Tuesday, December 31, 2013

First Results

We went to our first ultrasound and blood tests today. They unfortunately called with my results as I was driving, so I didn't get to ask questions, and am having a hard time looking up what is 'normal' 5 days into treatment. I "think" the results are normal, they're certainly not too fast which is the main concern right now and being on a high dose of Gonal-F. Here they are -

Left Ovary - Multiple Follicles (5-10)
Right Ovary - Few Follicles (2-4)
Estradiol - 101.1 pg/ml
LH - 3.16 mlU/ml
Progesterone - 0.535 ng/ml

I hope they're normal. So far we've had a good experience with Boston IVF, though the holidays have really messed around with when I feel I can call them and ask questions. We have another appointment on Saturday for another set of bloodwork and ultrasounds. The one disappointment today (other than hoping i'd progressed much more than that so I could come down in dosage) is that we didn't get to see our normal nurse Amy to talk about our treatment. I should probably call her, I just don't want to bug......sigh. Maybe i'll call her Thursday, after the holidays are passed.

IVF in the Dark Ages

How did they do IVF in the dark ages you ask? By oil lamp and candles of course! We've had a spate of amazing weather - ice storms, snow dumps, wind - that has led to multiple power outs. Usually I enjoy these times - peace, quiet, games, candles, fireplace. But when you have $4500 of drugs in the fridge and $500 of drugs that need to be kept at above 68F, it's not hard to start to get anxious. Luckily we've got through by keeping the propane fireplace going and sleeping with the Crinone under our blankets, and running the generator to the fridge every 4 hours to keep things cold. So far, all is well.

Yesterday morning we had power out again (thankfully back by lunchtime), so had to do my morning lupron shot by oil lamp. Couldn't resist shooting a picture of that one, even though I don't usually look while B is preparing the syringe (no, my fear of needles has not passed). 

In other news, the Gonal-F shot has actually been fine. The needle though longer is finer, so i barely feel it go in, and B has just been doing two clicks at a time for me - 9 clicks in total. So far, so good. Side effects wise though things have not been great - the day after we started Lupron I woke up in amazing pain in my left leg. Thinking i'd strained it we just massaged and Tiger Balmed it. It still hasn't gone away though, and waxes and wains in pain levels. We talked to the pharmacist and one of the side effects of Lupron is bone and muscle pain, particularly in the pelvic area. Oi. I hope it starts to die down soon.....

Friday, December 27, 2013

Get set....and go!

...and we're off. Christmas day at 7am B did my first shot of Lupron....joy! It actually went okay, sometimes I get light headed with injections, this was one of those times, but in reality it didn't really hurt going in. Now we're on day 3, I can say that B is a pro at giving injections, and that lupron really stings about a minute after it goes in.

Today we start the Gonal-F - the big guns - and i'm really not looking forward to that one. For a start, that's the really expensive one, so no messing that one up. The second reason is it's just such a large volume. The lupron is 10 units, the Gonal-F is 450 units. The nice lady who did our injection training let me inject it out on the table to see the volume...and it was HUGE. Sigh. I guess at 35 I couldn't expect to suddenly just be okay with needles, even with daily ones.

In other news so far here in Maine we've had an ice storm and a snow storm clogging up traffic. We lost power for nearly two days (we did get spurts of power in that time) and luckily it came back on Christmas Eve, which meant hot showers - yay! It's definitely got us thinking about travel to Portland, and how we'll have to watch the weather and just be ready to stay down there if we need to....

Friday, December 20, 2013

Mr. Cellophane

Well, I keep saying I'm going to write a blog post or two and never seem to make the time, so today's going to be my intro post.

I picked the title because I was inspired by the musical 'Chicago' - one of the characters sings a song titled 'Mr. Cellophane', because no one really notices he's there. That's pretty much how this whole process has been for me so far, and it's been admittedly a bit disconcerting. When we go to appointments together, and we're waiting in the waiting room, the nurse always calls out for R, never for both of us. When the doctors and nurses talk, it's to R. If I say something, they always seem to have a surprised look (having, presumably, forgotten that I was there), and then answer... usually to R.

Although a bit odd, it makes complete sense - the focus of this effort is on R, not me, even though the actual fertility problem is with me, not her. Unfortunately there's not much I can do except operate as support staff, nurse, and shoulder to lean on. Oh yeah, and cheerleader. She's doing great so far; next week the hard stuff starts with the injections, but given this pic:

... I don't see how she can claim to have a problem with needles. ;-)

It just got real.....

Yesterday we went down to Portland to pick up our medication. We'd found an awesome local pharmacy that was the same price as those online - Apothecary By Design - and they do free teaching sessions for how to do all the injections (gulp). As a total needle-phobe, we decided it would be a good idea. So we headed down, parked in a snowbank and headed in to be greeted by a lovely lady who looked somewhat like a Christmas elf (complete with green jeans and red shoes). She took us into a conference room and went to get our nurse and our medications.

A few minutes later our nurse (pregnant....which is an interested choice for a nurse counseling an infertile couple) appeared with two giant boxes - luckily the larger was just the teaching materials! An hour and a half of practicing jabbing needles into a fake tummy, $5K and a chocolate bar later, and we headed out to do some final Christmas shopping then head to our acupuncture appointments (which has been going really well, I can even say I actually relaxed in the one yesterday!).

Everything got really real for me yesterday. I am not good with injections at all, so the two weeks of needles is going to be an interesting one. We are on so many different medications too, at different times and different doses, just keeping everything straight is going to be a challenge. We're on Lupron (10 units) twice a day for 3 days, then add in Gonal-F 450 units just in the evening (as well as the lupron). Everything starts on monday, I finish up the birth control pill, then start injecting on Wednesday (Christmas day). We're thinking a series of phone alarms and reminders will keep us straight.....

Friday, November 29, 2013

Happy Thanksgiving!

Today i'm thankful for medical science. Without it so many friends and family would not be here, or be in much worse positions than they are. Without it B and I would have no possibility of having our own children. Even through IVF we know our chances are only 30%, but having that possibility makes it worthwhile.

I know I also feel so fortunate that we're attacking this now, and that we have a reason we've ended up at an IVF clinic. So many couples have unexplained fertility, and I can't imagine how painful that must be. Our doctor summed it up nicely at our last appointment saying for us hopefully the stress would be less because we know why we're there, and that's so true. I instantly felt better when he said that, as i'd always been a little uneasy that it wasn't wigging me out more to be considering this pretty invasive process.

Hopefully this time next year we'll be thankful for our own miracle of medical science.

Wednesday, November 27, 2013

Moving forward

We found out Monday that our fears over my AMH levels were unfounded (damn you Dr. Google!), and we're candidates for full IVF, but unfortunately not Mini-IVF. We talked about options, about the process and about expectations, and have decided to move forward into an IVF cycle. Excited, scared, it's quite a step into the unknown, but we're stepping all the way in. So many things to organize before we get going. The first step is taken, i'm on the birth control pill, for the first time in quite a while now! The next step comes on Christmas day, when we start the joy of injectable medication. What a lovely Christmas present....:) That puts us in place for an egg extraction in the first week of January, and hopefully an implantation shortly thereafter.

The last two days have been a head-spinning mix of phone calls and web searches. Where to get the loan? Should we go through a direct-to-provider pay system, or just get a loan? Applying for both and seeing what the deals might be. If we go with the former we might get a good rate, but it won't include medication. The later we can cover everything. Phone calls and web searches to get medication prices - which have been anywhere from $9,000 to $5000. Rather luckily, and slightly unbelievably, it looks like our local (Portland, ME) specialty pharmacy might actually have the cheapest prices and the best rebates. Which is great, it means getting refills will be easy and they're right there to talk to and help. All of this is totally alien to me coming from the UK - i've never had to call around to find pharmacy prices before, never had to consider finding $25K for a procedure - it's all new.

Yesterday I had my first session of fertility acupuncture (shown to increase IVF rates). I never thought I would EVER be in an acupuncturists office. I hate needles. There is no way i'm doing my own injectable medication, that's going to be B's responsibility, along with holding me down for it. Acupuncture was okay, better than expected, but i'll challenge anyone who ever says it's painless. The lady was super nice though and also worked on my shoulder (which has been sore for getting close to 2 years now) and did an "interesting" procedure called cupping. It felt nice, but I do now look like i've been attacked by an octopus.

So onwards, upwards and keep reminding myself it'll all be worth it to give this a try, no matter what the outcome. Once again, I wish that B and I had met in our early 20's, but we are where we are, and i'm so thankful we have met. There's no guarantee that even if we had, we'd have had success either - my AMH is much lower than it should be for my age, as is B's sperm count, and though i'll always wonder why, there is no way to know, but age doesn't seem to be the major factor in our case, it just would have given us more time to work through the financial and emotional rollercoaster side.

Through all of this potential stress and anxiety it's more and more clear to me that we are meant to be together, are perfect for each other. How many people sit in the Dr's office considering expensive painful procedures laughing? B has promised a joke for every needle he sticks in me, and i'm going to hold him to that....:)

Sunday, November 24, 2013

The beginning

Every blog has to start somewhere, so here we are. B and I have been trying to have a baby for nearly a year, despite B undergoing a painful but very successful vasectomy reversal (previous marriage), with no joy. We decided to investigate options, while also looking at adoption and being floored by the cost and uncertainty it involved - way more than fertility treatments (which are not covered by insurance in the US) and in some cases you have a better chance of having a baby through IVF than the adoption process.

We went through a bunch of testing through Boston IVF in Maine, and tomorrow we head for our last consultation to discuss our fertility testing results. Tomorrow we find out  -

- what my results mean....Dr. Google doesn't have good things....what will Dr. Lannon say?
- if we're candidates for the $5000 Mini-IVF, or whether we're stuck to the $25,000 full IVF, or whether we're not candidates at all...

Tomorrow makes me very nervous. I've just about got my head around the fact that we won't be able to conceive naturally. We've just about got around our finances and decided how much we can borrow (2 tries max, more likely 1) and still have enough leeway to borrow even more to try for an adoption later. I know the success rates are very low (30%), and we're okay with that. What I don't know how i'll handle is the Dr. telling us my AMH results (a predictor of egg quantity and quality...so if IVF might work) are too low for IVF at all. I know it's a possibility, and I know i'm okay with adoption, but I don't really know what i'll really feel like if IVF isn't even an option after all this work up to it.

Over the last 5 years or so, i'd come to realise I may not have children of my own, ever. I'd become okay with it, truly. Meeting B changed all that for me, it changed everything. I hadn't been with someone i'd ever felt strongly about wanting children with before, and now I had. At 35 I knew time was short. Tomorrow we'll know.