Ugh, what a morning!

• The morning began rather painfully. I woke at 5:30 to 10/10 abdominal pain. I tried to recall my Lamaze techniques to breath though the pain in hopes that it would pass but the ensuing nausea and profuse sweating was too much for me. I woke Dave and explained what I was feeling. Immediately, he called Dr. R. at home for guidance. We were instructed to meet him at the office asap. We called our friend, Jennie, to come sit with the girls. By the time we were ready to leave, the pain had subsided. I was relieved but embarrassed as we entered the office. Dr. R. did a quick exam and ultrasound and determined that one of my ovaries had likely twisted around itself causing the pain (apparently this is rather common after stimulation). The ultrasound showed that my ovaries are still quite large and there is a small collection of fluid in my uterus. He assured us that none of these anomalies require surgical intervention or interfere my egg transfer and encouraged me to just go home take it easy.
• As far as the embryos go, 2 of the 5 stopped growing at 8 cells and will not likely evolve into anything implantable. The remaining 3 continue to grow but are "compact", hopefully they will continue to develop in time to be transferred tomorrow. Dr. R. sat us both down for a heart to heart and encouraged us that it is not over until we say it is and that he believes that there is still hope for a "love child" even if it doesn't happen this series. We left the office fairly discouraged. I felt quite sad that we may have gone through all of this without anything to show. Once we got home and I settled into the couch, Dave contacted the nurse at The Center for a little clarification. She stated that almost 70% of couples have to wait for a Day 6 transfer due to slower growing embryos. She reassured him that she would call first thing in the morning with an update and a game plan.
• For now, I am just lounging around trying to keep all of my innards from kinking off and counting the minutes until we have an answer. Thank heaven for the marathon of Project Runway being aired on Bravo today. This waiting game is not my strong suit. We are just going to lay low this afternoon and keep our eye on the prize. I'll update again tomorrow.

IVF update

This is the fortune that I recieved a few nights ago when Dave and I went to dinner. Hopefully it is a sign of things to come. I had my egg retrieval yesterday. The procedure went pretty well and I felt nothing as it was being performed. The discomfort began as I woke from the anesthesia but was relatively controlled with Tylenol w/codeine. Dr. Robbins was able to harvest 11 follicles. The embryologist decided that in order to increase our chances of fertilization, they would perform the ICSI (intra cytoplasmic sperm injection) method of fertilization. They called us this morning to report that of the 11 follicles retrieved, 6 of them were mature, and 5 of them have fertilized. They will call us again on Wednesday with an update on how they are growing. We are planning on implanting the most mature blastocysts on Friday or Saturday. I am down to one intramuscular injection of progesterone a day in addition to an oral steroid to decrease inflammation from the procedure and oral antibiotic to ward off potential infection.

The girls made it back from thier vacation yesterday evening and were very concerned about my "surgery". Ashley kept insisting on seeing my incision (the retiveal was a transvaginal approach). Yikes, I think it may be time for me to buy a book to help explain a little about the birds and bees as simply as possible. I am happy to share with them the basics about having a baby and I want it to be clear that it usually does not require this much intervention. They are at Vacation Bible School this morning, maybe they will get distracted and forget all about thier questions. Ha, fat chance! Wish me luck on explaining this one.

It's harvest time!

I saw Dr. R. today and looks like my ovaries are about to blow. All off my follicles are measuring at 19-20mm so it is time to collect them for the next phase. We are moving up my egg retrieval from Monday to this Sunday morning. I am a bit nervous about anesthesia and long needles poking through my netherlands but I suppose that this is all part of what I signed up for. Once my girly follicles are retrieved, we will introduce them to their male counterparts in the "love dish". We are hoping for a large showing of participants from both sides to participate in the orgy. In this case, the more the merrier! In 3-5 days we will evaluate the maturity of the ones that manage to hook up and choose the most robust for the trip back into my uterus. We will likely put 2 back and hope that either one or both of them implant and result in a baby. Dave is quite excited at the prospect of being a "real" dad. Please keep us in your prayers on Sunday and send proliferative thoughts this way.

Its been a stimulating week :)

Since the girls left for Nebraska, Dave and I have been busy stimulating my ovaries. Now, don't you go and think something kinky, trust me it couldn't be any futher from that. I have been doing 3 daily injections and we are finally seeing some results. I had an ultrasound and lab work on Sunday but Dr. Robbins was only able to see one ovary which only had 3 small follicles; the other one must have been hiding behind my bladder that he said was the size of Lake Coer D' Alene (note to self , don't drink the morning decaf latte until after the appointment.) Today, he was able to visualize both and thankfully, the previously hidden ovary had about 8 follicles. They measured in size at about 14-15mm(?). The goal is to get as many as possible to measure 19-20 before my ovaries burst (yes that is a potential complication), hense the frequent ultrasounds. So as it stands we have 10-12 follicles growing, however it is likely that there are a few more that we are unable to appreciate with the 2D ultrasound. So you may be thinking that 10-12 follicles are a lot. The statistics show the following sobering facts:

• About 70% of eggs retrieved will be mature.
• About 70% of the mature eggs will fertizile.
• About 40% of the embryos will develop into blastocysts.

With that in mind, we are praying that the odds will be in our favor. For now, we will continue the stimulation phase and wait until our egg retrieval tentatively scheduled for next Monday.

5 W's and H of IVF

Who: Dave and I (duh!)

What: IVF aka In Vitro Fertilization; a procedure that involves the retrieval of eggs, collection of sperm, and then placing them together in a laboratory dish to fertilize outside of the body.

Where: The procedures will take place at The Center for Reproductive Endocrinology and Fertility in Spokane. The injections will be done by me on me wherever I happen to be at precisely 7am and 7pm on the days the doses are scheduled.

When: We have already begun the suppression phase of the protocol. The series will continue through the end of June and hopefully result in a pregnancy (or two) by early July.

Why: Basic junior high biology class taught us that in order for a pregnancy to occur, and egg and sperm must hook up. Let’s just say that any biological children of Dave will not be Olympic swimmers. TMI?

How: Okay, down to the nitty gritty. After a multitude of exams, ultrasounds, blood work, and specimen evaluations the protocol that our physician has prepared for us will be in 5 phases.

1. Suppression: The purpose of this phase is to quiet the ovaries and prepare them for stimulation. This is done by taking oral progesterone tablets daily.

2. Stimulation: The purpose of this phase is to stimulate multiple follicles to grow so that they are of optimum size for retrieval. (Follicles are sacs of fluid and typically each one hold and egg.) Stimulation is done by injecting two different hormones twice a day into my abdomen (Yes, that means 4 shots a day). During this phase I will have an ultrasound and blood work every other day to determine my hormone levels (to ensure medication dosages are adequate) and the size of the follicles in my ovaries. We will be starting this phase on June 12th (our 4th Anniversary).

3. Retrieval: Once the doctor determines that the majority of my follicles are of optimal size, I will take a high dose HCG injection and plan on retrieval 36 hours later. The egg retrieval procedure is an ultrasound guided needle aspiration of the follicles from the ovaries. The procedure is performed under anesthesia at The Center. This is tentatively scheduled for June 23rd. It is at this point that Dave gets to participate. On the day of my retrieval, he will supply a specimen of his swimmers. The sample is washed and spun down to separate the highly motile from the ones swimming in circles. Finally, the motile sperm cells are placed in embryo culture medium with the eggs so they can do their business. In the event there are not enough sperm with a sense of direction, the embryologist may perform the ICSI procedure. I’ll give more details later if we have to go that route.

4. Embryo transfer: After all of the mature eggs and sperm hook up they will incubate in a temperature controlled environment to (hopefully) grow into mature embryos. Once we determine how many of the embryos have matured, we will have some difficult decisions to make including how many to place in my uterus and what to do with any “leftovers”. The embryo transfer itself is a relatively minor procedure that occurs 3-5 days after retrieval (tentatively June 28th). Basically, the mature embryos that make the cut are strategically placed in my uterus via a flexible catheter. Then we wait. I will continue one of my twice daily injected hormones to help foster a hospitable environment in my uterus for the embryos.

5. Follow-up: One week after retrieval, I will have estrogen and progesterone levels drawn to double check drug dosages. Two weeks after retrieval I will have my first pregnancy test. If the result is positive, then… well it is positive. If the result is negative, we will double check it again in a few days, if still negative then we start again at square one. Hopefully we won’t have to think about that.

Well… that is it in a nutshell. There is not a lot else we can say other than prayers for strength, courage, and patience are appreciated. As you can imagine, it has been a long road to get to this point and will be even longer until we have a positive pregnancy test. Your posted comments will be greatly appreciated as we endure the nexy few weeks.