Exciting Things Are Happening!!!

We submitted our completed paperwork at the end of October and we've spent the past three weeks anxiously waiting to hear from our case worker about our first meeting. We finally received an email from her today. Our first of four meetings will take place at the agency's office this Wednesday! Yes, two days from now! We have no idea what to expect from this first meeting, but we do know that the next two meetings are individual interviews that Jeff and I will schedule individually. The fourth and final meeting will take place in our home. We also learned that she's been in contact with a few of our references and they have been completing questionnaires on our behalf. We're so excited that things are starting to move forward!

We've also made a few big purchases for our nursery. We bought a crib and gender neutral crib bedding (well, I actually purchased that a few months ago because the design I had my eye on was being discontinued). People often ask how all of that works for adoption--do you buy baby things and work on a nursery ahead of time, or wait until the baby comes? It's just personal preference, really. It's emotionally too hard for some people to walk past an empty nursery every day. Seeing baby things in their home with no baby makes them sad. I can totally understand that, but for me, it's comforting to prepare ahead of time. I'm definitely a planner and I've waited a really long time to research strollers, choose a crib and find the perfect nursery rocker. I don't want to rush through that if we get matched at the last minute.

That said, it does feel a little strange to shop for baby things for without being pregnant. Surfing the internet and checking out baby stores online in the privacy of my home is one thing, but actually walking into a store feels a little weird. We went to Babies R' Us on Saturday to buy a crib mattress and browse the stroller aisle and I couldn't help but feel self conscious walking into the store. I wondered if everyone was going to look at us and wonder why we were there. It did make me a little sad to have all this inward excitement about growing our family, without any physical evidence of it. By the time we left I felt more comfortable and I know it's something that I'll become even more comfortable with as time goes on. I've decided I'm not going to let it keep me from making the most of our wait for a baby. I'll be back at Babies R' Us soon. We'll go register there after our home study is complete and we've been approved. Hell, maybe then I'll even park in the "reserved for expectant mothers" space!

What God Meant by Dawne Davis

Last night at our infertility support group, our facilitator shared an article with us. I found it so touching that I had to post it here. It was written for RESOLVE of Colorado by Dawne Davis. For those of you unfamiliar with RESOLVE, it's the National Infertility Association and their website, www.resolve.org, has tons of helpful resources. If you stumbled upon this blog because you are struggling with infertility, I highly recommend you visit the site. I also recommend finding a support group. Jeff and I are getting a lot out of ours and I wish we had done it sooner.

What God Meant by Dawne Davis

Couples experiencing infertility often receive well meaning, but extremely insensitive "advice." We can all list the most popular ones: "Just relax and you'll get pregnant," or "Adopt and you'll get pregnant," or the most painful from those who think they've got the goods on God's plan: "Maybe God never meant for you to have children." The sheer audacity of making a statement like that never fails to amaze me. The same people would never walk up to someone seeking treatment for cancer and say, "Maybe God never meant for you to live." However, because I'm infertile, I'm supposed to just get on with my life. It's hard to understand that people cannot see infertility for what it is: a disease for which I have the right to seek treatment. What if Jonas Salk had said to the parents of polio victims: "Maybe God meant for thousands of our children to be crippled, live in iron lungs, or die." What if he'd never tried to find a cure? Who could think for one minute that was God's plan?

What do I think God meant when he gave me infertility? I think he meant for my husband and me to grow closer, become stronger, love deeper. I think God meant for us to find the fortitude within ourselves to get up every time infertility knocks us down. I think God meant for our medical community to discover medicines, invent medical equipment, create procedures and protocols. I think God meant for us to find a cure for infertility.

No, God never meant for me not to have children. That's not my destiny; that's just the fork in the road I'm on. I've been placed on the road less travelled, and like it or not, I'm a better person for it. Clearly, God meant for me to develop more compassion, deeper courage, and greater inner strength on this journey to resolution, and I haven't let him down. Frankly, the truth be known, I think God has singled me out for special treatment. I think God meant for me to build a thirst for a child so strong and deep that when that baby is finally placed in my arms, it will be the longest, coolest, most refreshing drink I've ever known. While I would never have chosen infertility, I cannot deny that a fertile woman could never experience the joy that now awaits me. Yes, one way or another I will have a baby of my own. And the next time someone wants to offer me unsolicited advice, I'll say, "Don't tell me what God meant when he handed me my infertility. I already know."

A Plan

Jeff and I have been busy these past few months gathering as much information about adoption as we can. We've had meetings with several domestic adoption agencies in our state, as well as a consultation with a local adoption attorney. Our heads have been spinning from all the new information and possible  routes to take! There are basically three ways to adopt a child domestically in the United States. The first is through foster care, the second is through an agency, and the third is to do an independent adoption. With an agency adoption, the agency provides all of the services for you. They take care of your pre-placement assessment (home study), assist with matching the birth parents with adoptive parents, and handle all of the legalities after the baby is born. In an independent adoption, you hire an agency to complete your home study only, search for birth parents on your own, and then hire an attorney to assist with the legal part. We're planning to do a combination of the two.

We have decided to work with Children's Home Society of North Carolina. However, to keep wait times down, CHS only accepts couples into their infant adoption program when the number of waiting adoptive couples gets low. We are currently on their wait list, but it will probably be early 2013 before they're ready to accept more couples. Jeff and I are feeling very antsy! We're ready to get started, so we've decided to get going on our home study now (though CHS) and search for birth parents on our own until CHS has an opening for us. We'll most likely advertise on parentprofiles.com after our home study is complete. The adoption attorney we met with told us that the majority of his clients find children through that website.

We started our paper work about a week and a half ago and we're working diligently to finish it as quickly as we can. It will probably take another week or so to finish up. We were both required to get physicals, fingerprints, and background checks. We've had to gather tax returns, our marriage certificate and health insurance information. The most time consuming part so far has been the 40 question "autobiography" that Jeff and I each have to complete. Some of the questions are pretty basic and some are a lot more in depth. If you're curious, here are a few examples:

• What do you regard as your greatest personal achievement to date? Your greatest personal failure? 
•  What are the racial attitudes in your neighborhood and surrounding area? How do they compare with yours?
• What do you do to make the world a better place?
• What are the strong points in your marriage? What are the areas of weakness and disagreement and how do you deal with them?
• What would cause you to consider divorce?
• Describe your relationship with each family member when you were a child and now as an adult.
• Regarding your family with who you grew up, what three things would you choose to continue with your own children?
• What values were conveyed to you by your parents?  How do you feel about these now?
•  Describe your experience in school as a child and as an adolescent?
• What are your religious beliefs? How do you practice these? How do they relate to your spouses’ beliefs?

Some of those are pretty intense, right!? As soon as we finish and submit our paper work, we'll be assigned a social worker who will make several visits to our house. She'll conduct interviews with us together and separately and call our references. Then we'll wait to get (hopefully) approved! We were told that the entire process should take about 6-8 weeks. We're hoping to be "paper ready" or as some people say, "paper pregnant!" by Christmas! YAY!

Focusing on the Positive by Jeff

Through our infertility struggles I have always tried to stay optimistic.  Optimistic that the next cycle would work.  Optimistic that the next treatment would work.  Optimistic that the next pregnancy would last.  Optimistic that things would work out in the end.  As bad news and disappointment continually poured in I made a point to not allow myself to ask "why me" or to feel sorry for myself.  I recognize how blessed our lives are in nearly every other way- a great marriage, supportive family and friends, stable jobs, health- the list goes on.  

In spite of all the good in our lives, there is no denying that infertility has brought us a tremendous amount of grief.  Sure there is the obvious disappointment of a failed cycle or the numbing pain of seeing a lifeless ultrasound but there are also the less tangible impacts of infertility.  Putting jobs, vacations and your whole life on hold.  Withdrawing from family and friends.  The jealousy and guilt of not being able to fully share the joy of others' good news and happiness.  

Still, even infertility itself has a silver lining.  Reflecting back on the past few years there are a number of things I have gained from this experience.  We have a stronger marriage because we have been forced to communicate more and have grown closer through our shared grief.  I am a better husband because I am more in tune to Laura's feelings and needs.  Delayed parenthood has created space in my life for experiences and accomplishments that may not have otherwise happened.  We have taken trips.  I ran a marathon.  I recently began volunteering in my community.  We have learned a lot from watching our friends and family parent which will in turn make us better parents.  And most importantly it has opened our hearts to the possibility of adoption.

As with infertility, talk of adoption often focuses on the negative.  Adoption comes with many unknowns.  Some of these unknowns- the baby's health, the potential costs- are also concerns in a traditional pregnancy, though they rarely are the focus of conversation with expectant parents.  Adoption does come with some unique concerns but it also comes with some wonderfully unique benefits.  There is an excitement to not knowing what to expect and I'm sure there is an indescribable thrill to finding out you have been matched with a birthmother and will soon (perhaps VERY soon) become parents.  There is something truly amazing about the relationship between parents and their biological children but there is also something truly amazing about the relationship between parents, their adopted children and potentially even the child's birthparent(s).  The ability to raise a child with whom you have no biological connection is an altruistic and pure expression of love.  Our fertility specialist, who has a biological child and a child through adoption, expressed how wonderful it is to love an adopted child and allow them to become the person they are, rather than a reflection of ourselves and the person we always wanted them to be.


I know we, like many couples dealing with infertility, have been challenging to know how to deal with over the past few years.  Sometimes we have wanted encouragement.  Sometimes we have wanted others to acknowledge the pain and share our grief.  Sometimes we have wanted to hear from our friends and family and other times we have wanted to be left alone.  Most of the time we haven't really known what we want.  Adoption is probably foreign and might be a little uncomfortable for some people but finding the right thing to say to us or any couple hoping to adopt should be much easier than communicating about infertility.  Everyone will have questions (as do we) and we are happy to answer them.  But mostly what we have and will continue to appreciate the most is for everyone to focus on the positive- tell us you are happy for us and share in our joy.  In short, treat us just as you would any couple who is expecting a baby- because that is exactly what we will be! 

Arriving at Adoption

In addition to reading Adoption is a Family Affair, we've been reading Adopting After Infertility, also by Patricia Irwin Johnston. In the first few chapters of the book, Johnston presents the reader and their partner with a self reflection activity to promote discussion about how to "conquer the infertility dragon." To begin, she outlines "six losses perceived to be a consequence of permanent infertility." They are:

1. Loss of control over many aspects of life. This refers to giving up control of your sexual privacy, planning vacations and events around your fertility treatments, deciding whether it's the right time to accept a new job, what car to purchase, whether to buy a house with a yard or a condo in the city. The list goes on and on. Most people don't realize how infertility affects ALL aspects of your life.
2. Loss of genetic continuity.  This speaks for itself. For someone who was raised in a "blood is thicker than water" culture, this is an extremely significant loss.
3. Loss of a joint conception with your life partner. You may not realize how many times you think, "I hope my child gets my partner's athletic ability or sense of humor." or "I can't wait to see if my child will be good at math like me, or if he or she will be a history buff like my spouse." It's difficult to realize those dreams of creating a life with your husband or wife will not come true.
4. The physical satisfactions of pregnancy and birth.  To impregnate your wife or carry a child represents the ultimate expression of maleness and femaleness. You've grown up expecting your body to allow you to do this, and losing this ability can cause you to question your self worth.
5. The emotional gratifications of pregnancy and birth. Think for a minute about what it means to potentially not be present at the birth of your child....to not hear the sound of their first cry, or experience those overwhelming emotions of seeing your child come into the world.
6. The opportunity to parent. From a very young age most of us fantasize about being a parent. As little children we play house and push babies in strollers. As teenagers we argue with our parents about curfews and rules and make sure we tell them what we will and will not do when we have kids of our own! For many people parenting is a natural part of being an adult. Personally, it never once entered my mind that I would not be a parent.

After describing each of these potential losses, Johnston encourages the reader and their partner to rank these losses, from most significant to least significant, independently of one another and then to share their individual lists. Here were our results:

Laura:
1. Opportunity to parent
2. Joint conception with life partner
3. Loss of control
4. Physical satisfactions of pregnancy and birth
5. Emotional satisfactions of pregnancy and birth
6. Genetic continuity

Jeff:
1. Opportunity to parent
2. Joint conception with life partner
3. Loss of control
4. Genetic continuity
5. Physical satisfactions of pregnancy and birth
6. Emotional satisfactions of pregnancy and birth

Sharing and discussing the results is meant to help couples identify the next step in their infertility journey. Johnston gives these four possible choices for the next step:

1. Continuing treatment to the point of having tried every possible option
2. Using donor egg or sperm to allow one of you to maintain a genetic connection
3. Adopting
4. Embracing a child free lifestyle

For example, if the wife chose "physical satisfactions of pregnancy and birth" as her number one potential loss, but her husband chose "genetic continuity," trying another round of treatment using a donor egg and the husband's sperm might be their next step. Or if "genetic continuity" was most important to both partners and they had exhausted all of their treatment options, they may decide to embrace a child free lifestyle.

Jeff and I are extremely lucky that our lists are very similar and that we're on the same page about what's most important to us. Many couples are not and have difficulty agreeing on the next step. For us, parenting is our number one goal and continuing fertility treatments feels emotionally and physically exhausting. Not to mention the fact that we don't want to use all of our financial resources on fertility treatments because that wouldn't be the end of the journey for us. More fertility treatments may or may not make us parents. Adoption definitely will. We had already been discussing adoption before we did this activity, but it just reaffirmed for us that we are making the right decision!

Recommended Reading

As I mentioned in my last post, Jeff and I have been doings lots of reading. One adoption blog we stumbled upon recommended the book "Adoption Is A Family Affair" by Patricia Irwin Johnston. The blogger and her husband read the book before purchasing copies for their immediate family members, so Jeff and I decided to do the same. It's a short, easy read that focuses on educating family and friends of adopting couples about how adoption works. It also points out many of the myths and stereotypes surrounding adoption, most of which exist due of lack of knowledge about it. We purchased copies for our siblings and parents to read, but would love it if you decided to read it to! It costs about $10 on Amazon.com.

One thing I want to point out about the book--one or two of the reviews claimed that the author seemed insulting. We didn't think so, but she does assume that most people reading this book know little about adoption and therefore may have some negative preconceived notions and a few reservations about it. In the back of the book, the author publishes some pretty offensive comments that adopting couples have reported hearing. We know you'd never say things like, "If God intended you to have children, you'd be pregnant by now." or "Too bad you had to adopt. Your kids would have been real cute." Can you believe that people actually say those things to adopting couples!? Our families and friends have been nothing but supportive so far, so please know that we are not asking you to read this book because you have offended us. We just get asked a lot of questions about how adoption works and this seems like the best place to start. :)

One more thing...the "maybe you'll get pregnant after you adopt" comment does not offend us. We're unique in that we have gotten pregnant on our own before, and we have no clear reason for our pregnancy losses. We aren't planning to try to get pregnant on our own, but it could happen because it's happened before. However, we're not holding out hope for that, and you shouldn't either. We're really excited about adoption and we want you to share our joy as we build our family!

An Update and An Announcement

It's been a while since we've blogged, but it's had a rough few months around our house. Here's a timeline that will quickly catch you up to speed.

April: I started a new cycle on Easter weekend and our doctor gave us the "thumbs-up" to begin hormones in preparation for a frozen embryo transfer (FET). I took oral estrogen for 3 weeks, went in to have an ultrasound and schedule our FET and the ultrasound showed that my uterine lining was not thick enough. Our doctors wanted things to look perfect before transferring, so our FET was cancelled and were told to wait a month before trying again.

May: I started hormone injections since I did not respond well to the oral estrogen. My uterine lining looked perfect this time so we transfered our 2 remaining frozen embryos on May 21. A week later we found out we were pregnant again.

June-August: Weekly blood work showed that my HCG was doubling normally over the following three weeks, but I began to have some spotting, which turned into heavy bleeding. Diagnosis: Subchorionic Hemorrhage- a pocket of blood in the uterus. Dr. D told me it would not impact the pregnancy, but it was scary nonetheless.  Our 6 1/2 week ultrasound on June 18 showed one embryo with a fetal pole measuring normally. They couldn't detect the heartbeat yet, but assumed it was still just too early to show up. A follow-up ultrasound 5 days later showed no heartbeat and no growth since the previous ultrasound. Our pregnancy was not viable. We were devastated. How could this be happening AGAIN!? We got a prescription for a medication that would help my body rid itself of the pregnancy, and then took off to the beach for the weekend to grieve and process our loss. It's now two months later and my miscarriage is still not over. I had to take the medication twice, as it did not work the first time, and continue to have spotting and weekly blood work to check my HCG until things are complete. I am feeling much better physically, but look forward to days where I don't have the constant reminder of our loss.

Jeff and I have had some time over the past few months to grieve, do some soul searching, and think about our next steps. We've signed up for an infertility support group that will start in September. We've also made the decision not to pursue any more fertility treatments at this time. Our doctor still does not have a cause for my repeated pregnancy losses and says another round of IVF could work for us, but we are physically and emotionally worn down. I've been on fertility medications and hormones for over a year now and the idea of another round of IVF feels scary, uncertain, worrisome, stressful, draining....the list goes on. Becoming parents is our number one goal right now, not pregnancy, so we're looking into adoption! Like fertility treatments, adoption is scary, but it holds so much more promise and hope for us. We are really excited! We're in the very early stages--still reading books and blogs and requesting information from various agencies. We're hoping to schedule some consultations over the next few weeks and find an agency that is a good fit for us. Looks like our IVF blog is becoming an adoption blog! Stay tuned! :)

Moving Forward

We had a consultation with Dr. D this afternoon to get some of our questions answered and talk about how to move forward from here. We feel good about our meeting and our doctor remains hopeful that we can get pregnant. He feels better that we got pregnant and miscarried, than he would if we had not gotten pregnant at all. He told us that most miscarriages are a result of a random chromosomal abnormality in the baby, and have little to do with the mother. However, he did test me for an immune disorder that causes the mother's body to attack the embryo. If it turns out that I do have that disorder it can be easily fixed with medication. The only other thing that can be tested for is a chromosomal defect in either or us that is being passed on to the baby. Insurance won't test for this until you've had 3 miscarriages, and if we did test positive for the disorder there is nothing that can be done. It just means that we will have a greater chance for miscarriage than the average couple.


Dr. D told us that we can decide when we're ready to try again and transfer another embryo. (At the very least, I have to wait until I get my period, which should be about a month from now.) He also explained how our next embryo transfer will work since we won't be doing stimulation this time around. It's up to us to decide when we're ready and if we want to transfer one or both of our frozen embryos next time. We have a lot of decisions to make, but we're excited to be moving forward again.

At this point, we haven't decided how quickly we'll move forward and how early we'll share information about our next transfer. We've been doing fertility treatments for nine months now and we feel like we need a break from talking about it. We're so appreciative of your love, support and prayers. We hope that you understand that we're just mentally and emotionally exhausted. Our plan for now is to stay busy, travel, spend time with friends and family and enjoy lots and lots of Tarheel basketball!

Thank You

This has been a crappy week, but because of each of you, it's been a little less crappy. Throughout the week we've gotten the kindest voicemails, text messages, emails and e-cards. Homemade cookies, flowers and chocolate covered strawberries have appeared at our door. Offers for meals and hugs from co-workers have brightened our days. You have no idea how much your prayers, love and support mean to us. Thank you so much.

We'll have to take at least a month off from trying to get pregnant, maybe longer. It's always hard to take time off. It feels like we're wasting time, and after two years of trying to have a baby, that's a very frustrating feeling. However, we know deep down that we need to use this time to recover emotionally and physically. I have been on fertility drugs since June and my body has been through a lot this past month. I'm actually looking forward to a "no hormones added" cycle. We're hoping a mini vacation in March and our upcoming bathroom remodel will be fun distractions and will help the next month or two pass quickly.

Our meeting with Dr. D has been rescheduled for Monday, March 5. I'll post an update after that consult. Hopefully, we'll have a plan for moving forward that we feel good about.

Another Loss

It's been a really hard weekend for us.

On Friday I started having severe abdominal pain on my right side and my lower back. We immediately called our fertility doctor, but because I wasn't spotting he didn't think I was miscarrying. We had no idea what was wrong. We thought it could be a pulled muscle, a kidney stone, or appendicitis. When I started to vomit from the pain, Jeff decided to take me to the ER. Once there, we found out that I had several really large ovarian cysts, mostly on my right ovary that were causing all of my pain. These are a result of my stimulation medicine and are really nothing more than very large follicles filled with fluid. My biggest was 7cm. They are extremely painful, but will go away on their own. There really isn't any treatment for them except pain medication.

While we were at the ER they checked my HCG level and we were extremely saddened to hear that it had dropped from 1,900 on Monday to 1,500. We knew what that meant. We went back to our fertility doctor today and my HCG had dropped all the way to 330, and they confirmed that I am having another miscarriage. I do not have any bleeding yet, but because my hormones are dropping on their own, they suspect that it will come soon. According to my doctor, this has nothing to do with my ovarian cysts. He said that many people have cysts while they are pregnant and it should not have effected my pregnancy.

To say that we are sad, disappointed, and confused doesn't even begin to cover what we are feeling. We go back to meet with Dr. D on the 29th to discuss everything and hopefully decide how to move forward from here. Please continue to pray for us.

Exciting News!

WE'RE PREGNANT!!!!!!!!!!!!!!!!!!!!!

After what seemed like the longest week, our doctor told us the good news last Monday. I waited until today to post anything to be sure that my HCG levels (pregnancy hormone) were rising as they should be. In normal, healthy pregnancies HCG should double every 24-48 hours. The first time I was pregnant I had low, slow-rising HCG levels, which was our first indication that the baby wasn't developing normally and I would likely miscarry.  I wanted to be sure that wasn't the case again this time before I posted any news. I'm happy to say that my HCG increased from 153 to 1,948 over the past week. We go back for an ultrasound to (hopefully) confirm a heartbeat on February 29 at 8:30 and then I'll be released to my regular OB. In the meantime, I will continue taking 2 kinds of progesterone, estrogen and baby aspirin to support the pregnancy through the first trimester. Our due date is October 16.

We cannot express enough how much we have appreciated all of your prayers, emails, texts, phone calls,  and cards over the last few weeks. We have felt so loved and supported. Thank you so much! We ask that you continue to pray for a healthy pregnancy, as it is still very early. While we are sharing the news with family and close friends who have kept up with our IVF journey, we are not sharing the news publicly.  So no Facebook comments, please and thank you. :)

Longest week ever

Throughout this month everything had gone very smoothly and we had been asking ourselves when things were going to get hard. This week it finally got hard. Really, really hard. Through all the waiting it was difficult to stay optimistic. This past week felt like it would never end. We appreciate all the support from our friends and family. It was comforting to know we had so many people thinking about us.

Tomorrow we will have blood testing that will hopefully tell us we are pregnant and have healthy hormone levels. Having everyone's support through this process has been wonderful and we can't wait to tell you all if we get good news. However, we expect that we will need some time to process the results whether they are good or bad. Please know that we will tell you how things turned out as soon as we are ready.

Embyro, Meet Womb

                                                                                                                                                                                                                                                                                                                           

This morning we went to Dr D's for our scheduled embryo transfer. We were anxious because we didn't know how many embryos we would have remaining and still hadn't made a final decision on how many we would transfer. Once we arrived we got very good news. Of our 8 fertilized embryos, 6 were still viable. The cute grey blob you see above was the best one. The others are looking good but were not quite as advanced (likely because they weren't fertilized as quickly). Dr. D recommended based on our age and the quality of our embryos that we transfer only 1 but ultimately the decision was ours to do 1 or 2. Drum roll please....

We quickly decided we would only transfer 1 embryo. Dr. D said that he expects most of the 5 remaining will continue developing and be able to be frozen for later use. We will hear tomorrow how many fully developed and were frozen. If this cycle doesn't work we will skip a cycle and then be able to thaw an embryo for another shot in 2 months. Dr D's success rates suggest that we have a 53% chance that this cycle work. If it doesn't his success rate after thawing our frozen embryos is 50% per cycle.

After deciding on a single embryo we moved along to the procedure room as the staff prepared for our transfer. They did a test run with the catheter to make sure everything was in the right place and avoid any surprises. Then they loaded the catheter with our little embryo and injected it into my uterus. Once the catheter is removed, the walls of the uterus collapse around the embryo preventing it from escaping. If all goes well, the embryo will hatch from its protective shell today and implant into the uterine lining as early as tomorrow.

After the procedure we had a quick meeting with Dr D. He told us that he didn't like to give anyone false hope, but that hope was important and so far everything had gone as well as possible. It is a little surreal at this point to think we could finally be pregnant but we are excited and hopeful. We return in 8 days for a pregnancy test. Thank you for all the calls, texts and good wishes this past week. Keep hoping for the best this week!

Now We Wait

Our doctor called this morning to update us on our eggs. We were excited to hear that 8 out of the 10 eggs fertilized. The other 2 were not mature eggs, so it wasn't surprising that they didn't fertilize. We were also excited to learn that my eggs fertilized naturally when mixed with Jeff's sperm and they didn't have to use ICSI, which is a procedure where they manually insert the sperm into the egg.

Now we wait. We wait for our embryo transfer on Sunday morning at 9:00. Then we wait 8 long days for my pregnancy test on February 6th. And in the words of Tom Petty, "The waiting is the hardest part."

Retrieve and Conceive

Laura is still under the influence of sedatives and not permitted to blog.  This message is brought to you by her sperm donor.

Today's procedure went well and was quicker than expected.  We arrived at Dr D's at 8:00 and were at home with chick-fila biscuits in our stomach and the real housewives of beverly hills on the tv by 10:30.  Laura has had a little bit of cramping and is a bit drowsy but otherwise is doing well.

During the procedure Dr D. was able to reach both ovaries and managed to retrieve 10 eggs.  There were 14 follicles that appeared to be mature but 4 didn't make it.  3 things could have happened with those 4 follicles 1) they never actually had an egg inside  2) the egg escaped into Laura's body when they drained the follicular fluid away  3) The egg was destroyed during the retrieval process. 

We were a little disappointed with the number of eggs because only a third of successfully retrieved eggs are likely to make it through the fertilization process and the next 5 days to become a blastocyst and be available for transfer.  Dr D was slightly disappointed (they usually get around 80% of mature follicles which would have given us 12) but still expects we will have several blastocysts and maybe even enough to freeze 1 or 2 for later use.

We will get a call tomorrow morning letting us know how many eggs were successfully fertilized.  Dr D said the number of fertilized eggs is a better predictor of how many healthy embryos we will ultimately have so hopefully what we lost in the retrieval will be made up in the fertilization stage.  We most likely will transfer our embryo(s) Sunday morning.  Keep us and our growing embryos in your thoughts and prayers this week.

No More Shots!

I had my final ultrasound and blood work done this morning and everything looked good. My follicles are definitely growing. Most of them were in the 15-19 mm range, so they scheduled my egg retrieval for Tuesday morning at 8:30 am. That means I'm done with all of my follicle stimulating medications (injections)! I do have one final shot to take tonight at 8:30 pm. It's an HCG trigger shot that induces ovulation and is taken 36 hours prior to retrieval. After that, NO MORE SHOTS!

I will be under IV sedation for the retrieval, which is pretty quick procedure. While I'm having the retrieval done, Jeff will go back and collect a "sample." :) They'll fertilize my eggs with his sperm and we should get a call the next day telling us how many of the eggs they collected were able to be fertilized. Our embryo transfer will be 5 days later on Sunday, January 29.

We would appreciate your prayers over the next week. Please pray that the egg retrieval goes smoothly, that my eggs can be fertilized, and that they develop into healthy embryos in the days that follow.

Quick Update: Round 2

I went back to the doctor for another round of blood work and an ultrasound today. I had 19 measureable follicles in all. Everything continues to look good! Most of my follciles were between 13-15mm, so they still need a few more days before my eggs will be mature enough to retrieve. My estradiol level was close to 1,000 so I'm cutting back on my medicine from 4 vials to 3.

I'll go back on Sunday morning for another quick ultrasound and more blood work, and possibly again on Monday. Right now I know that I'll take my HCG trigger shot to induce ovulation either on Sunday or Monday night and will have my egg retrieval 36 hours later, on Tuesday or Wednesday. It all depends on how things look on Sunday morning.

I'm still feeling pretty good--no mood swings, headaches, or hot flashes, but I'm very bloated and feeling lots of pressure in my abdomen. It kind of feels like someone is blowing up a balloon inside me. This is a normal side effect from the medication, since my ovaries are swollen from growing so many follicles. It doesn't feel great, but I really can't complain!

Quick Update

The shots are going well so far. I'm not really experiencing any side effects, other than a little soreness around the injection site. I went in to my doctor's office this morning for a quick check up. They did some blood work and I had my first ultrasound. The ultrasound showed about 12-14 follicles on each ovary, 7-8 of which were measurable (between 6-10mm). According to my IVF coordinator, everything looked good! I got the results of my blood work back this afternoon and my Estradiol level was good, so the doctor is going to keep my dosage of Bravelle and Menopur (injections) the same. No need to cut back or add more--I'm right where I should be. My progesterone level was 0.8, which was perfect since they like it to be below 2. That means my body is not trying to ovulate. For now we'll just keep doing what we've been doing and I'll head back to the doctor on Friday morning for my next check-up.

One Car Seat or Two?

We knew when we started this process that we would have to make lots of tough decisions. The one we're wrestling with right now is whether to transfer one or two embryos.  When IVF became a real possibility for us, we talked about how many babies we were comfortable having. We both agreed that we felt comfortable transferring two embryos. The possibility of twins became very real for us. We kind of just assumed that if you had more than one to transfer, that's what you did. It makes sense, right? If you're taking on the financial burden of IVF and putting yourself through so much physical and emotional stress, why not make sure you have the best chances possible? One would think that two embryos versus one would double your pregnancy chances. But that's where we were wrong. It's just not that cut and dry.

At Dr. D's office, there is a 53% pregnancy success rate from transferring one embryo. (Our pregnancy chances are closer to 65% based on our ages and my AMH level). If he transfers two, the couple's chances for pregnancy is about 60%, with a 44% chance for twins. A 7% difference in pregnancy rates? That's all? We were really surprised.It seems to us like this data means that either IVF will work for you, or it won't. Transferring more than one embryo doesn't really make much difference (if you're under 40).

The hardest part about all of this, is that we don't get to consult with our doctors about their recommendations until the day of the embryo transfer. There are only 5 days between the egg retrieval and the transfer, and during those 5 days our embryos will change every day. Some of the eggs they retrieve won't be mature enough to fertilize. After fertilization, some may grow and develop beautifully, while others may not. It's impossible to know how many embryos you have, and of the ones that you have, how many are high quality until day 5. Our IVF counselor told us that it's like playing a game of "What If?" to try to decide now. The scenarios are endless. We'll just have to wait and see.

The one thing we do need to consider, is that our doctor thinks we will have more embryos than we'll need for one cycle. When showing his chart of statistics at our orientation, we learned that we fall into the category of patients that have an average of 16 eggs retrieved, 11 that become embryos, and 5-6 that make it to the blastocyst stage (day 5). That means it is likely that we will have some left for freezing, which makes the decision even harder. If we only have two, the decision's easy--put them both in and hope for twins. But if we have 5, do we really need to transfer more than one? Is it worth the chance of a high-risk, multiple birth pregnancy for only 7%, if you have embryos left that can be frozen and used later.

Right now I change my mind daily, maybe even hourly. It's such an overwhelming decision. How will we decide? I'm hoping the right choice is obvious when we go in for our transfer, but Jeff says that's wishful thinking. We've still got a few weeks to think about it and my prayer is that we'll know what to do when the time comes.

Let's Get It Started

It's a busy week for us! Last night we had our orientation at Dr. D's office with the other couples who are doing IVF this month. Today I had my baseline ultrasound, mock transfer and medicine teaching class. Friday we start stimulation via injections!

Our orientation last night was very interesting. Dr. D took us through an IVF cycle from start to finish, explaining each of the steps and procedures. He talked for about 45 minutes and shared a few videos with us. We got to watch an egg retrieval, see how the eggs are fertilized though ICSI (intracytoplasmic sperm injection--a fancy way of saying they insert the sperm into the egg) and view an embryo transfer. All of the videos showed our doctors and were shot in our office, which I thought was neat. He showed us lots of statistics and pregnancy rates based on AMH levels. You may remember that I had my AMH level checked when I did blood work at my first appointment. AMH is an indicator of egg quality and egg reserve. Mine was 2.96, which according to our doctor is very good. This put us in the category with the highest pregnancy rates, which made us feel really good!  After Dr. D's presentation we "signed on the dotted line" so to speak, and hit the road to go watch the Tar Heels play basketball!

Today I had my baseline ultrasound, which went well. Dr. D said my uterus and ovaries looked good! While I was in the exam room, he did a mock embryo transfer. Basically he just wanted to use the speculum and catheter that he'll use the day of the transfer to make sure that there were no problems inserting it into my cervix. The mock transfer gives them information about the shape and size of my cervix to ensure the real transfer goes smoothly. It took about 5 minutes. When I finished up in the exam room, I went down the hall to meet with our IVF coordinator to go over all of my medications and how to use them. Since we've done injections before, it was mostly review. However, I'm taking more medications than last time, so it was good to learn about the ones that are new to me.

As far as my injections go, I have 4 vials of medicine that I'll have to inject each night.  The good news is that all 4 vials can go into one syringe, so I'll only have to get one shot a day! My next appointment will be for an ultrasound next Tuesday, January 17 to check in on my follicle growth.

Thank you for continuing to check in our progress and for all of the love and support you send our way! We're so blessed to have such wonderful friends and family.