1 in 8

WE ARE 1 IN 8

1 in 8 couples struggle with infertility, and we are one of them. We have been blessed with 4 beautiful children thanks to reproductive science. I often think about how different our lives would be if we were alive and trying to build a family in an earlier time. Back when IVF wasn't an option, when women without children were referred to as barren, back when a woman's purpose was to provide an heir. Would we have pursued adoption? Lived a life without children? I'm thankful that we live in the 21st century and those questions will never be more than hypothetical.

You often times hear people say, "I beat infertility." I know I've said it before, but you don't ever beat infertility. It's something that stays with you. For me every monthly cycle is a reminder that we will never conceive a child on our own. Forget the fact that we aren't even trying to anymore. The emotions of failed cycle after failed cycle are still there, and they probably will be forever. When we were in the thick of it all, our marriage was tested and I can still remember the night when divorce came up in an emotional conversation. When you realize the family you planned together may not happen, or at least not in the way you envisioned it, it's sometimes more than a marriage can bear. Our relationship grew stronger through our struggles, but for many couples that isn't the case.

This week is NIAW, National Infertility Awareness Week. This week is so important because unlike many other diseases, couples who battle infertility often do so in silence. There is a stigma that surrounds reproductive health, and there shouldn't be. Battling infertility isn't something to be ashamed of, but many couples feel that way. It's hard when as soon as you get married people start asking when you will have kids. Then if you have one child, people start asking when you will have another. All of the comments and questions come from well meaning people, but they can be isolating.

I am fortunate that I have amazing people in my life who have been down the road of infertility before me. They were open about their journeys which helped me know we weren't alone. I was also lucky enough to discover a great network of women online who were going through their own fertility struggles. Many of them I still keep in touch with, and I am so thankful for their support when I needed it.

As I am sure you can imagine, with two sets of twins, I get asked a lot of questions. The biggest one being, "Do twins run in your family?" I could answer that they run on Rob's side of the family, because they do, but I prefer to throw it out there that all of our kids are the result of IVF. Sometimes that answer is follow by disappoint from the person asking the question, but more often than not a productive conversation follows. Frequently the person asking the question will then share their fertility struggles, or those of someone close to them. I prefer to be honest about our struggles and road to parenthood, because I never know if the person I'm talking to may be feeling isolated during their own infertility journey.

This year's NIAW theme is "Listen Up." It's important to listen if someone is trying to share their infertility story with you. Don't just offer a piece of regurgitated advice like "Relax and it will happen," or "Maybe you could adpot." Really listen to their struggles. Make sure people listen to your story. Whether you share on social media or just share one on one with a friend. Get others to listen to your story. Make lawmakers listen. Every day policies are being drafted that will take away my rights as part of an infertile couple. Let your representatives know that you don't support anti-family legislation and that infertility care is not an elective procedure.

Listen up! Speak up! Keep the conversation about infertility going. If you aren't battling infertility, chances are someone you know is. It's not just a women's issue, it's a couple's issue, and 1 in 8 of them are struggling with some form of infertility.

You can learn more about NIAW here or visit Resolve's website.

Our infertility journey is outlined here.

The Results Are In

We're pregnant! No ish about it. After too many at home tests, and two blood draws with our baby doctor, we're officially pregnant.

Shirts

I wasn't sure if I was going to test at home or not. I really thought I wanted to wait until our beta, but one trip to Target changed my mind. I started testing at 2dp5dt, 2 days past 5 day transfer, which equates to 7DPO, 7 days past ovulation. I thought I would still have some HCG from our trigger injection in my system, and sure enough I did. I got a faint positive followed by a full negative on 3dp5dt. After a full negative I knew any lines on a test would mean we were pregnant. Low and behold, faint line on 4dp5dt. We were pretty excited, but still cautious. 5dp5dt brought an even darker line. YAY!

I continued testing up until the day before our beta, and in all honesty that was a mistake. I started reading into the darkness of the lines too much. 7dp5dt was lighter than 6dp5dt, and all of the bad possibilites entered my mind. Then came Dr. Google which is always a bad idea. I bought more tests which did help to ease my mind. Seeing the word pregnant on a Clear Blue didgital test helps to put things into perspective. I am pregnant. Enjoy it. Stop worrying.

Monday morning I went in for our first beta. I got the call from my doctor at 4pm that afternoon that we were pregnant. Our first number came in at 230 which was a great starting point. My mind eased up a little after that call. I went in for a repeat yesterday, and our HCG was up to 423 and progesterone was over 40. Ok, now it's becoming real.

We have almost 3 weeks until we go in for our first ultrasound, which seems like forever but I know will be here in the blink of an eye. We are waiting to tell Brooke and Harrison about the baby until then. Tonight we get to do my last progesterone injection, which is cause enough to celebrate. YAY! The suppositories that replace the injection are not so great, but it's better than an inch and a half long needle in my butt cheek each night. So far I'm feeling good. A little extra tired, and a lot of extra thankful that H and B still take daily naps.

We went out for an early Mother's Day dinner with our parents and shared the news with them this evening. Now that they know, we are ready to share it with the world. Even though we're not even 5 weeks along yet, we're ready to enjoy this pregnancy. Welcome to the family baby, or babies!

Embryo Transfer

Wednesday afternoon I got the call from our fertility clinic's Indy office that our transfer would be bright and early on Friday morning. I was planning a pre-transfer acupuncture session which meant we had to be there even earlier. We dropped off the kids at my parents Thursday night and headed home for an early bedtime. 

Friday morning we were on the road by 5:15am. A coffee and gas stop later along with a two hour drive, and I was in the door for my acupuncture appointment at 7:15. I was a little nervous about the transfer to come, but after acupuncture, I was only excited. I don't know if it was because I really needed it, or if the acupuncturist was that great, but it was the best acupuncture session I've ever had. I was rested, recentered, and ready to go. 

I was done just in time for us to head back to the ART suite and get changed into hospital gear. I took my Valium, drank some water, and we waited our turn. I don't know if it was the Valium kicking in, or just boredom, but I had a little too much fun with my cap. Robbie and I kept each other laughing to pass the time, and before we knew it they told us it was time to go back. 

They had us walk back to the transfer room. In the room with Robbie and I were Dr. Bopp, a nurse, the ultrasound tech, and an embryologist. They did a mock transfer first so they could see how the catheter would insert and where to place the embryos. Then the embryologist handed Dr. Bopp the catheter with the embryos inside. The catheter was fed into my uterus and then the embryos were released. They watch everything on the ultrasound monitor to make sure the embryos were placed into the ideal location. The embryologist checked to make sure both embryos made it out of the catheter, and then it was back to our suite room. I got the royal treatment and was wheeled back in a wheel chair.

I was able to use the restroom and get dressed right away. After stealing our doctor for a few quick pictures, they released us to go. They won't let you walk out, so into the wheel chair I went, and Robbie and I were gone within 30 minutes after the transfer was done.

We loved The Cake Bake Shop so much that we deemed a return trip necessary. Robbie talked it up at work so much that he took back lots of cookies to hand out. I chose carrot cake, a few macaroons, and a magic bar. They're sadly all gone, and there are no trips to Indy in our near future. :(

I slept for about half of the ride home, and before I knew it were were getting off the interstate. The dogs were crazy when we got home. They acted like we'd been gone for days, not just a few hours. Robbie had to head into work, so the dogs and I set up camp on the couch and watched Mad Men all day, and all day Saturday. We picked up a lot of soup from The OG on Thursday night, so I ate soup for two days straight while lounging around. It was surprisingly quiet and boring around the house without Harrison and Brooke. I was glad when they got home Saturday night.

Yesterday we got out to run a few errands, and I made dinner, but overall I'm still taking it pretty easy. I have an acupuncture appointment this morning, but nothing else planned for the day. maybe a short walk with the kids this afternoon. They've been really good about respecting my limitations. They still ask to be picked up and for me to run around with them, but when I remind them I can't they seem to understand.

So while we aren't technically pregnant, we're pregnant until proven otherwise. I'll live in my happy little pregnancy bubble for the time being, and hopefully it won't burst. A successful transfer isn't a 100% guarantee, but we have about a 70% chance of this cycle working, so the odds are in our favor. I go in sometime over the next couple weeks to get a pregnancy test drawn at my RE's office. We won't be sharing any news, good or bad, until we get a confirmation from the doctor and we share with our families first. As always, I am open to answering and questions, and you can follow along with daily updates on Instagram (@jennpargeon)

Thank you SO MUCH to all of you for your kind words, well wishes, positive vibes, thoughts, and prayers. They really do mean the world to us. We love and appreciate ever single one.

Egg Retrieval

Friday morning I had a bright and early 8am monitoring session. We were up to 10 follicles over 18mm, so I was pretty sure we were going to trigger that night. So were all of the nurses. Sure enough, I got that call that afternoon that my estrogen levels were over 4,000 and that I was to do my trigger shot that night. The trigger shot finalizes the maturation process so the eggs are ready for retrieval. It has to be timed exactly 36 hours before egg retrieval. We did a 5,000 iu shot of Pregnyl for our trigger. I mixed it up, iced my bum, then made Robbie watch me do the injection. He looked like he was about 2 seconds from passing out.

Saturday was business as usual. No injections, YAY!! Our retrieval time was 8:45am Sunday morning and we needed to arrive an hour early. Our alarms went off at 5am and we were out the door by 5:45.We both managed to stay awake through the entire drive. We arrived at the Carmel office at 7:40. We signed in and were immediately taken back to the ART suite.

I got dressed in my sexy gown, socks, and cap. There was a warm blanket too, so it wasn't all bad. The nurse took my blood pressure, placed and IV, and then we got to sit and wait. We talked to the anesthesiologist, and embryologist, and then our RE, Dr. Bopp, came in. We were the second retrieval of the morning, I feel bad for whoever had to be there before 7, so we sat in our room and bided our time until it was time to go back.

When I walked back to the operating room, Robbie went off with his sterile cup to make his contribution. This is how babies are made people. ;) After I was on the operating table, the nasal cannula was placed and the good drugs started flowing through my IV. Dr. Bopp came in and asked if I wanted him to sing me some Neil Diamond. I remember saying yes, and then it was lights out. 

The procedure itself only takes about 15 minutes. I don't know how long it was until I woke up, but Robbie was back in the room when I did. The nurse was in almost immediately. She brought me pain meds, Teddy Grahams, and apple juice. I felt like I won the after surgery snack lotto. Once my snacks were done, the nurse made sure I could sit up on the edge of the bed for a few minutes. They let us know 14 eggs were retrieved, and that they would call us tomorrow with the fertilization report. Then I got dressed, and we took off.

We made a quick stop at The Cake Bake Shop in Broadripple before we headed north. I had been dying to go here since one of my IG friends posted a picture a couple months ago. The decor, the pastries, and even their packaging is all amazing. If you have the chance, GO! I don't know that we'll have time, but I'm hoping maybe we can stop in again before or after transfer.

As soon as we hit the interstate, I started feeling nauseous. I was hoping for a little iced decaf caramel machiatto action, but I opted for just a buttered croissant that I scarfed down in a gas station parking lot while Robbie got me Gatorade. I cuddled up with my pillow and fell asleep as soon as we started moving again. We made it home just in time to pick the kids up before their nap.

Brooke and Harrison both brought me a few daffodils from Grandma's garden. They were so excited to give them to me. It was adorable, and definitely my favorite part of the day. I was pretty sore for the rest of the day, so movement was limited. I was still sore enough on Monday that I took some Vicodin when I woke up. Today I am not as sore, but I am still very bloated and uncomfortable. I have been chugging Gatorade in hopes of keeping fluid out of my ovaries and abdomen. 

I got the call yesterday morning that of the 14 eggs, 11 were mature, and 8 fertilized with ICSI. Unless our embryos all take a steep decline, we are scheduled for a Friday blastocyst transfer. The Carmel office will be calling tomorrow with our transfer time for Friday. I got all set up with Indiana Reproductive Acupuncture, so I will be having acupuncture done before our transfer.

We started a new set of meds yesterday, but only one injection. Unfortunately it's a 1.5" needle intramuscular injection. Robbie was a little nervous, but he did a great job last night giving me the injection. He hadn't had to do any injections through either of our IVF cycles up until last night. 

Our next few days around here will be pretty quiet as I try to rest, and we get things ready before I am on bed rest for a couple days, and the kids have their longest stay away from home. Two full days at Grandma's, and maybe an extra night depending on our transfer time. As always, news makes it to Instagram well before it makes it to the blog, so feel free to follow along @jennpargeon.

IVF #2 Update

We are just over a week into stimulating for IVF, and things are going well so far. We got off to a little bit of a rocky start, but we're smooth sailing now. When I went in for my monitoring appointment last Thursday, there were only 11 follicles that were growing, and my estrogen levels were at 82. That's really low, and not what they like to see. So they upped my meds and told me to come back in two days.

My appointment on Saturday was met with better results. Estrogen levels were approaching 300, and a couple follicles had reached the 10mm mark. We're aiming for 18-22mm, so still a ways to go. At yesterday's appointment, there were 26 follicles at 6mm or higher, and 2 of those were at 15mm, and my estrogen was at 753. Things are looking good. 

When they upped my meds, I went to 187.5iu of Menopur and 200iu of Follistim per day. We were tentatively scheduled for retrieval on Friday, but I have a feeling they're going to push us a day. The slow start put us behind enough that I thing we're looking at Saturday. I go back in tomorrow for another ultrasound and more blood work, and we'll know tomorrow afternoon if we will be triggering that night, or if we'll continue with stims. 

By Sunday morning, I was really starting to feel the bloat come on. Something as simple as chasing the kids around the playground, or giving them underdog pushes on the swings has become difficult. Monday morning I decided it was time to give up on real pants for the rest of this cycle. My jeans still button without a fight, but man do yoga pants feel so much better. 

We've been telling Brooke and Harrison that mommy is going to have tummy surgery and that's why I can't pick them up or run around with them. They seem to respond to that logic, but it's hard to not be able to pick them up. We've been trying to get out of the habit for a couple months now, but it's tough. I've still been picking them up if they get hurt, but I won't carry them anymore if they ask for it, and after retrieval it will be no lifting at all. 5 lbs will be my limit.

I've been trying to be conscious of what I'm eating, but it's hard with 6724 pounds of Easter candy in the house. In the grand scheme of things, I know a couple pieces of candy per day won't make or break a cycle. I have been eating a lot of protein and healthy fats, along with fruits and vegetables. Hard boiled eggs, yay Easter, avocado, grilled meats, pistachios, Penne Pomo, because olive oil, and Virgin Marys with lots of olives are a few things I've been consuming in mass quantities over the last week. I've been drinking as much water as possible and have also been upping my milk intake. I know I need to kick my decaf coffee to the curb, but I swear my days go better with a cup of decaf. I know I didn't worry too much about any of this last time around, but this cycle feels so different. So final.

Other than being sore and bloated, I am feeling really good. No crazy hormonal side effects and no headaches. I'll hopefully go in tomorrow and see lots of follicles approaching the 18mm mark. I'm ready for my last day or two of stims, and then the dreaded PIO starts. Bring it on!

Let The Stims Begin

There is a lot of waiting involved with IVF, and infertility treatment in general. Waiting in the lobby, waiting for test results, waiting to save money, waiting until you can take a pregnancy test. As much as I hate the dreaded two week wait leading up to a pregnancy test, I hate waiting for cycle day one even more. It so tedious to wait for a new cycle to start. Knowing any moment it could happen, but it hasn't yet.

We made it through our suppression phase and are now onto the good stuff. Monday morning I went in for a baseline ultrasound and to get my estrogen levels check. The Lupron has been doing it's job, and my estrogen levels were at 35.8, they like to see less than 50. My lining is at 6mm, nice and thin, and we were able to see lots of visible follicles. 17 on the left and 18 on the right.

Once I was done getting poked and prodded, I got my calendar, was handed a stack of consent forms to go over, and handed over a big fat check. I was super excited when I left the office. Excited for 9pm to roll around so I could give myself a myriad of injections. I know that sounds crazy, but it's true. Right now I'm not anxious, I'm just excited. We've been through this before. For the most part I know what to expect, and at least for a few days, I'm in control. 

My nightly protocol now includes 5 units of Lupron, down from 10. 125 units of Follistim and 150 units of Menopur. Follistim is by far my favorite injection. Yes, I just said favorite injection. There's no mixing or measuring. You just click the pen to the right amount, screw on a needle, and shoot up. Menopur I could do without. It burns like a son of a you know what. Last night was my first time taking it, and I'm already over it.

I'll continue on with this regimen at least until Thursday. I go in Thursday morning for another ultrasound and blood draw. I'm then back on Saturday and again on Monday. We will hopefully see quite a few follicles growing. If they're growing too fast, too slow, or if my Estrogen levels are off, they will tweak the med dosages.

Right now we are tentatively looking at retrieval on Friday the 17th and transfer on Wednesday the 22nd. That can definitely change depending on how I respond to the meds, but I think last cycle we were pretty spot on with the calendar. We had 20 eggs retrieved, 19 that fertilized, and 5 that made it to blastocyst transfer or freeze. Similar results this time around would be fantastic!

I have been continuing with weekly acupuncture appointments and will continue with those at least through transfer. If you did acupuncture to accompany IVF, how often did you do it while you were stimming, and did you keep going after transfer? I need to ask about it on Thursday, but I'm curious as to how often others did it.

I probably won't do another IVF blog post until we for sure know when retrieval will be. I will however be overgramming, as per usual. You can follow me on Instagram (@jennpargeon) for the daily play by play.

Medication Start Date

We officially have a start date for injections. March 25th is when I'll be taking my first dose of Lupron. Come 9:00 that evening you'll find me with an ice pack, a syringe, and a vial full of drugs. I'm excited to start, but most of all I'm anxious. I don't remember feeling like this last go round. My heart was racing on the drive to an appointment at my RE's office. I thought it was because I was rushing to make it there on time, but I had a hard time settling down even after I was seated in the waiting room. It wasn't until I was sitting across the table from my favorite nurse that my heart rate started to slow.

Even typing about it now has me a little worked up. I don't know if it's because we're paying out of pocket, if it's because I know it's our last fresh cycle, or if it's because there are so many other things going on in our lives right now. I do know that I've never been more thankful for an acupuncture appointment. During Thursday's acupuncture session, I could feel my entire body relax. I didn't even care about the fact that I drank to much water before my appointment and it felt like my bladder was about to explode. I was beyond relaxed.

140. That's how many needles I received in my oversized box of medication. I will thankfully not be using all of them, but yikes! 

I received my huge box of medications on Wednesday. There was something oddly comforting about unpacking all of the vials and syringes. A sense of having done this before and being back on familiar territory. Since there are a couple new drugs in my protocol this time, I met with Brook at Dr. Bopp's office on Thursday to go over mixing and injecting the new drugs. Everything seems straight forward enough, but it was nice to have a little crash course. Menoupr is the biggest new one this go round. I have to mix liquid with powder, and then once it becomes a liquid, it then gets mixed with even more powder. It's not hard to do, but definitely a process I was happy to have laid out visually in front of me.

So now we're just biding our time over the next week and a half. I wonder if the kids have any sense of big things to come?  We aren't going to be telling them anything about what's going on until after a couple positive ultrasounds, but I do think they've noticed that mommy has been spending a lot of time visiting the doctor. Once we start monitoring, I'm sure they'll be coming to appointments with me, so I'm sure there will be some questions then. Although, maybe I'm over thinking it and it will be no big deal to them.

I am gladly taking suggestions on your best relaxation techniques. If you've done a fresh cycle with kids before, I'd also love any advice you have on answering questions regarding the process. Hit me with some answers, please!

Getting ME Ready

I know I posted about this when we were preparing for our FET too, but getting ready for IVF takes some work. Now that we're paying for it completely out of pocket, I especially want to make sure I'm doing everything I can. And more than just taking a pre-natal and cutting out coffee, something I'm waiting until the last minute to give up.

I, along with everyone else, started back to the gym after New Year's. I didn't go back for a resolution though, I went back for a baby. Or the possibility of two babies. Twin pregnancy killed my muscle tone, and even though I have been a gym rat on and off over the past two years, I've never really regained the tone I lost. I've been going 6 days a week for the past few weeks, and for the first time in three years, my bum is start to perk up, I have some mini arm muscles, and if I look just right, there's even a little definition to my abs. Ok, so I can't really call them abs because after twin pregnancy, I will never really have abs again.

I hate cardio with a passion, but between Wendy Williams, my guilty pleasure, and a little Chromeo on Pandora, I can make it through 30 minutes on the arc trainer. I've been really focusing on weights, and have been stepping out of my comfort zone of Cybex machines. Another guilty pleasure of mine is late 90s and early 2000s rap, so Ludacris radio helps me pump out a few extra reps. I'm telling you, music makes all the difference.

I have approximately 2 more months until all exercise other than walking will come to a halt. Once stims start, I'll have to slow it down. We don't want any overstimulated, twisted ovaries. So I'm going to make sure I keep at it until them, and if I start to talk myself out of going, or cutting my cardio time, I just remind myself that it's for the baby(s).

As much as I don't always love the gym, I do always love acupuncture. I did it for the first time a few years ago to help with headaches, and it was great. I find it very relaxing, and the benefits are amazing. I didn't do it with our first IVF, but it is something our RE highly recommends. When doing acupuncture for fertility, the aim is to improve egg quality, ready the uterus, and help with relaxation.

I am seeing the same acupuncturist I saw previously, and am going once a week. A session consists of 20 minutes with 6 needles in my back. Sometimes the needles are paired with electrical stimulation, and sometimes they are not. Once the first 20 minutes is over, I spend 20 minutes with 12 needles on my front. they are placed in my abdomen, hands, wrist, feet, and ankles. Again, sometimes paired with electrical stimulation, and sometimes not. It is a very relaxing process, and an appointment that I look forward to every week.

Our RE's Indianapolis office has an acupuncturist on staff, so when we go down for retrieval and transfer, I will be getting acupuncture treatments there as well.

I haven't made any big changes diet wise. I have been avoiding all of the bad for me stuff that I want so bad. Cupcakes, cookies, and more cupcakes. I have considered doing Whole 30, but I really don't know that it's something I am willing to commit to. Not because I don't think I could do it, but I have zero interest in having to make my food, and then something else for Robbie and the kids if the don't want to eat what I am having. And really, if I have to give up coffee soon, I may as well enjoy it with cream while I can. Am I right?!

So who else out there has been through IF treatment? What did you do to get ready? Were there things you would do the same or do differently?

IVF #2 Protocol

I can't believe we're only a couple months away from the start of our fresh IVF cycle. I am excited, scared, nervous, anxious, hopeful. Pretty much every emotion in the book can describe how I feel about this. It changes from day to day. Most days I'm excited and hopeful. Other days I'm sad thinking about our canceled FET and how if the embryos would have survived, we probably wouldn't be going through this right now. Thinking about the baby or babies that might have been. They would have been a couple months old about now. And while I've come to terms with losing all of our embryos, it's still painful to think about.

We've had a lot of progress over the last couple weeks when it comes to this next go round. We've had some tests done, received our protocol, and started working on getting our meds taken care of. Not only is the procedure not covered by our insurance, but neither are any of the medications. It makes me so glad we pay the ridiculously high premiums we do so that none of this can be covered. Sense the sarcasm? Yeah, I laid it on pretty thick. On the plus side our RE's office is helping us get the best possible prices on our meds and informed us of some potential assistance programs for cash paying patients.

Our tests that we had done pretty much dictated the protocol we will follow this time around. Since we already know from our canceled FET that all looks well internally, all I had to do was give a few vials of blood. My cycle day 3 labs are as follows:

Estrogen - 42.5                                  Normal <50
FSH - 6.5                                             Normal <10
AMH - 2.58                                        Normal >1.2

All of those numbers are within normal range, and pretty similar to where they were for our first IVF cycle. I did a day 21 Lupron protocol then, and will be doing the same protocol this time. However, the protocol has changed a little bit since last time, so there are a couple new drugs I'll be taking. The list of meds include:

Lupron
Follistim
Menopur
Ovidril
PIO

For those of you not familiar with IVF meds, the Lupron is used to down regulate the ovaries and make sure I don't ovulate. Follistim and Menopur are then used to hyper stimulate the ovaries. The Menopur is is new to me drug. Once there are enough mature follicles, Ovidrel is used to finalize the maturation process. PIO, is a progesterone injection that is taken only after the egg retrieval. All of the medications are injectables, and the only one I'm nervous about is the PIO. I didn't have to use it last time, and I've heard it's a real pain in the ass, literally.

Robbie wasn't lucky enough to get out on testing this go round. It's been a while since he had to have any testing done, so the needed an up to date semen analysis.

57mil/mL
26% forward motility
1% normal forms

Those numbers are pretty in line with all previous tests. Different clinics use different testing criteria for SAs, so I don't want to say what normal numbers are. According to our clinic, all Robbie's numbers are in the low range of normal, except for the morphology. It's due to the morphology number that we have to do IVF and that we'll do a process call ICSI, Intra-cytoplasmic sperm injection. They take the sperm and inject it directly into the egg instead of placing them in a dish and letting fertilization happen on it's own.

Now that I've bored you to death with all of the medical aspects of this, I'll hit you with our timeline. This can change by a day or two depending on my cycles, but I will be starting Lupron the last week of March. The first week of April is when we'll start stimming, and it will be about a month until we know if it worked. Pretty damn exciting stuff!

Over the next two months we are doing as much as possible to get ready, which I'll share more about later. The IVF process is rather draining, so I want to make sure I'm as healthy as possible. I also want to make sure we have any and all projects around the house, and at work done by then. It's going to be a busy and exciting few weeks, and I'm sure I'll be starting injections before we know it.

A couple weeks ago I was making chicken noodle soup. As I was cutting up vegetables, I started feeling a little queasy. I remembered briefly having the same feeling the day before. The first thought that popped into my head wasn't "maybe I'm coming down with something," it was "maybe I'm pregnant." So there I stand in the kitchen counting cycle days trying to figure out if it's even possible.

Robbie and I have been married for almost 10 years, and we've been trying to, or not trying not to, get pregnant for almost 7 of those years. In that time, I've learned more about reproduction and fertility than I ever wanted to know. I have also learned, and come to terms with the fact, that we will probably never get pregnant on our own. That still doesn't change the fact that every month I hold out hope for a miracle. And every month I am disappointed when a new cycle begins.

I am past the point of charting my cycles. I don't cry anymore when another month comes and goes. But I know enough to know when there is that less than 1% possibility that it could happen. And it never does, but it could. And so I hold onto that hope, and the disappointment that comes with it. I feel like that's a good thing.

When we had frozen embryos there was never any question as to whether we'd try for more. The answer was always yes, we'd like to have more. But then that option was taken away from us, and we had to really consider what we thought our family should look like. Robbie and I are both in agreement about another round of IVF, but there are days that I question if the expense is worth it. We have two amazing children and I know we could be happy if we are never more than a family of four. We're prepared for that, and we will gladly enjoy every day, just the four of us, if that's where our journey takes us.

The disappointment every month reminds me that the desire for more children is still there. It confirms to me that we are making the right choice to go through this again. So while I hate the feeling I get every time a new cycle begins, I'm glad I still feel the sadness 7 years after we started on this journey. I don't think infertility ever gets easier, at least for me it hasn't, but I've learned to live with it. I've learned to cope with the feelings of sadness, disappointment, and emptiness. Because along with those come feelings of hope, anticipation, excitement, and joy.

After the start of the year, we'll begin testing to make sure we're ready for our upcoming IVF cycle. While I don't necessarily enjoy blood work and ultrasounds, I'm excited about them because of what they mean. They mean we are getting closer to having a real chance at expanding our family, and that is something to be happy about. I will take the other emotions as they come, but being optimistic and happy is what I will choose to focus on.

The Game Plan

I recently, well in June so not so recently, had a follow up meeting with our reproductive endocronologist to discuss our failed FET and the potential for future cycles. Depending on what research you look at, the success rate for thawed embryos is 70-90%, so why did we have 3 embryos not survive the thaw? What does this mean for future cycles? What do you recommend we do in the future? I had a lot of questions.

What I found out didn't really answer the question of why none of our frosties made it. All three were low grade embryos, good enough quality to freeze, but barely. So there's no reason to think there was anything genetically off, but would it impact future cycle? Our RE thinks not, but since we didn't do any testing, there's no way to know for sure.

So that brings us to future cycles. Yes we are planning to do another fresh IVF cycle. We were looking at the beginning of the year, but it's looking like March or April now because I need to be able to make it to Denver in August. 8 months pregnant ladies don't usually get the green light to fly. We still have a few basic tests to run once we get closer to the start of our cycle, but the plan looks pretty identical to last time. Same drugs, same protocol. The big question will be how many embryos to transfer.

I know there are a lot of variables in this situation. We could even go through all of the drugs, monitoring, and stimulation and not wind up with any embryos. It's a possibility, but hopefully one we won't face. Best case scenario, our cycle goes exactly like last time and we have a handful of embryos to transfer or freeze. Statistically we have a 40% chance of a successful transfer with one embryo or a 70% chance with two. Those are our chances for a singleton pregnancy, assuming we have good quality embies.

So, what about twins? There's a 20-30% chance that we would wind up with twins if we transfer two. Yes I want to have a natural birth, a low risk pregnancy, the "normal" pregnancy experience. But if we play the numbers, two embryos it is. And would a second set of twins be a bad thing? Absolutely not. It would be a blessing. It would make for a long a difficult pregnancy and a definite hospital delivery, but I know we would manage.

Having twins has been the most amazing experience. Seeing their relationship grow and change. Watching them play with their best friend every day. Watching them help one another or comfort their twin when they're sad. The bond they have is beyond words, and we would be lucky to experience it again if we were so fortunate.

So we have a plan. We have a date. And now we wait. So much of infertility treatment is a waiting game. Waiting for test results, waiting to save money, waiting for insurance approval. Even though we are still 5 or so months out, having a plan feels good. It gives me hope. Something to look forward to. Something to pray for. 

And there you have it, where we are in our journey. Because I know all of you were just dying to know. But, some you you asked so now you know.  

National Infertility Awareness Week

Today is the last day of National Infertility Awareness Week. One in eight couples suffer from infertility. We are one of those couples. I have been very open about our struggles to conceive. It took us 5 years, multiple procedures, lots of prayers, and tears before IVF helped us conceive Harrison and Brooke. We were extremely fortunate the first time around that our insurance coverage was based with Rob's employer's corporate office in Illinois. Illinois is one of only 15 states that have some type of infertility mandate. 15 out of 50 states. Not very good odds. While the procedure still cost us a few thousand dollars, it was nothing compared to what the total cost is without insurance.

After our canceled FET cycle, we are looking at doing a fresh cycle again. A fresh IVF cycle is a very involved and often painful procedure. Multiple injections per day for weeks or even months on end. Swollen ovaries and possible OHSS. Surgery to retrieve the mature eggs. While all of that seems scary, for most couples the scariest part of IVF, and other less invasive procedures as well, is the cost. Because the majority of insurance plans won't pay a single penny. Many carriers won't even help cover the cost of diagnosis. We are looking at $11,600 plus another $3,000-$4,000 for meds, all out of pocket. (Some clinics cycles cost over $20,000 once you factor in ICSI, PGD, and assisted hatching) Indiana is not a state with a mandate, so our insurance doesn't cover any costs incurred during a cycle. Why do so many insures refuse to cover costs associated with treatment and diagnosis of infertility?

After going through a barrage of testing during our first couple years trying to conceive, we were given a less than 1% chance of conceiving naturally. That means it's almost impossible for us to get pregnant without help. I know that God works miracles, and I continue to pray for one every day. I believe that God gave us the technology to help those who struggle to conceive get pregnant, and I am thankful for that beyond words. The realist in me knows where are issues conceiving are, and I know that we won't get pregnant on our own. We will try everything possible to make it happen though. Supplements, lifestyle changes, acupuncture.

Secondary infertility sucks as much as primary infertility. Being open about our journey has brought forward so many supportive people. People who have experience infertility first hand or those who have seen loved ones battle the disease. Having the support of loved ones is helpful and comforting beyond words. I know infertility can take you to a dark place. Infertility is not who I am, but it is part of who I am. Acknowledging that has made the entire experience less painful.

Don't let infertility be a taboo topic. Please talk about it. Please be supportive for those you know that are struggling. Write to your senators and representatives. Support legislation to bring a mandate to your state. Participate in the Walk of Hope. There are so many ways you can help. Visit Resolve's website to learn more about infertility and to find out how you can help support the infertility movement. The more people who speak up about infertility, the more likely it will be that states and insures recognize infertility for what it is, a disease that requires the same care and coverage as any other disease.

Today was supposed to be transfer day. Rob and I woke up early, said good bye to the kids, dropped Jules off at daycare, and then we were on our way. I had an entire "day in the life," post planned for today to show everyone what transfer day looks like. We were half way to Indy when we got the call. It was 9:46am. 

It was supposed to be the embrologist telling us how our embryos were handling the thaw. Instead it was our doctor telling us we didn't need to come down. I knew as soon as I heard his voice it wasn't going to be good. He said our single embryo didn't reach viability. They thawed the other two and one of them stopped developing. Our last embryo was stalled, but there was still a chance it could make it. I remember him mentioning 30% of something. I don't know if that was the chance that it might make it, or if it stopped at 30% development. Either way, it wasn't good and there wasn't much hope for our last embryo. We were told we should head back home and they would call us to let us know how the embryo progressed.  

At this point, I knew it was over, but I still prayed our last embryo might make a turn for the better. At 11:45 I got a call stating our final embryo did not reach viability. Cycle canceled. While I knew this was a possibility, it wasn't one I ever thought would happen. I was so concerned about the risk of twins with a double embryo transfer, I didn't stop to think we might not transfer any. 

Devastated pretty accurately describes how we feel. We would joke about H and B having a twin sibling who was three years younger than them. We planned for these small lives to be a part of our family some day. Even though they never made it past tiny cells, and I never carried them, it still feels like we lost part of our family.  

When we started our IVF journey, we thought we'd do it once use all the embryos and then be done. Now all of our embryos are gone and we still have a desire for more children. After we mourn the loss of our embryos, we'll have to move forward. What that means, I don't know. 

We are so fortunate to be blessed with two amazing children. Brooke and Harrison fill our lives with so much joy. We will have to decide if our family can be complete as a family of four, or if we will try IVF again. The cost alone is enough to make us really evaluate things, but then there's the concern over new embryos. What if we have left over embryos? Are we ok with using all of them? 

One thing I know for sure, when we got home this morning, the excitement, happiness and love beaming from our children's faces make it all worth while. Thank you to everyone for all the kind words, thoughts, and prayers you've sent our way through this process. We truly appreciate all of you.  

5 on Friday - FET Edition

It's been a while since of done a link up, so today I'm linking up with Darci, April, Christina and Natasha for their Five on Friday link up.

One • We have less than a week until our FET. I can't believe we're only 6 days away. We won't know until Tuesday what time our transfer will take place on Thursday. While our RE has an office here, their main facility is in Indianapolis so we have to drive two hours to get there in the morning. Assuming we have a morning transfer time like we did with our fresh cycle, the kids will be having their first slumber party at Grandma's. While I know they'll be fine, I'm a little anxious, and excited. Their first night away from mom and dad is a big deal. Of course if it goes well, there may be nights away from us in the near future which means I may be able to sleep in once and a while.

Two • After waiting forever for our new insurance to get their act together, we finally have policy and group numbers. This means I finally have all of my prescriptions. I start progesterone on Saturday and begin taking a steroid and antibiotic on Sunday. This is in addition to the estrogen, baby aspirin and prenatal I'm already taking. I'll be taking 11 pills a day for the 4 days leading up to transfer. I'm pretty sure I need three days of the week pill boxes to keep track of everything.

Three • I've been fortunate so far not to have too many side effects from the medication. I know estrogen supplements give lots of women a laundry list of side effects. I thankfully haven't had any headaches. I have been extra tired, thank goodness H and B are great nappers, and my skin is a hot mess. While I've never had clear skin, my skin hasn't been broken out like this since I had *NSYNC posters on my bedroom walls.

Four • Fertility clinics have to report their success rates to the Society for Assisted Reproductive Technology. You can go to their website to find the numbers from previous years. The most recent year of data is for 2012. Our clinic has a live birth rate of 36.8% on fresh cycles for women under 35, the twins and I are included in that data, and a 30% live birth rate for frozen cycles. While fresh cycles are proven more successful than frozen cycles, the success rates are very similar now as you can see by the numbers listed. You can view our clinic's full success report here.

Five • I had my last appointment before the transfer on Monday. They did a lining check via ultrasound and checked some hormone levels through blood work. My lining was measuring 11mm, and they like to see anything over 8mm. Since my lining is looking good, there's no need for any more appointments before transfer. A lot of people think that they implant the embryo(s) during an IVF procedure, however that isn't the case. During the transfer they place the embryos(s) in the uterus, not in the lining. The doctor guides a catheter into the perfect position while watching placement via an ultrasound. Once the catheter is in position, they release the embryo(s) into the uterus. After that it's up to the God. To help give the embryo(s) a better chance of implantation, restricted activity is prescribed for the day of and day after the transfer. If you need me, I'll be laying in bed watch The Veronica Mars Movie for the 10th time.

FET Schedule

We have officially started our FET cycle.  We went into our RE's, reproductive endocrinologist, office today for our first appointment. After an ultrasound showed everything looks good, they gave us our schedule and sent us on our way, after we paid for the full cycle of course.

Our schedule seems so bare. It's great that the FET is so much less involved, but I feel like we're missing something. We already have all of our dates scheduled. I only have two visits and then the transfer. So, this is what they next few weeks will look like. On March 27th we will potentially be pregnant. On April 9th, we go in for blood work to find out for sure. It's crazy to see it all there in black and white. I was only excited about this cycle, but now I find myself feeling incredibly anxious about it all.

One thing I am not anxious about is getting to take Valium. It is quite possibly the best medication I've ever taken. The Doxycyline and Medrol are new this time around, but all the other medications I took last time around and didn't have any reactions to.

So here's to a long boring three weeks while we wait for the transfer, and an even longer and more boring two week wait, where I will try not to take an at home pregnancy test and will probably fail miserably. 

Getting Ready for FET

We have approximately one week until our FET cycle starts. There are a few things I've been doing to get ready for the cycle. The kids are weaned which was the biggest thing we had to cross off the list. I've also cut way back on my caffeine intake. I was drinking three cups each morning, and now I'm down to just one. When I hit up Starbucks I've been doing half-caf. Occasionally if I feel a headache coming on, I'll have an iced coffee or diet soda in the afternoon. 

There are no shots to take this time around, praise The Lord. I just have estrogen pills to take each day, and I've had those for over a month now. When I was pregnant with the twins I took gummy vitamins, which don't have iron, and my hemoglobin levels were lower than their usual low. I want to try and avoid that this time, so I've been taking Up and Up prenatal vitamins. They don't make me sick like most other prenatals do. Has anyone had luck with them holding up to morning sickness?

Twin pregnancy wreaked havoc on my body. The twin skin, wider hips and stretch marks I've come to terms with.  The complete loss of muscule definition I have not. I was not able to exercise from the start of our IVF cycle until we were released to my OB at 10 weeks. By that time it had been two and a half months since I had done any exercising, so walking was about the only thing I could safely do without getting my heart rate up too high. A few weeks of bed rest plus gaining 80 lbs meant I wasn't moving at all toward the end. My butt and legs paid for it. 

I am determined not to let that happen this time around. While weight wise, I weigh ten pounds less than I did at the start of the last pregnancy, I am still not in as good of shape. The kids are finally comfortable going to child watch at The Y, and they thankfully haven't had colds in over two weeks. That means we've been hitting the gym on an almost daily basis. In approximately 3 weeks, I'll be put on limited activity, pretty much no heavy exercise, until we potentially have a successful ultrasound. I want to make sure I'm in good enough shape that I can ease back into working out three or four days a week. That means weights and cardio 5 or 6 days a week for the next 3 weeks.  

Our RE's office recommends no alcohol from cycle day. That means I need to finish off all the beer in the house in a week. Thanks to a couple girlfriends, the wine is already gone. I have 8-12 random beers that need to be consumed.  This is a task I am looking forward too! Beer and season 1 of Veronica Mars tonight after the kids go to bed. 

That's how I am prepping for our FET. Nothing too fancy, but making sure all my ducks are in a row. The kids and I pray for their potential future brother or sister each night, and I of course pray for a successful transfer and pregnancy.  And that's it.  Now I need to wrap my mind around the fact that go time is a week away. 

Maybe Baby?

Last month we went to see our favorite doctor, Dr. Bopp, to talk about baby #3. A lot of people think since we have a boy and a girl, one pregnancy and we're done. Rob and I both feel that our family isn't yet complete, so we're praying we'll be able to expand our family. We have three frozen embryos from the IVF cycle we did to conceive H and B, and we plan use them.

I went back and forth on whether I would blog about the process as we go through it, or just do a summary after. I know that it was helpful for me to connect with other women who were going through the same things I was before, during and after our IVF cycle. I love the Inspire boards for connecting with women cycling at the same time as you, and I also found great reassurance reading the blogs of women who were experiencing the same things. 

I've always been open about our journey and that it wasn't easy to get where we are. As much as I wish adding to our family was as easy as a few drinks and a fun night in bed, it isn't and never will be. And I'm ok with that. When I look at Brooke and Harrison, I know things happen for a reason. We were meant to have them when we did, and not a moment sooner. Sharing our journey as we try for #3 seems like the right thing to do. If sharing helps even one person know that they're aren't alone in what they're going through, then it's worth it.  

After talking to our baby doctor last month, we decided we would try a single embryo transfer. I have one procedure I have to have done first, a SIS or saline sonogram, and I get to spend my morning tomorrow doing it. If all goes well during the sonogram, we'll start ordering drugs and preparing for a sFET, single frozen embryo transfer.  

At somewhere between $4000-$5000, all out of pocket, for a single attempt at a FET, we're praying the first attempt takes. Any extra prayers are greatly appreciated. I plan to share, but hopefully not over share during the process. If you have any questions please feel free to comment or email me, and I will answer as thoroughly and honestly as possible. A quick summary of our IVF cycle is available here.

On a lighter note, I hope everyone is having a great weekend.  We're looking forward to some more football this afternoon and hopefully watching the Broncos win.  Happy Sunday!

Drinking milk in their toy bin. You know, the usual.

Doctor's Visit

Usual doctor visits are not very exciting, however we had a really exciting one, at least for me, yesterday. We went to visit Dr. Bopp and the girls at Midwest Fertility.  I had some Follostim that expires in a couple months sitting in the back of my fridge. I know how expensive IVF meds are, especially without insurance, so hopefully someone will be able to use them.  Plus, I thought we should take in some DeBrand truffles for the girls.

I haven't been in for a visit since the day of our anatomy scan.  I've been hesitant to take the kids in since I know how emotional and sensitive the entire infertility journey can be. There are some days when kids, babies and pregnant women are the last thing you want to see, and I would hate to upset anyone in the waiting room.  

It was great to see everyone and for them to get to meet Harrison and Brooke.  Brook and Michella were both there, and it was so good to see them since they are who we spent most of our visits with.  I was so sad to leave their care when we graduated to an OB, and I can still see why.   They are amazing.  Of course they asked when we'd be coming back for another go round, but that's a story for another day.  

Getting Here

I thought that I would blog through our IVF experience, but three shots a day proved to be about all I could handle. My husband and I had been trying for a baby for over four years when we finally decided it was time for IVF. Once you decide you're going to do it you have to dive in head first. I was giving myself three injections per day, having daily blood test and visits with "Rocky" the dildo cam. It's a very involved process, but much easier than I expected it to be. Once you get over all of the needles it's a breeze. Unfortunately there are lots of needles. I gave myself injections in the car, in restaurant bathrooms, at rock concerts and of course at home. Everything is time sensitive, so unless you plan to give up your entire social life you have to make accommodations.

Fortunately for us all of the injections and bloating gave us a lot of eggs to work with. On the day of our egg retrieval they retrieved 20 eggs. 19 of those fertilized after being injected with sperm (a process called ICSI, intracytoplasmic sperm injection). We transferred two perfect blastocycts on day five and had three embies make it to freeze. Hopefully those frosties will be our next babies.

After waiting a few days I decided to take a home pregnancy test 6 days after our transfer. That equates to 11 days past ovulation to a non IVFer. Still very early, but there was a very faint line. After taking 5 more home pregnancy test and getting continuous positives over the next four days it was time for our beta. Our first blood pregnancy test showed a great HCG level of 277. So awesome. Even better our second one was 698. A doubling time of only 36 hours!

So here we are pregnant and keeping our fingers crossed that the little embryo(s) stays strong. Our next doctors appointment isn't until 10/25, but we'll get to hopefully see a heartbeat and find out if there are one or two embryos growing in there.

This is Robbie on the day of our transfer.