A Scare of a Different Sort

First off, we got the results from the MaterniT21 test, and everything is fine with the baby. Phew! That is a total relief.

Our new scare came on Sunday when I got an email from my OB saying that my insurance was no longer going to count him as an “in-network” provider as of next Tuesday. Despite the issues I had with his office over the penta-screen, I love my OB. He’s a total take charge kind of guy and is incredibly personable. I got the email when I was at work, and I totally lost it. I started sobbing (something I have NEVER done at work before). Luckily, there was hardly anyone there, so I don’t think anyone saw me. I went to the bathroom to try to compose myself, but it took a long time. I did not want to have to find a new doctor this late in the game. My husband and I had already signed up for classes at the hospital where he does deliveries. We both like him a lot.

I called his office today to find out what was going on, and they didn’t have a clue. The doctor had not personally sent out the email. They hadn’t even seen it before. I forwarded it to them. They recommended I call the insurance company and ask for a “continuity of care” form that would ask permission to keep seeing him at “in-network” rates since I have a preexisting condition (pregnancy). I called, and the guy I got on the phone was very nice. He explained to me that my doctor belongs to a group of physicians that is in the processes of renegotiating their contract with the insurance company. Those negotiations have to be settled by next week. The doctor’s group is holding out for a better contract, something they also did last year and ended up signing at the last minute. Bottom line: we shouldn’t worry about this until next week after the deadline has passed. I will call back then to find out what happened. Hopefully, it will all be resolved. We certainly can’t afford to pay out of pocket. We really need the insurance.

Hiatus Interrupted

I’m sorry it’s been so long since I’ve posted. The holidays took over and then there was some scary news. I had a penta-screen (a set of tests that includes the triple screen or quad-screen for genetic problems) at my OB’s office. It’s a blood test, and I didn’t give much thought to the idea that it might come back abnormal. Well, I got a call from the nurse 2 weeks later. She said that the test had come back “positive for Down’s Syndrome”. I was absolutely floored. I started crying. I couldn’t think to ask a lot of questions. She said that it was just a diagnostic tool and not an actual diagnosis. They set up an appointment for me at a perinatologist’s office where they would do a Level 2 ultrasound that would scan all of the baby’s organs to see if they are growing normally. I would also be offered amnio there which is the only way to confirm if the baby has Down’s. Unfortunately, the soonest they could get me in was 2 weeks later.

Of course, the first thing I did once I got off the phone with her was look up these tests on the internet. Turns out, the penta-screen results should be read as a chance of the baby having Down’s, not a “yes” or “no”. I called back to get my odds. They were 1 in 130. That’s less than 1%. Meaning, there was more than a 99% chance that the baby was fine. WHY DIDN’T SHE TELL ME THIS WHEN SHE CALLED THE FIRST TIME! My sadness turned to anger. Since then, I’ve read about other women this has happened to, and I think it is an absolutely cruel practice that OB’s put women of a certain age through in order to scare them about having kids so late. The test is largely dependent on the age of the woman. In my case, that should be the age of the eggs (the donor’s age), not my age. The nurse did say they reported that we used donor eggs, but I do not recall telling them the age of the donor. Unless they got it off my paperwork from my RE, I don’t know what they used for the age. She didn’t know what they used.

The next two weeks were the worst. My husband and I could barely hold it together some days. We cried a lot. However, we knew that it was probably a lot of worry for nothing. There was still a 99% chance that everything was fine.

We had the Level 2 ultrasound today. I am happy to report that our little boy looked great. All of the markers looked perfectly normal. Brain and heart activity were normal.  He didn’t match any of the markers for problems (bones around the nose looked good, his pinky had all the bones, his heart was great, his neck measurement was good, etc.). Based on the ultrasound, the perinatologist brought our odds down to 1:360 (around 0.3%) for Down’s. Just to be sure, we’re doing this new blood test they have that is 98% accurate for detecting 3 of the most common Trisomy (chromosomal) issues. That is much less invasive than amnio! We should have those results in about 2-3 weeks. The doctor felt good about everything being OK, though. I finally feel like I can enjoy my pregnancy!

Other than this emotional roller coaster, things have been going great. I feel great. The only somewhat scary issue I had the entire pregnancy was one brief incident of vaginal bleeding on Christmas Eve. It was bright red, but it certainly did not fill a whole pad, which is the marker for calling the doctor. I had some morning sickness, but I could keep it at bay by eating when I felt it coming on. After 12 weeks, my hips and rear end starting cramping at night. I’ve read that this is common because of the Relaxin produced by your body to get your hip bones to separate from your spine in preparation for childbirth. I have to stand up when I feel the cramping coming on, so I’m up every 2 hours or so. Often, I can feel my hip pop back into place when I stand. Luckily, it’s only at night. It’s actually a lot better when I sleep alone, but I really don’t want to give up sleeping with my husband, especially the last two week when we were both so scared.

I’m feeling very positive today. I think I may even go out an buy some baby things. I had been afraid to do so before now.

A Heart Thumping Good Time

Sorry I haven’t blogged in a while. I wanted to wait until after the first OB ultrasound just in case. Everything is going extremely well , though. The ultrasound was amazing! We got to see our little emby at 7 weeks, 3 days. There’s just one, which is perfectly fine with us. We thought there may be a chance at identical twins because my Betas were on the high end:

5 day transfer on 10/27

Beta 1: 400 on 11/6

Beta 2: 1000 on 11/8

Beta 3: 5316 on 11/12

The doctor said everything looked great. The baby is in good position in my uterus. The heartbeat was 157 bpm which was good. The ultrasound they used showed the oxygenated blood entering the baby and the de-oxygenated leaving. I go back to the clinic for another one tomorrow, and then I get handed off to my regular OB/GYN.

Speaking of my regular doctor, getting an appointment has been a nightmare. I called Thursday right after the ultrasound, and they said they needed my medical records. I had them faxed over, but the clinic apparently couldn’t fax them because it included an HIV test result (negative, of course). They didn’t tell me that, so I called back on Monday, and they hadn’t received the records so no appointment. I had to wake myself up in the middle of my sleep after midnights to call them. I was distraught. I figured out that the records were coming via mail, and I tried again today (Tuesday), waking myself up again to call before they closed. Well, now they are sitting on the desk of the person who answers the mail, but she’s gone till tomorrow. No one else can open the mail. Ugh. I have to wake my pregnant butt up AGAIN (3 days in a row!) to hopefully get an appointment scheduled. Since it’s the holiday season, I imagine the appointments are booking up like crazy. I have to have an appointment before I leave for  the holidays because my 10-13 week period starts the week before Christmas and ends the week after New Year’s. This is when a lot of the important testing to ensure the health of the baby needs to occur if we are going to have it done. I am so frustrated. I also have to get myself up super early on my last midnight to make my 12:15p appointment for the ultrasound. I’m going to be a zombie. The good news is, I have gotten some good naps in the last few days. I hope that continues.

We haven’t told anyone about the baby yet. It actually hasn’t been as hard as I thought it might be to keep it secret. We’re planning on wrapping up the ultrasound picture and giving it to our parents for Christmas. I’m excited to see the looks on their faces. Work is another story. Not too many people are going to be happy about this, especially my immediate supervisor. When one of the women I work with tripped over her cat and had to be out of work for a few weeks, the first thing he said to her was “You should kill that cat.” Lovely, huh? He has no children and is a workaholic. I think I’m going to go to his boss and let him know first. I’ll probably be accused of not keeping the chain of command, but I know his boss will be more understanding and have advice on dealing with my supervisor.

I was feeling great through Thanksgiving, which was good because I had a house full of people. I barely had any pregnancy symptoms, just the big boobs and a little extra tired. The morning sickness sank in the Saturday after Thanksgiving. It’s bearable. I just need to eat frequently to keep it at bay. I’m trying not to overdo it, so I’m tracking what I eat every day. The clinic warned me to watch my sugar and sodium, so it helps to keep track. It’s the worst at work where I don’t feel like I can eat and pee freely. I worked some day shifts when I first got the morning sickness, and they were the worst because there’s extra scrutiny of your personal activities. I don’t actually feel nauseous. It’s more like feeling hungry but having an upset stomach at the same time. Working midnights is actually much nicer. I can sleep most of the day and be lazy when I am home, and I feel more free to eat/pee when I need to at work.

So far, so good. It still doesn’t quite feel real yet. I do think I am starting to look pregnant. Luckily, it is sweater season, and I can get away with baggy tops to hide my boobs. I’ve only gained about a pound and a half since I got pregnant, but that seems to be on target for this early in the pregnancy. Once we get past the first trimester, I’m going to try to let myself get more excited.

By the way, my acupuncturist thinks we’re having a girl because the pulse in my left arm is so much stronger than in my right. We’ll see…

BFP!!!

Score one for the embryologist! I am pregnant!!! It’s still hard to believe this is happening. I don’t have any symptoms. I have been hungry a lot, but I was hungry before the transfer, so I think it’s just the meds. No matter if I am having symptoms or not, I am definitely pregnant. 5 tests have confirmed it.

My husband had to go on a business trip on Monday, so we did 2 different HPTs on Sunday morning. We got positives on both! We were feeling cautiously optimistic. My appointment for my first Best hCG wasn’t until Tuesday. The quicky test in the office turned positive. Pretty strongly so. My Beta Tuesday was 400 and my second test today (Thursday) was 1000. That’s on the high-end for singleton pregnancy, but not so high to be alarmed. Hopefully, it just means our little emby is strongly attached to mama. We have one more beta on Monday.

The first ultrasound should be the week after Thanksgiving. They said they wanted to do it Monday, but it’s going to be tough to get that in around work that day. Tuesday will be better (not that I want to wait!). I’ll talk to the doctor’s office Monday to see if we can put it off one day.

It’s a little weird to finally be pregnant, especially since I have no symptoms. If I can be so lucky and not get morning sickness, I will be one happy camper. At this point, it would be a small price to pay, though.

Transfer Complete!

I can’t believe the transfer day has come and gone! It was such a long, tiring process, but the home stretch wasn’t too bad. The week of the transfer was relatively calm because I was off and able to take care of last minute details and make it to acupuncture appointments without work getting in the way. I’ve been doing the Circle and Bloom meditations everyday. I did uterine massage everyday after my period ended. I exercised up to the day of transfer. After transfer, I have been a couch potato as much as possible. I did have to work a few midnights, but managed to get the 48 hour modified bed rest that was recommended.

The day of the transfer, we went into the doctor’s office around 8:15am. We found out we were their only transfer that day, so we got their undivided attention. Our doctor was not there. That was no surprise. We had only seen him once. From what I had read, I was expecting it to be one of the lower doctors on the totem pole, especially since it was on a weekend. I’m actually glad he wasn’t there. The doctor who did the procedure was a woman, and she had a great bedside manner. I think I needed it that day.

When they called us back, we were ushered into a small room with a tilting chair and an ultrasound machine. We met the embryologist who looked like she couldn’t have been older than 28. She explained that she had selected two excellent embryos for us and handed us pictures of them. Well, we had told the doctor (who wasn’t there) that we only wanted to transfer a single embryo. Also, both embryos she selected were fertilized via ICSI instead of IVF. That freaked me out a little. I felt like I didn’t know enough about ICSI. I thought they only used ICSI when the sperm were not able to fertilize the egg on their own. Apparently, that’s not the case at our clinic. I looked at the SART data, and 75% of their cases used ICSI in 2010. The embryologist said that it makes no difference as far as the embryo quality or the health of the baby, and the embryos she picked out were excellent and already beginning to hatch. I still needed the doctor to reassure me, and there is a tiny part of me that wonders if we did the right thing. I should have done more research and asked more questions once I got the embryologists report on Tuesday that said half the eggs were fertilized via ICSI. I know our clinic has an amazing success rate. They know what they’re doing. I just worry that they do not follow up on these babies later in life. Yeah sure, you get a “healthy” baby at birth, but what could go wrong later because of all of the tampering with the egg and sperm. I have decided to put all of these doubts away and be positive that this embryo is our baby-to-be. It will be healthy and perfect. It is the little soul we have been hoping and praying would come into our lives.

Prior to showing up at the doctor’s office, they asked me to drink 32 oz of water. My bladder was full, but I didn’t think it was uncomfortable when we got there. When they did a prelim ultrasound, the nurse noticed it was too full. She had me empty part of my bladder. Well, I didn’t empty enough. I had to go back and forth to the bathroom 5 times before I got it right. The bladder needs to be somewhat full to help them distinguish the bladder from the uterus on ultrasound.

The procedure itself was very simple. They inserted a catheter into the uterus, using ultrasound as a guide. The embryo was put in a “straw” and ejected into the uterus by flushing a small amount of liquid through the straw. I felt a little pinching, but noting major. They let me lay down listening to Enya for 20 minutes with my husband by my side after the procedure. He was a little choked up. It was sweet. After the 20 minutes were up, they had me empty my bladder and they sent us off with instructions for my medications. No real changes:

1 CC progesterone in oil injected every morning

2 progesterone capsules inserted vaginally twice a day

1 estradiol tablet twice a day

continue switching out the Vivelle patches every 3 days

The embryologist called the next day with the report on the embryos that were frozen. We have 10 total! 6 in individual straws and 2 double straws. 7 were rated excellent and 3 were rated good. Like my acupuncturist said, we could have a Brady Bunch if we wanted!

The doctor warned us that I should not pay attention to any “pregnancy symptoms” because all of the drugs I’m taking will make me feel pregnant. I did notice that the progesterone is starting to accumulate in my body. My breasts are a bit more sore (but not nearly as much as on birth control pills), and I have more gas than usual. That’s really it for symptoms. I don’t feel anxious or worried about getting pregnant. I’m glad we have lots of other chances in the freezer. I think that takes the pressure off. That being said, I’m not thrilled with the idea of having to go through all of this again.

My husband has to go on a business trip on Monday. I’m scheduled to go in for my pregnancy test on Tuesday. He was feeling terrible about not being able to come to the appointment. I read online that since I did not take stimulation medication, I should be able to do a pregnancy test on Sunday before he leaves (9 days after the transfer of day 5 blasts). If it’s negative, we can have some time to grieve together before he leaves and plan for the next transfer. If it’s positive, we can celebrate. I’m incredibly hopeful. I feel like it is going to happen this time. When the embryologist showed us a picture of the egg we implanted she said “This will get you pregnant”. She’s the expert, so my hopes are high.

Lucky 18

The retrieval was Monday, and everything must have gone well because they extracted 25 eggs, 9 of them were normally fertilized with standard IVF procedures (when they let the sperm find the egg on their own) and 9 via ICSI (intra-cytoplasmic sperm injection). Those 18 embryos are “cooking” in the lab right now. Amazing! The transfer should be on Saturday or Sunday. I will have to call the voicemail assigned to me by the clinic on Friday to find out when exactly it will happen. I suppose the odds are good that we will have at least one high quality embryo to transfer and a bunch that are acceptable for freezing. I do need to make sure that they know we only intend to transfer one embryo this weekend. They told me the doctor will do whatever you asked him to do at your initial meeting, but that was several months ago. We’ve only seen him once since then. I do not want to waste any of the embryos (especially the high quality ones).

I stopped taking lupron on Sunday, the day before the retrieval. We started the progesterone in oil shots on Monday. The nurse at the clinic showed my husband and me how to administer them when he came in to give his semen Monday. It’s a much bigger needle than the lupron shots, but it really doesn’t hurt nearly as much as I thought. If you are curious, just search for “progesterone in oil injection” on You Tube. I also started taking progesterone vaginally today (Wednesday) and an antibiotic.

We are super excited to get to the transfer. I’m still concerned about getting out of work. I’m just going to have to call in once I know when it is actually going to happen. I have this whole week off to get stuff done before the transfer. I wanted to spend it cleaning and making food to eat so I didn’t have to worry about that post-transfer, but I spent all day doing work instead. I need to learn to let that stuff go.

In The Dark

Things went pretty well until mid-week this week. I had my second ultrasound/blood work visit on Monday. Everything went well. My lining was at 9mm. It was right on track according to the ultrasound tech. I’m continuing to take the estradiol, lupron, and Vivelle patches based on the instructions I got Monday afternoon after the blood work came in. The nurse told me they would call on Wednesday with further instructions. They did call Wednesday and said the donor needed another day. They called Thursday and said the donor needed yet another day. I asked what was wrong, and I was told this was no big deal. I asked for more information, and she said there’s nothing to tell. I didn’t think to ask about the number of follicles that were maturing or anything else. I was just in shock and before I knew it, the nurse was hanging up. I think I’ve mentioned in the past that I am not good on the phone in these situations. I always think of a million questions after the fact.

The big problem for my husband and me is our schedule. I managed to clear my calendar for nearly a month. I took a ton of time off work. There were only 5 midnight shifts in the middle I could not get out of, so wouldn’t you know that is exactly when the transfer is likely to occur now. I am truly scared. I don’t know what to tell them at work. I can not tell them about the IVF. If my boss and co-workers knew, they would do what they could to make this hard on me. No one wants someone in their shift rotation who is going to need frequent leave for medical reasons, not to mention have a baby. There has been no woman in the rotating shift schedule in my office who has every had a baby, and only one who was pregnant. She was in an entry level job at the time and moved into day work once she told the office. That’s not an option for me. My husband also had to manipulate his schedule to try to get time off for the transfer. Even with his new schedule, if things get delayed another two days, I’ll be taking a cab home from the transfer. Unfortunately, all of our local friends are work friends. We can’t ask for their help without the truth about what we’re doing getting out. I love my friends, but they have the mentality of most in our office. They will not understand why we’re spending money trying to have a child. None of them really like children much and are not planning on having any.

So, here I sit wondering if my donor if OK. Is she not producing any follicles? Is she as frustrated with this clinic as I am? Are they going to schedule her retrieval during a midterm exam? She’s only 23. I feel terrible that she’s had to deal with such a scatter-brained organization. Hopefully, her experience has been better than mine.

We paid the donor’s fee ($5k) and her expenses ($500) to the donor agency on Tuesday, before we knew that the retrieval was delayed. I really hope we get some usable eggs out of this. I’m sure the donor agency is not going to refund that money to us, even if they do not give it to the donor.

First Pre-IVF Appointment

On Monday, I went in for blood work and an ultrasound. The ultrasound tech said my uterus is “gorgeous”. The uterine lining was 4mm on CD4. I went home happy. Things are still moving along. Around 3pm, I got a call from the clinic saying that they were going to have to delay stimulation, and they were not going to include today’s visit in my package price. I informed the person that I was not being stimulated since I was receiving donor eggs. She put me on hold. When she came back, she said that they will include it in the package and hung up. I was a little freaked out. Was something wrong with the donor’s stimulation? I needed to know, so my husband called the donor coordinator and left a message. I was in the middle of writing an email to her when she called back and said the whole thing was a mistake. The donor is doing well, and my blood work came back with no problems. That was a relief! I started taking 2 estradiol pills a day and applying 2 Vivelle estrogen patches every 3 days. They also reduced by Lupron to 5 units a day. The only symptoms I’ve had from the extra estrogen are minor headaches and cramping shortly after taking the pills. I’m also a little more tired than usual. I’ve been trying to get a short nap in before my evening shifts this week. I take that time to do the Circle and Bloom meditations. They are specific to your cycle day. They’re pretty relaxing. I generally get through about 3/4 of them before I fall asleep.
While I was taking my walk today, I listened to an episode of the Diane Rehm show that discussed the health benefits of Omega-3 fatty acids. My husband and I are both taking fish oil. This show made me very glad that we are. Here’s a link for those of you who are interested:

http://thedianerehmshow.org/shows/2012-10-03/assessing-health-benefits-omega-3

So Far, So Good

The Lupron really hasn’t been that bad. The biggest thing I’ve noticed is that I am more thirsty. I go through a lot of water. The first few nights, I woke up having to go to the bathroom and wanting some water to drink. I learned to keep a bottle of water by the bed. I’ve been trying to take water with me everywhere. The only other thing I have noticed is that I can fall asleep within 2 minutes of my head hitting the pillow. I’m not especially tired before that point, but I’m “done” once I get to bed.

Like me treatment plan predicted, I got my period today. It’s started out heavy right after I woke up around 6am. It was down to a trickle by 9 am, but then it was back to normal flow after noon. My acupuncturist mentioned that my period might be a little weird this month. So far, I don’t have particularly bad cramping.

I am going to acupuncture twice a week now. The sessions are longer now – about 40 minutes instead of 25. I’ve cut back to one 700 mg l-arginine tablet a day and cut out the CoQ10 entirely. I’m not taking any Chinese herbs anymore, either. My regime is down to prenatals, fish oil + vitamin D, l-arginine, and an extra calcium citrate + magnesium to get my intake up to the levels recommended by the book “You: Having a Baby”.

My husband and I did have one big scare earlier in the week. We got a call from the clinic stating that the second half of the money for the procedure was almost a week overdue. Needless to say, we freaked out when we got the message. Of course, they were closed by the time we got it. Luckily, our new coordinator responded to email and told us what time the business office would be open in the morning to take out payment. We paid it the next day. The paperwork we signed stated that the payment would be due when I started injectables. I think we both expected to get some warning from them when they wanted the money, but that didn’t happen and neither of us thought to pay it when I started the Lupron. The documents we signed stated that they could charge us for the full price of procedures, rather than the package price, plus a $3k fee if we didn’t pay on time. We were pretty nervous when we went to the clinic to pay, but luckily they did not penalize us. We happily paid out $9.6k and change and skipped out of there.

I’m looking forward to my first office visit on Monday. It’s hard to believe it’s finally here. I never thought I would be so happy to get my blood drawn and have a probe stuck up my vagina.

Treatment Plan

OK, we’re in business! Here’s my treatment plan:

9/26 – Start injecting 10 units daily of Lupron at night between 7pm and 9pm

10/2 – Take my last active birth control pill. Stop taking the CoQ10 and L-arginine

10/5 – Period should start around now. Start taking baby aspirin. Continue Lupron

10/8 – First office visit for ultrasound and estradiol testing. Listen to a voicemail between 5pm-630p to get instructions which may include (1) start taking 1 Estrace tablet twice a day and (2) apply 2 0.1 mg Vivelle dot patches every 3 days. Also, reduce Lupron to 5 units daily

10/15 – Second office visit for ultrasound and estradiol testing.

10/22 – Third office visit for ultrasound and estradiol testing.

After the donor receives her last injection, my husband will need to ejaculate that night and I will stop Lupron that after that night. We will get word from the clinic when my husband needs to come in to provide the sample for fertilization, and that day I will start injecting 1 mL of progesterone oil into the upper, outer quadrant of my buttocks every morning. We’ll get the fertilization report from the embryologist after 1pm. I’ll start inserting vaginal micronized progesterone capsules (200 mg) twice a day and take doxycycline (100 mg) twice a day. They will call me when we’re ready for transfer. It sounds like we’re still on schedule for the transfer being some time around the 24th.

The clinic arranged for the pharmacy to deliver all of my meds. I started the Lupron shots last night. They aren’t too bad. The only side effect I’ve felt so far is being more thirsty than normal. The needle is very small like an insulin needle. I looked up “how to” videos on You Tube that were extremely helpful when trying the figure out what needles went with what medicine, how to load the needles, etc. I’m a lot more worried about the progesterone needles. The are huge! I just have to remind myself that lots and lots of women do this everyday, and there is a baby at the end of this rainbow waiting for us.

Speaking of babies, my sister-in-law just had one. He’s totally adorable, and everything seemed to go really smoothly. She looked fantastic in pictures just minutes afterward. Seriously, there wasn’t a bead of sweat on her and her hair was perfect. I want her hair and makeup team in my delivery room! I think she has to credit the epidural for that.

I found out that the egg donor coordinator we were working with at our clinic has left/was let go. Of course, they do not elaborate on such things. My husband and I aren’t very about it. She was a bit arrogant. I think we missed out on getting the full instruction we needed on the shots, etc. because of her and she is the likely source of the miscommunication that delayed this whole process a month. What’s done is done now, and our new coordinator seems great. She let us know that all of our blood work/tests and the donor’s were all fine and the psych exam was also good. I would like to get a little more information from them, but we were just happy to hear anything. We barely heard from the other coordinator without prodding her. This is a good change.

I starting weighing myself just before I took my first birth control pill. I’ve lost 2 lbs since then, but my boobs grew probably 2 cup sizes. I was surprised to see that I lot a little weight. We’ll see what happens once I’ve been on the Lupron a while. I am going to try to track what I am eating and weigh myself everyday to keep tabs on things. So far, so good.