Final Preparations

I get the best fortune cookies.

Telling the story of this cycle seems to be dragging along.  I apologize for that.  It's nearing an end...I promise.

Somewhere between administering *Devil Lupron* shots, electromagnetic acupuncture, and ordering FET meds, Dr. Schoolcraft’s office called to say he would not be in the office on Monday, May 9, to perform my embryo transfer.  Huh?!

They said we could move our transfer to Wednesday, May 11, or we could have another physician perform the procedure.  Considering we came to Colorado for Dr. Schoolcraft, we opted to wait.  However, since our flight, rental car, and condo were already booked for Saturday to Saturday, we decided to leave those details alone.

On April 18, the frozen embryo transfer (FET) meds began.  I always assumed that there would be fewer meds for an FET.  That’s not necessarily true.  Keeping on schedule with meds for any part of an IVF cycle can be confusing.  I had to convert the “calendar” that their office gave to me into my own to make sure that I didn’t miss any dosages.  I was taking meds three times a day at one point during the cycle, so it’s just a lot to remember.

Many cycles ago, Todd organized all of our meds onto a single shelf in our pantry to make it easy to find everything.  It was a very romantic gesture.  Then, our girls made me a cute sign that said “Preggo Central.”  We have used that sign for every single cycle since.  This time, though, we moved the meds into the closet for easier access.  In another romantic gesture, Todd cleared off one of his shelves in the closet for the entirety of the cycle.

All of the meds & supplies I need for my FET, plus my red notebook containing my calendar.

For those like me that enjoy *geeking-out* on IVF med protocols, this is what I was taking:

• Vivelle 0.1mg patches – started with 1 and quickly escalated to 4 patches every other day
• Lupron 5 units daily – NOT *Devil Lupron* – This shot is much smaller with much easier side effects.
• Aspirin 81-83mg daily
• Medrol 16 mg daily
• Endometrin 100mg twice daily
• Doxycycline 100mg twice daily
• Progesterone in Oil 0.5ml every other day – Um, it makes a world of difference when this shot is not daily.

These were the starter meds for the FET:  Vivelle, Lupron, and Aspirin.

I do want to mention two more things about this med protocol. 

I have been known to state this cycle that Prometrium is one of my all-time least favorite drugs.  It’s just gross.  Well, Endometrin is the exact same thing except that it costs more and comes with applicators.  Totally. Worth. It.  I would not go back and do this any differently.

Also, thanks to the Progesterone in Oil (PIO) not being daily, I have been taking the shot without any pain relief.  If you have ever taken PIO, you know that most people use ice or Lidocaine or something to help numb the shot area.  Well, in past cycles, PIO was always administered in the evening, so I was able to do that.  However, this time, we are doing it in the mornings.  (“We” because it’s in the rear, so Todd has to administer it.)  Anyway, because I forgot to get up an hour before the shot to start the numbing process the first few times, I just decided to see how it was without.  Not as bad as you would think.  Honestly, I think I’m just getting used to it.  It still stings like crazy, but it’s worth it to get my beauty rest.

The only real side effects I had during this preparation were weepiness (you’re welcome, Todd) and sleepiness (you’re welcome, boss).

For the final 4 weeks of FET preparation, we both participated in relaxation therapy because we can and we should.  In addition to the electromagnetic acupuncture I was doing twice a week, Todd also went with me for weekly massages or float therapy sessions.  If you haven’t heard of float therapy, you should look it up.  Basically, you float in an 80% salt water mix for 40 minutes.  It’s incredibly relaxing.

This is what the pods look like.

It’s bitter sweet that all of this is finally coming to an end.  We have been saying that God was giving us our final embaby as a Mother’s Day gift.

Shocking Treatments

I briefly mentioned before that we took the girls to Copper Mountain to ski for Spring Break.  Well, this was a strategic decision on our part.  After the one day work-up at CCRM in October, we were informed that my uterine blood flow was low.  This was the first time it had been tested on me, so we weren’t really sure what that meant.  I had sipped on a Pepsi roughly 65 hours prior to the test, so they said that may have caused the issue.  Basically, I was going to have it retested when we were there for retrieval.  However, I forgot, and they forgot.  Humans.  When I called to ask about it, they said I had 3 options:

1. Have it retested at home for $270.
2. Complete the treatment for $380.
3. Have it retested at CCRM for free.  Well, that sounded absurd because it would cost more than $270 plus $380 to travel out there for the test.

So what did we do?  We traveled to CCRM for the test, of course.  We were going to take the girls on a trip anyway, so it made the decision easy for us.  This way, we knew the test would be accurate.

My ultrasound was set for Friday of Spring Break, so we had time for 3 days of skiing before we had to report for another transvaginal ultrasound.  I was very careful not to drink any caffeine the week of the trip.  Let me rephrase.  I was very careful not to drink any Pepsi or coffee the week of the trip.  However, I did drink about 4 cups of hot chocolate, eat a couple of Snicker’s ice cream bars, and gobble up some chocolate birthday cake.

We walked into the ultrasound room at CCRM with our chests held high, knowing we were about to pass this “ultrasound with dopplers” test.  And then she dropped the bomb.  The nurse asked if I had any caffeine or chocolate in the last 72 hours.

WHAT?!

How did we forget that chocolate had caffeine?!  They had never emphasized that before.  I swear.  Educated people here.  We just don’t always show it.

She performed the test, and I failed.

Within a few days, the nurse had called to say that Dr. Schoolcraft was recommending I go ahead and complete the treatment to be extra careful, but it was ultimately up to us.  She said it was a possibility that my test failed because of my indulgence in chocolate.  Ha!  If she wants to see an indulgence….

The unfortunate part was that treatment consisted of 8 rounds of electromagnetic acupuncture over the next 4 weeks.  I did my due diligence to get recommendations and call each of them for pricing and scheduling.  Finally, I settled on Brandy Valentine Davis at Cancer Treatment Centers of America because she would only charge $380 for the 8 treatments (a steal) and could take me with minimal time away from work.

Electromagnetic acupuncture is simply described as normal acupuncture with jumper cables clipped to the needles…if you ask Todd.  J

The next two pictures are actually my back and legs with several acupuncture needles.  Only some of them are hooked up to the leads.  If needles make you woozy...well, this is your warning.

The treatments were mostly enjoyable.  There was the one time that she accidentally turned one of the leads up high very quickly when she meant to turn it off.  It felt like I was being electrocuted through a needle because I was basically being electrocuted through a needle.  She never made that mistake, again.

For the most part, I had some of the deepest naps of my life during those sessions.  It was invigorating.

Our fingers are crossed that it worked.

*Devil Lupron*

Thank you for the love and support during National Infertility Awareness Week (#NIAW).  It was a great week!

Returning to our regularly scheduled programming…

So, after we found out on February 25 that we had one remaining embryo that was chromosomally normal, we waited patiently for our regroup with Dr. Schoolcraft on March 17!  Talk about torture. 

March 17 finally arrived, Dr. Schoolcraft called, and Todd and I were physically in the same place to take the call.  (Remember last time when we mixed up the time zones?  I swear we are educated people.)  During the call, Dr. Schoolcraft informed us that he thought we had about a 50% chance of this cycle working with our little embaby on ice.  We chose not to let that get us down.  After all, we know our God can work miracles.  Then, he confirmed that I would need to take Depot Lupron for two months before we started the frozen embryo transfer (FET) stimulation (stim) meds.  We couldn’t help but to let that get us down.

Flash back to 2012.  I took Depot Lupron for 4 months after my laparoscopy/hysteroscopy to allow my uterus to heal more quickly.  If you’re thinking, “Oh, I’ve taken Lupron to suppress my ovaries before a cycle,” you are thinking of the wrong Lupron.  This is the Lupron that Todd so cleverly coined *Devil Lupron.*  I don’t take offense because it’s true.  This Lupron rocked our world that winter.  It sends you into a state of menopause.  Hot flashes, night sweats, joint pain, mood swings…the whole gamut.

We were not quite prepared for the mood swings in 2012.  I would like to say we were better prepared for them in 2016.  However, recently I said that prometrium was my least favorite drug of all of the drugs in the world.  I’m starting to think I should retract that statement.  Maybe.  It’s amazing what you can forget over time.  I had a few bouts of unexplainable cries during this most recent two month stint, and one of them brought me to my knees in our closet searching for comfort from God.  Honestly, I can’t really think of a better place to be.

Anyhow, the hot flashes were worse this time.  They made me angry.  Looking back, it’s pretty funny, but at the time, I thought I might stab someone…preferably Dr. Schoolcraft.

Actually getting the Devil Lupron in our hands was a chore.  We priced it at two different pharmacies.  When our favorite, Walgreens Specialty, said they would have to ship it directly to the doctor for them to administer, we chose Accredo.  At first, we were told these two shots would cost a total of $2,000.  That is not a typo.  Luckily, Dr. Schoolcraft redeemed himself (from the decision to make me take this drug) by coding this as medically necessary to treat my endometriosis.  Score one for CCRM.  We were able to purchase both shots for a total of $150.  <Speechless>

The first shot came.  It was intimidating, to say the least.  Todd administered it into my rear flawlessly.  His years of practice giving me progesterone shots had paid off.  All of the symptoms began.  We survived.

See?  Intimidating.

The second shot arrived.  Todd had to give it to me while we were “Spring Breaking” in Copper Mountain with our girls.  Still a flawless administration.  The symptoms got worse.  He didn’t kill me.  Life moved on.  Simple as that.

We did run into two minor kinks after the fact.

1. I called Accredo to pay for the second shot.  The man that answered informed me I didn’t owe the full $75.  Without questioning and getting it raised, I paid and moved on.  When I called later to pay for a drug they shipped me without my prior authorization (it was easier to keep and use than to return it), I was informed I owed $75 for the second Lupron shot.  After many, many, many calls, I realized that although my credit card statement showed a payment to Accredo for the amount he said, they had zero, nada, zilch record of me making the payment.  Shockingly, no one at Accredo wanted me to send them a copy of my statement.  I’m still bumfuzzled as to how that happened!
2. Walgreens Specialty never canceled the order for the shot.  Now, remember that they said they wouldn’t ship it to us.  Well, when we ordered the remaining FET meds from them, we told them not to send the Lupron shot, too.  They didn’t listen.  They shipped it.  To our house.  Again, bumfuzzled. 

It has taken us three weeks to get both of these ironed out.  I’m not even sure why I’m documenting these problems except to prove that pharmacies are human.  In case you thought they were perfect, they are not.  This is proof that you should check your meds when they arrive and make sure you know what you have and the dosages.

Next time on Making Baby Provence, the downhill slope to the FET!

#startasking

As I have mentioned…a few times…this week is National Infertility Awareness Week (#NIAW).  The theme is #startasking.  This theme gives me so many feels.

As I mentioned in the previous post, I wish more friends and family would #startasking about our journey.  I know people fear that it will upset me.  I’m going to be honest, I might cry when I tell you about it.  However, it feels good to talk about it.  The thing is, some infertiles, i.e. Me, fear that talking about it too much will turn people away.  We are afraid you will start to look at us and think that all we talk about is infertility.  It’s like when your friend decides to sign-up for a Multi-Level Marketing company and you stop answering her calls.  You know what I’m talking about.

When someone asks me about our journey, it makes me feel less alone.

All of that is to say, don’t be afraid to #startasking me or your friend or your co-worker who is infertile how they are doing.  Ask them what the next step is for them.  Ask them if there is anything you can do to better support them.  Take time to invite them to coffee or a pedicure and learn about their struggle.  (I’m not saying you have to buy.)  But for the love, #STOPasking why they don’t “just adopt” or tell them to “just relax.” J

The real reason this theme gives me so many feels is…Jesus.  It was just over two years ago that I stood in the parking lot of a CVS in Dallas with Todd and told him that I was doubting my faith.  That’s really hard to admit publicly.  However, it was that moment that truly changed the trajectory of our journey.  Like an arrow that has to be pulled back in order to be launched forward, I was at the deepest part of that pull.

The following Sunday, we immediately found a church, began attending regularly, and joined a life group for blended families.  Within two months, we were serving as door greeters and in the children’s ministry.  Before I knew it, we were attending a weekend seminar on finding your God-given purpose in life.  Two months after that, I had the first meeting for Infertile Myrtles.  Very quickly, my arrow had been released from the Devil’s grasp and was starting its forward momentum.  I wasn’t signing up to become religious.  I was hopping on board for a personal relationship with God. 

Within the last two years, I learned something I had heard but never truly understood before.  When days are tough, it’s time to #startasking Jesus for help.  I believe I didn't understand it before because my life was pretty easy for the first 30+ years.  Then, the attack started, and I realized I couldn’t fight this battle alone.  Even Todd’s support, which is solid, wasn’t enough.

I have learned that when I don’t know the answer, or when the next step seems too big to decide on our own, it’s time to #startasking Jesus for guidance.

I have learned that when I start to feel envy of the mommies around me, it's time to #startasking Jesus for a softened heart.

I have learned that when I feel that relationship with a friend starting to slip away, it’s time to #startasking Jesus for restoration.

I have learned that when I feel like I can’t go another day down this path, it’s time to #startasking Jesus for patience.
 

I have learned that when I start to doubt if we will ever be parents, it’s time to #startasking Jesus for hope.

I have learned that when I feel all-consumed by our situation, it’s time to #startasking Jesus for peace.

Like I said, I don’t consider myself a religious person.  I consider myself to be in a relationship with Jesus.  He is my strength and my hope for our future.  I trust Him to stay by our sides for all of our days.  I have confidence that no matter where this path leads us, He will never forsake us.
 

All I had to do was #startasking Him to be a part of my life.

I actually took this picture at our favorite lake in Skiatook, Oklahoma.
God is such an artist.

Our TTC Story

This week is National Infertility Awareness Week (#NIAW).  I absolutely love this week because all of the bloggers come together to write about the same topic.  This year, the theme is #startasking. 

This is a great theme because I have had a few friends that have said, “I had no idea you did this,” or “When did you go through that?”  Also, I have had friends tell me they were afraid to ask too many questions for fear of annoying me.  Therefore, I would like to say that Todd and I are open books.  There are few things we do not share.  However, if there is something we are keeping quiet, I won’t be afraid to tell you.  In order to know more of my story or any other infertile’s story, all you have to do is #startasking.  If you know we are infertile, chances are that it’s healing for us to answer questions.  All questions.  It not only makes us feel like you care, but it helps us feel less alone on a very isolating road.  (More on this tomorrow.)

That being said, I decided to do an overview on our journey from the beginning until today.  It won’t be short because our journey hasn’t been short.  I have never really put our entire story in one place, so here goes.  I have even added links to where each part of the journey starts on the blog in case anyone is interested in jumping back to something particular to read more detail.

This is what we used to look like before...you know, life.

The Beginning

Todd has 3 children from a previous marriage.  After the last one was born, they decided he should have a vasectomy.  Fast forward 10+ years…

March 2010:  We got married and immediately became serious about our next steps to grow our family.  We had already researched urologists, but we weren’t sure if that was the direction we should go.

October 2010:  We went to Tulsa Fertility Center (TFC) to meet Dr. Prough about IVF.  The meeting did not go well, and we left there feeling uneasy.  We also met Dr. Steve Miller (who plays Steve Miller Band music during surgery – no lie), and decided that a vasectomy reversal was our way to go.  Spoiler alert:  What a waste…for us.

May 2011:  Todd’s vasectomy reversal.

August 2011, November 2011, February 2012, May 2012:  Negative tests for sperm in Todd’s...eh hem…specimen.  We were told it was time to pursue IVF or adoption if we wanted to grow our family.

IVF Cycles 1 and 2 – Dr. Clark Bundren

July 2012:  We met Dr. Bundren.  He promptly scheduled me for a laparascopy and hysteroscopy.

August 2012:  Laparscopy and hysteroscopy where I was diagnosed with stage 3 endometriosis and a uterine septum.  He fixed both of those during the surgery.

August 2012 – January 2013:  Depot Lupron…aka Devil Lupron, if you ask Todd.  Hot flashes, night sweats, depression…oh my!

April 2013 – May 2013:  IVF Cycle 1.

• Eggs Retrieved = 9
• Todd had MESA procedure performed by urologist.
• Fertilized = 6
• Transferred = 2 on day 5
• Ended in biochemical pregnancy around 5 ½ weeks

November 2013:  IVF Cycle 2.

• Eggs Retrieved = 12
• Mature eggs = 8
• We used frozen sperm, which turned out to be a very, very bad idea because of the way it was retrieved and the immaturity of the sperm.
• Fertilized = 8
• Transferred = 3 on day 3
• BFN (Big Fat Negative)

We were devastated.  I can still remember having to go in to talk to Dr. Bundren to get the results (which is abnormal) and getting to the lobby to sob into Todd’s chest.  That was one of the hardest cries I have ever had in my life.

January 2014:  Interviewed a doctor in Dallas, Dr. Douglas.  This is when my faith began to change.  I can still remember the day.  Also interviewed Dr. McKinney at TFC.  It went much better than our first encounter with TFC.  We decided to move forward with Dr. McKinney.  I have to make a quick statement to say that I am so glad we did.  She’s become one of our all-time favorite doctors.  She has cried with us, laughed with us, and spent many hours talking us through our options.

At this point, we had three doctors telling us our problem was 1) Todd's sperm, 2) my eggs, or 3) Todd's sperm and my eggs.  Literally, each doctor disagreed on our diagnosis.

May 13, 2014:  The inaugural meeting of Infertile Myrtles, my support group and LifeGroup begun to support women struggling with fertility challenges.

IVF Cycles 3 and 4 – Dr. Shauna McKinney, Tulsa Fertility Center (TFC)

September 2014:  IVF Cycle 3.  This is the cycle where we started using Preimplantation Genetic Diagnosis (PGD), commonly known as genetic testing.  It was performed on day 3, so the results were received before transfer on day 5.  Also, Dr. McKinney put me on the maximum amount of stimulating medication (stim shots) that she legally could.  We found out around this time that I had Diminished Ovarian Reserve (DOR).

• Eggs Retrieved = 6
• Mature eggs = 5
• Todd had epididymal aspiration performed by Dr. Prough (the one we didn’t love on our first visit).  Turns out, we really do like him.
• Fertilized = 2
• Genetically tested = 1 (1 was too deteriorated to test)
• Chromosomally normal = 0
• Transferred = 0

I was not prepared to have nothing to transfer.

November 2014:  IVF Cycle 4.  We refer to this as “The Good Cycle.”

• Eggs Retrieved = 9
• Mature eggs = 8
• Todd had epididymal aspiration performed by Dr. Prough.
• Fertilized = 7
• Genetically tested = 7
• Chromosomally normal = 2
• Transferred = 2
• BFP!!!  (Big Fat Positive)
• Blighted ovum miscarriage L

We found out around 8 weeks that we would miscarry, and it took until 11 weeks to start.  I won’t even go into what that miscarriage was like.  I have said it before, though.

February 2015 –April 2015:  I had said from the beginning of our IVF journey that we could not quit IVF until we tried Dr. Ahlering in St. Louis.  I had heard really great things about him.  We had a chance to meet him in person, and I loved him.  I knew he would be our next doctor.

I went to see the doctor that would monitor me in Tulsa for my cycle with Dr. Ahlering.  He found that my miscarriage had not completely finished.  Basically, I understood that I had tissue left in my uterus.  We scheduled a hysteroscopy and D&C.

IVF Cycle 5 – Dr. Peter Ahlering, Missouri Center for Reproductive Medicine (MCRM)

May 2015:  IVF Cycle 5.

• Eggs Retrieved = 7
• Mature eggs = 5
• Todd had TESE procedure performed by urologist.
• Fertilized = 6
• Transferred = 0

This was just a mess of a cycle.  I don’t even need to go into it all again.  It was a lot of unfortunate incidents coming together to rock my world. J

August 2015:  Ovarian cyst found.  I do not have cystic ovaries, despite being told I did when I was just out of college, but occasionally, this happens to a woman.  The problem is, it pushed back everything we were planning to do next.

IVF Cycle 6 – Dr. William Schoolcraft, Colorado Center for Reproductive Medicine (CCRM)

October 2015:  After many months of waiting for the cyst situation to fix itself, we headed to Colorado for a One Day Workup (ODWU) at the well-renowned office of Dr. Schoolcraft.

December 2015 – January 2016:  IVF Cycle 6.  Retrieval only.  Dr. Schoolcraft put me on Clomid, Testosterone, and Viagra during this cycle, which was so strange and new.  We loved the idea that he was trying new things.

• Eggs Retrieved = 11
• Mature eggs = 7
• Todd had MESE procedure performed by urologist.  Um, here is another doctor we love.  Dr. Cowan, the urologist.  If we ever need a urologist, we plan to fly to Denver for this guy.  He’s that good.
• Fertilized = 6
• Genetically tested & frozen = 3
• Chromosomally normal = 1

Dr. Schoolcraft does Comprehensive Chromosome Screening (CCS) for his genetic testing.  It’s performed when the embryo makes it to blastocyst stage (usually on day 5), so the embryos have to be frozen until the results are received.

February 2016 – March 2016:  Devil Lupron…again.  The shame!

April 2016:  Frozen Embryo Transfer (FET) meds started.

That brings you up to date.

So, to sum it all up:

• Failed vasectomy reversal
• 6 surgeries for Todd
• Stage 3 endometriosis & diminished ovarian reserve
• 6 IVF cycles
• 6 egg retrievals
• 54 eggs retrieved
• 35 embryos made
• 3 embryo transfers - 7 embryos transferred
• 1 embryo transfer on the way - 1 embryo to transfer
• 4 doctors
• 3 states
• 4 cities
• 2 miscarriages
• 6 total months on Depot Lupron (It's that important to mention.)
• Hundreds of shots
• I’m not even going to say how much money we have spent.  (Insurance covers nothing for us except for the occasional patch or antibiotic.)
• More acupuncture and massage than I can remember.
• Loads of love!

In the end, what we have to show for all of this is 1 frozen embryo waiting for us to bring them home, a better understanding of how we handle crises, a stronger marriage, and a deeper relationship with our Lord.  We have had days overflowing with joy and days full of sorrow.  We wouldn’t change a thing.  God has blessed us in ways we could have never imagined.  No matter what the future holds, we know He will be with us to the end.

I hope that answers any lingering questions anyone might have.  Basically, I just summed up the last 3 ½ years of blogging in one really. long. entry.  If there is anything I left out, please don’t be afraid to #startasking.

Today, I am participating in a blog link-up with Caroline, at In Due Time.  Can you tell I really like her blog?