My Infertility Journey

I want to start by introducing myself to you. My name is Lisa and I have been diagnosed as being “infertile” for 1.5 years now (I am now 38 years old). After trying to conceive naturally for more than 1 year, my husband and I were urged by my gynecologist (whom I’ve gone to for years) to see a Reproductive Endocrinologist (RE). Since that first visit to the RE, we have been through 5 failed IUI’s and IVF has been recommended to us as our next step. When we first started our journey with our first IUI cycle, I wasn’t prepared for all that was about to come as a result of going through these treatments. The ups and downs, emotionally as well as physically what the treatments do to your body. After the last IUI cycle, I got so depressed, I really felt like I was going crazy. And I felt all alone to boot.

Today, I look back thinking how nice it would have been to have some background knowledge on what to prepare myself and my husband for. This is why I write this. So if you’re contemplating infertility treatment, you can read this and have a better sense of what to expect before and while undergoing treatment. Of course, this is all based on my own experiences and the issues and concerns I had to personally deal with and you will have your own experience. I still in retrospect had wished I had a better sense of what was coming. How I should have looked into joining a support group, or had a better list of questions to ask while talking to my insurance company. How I found out was through trial and error. It would have been nice if I had a big sister to help me through or at least give me a heads up on issues I could possibly be dealing with. I think you never truly know unless you go through the experience yourself or have an in depth conversation with someone who has.

Perhaps you have been trying to conceive naturally for years or suddenly you are at the age of wanting your children and realize the clock is ticking….and LOUDLY! It wakes you up out of your sleep! Whatever your situation, before starting any form of treatment, you should read through the articles on this site. Whatever your path will be, always RESEARCH and ask all the questions you have before going through with anything! I hope you will find some of the information useful and wish you luck in your journey.

 

Hope needed

3 weekends ago, the doctor transferred 2 viable embryos on a day 3 transfer. Out of 7 follicles, 4 embryos resulted after ICSI. I was a complete mess around the time of retrieval, worrying the same bleeding complication would happen again but thankfully, I was alright. When hubby and I received the call about the 4 embryos, we were tickled pink to hear there were that many. I was definitely surprised going into retrieval thinking there would only be 4 follicles.

Then the 2 week wait came and passed and I finally had my beta test last Wednesday which was negative. To date, I have not experienced a positive beta, not even a low one. So after meeting on Friday with our RE, hubby and I are left to think about another IVF cycle, this time with a low dose protocol. My doc even wants to remove the estrogen patch and if necessary add birth control pills if my FSH is high. The high dose I was on may have affected egg quality. Of course this was indeed a blow to myself, sitting in that office chair feeling pretty helpless about my reproductive state.

My husband and I were really hoping this cycle would be our last one because after 3 cycles, the financial burden is no longer something we can ignore. For us, each IVF cycle costs us around $15K. This is because our insurance does not cover advanced reproductive services such as IVF in addition to the high deductible before any coverage begins. You hear people talk about being house poor, well, I don’t want to be infertility poor. For those contemplating IVF, financing is a huge stressor for many. Now, cost is a bigger part of the equation.

So where are we at? Well besides AF hitting me like a tornado, I’ve been feeling the usual high and low every time one gets the negative beta news. Funny how it doesn’t matter how many times you’ve experienced the news, you still go through the same emotional rollercoaster ride. And as always, I always feel a level of self-hatred as if I had a role in placing myself here. My husband of course, reminds me of how much he loves me and that I shouldn’t blame myself for anything.

For the most part, we still feel as if there is hope for us, however my RE reminds us that if the next cycle, possibly 2, doesn’t result in even a low beta that we should start contemplating egg donation.

Today, I am ordering my meds just so I have them and start on Day 2 again (next month starts a new deductible. Gulp.) Who knows, maybe the lower dose protocol will produce better quality eggs. The co-culture didn’t add much to the cycle so my RE doesn’t want co-culture next cycle.

In the meantime, I will be on the lookout for the baby stork. I seriously could use some hope over here.

 

IVF Cycle #3 – Hope this One’s the Last

So evidently, my pregnancy tests were all negative (after trying on our own) and we decided to start IVF Cycle #3. In my earlier 2 posts, I talked about the IVF Co-Culture I went through at Cornell. In this cycle, they did draw an extra vial of blood for the Co-Culture process. I’ll provide an overview of what’s transpired already in this 3rd IVF (hoping it’s the last!). My RE did say this protocol would be more similar to the first protocol I had but ultimately she did make a minor tweak in the Menopur dosing. Instead of 150 IU, she increased it to 225 IU.

DAY 12 – LH SURGE

DAY 20 – START CLIMARA PATCH #1 (8 DAYS AFTER SURGE)

DAY 22 – CHANGE TO PATCH #2

DAY 24/ DAY 1 – CHANGE TO PATCH #3. NEW PERIOD STARTS

DAY 2 – GO IN FOR BLDWORK + U/S. SIGN CONSENTS. PAID FOR CYCLE FEE. INJECT GONAL f + MENOPUR 225 IU EACH X 4 NIGHTS.

DAY 6 – BLDWORK + U/S. INJECT GONAL F + MENOPUR 225 IU X 2 NIGHTS.

DAY 8 – BLDWORK + U/S. 4 -5 FOLLICLES SLOWLY GROWING. EXTRA VIAL OF BLD DRAWN FOR CO-CULTURE (ABOUT 25 CC). INJECT GONAL F + MENOPUR 225 TONIGHT, THEN ADD CETROTIDE 1 CARTRIDGE TOMORROW NIGHT.

DAY 10 – BLDWORK +U/S. SAME FOLLICLES STILL GROWING. CONTINUE PROTOCOL X 2 NIGHTS.

DAY 12 – BLDWORK + U/S. SAME FOLLICLES SLOWLY GROWING. CONTINUE GONAL F + MENOPUR 225 IU AND 1 CETROTIDE CARTRIDGE.

DAY 13 – BLDWORK + U/S. SAME FOLLICLES NOW ABOUT 15-16MM IN SIZE. 1 SMALLER FOLLICLE AROUND 12MM. INJECT GONAL F +MENOPUR 225 IU AND 1 CETROTIDE CARTRIDGE.

Today is DAY 14 and so far I am waiting for my phone call from my nurse. As of this morning, retrieval date could be this Wednesday or Thursday. I saw my RE last week and asked her who would be performing my retrieval this week (of course this was the main thing on my mind!). she informed me it would not be the doctor who performed my last retrieval and that she would not put me through that just because she thought it would be too traumatic! (like thank goodness).

As it turned out, I did see the doctor who performed my last retrieval in the hall (I don’t think he saw me) and as I waited in the room, I could feel the fear hitting me as my thoughts drifted back to December last year. I could feel my eyes starting to feel funny like when you’re about to cry, but somehow, I held it together and brought myself back to the present. No one thinks this complication I had in December will happen again, so I am counting on them to be right. I’m just taking it day by day right now and when retrieval day comes, I’ll just have to to brave (GULP!).

So that’s where I’m at now. Wish me luck! I hope this IVF cycle’s the last!

 

IVF Co-Culture Done, IVF #3 On the Horizon

It’s been quite some time since my last post, but of course life always manages to throw some extra challenges our way. What’s been going on in the past few weeks?

At the end of April, I went in for IVF Co-culture. I think I put too much thought into the procedure and it actually wasn’t bad at all (causing myself a bit of needless anxiety). The day before the co-culture biopsy was to take place I went in early for blood drawing. In total, the assistant filled 6 or 7– 25 cc syringes. It wasn’t too bad, I made sure I ate breakfast and she used a butterfly needle. I think my anxiety about the blood draw stemmed from my recent experience in the hospital. The multiple blood draws daily, the IV and blood transfusions has made me want to run away from hospitals for good! OK I digress…

Getting back to the IVF Co-culture…

One hour before the biopsy, I took 400 mg of Ibuprofen as instructed. After a negative urine pregnancy test, the assistant took me to the procedure room. The room is actually the same type of rooms used for ultrasounds during IUI or IVF cycles. The biopsy took about 10 minutes in total. A speculum is used, then a catheter is inserted to suction the sample of tissue. The sensation you feel during the procedure is very mild cramping and the tissue suctioned is immediately placed in a cup. I had no problems getting dressed and making my way back home via the train. Spotting is common but I did not experience any. Thankfully, I survived this one without complication!

Also in the same month as co-culture, I started to experience panic attacks. For those of you who have never had one, it’s actually a pretty scary thing. Basically, you feel as if you can’t breathe, feel extremely anxious and you’re afraid you’re going to die. Sounds overly dramatic? Not to the one having the panic attack. So I’ve been going to therapy for about a month now and have gotten over the cycle and fear of my anxiety attacks. My therapist thinks the attacks are partly due to post traumatic stress from my recent stay at the hospital (see complication after IVF post). Mentally, I feel stronger than I did in April when my panic attacks started. Emotionally, I am feeling more stable and not a hot mess whenever someone would ask me “how are you doing?.”

I am happy to report I can ride the NYC subways without fear of an impending anxiety attack now! Hooray! It has taken me quite a bit to get to this point. Working through anxiety is tough sh@#$%t!

So what’s on the horizon? Hubby and I are still ttc on our own but decided if no ++ turn up on the urine sticks then IVF cycle #3 it is (gulp). A few months ago, I definitely couldn’t wrap my mind around another IVF, but now I can think about it and not be frozen with fear. We just pray for no complications this time.

Stay tuned possible IVF #3 mid July.

(the center is closed for most of June!)

 

 

 

 

IVF Co-Culture – Scheduling and Basic Info

 

I wanted to write a post about (IVF) Co-culture to help those who have been recommended it and need some basic information. When my doctor first recommended the procedure to me I couldn’t find much info online or in the forums. My post references the info I obtained by scheduling a co-culture  biopsy date at New York Hospital Weill Cornell’s  Infertility Center, the Ronald Perelman and Claudia Cohen Center for Reproductive Medicine. Please keep in mind, this info is basic and specific to this center. The protocols at your center may be different so always discuss your concerns and questions with your RE or your infertility nurse.

 

Just to give you a quick review, since Fall 2010, we have been through 5 IUIs and 2 IVF cycles, all without success. The 1st IVF in 2012 resulted in 8 eggs, 6 fertilized (without ICSI), 3 transferred, none frozen. 2nd IVF resulted in 2 eggs, 1 fertilized,  1 transferred (I did have some empty follicles!@#$$%^!!!!).

Protocol in 2nd IVF was different with the addition of Clomid before stimming and delaying trigger until the follicles were larger and more mature. The embryo quality in the 2nd IVF was of poorer quality which brings us to the Co-culture recommendation. For the next IVF, the plan is to add co-culture and go back to a protocol similar to the 1st without Clomid since it did not help.

 

Here’s what I learned:

  • Not many centers perform this procedure
  • Co-culture involves biopsying the uterine lining to harvest the endometrial cells. The cells are prepared and grown in a dish for about a week then frozen. They are thawed close to retrieval time. The embryos are placed on the cells the day after retrieval. The idea is the cells help the development of the embryos and hopefully improve quality.
  • Biopsies are performed Tuesdays and Thursdays only
  • Biopsies are performed in the luteal phase  5-12 days after your LH surge
  • LH surge must be monitored with an ovulation kit, cycle where co-culture biopsy is scheduled, you CANNOT try to conceive on your own
  • Blood has to be drawn prior to biopsy and again during the stimming cycle before HCG (in an IVF cycle)
  • All cervical culures must be complete and not beyond 1 calendar year of biopsy date
  • It is possible to have co-culture biopsy and go straight into an IVF cycle
  • The charge for co-culture is $1000 US payable when you start the IVF cycle
  • There is also a doctors fee
  • Biopsy is performed without any anesthesia. It is recommended I take Ibuprofen 400-600mg an hour prior to the procedure.
  • They say I can return to work after the biopsy and moderate cramping can occur

 

Since I haven’t had the actual biopsy yet, I can’t say describe what it feels like so I’ll add that in another post afterwards.

Ever since the complication in December, I get so anxious when I have to go back to the hospital! Wish me luck!

 

 

 

 

My Other Journey – Living More Green (Something more fun than Infertility!)

Ever since we started our infertility roller coaster, I have been working hard on this (other) goal of becoming healthier. Not only have I focused on my weight, the foods I eat and mindset, I have also been mindful of the products I use. I have read when women prepare to start a family; many of them make lifestyle changes. Perhaps on some level, this has happened to you. I have read women stop drinking caffeinated coffee or switch to decaff. Some quit habits such as smoking, drinking or doing drugs. Others start exercising and eating better. Personally, I did switch to decaf coffee, started exercising and eating better. I also decided to change things up by switching the chemical laden products I used to simpler, more natural products and that’s what I share with you in this post.

I recently picked up a book by Dr. Alan Greene called RAISING BABY GREEN. I haven’t read the entire book yet but have read through the chapters important to me. One thing I like about the book is it’s divided into specific chapters so I can read what I want. So far Chapter 1 speaks volumes to me. I have never been a fan of artificial ingredients like sweeteners or artificial colorings and have been more of a naturalist at heart but this chapter really enlightened me. It’s titled, The Womb, and hits home the effects of the environment on a mother and baby. I wanted to share some startling points for me:

  • The umbilical cord study (study by Environmental Working Group which tested the umbilical cord blood of 10 babies born in US hospitals for industrial chemicals. The results are scary; over 200 chemicals were identified).
  • How buying organic foods has much positive impact: on our drinking water, milk (think growth hormones and antibiotics), fruits and vegetables, on our soils and lands, the treatment of agricultural animals, hormones used in livestock and how many billion barrels of oil are imported annually.
  • How something simple like switching the regular foods your children eat to organic versions can reduce or eliminate the breakdown products of pesticides found in their urine.

I SO don’t want any of these or any other chemicals in my body or my families’. So in the past year, I already decided (probably like many of you) to get my body into prime baby making (and baby keeping) shape. I started researching chemicals and what their potential harmful effects are and decided to simplify and de-toxify my life as much as possible. So far, these are the items I’ve switched out, but it’s still a work in progress.

     BPA

To avoid this estrogen mimicking chemical, whatever I use that comes from a can, I have either purchased it in a BPA FREE can or buy it in dried version (e.g. beans). I personally use Eden’s Organic Cannellini White Kidney Beans. Instead of paying US$2.99/ can at the outside grocer, I can pay US$1.86 online (which is a huge difference).

I’ve also changed food containers from plastic to glass. Dr. Greene in his book advises to minimize eating and drinking from plastics with the recycling numbers 3, 6 or 7 because harmful chemicals can leach out. He says to opt for symbols 1, 2, 4 or 5. Even better is if you carry your food or water in stainless steel or glass containers. I carry my water in my SIGG Hello Kitty Aluminum bottle! (The lining is BPA free and it’s way cute!).

     Chemical exposure

To lessen the amount of chemicals exposed to my skin, I looked at the products I use and did Spring cleaning.

  • I replaced my (favorite) Bath and Body Works anti-bacterial hand soaps (filled with Triclosan) with Dr. Bronner’s Castile liquid soap. I use it to clean the dishes, bathroom sink, tub and toilet (added with baking soda and a little dilution). It’s a pretty versatile soap.  The best part is I scent the hand soap with a few drops of Lavender essential oil and I am in heaven (I just love Lavender!).

Chemicals just have harmful effects. They’ve been known to cause allergies, skin problems, disrupt and mimic hormones and cause cancer. They are showing up in our bodies, our waters and our wildlife. I do think of what the impact of all these chemicals will be on our health decades from now as well as our children we all are trying so hard to conceive (and boy, hasn’t it been hard trying??!)

  • Replaced artificially colored and fragranced lip stains with Burt’s Bees Honey Lip Balm and Crazy Rumors Hibiskiss lip color.
  • Replaced chemical sunscreen (Neutrogena Helioplex) to a mineral sunblock. (I totally loved the sunscreen until I developed an allergy to the chemicals. I was horribly itchy with red bumps every time I used it). Badger’s Baby Sunscreen uses NON Nano zinc oxide and contains mostly organic ingredients. For lip protection, I use Alba Botanica Mineral Terra Tints SPF 15 and Loving Naturals Sunscreen Lip Balm SPF 30. The Loving Naturals has a more pasty texture due to the higher percentage of zinc oxide (24.8%) compared to the Alba brand (5.5%). The Alba has a hint of color whereas the Loving Naturals does not.
  • An interesting tidbit about decaffeinated coffee, it still has some caffeine in it! But besides this, did you know there are several ways coffee beans are processed to lessen the caffeine content?? I sure didn’t know until I read about it in RAISING BABY GREEN. The 2 ways without the use of chemicals are the Swiss Water Process and CO2 process. The other methods utilize chemicals! OMG. The things I did NOT know!!! Now I only buy decaf coffee marked Swiss Water Press or has the logo.

As you can see, I’ve become semi obsessed, ehem, PASSIONATE about my other goal detoxifying our lives. I hope by making small changes here and there will make us healthier down the line. It’s been fun researching and trying out new ways of doing things. It’s also been very helpful to have my mind on other things besides injectable meds and ultrasounds! (We love those don’t we???).

I recently started working out again which has been great. To compete with my fast metabolism, I’ve been focusing on more healthy proteins, more high fiber veggies and fruits (can’t forget the carbs though, luv my rice and pasta!). After my complication post retrieval, I was so worried about losing all the weight I put on last year. What a feat!!! Not one pound lost!

2012 was the first year I started purchasing organic produce. For anything I cannot buy organic, I use this to wash; Environee Fruit and Vegetable Wash.

For those concerned about pesticide amounts in produce, here’s a helpful list made by the Environmental Working Group, http://www.ewg.org/foodnews/summary/

Arsenic in food,

http://www.consumerreports.org/cro/magazine/2012/11/arsenic-in-your-food/index.htm#chart

 These are just some of the changes I’ve made. What are some things you’re doing to change it up and get healthier??? Please share what interesting facts you’ve learned and what kinds of products are you changing up???

This one’s dedicated to my online peeps!!!

My sanity would not be here without you!!! Xoxo

hopin’ and prayin’ for us ttc 2013