The End (for now)

I think I'm in shock.

I'm calm, sad, stoic, a bit numb, but in shock. So, as most of you know through my text sent today, our blastocyst passed on this morning and our cycle was cancelled.

So, since I've captured everything, it's time to capture this experience too.

~~~~~~~
I could barely sleep all night. I was so excited. I beginning praying early in the morning, to my passed loved ones, to Beanie, to all of my friends on the other side, asking for guidance and strength in this process. I danced for Mark in the kitchen, what I like to call the "corn dance" and we talked about how exciting that today we'd be bringing our little one home. We laughed and smiled and made all sorts of milestone comments, the morning was sweet, and rich and full of hope. It was beautiful and nothing can change that.

My morning with Jonah was also sweet. I nursed him on and off the entire morning, because I had wanted to feel *just him and I* one last time before bringing the blast home in my womb. I just wanted some me and him time, and I made time for it and it was good and fulfilling. The time came, the nanny came in, we acclimated and Mark and I drove off. We were giddy, excited, hearts racing. We took a video (we took a video every single IVF appointment and milestone with Jonah's transfer) and we talked to the screen about how today was the day and we would meet our little one again. Mark was cautious as he always is, but the ride there was another exciting time (full of stops to pee, my poor bladder! I'd been drinking since the morning time.)

Once we got to the hospital, Mark suggested I get out and pee first and then he'd park and meet me in the lobby. I checked in up front and made a joke with the receptionist "I'm here to take home my bebe!" (I said that with a Austin Powers accent, by the way)

I curled up into the same chair in the lobby I always curl up into and picked up a People magazine. Flipping through I kept looking up to see when Mark was coming. The nurse K came out to see me and I said excitedly "So good to see you K! Today's the day!" Mark came through the door and I smiled at him and I thought the look on his face was strange. He said he needed to talk to me in the back room. I was confused. Why would he need to talk to me if I'm about to go into acupuncture?

He pulled my hand into an empty room and all of a sudden I was outside my yard again with the neighbor bringing my mauled chihuahua. The shock of loss while in such a complete opposite mindset is a trauma I cannot explain. When everything is good one moment, and then gone the next, it's unsettling, truly the word disturbing. To my soul, my psyche, my ability to just simply understand.

The same energy of Beanie's death loomed in the air and he sat me down on the chair and said while parking the car, the clinic had called him and told him that the blast had died during the thaw. I don't think the information really sunk in. I stared at him, the floor, the walls. And we cried. We held each other. We talked. And cried more. I cried for 41 days of medications and plenty more days of hope. I cried for the loss of something I don't think I could possibly explain.

And then I accepted. I accept. I accept that this has happened, I accept that it didn't make the thaw and that life must and will go on. I accept that this is a risk we knew the odds were on our side,but we knew this could have happened and unfortunately it did and we must heal and move on.

I will tell you I have a sadness in me that hits deep. My chest is heavy, the loss of the potential is overwhelming. I feel foolish for researching baby things over the last months. I admit to a mourning of not only my blast, but the thoughts and dreams I'd had over Jonah and his sibling at this age, proximity in ages, taking pregnancy tests over the next week, getting morning sickness, feeling movements all over again. Sure, just a bit delayed, but a sense of grieving none the less, if nothing less than potential.

And so that's it. That entire journey, gone within seconds. I started this blog almost six months ago, wow.

As I promised in my letter to my blastocyst:

"And with this letter, I must say my little blastocyst, that should you not survive this process, should you not survive the thaw, should you not survive to live ten months in my womb like your brother, that I thank you for giving us hope and experience in this journey. I thank you for letting Jonah "go first" and I thank you for the three years you waited to come back home.

Should you not join our family little blastocyst, I promise you I will acknowledge, recognize, and honor the menstrual blood that separates you from me weeks later. I will take pause and appreciate the precious things around me, the amazingness which is every single second of life that we often forget."


So I will do this and of course leave room for my sadness and healing. We'll try again early next year sometime. We will need to do a full "fresh" IVF cycle which involves a lot more meds, a lot more injections, one surgery for Mark and one for me. It's a tough road, a full cycle. But we'll get through it.

Thank you to all of my friends and family who have supported me and listened to me and maybe been at the end of my Queen Bitch phases. Love to all of you.

Less than 18 hours

Well, the time has come. I am nervous, scared, emotional, excited, all of the above. The clinic let us know that our blast would be thawed early tomorrow morning and would then wait for us at noon.

I feel speechless, or wordless as it were.

So maybe I'll just leave it at that. I've said enough for now. An update after we get home. Hopefully with a picture of our blast.

2 days

2 days. I'm getting excited. The clinic called me today to let me know my transfer would begin at noon. I get there at 10:45 for the acupuncturist which lasts for 45 minutes. Afterward I go into the "operating room" and we begin the procedure.

I found the post I wrote from our last transfer.

As I recall from my own memories....

There are two or three big monitors in this big room, the monitors are looking at what looks like a petri dish. There is a glass panel with a lab person behind it. You never really speak to them except....this person calls out your name and spells it letter by letter, first name, last name, all spelled - confirms birth date, confirms the transfer of one embryo.

Doctor looks excited and more serious than he's been since our first consult, you can tell he takes his job seriously as he carefully moves his hands. (by the way, I'm in tremendous pain this entire time from the bursting bladder, it was hard to recognize anything) Mark was taping the whole thing, so the red light on the flip camera was glowing under the lights.

The lab person magnifies many, many times and alas, there it is. Our blastocyst. What ended up being Jonah. Mark squeezes me as we see them "suck up" Jonah through a straw and then analyze the remaning fluid to ensure they had sucked him up properly.

Under ultrasound the doctor pulls up my uterus and you see it's shape on another screen. He's calling out instructions to a nurse about different things he needs (gloves, gauze, this, that) He says he sees the spot he wants to drop the embryo.

Then they transferred him, and I remember looking up to the ceiling, how weird all of this is! I just had our baby put in me! Afterward, we were wheeled back into the acunpunturist room and I demanded a bed pan. Oh my was that the best pee ever. Siiiigh.

So the needles, and I listed to Enya on my Ipod and imagined the blastocyst falling onto my thick, sticky uterus and staying there and making a home. I pictured it burying into my womb, I stayed calm. It was surreal. It was like "ok, wait - so um all done? Ok, so uh - that's it?!"

Everything is similar this time around with acupuncture and the transfer schedule (hopefully with less bladder pains). I have planned to have Lorena Mckennit's song "Bonny Portmore" playing immediately after the transfer. This is where I will imagine our little blastocyst making yet a new home with me. Back with me, I should say.

Mark's nervous. A lot is riding on this, folks. A lot of work and money and meds and emotional bandwidth, and I've maintained a level of positivity throughout the entire process but sometimes I can't help but get weepy and scared this won't work.

I'm in a better place to understand it, but it will still hurt. The experience however is beautiful, and this I wouldn't change for a thing.

3 more days

3 more days. Whew.

Good thing too because Queen Bitch showed up over the weekend. Not pleasant. Let's move on.

The PIO shots make me tiiiiiiiiiiiiiired. Like pregnancy tired. But I was able to nap today which was like, um, incredibly rare so that was nice. Shots are still going in, so I guess they're going well, but I look forward to stopping those.

We have managed Jonah though and since he HAD to know what we were doing, he now sits on his little chair in the room while "momma gets medicines". He waits patiently and I smile to him while I lay on the bed and Mark gives me the shot. We talk about 'making brothers and sisters' and I know he has no clue what's going on, but the fact that he gets to participate in this process is awesome to me, something I don't think I'd ever thought of before.

I'm gonna try not to fill my bladder as much for transfer. I've been reading more and more about it, and there's no real data saying it improves implantation rates, it more assists the doctor to be able to put the catheter in more accurate, which is great and all, but there hasn't been much data on whether or not the u/s guidance is even needed or a just 'drop it in the womb' approach is best.

all in all, I'm not going to torture myself. This isn't labor. I don't need to 'push through the pain' for the transfer. It was traumatizing the first time around, I felt violated and I don't want to repeat that experience. I can have a full bladder, but I don't need to be in that much pain.

SO ANYWAY - 3 more days.

Ow, my ass.

So this morning I was a lunatic. Scared about my IM injection.

Mark woke me up this morning to take my shot and I was highly anxious. And by highly anxious I mean marriage-damaging with my fright, raving like a lunatic, shaking - I was terrified about my shot.

(this is after 10 tattoos and a natural birth.)

Mark was patient, gentle and ready to take aim. (a little TOO ready if you ask me)

To make a very long story short (like seriously 45 minutes of raving/ranting/worrying) finally I was in position, ready for the inch and a half needle to plummet into the depths of my poor muscle. I felt like a cow. I wondered if my butt was a sirloin or a nice filet. I hope a filet so the muscle would be tender. :-)

BOOM. Needle in. Oh damn, that's not so bad, oh wait, OW, ok, almost done, OW, ok ready to pull it out, ok DONE. Needle is out. WHEW. IT'S OVER!!!!!!!!!!

right???

Mark looks at me. And looks at the needle.

"Oh no, there's still medication in the needle. Royal fuck up. I'm so sorry."

"Oh my god. We have to do this AGAIN?"

"Like I said, royal fuck up. Totally my bad."

I had to laugh. The look on his face and the hilarity of the entire morning was laughable and fit for a cartoon.

BOOM, in goes the second one. Done, for real this time.

Until tonight. And two times tomorrow and twice daily for the following five days. :-)

My butt is certainly sore, almost down to the kneepcap but it just feels like my brother punched/kneed me hard in thigh like he did that one Christmas. (grumble, grumble)

I feel much better about the process now and am not as fearful as before. I'm sure I'll get anxious before each injection but at least I know what I'm in for, and at least I have one hell of a nurse.

Thanks, honey. :-)

T - 5.5 days (Transfer Date Confirmed!!)

Wow. Less than a week.

I went into my ultrasound and blood work appointment today. As I was walking into the hospital, I saw the doctor who was about to give me the u/s crossing the parking lot. How odd I thought, this man crossing the parking lot is about to have a wand in my vag in less than 10 minutes. Yes, these thoughts do permeate my head, and yes you do get the pleasure of reading them. :-)

My estrogen came back as 967!!! From 285??? Holla!!!!!!!!!!

Dr. O said my uterine lining already passed the thickness they require (8-12 MM) and I'm at 13.5. He said it's time to pull the trigger and get this embryo home.

The nurse called and confirmed my embryo transfer is on...........

Wednesday September 29, 2010!!!!!!!!!!!!!!

And so it is. My next steps are as follows:

• Stop the fucking Lupron. (Ok, so she didn't say that verbatim but you get it.)
• Continue putting 4 patches of estrogen on my stomach every 48 hours
• Begin taking Medrol
• Continue vaginal pills of Estrace
• START THE HORRIBLE ASS INTRAMUSCULAR SHOTS IN MY ASS

I dread these injections in my butt and to think of a toddler running around whilst Mark trying to give me one makes me sick to my stomach. I think we may put him in the empty bathtub with some toys and run out and do the injection. The one time Mark 'wiggled' the needle while it was inside my muscle I almost fell out of the bed writhing in pain. I felt impaled. I was sure he took a sword to my ass. He did not. He 'wiggled'.

• Transfer booked
• Nanny booked
• Acupuncture before and after the transfer booked

It's close. I can feel it.

T- 7.5 days

Holy nausea. Yikes. So familiar with first trimester sickness, the past 5 days or so has gotten more and more nauseous . Like a boat, really. I'm hanging in there but woah, bed spins without the fun part before.

So, thanks for that four Vivelle patches. I look forward to meeting your other four brothers tomorrow. :-)

Thursday is my last estrogen check and they will call me later that afternoon to confirm my transfer day for sure. This is also the dreaded day I start the IM injections. See here.

My butt is quivering already.

T- 10 days

It's always so validating when the doctor sticks in the vaginal ultrasound wand and goes "Great, great!" with a big smile on her face. Ding! Where before I would ponder over every shadow and stripe, I saw what looked to me like a sparkling shiny uterus and I was happy, ready to go now!

She said my uterine lining looked "wonderful!"

Just got the call from the clinic staff, my estrogen went from 155 to 285!!! Nicely done uterus. Like open arms you have, welcoming our little one into your cozy great room.

My next steps instructions:

-Begin vaginal pill of additional estrogen tonight (Estrace)

-Continue Lupron injections

-Add 4 estrogen patches

-LAST Appointment (OMFG!!) - 9/23

T- 11 days til transfer

Holy crying jags batman!

Yes, you heard me right. My estrogen has reached the level that makes women cry at commercials and weep over the smallest of things. Though to me they don't feel small. I've been grieving over the loss of my Beanie and finding things to rage at as well (Hi Hubby!). I've been doing a swell job of containing The Beast but the tears have definitely started.

This part kind of feels good in a way because it allows me the opportunity to sob. And I mean a good sob too. The kind where your whole body gets into it. And afterwards it's as though you've run a mental marathon. But it feels better.

And today I feel better than yesterday and tomorrow maybe better than today. All in all, things are good. I have an estrogen check and ultrasound appointment tomorrow and I am eager to see what the results are.

Last time my estrogen was 155, this time ....? Let's hope my uterine lining is getting nice and fat and juicy.

Lupron shot gone wrong

This is what a Lupron shot gone wrong looks like. I accidentally injected my appendectomy scar about a week ago and the bruise has been so awful looking. It's finally turning a green hue but for a while it was dark black. Now I check for scars before I inject given I have 7 from 3 different surgeries on my abdomen! The redness was from me SCRAPING off the glue from the previous patches!

Did you check out the THREE estrogen patches currently taking home on my stomach?

Your estrogen be lookin' good!!!

I went in for my blood draw today and indeed my estrogen has gone from Under 25 to 155.

Now it's time for three new patches tomorrow morning and to continue my Lupron shots.

I have another blood draw and ultrasound this Sunday and one appointment left on Thursday.

Then it's D-Day! Or maybe I should say B-Day for Blast! But then that's like birthday isn't it. It's kind of like a birth day! Ok, I'm stretching now. I'll still call it B-Day.

:-) Go estrogen!

It's official! We're in cycle!

I had my suppression check Saturday morning and all was sufficiently suppressed and there were no cysts or anything else Funky growing in and on my womb. She was pleased.

So this morning I reduced the Lupron to a 1/4 of what I was taking, and I started taking the estrogen patches which go on my stomach. Those are no biggie and are closest to the nicotine patch I can think of to describe. Except it's shooting a bunch of Woman-Juice into my system that should make me have at least 234 crying jags and 2 and a 1/2 rage sessions. Mark can't wait! Heh.

Next up is an Estrogen check on Wednesday to confirm my estrogen is rising nicely. The nicer it rises, the nicer my uterine lining thickens up in preparation for our blastocyst. The next 13 days are all about making my uterus nice and thick and attractive. I will spend the next two weeks switching the patches from 1 to 2, to 2 to 3 and 3 to 4 and 4 over and over a couple of times and then once they think it's good to go, well start drinking your water ladies, it'll be show time.

A little over two weeks until the big day. Crazy.

Dear Blastocyst,

Dear Blastocyst,

Hi there little blastocyst, I'm your momma. You came into our lives almost 3 years ago through miracles of science and technology. At the time, I didn't really know what you were besides a set of predefined cells, complex in nature.

But you see, three years ago, we brought your brother to my womb and ten months after that he joined the earth in a fury. And I realize now that those complex set of cells were so much more than just an odd oval shape of something past my understanding. They were the potential of the start of something so amazing and surreal.

And so over the past few weeks as I've been taking my shots and my hormones, I've been thinking more and more about you. It's dangerous to do so of course, and I'm sure the nay sayers would discourage humanizing you at this early stage in the game, but the fact is - you are our little blastocyst, whether or not you survive in my womb, you are ours. You are a creation of us. You are Jonah's sibling, you are made from the cells in my very body. You are me. And I love you. And I cannot pretend that I do not.

Today I pulled my car over to the beach and sat and thought of you. The fact that you are really a 3 year old right now! The fact that you have had quite the journey so far in life. You flew to Nevada and stayed in cool temperatures waiting until it was time for us to beckon you. You waited patiently. You made the plane ride without a scratch. You will return back to me in about 20 days. Grasping my mind around all of this is so incredibly difficult and amazing at the same time.

I think what I'm trying to say little blastocyst, is that I feel close to you lately. I feel a connection, an energy ignited, a spirit, a change in the distance. And I'm ready. I'm ready for what I'm not ready for.

And with this letter, I must say my little blastocyst, that should you not survive this process, should you not survive the thaw, should you not survive to live ten months in my womb like your brother, that I thank you for giving us hope and experience in this journey. I thank you for letting Jonah "go first" and I thank you for the three years you waited to come back home.

Should you not join our family little blastocyst, I promise you I will acknowledge, recognize, and honor the menstrual blood that separates you from me weeks later. I will take pause and appreciate the precious things around me, the amazingness which is every single second of life that we often forget.

Thank you for this gift little blastocyst, no matter the outcome. No matter the outcome.

We love you and we will see you soon.

Love,

Your Momma

CD20 - Stop the BCP!!!!!!!!!!!

Sweet Jesus, the day has come. Today is my last birth control pill.

EFF YOU BIRTH CONTROL PILL!

Ok, actually it wasn't THAT bad. (I can hear my husband chuckling in the distance). A couple days of Raging BitchLand and then normalcy, or whatever that means in this moment.

So, I made the 18 days. I made it, I made it!

Now to continue this Loathsome Lupron and check my suppression this coming Saturday.

We asked the embryologist to tell us a little more about our little blastocyst and how it compared in quality to Jonah as an blastocyst . Here was the response. I love our embryologist. :-)

"The embryo (Jonah) we transferred in your fresh cycle was a expanded blastocyst with a inner cell mass (this part makes the babyJ) grade of A and a trophectoderm (this part makes the placenta J) grade A. The one we froze was an expanded blastocyst with an inner cell mass of grade A and a trophectoderm grade B. The differences are very subtle but the one we transferred was ever so slightly better. It is like comparing an A+ to an A."

A little over 3 weeks until transfer!

CD17 - Day 4 of Lupron

Today's shot went in easier and didn't leave a marble under my skin. I still have a migraine so I called the clinic to check in on both things. I don't remember any lumps or any trouble really the first time around with my sub q shots so I'm not sure what's different this time around.

If you do a simple Google search for "Oh my god, what is happening to my head after taking this effen Lupron medication" you will come up with a million stories from my fellow IVFers on this dreaded Lupron headache.

So, I need to change my mindset, kind of like labor and just power through this. 3 more days on BCP, whew.

CD16 - Day 3 of Lupron

I just feel shitty. I'm trying to be upbeat and positive but I just feel run down, sore, achey and annoyed. I've had a migraine for 2 days now. Nursing has been just so, so painful. I'm sure this is what it's like to have your milk dry up and nurse in pregnancy. It's so, so painful. The right boob especially, since I know you want ALL the details.

So anyway, I get to stop the BCP on Monday (oh thank god) and next Saturday is my suppression check to see if I can start my estrogen.

Ok, back to being run down. Off to take a nap, take care of my toddler all day.

CD13 - First Injection

First Lupron injection today!

We captured it for memories sakes just like the first time. This time we had a little Big Boy in the background helping us out.

12 more days of Lupron! Next step is to continue the BCP and the Lupron until my next appointment on Sep 11 where they will check to see if I'm properly suppressed before pumping me full of estrogen to make my lining nice and thick.

I'm 14 days into the 41, almost half way there!

CD11 - QB has calmed down

That's right. The Queen has calmed down. The hormones seemed to have equalized a bit, and while still terse and without my normal low dose of tolerance, I seem to be out of the 'crazy cloud'.

Now on to my Lupron injections starting Tuesday! I'm gonna prep the meds and needles tomorrow night and make sure I remember how to do it all. Exciting. Let's hope I don't turn into a werewolf in mid-day.

Me on Lupron?

My milk supply has certainly tanked. While I still have milk, here on day 10 of the estrogen and progesterone intake, I can feel a noticeable difference. Nursing also HURTS. It's like what it feels like during ovulation and my period but about two to three times worse. I'm finding myself limiting him like "wait until nap" which he readily has been accepting so that's been good.

Otherwise, all is well in my world. Well and calm and continuing to press forward.

CD8 - Still Bitchy!

I've really been a bitch. Irritated. Agitated. Annoyed and without tolerance.

So far, Mark is getting the brunt of it and its only been 48 hours since the Queen Bitch came out. But I know it feels like weeks.

I'm trying to reel her in. Sigh.

Queen Bitch

The Queen Bitch has shown her ugly head! My mom and husband can attest that indeed I have been a testy lady as of late! I seemed to have lost my 'sensitive' filter' somewhere between last night and this afternoon.

Now to reign her in!

CD6 - Day 5 of BCP

Still here, still surviving! So far I'm doing great on the BCP and we're five days in. Less than two more weeks on these bad boys.

I start Lupron next Tuesday which is a huge step toward our goal.

So, not much to report. My boobs are growing from the meds but there seems to be no impact on milk supply yet though I have to report he's been nursing like a newborn lately so maybe there is an impact?

Anyway, all is well, my uterus is prepping and excitingly rubbing its uterus hands in anticipation.

CD3 - Day 2 of BCP

Can I get any more acronyms in there?

I don't know whether it's my period or day 2 of the Loestrin, but I've got a yucky monster headache that just won't go away. I feel mildly ickish and a bit detached. In other news, I had a hot shower which was wonderful!

The nurse called back and indeed my protocol will be what it is with 18 days on the BCP instead of 14. Oh well, I tried. Transfer date right now is set for September 29th! This could be plus a couple of days if they think my uterus needs a little more thickening. :-) I start the first injections on August 31.

I feel like a pro now. I'm gonna be able to inject myself and move on to fixing Jonah breakfast in the next minute. My little distraction from this process. :-)

CD2 - Baseline Ultrasound done

Nicely done uterus!

My uterus scored all A's today. No cysts, Weird Things or anything else blocking me from conceiving our next little one.

I've been given the green light to proceed with our cycle! WOOHOO BITCHES!

That being said, I start the birth control today and it is likely our transfer will be the end of September. I'm excited! Much to report:

-I had my list of questions and the nurse had some information to give and some to ask the doctor for later. She said in her several years working there, she's only seen one time that an embryo didn't survive the thawing. She said the clinic is incredibly picky about freezing embryos, and if they don't think the embryo is strong enough to thaw, they don't keep it. So the quality of our little embryo (I'll name it if it takes up home in my womb) is supposedly very high, which is always nice to hear.

Though, because I'm type A, I asked for the embryologist to pull up my records and call me so we could chat embryo grading. While in the long run, it doesn't really matter because the universe will choose whether or not that little one survives, I am curious into the embryo grading as compared to Jonah's embryo. More intrigued than worried. Funny!

I told her I get "batshitcrazy" on birth control pills and she said she would look into a shortened schedule, maybe by like 3 or 5 days which would be great. Right now they have me at 18 days, which is 4 more days than last time, so I know it's not a must have. We'll see if she gets me a shorter protocol today.

She confirmed our embryo arrived safely and was currently 'chilling' out in their lab. It's so funny to think that our potential child is sitting in another room so close to me. That could be a baby we hold in 10 months! WEIRD. (I also had a dream last night that Jonah had a little BROTHER!)

Once I have my new schedule, I'll update it below. So now it's just the waiting game, the roller coaster of emotions, the physical sensations of the insanity that is chemical imbalances of hormones. Ah, conception! I will foil you again!

With all my meds I also got my Big Ass Needles. They go straight into my butt with Mark holding the other end. These puppies are a force to be reckoned with.

Here's an example:

Son of a......

:-)

More updates once the chemicals have seeped in. I'll create another 'side effects' list on the side.

And so it begins....

Another reminder of Jonah as an embryo in the blastocyst stage:

CD1 - Period has arrived!

Lo and behold, the period has arrived!!!!

I have an appointment tomorrow morning at 10:45 for an ultrasound and blood work to check my estrogen level. Cycle Day 2 (CD2) tomorrow!

Our embryo has shipped!

I called this morning and our lone embryo will be taking flight this morning from Nevada to Seattle.

Welcome home little embryo! My uterus can't wait to meet you!

In other news, I've started spotting so I know my period will arrive any day. OMG, and so it will begin! AHHHHHHH!

Surprise, the meds arrive!

Lo and behold, the meds have arrived!

Let me remind you of what landed on my doorstep today:

• Birth Control Pills - Loestrin
• Lupron injections
• Vivelle Transdermal Dot
• Estrace
• Doxycycline
• Medrol
• Progesterone in Oil
• Tranxene
• Prometrium
• 25 g needles 1.5 in
• 18g syringe

If everything goes as planned, I'll start the BCP around the third week of August. Holy crapola folks, it's happening again!

Here is a picture from our first IVF cycle. There were a hell of a lot of more medications that time around. This time only a Fed Ex box!

First time:

This time around:

Little baby out there, we're coming for you!

Signed and Sealed

Mark and I signed the embryo transfer papers and had them notarized today. I'm getting more excited about the possibility of having another child. Something in me clicked recently, I'm not sure what it is. I know the older Jonah gets, the more comfortable I feel that he will be able to handle the transition. I think now he could handle a pregnancy and by the time nine months went by, I believe he would fully understand that a baby was soon going to join the family.

I'll send these papers off on Monday and it will be official. Our little blastocyst will be taking flight from Nevada to Seattle. First Class baybee.

With all of the recent tragedy of the loss of my precious Beanie, I think a new spirit would be a divine addition.

My period started this morning. It is the last period I will have with my own natural hormones and blood. The next time I start my period I will be trying to make a baby. Approximately 35 days from now I will begin the process of conceiving our next little one. It's an amazing journey. And I'm happy I'm feeling more ready.

Here is a reminder of what our little Jonah looked like as a blastocyst. The other brother or sister in his 'batch' of embryos is currently chilling out (heh, literally) but he/she looked very similar to this as well:

Here's to hoping!

Thumbs up!

The IVF clinic called to say that all was A-OK and I am good to proceed with our IVF cycle in August.

Woohoo!

A lot of Updates

Man, have there been some updates. Let's hope I can update this thing in between Jonah pouring coffee grounds into a bowl and the dogs waiting to lap up what they think is food falling from the counter. Ok, here goes.....

For awhile there I was really waffling on whether or not I would proceed with the IVF cycle in a couple of weeks, mostly my own fears of how pregnancy will affect me and my relationship with Jonah. Somewhere I got enough balls to proceed so I knew it was time to get the show on the road.

After moving back into our house, I felt a bit more settled. I called the pharmacy that orders my IVF meds and got all the medications ordered. It only came to around $1000 which is amazing compared to the $5k of a full IVF cycle. She read off all of the meds and while before I got overwhelmed and nervous, I started feeling excited again. Excited to think about telling Jonah about the baby in my belly, excited to think about embarking on an unknown journey and what that may mean for our whole family.

I had them ship the meds to arrive on my birthday which is a little over a week. What a great birthday present I think. :-)

Then I contacted the Embryo storage place and had the papers sent to me to transfer our embryo back to the clinic. We have to go get these forms notarized and then ship off and then our little guy/girl will take a flight on over to Washington from Nevada. (Isn't that some crazy shit??? Our little embryo will be taking it's SECOND plane ride before it ever finds a host uterus!) He/she will arrive in Seattle before August 1.

THEN it's show time, right?!

Well. What I thought would happen, happened. The clinic called me to say that my prolactin levels were elevated and was I breastfeeding Jonah? You're damn right I'm breastfeeding Jonah.

"Do you have plans to wean in the next couple of weeks?" Sigh. I knew this would happen, but I'd done the appropriate research ahead of time to be able to have this conversation and I felt confident.

I delved in and explained that I was well researched on the topic, that I'd been monitoring my prolactin levels for 7 months now and I could send her the data saying that indeed my levels were not elevated. I explained that elevated prolactin levels could be due to my thyroid meds, my SSRIs and the fact that the test was not taken in the morning which is most accurate.

They don't know if they will proceed with the cycle given I am breastfeeding. So I pulled out the Dick Card. I couldn't help it. I really didn't want to switch clinics, and start all over. So the Dick Card goes like this:

"Well, before we get off the phone - I'd like to set your expectations that I have a doctor at the {insert competing fertility clinic here} who is happy to do a cycle while I'm breastfeedig so it really comes down to who wants to take us on. Can you pass that information along to the doctor too? Mk, thanks."

So, why don't they want to do a FET while nursing? Well, they don't want anything to screw up a potential pregnancy and there's a lot of myths and misunderstandings that come with pregnancy and breastfeeding. It's easier to wean (for them) and then they can start 'fresh'.

While hormones are definitely different while nursing, the fact that I've been nursing for almost 2 years brings down my hormones to almost my pre-pregnancy status. The meds I will be taking are hormones and for an almost two year old nursling, the transfer through breastmilk is negligible. Of course doctors don't want to take chances, so they'd much rather me wean.

So, why don't I just wean then???

Because we're not ready to, so we're not going to. There will only be one time in life that Jonah and I will have this nursing relationship and we're not ready to give that up yet for anything.

So, I will wait and see what the clinic has to say on whether or not they will proceed with me as a patient. For the sake of my convenience and sanity, I hope not to have to start all over at some clinic, but you know what, I will.

So bring it on bitches!!!

If all goes well though, I start my meds in about 5 weeks!

Trial Transfer Complete

Trial transfer was a success! The full bladder part was again rough, but not nearly as rough as the transfer last time so I was thankful for that! It was nice (I suppose?) seeing Dr. O and there didn't seem to be any hard feelings or anything. He said it would be best for me to have an even FULLER bladder for the real transfer, and I know my mouth probably dropped open. That shit is torture! I think I had close to 50 oz of water in an hour. Ouch!

Mark was with me and we laughed at odd things like we always do in waiting rooms and it felt funny to be doing this all over again. We chatted with the nursing staff and my favorite nurse Sarah was still there. She gave me a hug and said she never forgot me and 'my spreadsheets' and that made me laugh. Her face turned to such warmth when she found out I'd left my job to be with Jonah full time. We ran into the embryologist who was commenting on my 'cool neck tattoo' and he remembered us from the previous cycle. I thanked him once again, as his information and guidance is what helped us in our final moments of deciding on whether or not to do an eSET. it's like consulting a gambling expert. heh.

so it was cool to see the ole gang, and everyone made "oh you're here for number two? gluttons for punishment these two!" and those kind of jokes but it was all so sweet cause you could tell they say those same things to many folks. It was just a great feel to it all. I was glad to be back.

Now, all the diagnostics are done! Sweet!

All that's left is for me to order the meds, transfer our frozen little embryo from the long term storage to the clinic and pick a date sometime in September!

T-4 hours until Trial Transfer

So far, so good. We woke up Jonah 2.5 hours early this morning so I could take Mark to work. We figured the early wake up would mean an early nap, which would mean the babysitter would not have a Cranky Jonah on her hands when I dropped him off.

Success! He's already down since 10:30am! Nice. So now I eat my cheetohs and turkey sandwich contemplating what's ahead. The only part I'm not looking forward to is the full bladder but I'm gonna power through it and it will be fine. I'm sure all will go well with the actual trial transfer itself and hell, we'll get to see Dr. O again.

Another one down! Next step? Baseline ultrasound when we're ready to start the cycle! Omg!

SHG Complete

All went well today. I thought I'd be a lot more nervous than I was, but the whole thing was actually pretty pleasant.

Jonah, Mark and I headed out to the Seattle clinic. We've never been there before so I was curious what it would look like considering we're likely to do all of our blood work, ultrasounds and monitoring there. The actual trial transfer and transfer itself will be in the Kirkland clinic.

We saw Dr. L and he remembered us from our last cycle. He remarked that it was nice to see Jonah, the product of our first IVF cycle, and so often he bears the brunt of patient frustration for cycles that don't work - that it was nice to see living proof of one that did work.

Jonah thought HE was going to the doctor, so he cried and cried but finally settled down once he realized it was the "momma doctor". Dr. L asked me if I remembered what everything felt like from the first SHG and I admit I was an ole pro. I barely winced when the hoo haa jacker was placed in, and the catheter into my uterus was also a piece of cake. I remember the first time around I was completely nervous, taking advil ahead of time, oh the difference!

It was actually a really sweet scene with Mark telling Jonah "that's where you lived little man" - when my uterus came onto the monitor. We talked to Jonah about 'making a brother or sister' and while he totally doesn't get it right now, I know eventually he will.

Dr. L placed the saline inside my uterus and said everything was wonderfully normal. Score! I freaking love my uterus! The whole thing was done within 10 minutes and we were on our way out the door. Both Mark and I remarked how this time was around was so much less scary, so different. I actually felt elated and excited, not negative and worried.

Afterwards, we dropped Mark off and Jonah and I headed to the park. I saw one of my long ago acquaintances and she was 7 months pregnant! We talked for a while - and it must have been the combination of the beautiful sun, but I just became so positive and happy about having another child.

I babysat another toddler last night, a friend of mine and I got a peek into what it would be like having two. While I know two hours does not accurately represent the work needed for two, I must say it felt 'complete'. It really felt like THIS would be perfect. It was the perfect blend of people and family and again got me even more excited. When Mark came home from work and saw me holding two toddlers, I saw a glimmer of happiness in his eyes. He told me later it was really nice to see me holding two children. I don't think I'll ever forget that.

So, SHG is done! SWEET! Now onto the dreaded full bladder trial transfer. We have a sitter for that one, thank God, so now it's just about getting through the bladder part!

Go Uterus!

Quick Update

Heh. Katie the nurse let me know that they meant to put 'per vagina'. Oh well. She said I had the office laughing, so that's good.

I'm feeling a bit anxious about my diagnostic procedures this week. I'm sure they will go off without a hitch. We were able to get a sitter for the trial transfer, so that's awesome. Now that we're thinking of pregnancy #2, everywhere I look are pregnant women!

Kind of like when you think about a new car you want and all you see is that car everywhere! I'm definitely not ready to BE pregnant yet, but I'm on the on-ramp - thinking about merging. :-)

An email I sent to the nurse.

You can take the girl out of Microsoft but you can't take the Microsoft out of the girl....


To: Katie the Nurse
From: Me
Subject : Correction of a typo on the FET schedule

Hi Katie,

I wanted to let you (and the clinic) know of a pretty humorous typo on the FET schedule you sent me. I would suggest you have this updated! :-)

The typo:

On Day E8 -Endometrium Check - the instructions inform the patient to "begin Estrace 2 mg PER VAGINA".

*laughs* While I get a kick out of this, I'd hate for those double-vagina ladies to get an extra dose of estrogen.


Thanks,
(my name)

Appointments!

I chatted with the receptionist and we got our appointments scheduled!

SHG- May 14th @ 9:30

Trial Transfer - May 25th @ 3

She also said Mark and I would need to get a full blood panel once more, which is no big deal and I'm hoping they can fit that in with one of these appointments to minimize the scheduling impacts. I'm still nervous on how this is going to work with Jonah in tow, but I know we're going to make.it.work.

Funny, our trial transfer is with our "ex" doctor, Dr. O - so since we switched doctors at the beginning, this should be....uh....interesting to say the least.

"Hey there guys! Long time no see!" (inside he's thinking - what, I got you a kid out of the first one and you dump me?!)

"Hey great to see you. Wanna take a gander at my vag?" (inside I'm thinking - oh no, what the hell is he thinking??)

All will be well! As Tim Dunn says "Make it work!"

Period arrives!

Woke up this morning to the gift from our blood goddesses (got my period, mk?). Woo hoo! Time to schedule those diagnostic procedures! I called Katie this morning and left her a voicemail saying next Monday would be best so we shall see what she comes back with. It was neat logging into the 'Patient Portal' all over again and clicking the "Get your period?" link. Nice!

Next steps here we come!

Tentative Schedule!

Well, ladies and gentleman - our tentative schedule has arrived! I can definitely say getting this makes it all 'more real' and I was a bit surprised with how overwhelmed I felt by the whole thing.

I think my biggest fear is how I will react on all of these hormones and how that reaction will affect my family. I know the hormones the first time around literally made me bat-shit crazy. I cried almost every day, had crazy side effects like eye twitching, hot flashes, dizziness and more. The difference now is I'm responsible for our son, and most of this I will need to just 'suck up' to be functional for him. I can do this though. I have the support of my husband, friends and family and I need to just take it a day at a time. Each day that passes will feel like an accomplishment, I know it.

I chatted with the IVF coordinator yesterday at length about all of the upcoming appointments I need to get out of the way before August. She said when my period starts, I need to call the clinic and schedule the SHG. (CD 5-12). At that time I will also schedule the trial transfer (I need to make sure I've ovulated by then - I will be buying a 100 or so of the LH OPK strips online, along with HCG strips again!)

She said approximately six weeks prior to transfer, I'm to call Reprotech (where our little totsicle is living) and have them ship him/her over to the clinic. The nurse will order my meds and have those shipped to the house. We'll need to retake the needle injection class again.(although I feel fairly confident except for the IM injections but Mark will do those!)

All in all the coordinator was a lovely woman to talk to, excited for us and the upcoming transfer and had a real "I'm gonna take care of you" feel to her which if anyone knows me, customer service is definitely important.

Lastly, the amount of medications made me squirm. I'll list them all below. The only one that makes my skin crawl is the antibiotics, for many reasons, so I may forgo those. I've been reading up on why IVFers are prescribed these, and I feel at a low risk for uterine infection. I'll ask the doctor about it - perhaps they can prescribe me some Yeastie Meds and then I'll take them. Still, the amount of meds is a bit consuming:

• Birth Control Pills (for 20 effen days, wtf!)
• Lupron injections
• Vivelle Transdermal Dot
• Estrace
• Doxycycline
• Medrol
• Progesterone in Oil
• Tranxene
• Prometrium

I'll include a picture of the schedule below. This is only tentative because the whole thing depends on when I get my period in the August/September/October time frame. It could be as early as late August and as late as early October! This at least walks me (and you!) through the process of what we will be:

FET Consultation

Yesterday we had our FET consultation with a new fertility doctor in the same clinic. Dr. K. We liked her dearly, a bit more than our previous Dr. So that started everything off on the right foot.

I came prepared to defend nursing to the tee, but she never asked. So me and good ole' Clinton went with the Don't Ask, Don't Tell policy. Sweet!

Here's the gist!

Because our lone embryo was frozen via vitrification instead of a 'slow cool' process, we now have a 90% chance that the little guy/girl will thaw out and survive. If the embryo does survive, it has the same pregnancy odds as if we did a fresh cycle, so approximately a 70% chance.

Thems some good odds! (What is Vitrification? Vitrification is ultra-rapid IVF embryo freezing instead of the traditional slow freezing process. It leads to better thaw, pregnancy and live birth rates. Relatively new.)

We went in thinking our embryo would only have a 40% chance of thawing out but because of this new technology it increased the odds significantly. Awesome.

The process:

Dr. K walked us through how it would work:

1. After my period starts, I would begin birth control pills for approximately two weeks.
   
2. I would then suppress my ovulation by taking Lupron sub-q injections.
   
3. Then I begin estrogen patches and vaginal pills.
   
4. THEN I begin taking progesterone IM shots.
   
5. Then I come in for the embryo transfer.

Total Time = ~1 month

Before we do any of this, we have to do the following:

• SHG Procedure - you can read about that here from my first blog.
• Trial transfer - you can read about that here from my first blog.

The SHG is completed within Cycle Day (CD) 5 -12 of a menstrual cycle and the Trial transfer is done between ovulation and your next period (the luteal phase). So the next time I get my period, I will be scheduling the SHG and get that puppy over with! If timing is right, I'll get the trial transfer over with that same cycle.

Deciding on Timing
After the appointment, Mark and I went to eat at one of our favorite Mexican places and we exhausted ourselves talking about timing for the transfer. July? October? August? We settled on......September!! September means I can still go to the work trip next year in Hawaii and I'll only be 7 months pregnant instead of almost 9 (ack). It means if I get pregnant, I will be in the glorified second trimester when I travel for Christmas. It means a due date of June or so, not the hottest month of our weather patterns and after the height of the nasty allergy season for me.

So, September it is.

Managing a Toddler while doing IVF/FET

Woo - doggy, this might be a challenging one. We don't have consistent child care, so we will likely be bringing Jonah to most of the appointments. Isn't it weird that he could participate in the making of his brother or sister? Most of the appointment times are at 7am, for blood work and ultrasound so I suspect on those days we will be waking him up super early and dragging him with us. While it sounds scary and chaotic, I know it will only be temporary and everyone in the family must 'pitch in' to get us through this part. Welcome to IVF Jonah! The doctor did say on the actual transfer day that we would not be able to bring Jonah (duh!) so we'll find someone to watch him that day for several hours.

Costs

The FET is considerably lower in cost than a full IVF cycle so we're looking at $5,000. Mark's insurance will pay for this, but if we have to repeat it, we may be looking at covering some of the costs ourselves. But I'm not going to jump too far into the future, and take it one step at a time on that one!

Emotions

Overall, I feel excited about this cycle. Sure, it may or may not work. Anything could happen. But I feel less in the 'unknown', more confident about the process and our stakes, and because I already have a child there isn't the looming 'this won't ever happen' feeling anymore. Not having that feeling relieves much of the stress I tell you. Mark is excited, less anxious than before, and is ready to start the journey come time. We're both thrilled the FET isn't as intense and overwhelming as a full IVF cycle is. If the FET doesn't work, I will be able to start a full IVF cycle the very next period, so that will be great.

I've been asking both my mom and Mark about 'having enough love for a second baby'. Both chuckled and told me this isn't a concern, that once the new little one arrives, I will realize my love grows exponentially. This is comforting to know. While I have worries about Jonah's needs, or his jealousy with a new little one, I also know I am giving him the gift of a built-in friend, a playmate, a complement to our family. Sometimes you just have to dive in feet first and hope the water isn't too freezing.

That's what jumping into motherhood feels like this time around. Shocking at first I'm sure, but warm once you get in. (maybe?)

Next Steps:

• Call "Katie" at the clinic and schedule financial consultation, SHG and the Trial Transfer

Crazy!

We're Baaaaaack!

Yep, we're here again. Thinking about #2.

We have an appointment set up for April 15th to discuss with our RE's the possibility of transferring our one remaining embryo. I'll do my best (with a toddler this time) to document the journey, the ups, the downs and the process of hopefully bringing our second little one into the world. I admit, the thought is terrifying and exciting all at once.

When we went through IVF the first time around, we were left with two embryos in the blastocyst stage, day 5. We transferred Jonah, and had the other embryo 'frozen' for use at a later time. Well, the timing is coming up for us to transfer that totsicle.

What is in a FET (frozen embryo transfer)?

This procedure takes embryos that have been frozen for a period of time and replaces them in your uterus after they have been thawed. FET is a relatively non-invasive procedure, which is why many couples choose to have it performed. It can be successfully performed on women who are experiencing either natural or controlled menstrual cycles.

Since I do not have regular cycles, I will opt for a medicated cycle. This means less monitoring, but more medications.

What medications will I need to take this time around?

• Birth Control Pills - helps doctors begin to control the menstrual cycle
  
• Lupron - Typically, Lupron is used for pituitary suppression. For most women, this will require approximately two weeks of daily Lupron injections.
• Estrogen - During a normal menstrual cycle, estrogen is produced by the developing follicle. This estrogen acts on the uterus to thicken and mature the uterine lining. Estrogen is given in a FET cycle for the same reason.
• Progesterone - Once the uterine lining has been thickened sufficiently, progesterone is added. Once the progesterone is added, the Lupron may be stopped. Progesterone matures the uterine lining and makes it receptive to an embryo to implant. Once the progesterone is begun, there is a certain “window of implantation” during which the embryo must be transferred.

FETs are a hell of a lot less invasive than a full IVF cycle. Less meds, less craziness, same hope though. I hope to go into this cycle with a broader sense of maturity. I know more now, I'm a mother now, I know what the needles feel like, I know what the hormones do to my body, I just plain know more now. And I hope this knowledge will help me in this process. I say to myself that I want to be a bit more detached this time around. I don't want to analyze every technical aspect of it this time around. However, I also know I am a type A individual and I manage my anxiety by collecting data, frantically researching other's stories and any similar studies.

At least this time around I have Jonah to keep me busy. I worry about how the hormones will impact our nursing, how the morning sickness (if I get pregnant) will impact my ability to be a good mom, I worry, I worry, I worry. But these are all similar worries that most first time moms have when they think about a second one.

We shall see. I'll update more after the consultation. Wish us luck. :-) (I've already got my spreadsheet of questions, and comparison data from the 2008 cycle. You didn't think I'd go in empty handed did you?????)