Archive for May, 2011

May 31 2011

IVF Part Seven: Pregnancy Testing

Published by under IVF,The Man

Taking a pregnancy test when you’re undergoing IVF is not really like taking a pregnancy test at any other time. Every other time I’ve taken a pregnancy test, it was of the “pee on a stick” variety, known in infertility circles as the “HPT” (home pregnancy test). In this case, I was discouraged from home testing, and there’s a good reason for that. All pregnancy tests measure HCG, the hormone produced by embryos that have successfully implanted and have begun to develop. Home urine tests can only measure up to a certain threshold. If HCG is present, but below the threshold of the test, you’re going to receive a negative result. The blood test for HCG, however, can detect even the smallest amount of HCG in your blood. My doctor’s office told me that they consider anything 5 and over to be a “positive”. My understanding is that home tests cannot detect levels that low; most home tests only can detect at levels of 20 mIU/mL. So, home testing, even on the day of your blood draw, may provide you with a false negative and cause unnecessary heartache.

The day we went in for my test (May 31) was like a regular blood draw day: show up between 7:15 and 8:15 AM, get blood drawn, go home. Except, if you remember, we live two hours away from my reproductive endocrinologist, so for this simple blood draw, I got to get up at 4:30 AM. Needless to say, after four hours in the car, with just a quick break in which I was poked by a needle, I was not feeling particularly sunshiny. I was supposed to get a call “that afternoon” telling me the results, but I was already convinced that it was going to be a failed cycle. I had absolutely no feelings of “being pregnant” or “just knowing” or even “feeling different”. After the cramps had subsided in the first week, I felt extremely, disappointingly normal. It was hard for me to remain positive. I’m sure it was worse for The Man, because he not only had his own negative thoughts to battle, but I wasn’t even trying to maintain any kind of charade for his sake. I was OVERWHELMINGLY negative about the whole thing. I had gone from “not wanting to get my hopes up” to “not really having any hope”.

So, when one of the nurses called at around 10:30 AM with my results, I did not sound happy to hear from her. I was polite, though. It wasn’t her fault. Of course, when she said “Congratulations!” everything pretty much changed immediately. And by that, I mean I started crying immediately. I said, “REALLY? REALLY?!” as I was rushing across the yard to where The Man was working. He could see that I was crying, but I knew he would have no idea why I was crying (good news or bad), so I gave him a thumbs up.

The nurse told me (as I said previously) that they considered anything over 5 to be a positive, but I had tested at 30. I had to come back in two days for another test, as they were looking for that number to double, and then double again a few days later. We weren’t out of the woods; there was still the possibility that this could end without there being a baby or even a “real” pregnancy. I wouldn’t be totally convinced that everything was real until I saw the heartbeat on an ultrasound. But just knowing that we COULD get a positive pregnancy test after so long (and we had never gotten one before, NEVER) was reassuring and a cause for celebration.

(Just to check, I took a home test the day after we got our positive result from the doctor. I used a First Response Early Result test and STILL only got the faintest,very hard to see line indicating pregnancy. This just confirmed for me that people doing IVF should stay away from home pregnancy tests! Only trust your doctor’s results!)

Two days later, we were back in my doctor’s office for another blood test. That afternoon, they called and told me that my HCG levels had more than doubled, bringing me up to 68.something – didn’t catch the last number. This was good news. We were on track. Two days after that we were at 130+, and two days later we were over 600. After that, we didn’t need to come in every two days anymore. Instead, they scheduled us an ultrasound for that Monday (June 13) to make sure it was a normal pregnancy (as opposed to being ectopic). At that ultrasound, we saw that not only was the pregnancy a single pregnancy and normal, but we also saw the heartbeat. It was official: we were having a baby.

The IVF Series

Part One: Making the decision

Part Two: Flurry of tests and consents

Part Three: Drugs and money

Part Four: Stimulation

Part Five: Retrieval

Part Six: Transfer and waiting

Part Seven: Pregnancy Testing

5 responses so far

May 20 2011

No thank you for your support.

Published by under Infertility,Rants,Stupidity

When dealing with infertility, there are a number of places online where you can go to get information, share stories, and get support from other people in your situation. That is, if you don’t mind diving head first into the realm of inappropriate cutesy-ness and impenetrable acronyms. For some reason, the online infertility community has decided to basically surround themselves with animated emoticons and a whole lot of jargon that a newcomer has to pick up on if they want to make heads or tails of the conversations. When you are diagnosed as infertile and begin seeking treatment, your world becomes crowded with new terms and information just by virtue of your diagnosis; most of us are not casually familiar with the things that could go wrong when you’re trying to reproduce. You usually get a nice crash course when it turns out that you are not one of the ones who can just “get pregnant”. And while many doctors do take the time to explain things to their patients, oftentimes you will want to do some research on your own to educate yourself as much as possible. This is a serious problem, after all. It will affect your whole life, and may be the turning point veering you off from “parent” to “not so much parent”.

However, when you go out searching for answers and to talk to other people who are in your situation, you’re going to have to put on your sparkle panties and start speaking a specialized form of txt tlk. Because apparently infertility turns you into a 16 year old. (I feel extremely sorry for the men who venture into these communities for this reason.) It’s for this reason that I hardly ever go to these forums – I find the whole atmosphere to be ridiculous. But you might choose to go there because, let’s face it, they are some of the only places to talk to other people in your situation. Let’s get you geared up to make your debut!

Stupid Sig File

The first thing you’re going to need is an abnormally long signature, detailing every single step of your infertility journey. It may look something like this:

TTC since 11/07

HSG on 12/07 – tubes clear

6 IUI between 1/08 and 8/08 – BFN! (animated emoticon of someone beating their head on a wall)

IVF Cycle 1 10/08

Retrieved 8 eggs – 5 mature

Transfer 2 embryos 11/08

Preg test 11/08 – BFP!!!!! (animated emoticon of a dancing smiley AND/OR a small two-line gif indicating positive pregnancy test)

M/C 5 wks. (animated emoticon of a smiley with angel wings and a halo)

IVF Cycle 2 3/09

Preg test 4/09 – BFP!!!! (animated emoticon of a dancing smiley AND/OR a small two-line gif indicating positive pregnancy test)

DD born 2/10 (some kind of girly emoticon)

Remember, that whole things shows up underneath EVERY SINGLE POST you make on the message board. Even the one-liners that say “Keep trying! Baby dust and sticky thoughts!”

Baby Dust and Sticky Thoughts

You can’t say “good luck” or “I’m thinking of you” or “I’m praying for a positive outcome” on the infertility forums. You are just about required to say something like “baby dust!” or “sticky thoughts!” You say “baby dust” when you are wishing that someone will get pregnant in the near future. You say “sticky thoughts” when someone has just had an embryo transfer and you are hoping that the embryo will implant and result in a successful pregnancy. There’s nothing like trivialization!

Did you want some acronyms with your advice?

Finally, you’re never going to communicate on the forums unless you learn the language. And by “language” I mean “stupid acronyms created to make newbies feel stupid”. You may have noticed some of them earlier in your sample sig file. SOME of the acronyms are actually from the medical community (such as IUI and IVF) and those ones you are probably already familiar with if you’ve started treatment, but some of them are just there for…I don’t know why. Stupidity’s sake, I guess. I’m going to just provide some examples, because there are TONS and TONS of these.

TTC: Trying To Conceive

IVF: In-Vitro Fertilization

IUI: Intrauterine Insemination

BBT: Basal Body Temperature

M/C or MC: miscarriage

DD, DS, DH: Dear daughter, dear son, dear husband

BD: Baby Dance. It means sex. Isn’t that revolting?

AF: Aunt Flo. Menstruation.

BFP/BFN: Big fat positive/big fat negative. Refers to the results of your pregnancy test. Can’t just say “positive” or “negative”. Not cute enough!

HPT: Home pregnancy test

LO: Love Olympics. Also means sex. Do you get the feeling these women are a little loopy?

PG: Pregnant

Extra Credit: Emoticons

While the use of emoticons is not required, per se, it is heavily encouraged. How else is everyone going to know that you are frustrated that your latest progesterone test showed that your levels have inexplicably dropped unless you include an animated gif of a yellow head beating itself against a brick wall? How else is someone going to comprehend how traumatizing a miscarriage (or M/C or MC) was unless you put a little angel emoticon in there? If you can find an emoticon waving a magic wand and spreading sprinkles to use whenever you wish someone “baby dust!”, well…that’s just gold, right there. Solid gold.

In conclusion, many women frequent these forums and they must enjoy them or at least enjoy the sense of community that they find there. However, I cannot bring myself to become a regular because I can’t stop seeing the posters as those kind of women who wear pink kitten sweatshirts with fold-down collars. By which I mean that they are well-meaning, but out of touch, and have very little to nothing in common with me. I get the feeling that if I were to be sarcastic or swear on one of these forums, several thousand heads around the world might explode from the non-cuteness of it. I don’t have anything against these women, it’s just that they create an environment that makes me feel that I don’t have anything in common with them, either. There are already a huge number of women that I don’t have something in common with: I can’t get pregnant the “normal” way. Why do I need to feel out of place in the community of people who are supposed to be “like me”? I don’t.

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May 16 2011

IVF Part Six: Transfer and the Two Week Wait

Published by under Infertility,IVF,The Man

The first part of getting ready for transfer is to start progesterone in oil injections the day after retrieval is done. These are the injections that everyone who is going through IVF tends to fear. If you search them on the internet, you will find horror story upon horror story of painful shots that leave welts and terrible soreness. When you consider the fact that you have to do these shots for TEN WEEKS if you get pregnant, no wonder people look on them with dread. I wanted to minimize my suffering as much as possible, so I combed the internet for tips.

First of all, I had one of my nurses draw a circle in the target area where the shot has to be administered. On the night we did the first injection, we prepared the syringe and then recapped it and wrapped it in a hot washcloth to warm the oil. I also put a hot washcloth on the injection site to warm my muscles. The Man iced down the injection site slightly just before giving me the shot. He put the needle in quickly, slowly injected the contents, and then pulled the needle out slowly. Afterwards, I massaged the injection site and walked around for awhile to work the muscle and help disperse the oil. The next day I had very slight soreness at the injection site, but no lumps or welts. The only discomfort I experienced during the injection was the initial small poke and then a slight stinging as the oil was slowly injected.

The major problem with the progesterone in oil injection is that it is, in fact, oil. It doesn’t disperse quickly like the other injections you have to have, which are thin liquid like water. If you don’t work at helping it disperse through the muscle, it WILL just sit there and form an uncomfortable lump. Warming the oil thins it slightly as well, making this dispersal easier. I don’t doubt that some people will have discomfort no matter what – everyone responds to things differently – but make it as easy on yourself as you can.

My transfer took place three days after my retrieval, which is pretty standard. The doctors retrieved eight eggs, seven of which were mature, and five of which successfully fertilized into viable embryos. Of those five, two were transferred and three were put into cryogenic storage.

At 7:30 AM on the day of transfer (May 19, 2011), I started drinking my water and took two 5 mg Valium. We reported to the doctor’s office at 8:00 AM for an 8:30 procedure time. Just like for retrieval, I had to put on a gown and footies and go into the prep/recovery room. Kris came in and asked if I was feeling “loopy” from the Valium. I told her no, because I felt normal. So, she had me take the other two 5 mg Valiums that I brought along. We had to do some paperwork, signing a basic consent and then another consent saying that Dr. Singh was going to transfer two embryos and freeze three. Then he handed us a picture of the two embryos that were going to get transferred. That was pretty surreal: looking at two little globs of cells that might one day be our children.

After a little while, I was walked back to the procedure room. The Man came along with me and sat in a chair next to my bed the whole time, which was nice. There was a little hitch with the ultrasound machine, which didn’t want to cooperate, but after a hard reboot, it got into the game.  The procedure itself was like having an IUI or a PAP smear. There wasn’t any pain, and there was just a little wait after the catheter was in while they retrieved the embryos. Once the embryos were transferred, there was another little wait while they verified that they hadn’t gotten stuck in the catheter and had actually transferred. Then they wheeled me into recovery, where I got to lay with my head slanted down for about 45 minutes.

After the 45 minutes had passed, I was allowed to go to the bathroom, get dressed, and leave. I was on bed rest for the rest of the day. Once we got back to the hotel, the Valium finally kicked in and I slept for several hours. Once I woke up, I quickly reached the conclusion that bed rest is pretty boring. I could get up to go to the bathroom, but otherwise I was stuck in the bed, watching TV, working online, or reading books. Not really a problem if I’m at home with all my recorded shows, movies, and library, but in a hotel? Ugh.

The next day I was able to get up and move around some, although I was still supposed to be “taking it easy”. It was a big relief to sit in a chair and be able to stretch my legs for a bit when I wanted. I didn’t really have any symptoms or pain, aside from a couple episodes of mild menstrual-like cramps. I figured that was from the procedure the day before. Mostly, I spent the day instructing myself to settle in for “the long wait”. My pregnancy test was scheduled for May 31.

For the first week of the wait, I experienced intermittent cramping nearly every day. These were just like strong (for me) menstrual cramps. Of course, this really freaked me out until I looked online and discovered that this is actually a very common symptom, and as long as it’s not accompanied by spotting is really nothing to worry about. The nurses had told me that the difference between me being miserable and me feeling OK during this time period was to keep drinking protein shakes and a lot of water. I had really slacked on this for a couple of days, which might have contributed to the cramping.

Is there any way that anyone has found to make this wait pass with a minimum of anxiety? I alternated between my pessimistic thoughts that the procedure hadn’t worked, to feeling guilty for not having enough faith in God to lead me to the proper outcome (whatever that might be), to trying to force myself into a positive mindset by making baby items. I read and re-read WSU’s success rate report (78% for fresh transfers for women under 35) and tried to tell myself that we had done everything we could to ensure success.

One other thing we did during this time was refine our progesterone in oil injection procedure. We bought a heating pad, which really made a huge difference. I would heat the injection site for about 10 minutes beforehand. The filled syringe would also be heating under the pad next to me at the same time. After injection, I heated the site again for 10 more minutes. This really helped reduce the soreness and bruising.

I would have to say that for me, the biggest problem with the “two week wait” is that we went from a lot of activity down to almost none. During the stimulation/retrieval/transfer part of things, you’re doing quite a lot. I had doctor’s appointments every day where I got an ultrasound and blood work. I got a call every day telling me if my meds were going to be adjusted. Every night, I had to inject myself multiple times and sometimes take a pill on top of that. But once transfer is complete, you’re shoved right onto bed rest and then you’re left with only one lonely injection to administer every night. During the busy time, there was a definite feeling of energy, accomplishment, and purpose: “OK! Things are getting done! I am doing things to help this situation progress!” There were also daily updates reassuring me that everything was going well, that things were going just as planned. During the wait period, there is none of that. There is really nothing you can do to help things along, and there is no reassurance that things are going the way that they should. You have absolutely no indication as to whether or not all of that work paid off until two weeks after retrieval, when you take your blood pregnancy test.

The IVF Series

Part One: Making the decision

Part Two: Flurry of tests and consents

Part Three: Drugs and money

Part Four: Stimulation

Part Five: Retrieval

Part Six: Transfer and waiting

Part Seven: Pregnancy Testing

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May 15 2011

IVF Part Five: Retrieval

Published by under Infertility,IVF,The Man

The day after I took my HCG (or “trigger” shot) I had to go in for blood work. The lab work form that I got said I was in for a “Pregnancy Test – HCG”, so I guess that HCG makes you appear pregnant when properly administered. I was then told that I had to be back in at 6:30 the next morning to get ready for my retrieval at 7:30 AM. I could eat or drink nothing from midnight on.

So, bright and early at 6:30 AM, The Man and I presented ourselves at the office. Only, the office was locked. So, we stood in the hall for about five minutes until Kris came out of another door and said, “Hello, my dears! I’m going to take you in the back way!” This door led right into the prep/recovery room. I was taken into a locker room and told to get totally undressed, put my clothes in a locker, and then put on a hospital gown and footies. I did that, and went back into prep/recovery, where I was laid down on a bed while The Man sat in a chair next to me. Kris took my vitals and then went over a bunch of consent forms with me. Then, The Man and I just sat around and chatted until the nurse anesthesiologist got there.

The nurse anesthesiologist (I don’t remember her name) came in to ask if I had any medical conditions or allergies that I knew of, and to explain that I would be sedated (but not under full anesthesia, so I wouldn’t have to be intubated.) After that, Dr. Singh and Dr. Bannerjee (his Fellow, a GYN in training to be a RE – WSU is a teaching institution, obviously) poked their heads in to ask how I was feeling and let me know they were going to go change and start to get ready. After that, Kris came and tried to put my IV in, and she tried to put it in the crook of my elbow, where blood is drawn from. I’ve never had an IV before, so I was expecting a little extra pain, but this was like…um OW, OW, OW. She asked how it felt and I said, “Well, it kind of feels like someone is pinching me very hard right there, and not letting go”. Apparently, this is not how it is supposed to feel, because Kris called in the nurse anesthesiologist who said, “Oh yeah, that’s not in right”. She pulled it out and put the IV in my hand, which was a lot better. The initial pinch was a little worse than blood draw, but after that, there was no real pain.

Kris had to go prep another girl who was also in for retrieval, so another nurse took me to the bathroom and told me to empty my bladder. After I did that, I got to go say good-bye to The Man, and get walked into the procedure room. I’ve never had any kind of “surgery” before, so this was a new experience for me, and I really didn’t enjoy it, just because I’ve never felt more like a lab specimen. Kris, Dr. Singh, and Dr. Bannerjee were in the room, along with the nurse anesthesiologist. Some other guy came in just to verify that I was wearing the right name bracelet.

I got laid down on the bed. My arms were placed out to the sides, kind of like I was being crucified. Kris started putting monitors on me. Dr. Singh and Dr. Bannerjee positioned my legs in some low stirrups and then sort of wrapped them in towels (I THINK…I was flat on my back at this point, staring up into one of those big round surgical lights). Kris put an oxygen tube on me, and the nurse anesthesiologist said “I’m going to give you something to make you feel sleepy.” This went into my IV. I remember looking up at the light and thinking “Wow, that light is getting fuzzy”. And that was it. That was the last thing I remember until they were wheeling me into recovery and someone was asking me “How do you feel?” I think I told her I felt “OK”. They had apparently been talking to me before that, but I don’t remember.

They brought The Man in, and I managed to open my eyes for him. I felt kind of groggy, like I just woke up from a deep sleep, but I didn’t feel nauseous or sick. Dr. Singh came by to tell us that they had retrieved eight oocytes, which is what they expected, based on the number of follicles they had seen during all of my ultrasounds. I think I asked if that “was good”, but I didn’t get an answer.

I laid around, waking up, and talking to The Man for awhile. The other nurse – I believe her name was Laura – came in to take my vitals and ask how I was feeling. I told her I had some mild cramping, nothing terrible. She asked me where I fell on a pain scale of 1 – 10 , and I told her about a 2 or 3. Then she asked me if I remembered how many oocytes I was told they retrieved, and I said eight. She said, “OK, good. That’s one of the ways we judge how well you’re coming out of anesthesia.”

A little while later, she gave me a graham cracker and a cup of apple juice. A little while after that, I got more apple juice and two Tylenol. Then Laura took me to go to the bathroom, telling me that I had to empty my bladder before she could take my IV out. So, I did that, she took out my IV, I got dressed (The Man went and got the car while I was getting dressed), and Laura put me in a wheelchair and wheeled me out to the car. It was around 9:30 AM when we left the doctor’s office. I had stayed in recovery for about an hour. The procedure took about 30 minutes, from what I was told, and we were about an hour signing paperwork and prepping for the procedure.

The Man and I drove back to the hotel and I managed to stay awake for maybe an hour before going back to bed for a nap. My alarm went off at 12:00 PM because I had to take my doxycycline and my methyprednosolone. I woke up still feeling tired, but not too bad. My cramping was still mild. They had told me that if I wanted to feel OK instead of terrible, I needed to keep drinking a lot of fluids and drinking my protein shakes.

All I had to do now was to wait for the call to tell me how many of my eggs were successfully fertilized. They told me before the procedure that they always expect that around 70% of the eggs retrieved would be suitable for fertilization, but not every one would be successfully fertilized.

(My retrieval took place on May 16, 2011)

The IVF Series

Part One: Making the decision

Part Two: Flurry of tests and consents

Part Three: Drugs and money

Part Four: Stimulation

Part Five: Retrieval

Part Six: Transfer and waiting

Part Seven: Pregnancy Testing

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May 13 2011

Take responsibility for your own life.

Published by under Life and Living It,Rants

This is from an article I just read:

“Events reveal people’s characters; they don’t determine them. Not everyone with divorced parents has terrible relationships. If two people are hit by a bus and crippled for life, one will become a bitter shut-in; the other, the kind of warm, outgoing person (cheerful despite everything) whom everyone loves to be with. It’s not about the bus, and a dreadful childhood is no excuse. You have the chance to be the person you wish to be, until you die.” (10 Truths I Wish I’d Known Sooner by Amy Bloom)

Stop blaming experiences that happened to you for the way you are. Things happen to everyone; no one has complete control over the circumstances of their life. The only thing you can control is how you react to those events and what kind of person YOU CHOOSE to become as a result*.

I think there is a growing problem in our society of people not wanting to take responsibility for their own lives, and instead look for someone or something to blame for the problems they encounter. Frivolous law suits are one symptom of this. People seem to think they are entitled to some reward when bad things happen to them. That’s life! Bad things happen! But as an adult, you should be expecting some bad things to happen to you. It’s your job to figure out how to get through the bad things and get your life back on track, and most importantly, LEARN from every experience that comes your way, so that you are that much more equipped to deal with the next thing that comes along.

*Obviously, there are some exceptions, experiences so traumatizing that psychological damage is done and the person must undergo “retraining”, in a sense, in order to learn how to deal with their new situation. However, even in this, there is a choice. There are people who choose not to get help and instead choose to remain a broken person.

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