"Take Care of Our Investment"

Loving words from Dave this morning before he left for work.  I'll take a pregnancy test a week from today.  The clinic told me not to trust a home pregnancy test because of all the hormones I've been pumping into my body (apparently they might trigger false readings).  

Rational Emily thought this was sound advice and didn't plan on buying any home pregnancy tests.  However, Irrational Emily is starting to nag Rational Emily about this logic.  Folks, I don't know what to do.  Should I take a home pregnancy test next week. . . just for fun?  Or stick to my guns and wait till the official clinic one next Friday?

The waiting is hard but I'll be back in school full-time next week.  I'm volunteering on Election Day to drive voters who need rides.  I'm also going to South Meck High School on Thursday to log some observation hours.  Hopefully, a full schedule will keep me preoccupied.

As for the hyperstimulation syndrome, all my symptoms have faded (yea!!).  I no longer have shortness of breath and abdominal bloating and my weight is slowing moving back to normal.  I do have some lower abdominal cramping when I move too much during the day.  However, this is not a symptom of the syndrome.  If anything it's either my body implanting little Atticus and Bobo or rejecting them (let's hope for implantation).

Happy Halloween everyone!  I've got to run out and get some candy for the six kids who trick-or-treat in our neighborhood (the downfall of city living).

The Adventures of One Cool Chic & The Oprah Show Tricked Me!

Yesterday was a struggle in boredom (thanks to Amanda for shaming me into being creative).  This morning I resurrected my old alter-ego One Cool Chic and drew this little sketch (One Cool Chic was created out of boredom at work many, many years ago).  Whenever I got bored, I invented new stories for her.  This is the first time I've actually drawn one of my stories.

She's a very fashionable Chic (obviously) and believes she can do anything, even though the world constantly tells her she can't.

Here's some close-ups of her story: 

The Slimy Snake says "You can't cross that creek One Cool Chic."

"Oh yeah!?!  Watch me!!" One Cool Chic says.  She begins making a catapult and launches herself over the creek with a rock.  See her flying over the creek!!

One Cool Chic lands on Slimy Snake and says "I can do anything!"

While I was creating my masterpiece, I decided to watch yesterday's Oprah show.  Folks, you've got to be careful with Oprah.  Sometimes she does really depressing or bizarre shows (last year's fixation on transgender-ness got excessive).  I always read the DVR description before watching her show. 

Yesterday's show seemed pretty innocent 'Miracle Children with Celine Dion' (sounded really uplifting).  Here's how the episode was even advertised on Oprah's website:

About 45 mins. into this episode, I got tricked.  They showed a YouTube clip of a little baby born with Trisomy 18 (a fatal disease).  The YouTube clip is really sweet, but after hearing three miracle stories where the children lived, I wasn't prepared for this clip to end the way it did (if you dare to watch it click here).  

The baby lived 99 days.  The miracle is that the baby lived at all (but you don't find that out until the end of the video).  After the video, the cameras pan back to a crying Celine and Oprah (and Emily).

Look, I'm on some serious hormones right now, I'm not interested in situations that will elicit extreme emotions.  I won't even go see a scary movie this weekend with my girl Ash (but I will go see HSM3. . . pretty please, anyone?). 

Am I Pregnant Yet?

Bed rest is boring work. . . 

Day 5: Transfer

Yes dear readers, after months of following this ridiculous blog the day has finally arrived!  Our little embryos were given back to Dave and I; they are resting nicely inside my belly.  Now all we have to do (this is a team effort) is stay on bed rest till Wednesday afternoon and wait patiently for November 7th's pregnancy results.

It was a good day.  I met with my acupuncturist this morning for a relaxation session.  She put little gold-plated beads inside my ears (they are attached to an adhesive backing).  I gently rub them a few times a day.  They will help calm my uterus and encourage implantation.

After that appointment, Dave and I went window shopping for an hour before heading to the clinic.  I took my Valium one hour before the transfer (a rather amazing little pill).  I was awake for the procedure (and relatively relaxed).  I got to see the embryos on the video monitor shoot into my uterus (welcome home munchkins!).  Then they wheeled me into a semi-private waiting area where I rested for 30 mins.

Dave drove me home where I spent the afternoon sleeping.  He's been taking care of me all afternoon (he even gave me a bell); he's determined to make sure I stay in bed.

Here's a picture of our embryos:

The mass of cells in the center is what will become our babies.  The outer cell structure will become the placenta after implantation.  Both embryos reached the critical blastocyst stage of development.  That's the normal Day 5 or Day 6 stage in a natural pregnancy; it occurs right before implantation and happens in the uterus.  What does this all mean?  We've done everything right so far.  We have 2 great embryos and now all we do is wait for them to implant.  

We asked Dr. Skywalker if he wanted to name them.  He called them 'A' and 'B' (not very creative).  Well folks, it's up to you.  What do you think we should call these little blobs?  Mind you, these will be their temporary names until Dave and I find some inner creativity of our own.

Day 4: Law of Attraction

I've been forcing myself to finally read The Secret.  I bought it over a year ago (even kept the receipt inside the book because I wasn't 100% about the purchase).  Sometimes I think you have to be in the right mental frame of mind to begin a book like this.  I lovingly describe my current mental state as determined (or desperate, depending on your disposition).  

I'm determined to dabble in anything that will even remotely help the IVF process turn into a successful pregnancy and happy healthy birth!

To date I have done the following:

• studied the feng shui bagua chart to locate the children area of my home.  It's in the kitchen (which prompted David to say 'What's it doing in there?').  

• wearing a make-a-wish bracelet which supposedly you wear until it breaks then your wish comes true (my dear, sweet Shannon is feeding the addiction).  

• carrying a japanese fertility medallion in my purse (since 2006).

Today, Dave and I went to the bookstore.  In preparation for my pending two days of bed rest I wanted to stock up on some books.  Channeling my inner positive thinking I purchased two pregnancy-related books!  I got The Baby Name Wizard by Laura Wattenberg and Belly Laughs by Jenny McCarthy.  

The Baby Name Wizard is a really cool book that maps the popularity of names over the last 100 years.  It uses data from the Social Securities Administration then crosses that data with cultural statistics to show the trendiness of a name.  For example, Mary is a widely popular girl's name ranking in the middle consistently for the past 100 years.  However, it's usage frequency has dropped 95% over the past century.  

It also gives you alternate suggestions to names that you like, but don't want to use and the background of the name.  There's even a website version called www.babynamewizard.com. 

Belly Laughs was recommended by a complete stranger in the bookstore.  I was sitting in the pregnancy section and this stranger asked me if I was pregnant.  I said 'Yes'.  It seemed the least time consuming response and technically I do have 7 embryos growing. . . just not inside me at the moment (hopefully God will see the greater good in my little white technicality).   The book looked like a lot of fun, so I mentally said 'why not?'

This bookstore stranger further introduced herself and told me about a really neat group here in Charlotte for mothers, mothers-to-be and wanna-be-mothers.  The group is called Charlotte Mommies.  They have a website you join (www.charlottemommies.com) which gives you access to a regional community of babysitters, support groups, tips and recommendations, etc.  Best benefit, this group will deliver meals every other night for the first two weeks after you give birth!

See what the Law of Attraction has done for me already!  I'm ready for transfer, bed rest, implantation, positive pregnancy tests and beautiful, healthy babies!!

Day 3: Embryo Update

We got a call from the embryologist this morning with a report on the developmental progress of our embryos.  On Day 3 they typically like to see 6 - 8 cells in an embryo.  Here's what our flock is up to:

1 embryo has 2 cells

1 embryo has 3 cells

1 embryo has 4 cells

2 embryos have 5 cells

2 embryos have 7 cells

3 embryos have 8 cells

2 embryos have 9 cells

These are good numbers, we've got 7 embryos growing on target.  Later today the clinic will call back to give us a time on Monday for transfer.  Dr. Skywalker will pick the strongest 2 embryos from the group.  

As for ovarian hyperstimulation syndrome, I'm doing alright.  I show some symptoms in the evening like severe abdominal bloating, weight gain and shortness of breath.  However, I am still able to pee and by morning my weight is back to normal (the nurse did say evenings would be the worst).

Last night we started the daily progesterone injections (the one's Dave gives with the bigger needle into my backside).  It wasn't so bad, we were told to put some ice on the area to numb it (worked like a charm) and then use a heating pad to relieve the soreness (sitting on one right now).

This weekend we plan on carving pumpkins and drinking apple cider.  The goal is to get me out of the house (assuming my energy level cooperates) before I'm stuck on two full days of bed rest.

Day 1: Overachievement

Aw shucks, isn't my honey sweet?  I'm so proud of him for posting.  Oh, and in response to your comments of how many sperm he donated, his reply is 26 million to my 26 eggs.

The fertility clinic called today.  They were able to fertilize 17 eggs and of those 17 eggs 14 became embryos.  You read correct folks, we've got 14 little embryos happily dividing and the best two will be used for transfer on Monday.  

On the flip side, because I produced so many eggs I'm probably suffering from Ovarian Hyperstimulation Syndrome (OHSS).  Basically, with this syndrome the ovaries keep producing fluid even after all the eggs were retrieved.  This fluid has no where to go, so it builds up in the abdominal cavity.  About 1% of women who have this syndrome have to be hospitalized (for more medically accurate information check out www.dukehealth.org). 

Dr. Skywalker prescribed some additional medication to help combat this syndrome.  I'm suppose to drink a lot of fluids; however (ironically) not water.  I was told to drink milkshakes (yea!!!), V-8 (uhmm) and Gatorade (ok), as well as eat a lot of soup.  The goal is to stay hydrated and make sure I pee a lot.  

Transfer is tentatively set for Monday.  We expect a call tomorrow from the clinic to confirm the transfer date and time.  Thank you all for your good wishes and happy thoughts!!  

Retrieval Day

Hey, this is Dave. It was a busy, busy morning.  We arrived at the IVF clinic at 8AM sharp, filled out some paper work, showed our Photo IDs and went in to begin the procedure prep.  Emily put on her cute little gown (that shows her butt), got an IV and some drugs to put her out (low dose though, not enough to influence the eggs).  I was then escorted to a special room to do my part.

When I got back Emily was on the gurney ready to go in.  I gave her a kiss and sent her on her way.  I was in the waiting room for barely 30 minutes when they came and got me.  Emily was back in the prep area.  She was very groggy.   I tried to keep her talking so she would wake up faster (nurse's suggestion).  A few minutes later the nurse came over and told us they had retrieved 26 eggs (8-12 eggs is normal).  That was great news. 

Now they will pick the best eggs and fertilize them.  We will know tomorrow how many were fertilized.  The ones we don't use will be frozen.  It took Emily about another 30 min to feel ok enough to travel.  Then we went home.  

She is resting nicely at home in bed.  Charlie was nice enough to come over and keep her company for the afternoon. We are scheduled for embryo transfer on Monday, Oct, 27th.

Everything has been going great and we are very confident that babies are in our future.  To everyone who has been keeping up with this blog - Thanks for your support.

Oh! My Aching Ovaries!

Well folks, tomorrow's the big egg retrieval day (otherwise known as Day 0 in fertility speak).  Today, however, I feel like crap.  I'm so exhausted, my ovaries hurt, I have the attention span of Lavender and general attitude of Bailey (i.e. spacey and b*tchy).  

I'll probably be out of it most of tomorrow, so you won't hear from me.  As an alternative, I'll ask Dave to write a post (40% likelihood of that happening).  If you really want him to post tomorrow, I suggest leaving a TON of comments or emails for his encouragement.  I can't promise he will actually post about IVF.  You may end up reading a post about golf, cars or some engineering techno-babble (great bits of information when used as a sleep aid).

This morning I had my pre-op appointment for egg retrieval.  Here's what will happen:

Dave and I report to the clinic first thing tomorrow morning.  

I will take a light anesthesia and Dr. Skywalker will remove my flock of eggs; meanwhile, Dave will produce a fresh supply of 'man seed' (his words, not mine).

The embryologist will begin uniting my eggs with Dave's sperm to create embryos.

Thursday our IVF nurse will call us with the number of fertilized eggs.

Embryo transfer will occur on either Day 3 (10/25) or Day 5 (10/27).  Dr. Skywalker will watch the dividing embryos and judge which day is best for transfer (typically Day 5 is preferred).

After transfer, I will spend 2 days on bed rest.

On Day 16 (11/7) I go to the clinic for my first pregnancy test.

There you have it!  The remainder of our IVF protocol.  Your good wishes are so appreciated.  Keep them coming!!

Ta Da!

I had another ultrasound and lab work done this morning.  The lead eggs have reached 20 mm and it is time for egg retrieval.  We do that Wednesday morning!!!

We were ordered to take Ovidrel tonight at precisely 9pm--the timing is very important.  We have to take Ovidrel 36 hours before egg retrieval.  

I no longer take the Gonal-f and hCG.  Tomorrow morning I go in for additional lab work and a pre-op visit.  Things are moving so quickly.  

Keep you posted.

'You're Going To Make My Numbers Look Great!'

This morning we had our third ultrasound in seven days.  Everything is looking real good.  I've got a GAZILLION maturing follicles (as you can see in the latest ultrasound picture).

Dr. Skywalker is really excited about how things are progressing.  He checked my uterine lining (it is nice and thick) and counted the growth of my flock (right on schedule).  

When the lead egg reaches 20 mm (right now it's about 17 mm; the others  are averaging 15 mm) I will take Ovidrel.  This injection will trigger the ovaries to release all eggs and then we'll do egg retrieval.  

Dr. Skywalker says if all continues according to plan we would do egg retrieval on Thursday or Friday; which means embryo transfer the last week of October.  

Right now, things are looking really positive for Clan Donovan and our flock (see how happy they are)!  Even Dr. Skywalker was really positive.  He told us we we were going to make his fertility numbers 'look great' this year!

In other non-fertility news, we had a cold snap last night.  Turns out our heat doesn't work.  Some of you may remember the lightening strike that fried our AC unit this summer (perfectly timed with the heat wave).  Looks like the furnace was fried too (someone is coming out tomorrow to take a look).  In the mean time, Lavender and Bailey have been put to good use as unwitting bed warmers.  

Is It A Litter, Nest, School, Flock. . .

I had my second ultrasound today and Dave did a precautionary sperm freeze--to create a back-up reserve in case fresh sperm (the preferred kind) is not available on egg retrieval day.  Sperm freezing is optional; however, Dr. Skywalker urged us to consider paying for it (about $410).  

He told us about a couple who did not sperm freeze.  Apparently, on the day the wife did egg retrieval the husband needed to submit his sperm.  For whatever reason he couldn't preform the task and immediately left the clinic--and his wife on the operating table with a ton of eggs and no sperm to fertilize them (we don't want that kind of pressure hanging over Dave; therefore, a precautionary sperm freeze is worth the 41,000 pennies).  

This is a picture of my right ovary from today's ultrasound.  Some of the maturing follicles are circled in red .  I've got a good group (litter, nest, flock, etc.) brewing in both ovaries.  

The doctor counted 11 maturing follicles and 10 additional follicles under 10 mm.  If you do the math that's 21 follicles, I had 18 on Monday (not sure if there was some Florida counting or if the Gonal-f medication triggered more follicle production).  Having more than 8 maturing follicles on Day 4 of FSH (follicle stimulating hormones, i.e. Gonal-f) classifies me as a high-responder.  

This is good, but it does put me at higher risk for ovarian hyperstimulation syndrome.  About 33% of IVF patients experience some mild form of this, yet only about 3 - 8 % will experience a severe form (this link to www.ivf-fertility.com explains it better than I can).  At the moment, there is no need to panic or worry. 

The second picture shows an endometrioma (the gray blob circled in red).  I have two, one in each ovary.  Will this cause a problem for egg retrieval?  Unlikely, the doctor said they do their best to move around the endometrioma while collecting eggs.  If needed they will go through the endometrioma, but it's not preferred--the thick bloody tissue of the endometrioma gets mixed with the egg (which just sounds completely messy and undesirable).

This afternoon I got a call from the clinic.  I will continue taking 300 units of Gonal-f, 10 units of hCG and start the nightly Ganirelix injections.  Ganirelix suppresses the body's natural desire to release luteinizing hormones (FH).  FH surges trigger ovulation (i.e. the releasing of the eggs) it's too early for my eggs to be released. 

I go back to the clinic Sunday morning for another ultrasound and lab work.  Things are moving quickly!!  Wish us luck!!

Attack of the Bloated Belly!

One side effect of stimulating my ovaries. . . they get enlarged.  I'd like to think this is contributing to the extra 3 pounds on the scales this morning, and the more voluptuous look in the mirror (it couldn't possibly be the birthday cake, banana pudding, chocolate chip cookies, Little Debbies and cheese puffs all consumed during Birthday Week).

Here's a picture of me giving myself the first injection on Monday night and then after the injection (it wasn't so bad).  Last night we decided to let Dave give the injections (don't want anyone feeling left out).  I've got tiny little bruises on my belly where I've been giving the injections.  The biggest bruise is from Dave's injection last night (I think he was nervous).  Good thing bathing suit season is over!

Go, Go, Gadget Follicle Stimulation, Activate!

Alright, I mentioned this briefly in yesterday's post, but I feel it needs repeating and it's own post space. I have a total of 18 antral follicles!

18 Antral Follicles!

A follicle count ranging from 15 - 26 is considered normal (i.e. good). Here are some generalities that fit my profile:

• Normal follicle count should have an excellent response to ovarian stimulation (what I'm currently doing every night with my Gonal-f injections).
• Likely to respond well to low doses of FSH products.
• Very low risk for IVF cycle cancellation. Some risk for ovarian over-stimulation.
• Best pregnancy rates overall as a group.

I'm very excited about this news! I am in the best success rate category because I am under 35 and have a good antral follicle count.
For those of you wondering what is an antral follicle, here's my best attempt to explain. Antral follicles are often called 'resting follicles'. They house immature eggs. Women are born with all their eggs already in their ovaries. These immature eggs are housed in antral follicles.
During an ovulation cycle the ovaries will release a specific amount of antral follicles, 15 - 26 on average for most women (as women get closer to menopause the amount of antral follicles decrease until all eggs are gone). The body naturally lets these antral follicles develop their egg, and then during ovulation the best egg in the bunch gets released for potential fertilization.
What does this all mean for me? Well, I have 18 potential eggs for this IVF cycle. Research shows the number of eggs retrieved has a direct correlation to IVF success rates (the more the merrier). Over the next 8 - 13 days I'm taking Gonal-f (follicle stimulating hormone) to help these 18 antral follicles develop quality, mature eggs.
Clan Donovan is feeling pretty good at the moment (of course, check back in a few hours, it could just be the hormones talking).

Save the Drama for Some Other Mama

6:30 am  Hit the snooze button (because it is offensively early to your low quality of sleep).

7:00 am  Rummage through closet looking for sweat pants to go with new Terrasoles birthday shoes.

7:30 am  Arrive at clinic only to find you are not on the appointment schedule (your nurse didn't book your appointment).

8:00 am  Get ultrasound (you still have some endometriosis in both ovaries; but not enough to stop IVF treatment.  You have 10 follicles in one ovary and 8 follicles in the other--this is a good number).  Have blood drawn.  Told to wait by phone for further instructions.

9:00 am  Wait by phone.

10:00 am  Wait by phone.

11:00 am  Wait by phone.

12:00 pm  Eat sushi.  Wait by phone.  

12:30 pm  Fertility clinic calls!   Your estrogen levels are good.  You can start stimulation phase.  You and your husband both take an oral antibiotic twice a day for the next 10 days.  You get to take 2 injections every evening until Friday.

2:00 pm  Walk the mall (your personal sanctuary).  Window shop (to find your inner peace).

3:45 pm  Get haircut.

5:20 pm  Hair was cut shorter than expected.  Slightly saddened.  

8:00 pm  Prepare for 2 injections.  Realize you are missing one medication.

8:15 pm  Freak out.

8:20 pm  Call fertility clinic.  Get voicemail.  Freak out more.

8:30 pm  Call Kammer (you always call your friend Kammer for medical advice and other general trivia questions. . . he's in med school and a know-it-all).  Get voicemail.  Still freaked out.

8:40 pm  Call pharmacy.  Get answering service.  Leave message.

9:00 pm   Make executive decision.  Take the one injection you know is correct.  Deal with missing medication in the morning.  Freak out level stabilized.

Just a brief glimpse into the world of Clan Donovan.  Yesterday was slightly traumatic.  For those interested, I was told to take 300 units of Gonal-F and 10 units of hCG; however, my pharmacy did not ship the hCG (we didn't realize this until today when I FINALLY got to talk to my doctor).  

Much of last night was spent trying to find out if the Ganrelix we had in the fridge was a brand name for hCG (there was a lot of 'Googling' going on and many failed phone calls made).  Long story short, our pharmacy will overnight the hCG for AM delivery.  Dr. Skywalker says we are okay missing the first two doses of hCG, it is given to help embryo quality and not all fertility clinics use this protocol.  

Phoenix is in the Fridge!

Good new for Clan Donovan!  Our fertility medication arrived this morning.  I even got my very own BD Sharps Collector (that's those red containers with the big orange bio hazard sticker nurses use to dispose used syringes) and some alcohol swabs!  The medication is already in the refrigerator, safely wedged between the pickles and pimento cheese spread.

Also, we mailed our hefty IVF payment earlier this week.  We are ready to rock n' roll with this little/big scientific experiment.  Now it's time for a weekend of fun and relaxation.  Apparently it's forecast to rain the whole weekend.  I believe Dave's comment to this bit of suspicious news was 'I didn't order that for my birthday' (he's been ordering golf items on eBay for a few weeks now--all in the name of his birthday).

Phoenix Accepts Relocation Package

We got a call on Sunday from Freedom Fertility Pharmacy (I know, we were also surprised they work on Sunday).  On a whim I asked them earlier last week to run our fertility medications through insurance since our prescription drug insurance is carried by a different company than our medical insurance (which does not cover fertility treatment).  Apparently this company will cover our fertility medication!  There is just one small hitch, the complete order has to be transferred to a different pharmacy, approved, verified and shipped tomorrow for Wednesday delivery to our Casa.  

Why Wednesday delivery you might ask?  It's Birthday Week for Clan Donovan and we are spending the last half at the beach (yes, we know we were just there. . . its cheap and easy).  Dave turns the big 4-0 on Thursday and I turn a respectable 30-something on Sunday.  Dave's family is driving down from 'the North' to meet us at the beach for the celebration.  

So between a history mid-term and education paper deadline, I spent the day placing various calls to the new pharmacy and my doctor's office--all done in an effort to ensure the transfer went quickly and smoothly.  Hopefully, I'll get the 'package' on Wednesday!

P.S.  

In other news, I spent the weekend with my Grandma.  Surprisingly folks, she reads this 'blob' regularly and would like everyone to know she is not committed to voting for Palin.  She is officially undecided (I recommended she write herself into the ballot if she couldn't make a decision.  You know, just to exercise her voting rights).  She also wanted me to tell everyone I am a wonderful granddaughter.  

No One Leaves Empty Handed

Dave and I went to injection training class today.  They gave us a gift bag (we're still trying to figure out why).  All it contained was our injection paperwork; a folder would have been more practical. 

Starting on Oct. 13th I get injections of various hormones mostly in the morning and/or evening.  Today taught both Dave and I how to give those injections safely.  We'll also receive a detailed medication protocol sheet complete with dates/times for each injection.  

The big scary injections are the intramuscular ones that I'll have to take after egg retrieval.  Dave administers those into my backside, the needles are longer and bigger.  We were told to practice on a grapefruit or an orange (apparently they have a similar feel as my backside. . .).  

Phoenix is in transit

We got a call this morning from Freedom Fertility Pharmacies (love the name). Apparently they are a large mail-order pharmacy specializing in fertility medications. Our clinic uses them and called in our IVF medication.

The lady on the phone was very nice and patient (I was somewhat asleep when she called). She wanted to schedule a delivery day and time for our medication. Delivery requires a signature and some of the medication needs to be refrigerated immediately.

We had to make the medication payment over the phone, grand total was $2165.03 (we had estimated $3K). We were also given an expected delivery time of anywhere between 8am - 2pm (I got confused for a second, thought I was talking to the cable company) .

On Friday we'll make our big $11K payment to the clinic for the IVF procedure. I thought these payments would depress me; but apparently they've triggered my spending gland. I'm now in the mood to go spend more money (I want decorative pillows for my couches, a handheld vacuum cleaner, IKEA bookcases, new fall sweaters and long sleeve t-shirts, new floor lamps. . . ).