Testing the Tube: A New Journey

As many of you know by now, we are pregnant with babies #2 & 3! That's right, TWINS!! EEEKKKK! This more than makes up for our 5 failed attempts at conceiving last year. For those of you who are interested, this post is the story of how we got pregnant.

We started the IVF (in-vitro fertilization) process January 8th. It was quite different from doing IUI's (intro-uterine insemination) which we had done to get our Lily. I had a thought the other day that Lily, even though we had to do an IUI to have her, she still was conceived "inside" of me. Meaning, the sperm found my egg and the whole fertilization process was done inside my body as if I actually got pregnant by having sex. TMI? Sorry. But baby #2 will be a "test tube baby." I don't like that title, but that's basically what he or she will be. My egg floats around in a petri dish and Dan's sperm will be placed in the dish to find it's way to the egg OR the sperm will be ejected directly into the egg with a process called ICSI (intracytoplasmic sperm injection). Once fertilization happens, the now embryo, will be placed back inside of me to hopefully implant itself into my uterine wall. How amazing is it that we live in an age where this is a new normal for people who can't conceive naturally?

All together, it took 9 weeks from the start of the process to the end when we found out that we were pregnant. What a long journey but definitely worth it.

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I was on 10 medications with the IVF process:

Medication #1: The Pill - Started 1/10/14 ... Ended 1/30/14

True that the pill is used to prevent pregnancy, but it also has a greater function for those who will be doing IVF. The Pill will stop my follicles from growing eggs. This is important because we need a lot of eggs to grow all at once for the best chance of egg retrieval.

Side effects? A little moodiness.

Medication #2: Lupron - Started 1/26/14 ... Ended 2/24/14

Lupron (leuprolide acetate) prevents ovulation in order to control the timing of IVF or artificial insemination. I started taking Lupron 2 1/2 weeks after the start of my cycle. It is taken as an injection in my abdomen.

Side effects? It has been giving me major headaches at night and upset stomach. Luckily, once I started the next 2 meds on my list, I went down in the dosage amount of Lupron...which helped ease the headaches and stomach issues.

Medication #3: Menopur - Started 2/9/14 ... Ended 2/23/14

 This is used to stimulate the development of multiple eggs and is injected in my abdomen.

Side effects? Well, besides the horrible burning sensation I get from injecting it into my stomach, I would say moodiness is a major side effect.

Medication #4: Gonal-F - Started 2/9/14 ... Ended 2/24/14

This is a human follicle stimulating hormone that gets injected in my abdomen. I take this in conjunction with the Lupron and Menopur. 

Side effects? Moodiness.

Medication #5: Ovidrel - Started 2/25/14 ... one dose only

Another injection in my abdomen, Ovidrel stimulates the release of the egg during ovulation. I only take this once.

Medication #6: Dostinex - Started 2/27/14...Ended 3/4/14

This was used to prevent Ovarian Hyper-Stimulation Syndrome (OHSS). I had a lot of follicles so they didn't want to take any chances.

Medication #7: Doxycycline - Started 2/26/14...Ended 3/4/14

This antibiotic pill will be taken 2 times a day for 7 days starting the night before they retrieve my eggs. We don't want an infection!

Medication #8: Methylprednisolone - Started 2/27/14...Ended 3/4/14

I take this pill once a day for 6 days the night of the egg retrieval. It is used to relieve inflammation.

Medication #9: Crinone - Started 3/1/14...Ended 4/24/14

This coats the vaginal tissues to provide long-lasting release of progesterone. I'll be taking this once a day. I will continue to take this for the 2 week wait and if I am pregnant, I keep taking it until week 10 of my pregnancy.

Medication #10: Estradiol - Started 3/8/14...Ended 3/17/14

Making sure the estrogen levels are where they need to be, I will be taking this pill 2 times a day.

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As you may have guessed from reading all the injectables I needed to take, my abdomen looked like a drug addicts arm with all the puncture marks and bruises. Not pretty.

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The Retrieval Process

On 2/27/14 I went in to my fertility doctor's office at 7:30 am. I was put under local anesthesia for this procedure.

I had a total of 16 eggs retrieved. Out of those eggs, 9 were able to be fertilized. 2 were chosen to be placed back inside of me. Out of the 7 remaining embryos, 3 survived to the freezing process for that just in case we need them scenario.

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The Transfer Process

On 3/4/14 I went in to my fertility doctor's office at 8:45 am. I went in with a full bladder, the 2 embryos got injected inside of my uterus at precisely the spot where they will need to implant themselves, I stayed laying down for 30 minutes, I went home to wait.

I was a 5-day transfer, meaning the 2 embryos that were placed inside of me already made it to the blastocyst stage. This is a good thing because it means that they were stronger and more likely to survive. Now they just need to attach to my uterine lining.

Here's an outline of what is happening when everything goes according to plan.

5-Day Transfer

Days Past Transfer (DPT)	Embryo Development
One	The blastocyst begins to hatch out of its shell
Two	The blastocyst continues to hatch out of its shell and begins to attach itself to the uterus
Three	The blastocyst attaches deeper into the uterine lining, beginning implantation
Four	Implantation continues
Five	Implantation is complete, cells that will eventually become the placenta and fetus have begun to develop
Six	Human chorionic gonadotropin (hCG) starts to enter the blood stream
Seven	Fetal development continues and hCG continues to be secreted
Eight	Fetal development continues and hCG continues to be secreted
Nine	Levels of hCG are now high enough to detect a pregnancy

                                                                                                                                                           Taken from nyufertilitycenter.org

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The 2 Week Wait

Once I got home, I was put on strict bed rest for 48 hours.  After that I was on restricted activity for the dreaded 2 week wait. That meant no lifting heavy objects. Hmm? What about Lily? Yes, she is a heavy object and I was very limited by how I could lift her if needed (in and out of the crib only).

The 2 week waiting period to find out if all the work to get pregnant was a success was so dreadful. I just wanted to know already!!!! During that time I was going in for blood work to make sure my hormone levels looked good.

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Our Wait Is Over

On 3/12/14 we got our answer to whether this whole lengthy process worked. We didn't have to wait the full 2 weeks to get the call that informed us of our future... We are pregnant!

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Our 1st Ultrasound

On 3/19/14 Dan and I went in for our 1st ultrasound to make sure everything was looking good. We were very curious to find out if just one embryo made it or both. We got our answer - BOTH took and we are having twins. Wow. The first thought was, "We need a bigger car." Oh boy. We are going to be a family of 5!

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Our 2nd Ultrasound

On 3/27/14 Dan and I went back to our fertility doctor to hear the heartbeats. This was nerve racking. With everything that we have been through from our very first pregnancy back in 2009 to now, we have always been very cautious...or at least I have been. No need to worry right now though, we heard two healthy heartbeats!

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Our 3rd & Final Ultrasound With Our Fertility Doctor

On 4/3/14 I went in for my last ultrasound with our fertility doctor. This time, my sister Kristene came along to videotape so Dan could see when he got home from work. Again, we heard two beautiful, healthy heartbeats! 

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Now our journey to being a family of 5 really begins. Stay tuned!

Another Long Journey

This post is about our hopes to having baby #2 and the process by which we have had to endure to try and make it happen. It's a long post and I apologize.

(IF YOU DO READ THE WHOLE POST PLEASE LEAVE US A COMMENT! Your thoughts are always appreciated.)
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Try #1

On March 27th I started my cycle. By cycle I mean that annoying monthly visiter every girl dreads appearing due to the cramping, binge eating, crying, anger, and what ever other emotions and actions we may have just before, during, and just after. So there I am, with my monthly visiter on day one, calling up my fertility specialist to make an appointment for day 3 to get blood work and an ultrasound. Hooray! We get to start the process for baby #2.

Day 3 (3/29) rolls around and I go and get blood drawn and an intrauterine ultrasound done early in the morning. Gotta make sure everything looks A-OK before I can start my cycle of meds before the IUI (intrauterine insemination). That afternoon I get the go ahead to start taking Femara, also known as Letrozole, which is a drug used to stimulate ovulation in women with PCOS (polycystic Ovary Syndrome). It helps stimulate extra follicles and eggs. This has helped me before with getting pregnant with Lily. I have to take this medication for 5 days.

Day 10 (4/5) came and off to the doctor again. This time I have to get more blood drawn and another intrauterine ultrasound. They are now checking to see if the Femara helped stimulate my egg growth. It did! I had 1 good follicle on my right side and 2 on my left. By "good" I mean big. Ones that seem to be growing well. You need at least 1 follicle that is between a range of 18mm and 22mm to trigger ovulation for the IUI's. This means that if you do become pregnant, the egg will be mature (large) enough to sustain the pregnancy. This is where I have trouble on my own. My follicles don't mature enough to sustain a pregnancy, hence my 2 prior miscarriages before having Lily. Yay for modern day medicine to help me out with that! By day 10, I already had one follicle that was 21mm, another that was 18mm, and the 3rd was 15mm!

Day 13 (4/8) I went to the doctor again. My intrauterine ultrasound showed that the follicle that was 15mm had stopped growing. No big deal, I still had two more large ones and they grew even bigger since my last visit. That afternoon I got the thumbs up to take my ovulation trigger shot, Ovidrel, on day 14 (4/9).

Day 15 (4/10) IUI day #1! Alright. Here we go. Dan and I had Lily spend the night at Dan's parent's house so we wouldn't have to worry about her today. In the morning we did our thing and off to the doctor's office we went! We had super high hopes in making this IUI process work on the first shot. Evereything went well on IUI Day #1 and now for IUI Day #2.

Day 16 (4/11) IUI Day #2. As much as we missed Lily the previous night, we had her stay with my parent's this time so we could have uninterrupted IUI business. Same as the previous day, all good with a hopeful IUI outcome. Now we wait 2 weeks for a blood test to see if I'm pregnant.

Day 17 (4/12) start taking progesterone (Crinone) once a day for these 2 weeks. It will help implantation if I do become pregnant. If I do get that positive result in 2 weeks, I will be taking this medication for the whole first trimester.

2 week wait is finally over (4/25)! I went in the morning to get my blood drawn. The results are in.
NOT PREGNANT. Damn! Now we start all over again. It took 4 IUI's before getting a positive with Lily. Let's hope it only takes 2 this time.

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Try #2

On April 27th I started my cycle (day 1) and this whole process starts all over again. Just a side note: my cycle started on April 28, 2011 when the IUI worked with Lily. Could this be a coincidence? Could it be fate? If we do get pregnant this time around baby #2 will have the same due date as Lily (although Lily came 3 weeks early).

Day 3 (4/29) I go to the fertility doctor for blood work and an intrauterine ultrasound. Everything checks out and I can start taking my medication (Femara) for 5 days.

Day 10 (5/6) time to get more blood work and another intrauterine ultrasound. Looking good in there with a nice, thick lining (on the uterine wall) and it looks like I have 2 follicles that are growing on my right ovary. They aren't as big as they were last month on day 10 but they are still good. Keeping my hopes high that this time will work!

Day 12 (5/8) off to the doctor's office for yet another intrauterine ultrasound and blood work. This whole process sucks but is definitely worth it in the end.

Day 13 (5/9) oh boy! Another morning at the doctors. Blood drawn and intrauterine ultrasound complete. My results show I am ready to take the Ovidrel trigger shot to start ovulation! Dropped Lily off at my parent's house for a sleep over.

Day 14 (5/10) IUI Day #1. 80,000,000 sperm, 85% mobile, 2 mature eggs. Wow! Those are some good odds!!! Dropped Lily off at Dan's parent's house for a sleep over.

Day 15 (5/11) IUI Day #2. Praying to fertility Gods and Goddesses around the globe that this works! Now we wait 2 weeks for blood work to see if it did.

Day 16 (5/12) start taking progesterone (Crinone) once a day.

2 week wait is over (5/24)! Blood drawn in the morning. The results are in.
NOT PREGNANT. Shit. Hopefully 3rd time's a charm with this one. Now to start all over again. UGH!!!

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Try #3

On May 27th I started my cycle (Day 1). I'm so disappointed we have to go through this whole process again. The only thing that keeps me doing it is that end result - a baby. Let's all keep our fingers crossed it works this time around.

Day 3 (5/29) Blood work and an intrauterine ultrasound. Everything checked out and I start my medication (Femara) for the next 5 days.

Day 10 (6/5) Blood work and an intrauterine ultrasound. I have only one good follicle this time around on my left ovary. One is OK. You only need one to get pregnant!

Day 12 (6/7) More blood work and another intrauterine ultrasound. It's never ending. Things are moving along slowly this cycle but still is OK.

Day 15 (6/10) Can you guess what I had done? That's right! Blood work and an intrauterine ultrasound. Things looking good and I got the all clear to take the Ovidrel trigger shot tomorrow (6/11) night to start ovulation.

Day 17 (6/12) IUI Day #1. Please work!
Day 18 (6/13) IUI Day #2. PLEASE WORK!!!

Day 19 (6/14) Start taking progesterone (Crinone) once a day.

2 week wait is over (6/27)! Blood drawn. Results are in.
NOT PREGNANT. Ugh. Now our doctor wants to sit down with us to go over our options. This sucks!

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Try #4

On June 30th I started my cycle.

Day 3 (7/2) Waited until Dan got home from work to go to the doctor. Blood work and intrauterine ultrasound done. Talked with our doctor about our treatment options. Was told that even though the IUI's worked in the past (for Lily) doesn't mean they will work now. I'm older and things may just be harder for me now. I have two options:

1. Another IUI but this time instead of taking Femara on days 3 to 7, I will be doing injectables starting on day 4 through to the ovulation trigger shot. 
2. Instead of IUI, I can do an IVF. That's where they take the egg out and inject the sperm directly into it, then put it back inside me. I would do injectable with that too but not until around day 21. 

Day 4 (7/3) Decision day. It seems our insurance has been taking very minimally from our $15000 lifetime allowance for infertility treatments. This is great news because an IVF cycle is about $15000 in itself. So we have decided to do just one more IUI cycle but this time with the injectables which I will be starting tonight. If it doesn't work this time around, we will then do the IVF.

Day 5 (7/4) Injectable day 2.

Day 6 (7/5) Blood work and intrauterine ultrasound. Injectable day 3.
Day 9 (7/8) Blood work and intrauterine ultrasound. Injectable day 6.
Day 12 (7/11) Blood work and intrauterine ultrasound. Injectable day 9.

Day 13 (7/12) Blood work and intrauterine ultrasound. Injectable day 10. Finally get to take the Ovidrel trigger shot tomorrow (7/13) night to start ovulation. I have 3 good follicles which means 3 eggs should release and we have 3 chances to get pregnant. PLEASE WORK!!!!!

Day 15 (7/14) IUI Day #1. Lily is 18 months old today. PLEASE let that be good luck!
Day 16 (7/15) IUI Day #2.

Day 17 (7/16) Start taking progesterone (Crinone) once a day.

2 week wait is over (7/29)! Blood drawn. Results are in.
NOT PREGNANT. So disappointing. Because this was our first try on the injectables, we decided to do one more cycle with them.

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Try #5

On July 30th I started my cycle.

Day 3 (8/3) Blood work and intrauterine ultrasound. Injectable day 1. This time I'm on a higher dose.

Day 7 (8/5) Blood work and intrauterine ultrasound. Injectable day 5.

Day 10 (8/8) Blood work and intrauterine ultrasound. Injectable day 8. Wow! The higher dose of injectables seems to be doing the job. Maybe too well. I have 15 growing follicles on my left side and
10 on my right. This was in the back of everyone's minds that might happen since I have a lot of follicles in the first place (they just don't seem to grow on their own). This time when I take my injectables I will take them at a lower dosage to try to slow things down a bit.

Day 11 (8/9) Blood work and intrauterine ultrasound. Well, the lower dosage of injectables worked and the follicles carrying growing eggs seems to have slowed down the growth a bit. The good news is that I would be the perfect candidate now for an IVF cycle since at least 7 eggs would be released when I ovulate. The bad news is that I can't do the IUI cycle we wanted this time around because at least 7 eggs would be released when I ovulate. My chances of having multiple births is too great. By multiple, I mean quadruplets! Yikes!!

What this means for us: We will now stop trying for baby #2 this year. An IVF cycle costs $15,000 plus the cost of meds. We have a little less than $14,000 left in our medical insurance to cover it but spending $2,000 or more right now out of pocket is not an option for us. We have our new house to get settled before we can spend any money on anything else.

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5 months of trying. 5 months of medication. 5 months of poking and prodding. 5 months of hope & 5 months of disappointment. 

When you are younger you never think that getting pregnant would be so hard. I will be 36 this year and you always hear that once you hit and pass 35 years of age, it gets even harder. Dan and I are so blessed to have had this process work for us 2 years ago. We have Lily and she truly is our rainbow baby - the beautiful light after our 2 heartaches. If she is to be our only child we are truly fortunate. 

We will try again so Lily may have a brother or sister. We will go through this process again, as long and painful as it may be. We will not give up hope of having another baby. In the next 4 months we will concentrate on our new house and doing everything we can on making it a great home for our family. Then, in January, we will try again. 

Thank you for reading through this blog post. I know it was long and there was no happy ending, but Dan and I feel that if this is the end, we already have our happy ending - we have each other, Lily, and a new home.