It's that Time Again!

Yes, it's been 7 long months, but it's that time again!

I would have written sooner about the impending date, but I wasn't feeling inspired. But once I got back into the routine with the medications, it all started coming to me.

Let's go back a bit first...a lot has happened in those 7 months, kind of. Well, we had to pause because my IPs had run out of embryos, and they needed to make more. The mom went through the difficult egg retrieval process, and in May, they had embryos and we thought we'd be scheduling another transfer for June. Sadly, that did not come to pass. When they tested the embryos, it turned out they weren't viable. So they were back to square one. I can't imagine how gut wrenching that is. They were faced with trying again with the mom's eggs or getting an egg donor. The decision was made, out of concern for the mom's health because it is in fact a difficult process, to go with an egg donor. She told me today that she's angry with her ovaries. That really made me think. I mean, when I found out, I thought that was sad and frustrating, but I didn't really put myself in her shoes. When she told me that, it made me put myself in her shoes. It's got to be really hard going through this IVF process anyway, and then to add to it that your ovaries aren't cooperating and you must use an egg donor just makes it even more difficult and emotionally taxing. I wish that was something I could fix for her too.

So, in June they started on the task of securing an egg donor. I had to fill out some information with an egg donor bank, and then just kept waiting. In July, we had to renew our contract since a year had passed, though that was quick and easy. Finally, in August, I got the message that we were ready to move forward. I coordinated the timing of the medications with my IVF nurse (they needed to be timed with my cycle), and by the second week or so I had started my medications again.

Now, something else happened in those 7 months. I lost 18 pounds! Woohoo! I thought, great, I can start a pregnancy in the best shape I've been in since my early 20s, and I can maintain a fit and healthy pregnancy. But I think that weight loss may have affected this in other ways I wasn't expecting. I started with the Lupron injection in my abdomen on August 13th. In the past, these injections have never bothered me. This time was different. Three quarters of the time they didn't bother me, but there was that last quarter that they really hurt a lot! I don't really understand what the difference was. It was even the right side and not the left side (because you alternate which side you inject on each night). I don't know if less belly fat could have something to do with it or not, but I was definitely feeling the difference!

One more thing that happened in the past 7 months...I moved! So I had to decide whether to keep going to my previous local monitoring center or see about changing to one closer to me. The old one would have been about 20-30 minutes away, but I was able to find a closer one only 5 minutes away. So I thought the decision was easy! Little did I know that this one wouldn't be as accommodating with the appointments. My old one could see me anytime in the morning, and I usually went around 11am. But this new one required me to see the doctor and not just an ultrasound technician, so I had to work around the doctor's schedule, which meant that my monitoring appointments had to be at 7am. In fact, the first one I had to be there at 6:45am. Not being a morning person and also having to drag my 4 year old with me at that hour, I was seriously considering switching back. But I decided to just make it work. I had my first monitoring appointment on August 20th and then started my estrace pills after that.

The purpose of the medications is to basically shut off my reproductive system. They don't want my body releasing eggs when it's supposed to be receiving someone else's embryo. So they use the medications to turn off my system and control the conditions in my uterine environment, and then other medications, like the progesterone, are added to support a pregnancy if the transfer is successful until the pregnancy is far enough along that the placenta is producing enough progesterone to support the pregnancy on its own. And then it's a normal pregnancy. The monitoring appointments before the transfer are meant to take frequent observations of my uterine environment and make sure my body is cooperating and is ready for transfer. They take blood to check the levels of estrogen and other hormones in my body, and they do an ultrasound to check the lining of my uterus and make sure my ovaries are not getting ready to release an egg. I have 2 monitoring appointments before the transfer. Then, 5 days before the transfer I switch up the medications a bit. I always stay on the estrace, but we add an antibiotic and Medrol, and I switch from the Lupron injections to progesterone injections. I think the purpose of the antibiotic is to rid my body of any infections at transfer time. I don't remember what the purpose of the Medrol is, but I can tell you one thing, it tastes HORRIBLE! I don't remember having a problem with it in the past, but this time, I'm really struggling with it. The first night I had to take it, the pill didn't go down right away, which happens sometimes. But it left this ridiculously bitter aftertaste in my mouth that didn't go away for hours! I was eating and drinking whatever I could to get rid of it but it wouldn't go. It was even still there the next morning! It was horrible. So the next day, I got the bright idea to drop it into a drink and immediately drink it. BUT, the pill got stuck at the bottom of the glass. So I ended up drinking a lot of Medrol flavored liquid and eventually the semi-dissolved pill. The result wasn't quite as bad as the previous night, but it was still bad, nonetheless. So 3rd time was the charm. The way I figured out to swallow this pill without getting any of that bitter taste stuck in my mouth, is to pour a liquid into a spoon, drop the pill on and immediately swallow it. It doesn't get stuck, and it doesn't have to sit in my mouth for any period of time, and it doesn't have time to start dissolving in the liquid. Thank goodness that was solved!

Next quandary...the progesterone injections. There are two types of progesterone, that I know of. One is in ethyl oleate, and the other is in sesame oil. For my very first transfer, I started with the ethyl oleate. The injections themselves weren't bad, but the progesterone going into the muscle made the muscle very sore. But with the ethyl oleate, it was so sore that literally just a minor touch was extremely painful. So you can imagine, with a 3 year old bouncing off me, there were some painful cries. Without me even asking, they ended up switching me to the one in sesame oil. Now this one is thicker and harder to inject. It actually gives me thumb cramps injecting it, BUT, the soreness wasn't even close to as bad. There was still some, but barely anything compared to the ethyl oleate. 

I have never been switched back to the ethyl oleate. So, starting the progesterone again, knowing it was the sesame oil, I didn't expect to have any problems. Now, mind you, to me, the progesterone injections are the worst part anyway. They're the most difficult, cause soreness and you have to do them for a while; until the pregnancy is 8 or 9 weeks. I actually think I will prefer the labor and delivery to the progesterone simply because the injections last so long with the side effects they have. So I already wasn't exactly looking forward to them, but I didn't expect to have any problems since the sesame oil was a relief last time when I switched. Nope. Not the case this time. Again, I don't know if it has to do with losing the weight, but I definitely felt them this time, and still do. The injections themselves hurt a small amount, though not enough for me to complain about. But the soreness was immediate and significant. I thought perhaps as well there was enough progesterone built up in my system last time that that's why I didn't notice a difference for the second try. But this time there was plenty of time for it to clear so it's completely starting fresh again. My muscles had gone completely back to normal, so the reintroduction of the progesterone made the soreness worse this time than previously. Sometimes just getting up causes me to pause. It's regular and constant. It hasn't stopped me from working out and going about my days as normal. But I do feel it constantly. 

All of those things are worth it though. Because hopefully, today, we have created a pregnancy.

As usual, I had to be at the clinic at 6am for bloodwork and ultrasound. Normally I arrange transportation from my hotel to the clinic. But this time, when I mapped it, it literally said the hotel was 19 seconds from the clinic. They were practically next door to each other! Only separated by a couple office buildings and some wooded areas. I knew that walking it wouldn't be 19 seconds, but I couldn't rationalize hiring a driver for 19 seconds. Fortunately, when I arrived yesterday, I had some time to kill, so I walked it then to make sure I knew where I was going in the morning. For those of you in a place like South Florida, this may sound odd to you. It's just down the street! Isn't it obvious?! Well, this isn't South Florida. This is Basking Ridge, New Jersey, in the wooded hills. It's not obvious. It was easy to figure it out yesterday evening, and on the way back, I even saw a mama and baby deer eating and drinking in a small creek that the road passed over! However, this morning, when I realized that the road had no street lights and it was pitch black, I was questioning that decision to walk! I'm very glad that I walked it the night before. Only a small portion of it I had to stay on the dark road. Once I reached the office buildings I could walk through their lit parking lots, and didn't have a problem anymore. But there was a brief period of time I was concerned about encountering a wild animal or a serial killer in the pitch black. I'm not ashamed to say I did some praying! But I did think to myself, it's highly unlikely a serial killer was hanging out there waiting for someone to come walking along, because who else would be walking along there at that hour! 

I obviously made it safely. I had my monitoring done, and then immediately went downstairs for transfer. This is different because in the past it has been a frozen embryo transfer, so it's been in the afternoon. But today was a live embryo due to the egg donation, so it was first thing in the morning. And boy did they move that along fast too! I expected to have to wait a little bit, at least while I drank my water. Nope. I was halfway through my apple when they took me back. I still hadn't finished it when the technician came to give me the laser acupuncture (this increases the chances of a successful implantation). Then I was given my 2 cups of water to drink, which I downed in about 10-15 minutes. They require the water because when the bladder fills up, it pushes the uterus into a better position for the transfer. It's easier for the doctor to insert the catheter directly into the uterus this way. Otherwise there is a bend that is harder to get around. Again, I don't know if it's because I lost weight, but holding my bladder was much harder this time! I didn't have this much trouble in the past! After the transfer I had to lay there for 15 minutes before I could get up. I was literally counting down the minutes painfully waiting until I could carefully rush to the bathroom! 

The transfer seemed to go very well though. I don't know why it seemed different this time. I can't explain it. Maybe it was the doctor's disposition. He was a little bit slower and seemed like he took extra precautions to make sure it went the best it possibly could. But I felt really good about it. He said the embryo was beautiful, and they also froze another one for later if necessary. The transfer itself is not painful at all. It feels like a Pap Smear but instead of taking a sample of my vaginal wall, they're sticking a catheter up there and dropping off a microscopic particle in there. It's quick and easy too. You spend the majority of the time waiting before and after the procedure than you do doing the procedure. Afterwards, the technician immediately came in for the post-procedure laser acupuncture, I waited until we were given the clear to leave, and then we were done!

I did learn some new things from the nurse at the end. She said that it's actually worse to stay on bedrest for the day or two after. It's better to move around a little bit. Not a lot. They don't want you doing any aerobic activities. But they don't want you laying around the whole time either. She also said that a study done by another organization has now proven that laughter helps increase the chances of success. So I've spent a good portion of the day today watching old Friends episodes! I did have some mild cramping earlier this evening. I remember from the first try I had some cramping in the hotel, and I thought then that it was the implantation. I did turn out to be pregnant that time, even though it was implantation failure and resulted in a miscarriage. Perhaps the cramping I felt this time around was implantation as well. One can only hope!

So now the waiting game begins until Pregnancy Test Day! The test will be next Thursday, the 19th. So it's not too long, but will probaby be nervewracking nonetheless. During that time my orders are strict: Avoid dehydration or overheating, No aerobic activitiy of any kind, No sexual activity, No smoking, No alcohol, No caffeine, and only medications specifically cleared by my IVF nurse. I will continue the estrace and progesterone injections though. Hopefully, I will be continuing them long after that as well! Wish us luck! 

*Note: Considering this post turned out a lot longer than I anticipated, thank you for caring and reading! I guess after such a long wait, I had more to say than I realized! Much love to everyone, and positive vibes all around!

Jessica