November 29, 2009...Encouragement During this Long Wait

Trust in the Lord, and do good; Dwell in the land, and feed on His faithfulness. Delight yourself also in the Lord, and He shall give you the desires of your heart.

Psalm 37:3-4

November 25, 2009...I'm Back!

Wow, it has been a LONG three days!!! I actually thought I would be better at best rest than I actually was. For the first two days I was required to lay flat on my back, which was much harder than I thought. Then today, I just pretty much had to be a couch potato. Moving into an upright position this morning and hanging out on the couch was much more enjoyable than laying flat in my bed. I am glad my sister was able to get on here and give a little update (thanks Kris!). I wanted to be sure you got at least a little news as to how the appointment went on Monday. Our transfer went very smoothly. I can honestly say the worst part was probably my full bladder. Not only was I full, I was very uncomfortable. I actually ended up in acute care on Sunday, the day before our transfer, and found out I acquired myself a little urinary tract infection. Needless to say, being required to hold a full bladder was borderline inhumane! I was put on antibiotics and have definately felt relief! Before getting started the Dr. came in with the grades our embryos were given on day 5. They are graded on an ABC scale. Three of our embryos were a B+, two of them were a B and one was a C. Our big decision was to decide how many we wanted to transfer. He gave us the choice to do one or two. We obviously choose two. Two of the B+ embryos were actually blastocysts already, so that was very good news and those were the two we transferred. Cody and I had to completely "gown up" before going into the procedure room. I wish I had a camera....I got the giggles looking at cody in a super tight garbage bag-looking gown, a mask, and a hat that made him look more like a chef than a patient. Once we got into the procedure room, I actually couldn't even look at him because I was laughing so hysterically. Once I was situated, the nurse started the ultrasound and was very impressed with my full bladder!!! It pushed my uterus into the exact position it was supposed to. We got to watch everything on the ultrasound monitor. We watched the cathether moving in and in a very brief moment, we got to watch our two tiny embryos move out of the catheter and into the uterus. What an amazing feeling! When he was finished I had to lay upside down for an hour. And when I say upside down, I mean it. My bed was actually at a pretty good angle with my feet in the air. When we were finished there, we then headed over for my last acupuncture session and then headed home where I have been vegging out for the last three days.

Yesterday I received a call from the lab with our final embryo report. They give them until day 6 to see which embryos have made it that far and if they look well enough to freeze. Of our 4 remaining embryos, 2 of them arrested and 2 of them still looked great!! It was absolutely amazing news for us to hear that we have 2 embryos to freeze.

I am down to one injection per day. Although it's only one, it's probably the worst one possible. The progesterone in oil burns like hell and leaves a terrible bruise. I am sure to ice it up good before Cody gives it and we try to alternate hips depending on which one feels the best at the time. I also just started a Vivelle patch today, which is just another dose of hormones.

I have to go back in a couple of weeks for the big pregnancy test. I am actually going to reserve the exact date for just Cody and I.....I figure we have to have some element of surprise. Until then, we just hurry up and wait....and pray!!

Cody and I want to wish you all a very happy Thanksgiving tomorrow. As we reflect on the blessings we have received this past year, every single one of you come to mind. We have been blessed!

November 23, 2009...Embryo Transfer

Hello! This is Holli's sister Kristal and because she is required to be flat on her back for the next 2 days, she is unable to get to her computer. So, here I am to update! I talked to her on the phone this afternoon.

The transfer went well this morning. They had 3 embryos that looked really good, 2 that were decent, and 1 that was not so good. So they chose the best 2, and transferred them both. They were able to watch the embryos on the ultrasound monitor, being transferred from the catheter into the uterus. And they even got ultrasound pictures. She is pretty excited about that (I told her, they were the babies first picture!)

Holli wanted me to update with the basic information, when she is up and around again she will give the "extended version" of the appointment.

November 20, 2009... Growing Embryos

I finally got a chance to talk to Dr. Hansen's office this afternoon. They let us know that our teeny tiny babies are still growing in petri dishes! Crazy, I know. The nurse didn't get a chance to talk to the embryologist much about how well the embryos looked specifically, but she did say they felt they looked good enough to wait and do a 5-day transfer on Monday!!!  It's a little frustrating not to know anymore about how well they are doing...if any are pulling ahead or if others are lagging behind. Our transfer is scheduled for 7:30 Monday morning. The embryo transfer is the last procedure in the IVF process, and it could be considered the most important. The entire IVF cycle depends on the very delicate placement of the embryos at the proper location in the uterine cavity.  I was also told that I have to come with a very full bladder. And the way they made it sound....VERY FULL. Apparently this allows for better ultrasound visualization of the catheter and a full bladder also pushes against the uterus in order to get a better angle to insert the catheter, making the process easier and less traumatic for both the endometrial lining and the embryos. The nurse said a full bladder can increase my chances by 30-50%. I will have a full bladder!! The process will look much like my first IUI's, only the catheter will be loaded with the embryos, rather than just sperm. The catheter will be threaded through my cervix and into my uterus all while being guided by ultrasound. When the catheter tip reaches the ideal location, the embryos are then "transferred" or squirted out of the catheter onto the endometrial lining. After the procedure I will be required to lay in the office for an hour.

I will also be finishing up my last couple of acupuncture sessions. I am to do one treatment before the transfer and one after the transfer. The pre-treatment will most likely be done on Sunday night...needless to say, these doctors are wonderful! This treatment is to prepare my body for what is about to happen. The post treatment will take place immediately after I am done at Dr. Hansen's office. The post treatment has a very small window of time that it can take place. The purpose of this treatment is to get my uterus to contract just enough to get the embryos burrowed down into the uterine lining. Amazing stuff!!

After the transfer I will be taking it easy for a few days...giving those little buggers the best chance possible. We are really trying to draw that fine line about getting really excited but not getting overly excited. Please pray for us.

November 19, 2009...We Have Fertilization!!!

Our nurse called me this morning at about 9:30 with our news. Of the 12 eggs they retrieved yesterday, one of them was immature and one was "empty" or lacking any genetic material. So 10 of them were appropriate to be fertilized using ICSI, (inserting a single sperm directly into each egg). Out of those 10 eggs, 6 of them fertilized!!!! We are soo excited to get this news!! We were also supposed to find out today whether or not we would be doing a 3 or a 5 day transfer. But, it turns out that 6 embryos is a borderline number to make a decision, so they weren't able to tell us today...go figure. The embryologist would like to give them another day in the lab and call us tomorrow with the decision. I've been reading a lot about it and have definitely found some varying opinions in the medical community about which day is better to transfer embryos back into the uterus. I read today that when embryos are cultured from day 3 to day 5, some of them may stop developing but most of them will continue to become blastocysts. Therefore, by choosing the best blastocysts for transfer on day 5, they can choose much more reliably those with the best potential for implanting and making a baby. In my opinion, I would feel better about a 5-day transfer, because it allows the embryos a little more time to develop and to reach the important bastocyst stage before transferring them back. I am sure it is a case-by-case situation of watching each particular couple's embryos to see how well they're tolerating it in the lab and whether the embryologist thinks it would be beneficial to get them into the womb sooner. Either way, we won't know our transfer day until tomorrow. And, of course, we still don't know how many we'll transfer back because we don't know how many out of the 6 will make it that far. Most likely, because of my age, the doctor will recommend transferring only one or two embryos. But trust me, we didn't come this far to only transfer one...I will fight tooth and nail to transfer two...we are too invested at this point. We hope and pray that all of them grow like they're supposed to so we can freeze the one's we didn't use for a future cycle. If any of them make it long enough and look healthy enough to go through the freezing process, our next cycle would be starting right here. Everything we have done up to this point would not have to be done again if we could use frozen embryos. They would only have to survive thawing and the transfer. Which would be a miracle, but let's not get too far ahead of ourselves!

As far as healing from the egg retrieval, I am feeling pretty good. Yesterday I had some terrible cramping but slept most of the day away. Today I still have some pretty good cramping, but nothing to complain about. When I put my dress pants on this morning and went to button them up, I thought to myself I would much rather be spending the day in my pajamas!!!

November 18, 2009...Egg Retrieval Accomplished

The egg retrieval went great today. IV drugs are amazing, that's all I've got to say. I've been experiencing some pretty intense abdominal cramps, which is completely normal because they seriously jabbed a needle through my uterus and directly into both ovaries to aspirate the follicles. Ouch! But anyway, we were out of the office by 9:30, so no complications at all. They retrieved 12 eggs. That is actually a very good number. Ten eggs is average, and they hope to get in the range of 8-12, so we were right on the money. The lab will fertilize the eggs this afternoon and we will get a phone call sometime tomorrow (Thursday) letting us know how many eggs actually achieved fertilization. It is a little out of my comprehension to think that Cody and I are potentially creating embryos right this minute. It's really quite amazing.

The nurse did my first IM (intramuscular shot) in my rear this morning while I was still in recovery. The injection is progesterone in oil and is something we now have to do everyday. I am hoping Cody does as good of a job as the nurse did...I am sure he will, I have faith in him!! I will also start on an antibiotic tonight to deter any possible risks of infection from today.

We can't wait for the phone call tomorrow, hopefully with some good news. I will share with you tomorrow!!

November 17, 2009...Egg Retrieval

I just want to clear up any confusion as to what is happening tomorrow. Tomorrow we are doing our egg retrieval only. Cody and I have to be at the lab at 6am where Cody will give a semen collection and I will get ready for the retrieval. The procedure will actually start at 7 oclock. They will put me to sleep and then Dr. Hansen will insert a long needle through my vagina and into my ovaries. He will aspirate all of the liquid out of every follicle on each ovary. When he is finished, he gives everything to the lab who then have a long day ahead of them. They will wake me up and hopefully I will have a quick recovery and we will be on our way. As long as I am feeling fine, I should be able to go back to my regular routine on Thursday. Throughout the day tomorrow, the lab will be removing my eggs from the liquid aspirated and place them in a dish. They will then look through Cody's sperm and pick out the "best looking" sperm and prepare them. Once everything is ready they will be doing the ICSI procedure, where they will be inserting a single sperm into each egg. This is obviously an extremely delicate process. Once the sperm is inserted into the egg, we then have to wait to see if fertilization occurs. Tomorrow, before we leave, we will only know the number of eggs that were retrieved. We will then receive a call on Thursday from the nurse telling us how many of the eggs actually fertilized (which we will then call our embryos). They very rarely get 100% fertilization, but we are hoping for a good number. We will also find out whether or not we will have a 3 day transfer or a 5 day transfer (that is the time when they will transfer the embryos back into my uterus). This will be determined by how many eggs were retrieved and how they look once fertilization takes place. The embryos then have a few days to "grow" before the transfer takes place. This will happen on either Saturday or Monday. So yes, tomorrow is a big day. Please pray for peace, comfort and success....I am VERY nervous.

November 15, 2009...Wednesday It Is!

We have a date. Our egg retrieval is scheduled for 7am this Wednesday!! After looking at my follicles again today, the number of measurable follicles has gone up, but I didn't ask how many total follicles we were looking at now. When the dr. does the egg retrieval he said that he goes into every follicle and aspirates the liquid out of each of them. He then hands it directly to the lab and they are the ones that take it and look for the egg. So we may not get an egg out of every follicle, but that is the hope...so that's why he goes into every one, even the smaller ones. We are just hoping for a good number of good quality eggs. I will continue with my shots through tomorrow night, along with my hCG trigger shot, which is exactly 35 hours before the retrieval. Then no shots required for Tuesday!!! I know it's only one day, but at this point, I'll take whatever break I can get! Cody and I have to be at the clinic at 6am that morning. The actual process takes a very short period of time, but because of the invasive-ness of it all, they do put me under anesthesia. Including recovery time, the nurse thinks we will be out of there between 9 and 9:30 that morning. We are praying that everything goes smoothly.

Believe me, I am beyond nervous, HOWEVER, I am absolutely thrilled to be here and actually have this date scheduled...we are finally getting to the good part!!!!

November 14, 2009...No News

My ultrasound this morning showed that I am getting closer, but still not quite ready. The doctor really wanted to be able to give me some more detailed news, but he said he just couldn't. They would like me to continue with my meds. AGAIN, back to the pharmacy...sending me into meltdown mode once I got into my car. For some reason I was under the impression that my first large bag of medicine was going to be everything I needed. So every time I have to fork over more money, it's a little difficult to swallow. I understand that my body is unpredictable and of course they don't want you to pay for more than you need, but our cost for meds alone is really starting to stack up. Anyway, my ultrasound this morning showed 4 follicles on the right side and 6 on the left (so a couple less than the original 12 they were thinking). The biggest follicle in my right ovary measured 15 and the biggest one in my left is measuring at a 17. Ideally they would like the follicles measuring between 18 and 22. So I have to go back in tomorrow morning so they can take another look. I am really hoping we can pinpoint a retrieval date tomorrow. It's hard not to want to rush things but I have to put my faith in everyone that they know what they are doing and we will get the ball rolling when I am ready, and not until then.

November 13, 2009...On The Road Again

I apologize for not getting an update on here yesterday, just didn't get the time. I had my ultrasound appointment with Dr. Hansen yesterday morning at 7:15. Then I drove back to Worthington to work for the day, and then had to be back in Sioux Falls by 4:30 for my acupuncture appointment. I didn't get back to Brewster until about 8:00 last night, only to finish laundry and quickly pack our weekend bags so they could be in the car this morning as we have to be back to Sioux Falls this afternoon for another appointment. This has been a little challenging and I am putting a lot of effort into making sure I always have with me the right medication for the right time of day. All of my injections are required to be given at the same time every day, and because I haven't always had Cody with me at these times, my parents have had to step up and take on the challenge. We got a pretty good show yesterday morning when my dad attempted my morning injection (right mom?).

The results of my ultrasound showed that my eggs are growing, which is good, but they are not yet mature enough. Everything is a very exact science. All of my eggs have to be just the right size before egg retrieval. But they can't be too big and they can't be too small. So finding the perfect time where the majority of eggs are within the right size is a tricky process, hence all of the ultrasounds so they can be montirored very, very carefully. My plan of action is to continue with the stimulating meds and go back in Saturday morning for another ultrasound. So back to the pharmacy, another $460.00 for just four more injections to get me through to Saturday morning, and away I went. Thanks to my uncontrollable mood swings I seem to be having lately, I actually thought I might cry over the thought of handing over my check card. But once I got into the car and called Cody, we have learned it's easier to just laugh at the insanity of it all rather than getting upset.

The dr. is thinking my appointment on Saturday will give us much more information as to when my egg retrieval might take place. They are guessing Monday, Tuesday, or Wednesday of next week, but hopefully they will get that narrowed down once we go in on Saturday. Stay tuned for further details.

November 10, 2009...Grow eggs, grow!!

I started my stimulating meds last Saturday morning. This will help all 12 (or thereabout) follicles develop into mature eggs that will hopefully be capable of being fertilized once my egg retrieval takes place.  So now we're up to three injections a day, one in the morning and two at night. I am also continuing my trips over to Sioux Falls for acupuncture. Although I'm beginning to feel a little like a pin cushion, everything is going well, so I can't complain. I have another ultrasound appointment scheduled for early Thursday morning. Hopefully this will give us a little more information as to how my follicles are looking and possibly more of an idea of when egg retrieval will occur.

I would like to give my husband HUGE props for being the absolute best husband a girl could ever ask for. He has provided me with unlimited support and patience throughout this process and I don't know what I would do without him. He is going to make an incredible dad someday!

November 4, 2009...BIG Day!

I started my morning with acupuncture. I know right, completely stepping out of my comfort zone with this one. Our doctor, along with several other people, recommended we (or I) should do acupuncture along with our IVF cycle. As invested as we are in this process, we thought we should really go all the way. Leave no recommendations un-dabbled. So here I am dabbling into something I never thought, in a million years, would be something I could see myself doing. Seriously, lying on a table, my body covered in needles....yeah, not so much anything I would have ever envisioned. I kind of wished someone was there to take my picture!!! But it actually wasn't too bad. I can honestly admit there was nothing to it....which is probably a good thing, because there is a recommended 8 session protocol to accompany IVF. The purpose of acupuncture, in my case right now, is to increase blood flow to my uterus and my ovaries. This will help with the implantation process. Let's keep our fingers crossed.

After spending my morning spreading my wings, I headed over to Dr. Hansen's office for my first ultrasound appointment. At this point, my ovaries look good. They are showing about 6 follicles on each side. So hopefully there will be about 12 eggs on the day of Egg Retrieval...give or take a few. But 12 is a perfectly average number, so they were happy with that. Typically they would have started me on my stimulating medications today, but they want me to wait until Saturday. If they would have started me today, then my Egg Retrieval would have more than likely landed on a weekend. Which, if they can help it, the lab "people" really prefer not to do it on the weekends. So, if they start me on Saturday then my Egg Retrieval will fall sometime during the week. Which, as of now, they are looking at sometime around the 17th/18th of November. Then on to the pharmacy to pick up my "bag of goods."  This is all of the medication that I will need from here on out. Even with our insurance coverage, I have one thing to say.....STICKER SHOCK!!!

I finished out my afternoon with a bang.....a root canal!  No need to elaborate. A LONG 3 hours later and another big check, I called it a day. I did a lot of praying today. Not only for comfort, for obvious reasons, but for peace and acceptance. It's a hard thing to grasp...the fact that we are putting all of this time, money, and effort into something that isn't even a guarantee. But we remain hopeful!