Frustrating Update

I know I’ve haven’t done much with the blog lately, but there hasn’t been too much to share. We went in for the IUI procedure about two weeks ago on Sun. 10/27. This procedure usually has about a 10% chance of resulting in pregnancy, but from a canceled IVF the chances go down to a 5% chance.

That being said, today I learned I’m not pregnant. Carl and I have an appointment with the doctor at the end of the month to discuss next steps. We’ll need to learn if there is anything that can be done to help us get further along in the IVF process before we decide if we want to try it again.

I have to be honest that I’m pretty disappointed that we didn’t get further in the IVF process. It’s been a bummer to pump myself up with all the drugs with so little success. Even worse is after we downgraded to IUI, Carl still has to give me a huge shot every night, just in case. It can all be a little frustrating, but not the end of the world.

I’ll keep you posted after our appointment in late November. Thank you for all of your support in this process!

Appointment Fri. 10/24

This week I have been giving myself three shots a day and have gone to the Doctor’s office both Monday and Wednesday to take blood samples and today, for blood and a sonogram.

From the blood test, my hormone levels have been right on target, however, the sonogram today did not have the results we were hoping for. With the medications I’m on, we want to find several follicles all growing at the same rate. Today we found one follicle larger than the others on my left ovary. This is called a dominant follicle, which potentially attracts all the meds from the other follicles preventing their opportunity to also produce eggs.

Because of the dominant follicle and the probability of fewer eggs, Dr. Chantilis has called off the in vitro (IVF) procedure. Instead we will try another round of intrauterine insemination (IUI).

This is disappointing, but IUI is still an opportunity to get pregnant.

If we are not pregnant from this cycle, Carl and I will have to meet with the doctor again, evaluate our options, and determine if we are willing to try IVF again or not.

Pop-culture Pressure

A few weeks ago I’m waiting for an appointment and I come across a Self magazine. On the cover is Jennifer Lopez, who I love, so I flip inside to an article on how she’s “doing it right.” The article explains that while she’s working on a new album, production, and promoting her new perfume line, Jennifer Lopez and her husband, Marc Anthony have decided to raise their twins without the help of nannies. She only has her mother or sister help out. Additionally, she’s now training for a triathlon.

So many things about this article frustrated me. Not the least of which that Jennifer Lopez is 38 and just had twins. It seems like a slim possibility she had children without the help of a fertility specialist at her age, and the fact she had twins making it seem even more likely she had a little help. She has a right to her privacy, but an article on her struggles to have children and then finally being blessed with twins would have been immeasurably helpful to me instead of a litany of all of her accomplishments, including losing all of her pregnancy weight by training for a triathlon all without help raising the babies beyond her immediate family. It’s so easy to feel like a failure before I even get started with these unrealistic mothers splashed on the covers of magazines.

Concerns Related To Work

Even before we made the decision to try to have a baby, I’ve been worried about how we’ll manage and particularly with our work schedules. Now with the fertility treatments, it has definitely complicated work.

I’m working so hard to be respected and eventually promoted to principal at work, I don’t want anyone to know we’re trying to have a baby. I’m afraid I’ll be judged if I get pregnant, that the leadership will think I can’t carry my fair share of the work load and ultimately take me out of the consideration set for promotion. There’s nothing I can do about it and worrying really doesn’t help anything, but how I will be perceived at the office is a nagging concern.

That’s if I even get pregnant. Starting October 20th with nearly daily doctor visits I can’t travel as easily and when it come time for IVF, I’ll have two potential days I’ll have to be out of the office all day; for both egg retrieval and embryo transfer. These will fall right at the end of October and I’ll have clients in town for a big M. D. Anderson creative presentation on Wed. 10/29. This treatment takes the priority and if I have to be out of the office on the day of the meeting then that’s the way it goes. However, this client comes to the agency only twice a year and I’m still proving myself to them so I’d like to be in the meeting. It’s not the end of the world and in the big scheme of life the meeting is meaningless, but it’s also a little nagging concern.

Ultimately we all have to make sacrifices to get what we want, I’m just hoping I can find a good balance between work and family without losing any of the ground I’ve worked so hard to gain professionally. What’s funny is how much of a worry it all is without even having a baby yet.

Appointment Thurs. 10/16

Today I went to the doctor’s office for a baseline sonogram and labs.

Sonogram
When I did the IUI cycles, I was on hormones that would stimulate ovulation. After the egg would release, the follicle it came from would sometimes cause a cyst. This is normal, but when you have a cyst we wait until the next cycle so the hormones are not wasted on the cyst instead of an active follicle. For this baseline sonogram we checked to make sure I had no cysts, which I didn’t so we’re good to move to the next round

Labs
For this part of the visit a nurse draws blood to check my hormone levels to confirm they’re within normal parameters. My blood test checked out fine.

Next Steps
Since everything checked out, this Saturday I’ll start stimulation meds. This means I’ll be giving myself shots daily in the morning and evening of three different hormones:
• Menopur in the stomach in the morning
• Follistim in the stomach in the evening (same thing I did for IUI prep)
• Lupron in the thigh in the evening (been doing this for two weeks already)

Next week I’ll go to the doctor’s office for labs the mornings of Monday, Wednesday and Friday. They’ll track my progress and if all goes well sometime the week of 10/27 I’ll give my self a shot of Ovidrel to trigger ovulation and we’ll schedule egg retrieval.

Why We Sought Fertility Treatment

This was a harder decision to make than we thought. We think we’re pretty lucky in general. We’re very happy in our marriage and have a comfortable lifestyle; we recognized having a baby complicates life. Everyone says having a baby is the biggest joy of your life and that you just can’t understand until you experience it, but we’ve noticed it’s not easy even if it is rewarding.

Overall, I’m a little selfish because I wanted a baby that was a product of Carl and I both, so adoption wasn’t in the consideration set. This IVF treatment is the last round for us. If it doesn’t work we’re not going to push anymore. We’re excited and nervous about IVF, but we’re both comfortable if it doesn’t work out. We’ll continue to travel and perhaps even get another friend for Max and Leo.

IVF Explained

In vitro fertilization is a little more complicated than IUI. I have to take more medicines to control ovulation and generate as many eggs as I can. Eggs are then surgically removed, fertilized and then embryos are transferred back into my uterus. Below is a breakdown of the steps:
1. Ovulation Induction
• Taking medications to produce several eggs in one cycle
• Go in for frequent ultrasounds to monitor how my follicles are growing to determine when they are mature enough for egg retrieval

2. Egg Retrieval (possibly late Oct. sometime between 10/28 to 11/1)
• Doctor surgically removes the eggs
• A vaginal ultrasound is used to locate the follicles and guide the needle for egg collection
• A needle is inserted through the wall of the vagina, into the ovary and follicles to retrieve the eggs

3. Fertilization and Embryo Culture
• Embryologist mixes eggs and sperm
• ICSI-Intracytoplasmic Sperm Injection, one sperm selected and injected directly into one egg
• If fertilization occurs, eggs will be incubated and monitored for 2-5 days

4. Embryo Transfer (possibly one day between 10/31 to 11/6)
• The embryos are transferred to the uterus
• We’ll discuss with the doctor how many embryos to transfer
• Transfer is similar to IUI, using a catheter to insert into the uterine cavity

5. Embryo Implantation
• Approximately 2 weeks after the transfer a pregnancy test is taken to determine if the embryo has implanted in the endometrial lining of the uterus

This is what we’re working towards, but we have to have success with each step and even then the possibility of pregnancy based on our circumstances is only 40%

Travel

Late last week I had a business trip to NY and Carl planned to join me on Friday night for dinner and some sightseeing the next day. When I planned the trip, I didn’t know we’d be committed to IVF, but I’d already started giving myself shots of Luprin on Wednesday evening before having to travel on Thursday. I got all nervous about having to travel with the vial of medicine and the needles for injections. My initial plan was to check the medicine and needles in my bag so I could avoid sending it through security in a little zip lock bag, but then I worried if my bag was delayed or lost I’d be without it and mess up the cycle.

So I ended up sending the vial through security in a zip lock with shampoo and lotion, and just leaving a needle in my purse. Carl said I should take my prescription, but the nurse called it in for me so I didn’t have anything. As it turned out I didn’t get stopped and everything worked out fine but I’m hoping I don’t end up traveling when I get to the days I have to give myself three shots.

Situation

Carl and I decided to start trying to have a baby in July 2006. After a year of trying I went to my OB/GYN to run a few tests where we learned the following:
• Estradail level at 27, should be 30-100
• FSH at 11.4, should be less than 10
• HSG - normal

Because of my age, 37, and the test results, she recommended we go see fertility specialist Dr. Chantilis.
http://www.dfwivf.com/infertility-specialist-chantilis.html

We got an appointment with Dr. Chantilis in February 2008, who ran a few more tests on Carl and I both before recommending a path.

IUI
We started with IUI, intrauterine insemination. In this procedure I start by taking a pill called Clomid, then at a certain point in my cycle I give myself shots of Follistim in my lower abdomen to help stimulate ovulation. After about 5 days I visit the doctor for a sonogram to determine if I have a good follicle to release an egg. If so, a shot of Ovidrel is required to trigger the egg release. Two days after the trigger shot, Carl provides a sperm sample and the doctor injects it directly into my uterus right next to the new egg. There is a 15% chance of pregnancy with each IUI cycle.

IVF
After trying IUI cycles three different months, March, June, and August, we made another apportionment with Dr. Chantilis to discuss next steps. On Monday 9/29, the doctor recommended we try IVF, in vitro fertilization.

http://www.dfwivf.com/ivf-in-vitro-fertilization.html

Carl and I went back to the doctor’s office the next day for our IVF briefing and I began the first in a series of shots on Wed. 10/1. Everything is moving pretty quickly, a lot more steps are involved in IVF, but there is a 40% chance this procedure will result in pregnancy.

Purpose

As Carl and I have been seeking fertility treatment to try to have a baby, a friend suggested I start a blog. She was joking, but the more I thought about it I decided it was a good idea for two reasons.

First of all, I’d like to share our progress with a small group of family and friends. Some of the steps are complicated and emotional and this will allow me to keep those closest to us informed of the details as they unfold.

The second reason is purely selfish. The blog will be a journal for me to remember this time and the act of simply recording what I’m going through is cathartic.

I hope this record is helpful both to me and you, my dearest family and friends.