Month: April 2016

Some relief, and infertility awareness week

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So I’ve been on the Celexa a few days now.. I’m starting to feel better. I wonder if maybe I need a higher dosage.. 40mg as opposed to 20mg.. but I’m going to hold off for now and let it settle in first before I make any decisions. Yesterday I stayed home from work- my Metformin was giving me terrible stomach pains and trips to the bathroom, and I had been needing a mental health day for a while. I work with patients during the day and when you’re not feeling good yourself it’s very hard to take care of others. I think it was much needed and helped, this morning I even got up early and made Adam and myself egg sandwiches for breakfast. Yum!

The other day I made a post about infertility awareness on my Facebook page. While some people knew about our struggles, most did not. The outreach I received after making the post has been so touching. I received a few messages from former classmates in college telling me their struggles and eventual triumphs, and one of my former teachers I made friends with when I was in high school reached out and told me she had no idea, wanted to hear my story, and we are meeting up for lunch this weekend. I haven’t seen her since my wedding in 2013! I’m really glad I posted something, because not only am I being supported by so many people, I’m realizing just how many people I know are also affected by infertility… even with the knowledge that 1 in 8 couples are infertile! I was even able to support someone else who is at the “beginning” of their infertility journey.

I’m still on my BCP, my end date is on Sunday. Looking forward to getting closer and closer to my transfer, but of course I’m nervous.

And the winner is… Celexa!

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So I started Celexa this morning. According to my PCP and research, it’s one of the safer anti-depressants to be on during pregnancy. I did see some mention of coming off of it during the third trimester, or switching to Zoloft, but I’ve also read accounts of women remaining on it during their entire pregnancy and into breastfeeding. I’m going to focus on getting pregnant and staying mentally healthy until I worry about a 3rd trimester and breastfeeding 😉

I’m glad to have started the Celexa, and I hope it kicks in soon. My depression has been pretty strong since the failed ET.

In other news, I still have some minor itching on my hips where I was getting the PIO shots, and they are still bruised. I stopped the shots April 14th! Hopefully the new progesterone shots will not have the same reaction, as the itching has been driving me bonkers.

I guess that’s it for now. The waiting continues.

Weaning off Paxil, what med next?

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I’ve been weaning myself off of Paxil. I take 20mg per day for depression. Both my PCP and my RE told me that staying on would be safer for me- which I agree. I’ve had anxiety and depression for a long time, and though I go to therapy I’m always going to have those things. It’s just a fact, which I’ve accepted.

I’ve been depressed since the failed ET, but since I’ve cut my prescription down to 10mg, I don’t think that’s been helping. I put a call in to my PCP to find a medication that’s safe for pregnancy- both being pregnant and nursing- so we’ll see what’s next. It’s frustrating for me the differing opinions on these medications. I’ve heard Paxil is a class D drug and NOT safe for pregnancy, but then I’ve heard it’s okay to take. The pharmacist I spoke to when ordering my next batch of progesterone told me that Paxil was indeed, not safe, and to find alternative medications.

While it may be okay- if there are alternative options out there that are safe to take during pregnancy- I’m going to do it. I hope whatever I take next agrees with me- trying to figure out your medication is hard enough, never mind while going through IVF.

I’m tired and wish I could take a mental health vacation- alas, that’s now how things work. Another week of birth control!

BC Stop date and insurance annoyance

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Well, today my insurance approved my FET, and they are counting it as cycle 3. I was approved for 4 cycles of IVF through my insurance in a lifetime, so needless to say I am nervous.

When I met with Dr. Plante, we discussed how my insurance may or may not count things. Some insurance companies count FETs as part of the cycle the embryos were frozen in. Unfortunately for me, mine does not. If this FET, my cycle 3, does not work then for my fourth and final covered cycle, Dr. Plante suggestd doing the whole shebang over again- even though I have 5 frosties in storage. She said it would be more cost effective for us to do another full cycle covered under insurance so we can have even more frosties in storage, as FETs are less expensive than the whole thing. WHEW.

They’re also only covering half of the Estrace dosage I need daily, and not covering the new PIO injectables I’m taking. Luckily I can cover those but I’m a little frustrated. I had an allergic reaction to the sesame oil in the first PIO shots, so this time I’m getting the progesterone compounded in a different way.

Although I’m grateful I get 4 cycles covered, I’m nervous we will start having to pay out of pocket and this process will slowwwww down even more. Each FET is a few thousand dollars. So that’s weighing on me at the moment.

My stop date for my BCP is May 1st, which is next Sunday. Once I stop taking my BCP I will get another period, and with the first day of my period I am to call my care team.

So we’re trucking on! Fingers and toes crossed this “cycle” works!

The good and the bad about support groups

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I love love love having different communities of women to go to about this crazy IVF journey. It’s really nice to be able to talk to others that are in the middle of the same process that you are. I have an amazing support system of family and friends as well but sometimes you just need to talk about the IVF process in depth- which can be hard to discuss with someone who isn’t going through it.

Up until now I’ve been pretty damn positive throughout this process. I’d see others’ success stories and feel excited and happy for them, and don’t get me wrong, I still am, but there is a new element that I did not expect to happen. I’m so so sad sometimes. Ladies who transferred around the same time I did are posting their beta numbers, and they are pregnant. I’m happy for them, but I’m sad too. It’s taking me a little longer than I expected to get over this failed transfer.

Support, a place to ask questions and read others experiences, and a place to share your triumphs. SO good. The bad? If your transfer failed, seeing some beta numbers can make you really fuckin’ sad.

I wish I could take a mental health day. Soldiering on..

Cycle two- close but definitely no cigar.

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I started cycle two full of anxiety. The vigor and excitement and buzz that surrounded my first IVF cycle wasn’t there. I kept hearing from everyone to just stay positive, and of course I was trying, but still I was wary.

I started my medications and I was off. Same old routine that I had gone through the last time, monitoring appointments every other day, with blood work.  I ended up stimming for a shorter amount of time at 7 days as opposed to the first round of 12. I was very paranoid about overstimulation, and I was not looking forward to my egg retrieval.

The trigger shot
Growing follicles

March 30th I went in for my second retrieval, this time I was a lot more calm and was excited to get it over with. When I was going over the paper work the nurse mentioned that my fresh embryo transfer would be scheduled for that coming Monday. I remember clamping my hand over my mouth and tearing up, willing myself not to cry. Transfer? Already? We weren’t doing another freeze all? I didn’t overstimulate?! I was excited about that. The doctor was able to retrieve 26 eggs this time around, which was unbelievable considering the first time we only were able to retrieve 12 eggs. My husband jokingly referred to me as the easter bunny. Ha!

April 5th was the day that our two perfect little embryos were transferred back into my uterus. It was an emotional day. Adam was there holding my hand as they went back in, and I was wiping tears from my eyes as we waScreen Shot 2016-04-04 at 3.16.00 PM.pngtched on the screen. I remember the embryologist telling me they were “beautiful” when she brought them in. The doctor told me to go get pregnant and within ten minutes we were out the door. We were both so excited and gushing. Adam wanted to post our embryos on Facebook, the first time it was feeling really real for him. I told him to hold off, in case they didn’t take. We did share the photo with some friends, but having to explain to all our social media friends seemed daunting.

Our beta, first pregnancy test, was scheduled for Thursday, April 14th and those days of waiting were absolutely torturous. Waiting, wondering, hoping, wishing- it was a lot. I held off on any HPT (home pregnancy tests) until day 4. I took a HPT test 4dp5dt and I saw almost nothing. Almost.Screen Shot 2016-04-19 at 3.16.00 PM I decided to test again the next day, in the morning, and I saw a faint faint line. I was excited but cautious. I had felt rumblings going on down in my womb, cramping and twinges and pulling. I had terrible heartburn every single day, no matter what I ate. It woke me up in the middle of the night. I was getting more and more excited. Surely, I must be pregnant! I thought to myself. A day after my retrieval I started doing acupuncture. The day after my transfer I lay in the acupuncturists room, needles stuck in between my eyebrows, legs, arms, and feet- my hands on my stomach, I felt an energy, a buzz. I could feel them! Then, during week two, the buzz, the energy, it was gone. I felt empty. My HPTs were stark white. My heartburn was gone. At 6dp5dt we had had intercourse and I had bled right afterwards. Adam called our care team, me in a panic, did we do anything wrong? They reassured us we hadn’t, but to refrain from further intercourse to keep from freaking ourselves out. The next 4 days every time I had a bowel movement I bled bright red blood. I called for three days, freaked out. Nothing I could do but wait until my beta. It could be my period coming, but that was too early, or it could be my cervix being sensitive. No way to know until it was time.

The drive to the clinic on the morning of my beta was full of anxiety. I knew it was going to be negative, but did I? I told the phlebotomist that I didn’t think it worked, that I wasn’t pregnant. She gave me a sympathetic look, wished me luck and I went on my way.

I received a phone call from one of the nurses from my care team around lunch time while I was at work and I could tell from her voice and when she asked me if I had a minute to talk to her somewhere private that I knew my fears had been realized. I wasn’t pregnant. Our conversation was a daze and I scheduled my follow up with Dr. Plante for the following Monday (which- in real time, was yesterday.) I hung up and cried into my lunch. My co workers avoided asking me about it, they knew what was going on. I cried to my boss, told her about my follow up, then took an extra long lunch. I called Adam, and my mom. I was so upset.

One of my good friends had a baby show a few days after I got my results and I couldn’t go. I didn’t want to be the crazy lady crying at onesies at her shower. I felt awful but knew it was the right decision. I was just so emotional and raw still.

Yesterday, which was Monday, I had my follow up with Dr. Plante. She said I did everything correctly, and that the cycle was textbook perfect. The embryos were textbook perfect. It is literally a flip of the coin every single time. Luckily for us, I have 5 embryos frozen and waiting for me. We submitted the paperwork to my insurance for my FET (frozen embryo transfer) and I’m currently on birth control pills, as well as my period. Once they get the okay from my insurance, I’ll be given a stop date for the BCP and I’ll have my next steps.

This is a rough journey, an emotional one, and it’s very hard. Now you’re caught up to present day, and I’m onto cycle 3. Hopefully third time is a charm!

 

Testing Cycle Results, Cycle one!

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Our test results concluded that my tubes were blocked, I wasn’t ovulating, and Adam had a low sperm count. IUI was out as an option for us, and we had our double whammy infertility results- IVF it was. The next step was for Adam to go to the urologist to make sure everything was alright.

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Our Christmas tree ornament for 2015

I received a text message from him after his appointment that simply said.. “I have X-men sperm!”

…what?

Apparently Adam has 97% mutant sperm. They have two heads, or two tails, or no tails. So with that information, the okay that he was alright, and a plan in place, I had my baseline bloodwork and we were ready to rock in February of 2016.

When my meds showed up to my work I was overwhelmed to say the least. Look at all these needles! Look at all this medication! I watched youtube videos of other women doing their sub-contaneous injections, I watched the Freedom Fertility instructional videos, and tried to mentally prepare myself for the road ahead. Then, finally, my orders came in.

I’ve been recording every single injection I’ve ever taken since we began our IVF journey. I’m a hoarder of nostalgia, and plan on turning this footage into some sort of compilation some day, but right now it’s tucked away just being stored.

I was so nervous, I was shaking. Adam recorded me as I stared down at my belly, wiped clean with an alcohol prep pad, pinched skin between my fingers. I attempted once, as soon as the needle got close to my skin I stopped. This was so much scarier when you’re doing it to yourself! I was very determined, though, and after a few false starts I was in. It wasn’t as bad as I thought! I can do this, right?

As you know, we are two cycles deep and preparing for our next transfer. Here’s the run down of how that first cycle went.

I stimmed for 12 days. I had my egg retrieval on February 20th, and we had 12 eggs retrieved. Out of those 12 eggs, 6 were mature. Out of those 6 mature eggs, only two fertilized into embryos via ICSI (they put the sperm directly into the egg) and on the fifth day, I received the call. Our embryos stopped growing. The cycle failed. I had been planning on doing a freeze all cycle since I had overstimulated. After my first egg retrieval I had to take three days off of work, in addition to the two days I laid around on the weekend. I couldn’t poop for a week, no stool softeners gave me relief, and after and enema and two suppositories I had little relief over a few days. I tried drinking prune juice and projectile vomited it back up. I looked 5 months pregnant. Needless to say, I did not have a good time.

Receiving that phone call at work was awful. I went into the bathroom and cried after I got off the phone with Dr. Plante, who was very comforting. I called Adam and cried to him, too. Dr. Plante asked me if I wanted to take a break and I said no, as long as medically safe, I’d like to continue on. So I booked a follow up with her, and the next week I dropped in to talk about what went wrong with our first cycle.

My estradiol levels (a form of estrogen) had dipped low 2 or 3 days in to my cycle. Dr. Plante had to adjust my injections accordingly, and though they did rise, they hurt my egg quality. With your estradiol levels you want an even, clean rise and they did not have that. For my next cycle, she was to start me at a slightly higher dose of Gonal F, and I was also put on Metformin to help control my hormone levels.

Metformin is a diabetic drug, but it is also prescribed to women who have PCOS. It’s hard to get used to, it gives you terrible stomach aches and diarrhea. It’s not fun, but I was willing to suffer through if it meant better egg quality cycle two. So! I had my period, I started another round of birth control, and prepped myself for cycle two…

Morality and our Consultation

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What people may not realize is, infertility is SO common. A lot of people battle it silently. They don’t share it with others. I think as the years go on, this is less and less common, but for now, it’s still kind of the standard practice. I totally get it, too. Infertility and IVF treatments are hard. Not only are you emotionally hurting, physically- at least for the ladies going through the injections and monitoring- you are hurting. You’re being poked and prodded, you’re having wands shoved up your vagina every other day, you’re having needles shoved up your vagina and poked through your ovaries- this is a very physical labor of love! (I think shoved is the wrong word, as of course the doctors and nurses are very gentle, but you understand me, right?) Why would you want to share that with the world?

Not only that, but you can be judged by others for even fighting so hard for something that might not be “meant to be” for you. (Full disclosure, I hate that term sometimes.)

I had a tough time coming to terms with actively bringing science into having children. I look at the world around me, I hear about people starving or out of water in other countries, I see climate change and the way it will go if we don’t do something about it, I see rampant racism and sexism and how our society is, and I wonder- am I/are we being selfish for trying so hard to have a child, to bring one into this world? Not only that, but there are so many children already out there that need loving homes and great parents to look after them, love them, and raise them. Morally I wrestled with this for a long time, and truth be told, I still do. My conclusion is that strife has long existed in our world and will continue to exist. I’m only human, and biologically, the pull to not only have children, but to grow them inside of me for nine months, to give birth, to raise them with my husband- is a pull I cannot fight. I may be selfish, but I’m human, too.

So, trudging on, in October of 2015 we had our first consultation with our fertility specialist- our reproductive endocrinologist (RE)- Dr. Beth Plante. She works with the Fertility Centers of New England. She asked us about our struggles so far, got some information about us, and talked to us about the processes we could go through. Before we decided/she could recommend IUI or IVF or any of that, though, we had to go through the testing cycle. She made us feel very comfortable and she is a sweetheart. I’m glad we found her.

The testing cycle included a sperm analysis for Adam, some blood work for the both of us,  and an HSG test (Hysterosalpingogram) for myself. I was very nervous for this test. I had an IUD to prevent having babies years ago (ha! I guess I didn’t need that after all, eh?) and it was one of the most painful experiences of my life. I’m not sure if it was because a resident was putting it in, or because I wasn’t on my period when it was being ‘installed’, or what- but flash backs to my legs up in stirrups with several doctors looking at my bits while I held a nurses hand and screamed obscenities and made awful noises for 45 minutes were flooding my brain. They had to dilate my cervix and try many many painful times to get the damn thing in. One of them quipped that this was what childbirth felt like- as someone who considered a natural home birth I thought to myself- epidural please! By the way, after all of that after two months I pulled it out myself- it gave me awful side effects and was just not for me.

So anyway, back to the HSG test. The reason I was so nervous was because it involves inserting dye into your cervix- and any time I hear that anything is going into my cervix I think back to the IUD party I just described- and shudder. The dye goes through your fallopian tubes and if it spills out the end of them, your tubes are okay! If it doesn’t they are blocked.

Dr. Vitiello did my HSG test, she is another one of the doctors over at the Fertility Centers of New England. She is hilarious. She’s straight to the point, sarcastic, and very good at calming a crazy anxious lady (ahem, me) down. When I told her I was nervous she quipped that she was too, as it was her first time preforming the test. (In case you are wondering, no, it was not her first time preforming the test. I’m sure you caught the joke but just in case…) When she told me that the dye was already running through my tubes, I said “NO way, you’re joking!”, and she said “I just met this girl and she’s calling me a liar!”

The same day I was having my HSG test, Adam was having his sperm analysis. He described going into the room, seeing the recliner with a pad on it he was to.. ahem.. produce his sample on. He also described the light reading materials he had to choose from 😉

After the test he left and there was a waiting room full of women that watched him go. I laughed as he recalled his story but I also reminded him that their husbands/partners/donors/friends/what have you were also going through this so not to fret too much.

Adam sent me this photo as he arrived in his specimen collecting room, I responded with a thumbs up. Go get em’ tiger!

The testing cycle took a bit for us and our testing was completed in late November of 2015. This post is getting pretty long, so next time I’ll tell you our results and all about cycle one.

Our Friggin’ IVF Journey

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“I don’t think I could ever do that.”

It’s what I said one day at work, several years ago, to my boss at the time as she described what her friend was going through in regards to in vitro fertilization. Having babies was still a close but far enough away plan, and so I had no idea at the time that I was indeed infertile and would definitely be doing that. 

It’s not that I thought IVF was a bad thing, it just sounded cumbersome. You give yourself how many injections?  I didn’t even know about HSG tests, egg retrievals, transfers and monitoring appointments. I had a very rudimentary understanding of what IVF was.

Here we are, at least 4 years later, and we are very much in the process of doing IVF.

My name is Katlyn, and I’m a 28 year old hopeful mom to be. I’m married to my wonderful husband Adam, and we have been together for 7 years next month. We were married in 2013, and in very late July of 2014 we decided, on a vacation in Canada, that we would try to start having a baby.

We very lazily (or, I guess what “normal” people do) stopped using protection and started waiting for pregnancy to strike. Needless to say, it didn’t.

I had been diagnosed with PCOS- poly cystic ovarian syndrome- two years prior, and while my doctor said it might be difficult for me to conceive, I didn’t take too much stock in it. How wrong I was.

Over the course of trying to have a baby naturally, and it just not happening, I started to attack the problem with more vigor than I had at first. I downloaded this application on my iPhone called Ovia, I started tracking my very rare periods and cycles, and I started temping- taking my temperature every morning before I got out of bed. We started having “baby making sex” which sounds fun, but trust me, can be a chore. Tired? Too bad, I might be ovulating.. let’s get it on!

Still, nothing. I started to mention this to my OBGYN and schedule more frequent appointments with her. She suggested I lose weight. That might kick start my period to become regular. I lost ten to fifteen pounds, nothing. She suggested a healthier diet. Still, nothing. I was taking supplements. I was peeing on sticks with a lot of frequency. The first time I got a little smiley face for ovulation I jumped up and down in my bathroom.

Finally, after a year of trying naturally, my doctor said to me, “Well, we can put you on Clomid, or you can go see an infertility specialist.” The words I had been waiting to hear. Infertility specialist. I knew it wasn’t going to happen on our own. I knew enough about Clomid that I told her I’d like to see a specialist. Not that there is anything wrong with Clomid, but it might not be for me, you know?

This summary makes thing sound very quick, but, this was a long process. I looked up IVF centers local to me and after canceling the first appointment I made- the reviews of the doctor scared me off- I found someone who I thought would suit my husband and I’s personalities. After going back and forth with insurance companies, my primary care doctor, my OBGYN, and the fertility center- many many phone calls made during snippets of my work day- I was finally approved for a consultation with my fertility specialist. Things were about to get going and I was nervous and excited. Finally some movement!

I decided to start this blog last night at 1:45 in the morning. I was googling symptoms of PIO (progesterone in oil) injections and I got caught up in another woman’s blog. There was an epilogue at the end that was very uplifting and unexpected, given this woman’s history of posts. (Spoiler- she ended up having a baby naturally after many attempts at IVF!)

I know that during this process, you’re going to turn to your Facebook support groups, other IVF forums, blogs, and of course Dr. Google. I figured if I could share my own journey it might not only be therapeutic for me, but maybe help someone else googling PIO injection reactions at 1:45 in the morning. (Ouch! Itchy!)

I think that’s a good place to stop for my intro. I’ll dive into my consultation and cycle 1 in my next post. Spoiler alert- I’m about to start cycle 3, sooooo I’ll get you caught up. Whoever “you” are.