Sunday, January 31, 2010

Our IVF Journey, Part V – Bedrest, Believing & Beta Test

This is Part V of a five-part post. For the first few posts on our journey, read:

Our IVF Journey, Part I – The Two Zees, Infertility and IUIs
Our IVF Journey, Part II – Infertility, Disease and PGD IVF
Our IVF Journey, Part III – PGD IVF (needles and drugs)
Our IVF Journey, Part IV – Retrieval & Transfer

The first five days after the transfer I was on strict bedrest. I could only get up to go to the bathroom and that was it. Opinions on bedrest vary from RE to RE. The latest statistics show that any bedrest past the first few days does not improve pregnancy rates, but I wasn’t taking any chances.

Tall Man gave me my intramuscular progesterone and delestrogen shots while I laid on my side in bed. I iced my bootie for a few minutes before the shot and then used a heating pad after while we massaged the injection spot. I had to lay flat on my back most of the time, sitting up only to eat and then back down. My husband and friends were my angels helping to keep me company, keep me fed, and keep me busy. Electronic yahtzee was a lifesaver. I’m a geek, what can I say?

The sixth day post-transfer was shower day. Hooray! I never thought a shower could feel so good. Even so, I kept it short and rested for the remainder of the week. I won’t tell you that the resting was easy. My heart wanted this so badly and my mind was racing. I was on emotional roller coaster ride of my life. I wondered, will this little twinkle in my heart ever become a baby? It will. It will! I just had to trust in God and stay positive.

Eleven days post transfer we had our blood test to detect if a pregnancy had taken place. It took all of five minutes to draw the blood. The medical vampire, professionally known as a phlebotomist, calmed us down as we sat there rambling. We were in and out of the office in no time, but then came more waiting. After weeks of waiting, what was a few more hours, right?

Tall Man and I drove around for a bit until settling at home a few hours later to wait for the doctor’s phone call.

At exactly 11:14am, the doctor called and asked for “the infamous Ellie.” I told him it was me, then I heard him say, “one, two, three,” and the whole office shouted, “You’re pregnant, Ellie.” I was stunned, happy, giddy, and about a hundred other emotions. I said, “thank you” and we hung up. As if my little “thank you” could ever express the amount of gratitude I have in my heart for our RE and his team of beautiful professionals.

“Blessed be the Lord,
Because He has heard the voice of my supplications!
The Lord is my strength and my shield;
My heart trusted in Him, and I am helped;
Therefore my heart greatly rejoices,
And with my song I will praise Him!”
(Psalm 28:6, 7)

I don’t think I was ever able to appropriately thank our friends, family, Dr. Werlin, his staff and so many others who showed such great love for us during this time. God answered our prayers. He is so merciful that we have a baby who did not inherit the deadly gene! He is now two and a half and his picture graces this post.

We are truly amazed by God’s love, grace and mercy. Blessed be the Lord!

Tuesday, January 26, 2010

Our IVF Journey, Part IV – Retrieval & Transfer

This is Part IV of a five-part post. For the first few posts on our journey, read:

Our IVF Journey, Part I – The Two Zees, Infertility and IUIs
Our IVF Journey, Part II – Infertility, Disease and PGD IVF
Our IVF Journey, Part III – PGD IVF (needles and drugs)

Retrieval Day – Exactly 35 hours after the trigger shot was egg retrieval day. My husband and I went to the surgery center, where I changed into an ever-so-stylish hospital gown, cap and booties. The nurse started an IV and within minutes my gurney was wheeled into the surgical room. The RE and anesthesiologist greeted me and comforted my nerves. The doctor turned my attention to the ultrasound screen to show that my follicles were still there. I prayed that they would all contain viable eggs. Counting backward from 100…99, 98, 97…I was out!

•I woke up in recovery with cramps and a strange hankering for chili fries. The doctor told me that everything went very well and they retrieved 22 eggs. Wow, what a day! I went home, gingerly walked up the stairs, and plopped into bed for the rest of the day. No chili fries for me.

1 day post retrieval – The doctor called to tell us that 21 out of the 22 eggs were injected with sperm. Still great numbers! We were happy.

2 days post retrieval – the doctor called to say that 12 of them fertilized, 2 were abnormal, 4 degenerated, and 3 were still iffy. We were so happy with 12 fertilized embryos. This would normally be when the embryos are returned to the uterus. Most IVF protocols without PGD are day 3 transfers. However, because of PGD, our journey would take an extra detour here.

3 days post retrieval – Our 12 embryos were biopsied. Each of the twelve embryos still growing and dividing in the lab would have one cell removed for PGD. This process does not harm the embryos. Those individual cells were then sent overnight to the Reprogenetics lab in New Jersey for the genetic probe test. Within 24 hours they notified our doctor which embryos were affected with the defective gene.

4 days post retrieval – Waiting day…no news at all.

5 days post retrieval – Embryo transfer day. I felt like a mother penguin who lays her egg, transfers it to the male to incubate and then returns after a long winter to reclaim her baby penguin. My eggs were retrieved and left to incubate at the fertility center and this was the day I could come back to reclaim my babies. Oh the joy!

We received a call that morning only hours before the transfer about the status of our embryos. The genetic tests revealed that 7 of the embryos were affected with the defective gene and 5 were free of disease. The tricky part is that these were just the biopsy results. This process also hinges on the hope that the embryos which don’t have the defective gene are still growing and dividing back in the lab.

The doctor gave us the great news that 3 of the embryos were of excellent quality and if we agreed, he would transfer all three blastocysts. Three was our number! Sadly, the other two stopped growing and went to heaven to be with Jesus.

So, Tall Man and I put on our hospital gowns (yes, he had to wear one too). They wheeled me into the room for the transfer. The doctor showed us the ultrasound screen where he inserted the thin catheter into my uterus…and voila…it was finished. The embryos were gently placed far back in my uterus into the lining. Home sweet home!

Then everyone in the room counted to three and said, Get pregnant, Ellie! I spent the next hour inverted on the gurney (head below my feet), so the embryos wouldn’t move. I was overwhelmed with emotion as Tall Man and I began to pray for our little “penguins” and prayed for God to protect them and grow them.

Hubby drove me home while I laid flat in the back seat of our car. I told him to be careful as he was driving a family of five!

Tuesday, January 19, 2010

Our IVF Journey, Part III – PGD IVF (needles and drugs)

This is Part III of a four-part post. For the first few posts on our journey, read:

Our IVF Journey, Part I – The Two Zees, Infertility and IUIs
Our IVF Journey, Part II – Infertility, Disease and PGD IVF

Now, I’ll attempt to describe how my body was prepared for the IVF retrieval and transfer (needles and all). First, understand that an IVF cycle with PGD is very similar to a regular IVF cycle, with one major exception. The embryos are biopsied prior to embryo transfer. Even though women’s cycles and protocols may vary, here’s an account of our cycle to give you an idea of what can be expected.

Our RE started the entire process by putting me on the birth control pill. This is the first step to the doctor controlling my cycle. It is also protection because the drugs being injected will harm a fetus so they want no chance of pregnancy during an IVF cycle. About two weeks into the birth control pill, it was time to begin the injections. I was nervous at first because I had never done anything like this before. I don’t even like giving blood because needles scare me. My husband and I traded off doing the injections. The injections were subcutaneous, which meant tiny needles just under the skin. After a few days, my fears subsided. It was just another hurdle toward our beautiful goal. Anything for baby, I just kept telling myself.

The first injectable drug was Lupron. Lupron was used to fully suppress my cycle where everything and anything natural is stopped. About two weeks into the Lupron, I started the stimulation drug, Follistim. It does exactly what the name suggests, stimulate follicle growth. Normally, your pituitary gland naturally secretes the follicle stimulating hormone which tells your follicles to grow. However, since the Lupron had suppressed my entire natural cycle, I needed to inject the Follistim in order to grow my follicles “manually.” I also continued the Lupron injections so I wouldn’t accidentally ovulate before the egg retrieval.

At this time in the process I was going to the doctor every other day so he could see via ultrasound how the follicles were growing. I didn’t feel any side effects from the Lupron or Follistim. No hot flashes, nothing. At one point in the process, I even wondered if we were doing it right and if the drugs were getting into my system. Well, the ultrasound revealed something was happening because we saw all of the follicles on the ultrasound screen. It was then I knew the drugs were working.

On day 10 of the stimulation drugs I had an ultrasound and most of my follicles were between 18mm and 26mm, a good size for retrieval. I was warned that some eggs would be too mature and others would be immature to inject with sperm. The doctor told me to administer the trigger shot (HCG) at 9:00pm that night. It’s a timed shot, so it has to be exactly 35 hours prior to the retrieval. This is one shot that leaves no wiggle room for mistakes.

He prepared the syringe and I prepared the injection site by icing it for a few minutes. This shot was an intramuscular shot which had to go in my hip/bootie area. Not fun. My husband inserted the needle, and began injecting the HCG. I asked if he did the shot yet because I didn’t even feel it going in.

He was so excited that it went so well, he pulled it out rather quickly and a different angle. Ouch! I started bleeding and we both panicked. Did I get enough HCG? Why was I bleeding? What happened? I called a friend who recently went through PGD IVF and she and her husband walked us through our emotions and fears. She reminded me that my labwork the next day would reveal the HCG in my blood and that I had nothing to worry about. She was right.

Tuesday, January 12, 2010

Our IVF Journey, Part II – Infertility, Disease and PGD IVF

As we approach my son’s second birthday, I thought I would share the journey that led to his birth. For the first part of our journey, read Our IVF Journey, Part I – The Two Zees, Infertility and IUIs.

Here is Part II, which covers our continued infertility issues, genetic disease and PGD IVF.

After the three clomid cycles and two failed IUI cycles, we were frustrated and fearful that we may never be able to have a child. Our ob/gyn referred us to a reproductive endocrinologist (RE) to consider the next logical step, which in our case was invitro fertilization (IVF).

However, there was one item we had to get clarity on before moving forward to IVF.

Disorders, disease and other single gene defects
In our case, our journey took a brief detour because we had one hurdle we needed to get past before continuing on to IVF. We had known for years that my husband was at-risk for a genetic disease, but moving on to IVF meant it was probably time to be tested. To protect my husband and our family, I won’t mention the specific disease by name, but it has devastating if not terminal effects.

We couldn’t help but ask God why we weren’t getting pregnant even after the IUIs. In the back of our minds was the possibility that Tall Man had inherited the gene. So, we prayed and the answer we received was that it was time to put the baby making on hold and get tested for this disease.

God’s plan was better than our plan and looking back, we can know see His mercy that he didn’t allow us to get pregnant on our own so the gene would not be passed on to our children.

Within months we were face-to-face with a genetic counselor who would read the results which would change our lives forever. The test came back positive. We knew how we would have to move forward.

Having this new information regarding the genetic disease was bittersweet. Yes, this meant my husband would eventually suffer this fate, but it didn’t mean my children would have to.

With a fairly new procedure called, pre-implantation genetic diagnosis (PGD), my husband and I could go through the IVF process and use PGD to detect whether embryos had the defective gene or not. Our insurance did not cover the IVF procedure nor the PGD procedure. This was our only hope for a baby.

PGD IVF is an option for couples who face single-gene defects like cystic fibrosis, tay-sachs, sickle cell anemia and huntington’s disease. It is also used for recurrent miscarriage.

I will describe our entire PGD IVF process (needles and all) in my next post.

Tuesday, January 5, 2010

Our IVF journey – Part I (The Two Zees, infertility and IUIs)

As we approach my son’s second birthday, I rejoice in the fact that he is our little miracle. To celebrate the little twinkle in my heart that became our twinkle baby, I thought I would share our story of infertility, disease and PGD IVF which led to the birth of our son.

So, lets start at the beginning:

Our IVF journey – Part I (The Two Zees, infertility and IUIs)

Tall Man and I were married in 2002. In 2004 we began trying on our own to grow our family (I was 34 at the time). This was exciting at first, but after a year ovulation calendars, tracking basal body temperatures, and negative home pregnancy tests, I went to my doctor to have “the conversation”.

My OB/GYN was extremely blunt with not a warm fuzzy in sight. I caught a glimpse of my medical chart and she had written the word, “infertile” on the top page. It was then I realized we had a problem.

Tests revealed that I had an elevated FSH, which can be an indicator of diminished ovarian reserve. I had no idea a simple blood test on day 3 of my cycle could tell me that my pituitary gland was working overtime to produce Follicle Stimulating Hormone to grow my follicles each month. Who knew?

She sent me home with a prescription for Clomid and told us to get busy. We did this for three months and nothing changed.

She also recommended that Tall Man have his little swimmers analyzed to see if he was adding to our issues. Turns out we did have male factor issues (low sperm count and varicoceles).

Our chances of conceiving on our own were pretty slim, so I switched doctors (warmer and fuzzier) and we did two cycles of Intrauterine Insemination (IUI) with clomid. During these cycles my follicle growth was monitored with ultrasounds. The insemination was a simple procedure done right there in the office. Still…nothing.

After three clomid cycles and two failed IUI cycles, the wind was knocked out of our sails. We took a break from trying and re-directed our prayers.