Strunk Baby Update

I have long overdue pictures for you all! Little Strunk Baby made his/her debut on December 2. We got to see AND hear the heart beating, even at 7 millimeters long!

Tomorrow we get our second ultrasound, and I can't wait to see how much he/she has grown in the past 13 days!

I'm feeling pretty good overall. I eat every 2-4 hours (just like feeding time at the zoo) and I'm trying to make healthy choices. Although I think tonight's dinner will be toaster waffles and oranges or grapefruit from my grandparents' citrus trees.

Please keep us in your prayers, particularly for peace. It's still a long road ahead and though we feel as if we've overcome the hardest hurdle, it's hard to let go of the worry and doubt.

3rd beta results

Happy Thanksgiving!

Jonathan and I are so blessed to have each other and our wonderful families and friends. We cannot believe how much extra we have to be thankful for this year!

Even though my third beta came back at 10,107 (nope, not a typo), it is still hard to imagine there is a little Strunk or two happily growing away while I go about my daily life. Other than short bouts of nausea and headaches if I wait too long after I feel hungry to eat something, I don't feel pregnant. I'm sure that will change.

I'll be six weeks pregnant on Saturday so the clinic was able to schedule my first ultrasound for next week. Even though the baby will only be about the size of a pea, we should be able to see the heart beating. I'm pretty sure it will be even more incredible than seeing the embryos "ride in" on an air bubble as we did exactly three weeks ago today.

Please think of all three (maybe four) of us on Wednesday afternoon. We hope and pray that our little Strunk is healthy and happy.

2nd beta results

I got my second beta results back on Wednesday and they came in at an impressive 683.4! This is really exciting and still puts on us on the high end of normal results for a single pregnancy. And that is absolutely fine with us! The goal going into this was one baby, and if we get two, fantastic. I'm pretty sure one is plenty though! As I mentioned in my last post, beta results are supposed to double every 48-72 hours in early pregnancy, and our doubling time right now is 33.24 hours. Yahoo!

Also, my thyroid (TSH) levels showed no spike from the pregnancy. That means I won't need additional medication for now. My PTT levels showed nothing in the way of scary clot time. I was just over normal levels, which is to be expected on the heparin. I haven't had any symptoms from the heparin injections other than bruising (normal) and dizziness once in a while.

We got for one last beta result on Tuesday. I was told that there isn't any specific number they are looking for and that the clinic just checks the levels once a week until the ultrasound. My ultrasound will be scheduled for sometime next week -- it's getting closer! We can't wait to hear the heartbeat!

Think of us on Tuesday as we have our last blood work!

First beta results

I have my results back from my first hCG level (beta) test and they are: 251.5 mIU/mL! When I spoke with Nancy today, she said this is a great first number. My progesterone was also right on track with a level of 36.13, a great for first trimester pregnancy. This means I am without a doubt pregnant. Forget the 13 positive pregnancy tests I've taken so far! :)

I go back again tomorrow for more lab work and will hopefully have it back by tomorrow afternoon. They will do another beta test, but this time they will also test my thyroid and partial thrombin time (PTT). The thyroid test is just to be sure my thyroid hasn't spiked due to the recent pregnancy. The PTT test will detect how long it takes my blood to form a clot. This is because I am still taking the blood thinner, heparin, since transfer on 11/5.

We are praying with all our hearts that tomorrow's beta level comes back at no less that 402. At a miniumum, hCG levels in early pregnancy need to double every 48-72 hours, with no less than a 60% increase in two days. Please keep us in your thoughts and prayers as we wait for this critical piece of information. If all goes well, we'll have an ultrasound as early as the first week in December!

Enough with the medical dictionary! In FUN news - I love being pregnant! In the four days we've known, I've received four gifts! I get to have a baby and be showered with attention and presents?! Fantastic! Sign me up! Seriously though, it has been so great seeing how much this meant to other people. And I've wandered through Target's maternity and baby isles this weekend, feeling like I belonged there. It was an uplifting feeling and though I didn't buy anything, I almost cried on several occasions.

Again, thank you for your prayers up to this point and we ask you for more. I'm going to do that a lot in the next 9 months!

It's finally happening!

So most of you, if not all, are aware that Jonathan and I (mostly me) are pregnant. But only a few of you know that Jonathan knew before I did!

When my alarm went off at 4:15am yesterday, I did my pregnancy test as I have been doing since last Sunday. When I saw the control line and no second line appeared, I put the test on the windowsill and went back to bed. I normally throw the test away and I have no idea why I didn't. When my alarm went off again at 6am to remind me to give myself my heparin injection, I got up and went to the guest bathroom to do just that. Jonathan got up and used the master bathroom. When I got back, Jonathan asked me, as calm as can be, "Did you take a pregnancy test this morning?" I told him I had. He then asked, "Did you look at it?" I said yes and asked him why he was asking. He said "no reason" and got back in bed. Then I went to use the bathroom and saw that the "negative" pregnancy test was now positive! I said "I think there's two lines!" and Jonathan told me he thought that was the case and had even looked at the instructions on the box but was worried he might somehow be wrong if I had already looked at the test. He knew I would have woken him up if I had seen the second line.

There was a little bit of drama next as I explained to him that the test results are only valid for ten minutes, and it had been nearly two hours since I had taken the test. So I took another, and it was positive! Five pregnancy tests (and three different brand names) later, we finally started to believe it. I think the real kicker for us was when we took a digital test that read "pregnant" as clear as can be. There's no wondering if you're imagining lines on those things! That was right before we attended a baby shower yesterday afternoon. It made for a much more exciting shower for us!

Today I've only taken three tests. I'm sure I'll take many more this week. My blood test is scheduled for tomorrow and I'll have those results on Tuesday. Then I'll go again for a follow-up blood test on Wednesday or Thursday to make sure the hCG levels are doubling. Doubling hCG rates will calm fears of a chemical or ectopic pregnancy. I'll keep you all posted on those, as I am sure many of you are almost as anxious as we are.

There's still a lot that can go wrong at this point, so we need your prayers more than ever. What we are certain of is that this is a step in the right direction. We are thanking God for this blessing and ask that He continues to keep this pregnancy on a healthy track.

Update on the popsicle kids

We heard from our nurse today that an additional one out of the five embryos were added to the eight blastocysts from Thursday. The four others stopped growing. It's nothing to worry about though; combined with last cycle we have 13 embryos frozen, 10 of them blastocysts! I'm not sure how many FET (frozen embryo transfer) cycles that equates to, but at least it gives us the opportunity if this cycle is a bust. We certainly hope to not have to think about that for a few years when it's time for a sibling!

Grade-A blastocycst transfer

FANTASTIC NEWS! We walked into the transfer room today having absolutely no idea how our 15 embryos were doing. There was a picture of them up on the computer screen, but we had no idea if they were healthy.

When the embryologist came in, he said that they were absolutely "gorgeous" BLASTOCYSTS! They made it to blast stage!

When the doctor doing the transfer joined us (it's a full room: me, Jonathan, ultrasound tech, embryologist, endocrinologist) he said again how "gorgeous" our embryos were. I asked him how many they were going to transfer because I knew that our doctor's protocol for this cycle had said "up to three" embryos. That's when the endocrinologist and embryologist both said that there was no way they'd transfer three because the embryos were of such great quality. He showed us how thin the outer shell was on each. The shell starts out thick, and as the embryos get ready to literally hatch out of it, it thins out. This means that they didn't have to help them hatch out, they're taking care of it on their own!

During the transfer procedure, the doctor said I had a little bit of bleeding still left over from the retrieval, but nothing to worry about. Again, I got to see our two "kids" (or the air bubble they were riding on) travel right into my uterus on ultrasound. So very cool. I was instructed to start taking the heparin tonight so I get to wear a really awesome *cough cough* bracelet just in case something happens to me and I'm unconscious and can't tell medical personnel that I am on blood thinners.

I know everyone wants pictures and I aim to please, so.... tada! If they look different from last time, it's because they are. Like I mentioned in my post from a couple days ago, they change a lot in 48 hours, or at least have the potential to. It's a completely different animal (see the Eight-Celled Children post from September if you want to compare). These are more like 100-150 celled-children.

If you can see the dense cluster of cells (easier to spot on the left embryo, at about 10 o'clock), those cells will become the baby. The scalloped cells on the outer edge will be the placenta. Pretty neat to realize that each one of us starts out this way.



As for the fate of the other 13 embryos, 8 were fantastic enough to freeze today and the other five will be observed for a couple more days to ensure that they could survive freeze. I should have an update on their status early next week. I am excited that we have 12 total embryos frozen as of today, 9 of them blastocysts. I would love to see the other five make it as well, but I'm extremely happy with our "stash."

I really really really cannot thank you all enough for your support. We are so very blessed not only to have this opportunity to pursue our dream, but to have incredible friends and family to back us up. I have received so many countless phone calls, emails, comments, and text messages and we never, I mean never get tired of them. I wish we could name a kid after each one of you. :) The pregnancy test will be on November 16, so keep thinking of us!

Transfer scheduled

The transfer will happen tomorrow at 11:30am. I am very happy that we've made it to five days, but I have no idea how the embryos are doing at this point. Truthfully, I don't even think they'll bother them until right before doing the transfer tomorrow. I guess we'll have to wait until then to find out the quality and if they made it to blastocyst stage.

Either way, Jonathan and I are going to take ourselves out to a much-deserved sushi lunch afterward.

I'll give everyone an update (and hopefully a picture of the "kids") as soon as I know.

Thank you for the continued prayers, comments, and support. You have no idea how much easier this process is being able to share with friends and family who love us. Sweet Aunt Marcy, you better hope for at least one girl if you have any hope of a child being named after you! :)

Five-Day transfer!

Nancy call me this morning and told me that we would not be transferring the embryos today! Yahoo! That means that we will be doing a five-day transfer on Thursday. This is really great news. It means our embryos look healthy enough to keep on growing in that petri dish. The process will weed out some of the weaker embryos in the next two days, and allow a great success rate for us!

If you're interested in the details of why this is the case, here is an article for you. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700692/

Nancy will call tomorrow with a transfer time for Thursday. I'll keep you posted on our appointment time.

Recovery/waiting for transfer

I'm back! I appreciate everyone's prayers during the entire weekend. 15 embryos is great: it's a 50% increase over last time!

Some of you have heard, but my egg retrieval was not as fantastic and easy as last cycle. In August, when I woke up after retrieval, I felt fantastic, better than I did before going under. Saturday was not so easy. I woke up during the retrieval, which the doctor doing the procedure confirmed. He said I "got a little uncomfortable on the left side." Well, obviously if I managed to wake up during my drug-induced stupor and remembered it. Thankfully, the anesthesiologist knocked me back out in a hurry and next thing I knew I was in the recovery room. I was in a good deal of pain but Jonathan got that under control quickly enough and I was able to sleep for pretty much the next two days. I'm not sure what was different this time. My guess is that the follicles were just harder to aspirate.

Despite all of that, if it means we get pregnant, it will be completely worth it! I've got a tentative appointment tomorrow at 11am for transfer but we're hoping that the embryos can hold off until Thursday for a 5-day transfer. That will mean they're bigger and happier and better chances for a baby!

So please continue to pray for the 15 tiny Strunks in the petri dish. We need them to hang on just a few more days!

15 embryos!

Good morning!
Melissa just gave me the report, and they have good news!
They have 25 mature eggs and 15 embryos. This is very good news from the Strunks!
Have a happy Sunday!

Jamie

And the total is...

OK - Johnathan just texted again....and the total is (drum roll, please) ....

25 mature eggs!
Melissa is doing fine; she's a little sore, but nothing too bad.
Stay tuned!

And...she's out!

Hi Everyone!
Jonathan texted me and they've just finished the retrieval. Now, we just wait for the count! Say some prayers, people!

Jamie

All set for a Happy Halloween!

I met with my doctor today who informed me that things looks fantastic as far as the number and size of the follicles and estrogen level. I just need to make sure that I drink lots of water to prevent OHSS. I had a small amount of fluid in my endometrium so I was instructed to take Mucinex D until transfer as a precaution. Apparently it dries up things other than just your sinuses. The fluid isn't a huge deal, but it can make my uterine lining "spongey" for transfer. I don't really understand it, but "spongey" doesn't sound like anyplace I'd like to hang for nine months.

Egg retrieval will be on Halloween at 9am. I know not many of you will be up at 9am on a Saturday, but please keep us in your thoughts and prayers as always! I'll have Jamie give an update as soon as we know the number of eggs retrieved and then fertilized.

Transfer will be either Tuesday or Thursday, depending on egg development and quality.

Thanks everyone for reading. I really do appreciate all of your kind words, so comments are encouraged!

Busy ovaries

Hi everyone! Here is a quick update on the progress this cycle:

With an AFC of 44 as opposed to last cycle's 30, along with more FSH this month, my ovaries are very busy and pretty sore. I am incredibly happy about this because it means that we're getting even better results than last time. I'm on cycle day 9 right now and I have 31 measureable follicles compared to last cycle's 21 measureable follicles on this same day. Also, my estrogen levels are almost 1,000 points higher than this time last cycle. More estrogen = more follicles! I had an unexpected sushi lunch with my dad today as well so it turned out to be a great day. I'm hoping it was the last time I get to eat raw fish for quite a while!

Jonathan will definitely be injecting the trigger shot tomorrow night. Nancy will call us after my appointment tomorrow to tell me exactly what time to administer the shot and what time egg retrieval will be on Saturday. I have a personal goal of 30+ eggs retrieved, but we'll see what happens. I can't exactly train for this. Well, maybe that's what I've been doing for the last 3 years! I agree with one of the sonographers this week when she said, "You've certainly paid your dues; it's time for you to be pregnant!"

On to round two!

Hi folks! Sorry we've been MIA, but there really hasn't been much to report in the month we didn't cycle. My medication is in, including the new stuff: heparin and prednisone. As I mentioned last month, the heparin is meant to thin my blood to prevent the micro-clots from interfering with implantation and the prednisone is a steroid used for eliminating any uterine inflammation that might be present and lower my immune system just in case my body was attacking the embryos last time.

It was a bit of a surprise, but my cycle started this morning. That would have normally meant that we would head up tomorrow (day 2) to get clearance to begin taking the FSH. However, since Jonathan just happened to have an appointment in the same building today, our wonderful nurse let me do my cycle check one day early to keep us from having to drive any more than we already do. I won't know what my estrogen levels are until tomorrow, but she said everything looks great so we should be good to go.

What I DO know is that my AFC was 44 today! Last cycle it was 30 and we got plenty of eggs at retrieval, but the 50% higher count means that we could get even more eggs this time! That is very good news for us and a fantastic start to the new cycle. Let's pray things keep going this well. With the new protocol and today's AFC, we really hope this is a sign of great things coming our way!

Oh, one more thing. Our retrieval is tentatively scheduled for October 31. Yep, Halloween and more importantly, Gators vs. Dawgs. If the Gators can make them look like chihuahuas, I'll take that as another good sign! (Please still pray for us if you're a GA fan! We need it!)

New plan

So by now everyone is aware that our first IVF cycle was not successful. My beta (a test that measures hCG levels in the blood) was less than 0.5 so that indicates that neither embryo ever implanted. My doctor was very surprised that we had such a perfect cycle and then BFN. BFN is an acronym in the infertile community that means "Big F***ing Negative." It's certainly not scientific, but a great description of what we had.

Jonathan and I have decided to move on to another fresh cycle instead of using the frozen embryos we have in storage. Chosing another fresh cycle requires that we sit this month out to allow my ovaries some time to rest from all the hormones. It will also allow us a greater chance of success and possibly more embryos in storage for future siblings if we are lucky enough to get pregnant our next round. It also give all three of us (me, Jonathan, and our doctor) time to regroup and determine the next plan of action.

Bear with me, this next part is hard to explain. It's hard for me to understand and I've been researching it for months......

I have been on Folgard since May of this year, when I was tested for MTHFR (methylene-tetra-hydrofolate-reductase) abnormalities. MTHFR is a gene important to the production of the amino acid homocysteine. Too much homocysteine in the body can increase a person's risk of heart disease and blood clots. I have heterozygous A1298C MTHFR. This means that one copy of my MTHFR gene is normal, and the other is not. Of all the clotting factors to have, mine is the least severe. It's treated with baby aspirin and the Folgard I mentioned above. Folgard is just a prescription strength Folic Acid and B-complex that I will take for the rest of my life.

Now, what do blood clots and vascular problems have to do with pregnancy? A lot actually. When an embryo is trying to implant the uterus, the tiny, microscopic blood vessels must be able to form so that the embryo can grow into a baby. If a microscopic blood clot were to form in one of these vessels, the embryo would be unable to implant and there would be no pregnancy.

Because I have tested positive for a genetic clotting factor, it is likely that there are other factors I would test positive for that have not even been isolated for testing by the scientific community. So my doctor wants to add another medication in the battle against my blood: heparin. Heparin is an anticoagulant used for people with blood clots. It is also used for women with more severe MTHFR abnormalities or who have reccurent miscarriages. Even though it is not typically used for heterozygous A1298C, thinning my blood even more than just the baby aspirin and Folgard already do will reduce the chances of microscopic clots in my uterus even more.

She would also like to put me on steriods after the retrieval for a longer period of time just in case my immune system is trying to attack the embryos. The steriods will suppress my immune system and calm any inflamation that might be present.

There were also some indications last week that my progesterone (the hormone that supports a pregnancy) levels were low. Next cycle we will be supplementing the injections with oral progesterone as well and checking the levels from earlier in my cycle.

There are certainly some risks to the new plan. Jonathan and I have an appointment with our doctor next Wednesday (9/23) and hope to have more information on what exactly those risks are so that we can make a decision. Though the news that we aren't pregnant is heartbreaking, we are very excited that our doctor is already looking ahead and determined to get us a baby! We feel very blessed to have her knowledge and experience to help us along and we are certain that we're in the right place.

Thank you all so very much for all your prayers and well wishes. We have felt very supported and uplifted by all the comments on the blog, facebook, and in person. Please continue to pray for us in this month off. We need patience and wisdom.

I'll be certain to update everyone of what we learn at our appointment next week.

Love,
The Strunks

Frozen embryos

Well, of the eight embryos that we did not transfer on Monday, three were frozen that day because they looked happy and healthy enough that they might be able to survive thaw. The other five were watched (I like to picture the embryologists babysitting the little guys) to see if they continued in their growth and could be frozen along with the others. Only one of the five kept growing and looked healthy enough to survive thaw and was frozen yesterday. That leaves us with a total of four frozen embryos if it is determined that a frozen IVF cycle would benefit us if this cycle isn't successful. Hopefully we won't ever have to worry about that!

Eight-celled children

Alright, everyone! It's the long-awaited photo of our "kids" in all their eight-celled glory! Don't they look like happy little Strunk Babies? We hope they're both happy enough to hang around for nine more months!

Embryo Transfer

So in a last minute call from my clinic, the embryologist decided that he DID want to transfer the embryos today instead of Wednesday. We made the two-hour drive in about an hour and a half (we would have loved a police escort) but we arrived safely.

The procedure was done adjacent to the cryogenics lab. We even got to peek inside. It's so amazing; the floors around the cryo-tanks peel (even concrete) because it's so cold! The doctor doing the transfer told the embryologist to prepare the embryos and then the embryologist just popped out of the cryo lab and handed them to him. The transfer took just seconds and we were able to see the two "embryos," well actually just the tiny bubble they were riding on, as they entered my uterus through the tubing. Truly incredible. I can't say enough about how insane it was to watch. After that the embryologist checked the catheter to make sure that the embryos weren't still in it and that was it! Other than the ridiculously full bladder I had (necessary for the procedure) it was an enjoyable day at the clinic.

OH! And I actually have a picture of the two embryos that were transferred today. I'm hoping to be able to say to my kid(s) one day, "hey, this is you three days after conception when you were only eight cells big." Who gets to have a picture of their eight-celled children?? I do! I do! I'll have to make Jonathan scan it so that everyone can see our amazing little Strunk babies.

Embryos are graded like students: A=excellent, B=good, C=not so good (but passing), D=boo for you. So out of our ten embryos, we have three grade A (two of which were transferred today), two grade B, and five grade C.

The two B's and one A left over will be frozen today for potential use if this cycle fails of if we want more kids. The other five will be given a couple more days to grow to see if they would be strong enough to make it through a thaw. If there are any of those five strong enough after two more days, they will be frozen along with the three from today. It gets confusing even to me so if you're lost you aren't alone.

So far so good.....

Hi everyone! It's Melissa again. Thanks so much to Jamie for keeping everyone in the loop while I was out of town all weekend. And thank you for the prayers. They're working and God is working miracles at a laboratory in Atlanta!

The IVF nurse called me this morning and said they're 90% sure that the embryo transfer will be on Wednesday but we'll know more tomorrow morning. This is great news. The longer the embryos have to grow, the better the embryologist can "weed out" the weaker of the bunch. Of course I'm hoping they'll all be strong and fabulous and they'll have trouble picking out which two are the best for transfer because all 10 are so great.

More updates tomorrow....

Egg Update

Melissa just texted me and reported that of the 24 eggs retrieved, 20 were mature and 10 of those fertilized. Now we just pray that they keep growing. They're on their way!!

All for now!

JCD

Egg Retrieval Update - She's awake!

Hi Again! (It's me, Jamie)

Jonathan just text messaged me and said that Melissa is awake and doing well.
The doctor told her (and I'm quoting Jonathan here) that "she was an egg machine" and that they counted 24 eggs - two years worth!

On Saturday, they will know how many mature eggs were retrieved and how many fertilized.

All for now!

JCD

Say a little prayer!

Good morning!
My name is Jamie Dickson, Melissa's best friend. As you all know, she will be having the egg retrieval procedure at 8:30 this morning, so I am reminding you to please pray for her and Jonathan as they take another step towards parenthood.
I'll be posting updates today and tomorrow, so stay tuned. =)

And, on behalf of the Strunks, thanks for your prayers.

Jamie C. Dickson

Egg retrieval: Friday 8:30am - Prayers Please!

Ok, so this should be a short post because I've got to take Cleveland to the vet in a few minutes.

I just got a call from our IVF nurse and the Pregnyl (trigger shot to "trigger" ovulation) is to be administered tonight at 8:30pm. That puts egg retrieval at precisely 8:30am Friday. We'll be at the clinic from 7am that morning, but if everyone could please put a note on your fridge, bathroom mirror, blackberry, iphone, WHATEVER to pray for us and our doctors at 8:30am Friday, we would appreciate it very much. I don't care if you're Budhist, Jewish, Hindu, Christian, or atheist; just pray. I promise we will appreciate it all the same as I am extremely nervous, not necessarily about the procedure but the quality of my eggs and their successful fertilization.

We won't know until Saturday how many mature eggs were retrieved and how many fertilized but I will update as soon as I know.

Thanks everyone! By the way, this is the prayer I have been repeating to myself for comfort over the past few days:

"May today there be peace within.

May you trust God that you are exactly where you are meant to be.

May you not forget the infinite possibilities that are born of faith.

May you use those gifts that you have received, and pass on the love that has been given to you.

May you be content knowing you are a child of God.

Let this presence settle into your bones, and allow your soul the freedom to sing, dance, praise and love. It is there for each and every one of you."

One more day of FSH

Nancy, our IVF nurse, was VERY pleased with the progress my ovaries are making. She and our reproductive endocrinologist ordered one more night and one more morning of FSH. This means that tomorrow night Jonathan will give me the trigger shot.

The trigger shot is hCG (that's right, the pregnancy hormone) called Pregnyl and will cause my body to ovulate. After five straight days of forcing hormones to STOP by body from ovulating, the Pregnyl is administered to convince it that yes, it IS time to ovulate and that it needs to be on time. And it must ovulate precisely when egg retrieval is being performed in order to capture the most number of mature eggs possible. My clinic will let me know tomorrow what time to give myself the Pregnyl and exactly 36 hours later I will be under the knife....er.... needle that is.

I've been freaking myself out all afternoon googling images of egg retrieval. These are not graphic, thank goodness but they are still unsettling when I think about all that is at stake. http://www.avapeter.com/p/en/483-1.gif

I will be under "twilight" anesthesia for Friday's egg retrieval. It is similar to the anesthesia used for dental work and colonoscopies; I will be semi-awake and able to respond to commands but will I won't remember a thing. Which is great, because I'm pretty sure that stuff could haunt your nightmares.

While I am under, Jonathan will be providing a... sample.... to fertilize the eggs. Each of my eggs will be fertilized by a procedure called ICSI, or intracytoplasmic sperm injection. It sounds complicated and I'm sure it's not easy but it's simple enough to break down; ICSI is basically just injecting one single sperm into one single egg with a microscopic glass needle. Technology is amazing, isn't it?

Jonathan and I will get a call sometime Saturday to let us know how many eggs were retrieved and how many were mature enough for the embryologist to fertilize with ICSI. Then we wait for more news as the microscopic embyros grow. After three to five days of growing, we will hopefully have at least two embryos to transfer back to my uterus. The rest will be frozen for later. We're desperately hoping that "later" means when the kid conceived this month is ready for a sibling and not "later" this year because this IVF wasn't successful.

It is really hard to believe that we're getting ready for egg retrieval. This has been months, even years in the works. We actually have a 50% or greater chance of becoming pregnant next week. Incredible!

Overdue update

Let me first apologize for the delay in updating the blog. We were in Atlanta all weekend going to IVF appointments AND having a little bit of much-needed fun with the family.

My medication dosage was increased on Thursday afternoon and I've been trucking along on the new dosage since then. My estrogen levels have been right on track; this is great news because serum estrogen levels are one indicator of how many follicles I've got and how ready they are for retrieval. For every mature follicle, there should be approximately 200-250 units of estrogen. As of today, my level was at 702. There were 20 (!!!) measurable follicles on ultrasound today. My doctor seems certain that at least 14 to 15 of them will make it to maturity by Friday, my (tentatively) scheduled day for egg retrieval.

On Saturday, my doctor added Ganirelix, another injectible medication, to my daily regimen of drugs. Ganirelix stops the LH (luteinizing hormone) surge that causes ovulation. By giving myself the Ganirelix injeciton every morning, I am forcing my body to wait for ovulation until it is time. It burns and itches more than the Follistim injections but that's just because of the slighly larger needle.

For the next couple of days, I'll continue to give myself the Follistim twice daily and Ganirelix in the mornings. I go in for more labwork and another ultrasound tomorrow morning and should know by tomorrow afternoon if my egg retrieval will be set in stone for Friday. I'm really hoping that it will be because that will give more follicles a chance to get mature enough and potentially get to the 20+ egg retrieval goal my doctor had set for me.

We have definitely felt everyone's prayers and well wishes pulling us through this past week. So far, it has been less stressful than all of last year's treatments. I am not sure if that is because we finally feel like we have the opportunity to pursue a treatment that we feel will be successful for us or if it's the fact that we've shared our struggle with everyone and so they have been able to pray for us. Perhaps it is a combination of both. Either way, we are SO GRATEFUL to everyone and everything you are all doing for us, from my mom buying low sodium beans because she knows that I'm supposed to be eating very little salt to prevent OHSS and replacing her flourescent light bulbs with incandescent so that I won't get a migraine to Jake and Jamie always offering to feed our dogs if we get home late from appointments. Thank you so much. Please continue to keep us on your prayer list.

AFC = 30!

We had a wonderful day yesterday at the clinic. We found out that my antral follicle count (AFC) was 30! The AFC I had done in June was 20, which is still a great number, but 30 is fan-friggin-tastic!

Because each fluid-filled follicle should contain an egg, an AFC test gives the doctors an idea of how well you could respond to the medication and is the potential number of eggs that could make it to maturity by egg retrieval time. However, sometimes there are more eggs retrieved and sometimes there are less but it's a good starting point to help understand what our chances are. Here is a great link that shows how promising this cycle looks for us: http://www.advancedfertility.com/antralfollicles.htm (see charts)

Since my doctor would like to retrieve between 20 and 30 mature eggs from me, we are right on track.

I could hardly believe it when after counting 13 follicles on my right ovary, the ultrasound technician just kept on counting with my left ovary until she got to 17! While an AFC of 30 does put me at a slightly higher risk for ovarian hyperstimulation syndrome, or OHSS, it is one of the reasons we have to travel to Atlanta every day for the next week and a half. Our doctor and nurses will be monitoring me very closely through ultrasounds and bloodwork to try and make this process as safe as possible while still successful.

Last night I began the FSH injections. FSH is follicle stimulating hormone. Our bodies (male and female) produce this naturally, but the additional amounts of hormone added are meant to allow as many potential follicles to grow as possible. Right now my dosage is 150IU at 7pm and 225IU at 7am daily. After tomorrow's bloodwork results come back, a nurse will call me and let me know if I need to change my dosages. For now, we'll just wait and grow the follicles until they tell us it's time to go get those eggs!

IVF time!

Hello everyone! I am so excited to announce that it's finally time for our IVF cycle to begin! Cycle day one came early this morning after days and days of waiting. (Thirty-seven to be exact.) That means that tomorrow we'll make the first of many treks to Atlanta to visit with the doctors and nurses and hopefully get the "all clear" to begin the injections tomorrow night.

As for today, Jonathan and I are beginning the first week of our antibiotics to make sure we're both healthy enough to make it through this process. Your prayers and well wishes are appreciated.

I'll be sure to update everyone tomorrow on our protocol and let you know if we are good to go!

Medication has been ordered - major milestone

Hi again! First of all, let me say how encouraging it is to read your comments and messages about the blog. It is always scary to put yourself out there when you've kept family and friends in the dark for so long about your infertility struggle. I appreciate everyone who is following us regardless of whether or not they are posting comments/sending messages.

I called Concord, our fertility pharmacy on Thursday just to make sure they had the progesterone in oil (PIO) that was suspended in ethyl oleate (the thinner oil) that we used for our last IUI cycle. They had told me previously that all I needed to do was give them a heads up so that they could make it and have it ready when I needed it. Well, when I called them Thursday, the tech informed me that they could no longer get PIO in ethyl oleate and that I would have to use the PIO in sesame oil or peanut oil, which are much thicker than ethyl oleate. This means that instead of sticking myself with an 1 1/2 inch-long 25 gauge needle, I would have to stick myself with 1 1/2 inch-long 22 gauge needle. I know this does not sound like a big deal, but it's the difference between large, painful bruising and tiny, tender ones. Above, I posted some pictures of the difference between a 21g needle (I didn't have a 22g on hand) and a 25 g needle so that you could see what a difference this would mean for an intra-muscular injection.

Thankfully, we found a pharmacy that could get us the PIO in ethyl oleate so I won't have to worry about that anymore! All of my medications are being delivered to my job on Tuesday on dry ice. I'll have to run home and pack most of them in the fridge until it's time to use them. I think it will finally seem real when every time we open the fridge, there will be our vials of medication sitting next to the milk and eggs! All but one of the medications we have used before when doing IUI but has been awhile. Thankfully there is a refresher course online I can take if I forget anything.

A long time coming.....

Hi, everyone!

I am really excited about this blog. It's a great way for us to keep friends and family updated without having to answer too many questions after what might have been a very rough day or week. I thought in this first post I would update everyone on some of what we've been through in the past few years. This will be a review for some of you and news to others. Keep in mind this is keeping a VERY long story short, but I did not want to post a novel here!

We were married in April 2006 and had a beautiful wedding despite the torrential rains. That fall, I got off of birth control and got on prenatal vitamins. Through a series of testing, we found out in January 2007 that things were not going to be as easy as we had hoped. However, we were not yet ready to pursue fertility treatments. We spent 2007 making some important decisions. In December, we had our first appointment with our reproductive endocrinologist.

In January 2008, I had a laproscopic hysteroscopy to remove stage 1 endometriosis, pelvic adhesions, ovarian cysts, and uterine polyps. We were officially ready to start infertility treatments.

The course of action our doctor chose for us was intra-uterine insemination, or IUI. If you aren't sure what this is, here's a link, though it might be more than you cared to know. (http://en.wikipedia.org/wiki/IUI)

We had IUIs in February, March, April, and June of 2008 using both oral and injectible medications. Though my response to the medications was very good, we did not get pregnant. After being beaten up emotionally, financially, physically, and spiritually, our doctor told us it was time to move on to IVF. Again, if you're curious.....(http://en.wikipedia.org/wiki/IVF)

We never thought IVF would be right for us. Not only is the cost prohibitive, but the procedure is much more involved in every way. Strangely enough, the risk for multiples is actually LESS with IVF than it is with IUI. Just a note for those of you who are worried we'll need our own reality TV show soon: Jon and Kate Gosselin of "Jon & Kate + 8" got both their sets of multiples from IUI, not IVF. That's not saying there won't be risks. I'm just putting things in perspective for you.

Well, I am sure you can all see where this is headed. We found a way to afford IVF and decided that whatever it required of us emotionally would be well worth even just the chance to have a child. We were able to get approved for a shared-risk program that guarantees all but a small portion of our money back if we do not succeed. We purchased a package that includes three fresh and three frozen (6 total) IVF cycles.

We've had some set backs along the way in terms of final approval and getting our protocol, but this time we are really ready to go! We're just waiting on mother nature to bring my next cycle. And that could be anywhere from 1 1/2 to 3 weeks.

Please pray for my sanity during this time. While we are very excited and know that we are blessed to have this opportunity, we know what the stakes are and that's what makes it tough.