Immune Protocol:

I received my immune protocol from Dr. B. Yay!  It's a LOT.  It's extremely detailed but I'm thrilled to try something new! All pending my local RE's cooperation and if the embryo thaws properly, I'll be doing a "natural" FET alongside 1000 other meds (only slight exaggeration).  The only reason it's natural is that for the first time ever, I won't be doing BCP's OR Lupron injections.  That means less cycle manipulation but less control for my RE.  I really hope she agrees to all of it as the only plan B we have is to ship the embryos to someone that will comply with Dr. B's protocol.

The meds include: Baby aspirin, Letrozole (only for a couple days), Lovenox, Progesterone in oil, trigger shot, Prednisone, timed IV intralipid infusions, and benadryl. (plus a massive amount of supplements)

CD 2: Baseline u/s and bloodwork

I had my baseline this morning.  My uterine lining is still pretty thick (almost 9mm) but that was expected as it was over 15mm for my IVF cycle.

Here's the sticky part. I knew I'd run into issues with relaying information from Dr. B to my local NP.  I brought in the email from Dr. B's nurse with all the details of the protocol in writing for me.  Dr. B's nurse even faxed the protocol over a week ago to the Birmingham office so my RE would see it. My NP agreed to try and help me the best she could...and of course, I got the call I was dreading.

I don't have the words to describe how I'm feeling towards my RE right now.  She's said some pretty awful things to me in the past, which might be partly why I was already on the defensive when she called. I almost lost my mind with her on the phone just now.  I don't think I've ever been so angry at a doctor before.  She is completely unwilling to step outside the box for me.  She said that I sprung all of this on her (???!?!?WHAT?!?) and that she is not prepared to figure this all out.  I'm not sure what there is to figure out? Dr. B wrote out exactly what needs to happen and when it needs to happen.  She is refusing to write the RX for the IV intralipids as she "doesn't believe in it."  I asked if it will hurt anything and she said NO.  Then why can't I try it? She said she won't stop me from doing the infusion but she won't write the RX for it. UMMM, ok.  I explained that I've done 4 fresh transfers and 4 frozen and that I will not continue to do the same things over and over and get no baby.  She started getting testy with me but by the end of our conversation, she at least agreed to talk to a cancer center to see if another doctor there will write the RX so I can have the infusion there (as the RE clinic isn't set up for it.)  I even offered to pay a home health nurse to come administer it if she would just write the dang RX. NO go.  She also wasn't understanding all the blood work Dr. B wanted (basically monitoring me on the meds he wants me on...which is a GREAT thing!) and got all hissy at what this protocol entails. (Twice weekly fasting labs, labs 4 hours after a Lovenox injection to watch blood clot timing, etc.)  Being my own medical advocate is exhausting.

CD 3: Acupuncture
I still hate acupuncture.  That is all.

I had to leave a semi nasty (ok, not nasty, just firm) voicemail for the nurses in Birmingham.  I was told yesterday that I would get a cycle calendar and meds would be ordered by today. I got a call back within 5 min and was told all meds are being called in right now.  Ha! I had to argue to not have to repeat an SIS (water u/s) as I had a doc all up in my business (INSIDE MY UTERUS) in Sept so an SIS was NOT necessary to do again.  "Well, I have to get that cleared with Dr. H." Guess what?  She cleared me just last month...ARG. I better not have to do it again...

I start letrozole on Sunday and don't have another appt until CD 12 (which of course has to be in Birmingham at 7:30am on a Sunday. Sigh). 

Intralipids just aren't going to happen.  My RE is completely refusing to write the RX, even though Dr. B faxed over exactly everything she needs to do for it. All she has to do is sign her name...and I will set everything up with an infusion place I found in Birmingham. I have a couple more days to beg and plead...Will you pray she somehow sees the light and lets me do them?  Will you pray that our little embaby thaws properly?  Will you pray that my lining is perfecly thick and the transfer goes smoothly? This transfer is happening with our without the intralipids...DH and I both feel that pushing this any farther from my lap surgery in Sept is just not a good idea.  I'll keep you posted.

FET Joy and Acupuncture

Thursday Jan 17:

I got the call I was anxiously waiting for.  We now have one baby on ice.  While I I am relieved at knowing we  have one, we are still mourning the loss of the other two embryos.  I was so overjoyed at hearing the news, I forgot to ask the grade/quality.  I tried calling back and left a msg for the nurse (who is notorious for not calling me back) asking to know the grading because Dr. B had requested it.  DH and I have decided that we will try transferring the one embryo to me and not use my sister as a surrogate this time around.  I will be trying a completely new-to-me immune protocol so we wanted to see if that will work before moving on.

I've emailed Dr. B to get an updated protocol and I hope I hear from him before the weekend.  I have no idea about the timeline for this FET.  Will I have to be on BCP's again? Only Lurpon?  These are things I'd love to find out.  I'm now waiting on my period so I can go in for a baseline u/s and bloodwork.

Friday Jan 18:

Acupuncture...sigh...I'm not a fan. I know there are plenty of you out there that find it enjoyable and relaxing. I am not one of those people. The last time I did acupuncture, we lived in GA and I got the call that our embryo didn't survive the thawing process as I was lying on the table with needles sticking out all over me. It's not a good memory. I was dragging my feet getting in for an appt here but I decided today was the day. I had gotten a couple recommendations from my RE clinic and walked into one to find out prices and scheduling. Guess what? They could do my first session right then and there! Lovely. How nice. (I'm dripping with sarcasm.) Not only did I get a session of acupuncture, I also had the pleasure of doing Moxibustion which is burning herbs above the skin to apply heat to the acupuncture points. I now smell like a stink bomb. I will be doing this twice a week for three weeks, then once a week until we figure out the transfer date. Yippy skippy. How anyone can relax during all that is beyond me...I tried, I really did.  

Just some of my daily supplements

Awesome socks my sis sent me for transfer day

My hand bruise from the IV on transfer day (one week ago!)

Retrieval:

Retrieval day was yesterday and I'm so glad that part is over. DH and I got up at 4:30am (Skittle spent the night at a friends house so we wouldn't have to wake her) to leave for Birmingham.  My procedure was at 8:30 but they wanted me there at 7:30.  All the nurses were very kind, even when my IV had some trouble going in.  I wore my "IVF is a mutha" shirt from my sister, which I found very appropriate.  I warned everyone that I would need more meds to be sedated and for pain.  I wasn't wrong.  I remember and FELT every single needle poke the doc made in my ovaries.   The clue should have been when I started crying (and couldn't stop) when the RE was telling me how many eggs she got at the end.  I never went to sleep...the entire time.  I came out of the procedure room fully awake and fully crying.  DH was shocked to see me fully functional...yeah, good times.  They collected only 7 eggs (which I was predicting as I didn't stim long enough) but the RE could tell right away that only 4 were mature (EXACTLY what I had already known based on my u/s numbers).  This isn't ideal.

Thank you for praying. I ended up not having my RE as I had the other female RE in the practice.  She was patient with me and having her there helped me relax.

I was pretty miserable on the ride home as well as the entire rest of the evening.  I was given some pretty powerful pain and anti-nausea meds which helped me sleep well last night.

Birmingham called this morning to give me an update:
Of the seven eggs collected, four were mature. Of those four, three fertilized normally using ICSI. (Intracytoplasmic sperm injection) I ask now for your prayers once again. If you pray, pray for these three babies.  Pray that they would be strong enough to make it to day five when they can be frozen for future transfer.  We love them already and hope they can make it home with our family. 

I'll be honest, these numbers just aren't what we are used to hearing, so doubt and negativity has very much crept in. Last IVF, we had 11 mature eggs, 10 fertilize normally and four made it to day five. Between day three and five, a lot typically don't survive but I do believe in the power of prayer and that God CAN save our babies.

I know many of you are right along side us in this and I love you all for it.  Birmingham will call again on Monday to let me know if our babies survive the weekend and I will update again then.

IVF #5 Journal: Stim days 10-?

Stim Day 10:

I'm at the point in this lovely process where I'm completely and utterly bloated to the max every night and my ovaries pinch and ache pretty much all day every day.  Good times all around.  Took my last stim combo shot and Ganirelix injection (which was insanely painful for whatever reason) tonight.  Now we wait to see what the blood work and u/s show tomorrow...My current thoughts: "Am I going to have any mature follicles?" For the first time ever, I'm uncertain of that.

Tuesday Potential Stim Day 11:

U/S this morning showed 7 OK follicles.  Six are between 15-16mm and one is like a 12mm.  My lining is PERFECTLY gorgeous at 15mm (one of the best I've ever had and it doesn't even matter!).  In my opinion they are still too small for trigger tonight. I asked my nurse if I can continue stimming but that I was out of meds.  She thought for sure Birmingham would agree to let me stim longer and gave me enough meds for tonight to tide me over until some can be overnighted to me.  My goodness they are slow growing but I am so incredibly thankful that they had some extra meds to help me out.  While the thought of doing more stims isn't appealing I really think I need them to mature these eggs.

Waiting on the call from Birmingham to learn my estrogen level and what to do next...

Well, got the call from Birmingham and she had no idea I wanted to do extra stims and still wanted me to trigger tonight.  I asked to talk directly to my RE (which is the first time I've had any contact with her during this cycle). According to my RE and the clinic "protocol", if there's at least 4 follicles that hit 14mm, they trigger.  So much for individual case by case basis doc.  She agreed to let me stim one more night and trigger tomorrow night.  Her words to me were, "I can't let you stim 2 or 3 more days because I can't justify asking my staff to come in over the weekend for a retrieval with such a low chance of pregnancy."  I kid you not.  She told me that not once, but twice in our three min conversation.  Thanks for the vote of confidence. I really hope she's not the one doing my retrieval on Friday. I think I'll just go cry over here in the corner...

Estrogen: 1341
Progesterone: .8 (was .4 on Sunday)

Wednesday Stim Day 12:

After no one called me back to tell me what to do this morning, I called the Montgomery clinic and they said I should go ahead and come in for more bloodwork and u/s. They had no appts available but they thought they could squeeze me in.  I'm glad they did.  U/s today showed good improvement! 7 were between 17-20mm with another couple close behind.  I talked with the nurse practitioner (who I really like by the way) and told her what my RE said to me yesterday about not justifying bringing staff in on the weekend for me.  She was appalled. I also mentioned that no one was calling me to tell me when to take my antibiotic and how long DH is supposed to abstain for retrieval.  The NP thought if given another night or two of stim meds, those other follicles could catch up.  Yeah, well, I guess it doesn't matter because I don't have any meds since they wouldn't call any in for me yesterday because apparently I don't fit their ideal patient model.

All the nurse said when she called me tonight was:

Take 15,000 units of HCG tonight at 8:30.  Be here at the clinic at 7:30 Friday morning.
Estrogen: 1600
Progesterone: .7

This has been my least favorite experience of any IVF I've done.  I'll update again after Friday.

Love to you all!

Not a terrible amount for one cycle

A New Day:

I had a (hopefully?) well meaning friend message me some big unsolicited advice and thoughts about our infertility journey last night after I posted my blog for the world to see.  It was pretty much everything you DON'T say to someone who is infertile.   After the loss of our first baby, some people said some things to me that I'll never forget.  Things like, "It must have been God's will." or "You're too stressed. You need to relax and it'll happen." Or even, "Maybe you should adopt because everyone I know that adopts gets pregnant."  It stung and hurt at my core.  During the last 5 years, I had come to peace about where we were as a family, though my heart always longed for more children.  I had grown some thick skin about those types of conversations but last night takes the cake for things said to me that NO one who is dealing with infertility should hear. Remember what your mama taught you?  If you don't have anything nice to say, SHUT UP.

I will say however, that the out pouring of prayer and encouragement out weighs the stupidity of some people mouths.  I appreciate your words and prayers of peace.  Thank you all for taking the time to reach out to me, offer a hug, etc.  And a big thank you to my sister who sent me a perfectly silly, make me smile gift of fake squishy swiss roll cakes! 

I had asked Dr. B his advice about what's going on.  He gave me a sliver of hope saying I should push on and continue with the meds so that's what I'm going to do.

While I'm not feeling much in my ovaries right now, I do feel your prayers. 

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Sunday, day 8 of stims:

We got some good news!  My estrogen level was 91 on Thursday, but today is was 999!  That's more like it!  I have 4 great follicles measuring around 14mm or 15mm and 5ish ones around 11mm.  That's something! (My lining was even 11mm which is PERFECT for a transfer.)  I'll be stimming another two days in hopes of getting those numbers up a bit.  I wish I could stim another three days but I'll be out of meds.  Four eggs is not really what I had in mind for this cycle but with the less aggressive protocol and the supplements and meds I've been on, the goal is quality over quantity-and obviously it's WAY better than the ONE decent follicle we saw on Thursday.  My ovaries are DEFINITELY feeling it now but they don't hurt anywhere near what I've experienced in the past. 

My egg retrieval is tentatively set for Thursday.  I go back in on Tuesday for another blood draw and follicle scan to make sure things look good....

In the words of my daughter, "God's got this, mom."

My two shots tonight

IVF #5 Journal

Friday Dec 28:
Awesome. I've started AF.  Or whatever this is...bleeding from stopping BCP's. Is that the same thing? At least I don't have any cramping or pain issues. My u/s and bloodwork were fine. All good to go for stims!

Wednesday Jan 2:
Sigh. Not the u/s I was hoping for.  I've had four days of stims (375 of Follistim, 75 of Menopur) and I knew I wasn't feeling much activity in my ovaries.  U/s confirmed my thoughts.  Tech said I had 13 follicles.  12 of which were too small to be measured (one measured 11mm). That is NOT good. I'm waiting on a call from the IVF nurse in Birmingham to tell me what to do next.  I went back and read my blog from my last IVF and I had a slow start just like this one but they did eventually catch up.  I'm hoping the same thing happens.  My local nurse said I should prob expect around the same numbers as my last round.  I guess that's decent for being five years older....although it causes me great disappointment.   Up until this point, I wasn't rattled by all of this (well, that's not counting the Houston post office losing my injectable medications from overseas but that's another story).  I actually felt calm through all 4 days of stims and was just curious what other peoples follicles were like on day 5...I shouldn't have googled and I shouldn't have compared my body to others.  What it did was cause me to loose sleep and have total unnecessary anxiety about something I can't control at all.

With us freezing all embryos (if we can even get to that point that is) my uterine lining measurement isn't a "thing" this time around...not until the transfer anyway. At least that's one less thing to worry about.  Will we even be able to get any mature eggs? Will any fertilize? Will ANY make it to freeze?  If I don't have any to freeze, surrogacy isn't even an option.  Sure, I might be borrowing trouble right now but it's really hard to not think about it.

I'm on the brink of tears and now I remember why IVF is just plain hard.  Oh Lord, calm my heart and mind.  I'm just miserably sad and I don't know if it's just hormonal or what...I honestly didn't want to put as much hope into this as I am.  I really tried to stay emotionally unattached but with the amount of money one has to shell out for this, it's really hard not to be.  I haven't let my mind wonder to the thoughts of being pregnant again or the joy/dream of having another baby...and yet, it happened and it's crushing me.

I just spoke with the Birmingham nurse. Pretty much this is worst case scenario happening.  I'm just not responding to the meds like I should and the nurse is leaving it up to us if we want to cancel the cycle.  We were given three options. 

1. Cancel now and wait until AF to start a more aggressive protocol
2. Go in Sunday at 7:30am to Birmingham (which is a 2 hour drive) to check growth after 4 more shots and decide to cancel or continue based on my numbers
3. Go in to the local RE clinic Friday to get a growth check-but with only 2 days of stims, it's prob not worth it

As of right now, we decided to try for 4 more days and see what happens on Sunday.  I feel like I can't catch a break.  It's never easy, is it?