The FET update I’m sure no one is interested in anymore.

So if you’ve scoped out my FB or IG within the last week, you’ve probably figured out our news. If you haven’t, here it is: Andrew and I are expecting the arrival of TWINS in August. What? We’re excited (and terrified) and totally over the moon!

But I still want to share with you how we got here!

After our first round of IVF didn’t result in a pregnancy, we were able to go right into a Frozen Embryo Transfer (FET) since we had plenty of frozen embryos (11)! The protocol started off in a fashion fairly similar to that of IVF: with a pack of birth control pills and then a cycle day 3 baseline appointment. The baseline appointment, as always, consisted of an ultrasound and blood work to make sure all was quiet on the western front. Or whatever.

Everything looked good at my baseline appointment and I was given the go ahead to start hormone injections that day. This is where the process started to veer from my previous experience. With IVF I had to give myself 2 shots in the stomach every day, with a third shot added to the mix after a week or so. The hormones I was taking then were to stimulate my ovaries into producing a whole lot of eggs. With an FET, stimulating my ovaries was unnecessary; we didn’t need the eggs because we already had the embryos we were going to transfer. Instead of daily subcutaneous injections in my stomach, I only needed one intramuscular injection of estrogen every 3rd day. And instead of stimulating my ovaries to produce eggs, the estrogen was stimulating my uterine lining to thicken up and make a safe place for the embryos to implant. In other words, the estrogen was simulating what my body would be doing naturally leading up to ovulation.

Because the least painful IM injection site happens to be the butt/hip area, and because the needle was 1.5 inches long and there was no way I was going to be able to stab myself with that, Andrew (and sometimes my mom) had to take over the administration process. Kudos to them both for being able to stab someone they love without batting an eye (wait, should I be worried it was that easy for them?). Those injections started on 11/24 and continued every third day throughout the entire process. I’m actually still taking the injections now and will continue to do so until my 10th week of pregnancy.

After about 2 weeks of estrogen injections it was time to head back to the clinic for another ultrasound and some more blood work, this time to check that my lining was up to snuff and my hormones were all in line (it was; they were). The ultrasound tech said my uterus looked “perfect and beautiful” and later that day my nurse gave me the go ahead to add daily IM progesterone injections to the mix. That was on 12/7 and my FET was scheduled for 5 days after on 12/12 (the day after my 28th birthday). The progesterone injections were viscous and left big bruises and knots in the muscle, and they continued throughout the entire FET process and into my 7th week of pregnancy. That wasn’t necessarily the most fun I’ve ever had! BUT, they were necessary to simulate the conditions in my body produced by ovulation so that my body would be perfectly in sync with the day 5 frozen embryos we transferred.

The day of the transfer was exactly the same as with IVF, except with transferred 2 embryos instead of one, and the clinic was backed up by about an hour, which is a long time to wait with a full bladder.

I found the FET process to be a lot less taxing than IVF was, even though it certainly still had it’s ups and downs. There were fewer shots, fewer unpleasant side effects (though I still suffered from headaches, decreased appetite, weight gain, and GI upset), fewer monitoring appointments, and it was a much quicker process. All in all, I’m happy to have that part of my life over with for now. Infertility doesn’t go away with a positive pregnancy test, and we still have a long way to go before we have two healthy babies to snuggle, but for now we’re choosing to let go of a lot of the fear and anxiety during this sweet time and enjoy ourselves as much as possible (and all-day sickness will allow).

I’m going to continue blogging about infertility and it’s effects on this pregnancy – I hope you’ll continue to follow along!

What happens when IVF doesn’t work?

As I covered in my last post, our first go at IVF was unsuccessful. Sad, but not completely unexpected due to overactive hormones after my egg retrieval. So what’s the next step?

If you remember from my previous posts, IVF went a little something like this: birth control to calm things down, stimulating my ovaries with hormones to get them to produce a lot of eggs, retrieving and fertilizing those eggs, then transferring an embryo 5 days after fertilization and freezing all the remaining embryos for future use. If we hadn’t had any embryos to freeze, we’d be starting a new IVF cycle right from the beginning. And I’d be pulling my hair out because that was not the most fun experience I’ve ever had.

Fortunately for us our DNA really like each other, so we had 11 excellent quality embryos to freeze. 11!

That means we get to move forward with the –relatively– simple process of a Frozen Embryo Transfer (FET). Some fertility clinics do what’s called a natural FET cycle, where the woman is monitored for ovulation and then the embryo is transferred at the correct time after ovulation. For example, if during IVF the embryo is frozen 3 days after fertilization, then during an FET cycle the embryo is transferred 3 days after ovulation. If during IVF the embryo is frozen 5 days after fertilization, then during an FET cycle the embryo is transferred 5 days after ovulation. Got it? Good!

In my case, because I don’t ovulate or have a natural cycle, my body has to be manipulated with hormones to simulate what it would do during a normal cycle. Luckily, this still involves fewer hormones and needle sticks and monitoring appointments than stimming for IVF did! Honestly, I also think SGF prefers to do medicated FETs across the board because it’s easier to control/predict and get the timing down just right. You see, you want your body to be in sync with the little embryo(s) that’ll be getting transferred, that way everyone has a better chance at a happy ending!

Now that you have a bit of an idea of what the next step is, I’ll be taking the next couple weeks to share my FET protocol and experiences with you guys! I hope you’ll stick around to read about it!

Happy Belated Holidays

Hello dear readers.

My apologies for my somewhat prolonged absence. After our IVF cycle I took a break to celebrate the holidays and my birthday (I’m 28 now).

I hope you all had enjoyable holidays! I typically don’t enjoy this time of year very much, but this year was low-key and cozy despite it being a hard time for us. We got to spend time with family & friends and it was really special. NYE was especially nice as it involved sweat pants, snacks, and trivia. Though, I have to admit, I went to sleep right after my midnight kiss. I guess I’m getting old 😉

I know many of you have been wondering about the results of our IVF cycle. Unfortunately, it did not result in pregnancy. We weren’t surprised given the complications I experienced post-retrieval, and though we were sad we weren’t devastated.

In the coming weeks I’ll be sharing about what happens when “fresh” IVF fails & the next steps in our treatment. We only ask that you please respect what privacy we can maintain. Be assured that we will share any future news (whether good or bad) on our own timeline. Asking on social media if we’re pregnant or asking our family for details isn’t acceptable. I apologize if this sounds harsh, as it’s not meant to be — but rest easy that you will know any important information when we’re ready to share. In the mean time, sit tight and we’ll update you as we go!

As always, we’re eager to share our journey with you and ever grateful for all the love and support you give us daily!

The IVF update I’m sure you’ve all been waiting for: Part 3

First off, I’d like to take a second to thank all of you who read my blog. I’m constantly surprised when one of you tells me you enjoy reading it and it’s benefitted you in some way — especially given that I’m not a particularly good (or concise) writer, and that my posts consist mostly of my complaining about how tough life is.

In any case, I am deeply humbled and encouraged by your investment in our infertility journey. Knowing we have friends who care enough to stay updated makes the whole thing feel less lonely.

Now, on to the good stuff!

In case you haven’t been keeping up to date, I’ve been going over my experience with IVF. You can read Part 1 here and Part 2 here. We last left off right after my egg retrieval (ER) where 35 eggs were retrieved, 21 were mature, and 20 fertilized. I was scheduled for an embryo transfer (ET) 5 days after my retrieval, with a plan to freeze all remaining embryos for future use.

The day of the ET was fairly straight forward. That morning I was instructed to empty my bladder at 9:30AM and then drink 20oz of water in 15 minutes. From then on I had to keep my bladder full until after the procedure, and I really think that was the worst part! My ET was scheduled for 11:30 and we got to the clinic and were taken back to a room fairly quickly. After a nurse took my blood pressure (I was so anxious it was something like 153/100 — I thought I was going to have a stroke!) the reproductive endocrinologist (RE) came in to talk about what was going to happen.

By the day of the ET we had 12 embryos that were still growing, and we agreed to transfer one and freeze the rest. We signed some paper work to that effect, the RE called in the embryologist to confirm our identities and the transfer/freezing instructions, and then I got cozy in the stirrups as per usual. A nurse used an abdominal ultrasound to visualize my uterus (here’s where having a full bladder is useful — gets it out of the way so they can see the good bits), and the RE used that image to guide a very small catheter through my cervix, which didn’t hurt as much as I was expecting. After that came several awkward minutes of waiting for the embryologist to come back with our embryo, but finally she did and the RE pushed it through the catheter with some saline. They gave everything a minute to settle and then the embryologist took the catheter and checked it out under a microscope to make sure the embryo wasn’t still hanging out in it. It wasn’t.

That was basically it! After the RE was done, he and the nurse both left and I stayed in the bed for 5 minutes to let things settle a little more before getting up and (finally) emptying my bladder. All in all it took maybe 15 minutes from start to finish!

Before we left were were given some instructions for the next several days and a picture of the embryo they transferred (which we will always treasure).

The weeks following the ET were pretty straightforward as well. I had to take it easy, continue the progesterone suppositories I started after the retrieval, and go back to the clinic for blood work to see if I as finally pregnant. Those weeks, usually referred to as the Two Week Wait (TWW) are rather hellish if you don’t have anything to keep you distracted. Luckily I have a great husband and friends and plenty of things that kept me distracted even though I wasn’t working!

IVF was pretty terrible for me. It did a number on my body and my emotions, but in the end we created enough embryos that I probably won’t ever have to go through the process of stimming and retrieval ever again (and those were the worst/hardest parts). Hopefully we’re on the road to creating the family we’ve always wanted!

The IVF update I’m sure you’ve all been waiting for: Part 2

My apologies for the delay in posting the second part of the update. I’ve been super busy being unemployed and not contributing anything meaningful to society (read: finding a job is hard).

I believe we last left off right at the end of the stimming phase. If you need a refresher you can read all about it here. Basically, after 13 days of hormonal injections I was ready for my egg retrieval … or as Andrew jokingly called it, “The Harvest.” I’ll back track a little and restart my account from the morning of the 13th day of stimming.

Saturday morning I went in for my daily monitoring. I had 20-something follicles all measuring 18-19mm or above and was told I would probably trigger that evening. I met with a nurse to go over the trigger and egg retrieval (ER) protocols. The trigger helps mature the follicles and it causes ovulation in 36 hours, which helps the RE time retrieval for the most optimal moment. That evening I was called with my trigger instructions (0.8 mL lupron injection subq at 1am), and told to return for blood work Sunday morning & that my retrieval was scheduled for Monday at 1pm.

Sunday morning I went in for blood work to check my progesterone level. I was called in the evening with my results, though I don’t remember what the number was. Apparently the nurse who called was supposed to tell me my progesterone was high & what that entailed but she missed that important detail. I took 1g of azithromycin around 9:30pm with some food, and then didn’t have anything by mouth after midnight (water, gum, candy, anything).

Anyway, Monday morning I got up around 9:30 to shower & get ready to go … Which didn’t take long because they ask you not to wear jewelry, makeup, lotion, or perfume. They asked us to collect the sperm at home so that happenened we headed out since we had to be at the clinic by 11:30.

Once there we checked in and were taken back to the pre-op/recovery area after a short wait. I changed into a gown and signed a consent form. Someone from the lab came took our sperm sample after verifying both our identities. Shortly after that the nurse anesthetist came to introduce herself, go over any pertinent medical history, go over what type of sedation would be administered (propofol, fentanyl, and something else), and start an IV bolus of normal saline. At this point I told her I usually get really queasy & was worried about the long ride home, so she made a note to push dexamethasone and zofran through the IV once the procedure was over.

After the IV was started I still had a bit of a wait and eventually my RE came and talked to us about the plan. At this point he said “As you know, your progesterone is high so I’d like to freeze all the embryos and try a frozen embryo transfer (FET) in January instead of doing a fresh transfer today. Your progesterone will affect implantation and reduce your chances of conceiving this cycle by about 50%.” Well, that was news to us since, like I mentioned earlier, the nurse didn’t say anything about my progesterone level being too high when she called with my results on Sunday. We were kind of in shock and I started crying even though I was trying my damnedest not to! But we signed the paperwork and the RE assured me that Andrew and I could still think about things and call if we changed our minds (we did).

After the RE left it wasn’t much longer before a nurse came and got me. I emptied my bladder and then walked to the OR while husband stayed in the pre-op/recovery area. The set up was much like getting a pelvic exam: sat at the edge of the table and put my legs in stirrups. At this point the nurse anesthetist pushed some sedative IV, then the nurses applied a pulse ox, heart monitors, and nasal cannula to administer oxygen. Then the anesthetist said nighty night (and I said “see you on the other side” because I love bad jokes) and that’s the last I remember.

ER

This is what was going on while I was out cold.

I came to in the recovery area drinking a cup of water. Apparently I’d been having a conversation with the nurse about recently passing my boards for some time, but the IV sedation has powerful amnesiac qualities so I remember none of that. The first few minutes after coming to are still fuzzy — I guess I kept asking the same questions over and over again because I couldn’t remember I’d already asked, and I kept insisting that I really wanted to get into women’s health and skip working in med/surge all together. My nurse must have thought I was great (note: sarcasm). I also vaguely remember the RE coming around to let us know he retrieved 35 eggs & that that was great number.

I was in a moderate amount of pain (5/10) so the nurse pushed some pain meds and let me wake up a little more. After a while we did a “sobriety test” to make sure I was stable to walk, the nurse took out my IV, I changed back into my clothes, and we headed home. We were on our way out of the building by 3.

I took it easy at home for the rest of that day and the next. I experienced minimal pain/discomfort, but not anything bad enough to require the narcotics I was sent home with. A heating pad provided enough relief. I certainly didn’t have any complications associated with the high amount of eggs that were retrieved (like Ovarian Hyperstimulation Syndrome), and I credit that to my consumption of gatorade, coconut water, and extra protein to help prevent fluid accumulation in my ovaries.

On Tuesday morning, the day after my retrieval, I got an email with an update on the status of my embryos. Out of 35 eggs retrieved, 21 were mature, and 20 fertilized. We had 20 embryos of our own! Those were exceptional numbers and we were over the moon. Over the next few days we got almost daily fertilization reports & our numbers stayed pretty great. We were scheduled for a Day 5 fresh transfer (meaning an embryo transfer occurring 5 days after retrieval). I’ll write about that experience in my next and final update.

I know this was a really long post — thanks for sticking around!

The IVF update I’m sure you’ve all been waiting for: Part 1

So a few months ago I had my gallbladder taken out, and though recovery was more difficult than I imagined, I still managed not to fail nursing school or the NCLEX (with the help & support of my amazing husband, family, and friends). I’m now officially a registered nurse & school already seems like a distant memory.

My first round of IVF is also starting to feel like a distant memory — it feels like it was all so long ago even though it’s really only been a few weeks. And let me tell you, those weeks were rough and, again, I really couldn’t have done it without my husband. He’s been my rock.

Anyway, since IVF is a process — that’s an understatement — I thought I’d break it down into a few different phases & this post will cover phase 1: ovarian stimulation (“stimming”).

Before I started stimming I had to be on birth control for 19 days for the purpose of “calming” my reproductive system. The day after my last birth control pill I went to the clinic for a “baseline” appointment that involved an ultrasound to check out my uterine lining and ovaries, and blood work to check hormone levels and make sure I wasn’t miraculously already pregnant. Everything looked good at my baseline so 4 days after my last pill I started hormone injections to stimulate my ovaries into producing a lot of eggs. My protocol was “low and slow,” meaning I took lower levels of hormones for a longer period of time in order to avoid hyperstimulating my ovaries, which comes with it’s own set of problems.

I gave myself two injections a day for seven days (Monday – Sunday) and during that time went in for 2 monitoring appointments to check out follicle (egg) development and estrogen levels. After those 7 days I added a third injection to the protocol and continued stimming for 6 more days (Monday – Saturday), with daily monitoring appointments. On the final day of stimming I gave myself an injection, called a trigger, that causes ovulation to happen in 36 hours and I made an appointment for my egg retrieval at that time (that’ll be covered in phase 2).

So it all sounds simple enough, except that the injections stung and left bruises all over my stomach. And the hormones made me feel tired and hot and cranky and starving and weepy and a whole bunch of other not fun things. And I had a headache the entire 2 weeks I was stimming. And by the end of it my ovaries were so enlarged that they were touching — hint: ovaries are not supposed to touch — and it hurt to walk, go to the bathroom, laugh, breath, or pretty much do anything. AND I had a cold the entire time.

It was totally glamorous and, though I can (and do) complain about it a lot, it was actually a really cool experience. Every time I had an ultrasound and saw how my body was responding and changing, it gave me hope that one day I’d have a family. Every time I saw that my ovaries were producing big, beautiful follicles, I couldn’t help but marvel at the fact that I was looking at what will one day be part of the baby I’ll be holding in my arms. It really helped remind me what a miracle life is and it helped rekindle hope for a future with the family I’ve always wanted.

IVF and Gallstones Don’t Go Together

Some of you may have caught a FB status from Saturday about my trip to the ER. After a late lunch with Andrew, I had very sudden onset severe epigastric pain. It was 10/10 — the worst pain I’ve ever felt in my life. I’ll spare you all the gory details, but I turned gray on my way to the ER and couldn’t find my peripheral pulses, so I was pretty convinced I was hemorrhaging into my abdomen and my last few minutes on this earth would be spent whimpering in the passenger seat while Andrew drove. Glamorous.

Long story short: I didn’t die. Turns out I just have a bunch of gallstones & my gallbladder needs to come out. I know. I know. I should be grateful that’s all it is. And I should be relieved that it’s a relatively easy surgery in regards to recovery time. And I should be happy that this happened while not pregnant.

But I’m not happy. Not even a little bit. Because surgery and IVF don’t mix. Let me let you in on a little secret, since it doesn’t matter anymore. Had I gotten to go through with my IVF protocol as prescribed, and had it worked, I’d be pregnant by the end of this month. This. Month. I was due to start stimming with hormones this week, and my egg retrieval and embryo transfer were likely to be in the 3rd week of August.

Yup. I was that close to actually having a real chance at a family. That is no more. Now I have to wait until I graduate so I can get my gallbladder out. Then I have to recover, which takes 1 to 3 weeks. Then I have to start my IVF protocol from the beginning … Which means at least 30 days before even getting to the hormonal stimulation part. So that’s another two months before I get to the point where I am now.

But Gia, you say, two months isn’t that long! Time will fly by!

Please don’t.

It might fly by. It might not. That’s not the point. The point is that sometimes in IF it feels like everything, including (and especially) your own body, is trying to sabotage you. And sometimes you just feel like you need a break. Like just once something needs to work out in your favor.

So my apologies, friends, that this post isn’t snarky & there’s no lesson in it. Or whatever. That’s what it feels like with IF sometimes — you’re left wondering what the point of it all is.