The First (and Second) Good-Bye

Well, after my 2nd beta came back at 30 , I retested a few days later as I was told.  Looking back, I know see that during those 2 days, I was in denial about the pregnancy not continuing.  Maybe it was just a fluke & will have quadrupled when I get it drawn again I thought. I spent endless hours googling, trying to find a story of hope for our situation.  I couldn’t find any.

The 3rd beta came back at 34.  Test again in 2 days.  4th beta still in the 30’s, along with the 5th and 6th.  We began to accept that it was over. I was more angry than anything. Anyone who knows me also knows I don’t like to fail at things.  Whether or not it was in my control, I didn’t care.  We experienced a lot of different feelings.  We felt dumb for believing it would work the 1st time.  My hubs especially.  He kept blaming the doctors. I didn’t want to hear people try and reason with me on why, I just wanted to be left alone.

slap-e-card

By now, I should have been in my 6th week of pregnancy, when beta levels are in the thousands.  Still no bleeding.  Nothing.  Just torture with serial betas. Then, when I had my 7th beta drawn, it had increased to 60.  My doctor did not like this at all.  We already knew the pregnancy was not viable, but something was still growing. It was now the month of May. Remember, we started this cycle in February, retrieved in March, and transferred in April.

At this point, I just wanted it all to be over with.  My in-laws had arranged a trip to Florida for the 1st week of May before we began our first cycle.  They planned to come stay with us a few days.  Of course, we were so excited because we knew we would be sharing our news that we were finally pregnant with them.  But instead, I was miscarrying the weekend they visited.  It sucked.

Even though I was now bleeding, my beta would not drop.  My doctor informed me that I needed to have a d & c. Originally, none of us ever thought this would occur with such low betas to begin with.  Initially, I did not want the d & c, but I started to feel really uncomfortable, my uterus was actually heavy at this point.

So, I had the d & c, and my beta that morning was 120.  The highest it had ever been, which in the world of betas is actually extremely low.  It appeared that the placenta was still growing even though the pregnancy was lost.  The placenta was sent out to be genetically tested, but since it was so early on the results came back inconclusive.

About a month after we lost our 1st pregnancy, we lost our beloved dog, Nacho, that June.  He was almost 17.  I was completely devastated, along with my husband.  Nacho was our baby and a best friend.  We had no other children, he was it.  We got him when we moved to Florida back in 2003.  I didn’t know how I was going to get through it.  We shed way more tears the day he went to heaven than the day we lost the pregnancy.

nacho
A beautiful gift from my friend, Jenna

Nacho’s passing made us realize that there is always something worse that can happen to you.  When you are in it, you can’t see it that way, but it’s the truth.  When we miscarried after going through months of IVF, and years of other treatments, we thought it was the end of the world.  This wasn’t the case at all.  Nacho showed us we still had our families, friends, home, our other dog, Rocket, our careers, etc.  You can’t take anything for granted because it could always be worse.  Always. 

We spent some time over the summer honoring our 1st child and 1st dog we lost together.  My hubs made a small box, spray painted the words, “Baby Fish, We love you” on the top in pink (he thought it would have been a girl), we put a few items in it, and buried it in our back yard.  We planted flowers that our dear friends had sent us when we lost the baby.  Soon after, we planted a Palm tree in honor of Nacho in our backyard and sprinkled his ashes all around it.

nachostree
Rocket at Nacho’s tree

Just today, almost 9 months later, the first new branch has sprouted.  I know it’s our little boy telling us not to give up hope just yet.

hope2

The Beginning of the End for IVF #1

#beta
This image pretty much sums it up.

We were pregnant! So, what is the next step in the IVF world? 

A beta.  Oh, God how I despise that word.  Anyone who has conceived through a form of assisted reproduction most likely does too.

What is a beta?  A beta is the blood test you get to confirm your pregnancy.  Now, most women who get pregnant naturally don’t ever worry about a beta after it is positive, let alone the “quantitative status” of one.  They just get the confirmation from the blood test, “Yep! You are pregnant!”

Women who undergo IVF have the pleasure (HA!) of undergoing serial (yes, like a serial killer) beta tests if they receive a positive on their first beta. The beta doesn’t just give a positive to the fertility doctor, it gives the exact amount of HCG, the pregnancy hormone, in the woman’s system.  This amount needs to (basically) double every 48 hours in early pregnancy in order for the pregnancy to be considered a viable one.

As you can see, the couple who has just dealt with months or years of trying to conceive, who finally does conceive, STILL has yet another worry even after a positive test. No, they cannot just enjoy the fact that they are finally pregnant.

I must say that I think not dealing with serial betas is something many pregnant couples take for granted.  I don’t think their actions are intentional at all, I think it’s simply because they don’t know any better.  Lucky them.

So, back to our story.  After knowing I “felt” pregnant at dinner 6 days post transfer, I still waited a few days to test at home. BFP!!! In the fertility world, this is short for Big Fat POSITIVE!!!  Might I add, it was a faint positive.  Oh, the feelings we experienced. We had taken so many tests and waited outside that bathroom door.  We had looked so many times over the years to only see negatives.  I honestly began to think we would never see a positive together.  But this day was different.  Today we were pregnant!  We smiled and laughed and acted crazy.  We didn’t cry like a lot of infertiles say they do.

BFP

An hour later, we had already went out and bought a digital test since the lined test was faint.  We wanted to be absolutely sure.  POSITIVE again!!! I couldn’t help but send a picture of the positive tests to my mom.  She called crying tears of joy. My aunt, cousin, and brother were all there, screaming & shouting.  We were on speakerphone & it was hard to even hear what everyone was saying.  All I knew is we were all so happy in that moment.  I will always remember it.

The happiness continued.  I had my first “beta” done at the doctor’s office and confirmed the pregnancy on the spot (she would call with the beta later that day).  Our due date was set for December 24, 2014.  Yep, Christmas Eve!!  Anyone who knows me, knows that Christmas is my absolute favorite time of the year so this couldn’t have seemed more right.

betaWhen the nurse called with the 1st beta number that afternoon it was 60. “Hmmm…is 60 a low beta?” I questioned (we had IVF friends who had betas & their numbers seemed much higher, even on the first beta).  “No, as long as it doubles next time, no worries!” was her response. I took another lined pregnancy test to be sure, still positive, but faint.  At the time, I didn’t think much of it. I was only a little over 4 weeks along-hell, most people don’t even know they are pregnant yet.

My 2nd beta was set for 3 days later because it happened to be a Friday when I got the first one done.  So, we enjoyed Easter Sunday on the beach with our family-my hubs & I, my immediate family, my aunt, uncle, cousins, their husbands, and kids.  We took pictures, received cards, books, and a few baby presents congratulating us on our journey and our future baby.

Gifts from our family

Monday morning I got up at 5:30 am in order to get my beta drawn before I had to be at work at 8:30.  They said they would call me later that afternoon with the number.  I got a few hugs from the staff and again, everyone was thrilled.  The doctor called this time instead of the nurse, thankfully right after all of my students left for the day.  Then she said, “Can you talk? Are you sitting down?” My heart sank.  My beta had dropped to 30.

She informed me that the pregnancy would not continue, to stop taking all of my medications, and to have my beta checked again in a few days to make sure it was headed back to 0. 0, that’s what I felt like…a BIG FAT 0.

I walked out of my classroom to my car like a zombie.  I couldn’t speak.  And this was only the beginning.

So incredibly true.
So true.

IVF #1-Stim, Retrieval, Transfer, & the 2WW (all you ever needed, or wanted to know)

As promised, this post details our first IVF from the “stim” start to the pregnancy test.

Our goal is to share our experiences to those who are thinking of doing IVF, getting ready to do IVF, or have a friend or family member going through IVF.

Although every individual’s journey is different, we hope that this can provide you with some general insight on what to expect.  When we began IVF, we had a lot of these questions ourselves.

ivf

How often I went to the doctor for monitoring

Since we knew I would be going to the fertility practice a lot once our “stim” began (before egg retrieval, when you are pumping up your body to produce a zillion follicles that will hopefully produce nice, mature eggs), we arranged to start it over my Spring Break (teacher perk) so I didn’t miss work.  And if I felt lousy, I could relax at home.

Our stim was 10 days total.  Here are the days I went in for blood & an ultrasound, with my estradiol (fancy for estrogen) levels and follicle amounts (future eggs):

  • Stim Day 1-estradiol level 18
  • Stim Day 4-estradiol level 211; 16 follicles
  • Stim Day 6-estradiol level 744: 18 follicles
  • Stim Day 8-estradiol level 1556: 20 follicles
  • Stim Day 10 (trigger day!)-estradiol level 2619; 22 follicles

NOTE: It is important monitor the estrogen levels frequently because if they get too high, you can hyper-stimulate.  My doctor never wanted to see these levels rise much above the 3000 mark before retrieval to prevent hyperstim.  Many doctors will cancel the cycle before the trigger shot/retrieval if the levels are too high (we knew someone personally this happened to).

The doctor told us that our stim was textbook perfect! We were soooo happy since this was one of our worries. My body was reacting fine to the meds and we were moving on to the retrieval on day 12.

IVFbloodwork

The medications I was prescribed during “stim”

  • Follistim– 150 units once daily into stomach, rotating sides.  Easy injection, must be refrigerated.  Tip: Take it out of the fridge about 15 minutes before so the liquid isn’t so cold when injecting! Be sure to do this injection at the same time each day.
  • Menopur-75 units once daily into stomach, rotating sides.  This one stings a little & is a pain in the you know what because it doesn’t come ready.  You have to mix it! Unreal for the amount of money you are paying right?! I think a nurse should come with the meds for the cost. LOL.  We messed up the mixing once and I cried (those tears we talked about in prior post).  Thankfully, if you mess up, there will be (a little) extra of the meds, so don’t worry too much.
  • Pregnyl “Trigger” shot-this injection is done only 1 time which is 36 hours before the egg retrieval.  For me, it was on day 10 of my stim.  It is different for every woman based on how follicles are maturing when the ultrasounds are done.  I won’t lie, this shot royally sucks.  It is an intramuscular injection, unlike the Follistim  & Menopur which are subcutaneous injections (right beneath the skin).  They tell you to have your husband do this injection because it needs to be in the a*** in a specific spot. Initially, I thought I would have him do my injections for me.  When it came down to it, I would grab the needle from him.  Don’t ask me why, but I was more scared to have him do it than do it myself.  So, needless to say, I injected the Pregnyl & it hurt!
  • Prenatal vitamin/Folic acid/Baby aspirin 1x per day
  • Doxycycline- antibiotic to start the night before the egg retrieval and 2 days following

The medications I was prescribed after the retrieval until the day of the pregnancy test (if pregnant, continue Estrace, Crinone, Prenatals, Folic Acid, & Baby Aspirin until out of 1st trimester!)

  • Medrol-oral 4x per day, for 4 days after retrieval
  • Estrace-oral or vaginal pill 2x per day, this is estrogen
  • Crinone-vaginal suppository 2x per day (Yucky!), this is progesterone
  • Prenatal vitamin/Folic acid/Baby aspirin 1x per day

ivffollistiminjection

The Retrieval 

It was finally the end of March (remember we started birth control in February).  We couldn’t believe we made it to this day! This is a big step for an infertile. With IVF, you have to remember that anything can go wrong at any given time. So we were elated nothing had gone wrong…yet.

I remember feeling so ready to get those eggs out of me by the time the morning of the retrieval rolled around. I literally felt like a goose ready to lay a bunch of eggs LOL.  Totally bloated. Surprisingly, I wasn’t that nervous, just a little thirsty since I hadn’t eaten or drank since the night before.

When we arrived, my husband was taken to the “man room” to do the most important count ever.  I could tell he was pretty nervous.  Maybe that is why I wasn’t.  I knew if I was, it would make it worse for him, especially since he is usually so calm.  Turns out, all went well with Shane’s count; it was the highest it had ever been. Still low, but definitely an improvement.

He couldn’t be in the room during the retrieval, just the doctor, RN, & anesthesiologist. Once I was prepped and in the surgery room, the doctor showed me a tiny window pass through where the embryologist (and the sperm) wait for the eggs to be handed off to her immediately after they are retrieved. We elected to do ICSI along with IVF (where the embryologist chooses the bests sperm and injects them into the eggs).

I chose to be under general anesthesia for my egg retrieval rather than localized, or twilight anesthesia.  General anesthesia costs more, but it was worth it to me. When speaking with fellow IVF’ers, many told me the retrieval was the worst part of the process. Maybe.  When I woke up from the retrieval, we were informed that everything went perfect again! Another BIG step. We had heard horror stories of no eggs being retrieved and were scared to death it might happen to us.  We had 19 eggs retrieved.  Woohoo!!  The doctor seemed really happy & told us we would hear from the embryologist the following day.

#ICSI

The Days Following the Retrieval

Now we were biting our nails on whether or not any of these eggs and sperm would actually form embryos.  Remember, I told you it’s 1 worry at a time while you are breathing, sleeping, and eating IVF.

The embryologist called us the next day and told us that overnight:

  • 18 eggs were inseminated via ICSI
  • Of the 19, 13 fertilized normally with Shane’s sperm, forming embryos

More fantastic news! The embryologist would continue to be in touch with us over the next few days so we knew when we would be transferring.  In IVF, supposedly the longer the embryo grows, the better.  Why? It is like survival of the fittest.  The best embryos make it and the others usually don’t.

This made me laugh!!
This made me laugh!!

Day 3 after the retrieval we learned that:

  • 5 of the 13 embryos were no longer viable
  • 8 of these embryos were still viable and growing 🙂

Again, we were very pleased with the news.  However, the next few days I began to be a nervous wreck.  What if all of the remaining embryos die off like the 5 others did???  I was reassured it wouldn’t happen.  No one can assure you of anything during IVF.

Day 5 following the transfer we were informed that:

  • Our 8 embryos were still viable!  Thank God.
  • The embryos were graded as follows:
    • 3 embryos were 6AA (best grade you can get…hooray!!!)
    • 2 embryos were 6AB (second best)
    • 3 embryos were 6BC (not the best)
  • TRANSFER DAY WAS SET FOR TOMORROW!!
We made it to day 6!!
We made it to day 6!!

The Transfer

We welcomed the month of April 2014.  This is was the day/month we had been waiting for for years! Our transfer was 6 days post retrieval, the latest a transfer can be done before the embryos must be frozen. Many people have transfers as early as 2 or 3 days after their retrieval, depending on how well the embryos are doing.  Since this was our first IVF, and our embryos were graded great, we decided to transfer only one 6AA embryo.

The actual transfer itself is a piece of cake compared to the rest of what has been going on (it only takes about 5 minutes).  You get there about 30 minutes prior and they prep you.  You need to have a full bladder for the transfer so the uterine cavity is able to be clearly seen on ultrasound. This was hard for me because I have a really small bladder to begin with!  If you are in the same boat as me, you can ask them to fill your bladder for you (I learned this on IVF #2) right before they transfer the embryo.  This way you don’t even worry about drinking & miserably holding it.  After the transfer, they will drain it for you while you rest.  Ahhhhh.

Good news-this time hubbie gets to be in the room with you, and you are awake!! He sat by me & held my hand the whole time.  We were in the same room as for our retrieval so the embryologist can access the room with the embryo when the doctor is ready.  The embryologist actually comes in with a picture of the embryo before the transfer and discusses it with you. Again, all was going very well.  I was starting to think maybe this wasn’t too bad after all!

Then the RN begins by doing an abdominal ultrasound to make sure the bladder is full & the uterine cavity is clear.  If this looks good, the doctor cleans out the cervix since you have been sticking that gooey Crinone (progesterone) up there for a week now! Ughh. My doctor always plays music during transfers. Hey, whatever floats your boat I guess.  The lights are dimmed so it is actually more of a relaxing atmosphere than you would think.

AbdominalUltrasound

She then inserts a catheter (painless) into the uterus, and what’s nice is that you are seeing all of this take place on the ultrasound screen right next to you.  After the doctor makes sure the catheter is in the right place, she calls for the embryologist to bring the embryo in.  It feels like an eternity for this to happen.  Literally.  The embryologist brings the embryo in a catheter that fits into the doctors catheter.  You are praying that they both have very steady hands.  You start thinking what if they drop the catheter? What if they insert it in the wrong place?  Dear God.

The doctor releases the embryo and you actually see what appears to be a little white dot on the screen in your uterus! Super cool.  It could be your future baby!  After the embryo is in the uterus, you rest there for about 30 minutes. I make my hubs tell me jokes so I can laugh.  It’s good for the soul right?

Before we left, the doctor explained that everything went perfectly with the transfer.  Another step in the process accomplished.  We set the date of the blood test to see if we were pregnant for exactly 10 days later.  Yes, this my friends is what is called the excruciating 2 WEEK WAIT (even though it’s not really 2 weeks, it feels like 4, so it’s earned its name for sure).

#IVF, transfer

The 2WW

The next 48 hours are strict bed rest (missing more work for sure).  A lot of doctors aren’t big on bed rest, but mine happens to be.  If yours is too, make sure you have some movies, books, and good food of course.  We watched Frozen and I started reading Wild.  My hubs made sure I was off my feet and pampered me.  It was nice.

transfer

Then the new phase of worrying began.  I can’t lie, the next 8 days were difficult mentally.  Anyone who has been through IUI or IVF knows this. We both went back to work and tried to keep our mind off it.  Thankfully, I had state testing going on at school so that kept me somewhat focused.  But the thought of what if it didn’t work kept creeping into my mind.  It’s pretty consuming.

Day 6 post transfer we decided to go out to dinner with our family.  It was a Friday night, and my aunt & uncle were in town.  I remember sitting across the table from my mom and I could smell her wine.  A little later, my hubs came back from the bathroom and I could smell the soap on his hands.  I felt off.  That’s when I knew it had actually worked.  I was pregnant; for now.

#pregnancytest

 

The Journey of a Thousand Miles Begins with a Single Step…or Shot

We decided to pour our hearts and souls (and pocketbooks) into a process that has no guarantees. That’s right, no guarantees.  As you may have guessed, we decided to do it;  IVF that is.  We redid every test under the sun before we began just like we were told, with a few new ones added in for good measure.

I remember the excitement before the start of the first cycle.  Excitement because we thought for sure it would work.  Excitement because we would finally have a family after 6 years of trying for one.  Excitement because finally, we were here and it was our time.  I also remember the fear.  Overwhelming fear.  Fear that I would get terribly sick and hyper-stimulate from all of the drugs.  Fear that we wouldn’t administer the drugs properly.  Fear that our cycle would get cancelled because my body didn’t react right.  Fear I wouldn’t have any eggs retrieved.  Fear my husband wouldn’t be able to produce a sperm sample the day of the egg retrieval.  Fear that I would fail to get pregnant.  Fear of losing our money. Fear that it could tear us apart if it didn’t work.  The thoughts were endless.

Ironically, I never feared that I would miscarry.  I think at the time, you only focus on whether or not you will get pregnant (if you have never miscarried before). You can’t see that far out, especially on your first IVF.  One worry at a time.

us

Getting Started, “Pre-IVF”

We met with the surgical coordinator, and she gave us a calendar of the dates for our cycle, with the details of what medications to take each day.  The calendar dated from February 9th, 2014 to April 19th, 2014.  That’s a long time.  That’s a lot of blood, sweat, and tears! And drugs.

Next, we met with the financial coordinator and chose our package.  Sounds like a vacation but it’s not.  We decided we would only pay for 1 fresh cycle.  We couldn’t imagine paying for more.  Plus, we thought it would work the first time, even though the statistics say that most couples need at least 3 IVF’s to achieve a live birth. Key word, live. 

Once we chalked up the cash, we got our meds shipped to us.  That was a scary day.  It was now so real. The surgical coordinator gave us an injection training and made sure all the correct meds were there (another day we had to miss or go into work late; there are lots of these days with IVF).  I was so confused at the injection training…thank God for my husband who is always so calm.  What would I do without him?  She also gave us our own “special” voice mail box that we would call after 5pm on the days we had blood work and ultrasounds done to get our results.  The voice mail was very important because it told you the dosages to inject each night based on the blood work and ultrasounds from that morning.

#IVFmeds
All of my meds for IVF #1

And then it began. I was on birth control for a month to suppress my ovaries, and when I got my period in February, I had the infamous day 3 ultrasound done to make sure I had no cysts (a must before starting an IVF cycle), which I didn’t, so we were good to go. I started following the calendar like a science and taking the medications, or “stimming” as they call it in the world of IVF.  I triple checked everything.  We watched You Tube Videos numerous times before we would do an injection to make sure we were doing it correctly.

calendar

Note: I would recommend keeping a journal if you do IVF because sometimes you simply forget things (the drugs can make you forgetful at times!).  I kept a journal and wrote in it everyday.  I wrote about what I ate, what injections I did and their times/amounts, along with any oral pills and their times/amounts, what my estradiol levels were, the size and amount of follicles, what type of exercise I did, my mood, if I had acupuncture done that day (I bought a package and did this once a week for a month leading up to the transfer date).

baby_dust_fairy_journal

As you can see, there is sooo much involved in the IVF process. We have decided to put further information into our following post titled, “IVF #1-Stim, Retrieval, Transfer, & 2WW (all you ever needed, or wanted to know)”