Wednesday, December 26, 2007

The Transfer (The Good Parts Version)

As promised, let me go into a bit more detail on why Monday was so great. Back in March, the doctor told us that between the miscarriages and not producing very many follicles on the first round of injectables, we might be looking "reduced ovarian response" (probably not exactly the right medical term). If that were the case, we would be facing the likely possibility that none of JF's eggs were any good, and donor eggs would be the only viable option. The next round of injectables, at double the dose, went much better, but the doctor left us both with the impression that there was still serious doubt to the quality of those eggs. So I, at least, spent the last nine months thinking there was a good chance that we were going to eventually start IVF, spend the first round learning that it was hopeless, and then move on to donor eggs. The doctor did tell us this month that he no longer considered this a likely diagnosis, but that wasn't enough to clear the idea out of my mind.

So I spent the weekend trying to enjoy the early Christmas with my family, while inside I was bracing myself for disastrous news, either in a phone call or at our appointment on Monday. I'm pretty sure JF felt the same way -- she said she had nightmares that only one embryo made it far enough along to transfer. I found myself thinking that wouldn't be so bad, at least in her dream there was one that worked! But I didn't want to say anything that would get her down.

So Monday morning we said goodbye to my family, and I drove us to the fancy IVF center with dread in my heart. (Example imagined bad scenario -- there is nobody else there when we get there, because we missed the message saying none of the embryos made it, and it being Christmas Eve they just stayed home.) Because it was a fairly long drive, in winter, we left early, and arrived at the center 30 minutes early. Moments after we got there we were ushered back by a nurse, and that's when I knew we were really in trouble -- surely it could only mean they wanted to give us the bad news quickly.

Only then she took us to a gurney, and gave us hospital gowns, and suddenly there was a ray of hope -- I figured it was unlikely they'd give us gowns to sit down and give us bad news. Then she casually told us that seven embryos had been cleared as normal by the PGD testing, and the doctor would soon be checking over to pick the best ones to transfer. That's when it finally got through to me that this might work out. I felt comfortable enough to joke that this was probably the only time children of ours would be considered normal. I think JF expressed a worry that maybe the doctor might still find a problem with all the embryos, but in my mind the situation had shifted from inevitable trouble to strong hope.

Finally the doctor showed up, and gave us the news. Of the seven, two were still a bit behind, and two were absolutely prime for transferring. (I think this means the other three were merely average.) The question of gender came up, and I momentarily panicked, because this was something we hadn't really thought of ahead of time. But luckily the situation was ideal -- the best two were one of each. The other five would be evaluated the next day (ie yesterday) to determine if any were suitable for freezing.

Exciting as that was, the big news was that the possibility of problems with eggs or sperm is off the table. It now looks like the issues have been hormones and timing -- things IVF is already designed to work around. All the pills and the shots every morning may be a pain in the arse, but they're a lot easier to put up with when it looks like they have a good chance of making everything work.

So there you have it -- easily the best news all year for us. It doesn't mean that this cycle is necessarily going to work. But it does mean there is a good chance it will, and plenty of reasons to be optimistic that things will work out eventually.

Which is pretty much the best Christmas present ever.

Monday, December 24, 2007

The Transfer (The Quick Version)

Just wanted to say (for those of you following along at home) that the transfer today went smoothly. The PGD testing cleared seven of the ten from the last stage, and the doctor transfered the "best" two. So tonight we're exhausted, but incredibly relieved and filled with joy.

I'll try to post more in the morning; for now, JF has asked me to read to her from Gawain and the Green Knight.

Friday, December 21, 2007

SF: earning jewels for his crown

(I first typed "corn" instead of "crown" and almost left it at that ...)

Well, I seem to be over the nausea, but all is not right at our household:

The dog has fallen ill.

She had some, erm, digestive problems that led us to feed her a bland diet yesterday ... which she then vomited up today. And then some. And then some more.

SF got up at 4 a.m. to take care of her and didn't really get back to sleep. The vet said it looks like she has a stomach bug and kept her for a few hours to give her IV fluids. We now have anti-nausea and anti-diarrheal medicines to give her tomorrow.

This has thrown a monkey wrench into our plans to visit SF's parents this weekend, but we'll figure it all out. We can't take a puking dog, but the vet says if she's not vomiting tomorrow, it's probably safe to go.

With the transfer set for Christmas eve, we've been in a difficult position: visit before the holiday and tell them we're a no-go for Christmas day itself and stay home and eat ice cream, visit after the transfer and hang out with SF's pregnant sister-in-law and her husband and try to shut out the evil green monster, or go for the entire four days.

None of these plans is perfect.

Thursday, December 20, 2007

Fertilization report

The nurse called this afternoon and said that of the 17 eggs retrieved, 10 fertilized. I don't know anything about quality yet. Maybe ... tomorrow?

Today was pretty slow for me. Between the anaesthesia and the pain meds, I've been pretty out of it for much of the day ... probably could have made it through work if I had to, but (a) I keep falling asleep and (b) we're closed right now for renovations, and the work that needs doing is primarily heavy lifting, which is off limits.

And ... I just threw up. So we'll have to see about work tomorrow. Thank goodness lunch was a long time ago, because it was Spaghettios, and not to be crass, but they taste like puke going in. I really wouldn't care to meet them again.

Wednesday, December 19, 2007

Home Again

The retrieval fetched 17 eggs, a most auspicious number. I performed my duties successfully as well. I just successfully gave JF her first Progesterone injection as well.

All-in-all, it appears today has gone as well as could be hoped (knock on wood). Now it's just down to various housekeeping activities and catching up on my sleep.

Tuesday, December 18, 2007

Retrieval

Retrieval is tomorrow morning. The facility is about an hour's drive away, so we're heading out tonight to stay in a hotel. I find myself extremely nervous about the entire process; I've no idea how JF is still functioning at this point.

Sunday, December 16, 2007

I have a date!

We'll going in Wednesday for the retrieval, which means a Christmas Eve transfer. I'm not such a n00b as to believe in the magical power of dates in this situation (after being due on my deceased grandmother's birthday -- twice -- and miscarrying -- twice -- these things lose their magic). Simply knowing the schedule will help us try to plan family stuff; they've been very patient with us as we offered them nothing but portions of our own uncertainty.

As I watch the crowd of five kids trying to shovel 11 inches of snow off our entire street, I am glad we decided on a hotel room the night before retrieval over trying to get to the clinic an hour plus away by 7 a.m. in winter.

Hopefully by next week they'll be able to find my uterus again, so they have someplace to transfer to. It seemed to be off roadtripping this morning. Can't blame it: I'd be off in Lungdon or Handsylvania or Puertoe Rico myself, given the chance. Probably stay away from Assyria, though ... I heard a rumor someone's planning on shooting up the place.

Excitement

Just spent 30 minutes shoveling the driveway so we can run out for an ultrasound at 8:30 this morning! This is the one that should tell us our scheduling for this week and next -- if we can make it to the doctors'.

Wednesday, December 12, 2007

A New Twist

Today's ultrasound went well, looked like there were at least 9 follicles in the 6-8 mm range. But there is a new wrinkle with the Gonal-F injections -- starting Friday we are to scale back slightly on the Gonal-F, and mix it with Luveris before injecting. I can't say I know the reason why, but I suspect JF will have thoroughly researched it on the web by this time tomorrow.

For all that I am still scared by the prospect of serious injections to come, I am kind of geekily excited by this. I think that's because it looks like giving the shot will be about the same difficulty level as a normal trigger shot, so not new and scary -- and there is the cool drug mixing stage with this. Okay, honestly, I don't know why that's cool, but it feels that way to me now. Guess that's better than panicking about it when the time comes.

Friday, December 7, 2007

Gonal-F shots now underway

The call never came on Wednesday, which was supposed to mean we were to start the shots on Thursday. Let me tell all of you out there that this is a bad method of communication, because you're going to sit and wonder if no call really is a positive message or just an accident.

So Thursday morning, we called them and left a message asking the nurse to confirm. At noon I got the call confirming that the blood work was okay -- but this nurse thought that the ultrasounds warranted consulting the doctor, so we were to wait until we heard more. Finally a few minutes after the doctor's office closed, we got the go-ahead to start the Gonal-F.

Wednesday, December 5, 2007

Okay, that was new....

JF and I went in for the ultrasound check this morning. It's the utterly routine check to make sure everything is looking groovy to start the Gonal-F -- old hat for us by now.

Only this morning, there were two nice sized (11 and 13 mm, I think) follicles sitting there on the ultrasound. The nurse did not seemed unduly fazed by this, but it sure surprised JF and me.

So now we're waiting for the blood work to come back. If it's good, we proceed as planned; if not we wait a week and check again. Apparently the Depo-Lupron should still be in JF's body; it may just take a bit longer to suppress her reproductive system down to the point we can start the process.

Afterward, we paid in full for this round of IVF. There was a bit of a glitch, too, as I had apparently (sensibly IMO) set a limit of $5000 per transaction on the card. I called the number on the back of the card and we sorted things out.

Tuesday, December 4, 2007

Update

We seem to have fallen out of the habit of updating this blog, as our last few weeks have been extremely busy. Rest assured that we are still working on the IVF cycle, and things are about to get properly under way tomorrow with the first ultrasound and corresponding payment in full for the cycle. We should be back to daily Gonal-F shots on Thursday. (Knock on wood.)

So far, the big excitement on this cycle was last week's Depo-Lupron shot. It is much more serious business than the injectables we have been dealing with in previous cycles -- a longer (and thicker, I think) needle, and it goes into muscle rather than fatty tissue. Because we will have to administer shots like this daily later in the cycle, the nurse made me give JF the shot while she monitored things.

Can I just say how scary I found that? I just hope it gets less nerveracking after a few days of doing it every day. Still, it seemed to go fairly well. JF claims it barely hurt, and I think I know how to make it hurt even less next time.