Update...

Been awhile since I have wrote so thought I would keep people updated and clarify a few things.
Nothing really exciting happening lately.  The clinic in California needed some blood work, swabs and a saline infused ultrasound to check out my uterus.  I had not had this done before so I wasn't sure what to expect.  If you are interested in details...check out this web page...it's pretty accurate.

http://www.dreamababy.com/downloads/Saline%20Infusion%20Sonography%20(SIS)%20Patient%20Information.pdf

To prep for this...I had to first get a period.  Easy..right?  Well, at the time I was at least 7-8 weeks with no period.  I initially thought a miracle had happened and I was pregnant.  Nope!  Blood work was normal...just my body being my body!  Could be different reasons for this...my body is confused with all it has been through over the past year or so...or could be the beginning of my pre-menopause stuff.  Really...other than not being able to try naturally....was kind of nice!!  Anyway, it really was an easy fix...on birth control for 10 days...then I got my period.    I wasn't sure what to expect for the procedure itself. I had visions of my uterus be pumped full of saline, feeling bloated and seeing something on the ultrasound screen like my bladder when it was full.  It was actually pretty quick and painless. They used a catheter to insert the saline while a internal ultrasound was done.  The worst was having the pap done and speculum inserted....the joys of being a woman eh!:)

So..now I am back on birth control.  This sort of puts my body in limbo/a standstill so to speak.  We are just waiting to hear back from California regarding our schedule for the summer.  

I have had a few questions about this whole egg donor thing.   Basically our donor will go through the first half of the IVF process up to retrieval of the eggs.  Dennis' sperm will be used to fertilize.  Then embryo's will be transferred into me.  So...I get to carry!  So, they aren't mine genetically but I get that bonding time for 9 months!  Fingers crossed!!!  If you have any questions let me know..  I will likely get into the whole process more as we go through it...

Exciting funding news!!

For anyone knowing someone who might be starting IVF treatments in the future...check these links out.  It is about time the government steps up!!

http://news.ontario.ca/mohltc/en/2014/04/improving-access-to-safe-fertility-treatments.html


http://news.nationalpost.com/2014/04/09/ontario-to-fund-in-vitro-fertilization-with-a-caveat-one-embryo-at-a-time-to-cut-risky-multiple-births/

Time for a break...

After finding out we wouldn't be starting the California protocol this next cycle we decided we would try another round...why not. They say after even a month off your body can have more success.  We ended up starting a short cycle IVF protocol with all the hormone injections it came with.  In the end we switched to an IUI again.  I had 3-4 good size follicles and Dennis' numbers were good! If it was going to work....this time should have been it. I really thought it was going to!!  Unfortunately, it did not.

After that cycle I decided I needed a break...for awhile....both physically and mentally.  If we are going to do the California egg donor...I needed to be 100% into it and ready.  Making the decision to take a break for me was still hard...despite my need for rest.  Part of me felt like I was giving up, wasting time.  We could still be trying, still have a chance...each month that goes by is a waste! I realize this isn't true but our minds do go in circles sometime.  Many people who knew we were doing this would say "You can still practice"  "You never know".  It is true...you never know...but for us to conceive naturally with no drugs and help would be one friggin' miracle!!

So, I have to say...it has been nice having my life back so to speak.  Nice not to be taking medication and ensuring I have my medication or needles with me before leaving the house.  I am still hormonal....what woman isn't?  But I think my highs & lows are better....I think:)  (Don't ask Dennis...might be a different story).  We have basically decided our next steps will be prepping for the California protocol.  We have looked at more profiles but are sticking with our original choice.




In my last post I alluded to things happen for a reason.  As most of you reading this blog know I accepted a job with the Spinal Cord injury program.  I start in a couple weeks!!  When this post came up I was at a point where I needed a change, a new aura to be around and a new challenge.  I at first wasn't sure but as I got thinking about it, I thought why not.   I say things happen or a reason because I am unsure I would have applied if I had already been pregnant...who knows....  Either way, it is a great move for me and I am very excited.  Sad to leave my current colleagues...yes a bit nervous...but it feels right...time to move on.

New year...new challenges...new excitement!!

They say things happen for a reason, and I do believe that.  In the moment...I hate that saying...but reflecting back I can see many things that wouldn't have happened if we had gotten pregnant all those times.  We have had a lot of fun and adventures which many of you have followed on facebook.:)  I am not saying kids will stop us from that...but it will be different.  So...if I give one piece of advice to anyone reading this who is going through similar struggles...keep on living...keep on doing things you love, keep doing things you and your partner love.

So..2014 started off with us deciding it was time to move.  We contacted the clinic in California and were waiting for them to send us profiles.  My understanding was we would pick someone, see if they were available, do legal stuff, send off drugs, she would start her cycle and by Feb-March we would be down there....

So...to get profiles of women..we had to send characteristics we wanted...So weird and surreal.  We naturally said curly hair, brown, causcasian, good shape, healthy....what else do you say when you are ordering your child's mom?:)  We also sent them a picture of me to help them out.  So basically they have a pool of donors that are part of their clinic.  What is nice about this clinic is they don't take a cut of the donor compensation fee..(so is a bit cheaper I guess).  They sent us multiple emails with multiple donors.  We would get pictures and a profile. How much we got of each varied.  Generally we knew her age, height, weight, eye colour, hair colour, etc, schooling, family information, health.  Some of the forms even had a place they could write about themselves or why they wanted to be donors.  It was a interesting, surreal and unusual as we sat down and looked through everything....overwhelming at first might be the best.  There are a lot of variables to consider.  Many were young...18, 19, the oldest 29 that we came across.  Some were going through school, others single mom's, others just wanting to "help out".   Some we vetoed right away based on medical issues, weird selfies,  odd comments on the form, etc.   We both had to agree on the person.  We had to like how she looked,  Dennis had to think she was attractive(naturally), healthy, good family history, active, seemed to genuinely want to help (based on the  writing).   And I was really banking on curly hair.  BUT ...apparently in that area of Cali...not a lot of curls happening.   I was sort of disappointed in that...everyone knows me by my curls...but really in the end...won't the Asian genes take over??:)    Anyway...we both had to have a good vibe from her, feel like she would be someone we would hang out with.  Believe it or not there are websites to help guide you through this process



  We narrowed it down and came up with our number one pick.   We then found out we were on a waiting list...June/July would be the earliest!!  WHAT?? Wait longer??  I was NOT a happy camper. I had allowed myself to move on, to think optimistically, to be ready for the next move, planned (see...the problem..planned) things would be going in a month.  I had anticipated being pregnant in the summer.  I guess I was really just tired of life being put on hold for an unknown amount of time with an unknown end result. I wanted things to move along now that we had a plan starting.  Little did I know there were other things I needed to do first for me.  

Acupuncture release.....

Many of you know that in the fall I took an acupuncture course.  A group of us from Parkwood went to Toronto for our 3 day on site training. Two of the days were mainly hands on.  In small groups we would be shown a point, then we would buddy up and practice on each other.  While my partner was doing the back points (GV 3, GV4, BL23 and BL25) I had a bit of a weird reaction. I was anticipating it might be uncomfortable as my low back doesn't really flex much...okay...I barely get it flat (insert comments from my physio colleagues here).  So...I thought it might be trickier to landmark, insert and manipulate the points.

Needles in...fine.  One of the instructors and my partner were fiddling/adjust one of the needles. I don't recall any pain, but maybe a flash and suddenly I was crying...I mean UNCONTROLLABLY.  I wasn't hurt, I wasn't thinking about anything...just full out weeping.  My partner felt awful, he looked so shocked and worried.  They pulled everything out and I just lay there. I couldn't stop...I tried to breath, talk myself down and then it would literally bubble out of me. It wasn't till she put a need in the "Happy point"GV 24.5 that I was finally able to calm down.  By the end I was SO exhausted, had bags under my eyes and bruises later. It took part way into the next week till I felt my energy was back.

The instructor reassured me this can happen with people, it isn't common but does happen.  People can get an emotional and physical "release"...something your body needed.  She says it is common post MVA.  Later when nobody was around I asked her more about it and told her a bit about my fertility journey.  There is a good chance it was linked.  WEIRD!

Please don't let this turn anyone off from acupuncture for any treatment. A reaction like this is extremely rare! I have had some amazing success with my patients and think it is a great tool.

Making a big decision...

In the last post I spoke about my CRA CRA moments....my moments of sadness and confusion, my moments of being irrational and then rationale after.  This was a pivotal moment for me in a way.  Trying to weigh out how much I wanted to pursue IVF no matter what (therefore my own biological child) with low percent chance and a price vs wait and use that money for an egg donor which has a MUCH higher success rate, vs adopt but run the risk of the child not being ours.  There were points during this downward spiral and during other poor me moments that I would think....DO I REALLY WANT A CHILD???  Maybe these are signs, maybe I am not meant to have children..  Maybe we should just take this money and travel the world!! That would be amazing....  Ride our motorcycles...  Possibilities are endless.  It is amazing what our minds can do. But I know we want children, that this is what we want...but it is hard.

At times I need to remind myself of all that is good.  We are healthy,  we have each other and amazing friends and family, we have great jobs, are stable and enjoy life! I remind myself that so many times.  When others ask how we keep going..... I tell them this...because it is true...this sucks...but there are worse things in life by far.

 Anyway, by this point in the year my body is exhausted too. My body doesn't know what normal is.  In the past 12 months it has been pregnant, miscarried, lots of ultrasounds, lots of needle pokes and a crap load of drugs/hormones.  I think in general I was struggling.  When talking to Dennis about it...he hears me...but doesn't have that emotional spin like I do.   When thinking about our options he is open to anything.  Me?? I don't know...in the midst of my spiral I try to figure out what is really upsetting me.  In the end... the questions going through my head are:

• When is it okay to move on to the next step?  
• How long can I continue like this?
• Am I giving up if I say no more IVF/IUIs?  (There is still that low chance of me having my own biological child.)
• Does genetics really matter?

I know that we will love a baby no matter what...I KNOW that...but giving up that possibility and choosing to move on and truly accept it...it is tough...one of the toughest things to do.  I ended up calling and talking to a friend who has a different journey but had to make that tough decision.  When i say talk...I think I sobbed and blubbered into her ear....but to talk to someone else and hear her story and how she coped/felt in this moment helped a lot. I knew nobody could make my decision but I needed to just talk it out.  I love Dennis dearly...but I needed to do this with someone who had been through it.  She helped me normalize my feelings and realize it was okay...and would get better.  After that...I was feeling like I was leaning toward moving on...it was time to start the next step...

More cycles, more drugs...

So our failed IVF transferred to IUI was a negative beta...but a clinical negative..meaning something happened.   In one way this was awesome...but in another way was it just making us hang on to this glimmer of hope??  I felt like my emotions were in the middle of a tug of war match.  So we met with Dr M at SOFT and had a hopeful talk.  Dennis' numbers were up last cycle...lets continue with stimulated IUI's (injections but lower dose) or if my follicle numbers look good early in my cycle start a short protocol IVF.   There was no reason things "shouldn't" work...we would just have to be patient with my body.  Pretty much the same advice we got from Dr H in California.  So great! How long do we wait?  When will my body produce more follicles.  These are all questions nobody has the answers for. If we were in our 20's...no biggie...but we aren't!

• So, the next cycle(October) was natural cycle, low numbers for both of us...Negative.

• Next cycle(november), Stimulated IUI which means going on a medication Clomid. (makes you feel yucky and nauseated) and then injections(yes, higher doses for me).  Perk of the  injections is by now I was a pro.  Since it was time specific I used to make sure I was always home, cancel plans.  This time I was doing some at the gym hiding in the bathroom and one trigger injection at work.    Follicles were good number and size this month but Dennis had lower numbers.-->Negative

• Next cycle(December) day 3 follicles look promising...really promising...so short cycle IVF protocol it was. Back on clomid.  I was stressed though...for our next ultrasound.  How do you decide if you continue along with an IVF cycle?  How many embryo's is enough to spend that much money and maybe get nothing? I know I shouldn't think of cost...but you do...or I do.  I think of wanting to continue with our journey if this doesn't work(do we save that chunk of money for it...or take the chance with a lower follicle count), I think of wanting to be able to do things and take our children places when we have them.  To be honest...part of me is just plain angry! Please don't take this the wrong way. I know we are fortunate, we are healthy, we are stable and FINE. Honest...just part of me...maybe the CRA CRA part takes over sometimes....and I SPIN!   In the end my body decided....day 8 ultrasound was low number of follicles again..so IUI it was.  --->Negative...Break time for a month for us....New year ....this is our year!!

Egg donor....hmmm

During one of my melt downs after the failed IVF cycle one of the nurses brought up the possibility of doing an egg donor. We had not really thought of this yet. We had assumed that if naturally with IUI or IVF treatments didn't work then adoption was next.  My mind set was that.  But egg donor...really?? How does that work?

Basically it is like sperm donors which seems to be a more common, or talked about thing.  We would use Dennis' sperm and donor we picks egg.  Another pro is that I would get to carry.  My question...can I carry?? I have only been pregnant once.  The consensus is there is no reason I can't.  Yes..my ovaries are on an accelerated aging path but our uterus' don't really age too much.  That's why many women much older than me..think our grandparents...can have children if dosed with the right meds.

The catch...in Canada you can't legally pay a donor/compensate them for helping you. There are clinics who try to "name" it something else what have been caught and shut down..with many women mid cycle to donate or waiting for a transfer.  So...you would have to find someone who would do it(go through the IVF process up until retrieval) for free!  We did have some family and friends offer to donate eggs.  Thank you!! It means the world to us...but we feel it would be too weird. It would feel like we are raising your child.  Not sure that is right...but we needed to be comfortable with our options.  One friend also offered to be a surrogate which is very generous. Our problem isn't me carrying...it is getting me to produce eggs and then fertilize. Getting to that IVF stage isn't' happening.

Our option then would be to go out of Canada.  There are many clinics throughout the world that do this.  SOFT did lot so research and now deals with a clinic in California called Fertility associates.  We ended up doing a consult with their Dr there.  We were encouraged to get his opinion on our situation and as well information on the egg donor program.  More to come about that soon.  Of course with it being outside of Canada it is not OHIP covered and is of course very expensive...over $20 000 plus meds and expenses to go out there.  So...big decisions to come.

IVF cycle...take two

Another busy summer 2012 was! It wasn't what I thought it would be like earlier in the year but we again enjoyed life as a couple with ball games, tournaments, golfing, visits with family & friends, weddings, camping,  and yes the motorcycles!!

Mid August I started the medication protocol for our second IVF cycle. By early September I had started the injections...even stronger this time..so more emotional, weepy and tired and more poor me moments! woot woot!!

Unfortunately, our IVF cycle was transitioned to an IUI.  My day 3 and 6 ultrasounds showed only 2 follicles. They were getting bigger but 2 wasn't enough to proceed with IVF.  This was likely related to my declining ovarian reserve and my body still adjusting to everything that had happened over the past half year. I was really bumbed. I had in  my head this was our "last hurrah" and if the IVF didn't work...move on, but it wasn't a full IVF so did that count?  I was at a huge physical and mental breaking point.  Even the nurses at SOFT noticed it and suggested I talk to someone about it.  I wasn't opposed to that.  I also took 2 weeks off work (booked already because of the IVF) and had some me time and some Ethan & Marci and a bit of Allan time.

The positive of this IUI.....Dennis' numbers were up!! Higher than we had ever seen them...which is awesome.  What next though??  If no luck with this IUI we had a few options 1)monitor my cycles and do a short IVF protocol (no suppressing...just ramping up what my body naturally does)-->which could be transferred to stimulated IUI's if not enough follicles. 2) Start adoption   3) A new idea we hadn't thought of...egg donor...

Considering Adoption

Our plan of starting IVF was delayed a few months due to my cycles taking some time to normalize.  The plan was still to start another long protocol IVF the end of the summer.    We also started thinking of other options.  I had always considered adoption and had heard it was quite a process in itself.   Why not get things started.  We met with some friends who had adopted through Children's Aid and another couple who had adopted Privately.  Both had different perspectives but both had amazing and cute children who they loved and adored. Both couples were so inspiring and had their own fertility journey story.  

So we started our research and found out that regardless of who you go through(CAS, private or international) you have to take this course. PRIDE course( Parent Resources for Information Development and Education) and do a home study.  The lady from CAS said we could  start the process and then would have to stop before starting the home study until we were sure we wanted to continue.  It also never expired.  So, we did the pile of paper work and signed up for the fall course every Wed night for 9 sessions.
One of the forms we had to do was strange to do. You had to rate on a scale about different attributes/characteristics, family things about a child, their family..that you were okay with.  For example would you feel comfortable with a child who has cerebral palsy? Are you okay with a mom who was an alcoholic.  It was very intense and in depth.  You were not judged...they just want the best fit...child and family.

The PRIDE course overall wasn't too bad.  I did learn a lot about CAS and the processes, programs available. I struggled at times with the fact that we were there taking a course to be a parent, to children whose parents didn't want them, abused them or couldn't take care of them.  Did they take a course before they had children?? That was the bitter part of me. I know it is to protect the children..and I get that....but part of me would have to count back wards and cool off occasionally during the sessions.  There were a lot of inspirational moments and wonderful stories of foster and adoptive parents and children.  The part I struggled with the most was that for the first year or more you didn't know if you would get to keep the baby.  CAS' new mandate for One child one home.  If you knew you wanted to adopt you would foster to adopt...meaning you would likely get a baby/young child and if things worked out would adopt that child.  However, CAS' mandate is to get the child back with its biological family if appropriate and safe.  So...there is always a risk of losing the child. But as they said...it is about the child....not the parents. I agree...but doesn't make it easier.

So...we struggled with what to do when the time came to make decisions about proceeding or not...

A reverse beta battle...

So with pregnancies you want your HcG(pregnancy) hormone to go up.  After a miscarriage you want it to go down.  Unfortunately, you have no control over this.  You are at your body's mercy.  Some people take a month others months!!  The plan was once my beta gets to zero, I should get a period. We were going to wait a full cycle and then give the IVF one more try.  It was the only thing that has ever got me pregnant..and it worked!  The miscarriage was just one of those things.

So....we waited, and waited....I would go for weekly blood test and it would crawl down.  We kept busy though with work,  day trips, week out East to meet our new nephew.  I was feeling better over all with less emotional outbursts...but I just didn't feel me.  I also was struggling with losing the weight I had put on..it wasn't a lot..but I felt bloated.  Also, I was upset that my body was stalling things, wasting valuable months to try...I wasn't getting any younger!  Now..I know we aren't old...but regardless of your age and how much you tell yourself not to...you have a time line/an agenda in your head. I was hoping to have things going and be pregnant again by time my original due date....but it didn't seem like that was going to happen.

May rolls around and I finally get my period! Yay!!  I go to SOFT for my day 3 blood work and ultrasound and again new something wasn't right with the image on the screen.  I apparently  had not fully miscarried!  Are you freaking kidding me??  It does help explain why I was still feeling so emotional, bloated and not me...my body thought I was still somewhat pregnant.  The nurses say they have never seen this happen before...usually if your HcG is dropping it's a good sign  So...again I think I have started a new post miscarriage protocol.

So..the plan was to have a D&C which was booked after our weekend away for Dennis' Tough Mudder.  I will try and not be too graphic in the next few lines but I am trying to talk about things that people don't talk about...but happen. I hope I am not upsetting or offending anyone. So, on our drive up I started having cramps, which progressed into the worst pains I have ever experienced.  I obviously have never given birth but this was my 10!!  To boot we had another couple with us.  They are now great friends but at that time I had not spent much time with them.  Our drive to Barrie was the longest ever. I couldn't get comfortable.  Ibuprofen, Midol, food, nothing helped.  I just kept trying to grin and bear it and twisted in my seat the whole way.   That night was awful, I couldn't sleep, felt sick.. I had an idea of what was happening...but wasn't positive.   The next morning thankfully I felt better. I was able to run around and take pictures of Dennis doing the Tough Mudder. He did amazing by the way and I was so proud of him. One of these years when we are done this crazy journey...I am going to do it!!   Later that day I passed everything....at least I thought I had.  Was a weird and sad moment. I know it was just tissue...but it was part of me.   Ultrasound at SOFT Monday morning confirmed it....so no D&C!

So...with everything finally clear my body finally started to feel mine again....my roller coaster moments were less. It made me appreciate even more how much our hormones do affect us.

Week 12 Ultrasound February 2013

Between our 7 and 12 week ultrasound was tiring.  We were short staffed at work so I was doubly tired by the end of the day.  I don't think I have ever napped or gone to bed so early in my life!:)   Most of signs pointed to things going well.  But I was still nervous.  I very dear friend of mine who was pregnant and a week or so ahead of me found out at her 12 week ultrasound that their was no heart beat. (Positive now..she just delivered a beautiful little girl a week or so ago).  It's such a fine balance...trying to stay positive, calm your nerves...  That being said I was pretty sure it was all good. We had our first visit with a midwife, had put our names on day care lists and were planning how we would tell everyone after our ultrasound.

The day of the ultrasound we were all ready with our camera's once we were given the okay.   But...this time there was no picture taking.  I knew as soon as the image came up on the screen....something didn't look right.  The image wasn't as clear as the first.  The tech excused herself...and got one of the nurses. I knew...didn't want to know. She confirmed what we thought...there was no heart beat. They figured it had stopped around week 8.   There was really no reason...it just happens.  My heart broke, I felt sick to my stomach and I just bawled.   Now over a year later it still makes me cry. Our miracle baby was gone....I had finally let down my guard after the first ultrasound and was excited, allowed myself to feel that excitement. And then this... This wasn't supposed to happen...it was OUR TURN! I went through a lot of emotions: anger, frustration.  We were supposed to be announcing and celebrating but instead I was taking meds to induce a miscarriage.  I felt like a shell.  Some told us to be strong...but I didn't want to hear it in the moment. Dennis...he deals with news differently..and I know he was trying to be strong for me.

I want take a moment to say thank you to all of you who knew and were there for us.  We received food and movie care packages, calls, emails, lots of prayers and words of support.  I know many of you have gone through miscarriages too.  Sharing your stories and how you felt helped normalize my feelings and work through them.    To my work colleagues thank you for putting up with me  and my random melt downs those first few weeks.  I know many thought I was crazy going back to work...but I had to...I needed to do something, be busy, stop feeling and thinking. The challenge was just a week or so before two other colleagues had just announced their pregnancy.  So it sounds awful but I avoided them for awhile to protect my feelings and not make them feel bad (they didn't know).

Who will win the Beta battle this time?

Dec 2012

We had to wait two weeks to find out if our IVF was successful or not.  My week off was great relaxing, doing things for me and visiting with some great friends.  Then it was back to work as usual.  Remarkably I was actually pretty calm, feeling hopeful and peaceful.  I tried to focus on prayer, positive  imagery and rubbing my fertility rock (lent to me from a wonderful friend who got it from a huge fertility rock in Ireland) and holding a beautiful newborn!  Hey...You never know!!

So...the big day arrives.  I go for blood work and get a call later... POSITIVE!!  Beta was 298...which is nice and high...could mean twins...or not.   (I had suspicions...but wasn't 100%) We were so excited...and shocked...it worked! Yes, it was early...but I had never been pregnant before...not even a less than 5 beta!!  Because of our journey it wasn't as much of a secret about our pregnancy.  Many of you knew because you had been with us through the whole IVF process.  We did keep it hush within this group though...until we knew for sure.

One thing that touched me huge was the reaction from the SOFT staff the next time I was in.  Everyone was hugging me, tearing up....they are such a compassionate group.  So...my beta kept going up...744!!  Overall I was feeling good.  I was tiring easier, having naps,  had an aversion to anything like turkey or stuffing, a bit of cramps at times and yes my boobs were bigger!  It was scary to feel so excited!!


January 9, 2013
A perk of going to SOFT is they do the first few ultrasounds and you get to see things on the big TV..so cool!!  They do an early detection Ultrasound (internal one) at about 7 weeks.. It is really cool!!!  We found out then that one had not survived...but that was okay...everything looked great!  It was 1.3 cm long and we could see the "brain bubble" and arm paddles!  The US tech is lovely and amazing.  She let us take pictures with Dennis' phone and record the heart beat 155 bpm.  We were told that everything looked as it should. After a good 7 week Ultrasound the chance of miscarriage was low...like 5%!!

IVF...lets do this!

October 2012....
A few months have passed and we have been busy with baseball trips, saying goodbye to my brother and family as they head out east and a motorcycle weekend to Lions head & area.  Taking advantage of my ability to ride while I can.  You should see the looks I get at SOFT from the other women when I show up for monitoring in the morning in full gear!  It is awesome!  The staff know me by now and aren't surprised.

So...early October, 2012 I started IVF preparation.  SOFT gives you a detailed itinerary of when to take what, stop what and inject one.  They also give you a millions consent forms where you have to decide what you do with extra embryo's, extra "stuff" from the process, destroy them, research, give them away. Quite intensive documentation with big decisions.

So the process:   IVF (In-vitro Fertilization) .  It refers to fertilization of eggs outside of a woman's body. It's the one where you take egg, sperm but them together in a dish (or in our case inject the sperm in the egg directly)..let them grow..then put viable embryo's back in.  It is much more invasive.  For those who are interested I tried to break it down a bit.

1.   Through medication my hormones are suppressed, then with more medication my ovaries are hyper stimulated in a controlled way.
For me this meant taking birth control pills for ~a month a half, then a nasal spray for about 8 days.  Then the fun part of re injecting hormones into my belly began...for 12 days.  All of this was fairly time sensitive so I had alarms going off on my phone at all times.  The injections were scary at first but now I can do it in my sleep practically.  Because of my low egg reserve I was on a strong dose which meant a lot of mixing!  Side effects?? I was definitely more hormonal and emotional (which made work a bit challenging)...but overall I thought it went pretty good. I thought I was going to be a monster.  Telling this to people after...Dennis had a different story.  His statement  "I thought I was going to drop kick you a few times".  Folks...that is love!:)

 Throughout all this I had a schedule to have blood work done and  internal ultrasounds. Ultimately we want lots of follicles and by time retrieval happens ones that are mature and can be extracted. I remember being upset with the first ultrasound. You hear of people ending up with 20 or something...I had 4...initially...by the end there was more but not the numbers I had anticipated.  So...my work girls had to deal with an emotional me many mornings after my clinic visits.

Example of follicles being measured with an internal ultrasound.  This is like what I would see on their big screens!

Another example of someone after medication stimulation.  Those are all follicles which become eggs.  You can see different sizes. Kind of cool eh!

One thing I remember that was weird was the feeling in my gut.  I didn't have a lot of eggs...but my ovaries were bigger than they were used to.  I literally felt like I was carrying a dozen rocks.

2 THe next step is "the Trigger". Based on ultrasound and blood work it is determined the follicles are ready.  The trigger is another injection which allows my body to have an LH surge which means ovulation/release of the eggs.  This is critical to retrieval and timing needs to be exact!! It is usually 32-34 hours pre-retrieval.
So for me...it was one more injection at the time SOFT calls and tells me to do it.  Easy after 11-12 days of injections already.  And a bit of a relief...my ovaries are stretched and not happy about it! Think of your belly expanding the way it did over 9 months but in 9 days!:)

3.  Retrieval and fertilization day! So...eggs are retrieved from my ovaries(sucked out so to speak), Then the lab does their thing with the eggs and sperm.  Due to the lower sperm count we also had a procedure called ICSI.(Intracytoplasmic sperm injection)--> sperm are directly inserted into the egg...so they don't have to fight their way through.

For us this was a long day.  The SOFT doctor's do the IVF procedures at a clinic ISIS..in Mississauga.  We went down the night before due to the early morning we would be having.    Dennis' job was his date with the cup.  Yes...as a woman I have had picks and pokes, multiple things shoved up and shot up me....but I don't know if I could deal with the pressure of performing on demand!  It's not like..oh well...next time.  These are important and high pressure circumstances.   His next job was to take care of me the rest of the day!
So...me..I was remarkably calm and that was before taking the Ativan I was prescribed.  When it's my turn I get set up with an IV for fluids and eventual "conscious sedation"...so I was awake for it all. This isn't the case with everyone.  I am fully monitored with ECG, oxygen saturation and BP.  Dennis gets to join me in the room too...and Dr M is lovely and charismatic as always.  Everyone keeps chatting as my legs are up in stirrups with god knows what being placed in me!:)  At this point I get the IV sedation and two local anesthetic injections...those sting the most.  Despite a mini crying meltdown (?meds?emotions??not sure really) it was a really cool procedure. we could see on the screen as he would drain the follicle, it would collapse and then allow the egg to extracted.  They counted how many were extracted as they are done...I think we had about 11...not a lot but something.
After I had to wait till my vitals were all good, had some food and then we could leave.  Other than being tired and crampy  I felt good.  So...after that we head home trusting the professionals to do their thing.

So...with the eggs...11 wee retrieved but not all can be used.  Some may not be mature enough, occasionally damaged during retrieval, etc.   The lab takes viable eggs and injects the best sperm into each egg and then waits. As for me I had to take some antibiotics to prevent ovarian hyper stimulation syndrome... which can come on in a few days. Luckily I did not have this issue.

4.Waiting to hear how things are going with fertilization.
The day after we get a call and are told 4 fertilized!  We had hoped for more...but again this was good with our history of issues on both of our sides.  Day after all were still growing.

5Transfer day.   Procedure is fairly similar to an IUI with a speculum and catheter.
The next morning back to Mississauga we go.  It was one of those full bladder procedures to help with guiding the catheter. I HATE those!  Dennis will tell you I have the bladder of a 4 year old...and it goes through me so quick.  I was so uncomfortable I to pee out so much prior...just so I could relax. The transfer itself only took 10 minutes.  Again we could watch.  Embryos are microscopic so they put an air bubble on either side so we can see when they are being transferred.  We decided to transfer two...which is quite common with most people.  
 Unfortunately we found out that one of the other 2 did not survive...they still weren't sure if the other would be viable enough to freeze. A few days later...I found out it didn't survive either.  That was quite devastating for me....but we were still hopeful with these two!!  The next week I took off work to just relax and let nature happen.  It's not a protocol but something I need to do for me physically and emotionally. No injections after but I did have to take a medication called Prometrium (type of progesterone) which helps with the uterus environment and implantation.  Let's just say you don't take it orally....and of course since my body has issues I got to take a higher dose more often!  So..they make them in these "rocket" forms and give you a "rocket" launcher to insert them.  My names for them...not how they are referred.  But I think it was quite accurate.  They are taken until a negative Beta or so many weeks into a pregnancy.

COST?
I won't spend too much on this but I know some want to know.  It does vary clinic to clinic and unfortunately isn't covered under OHIP.  Those who have blocked tubes due get some coverage...but that is the only fertility diagnosis that does at present.  For those at SJHC...not covered under our health plan.  I could put drugs through the drug plan.   Rough costs:
Meds(after drug plan)  $1000+ (mainly due to my high doses)
IVF   ~ $5000
ICSI ~$1000
Other expenses are travel, freezing (if applicable, etc)
The good thing is you can claim all of this on your tax return.
I have to say that we are fortunate enough to have the savings to do this.  I know many people out there who don't have the same opportunity.  SOFT does have some supports for less fortunate families. I have donated back meds that are unopened that I won't be using.

What do you mean I am running out of eggs?

On a day 3 check in August 2012, one of the nurses had a gut feeling about some of my blood work.  He wasn't positive but something was off with my FSH (I think) for someone my age.  If we proceeded this month with the IVF protocol we might use too low medications and not have any chance of success.   He suggested and I agreed to sending off and paying for specific blood tests (AMH) to be done.  I remember that day getting a message to call one of the nurses at SOFT.  I was at work, in the conference room..shaking, not knowing what to expect. He told me his gut was correct.    I was not the lowest...but one category up.  I had a low egg reserve.  This is often referred to Premature Ovarian Failure ...but we don't use the word failure..sounds negative.

I am going to take an excerpt from SOFT info page to explain a few things:

A female begins her reproductive life with about 40,000 eggs. The exact beginning

number is quite variable and may depend somewhat on genetics and heredity. The eggs are held

in suspended animation, half way through “meiosis one”. Meiosis is the cell division process

that allows us to produce eggs and sperm with 23 (or half) the usual chromosomes.

Some of the 40,000 eggs will be good, viable eggs and some may not be capable of

producing a pregnancy right from the beginning. The exact proportion of good and bad eggs also

probably depends on genetics and heredity.

With each cycle a certain number of eggs are “available”. Early in the reproductive years

this may be 40-50 (age 20) and later (age 40) it may only be a few. In a normal cycle, one egg is

chosen to ovulate and the others undergo “apoptosis” or programmed cell death. This is why

when we over-ride the body’s one egg per cycle system we do not use up extra eggs.

Interestingly, these eggs become available each cycle independent of the actual cycling. This is

why women with no cycles (naturally or induced by medication) still use up their eggs at the

same rate.

So with low egg reserve I literally have that...limited eggs left.  GREAT! (So...yes...this could mean early menopause...even better!  More hot flashes!!:))     Again this can be quite common. I was told of some woman who found out at the age of 20 they were getting low. Their doctor's suspected something for other reasons (their are many indicators).   Crazy!   It also indicates that the quality of my eggs could be lower...because there are less available or not enough hormones to make them mature.  So, the Doctor's' suggested we post pone our IVF cycle and start on their premature ovarian failure protocol for a few months.  I started on:

  1) DHEA--the short form for dihydroepiandrosterone. It is a mildly androgenic (male) pre-cursor hormone for both testosterone and estrogen. Recently, there has been a great deal of interest about the possibility that DHEA may improve fertility outcomes among women with diminished ovarian reserve.  - from SOFT information pdf    We initially bought this from a pharmacy in London who has to compound it...because it is not available otherwise in Canada.  Thanks to Commissioners pharmacy.  Because of that ..it is more expensive. OR...you can drive across the border to a GNC and get the same stuff 5 bottles for what I paid for one.  Way cheaper.  Did it make a difference? I don't know for sure, research is promising.

2)Co-enzyme Q10...also recommended for male infertility along with L-Carintine

A couple asides before I finish this post:.  I try to find the reason behind our journey, how we can help others someone.  SOFT, in particular one nurse has given this to me.  When he called and let me know about my low egg reserve I obviously started crying.  He stopped and asked  "Do you have a cold?".  In the moment I don't remember what I said...but later we laughed about it.  He told me his colleague was sitting beside him..swatted him and said "she's upset...she's crying!!".  He says he was having a boy moment! ha!  That was a learning experience and I have experienced this person grow in an amazing way.    In addition to that personal growth I was told that as a group the nurses look at people's lab values and trust their guts more; processes have changed because of me!  My case is used to teach new nurses coming into the clinic.  More woman are be flagged earlier allowing earlier and more appropriate treatment/protocols.  So..in a way I am paying it forward!

IVF..can I do this?

Back to the story...sorry it is taking a lot longer than I had anticipated.  As you all know I like to talk...so writing....yeah..it's the same:)  Feel free to let me know if I am boring you or rambling too much.  I just feel knowing our whole story will help the current stuff make more sense.  If you think of someone you know who is struggling with a similar issue and you think this might help them...let me know.  Or refer them to SOFT....the SOFT people have so many miracle babies...they have the HUGE wall with hand & footprints of all their success stories...quite inspirational!   This is one of 3 or 4 boards I think by now.  It fills up fast!!





Okay..I digress....
So...we had planned on a few IUI's but due to my cycle been irregular and vacations/being away we missed a few.  That was another challenge...timing.  It was hard to plan things, be available for blood work, ultrasound, etc and still plan holidays. We often found ourselves waiting and doing last minute things...or hoping it would work out.   So...by this time we had talked and decided if we are going to put our money and effort into one thing....IVF was next.  I really struggled with this decision. We both wanted to pursue it...but ultimately it was my decision, my body.  I was scared and nervous....I only knew a bit about IVF from movies, books....heard horror stories of you losing control of your body from all the hormones...and could I really inject myself??  After reading up and talking to a friend who had gone through the process I realized I could do this. I would have to be dedicated yes and deal with some potential side effects...but this would mean our own baby!!  I wanted no regrets before moving on.  So...we let SOFT know and started the monitoring and planning with them...

The emotional roller coaster

Going to take a break from the history catch up of our journey with this post and talk about coping with everything.    I have had people tell me how strong we are, how inspirational we are to keep plugging on and staying positive.  Thank you...but I don't always feel that way.    The highs and lows ebb and flow.  Yes..I allow myself my "poor me" moments, my "why" moments...and yes I CRY (I should be dry by now:)) I am often irrational as most of us are in those moments.  My mind knows the truth..that our time will come but my heart and my emotions at that moment take over.  I do however pull myself out of it and move on for that moment.  Some of your know this but I saw a psychiatrist throughout and after my divorce process.  Alot of the skills she taught me I use now.  The biggest thing I take with me at all times of struggle and have shared with others is:  

Allow yourself to be sad and feel it when you need to, take that time...but don't talk yourself into it. 

  I think this is very true!!  I try to live by that....sometimes it is hard.  It kind of aligns with the whole crucial conversations thing and not "telling yourself a story".  (My hospital colleagues will get this one).  Dennis is great about reminding me of these things.  He deals with things differently and stays positive that things will happen when they are meant to.

I will be honest I am not positive all the time....ask Dennis...he has to deal with me behind the scenes...god bless him:)   Don't get me wrong ....I hope and pray and use the "secret" technique after every try.  But a little part of me has to be the realist.  This is my way of protecting myself from that crash if and when we get a negative result.  Maybe this is a weird approach but I try to protect my feelings.  I do know...there is a reason for this journey and it will come clear but sometimes....sometimes...

Many of you who have been pregnant, have children I know are often hesitant around me. I love you all for worrying about me and appreciate the efforts when you know I am struggling.  I won't lie...my heart aches every time I hear someone is pregnant.  It is torn....I am ecstatic for the couple but jealous, sad, envious as well.  Some of you have had struggles like us, others not as much...which is a blessing for you.  But...maddening for me!:)    All kidding aside...please know I love to know about your lives and your children, your ups and downs with them.  That being said don't be upset if I quietly excuse myself at times...it is just me protecting my heart and emotions.  That is okay...I know my limits.

I think the hardest part for me has been those who don't know our struggle, who are naive to the fact that such struggles exist.  I have been to showers where I have been asked...so you are next?  you don't want children?  Some people would even touch and rub my belly and smile?  Like they knew something I didn't know.  I often just brush it off...use riding our motorcycles as an excuse to not have children right now.  I just wonder what people who REALLY don't want children go through??

So...we keep busy and live our lives through this roller coaster.  Life doesn't end....it just takes a different winding course.   We have had a busy couple years with a trip to Cuba, visiting Rick in the states, Allan out East, camping, road trips..yes on OUR MOTORCYCLES.....oh and who could forget...drinking wine!! Okay...but not the riding and drinking together...honest!

Thank you to all of your out there that have been so supportive up until this point. I don't think you know how much it means to Dennis and I.   Listening to be ramble about everything, a shoulder to cry on in a back room at work, boys night to give Dennis a break, wine nights.....it all means the world to us and does help us keep going.  Our time will come....