IVF # 3 - Stim Day 10 - That's a Wrap

Well, today's appointment did not go well. There was only one unmeasurable follicle on the right and maybe a few unmeasurable ones on the left. My E2 went down to 214 (from 251 on SD8). Since Dr. Sacks wants to cancel this cycle, I will stop taking all medications. He wants me to return next Tuesday for another ultrasound and bloodwork appointment. I suppose he wants to see if I've ovulated by then and if I have, I'll start this dog and pony show all over again. I really don't know if I should keep this up, though. My body has not shown that it will respond to any amounts of medications, nor estrogen priming. Not only that, but I think the estrogen and stims have taken a much greater toll on my body and state of mind this time around. I don't want to keep doing this to my body and possibly put my future health at risk.

I feel so incredibly blessed that we already have one beautiful and amazing daughter, so I should just count my blessings and call it a day. I think that all of the stars aligned and we simply lucked out with IVF # 1.

IVF # 3 - Stim Day 8 - Not Much Action Yet!

Well, today's ultrasound (# 3) showed not much activity. In fact, it seems that there were less follies than there were on Friday's check-up. On Friday, my RE said I had 3 unmeasurable ones on the right and 2 on the left...which is pretty promising for me. Today, he only mentioned that he saw one (also unmeasurable) on the right and didn't say if he saw any on the left. I'm still happy that a lead follicle hasn't developed, though. And the promising news from today's check-up is that my E2 has finally risen to 251. It seemed to have stalled between my bloodwork appointment on SD3 and my 2nd ultrasound on SD5. I continue to remain encouraged by the rise in estrogen and truly believe that this protocol is the best one for me! There was one little hiccup that I wasn't expecting, though. I have noticed a bit of spotting from time to time. I told my RE this and he said that my lining may still be thin...sure enough, it is. So, hopefully that will pick up, as well. I've never had an issue with my lining before, so now I have something else I need to ensure is in good working order. I'm not going to worry about it until show-time, though, and I will continue to have faith that my body will not let me down.

Finally, I got a nice surprise today when I learned that Emily is still working (or has returned to) the clinic! It was so nice to see her friendly smile and hear the re-assurance in her voice when she called me to report my bloodwork results. I also had a really nice nurse draw my blood today, too. She even told me that she had remembered me from IVF # 2. Luckily, everything with my meds has worked out, as well - I got them...but our checking account took a bit of a hit! It will all be worth it, though, in the next few weeks!

IVF # 3 - Stim Day 3

This morning's bloodwork results are in - after two nights of stimming, my E2 is 193 (it was 187 on Sunday). I've been reading that estrogen levels tend to drop at first during an EPP cycle, so I was happy with the slight increase. I feared that there was going to be a much bigger jump that signified a lead follie had formed. This slight increase helps me keep the faith that I actually do have a few follies forming!

So, things are progressing well aside from a few minor issues: 1) I still don't have my meds and 2) I haven't been very happy with the staff at my RE's office. I think that had they been on the top of their game, I wouldn't be dealing with this insurance complication. My nurse has not been very attentive to little details, e.g., 1) I told her that I had wanted to be on Endometrin three times and yet she still ordered Prometrium for me and 2) I just get the feeling that she's not very compassionate and that she's just bothered by her patients. I miss Emily and Naidra from IVF # 1. They really helped to make things go a lot more smoothly - IVF patients have enough to worry about as it is and having a helpful, responsive nursing staff can really take a big load off of our shoulders. Whatever happened to showing compassion and paying attention to details? That seems to be few and far between among RE's nursing staff. If it wasn't for my strong appreciation for and confidence in Dr. Sacks, I would consider switching clinics.

CD3 Baseline Check-Up

I started spotting on Friday, May 6th, so I set up my baseline appointment for Sunday, May 8th -- Mother's Day. :-) Since I've gone into this cycle thinking only positive thoughts that the Estrogen Priming Protocol is going to be a successful one for me, I had a feeling that I wouldn't have any cysts...which I didn't! However, I don't know if I had any antral follicles -- I can't make out anything on that ultrasound screen - it looked pretty blank to me. Dr. Sacks just reported to my nurse that my right and left ovaries looked fine, clear, ok or something like that. I tried to ask about the antral follicles, but I don't think I was direct enough -- Dr. Sacks just basically affirmed my question that there is a potential for follicles. There is always potential, though...I just don't know if this baseline looked any more promising than my others, antral follicle-wise. Time will tell, but hopefully won't tell me too soon. I'd like to have another "be the turtle; slow, but steady" stimming phase. My E2 was 178 (or 187). That's higher than my past cycles, but that is probably due to me being on estrace for 9 days. I got the clear to start stimming that Sunday evening (450 Follistim / 150 Menopur) and was advised to continue taking the estrace 2x/day. I return tomorrow (Wednesday) for just bloodwork. I assume I'll then return on Friday for my first ultrasound...which is the appointment that I'm really excited about.

As a side note - I've spent the last two days trying to get my meds. Since I have a new insurance plan, I have to go through different hoops to get them...and this time I'm not as fortunate as when I was with my previous company in that the meds (and IVF procedures) are only covered at 50%. I understand how fortunate I am to even get that type of coverage, but it puts more pressure on us for this cycle to be a success. It's a good thing I still have some meds left over from my last IVF cycle or else I may not have been able to start this cycle!

IOTO x 2?

It's time to embark on a quest for another bundle of joy. Considering I'm an only child and my husband has only one sibling (not to mention the fact that we're older parents), we really want Kaitlyn to have a sibling. I actually went through an unsuccesful IVF attempt in November. We tried the same protocol as IVF # 1. Since my response to that cycle was similiar with IVF # 1 (however with markedly more disappointing results*), I asked my RE if we could try the Estrogen Priming Protocol this time. (During my initial consultation with my RE, he told me that was the protocol that he wanted to put me on since he found that EPP worked best for poor responders, but since I had already started the Ganirelix protocol with my former RE, we decided to just go with that one and see what happened). My RE was open to trying the EPP protocol, so here is where things stand today:

CD3 Bloodwork: FSH (10.7) (YAY); E2 (52); P4 (.20); LH (2.0); Lining (8)
CD3 Ultrasound: OK (No Antral Follicles Reported)

I was scheduled to return to my RE's office on CD15 to confirm ovluation. Ovulation was confirmed (according to my CBEFM, I ovulated on CD11), so I started estradiol pills (2 mg / 2x/day) on CD16. Unlike most EPPs I've been reading about, mine doesn't include adding Ganirelix prior to getting my next bleed / AF. My next step is to call my RE's office once I get the bleed / AF and we go from there. Stay tuned! We're hoping for another IOTO success story, if we are so blessed! I'm inclined to think that we simply got lucky with Murtle, so if attempt # 3 works, I will be incredibly surprised and wonder why in the world we have been able to be blessed twice.

*IVF # 2 Stats (Ganirelix Protocol):
9/29/10 (CD2) - Started BCPs - FSH was 6.6!
10/25/10 (SD1) - Started Follistim (450) and Menopur (150)
11/1/10 (SD7) - Added Ganirelix
11/3/10 (SD9) - Triggered (E2 - 561) - 2 follies on R (15 and 24 (cyst?) and 1 follie on L (20)
11/4/10 - E2 dropped to 560
11/5/10 - ER - 1 Egg Retrieved (Again)
11/8/10 - ET - 1 Embryo Transferred (7 cells, 50% fragmentation)
11/20/10 - Beta - BFN

Kaitlyn is Here!

Well, life has been very, very busy as I'm two months late in announcing this and writing her birth story, but I am pleased to announce that my infertility journey has successfully come full circle as Kaitlyn is here! She arrived on her due date (yes, it appears as though she's a bit OCD like her momma, so she wanted to come when she was supposed to), Monday, June 21st at 12:43, after almost 20 hours of labor and THREE hours of pushing! She weighed 7 lbs., 1.8 ozs and was 20 inches long.

Considering she was behind in everything throughout the IVF process and throughout my pregnancy, I really thought she was going to be late. I had even worried about having to fight my OB because I was sure the topic of induction would come up since I was not dilated or showing any signs of labor at all up to the last OB appointment. I had completed my last day of work on Friday, June 18th and was feeling great, so I was looking forward to a planned "date day" (sleeping in, lunch at a yummy Thai restaurant, and even a matinee) with my husband on her due date and a few days off from work to relax, organize some things around the house, and doing some last minute things to prepare for Kaitlyn's arrival. Well, none of those things ever happened and Miss Kaitlyn has been in charge of my schedule ever since.

I got a manicure and pedicure on Saturday, June 19th as preparation for my husband and my date day. The manicurist was surprised how close my due date was since I wasn't showing that much. I joked with her about how pedicures were supposed to make women go into labor. She then told me that she had a client on Mother's Day who started to not feel well immediately after her pedicure and she had to call her husband to pick her up because she feared that she was going into labor! My manicurist wasn't sure if she ended up delivering that night or not, but I joked with her that if she did, the manicurist should tell every pregnant woman that her pedicures are a good way to get labor started!

I went to bed around midnight that night. My husband ended up playing PlayStation until 2 am! I got up to go to the bathroom at 4:30 am on Sunday, June 20th (Father's Day) and had to get there very quickly because I felt I was going to pee as soon as I rolled over to get out of bed. I made it to the toilet in the nick of time and I felt a huge gush of what I thought was pee come out of me. I soon realized that this probably was my water breaking since it took a long time to stop. I sat there for a moment and thought, "no...this isn't supposed to happen now...I still need a few more days. What should I do? Should I wake my husband?" I was tired (and nervous) and didn't want to head to the hospital this early in the morning. However, since I was GBS positive, I knew I needed to get there, even if I wasn't experiencing any contractions. So, I went back to my bed, rubbed my husband's back and said, "Honey...I think my water just broke." He got up without any hesitation and I told him I was going to take my shower. I continued to leak fluid during and after the shower...I was surprised at how much I leaked, especially since I gushed so much at first. I was nervous about what was to come (and wondered if I was ready for this huge life change), but I felt pretty well-prepared and thought if this was really it, we were ready for the most part. I think my husband was a bit nervous because he ended up putting the things I had laid out into my "Go Bag" and was ready before I was. I put on a cute black little shirt and asked him to take a picture of me before we left life at our home was we know it. The drive to the hospital was great - it was a little after 5:00 am and no one was on the road. The sun was just coming up and it looked like it was going to be a beautiful day. My husband almost ended up hitting at least two birds on the way, though! That's when I figured he must have been a bit nervous because I can't think of any other times where he's almost hit a bird when we were out and about! (Granted, there were a lot of them flying around - the early morning must be their time to get things done, ha ha).

We made it to the hospital at about 5:30 am - just about an hour or so before the next shift, so the hospital staff didn't seem very enthused that we were there, so we felt kind of uncomfortable. I don't think anyone was in triage or even in labor when we got there. (Since it was a Sunday, there were no scheduled inductions or c-sections that day). The rest of the day and subsequent hospital stay was kind of a blur, but I'll try to re-count it as well as I can. The nurse checked me out in triage (and wasn't in the mood for humor when we joked with her with something regarding me being allergic to cats and her thinking we could have domestic abuse issues). She or another nurse confirmed that my water had indeed broken, so they admitted me and advised me to start walking because I was only 1 cm dilated and I think 50% effaced. We dropped my stuff off in the room and started to walk a few laps around the unit. I can't remember all of the details about the rest of the day, so I will recap the highlights.

My parents arrived around 10:30 or 11:00 am. Unfortunately, the walking didn't help me to make much more progress, so when the OB (Dr. Keith) checked on me, she told me that they'd probably have to start me on PIT. Ugh. I so didn't want to be induced and was ready for a fight. However, Dr. Keith told us that since my water had broken, I would need to be induced to get things going because I could be putting Kaitlyn at risk for being in utero for so long without my amniotic fluid. So, I decided to go ahead and get it (and then get the epidural, too, because I figured the contractions would become more difficult to manage if I was on PIT). I think about two hours had passed before I started to feel the contractions and they were pretty intense. They were more bearable once my husband rubbed my back, but I could tell I was going to be in for a rough ride if I didn't get the epidural. Around 2 or 3, I still hadn't progressed that much, yet the contractions were pretty strong. I decided to ask for the epidural at that point. My husband and I weren't very fond of the anesthesiologist because he was pretty gruff. When he found out that I had scoliosis (and had to wear a back brace because of how severe it had been), he told us that he didn't know if he was going to be able to administer the epidural successfully. That scared us, especially since I was starting to get scared about how I was going to be able to stay still enough for him to administer it, but I got through it and the anesthesiologist was able to successfully administer it on the first try - thank goodness. After that, I didn't feel any pain (or even pressure, for that matter) for the duration of the labor and delivery. Unfortunately, I was no longer able to walk around the room after it was administered, so I was confined to wait in bed until Kaitlyn arrived. I think this was the point that they also inserted a catheter into me.

So then we waited...and waited...and waited. Considering the length of the labor, I needed fluid pumped into my uterus. Either the fluid or the epidural made me very cold, so I experienced chills for several hours. At one point (I think because Kaitlyn had dropped a bit), Dr. Keith also had to apply a monitoring device to Kaitlyn's head to better monitor her heartbeat. This further restricted my movement and the nurse on duty (who we weren't very fond of because she didn't seem to be very caring - she didn't adjust my pillows, empty out my urine bucket from when I was going to the bathroom, or give me fresh bed pads to catch all of the fluid that was leaking out of me) didn't want me to move around. Luckily, my doula, Alex, proved to be very helpful because she helped to re-position me throughout the night, gave me a lot of massages to help keep me comfortable, and asked the next nurse on duty (Catherine, who was wonderful) for fresh bed pads and blankets and to empty the urine bucket. During this waiting period, I just chit-chatted with my husband, parents, and sister-in-law. The time went pretty quickly, but I was ready for it to be over so we could meet our little girl. Everyone was placing bets on when I would deliver her - the latest time guessed was around 9 or 10 pm and I thought I'd definitely not see that time without child! Well, around 10:00 or 10:30 pm, Dr. Keith (or Catherine) told me I could start to push because I was finally ready. I didn't feel any differently than I did when I was just 1 cm dilated. Dr. Keith told me that it could take anywhere from a few minutes to three hours. I thought three hours seemed like an insane amount of time to push and that I was going to deliver within a few pushes. Well, Dr. Keith had to stop by at least two times to simply leave again since Kaitlyn was still not ready to make her appearance. I can't remember when Dr. Keith finally came back and started to "suit up" but it had been quite a while and I was excited to see her and get this over with. I had tried to push in many different positions, but nothing seemed to work overly well. I was surprised at how I didn't experience any pain at all during the pushing process...and I was also surprised that the pushing didn't require me to push constantly. I had to push three or four times when each contraction hit (my husband watched the monitor and told me when the contraction was starting) and the contractions came about every two to three minutes, so I got a nice little break in between each contraction. The longer the time went on, though, the shorter the time felt between contractions, so it was tiring. Around midnight it looked like Kaitlyn was just about ready to come out into the world. Her head had started to crown...but then she changed her mind and no matter how hard I tried to push, she just stayed there! A nurse came into the room and told us that she had never seen a baby stay so long at that position. Go figure! There was a lady in the room next to me who had arrived long after I did that was pushing at the same time I was. I thought for sure I would deliver before she did, but we heard her baby's cries a good amount of time before we heard ours! I think everyone in our delivery room was shocked at how long this was taking. I remember thinking that there was no way I was ever going to get her out and the doctor was going to have to get her out another way. However, I was too afraid to ask what would happen if I couldn't push her out because I didn't want to hear the answer (that she's either have to cut me, use forceps (or something like that), or that we'd probably have to convert to a C-Section...after all of this)! My husband, Dr. Keith, Alex, and Catherine were all cheering me on during each push and telling me that I was getting so close. Someone asked me to reach down and feel Kaitlyn's head so I had some additional motivation to keep on going. My husband told me that he while he kept telling me she was soon going to be out that he thought there was no way it was going to happen anytime soon. Finally, at 12:43 am, Kaitlyn decided she was ready to make her grand appearance. I remember that final push and feeling such a sense of relief and happiness that she had finally made it!

Since Kaitlyn had her cord wrapped around her a few times, she had to be taken over to the warmer right away so she could be attended to. She had ingested so much fluid, a NICU nurse had to put a suction tube down her throat to clear it. Luckily, my husband was able to be right there with her while this was going on. I was a bit worried about her state (especially since she wasn't crying or moving), but felt confident that she was going to be ok. I remember looking over at her and feeling so bad for everything she had been through and was going through now. What a dramatic change for a baby who had been so snug, secure and comfortable for nine months to come into the world in such a fashion. After what seemed like too long, Kaitlyn started to cry a little bit and was brought over to me. Her most striking feature was her cute, long toes! My parents and Karen were alerted that Kaitlyn was finally here, so they came in and took lots of pictures. As for the other stuff, Dr. Keith delivered my placenta when the nurses were working on Kaitlyn and stitched me up. I didn't actually have to do anything to push the placenta out. Dr. Keith also told me that I only had minimal tearing and didn't require too many stitches, so that was good too.

I remember trying to breastfeed Kaitlyn for the first time while we were still in the delivery room and it went well. At about 3:30 am (and after finally finding food appealing again - yay!), I was finally wheeled to the recovery room and my husband and everyone else left the hospital. Kaitlyn and I had a few more minutes to get acquainted. I remember looking over at her in the bassinet and she looked at me with these big eyes and I felt as though we sealed our bond at that moment. The rest of my stay in the hospital was a blur - and since most of the memories I do have of it aren't fond ones, I won't detail them in this story.

Despite the rough delivery and recovery period (not to mention just trying to get used to all of the basics of what parenting involves and how much stress having a newborn can put on a couple), I wouldn't have asked for a different outcome. My husband and I are so incredibly blessed with this miraculous little girl who continues to warm our hearts each and every day with her growth, development and budding personality. I am grateful that I have been able to take off of work for five or six months and love seeing how each day will unfold. I could watch her for hours - whether she was sleeping or awake. The love that I feel for this little child is more than I ever imagined it would be and I just hope that my husband and I can help her to grow into a very happy and healthy individual. While I can't wait to see what she will be like, I am also cherishing each and every day and stage that unfolds in the present. We waited a very, very long time for this precious little one and it was well worth the wait. She's currently sleeping in her car seat after a successful trip to the grocery store and I'm already looking forward to greeting her for her next feeding, changing and playtime already.

Dear little Kaitlyn -- your father and I love you so very, very much and always will and we hope that you will never forget that. We will try our hardest to show you this each and every day. There will be times where we won't know what we're doing, but everything we do will be done with love.

13th OB Appointment (39w3d)

We're getting closer! Today's appointment with Dr. Edwards went well. At first my blood pressure was super high and they were going to send me to the hospital, but since the nurses and I were chatting during it, they re-tested it and it was fine. My uterus went back up to 36 cm (from 32 last week) and I gained about 1/2 pound. I was not dilated, but my cervix was soft, which is one sign that my body could be preparing for labor. Dr. Edwards did say that she will have to schedule me for an induction if nothing is happening by my next appointment. If I could get her to deliver, I will feel better about the whole process, but I would rather not be induced. Once my due date comes around, I will be trying whatever I can to get Murtle to come naturally before that induction date! Oh, and Murtle's heart beat seems to be decreasing (now it's in the 130 range), which I believe is normal prior to delivery. So, we'll see if I make it to next Tuesday's appointment, which will be one day after Murtle's due date!