needles. I miss those little guys! 

This is an intramuscular injection, so it goes in the upper hip area. My poor husband gets so nervous before he does it, which is actually kind of cute. While he's warming up the bottle of PIO (prog. in oil) under his arm (seriously!) I am "icing up" with a bag of Safeway frozen peas on the injection site for a little less than a minute. This injection takes a bit longer because the progesterone is mixed with vegetable oil and it is slower coming out. 

Once again, we have established a routine. After the injection, he dashes to the bathroom to run a washcloth under hot water so I can rub it on the area. You need to rub it to avoid getting knots. I have to switch sides every night because apparently you tend to get sore after a while. Holy crap! Something else to look forward to!

No word on the status of my embies today. I am getting a call tomorrow morning to find out if I do the transfer tomorrow (3 days past retrieval) or wait for the blast. This is so nerve-wracking. 

I am also dealing with weird mood swings, whereby one second I'm sticking my tongue down my husband's throat in Bed, Bath and Beyond during a sudden attack of randyness and the next I'm arguing with him about what toaster we need to get and why the one I want IS SO MUCH BETTER, DAMNIT!!!!!!

My hubby has taken to putting his arms up and running around like he's on a roller coaster at Knott's Crazy Farm. I have to admit, this makes me laugh...most of the time. 

Egg Retrieval

Well, that part is over. I had a successful retrieval of 7 eggs yesterday, although there were more my doctor didn't take out because they weren't mature. Out of those 7, five have fertilized using ICSI, which is when they inject the sperm directly into the egg. We needed to do that because of DH's low count and motility.  My hubby's sperm was not at its best (we had some better counts on a few IUIs) which was disappointing since he's been doing so much to improve it. He has lost 15 pounds, sworn off chocolate and has been taking Fertility Blend for men and a daily vitamin. Oh, well.

I have heard it's quality not quantity that counts, so here's to a few good eggs!

The procedure went well. It's pretty simple but does require sedation. I was less scared about that this time because I had been under for the polyp removal. It's always the time after that's the most difficult because it hurts, darnit! You really need to take it easy the rest of the day because the anesthesia takes 24 hours to wear off. I am still sore today (the day after) and don't have a heck of a lot of energy. I started the progesterone injections yesterday as well as antibiotics, Medrol (to suppress inflammation) and Estradiol, a form of estrogen

I feel very bloated, like I have a fleshy fanny-pack stuck to my stomach. Pretty.

African Fertility Goddess

Follow the Yellow Brick Road

I guess the HCG is doing it's job since I'm going in tomorrow to have my...eggs....taken...out.

I think it just hit me that a part of me and not just a part of me but a part of my potential baby will be removed from me and put elsewhere. Elsewhere being OUTSIDE OF MY BODY. It's kind of like loaning someone your arm or something. And then there will be an embryo, our little  embryo, hanging out in some petri dish in a lab somewhere for a few days. I wonder if I can ask to see it first before they transfer it? Can I take a picture? Would my son/daughter be embarrassed if I brought that photo out with their naked bath pictures to show their dates? 

I don't know about you, but I would kind of like to see a picture of myself as an embryo. But wouldn't that be freaky??

This is all kind of mind-blowing. 

And there are the practical matters to consider. In amongst the consent forms and waivers and promises not to sue the doctor if this one doesn't "take" there are questions like, how will the embryos be disposed of/utilized in the event of my death, my husband's death or both of our deaths. We have one of five choices for that one: donate to research; thaw with no further action; donate to another couple; abandonment to the center; use by living partner. I know what I would do if, God forbid, he died, but wouldn't it be hard for my husband to "use" the embryos should I suddenly croak between tomorrow and next week? Would he want our baby so much he would hire a surrogate? These are not the typical discussions my hubby and I partake in. 

If we do have "extras" we are going to freeze them and pay the 300 plus yearly fee to hold them, just in case we need to do it again. 

And then the all important question of HOW MANY. 2? 3? I'm no Octo-mom wanna-be so, definitely not more than that. Luckily, I don't have to answer this question by tomorrow and can instead see what happens and hopefully the doctor can tell us what is best. But ultimately, it will be our decision.

It's Wednesday afternoon on a partly cloudy day in Southern California and I am seriously pondering the fate of  yet to be created potential being(s), part of whom will be extracted from my body tomorrow. 

Dorothy, you're not in Kansas anymore.

A Pee Cocktail? Nah, just HCG.

Yet another sojourn to the clinic this AM. All my numbers are high so I have officially stopped taking the FSH injectables. Hooray! At 9:45 tonight (yes, I was told to do it exactly at that time) I injected the HCG (Human chorionic gonadotropin) which stimulates the release of the egg during ovulation. It can also cause early puberty in boys. Just a random factoid.

Another random factoid is that HCG is made from the urine of pregnant women. I'm glad I didn't drink it instead. ;)

One more trip to the clinic tomorrow for yet more blood work and then to the surgery center on Thursday for the retrieval. 

I have been very tired and sort of dizzy...low, low energy these past two days, especially. It feels like my head is underwater, or being squished somehow. I just want to escape my body, even for a few minutes. I can't remember what it feels like not to feel like this. Let me out!!

Hopping Down the Bunny Trail

I went into the clinic early Saturday morning. My follicles were at 10-13. Went in again this morning and they are 19, 15, 10, 19 and 17 on the right side, 15 minus 1 on the left. As I learned from doing the IUIs, it's normal to have one side produce more follicles than the other. Thursday is now the projected egg retrieval, possibly Friday. Visits to the clinic are getting much more frequent as the retrieval day grows imminent. 

On a more ironic note, in the Pagan religion the Teutonic goddess of fertility is called Eastra (among many other names) derived from the ancient word for spring, "eastre." If all goes according to schedule, my "eastra eggs" should be sitting in a dish this Easter. The origin of the term "in vitro" is Latin and literally means "in glass." I wonder if they can fertilize my eggs in a basket instead? Hippity Hoppity!

Ho Ho Ho

I had an ultra sound and blood work on Wednesday and everything looks "good" whatever that means. One nurse said something about my follicles "sprouting." Isn't Sprout the name of the Jolly Green Giant's nephew or something? 

Anyway, I'm sprouting!! 

Going in tomorrow again because I miss the clinic and I want to say hi to the nurses. Just kidding. Another round of blah blah blah and we will see where I am and if I am still on schedule. So far, I am averaging about 2  visits a week, although it was more around the time of my surgery.

My stomach looks like a pin cushion without the pins. I am running out of places to poke! Where there isn't a red dot, there is a bruise. It's really quite a lovely sight.

I had more energy today. Maybe I am getting used to the drugs? Or the drugs are getting used to me.

Now

Today is the 5th day of my FSH injections. I am scheduled for the egg retrieval on Tuesday or Wednesday of next week. I have an ultrasound and blood work tomorrow to see where I am. I'm really hoping my body is cooperating and I can stay on schedule. Then, the embryo transfer is 3-5 days after the retrieval. The retrieval process requires sedation but the transfer does not and I'm told it feels like a pap smear. Eww. I have always hated that term. It just sounds so gross. Yes, I am twelve. 

Then, it's 48 hours of bed rest. I am going to have a little bell and I'll ring it every five minutes and ask for random things like crayons, fried oysters and monkey picked oolong tea. My husband is going to love me.

I have pretty much put the rest of my responsibilities on hold as this is sort of a job in and of itself. The time commitment as far as appointments isn't as bad as I thought it would be, maybe because I've gotten used to driving to the clinic so many times since last June. It's just the way the drugs make me feel that make me grateful to have planned ahead and cleared my schedule. Well, for the most part. After all, life does go on.

Last Wednesday and the Drugs

Hey, that sounds like a cool name for a band! Dude, I'm gonna see Last Wednesday and the Drugs at the Roxy on Saturday, wanna come? 

But I digress. Must be the drugs.

I was put on Lupron three weeks ago, after learning that my body was not cooperating with The Pill, as in I was still producing too much estrogen. I joked to the doctor and ultrasound tech that I must be too much woman, which earned me a couple of polite giggles. I tried. So I had my first needle pricking experience back then. 

Yes, it IS scary, but I found that it is not nearly as bad as I thought it would be, even though sticking a needle in your stomach seems so counterintuitive to...well...everything. But somehow, you do get your brain to transmit the message to your hand to PUT A NEEDLE IN YOUR STOMACH even when the rest of you is screaming, "Holy Sh*t!!" The first time is the worst and then you become a pro, so much that some people put it on YouTube. Or they blog about it. Weirdos. ;)

So last Wednesday, I went to the clinic for another ultrasound and more blood work to see if the Lupron was doing it's job. I was crossing my fingers because if it wasn't, it would mean another week or so of more Lupron and waiting.  

I have found that it is so hard to put my life on hold.  I feel like I did it already with the IUI's. But then again, the whole process of trying to get pregnant and not succeeding feels like that, doesn't it? Like I'm always holding my breath, just waiting to exhale. As if going forward with your life means leaving this behind. But we must function in our life, we must continue to work, to carry on relationships, to empty the cat box and walk the dog, to put gas in the car and buy groceries. But I never really feel like I'm truly living in the moment and am instead waiting...for the next pregnancy test, ultrasound, procedure, round of drugs, call from the doctor. You name it and I'm probably waiting for it. This is where some of that well-meaning advice comes in. "If you put all your energy into this, it won't happen. A watched pot never boils!" Or "I just didn't think about it and it happened!" As if they were doing something right and I am doing it all wrong. As if.

It turns out I could start with the IVF drugs, the heavy-hitters (called FSH, or follicle stimulating hormones, meant to supplement a woman's naturally occurring follicle stimulating hormones) on Friday, which was this past Friday. The nurse needed to show me how to give myself the various injectables, and she comes in the room with a very large California Pizza Bag. I thought it was a little strange, but very nice of her to bring me lunch. But it turns out, the bag was full of drugs and drug paraphernalia. 

One thing: I opted to take part in a drug trial so I didn't have to pay for the drugs, which can normally be anywhere from 2000-4000 bucks. Check to see if your clinic has that option. I'm not using experimental drugs or anything! They have already been on the market for a while.

So, I am taking Gonal-f (which comes in a handy pen form. Not environmentally friendly, but very easy to use)  Luveris and Lupron. One injection of Gonal-f in the AM and the other two before I crash at night. And I do mean crash because the Luveris makes me very tired. Like dead tired. Like someone hit me with a baseball bat and tossed me out of a moving car tired. I have not looked online to see what their side effects are this time (you know you've done that!) so I could see for myself what would happen. 

The Lupron  (which I started taking a little while ago) wiped me out for the first few days. I was sluggish and my legs, in particular, felt very weak. But after four days or so, I felt much better. The stims just make me feel weird. Very headachy. My eyeballs hurt. I seem to be more thirsty and I need a lot more sleep. I have very low energy a lot of the time but for some reason I had a burst of energy yesterday. Today, argh! I woke up today at 11am, only to want to go back to sleep. Ibuprofen helps with the headaches and I'm drinking lots of water, juices and tea. 

No caffeine, no alcohol from the start of the stims. After day 5, which I am on now, no exercise (anything that you do to intentionally increase your heart rate) and no sex (sex? What is this "sex" of which you speak?) until the pregnancy test, which seems so very far away right now.

I started out giving myself the injections but soon after, my husband started doing them and I highly recommend it. I think it's important for your partner to share some of the experience. As much as I wish he and I could exchange bodies for a while, that will never happen. So the next best thing is to have him participate in any way he can. We have our routine down pat by now and it's comforting to have him do it with me. It also helps him to have more empathy for what I'm going through and brings us closer during this awkward time.

Which brings me to...

The First Step

The first step at my clinic, at least for me, was to get on The Pill. Yes, that pill. Sort of puts a new spin on the term "birth control" doesn't it? Something about getting your hormones in check and keeping your body in a state of waiting. Oh, one thing; I am not, never wanted to be and never will be a doctor, so please don't take all of what I say as medical truth. I will try to be as accurate as possible when mentioning medical terminology, etc., but I may screw up. I'll try not to but... I'm just sayin'.

After I was on the pill for about a week, my doctor performed what's called a Hysterosonogram (also called a Sonohysterogram) to check out my uterus. It's kind of a super ultrasound to check for abnormalities inside the uterus that may be interfering with pregnancy. It is performed sometime between the end of your period and before ovulation, when the lining of the uterus is thin. It took about ten minutes, was relatively painless and only a little awkward. By this time, I think we're all pretty used to having our legs in stirrups. Giddy-up! Anyway, it turns out I had a polyp or fibrous mass at the top of my uterus. Lo and behold! I was told this could be our answer. Maybe I can skip in vitro altogether! How exciting. 

Not so fast, sista'.

I had two procedures done at the same time. One, called an Operative Hysteroscopy, to remove the polyp (which is what it turned out to be) and another called a Laparoscopy, to check for things like ovarian cysts and Endometriosis. I figured if he was going in anyway, he may as well check for all he can. (BTW, before Hysterosonograms, they would have to perform a Hysteroscopy, which is more invasive, expensive, etc., just to check. Ah, technology!)

It was an out-patient procedure, but it was the first time in a while that I had been "put under" so I was none too thrilled about it. Although I have to say, whatever anesthesia they used was pretty cool. The last thing I remember was getting wheeled into the operating room, waving the peace sign and yelling, "Peace, Love and Babies!" So, that part was fun. The post surgery recovery? Not-so-much. But I got to hang out and watch movies for two days and eat crap, so I guess it wasn't too terrible.

*I highly recommend getting a Hysterosonogram done before you start any fertilty procedures, especially in vitro.* I wonder why we weren't told to get it before our IUI's? I will ask my doctor.

It turns out the polyp only had a 10-15% chance of being the cause of our infertility so yes, Virginia, there is In Vitro. The good news? It wasn't cancerous. Big, fat, shining silver lining!

A Little Bit of Background in a Nutshell

My hubby and I started TTC soon after we got married. He was 39 and I was 36, so no time like the present! We did the natural thing (remember that?) for about a year. I started tracking my ovulation six months into it and we got very good at the whole timing thing. He even came home from work a couple of times to stick it to me. The romance of the whole thing kind of goes out the window at some point, doesn't it? So, it was about a year after we started trying that we decided to seek help. 

My gynecologist recommended a fertility clinic in Beverly Hills (not the Octo-mom's doctor, and yes I have been asked that) and off we went, after filling out the novel-sized packet of forms. It turns out I was at the exact point in my cycle where we could start the IUI process. I wasn't thinking it would happen so soon, but again, no time like the present, so...wham! I had my first ultrasound. The Hubster and I had already had all of the required tests done with our respective doctors so it just kind of worked out. 

Because this is less a fertilty blog and more about in vitro, I will spare you most of the details. But suffice it to say after an HSG (Hysterosalpingogram) to check my tubes (they were fine), we did SIX cycles of IUI, ten inseminations in all. That's a lot of trips to the clinic and a lot of emotional upset each month. We started in June, 2008, skipped two months and did our last IUI this past January. My favorite month was December, when I got my period early...on Christmas morning. Bah-humbug. I didn't need a Grinch to steal my Christmas.

I took Clomid for the first two cycles and all it did was make me "moody" (which is a nice way of saying The Girl from The Exorcist) and fat. Yes, I gained something like 10-15 pounds which I have been unable to lose. Happy happy joy joy.

So, we began the in vitro process...

The Beginning

I bought a real journal the other day.  You know, that thing with actual pages and stuff? That you use a pen or pencil to write in? Yeah, one of those.  This is a fancy-dancy one with moleskin (not real moles, silly!) pages, called the "legendary notebook of Hemingway, Picasso and Chatwin." I'm sure I should know who Chatwin is, but I don't. Anyway, here it still sits, snug in it's plastic wrap, mocking me daily with its still empty pages and uncracked spine. Oh, hell. 

And then I thought I would do something that has never been done before. I'd write a blog! Here I can not only get out what I need to (so it doesn't start building up inside like a hair filled drain) but I can also someday say to some woman at a BBQ or in line at the grocery store, or wherever, "You're about to do in vitro? Hey, I did that! Why don't you check out my blog so you can see what it was like for me!" And then (fingers crossed) I'll pat the top of my son/daughter's head and say, "And it worked, to boot!" I don't think I'd actually say "to boot," but you get the picture. Or, even better, some one out there in cyberspace will be about to start her first (and hopefully last) in vitro process and she, like me, will not know anyone personally who has done it before and she, like me, will have lots and lots of well-meaning but Baby-fied, Fertile Myrtle friends who could never really understand what she is going through. And she, like me, will most likely be, well, terrified/excited/terrified/freaked-out/giddy/terrified. 

And, let's face it, it's just easier to type. I can balance my laptop on my legs in bed and not disturb a sleeping cat or two. So, dear moleskin, you will have to wait. Hemingway never had it so good.

So here it is. The good, the bad, the ugly and all that's in between on my journey through In Vitro...