15 March 2012

2WW

In my last post, I described the IUI process  we went through trying to conceive #4. To continue ....

For anyone who has every actually tried to get pregnant, you know there is an up-and-down emotional roller coaster that you go through every month. The first two weeks of the cycle are filled with disappointment that you did not conceive the month before, AND your time and mind are consumed with the many things we crazy women do to try to increase the chances of conception. For some of us, these things may be as simple as a minor diet change or making sure to schedule love-making every other day. But the longer you are on the roller coaster, the more intense these preparations may become. For me, with a clear conscience because of a peace from God about fertility treatment, these two weeks were filled with medications, injections, vaginal ultrasounds, and lots and lots of prayer.

After possible conception, which usually occurs around day 14 of a normal cycle, the real gush of emotions begins because at that point, there is absolutely nothing you can do but pray. For anyone who has been on an infertility or trying-to-conceive (TTC) message board, this 2-3 week wait is called the TWO WEEK WAIT (2WW).

The 2WW is an extremely emotional time for someone who has been trying to conceive for a long period of time. For me, when I was not doing any kind of treatment, the 2WW would start with an initial positive, hopeful feeling that you "KNOW" that you have conceived and that a baby is growing inside. Then I would start searching for symptoms of pregnancy, like squeezing my breasts a little to see if they were sore, and thinking I might be feeling nauseous. That hopeful feeling starts to fade throughout that first week though when no symptoms surface.

By the beginning of the second week of the 2WW (actually the fourth week of the cycle), I would generally become very pessimistic and doubtful that I had conceived. And by day 8 or 9 after possible conception (day 22 or 23 of the cycle), I would start taking a daily pregnancy test. I have made many trips to the Dollar Store to buy 10 tests at $1 per test.

Then at some point later in the week, after I had convinced myself I was probably not pregnant, I would start feeling breast tenderness, increased discharge, and slight nausea (all of which can also be signs of  an impending period). And then the optimism was on again! If I hadn't gotten a positive pregnancy test by the 12th day after possible conception, I would go to the drug store to buy an expensive early detection pregnancy test because I was just SURE I was pregnant despite the 5-10 negative tests I had already taken.

And then when the bleeding would start, I would start the whole roller coaster cycle all over again.

Now, for a cycle with fertility treatment, things were definitely different. Not only did the doctors monitor things much more closely, but medications can effect symptoms and even the outcome of a pregnancy test. It was quite a significant difference, but the emotions were just as strong, sometimes stronger, and the hope ...and disappointment ...was just as real.

For this cycle, an IUI with injected medicines and an HCG trigger, the 2WW was interesting. Since the trigger shot is HCG, which is also what makes a pregnancy test positive, I could pee on a pregnancy test and get a very strong positive the day OF the IUI procedure, which should be the conception date, but it would be a false positive. The trigger shot stays in your system for about 10 days too, so taking pregnancy tests every day of the 2WW could just be misleading.

My plan was to pee on a stick every other day until it was negative to see when the trigger shot was gone from my system and then start taking them for real about 12 days after the IUI. Unbelievably, I did not do what I had planned to do. I was just so busy with getting our move scheduled and getting prepared for closing on the new house that I didn't constantly think about whether I was pregnant or not.

I was really pretty sure I was pregnant, and so, I was terribly disappointed when the pregnancy tests at 8 and 10 days after IUI were both negative, even though I shouldn't have been able to get a positive until 14 days after. I was just so sure that if I did conceive, I would have twins, which would make my levels higher initially.

So my wait continued at least for a couple more days. That Friday, 11 days after IUI we closed on our home in Carencro, and that Sunday, I was scheduled to leave for Houston to get ready for the movers on Wednesday. Life would go on whether I was pregnant or not, but I was hoping to have some clarity before Tuesday so I could handle some of the heavier preparation if I was not pregnant. Because of our previous 1st trimester pregnancy losses, if there was a possibility I was pregnant, I wouldn't lift anything heavier than our 24lb daughter, and that was definitely going to limit what I could do to prepare for the move.

I had very cautious hope and was really hopeful that I would find something out by Sunday.

06 March 2012

IUI

In my last post, I talked about trying to conceive Pregnancy #4 and using a more invasive fertility drug regimen. To continue ...

So after injecting myself with drugs for a week, I was given the clear to inject HCG, often called a trigger shot, to prompt my body to release any mature eggs into my fallopian tube. The body usually responds to the trigger shot at around 36 hours. So I was told to inject the trigger on Saturday night and come in for IUI on Monday morning.

Since we were doing intrauterine insemination (IUI), we also had to abstain from trying to conceive the natural way until after the IUI was complete. The abstinence for 48-72 hours would promote more healthy sperm available for the IUI procedure.

The HCG injection was actually pretty unpleasant. I had done a trigger shot before, but for some reason, the needles the drugstore provided for this one were very uncomfortable. The needle didn't want to slide into my flesh like a normal needle would, and because of that, it was very painful. The injection site was actually painful for about 2 weeks after.

On Monday, very early in the morning, I woke up in pretty significant pain on my left side. It was a pain I was somewhat familiar with. Because I have PCOS, I occasionally end up with cysts on my ovaries that generally grow and then rupture. And ruptured cysts on your ovary are excruciating! This pain was in the same location as a ruptured cyst but significantly more mild. Since I don't usually ovulate naturally, I can tell the difference when I do ovulate, and I the pain was me ovulating on the left side. My initial feeling was disappointment that it was on the left, because I don't have a tube on the left. Much to my delight, around the time the babysitter arrived to watch Abigail, I began to have significant ovulation pain on the right side. I don't know if I have ever been so excited about being in pain before!

Somewhat graphic detail alert!
The plan was for my husband to go to the office and leave a sample at 8AM and then head on to work. It would take them about an hour to prepare the sample. (They remove the extra junk in semen so the IUI injection is very concentrated, healthy sperm.) Then I would head to the office around 9AM for the IUI procedure.

The IUI procedure is where they insert a catheter through your vagina and cervix, directly into the uterus. Then they inject the sample through the catheter. The uterus is a sterile environment, and in the natural conception process, most of the semen never makes it through the cervix because a lot of it is not sterile enough to be in the uterus. Only strong sperm manage to get through to the uterus. The IUI process allows more healthy sperm to get through, and allows it to start its journey to the egg from a much closer starting point.

The timer looked a little like this except the back was an egg.
The procedure was actually a bit surprising. I went into the office and signed a consent. Then the doctor came in with a nurse, asked me if I had any questions, and told me to remove everything waste-down. When he and the nurse came back in, they asked me to verify my husband's name on the vial containing his sample. Then he told me to lay back with my feet in the stirrups, and he put in a speculum. About a minute later, he said, "Ok, all done." Then the nurse, set a timer for 10 minutes and told me to continue laying down until the timer went off, and then I was free to go. When I was getting dressed, I noticed that the timer was actually a sperm and an egg.

I prayed the whole 10 minutes. Mostly that I was conceiving at that moment, but also that if it was not God's will for us to get pregnant that month, that He would prevent it. I also prayed that God wouldn't allow us to have more than we could handle, and any more than triplets was more than I thought I could handle for sure!

I considered staying there for a while longer, but I decided to trust that 10 minutes was long enough. I saw a preview of a movie once where a woman walked out of the fertility office with her legs clenched together. Yea .... I was so much like that when I left the office.

IUI #1 was complete, and it would either work or not, only time would tell. Now for the two week wait ...

29 February 2012

Stabbing Myself with Needles

In my last post, I talked about trying to conceive again with the new fertility specialist, who recommended fertility medicine injections and IUI. To continue ...

So August 3, 2011, we started our next fertility cycle. This would be the first after the loss of our 3rd pregnancy. At this point, we were still living in temporary housing. However, we had begun the process of purchasing a home in Carencro, LA, which would be far enough north of Lafayette that my husband wouldn't have to drive quite as far to his job every day. I was scheduling the move of our household goods, and working on getting an extension to stay in the corporate apartment until the weekend we would close on the new house. Abigail was 19 months old, very active, and really starting to understand more of what was going on around her. So we were all very busy.

So busy in fact, that I didn't have much time to focus on getting pregnant. I was very happy for the distractions, actually, because it helped me avoid dwelling on what could happen, good or bad, with  this fertility cycle.

The Medicine
The medicine with this cycle was much more extensive than just taking 5 or 10 Clomid pills over 5 days. This time I was on three medicines:

  • Femara - I had to take 10 pills at one time on day 3 of the cycle. 
    I am not really sure what this medicine was for. 
  • Follistim - This was a medicine that I had to inject once per day for 7 days, starting on day 5 of the cycle. This medicine was administered by an injection "pen" that came with a case, a set of needles that were about half an inch long, and a vial of medicine that had to be refrigerated. I had to insert the vial, screw a needle on the pen, rub down my skin with an alcohol wipe, and then stab myself in the belly and inject. Then, of course, the needle went into a newly acquired "sharps" disposal container. This medicine didn't hurt too badly. The only part that hurt was the stabbing.
    This medicine promoted the formation of follicles in my ovaries, and hopefully at least one would fill with an egg.
  • HCG - This was a medicine that I had used before in Clomid cycles with previous pregnancy.
    The purpose of this medicine is to cause the ovaries to release one or more eggs into the dominant follicle or follicles.
So on day 3, which was a Friday, I took the Femara. Then on Sunday, I started the Follistim injections. The following Friday, day 10, I went into the doctor's office for a follicle scan. This is basically a vaginal ultrasound where they look closely at your ovaries to see if any follicles have formed, and if so, to make sure there are not too many dominant follicles. When there are an abnormally large number of follicles for someone with both fallopian tubes in tact, there is a high risk of multiples. If that happens, the doctor may call off the IUI and tell you to avoid intercourse so you don't end up with high-order multiples. 

I wasn't really sure what to expect. In all of my monitored Clomid cycles in which I had a follicle scan, there were either no follicles that were big enough, or only one. So I was very surprised when the US technician said "Wow, that's a lot of follicles!" She counted 6 or 7 in the left ovary and 7 or 8 in the right ovary. Not all were large enough or the best shape, but I was worried they wouldn't let me try this month because the medicine had worked too well. So I waited on the call from the nurse to let me know if and when to inject the HCG and when to come in for the IUI.

The coolest part about the medicines this time were that the side effects were unnoticeable. With Clomid, I would get headaches, hot flashes, and nausea. So the medicines actually worked much better, with less side effects. The medicine was pretty expensive as well, and without insurance would have cost about $500. Fortunately, my husband's insurance covered all but $35 of it. (We are so blessed!)

I got the call later that Friday afternoon from the doctor's office. They told me to inject the HCG on Saturday evening around 8, and to come into the office for IUI on Monday morning. 

We were on our way to another 2 week wait to find out if this cycle would result in our 4th pregnancy.

21 February 2012

Trying Again ...

Hi again, everyone! I took a 'holiday' break, and didn't realize it was going to take me until Mardi Gras to get back it!

In my last several posts, I talked about our 3rd pregnancy ending tragically and dangerously in a tubal pregnancy and emergency surgery. I also talked about trying to get into a new Fertility Specialist in the Lafayette area, where we had been living in a corporate apartment for a couple of months. And I discussed my confusion about why God was allowing my family to go through another pregnancy loss, as well as a disaster at our home in Texas and our inability to get anyone to buy our home quickly.

So at this point, we were still living in a temporary apartment in Lafayette, and we were restarting our home search in Lafayette, after having to bail on our original home choice. Our home in Texas had been sitting on the market for 3 months without much activity at all, and we had just paid out a significant amount of money for an insurance copay from a pipe situation and for some extra painting and upgrades to help market the house. And I was recovering from my 3rd surgery in 2011 by just mid July.

We had both had some testing done to determine what exactly was going on with our fertility, only to find out that while my husband was just dandy, my fertility situation had only become worse. My body wasn't ovulating properly, and my official diagnosis was PCOS with newly reduced chance for pregnancy because of the lack of ovarian tube on the left side of my body. So even if my body happened to ovulate, or even if we stimulated ovulation with medicine, any eggs coming from the left side would most likely never have a chance at getting fertilized. I was also now at a higher risk of having another tubal pregnancy because of my history.

After my last surgery, my first question was: "How soon until we can safely try again?" And the fertility specialist said I could try with my second period, but that my first would likely not happen for about 6-8 weeks. To my surprise, I started a period only 2 weeks later, but it was really light and kind of strange. So the doc let me take some progesterone to build up the lining of my uterus again. On August 3, just over 30 days after my last surgery, my period began again. I called the doc's office, and they cleared me to start trying ...THAT MONTH! I was surprised, but delighted and a little scared.

The doctor recommended that we use different, more potent fertility drugs this time (more on that in the next post) and that we do Intrauterine Insemination (IUI) to simply give us the best chance to conceive. I told them to go ahead and call in the prescriptions, but that I would have to call them back about the IUI part. I needed to pray about it, and I needed to give my husband time to pray about it as well. I had concern that because of his hesitation to pursue infertility treatment after we lost our Gabriel only 3 months before, he would not be a fan of going through with IUI.

After I prayed and felt peace about it, I called my husband at work. I told him how excited I was that we were going to be able to start trying immediately. I asked him if he was ok with the meds and trying now, and he said, "Sure!" Then, I hesitantly said that the doctor recommended IUI, and that our insurance covered it (which is unheard of). And I waited with anticipation ....for about 10 seconds. To my surprise, he said, "Sounds good." I was completely surprised. I told him the process and asked if he was sure, and he said, "Yep".

In my next post, I will go through the step-by-step process of the IUI cycle.

06 December 2011

Did God Abandon Us?

In my last post, I talked about having a second surgery to repair my uterus and taking some time to refocus. To continue...

We moved to Lafayette in April because it seemed very clear that God was moving us. My husband had a much better job to move to, and we were offered a great relocation package that would help us sell and buy a home and put us up in temporary living for up to three months. We put our Texas house on the market with the expectation that it would sell very quickly, and that we would break even financially because we were confident that God would come through since he was moving us.

The first week of May, we lost our baby Gabriel with a tubal pregnancy, thus affecting my future fertility. Our loss was devastating and discouraging. Then a couple of months on the market, we discovered that our home in Texas was not generating much interest. I became concerned because I realized that our time in temporary living was flying by. We were going to have to move out before the middle of July. And we didn't have anywhere to go...

And then, in the middle of June, I got a call from a friend in Texas who was checking in on our house every couple weeks. She called to tell me to get a plumber there ASAP. I frantically called a plumber, my husband, my parents for prayer, and my friend back to ask her how bad it was. Apparently, water had been shooting out of one of our upstairs bathroom sinks and had flooded half of the upstairs and had leaked into the downstairs. I packed a bag, put Abigail in the van, and started out the 4-hour drive back to Texas.

I spent the drive praying and on the phone. The plumber fixed the problem, but also said that we needed to have a drying company come out. I think that was when I realized that this was not going to just be a clean-up job. I arrived at the house to find the kitchen counters swollen, the hard wood floor in the living room swollen, about 1/4 of the walls swollen, the bathroom completely saturated, and carpet on both levels soaked and discolored. And I cried.

Since all of our furniture was still at the house, we were very fortunate that none of it was damaged. We were also fortunate that we didn't have any mold. In total, though, the insurance claim was more than $25K.
 
Initially, I handled all of this pretty well, considering. But after I started getting bills, and our mortgage company messed up getting us the settlement money to pay the contractors. Well ....that's when I started to fall apart.


 Our baby was gone, and we couldn't even start trying again for probably another month, with even less fertility than when I had two fallopian tubes. We had now lost almost $10K in mortgage, utilities, and deductibles and additional repairs for a house we weren't selling. My daughter, whom I had been cloth diapering since infancy was now in disposables full-time, and I was feeding her processed foods and fast food because of the chaos of our lives. She had been sleeping in a Pack-N-Play for three months now with no end in sight, and I was not even sure where we were going to live in a month. The house that we had decided to build wasn't going to be ready until August, and I was pretty sure we couldn't really afford it anyway, so we bailed on it and had to start looking again. Everything was a mess.

Where was God? Had he abandoned us? Was this move a move out of His will? What did we do wrong?

All of these thoughts were spinning in my mind, and I was dealing with a lot of anger. 

What is worse was that I had just started writing this blog. I was in the process of telling the story of our struggle with infertility and our first pregnancy and subsequent loss. I was writing this blog so I could help other women with these struggles see that they were not alone in their pain, and that God could bring victory even when you feel you are in the most desperate situation possible. How could I reach out to other women and how could I talk about victory when I was angry at God and questioning whether he even cared about me anymore?

On July 26-27, I was texting a close friend of mine about my frustration with God and my insecurities about whether we would ever be blessed again. And then on July 27, while I was still frustrated and feeling abandoned, I wrote the blog "Counseling and The Promise". My friend wrote to me later and basically called me out for questioning God after He had given me such a beautiful promise.

And I began to pray for God to change my heart and make me more grateful for the blessings He had already given me. A few days later, I woke up refreshed and feeling relieved. I was grateful for my husband, and for Abigail. I was grateful for a job that my husband loves, and that we had the ability to start over in our house hunt. I was grateful that we had this temporary apartment for another couple of weeks because of an extension we had been granted. And I was grateful for the children God was going to bless us with. The only thing that had really changed was my attitude, and it made such an amazing difference in my whole family's lives. 

01 December 2011

Another surgery (3rd this year)

In my last post, I talked about deciding to go to a new fertility specialist after the loss of our baby to a tubal pregnancy. To continue ...

So we went to the fertility specialist, only about a week after losing our baby Gabriel and my left fallopian tube to a tubal pregnancy. Of course, we knew that we were not going to immediately pursue another pregnancy, but we wanted to make a plan. I also had some fear in my mind that we could have more tubal pregnancies because of my new increased chances of having another. My husband hoped that we would get pregnant without assistance this time, and I did as well. The visit to the fertility doc was to get my system checked and cleared for another pregnancy over the next couple of months.

He recommended that we do a full check on both me and my husband to be sure everything was working properly. Hubby's test was just a semen analysis, which we had refused during previous checkups because we knew he didn't have any issues. I underwent two blood tests and another HSG, which is an x-ray of my uterine cavity while saline and iodine is injected through the cervix. This was the test that my last fertility doc had done after the surgery in January that was supposed to repair my uterine septum. I already knew that some of the septum was still left in the uterus, but they were not able to measure the amount left over.

Since the last fertility doctor had recommended going back in and removing the remaining septum, and we had seriously considered it, my mind was already thinking that it may be a good idea. So before I went in to have the HSG, I decided that if it was any bigger than 1cm, I would have surgery again. The doctor said it was about 1.5 cm, and so we decided to have the remaining septum removed while waiting to be able to get pregnant again.

And so, my third pelvic surgery in 6 months was performed the Friday before July 4. This time it was a laparoscopy, 3 holes in my tummy for cameras, lights and air, and a hysteroscopy, which goes up through the cervix and performs the surgery. The surgery was a complete success.

The recovery was not very bad at all. I had a few days with pain, and about a week of low energy and low activity. I also had to refrain from picking Abigail up for 2 full weeks though, which is complicated and difficult when you are a full-time mom of a 1-year-old!

The coolest thing that happened while I was laid up from surgery was that my new friends in Lafayette poured out so much love on me and my family. I had joined a group called M.O.P.S., Mothers of Preschoolers, just a few weeks before, and we had also found a great church, so we were starting to get to know some people. The ladies in my M.O.P.S. group were amazing! They brought us dinners for a week, and even ran to my aid when my husband got called into work while Abi was napping and I couldn't get her out of her pack-n-play. I was amazed at the love shown to me by people I had just met.

I decided to re-focus the attention that I had been spending trying to get and stay pregnant. I started focusing more on my precious little girl and helping her develop into the intelligent, happy little princess she was becoming. I also started researching adoption and planning for our move into the new house that was being built. We were waiting two months after the surgery before we could start pursuing fertility methods to get pregnant again according to the fertility doc's instructions. So I was in a bit of a holding pattern, and it was a great time of recovery and restoration.