IVF#4 2DP5DT

New Years Eve. Had a fun day at the movies saw The Hobbit then we got out in time and decided to do 47 Ronin too - loved them both - then went and had dinner at Ponderosa New Years Buffet, ate tons of crab legs lol. Scott's friend Joe came with us was nice. 

Bummer is my back is killing me now from sitting and the cold, in a ton of pain. It is so cold here it's making my fibro flare up bad and I can only take tylenol for it too :( Going to bed. not staying up till midnight, as we have to be at my mom's in the morning for our Christmas get-together. Tried not to think about the what ifs today but it was hard. I feel down, worried that nothing is happening again. 

I think of all I have gone through this past year the journey of ttc, testing, apt. procedures, etc. My hips are hurting from the PIO and my leg where I stabbed myself this morning, my tummy is black and blue and sore, I am bloated/swollen from all the Predisone I can hardly fit into my jeans and all I can think is this is it, can it just be time now God please! I had thought at the end of 2013 we would of had a better year. 

I can not but help to think of our baby Uri we lost last year and how he/she would of been almost 6 months now had our first holiday season together. I had told myself after that loss that it was ok cause by the end of this year I'd be pregnant again but it did not work that way. 2014 needs to be a better year and needs to be our time! I so yearn to feel that joy I had for but a brief few weeks again and I don't want to let my husband down again, please God not again, please let this year be a start of something wonderful for us. PLEASE hear our prayers!

IVF#4 1DP5DT

Got my lab results today from Dr. K from 12/19 visit.

Chemistry and Thyroid function are normal CBC is showing elevated White blood count of 15.3. Vitamin D level is low at 27.9 NKs 50:1 is elevated at 26.0 (target range less than 15); %CD56 is elevated at 15.3 (target range less than 12) Th1:Th2 TNF is elevated at 40.7 (target range 13.2 - 30.6); IFN is normal at 15.0 (target range 5.8 - 20.5)

She wants me to up my VIT D to 4,000 IU a day will have to go get some more today as I was doing 2,000 IU. Stay on 30mg of predisone, 2 lovenox a day and repeat CBC. I told them it have to be done today as after the end of the year I am not doing all those labs can not afford it.

I hope the intralipids lowered those numbers for the killer cells as this was done the day after I did them and then I did a second one too. It can take around 10 days for them to work.

The sad news of today is no embryo's to freeze today none where good enough to do so and they only freeze if expanded blasts. I wish I would of put my foot down and done the 4 yesterday, it may haunt me forever if this one fails again. So all we got is the two we left frozen and what we transferred yesterday. 

I feel pretty numb today like I am in a dream that we even did transfer yesterday. Probably my way of protecting my emotions right now. I know others have gotten pregnant on embryo's not half as good I just hope this time works cause this is it for any fresh IVF's for us.

IVF#4 Transfer Day

It's Time

Today was the big day. I woke up feeling excited that after yesterday's embryo report just maybe things would be better this cycle then in the past when we got to the clinic. We had to be on the road by 5am to get there in time. When we arrived all the lights where out and we wondered if they had told us the wrong time but a nurse came to the door and let us in. Took us back to the surgery rooms and I got changed into a gown etc. waiting for the Dr. to come in and let me know what kind of embryo's we have this morning to work with. Also had to keep drinking to fill my bladder.

When Dr. P came in the news was not as we had wished, prayed and hoped for. The excitement of the morning went away to only feelings of dread and stress. Yesterday we had 5 promising compact morula's growing. By this morning only 1 had made it to a full blastocyst and the rest where only almost full blastocysts. My heart sank and tears began to well up. Why us again, what is wrong with me, what is wrong with my body, my eggs, my life. I feel like such a defect and have all my life. It's so unfair that my husband has had to be saddled with a wife who can't give him kids and can't even produce excellent embryo's. After all I did from diet, to weight loss, to extra daily supplements, thousands of shots in my stomach, hours of trips in the car, tons of money and all we get is a report that our embryo's really don't have the promise they had thought would be there today. I know a lot can change from day 4 to 5 but I had so prayed this be not the case this time.

We had to decide how many to transfer and what we wanted to do. Our options where 3 where best in our RE's opinion, she kept saying that over 3 has been shown in studies to put off more proteins that may prohibit implantation. Other option was to wait a few hours and let them defrost our two frozen and use those two and the 1 full blast from the fresh. My gut was to do 4 of the fresh all week if they where not of the quality we wanted. My husband and I debated for a good 20min on what to do. If we used the frozen and none went to freeze this cycle then it was over we had no more try's, as we know this will be my last fresh cause of my age. And we did 5 of our 7 frozen in FET's earlier this year and nothing happened. So we crossed that off and decided we did a fresh because the statistics are that it's better, I wanted the 4, my dh said 3 (even though he agreed to 4-5 on the way to the clinic), I gave up and said fine do 3. Hours later I am still a little upset as I really wanted to do 4. Nothing I can do about it now, I felt pressured not to.

I am pretty scared that the quality is not good again and nothing will take or another mc will happen. I think being through this now for the 6th time and knowing what can and can not happen weighs heavy on a person. The first IVF we where so optimistic and had no idea now 2 1/2 yrs later all has changed. I do know that with the blood clotting disorder and immune issues addressed that at least maybe if one try's to take this time we may have a higher chance of not mc. I wish I had not waited so long to do IVF that we had known it was even a option 10yrs ago but back then I just had a obgyn and he not once mentioned I see a RE or do special testing and I had no idea about a specialist. I feel we have waited to long at 40 and with embryo's that did not make it to expanded or hatching there is slim chance for us.

The transfer part went well as always. Scott had to put on his bunny suit as they call it and our blue smurf hats, masks etc. We get to watch on the ultrasound screen as they insert the tube and the embryo's go in. The lab tech checks the tube to make sure all 3 came out and none got left in there. Had to joke with the lab tech or as they call him the expensive babysitter that here we where once again. I didn't do acupuncture this time around. We didn't really have the extra to have her come and do a session and the transfer being so early in the morning it would of made it difficult to have done it. Instead after I just laid there for 30min and rested before I got dressed and left.

We still have embryo's growing the lab yet at least 2 - 5 but they are not sure if they will make it to freeze tomorrow they would have to drastically improve to do so. All we have now after this is our 2 frozen from Sept. 2011 maybe one more chance at a FET if we can ever come up with the money to do so.Which is a big IF.

The Valium this time around made me very sleepy, we stopped and had breakfast at our place Gus dinner but I promptly feel asleep on the drive home and crawled in bed most of the rest of the day to rest. 

I have so many more fears this time around knowing we are down to the last try. It can be hard for others to understand who have not gone through so many failed IVF's or have seen miracles happen for them. I do what I can to stay positive and believe this will work as best as one can in my shoes. It is hard to explain in words how I feel, this 2ww til Jan 8th beta will be extremely difficult for me. I am not a person to cry and break down but this has brought me to it. I see so many new lives and families happening all around me to never feel life in me again, to never hold a baby of our own, to teach them, help them grow, to never have this is not what was suppose to happen, this was not our happy ending. Life has been a struggle for me all my life. One gets weary of struggle and pushing and hoping that tomorrow will be a better day. Had a talk with the nurse and stuff at the clinic while waiting for transfer on adoption and all the other ups and downs that brings and how difficult that is and almost impossible in this day and age especially for people like us with no funds and can't do it. Why is good people who just want to be a mom and dad who try to live a good life do what is right struggle and then others bang there pregnant, nor do they care to be pregnant or want a kid. I wonder all the time why God allows this and where is he. I kept telling Him this week if miracles happen then show me in my life and make something happen for us to help my faith if nothing else. I don't know if I will even be able to continue to minister to others dealing with infertility if this does not work for us, it's become really hard to see how happy everyone is who goes on to have babies and some on second babies and us empty arms year after year, how does one continue to provide hope to others when you feel no hope or feel God did not listen. I know my purpose should not be all wrapped up in being a parent or not but for me it has been for a long time, I don't have a career, a meaningful job, etc. I just have my desire for family. With that option taken away I don't know why I am here? I've told my dh that working with kids is not a option for me either that I've done that in the past but now it be too hurtful seeing families and not having even the hope of having one. Foster care maybe ok if we can do it to adopt just unsure if they would even except us. Infertility has taken from me joy and I don't think it will ever come back. I hate what it has done to me, and our marriage and my life!

I didn't really take any pics today of us at the clinic was not feeling up to it. I did get some pics of our embryo's and them going in that I can share below. Just pray for us that God hears us finally and not just with another mc but a successful pregnancy. My heart just can't take another failure!

Beta is Jan. 8th but I am unsure if I will do the blood work unless I get a positive HPT first.

little blue arrow shows the white area of the embryo's going in the uterus

our 3 embryo's and ultrasound pic of them going in

Full Blast - was the best one out of the bunch

early blast

early blast

Trying to hold on to His promises: 

Don't worry about anything, but in all your prayers ask God for what you need, always asking him with a thankful heart. And God's peace, which is far beyond human understanding, will keep your hearts and minds safe in union with Christ Jesus. -Philippians 4:6-7

"If miracles really happen then can one happen for us God?" - patiently waiting

"God's favor will cause things to fall into place for you, even when the odds are against you!"

Jesus said, “Keep asking, and God will give you your heart’s desire. Keep searching, and He will reveal Himself to you. Keep knocking, and God will throw His door wide open to you.” ~Matthew 7:7 (Randy Reed Paraphrased Version)
 

Isaiah 40:31 Amplified Bible (AMP)
31 But those who wait for the Lord [who expect, look for, and hope in Him] shall change and renew their strength and power; they shall lift their wings and mount up [close to God] as eagles [mount up to the sun]; they shall run and not be weary, they shall walk and not faint or become tired.

IVF Cycle Comparisons:

#1 Cycle: 32 eggs - 20 fertilized and were mature - Day 5 Transfer of 1 full blastocyst and 1 almost. 2 blastocysts on day 6 frozen - Results: Chemical pregnancy/miscarriage

#2 Cycle: 18 eggs - 14 where mature and I think it was like 10-12 that fertilized - Day 5 transfer 3 almost blastocysts transferred on day 5 - none made it to day 6 to freeze - Results:BFN

#3 Cycle: 28 eggs - 20 mature  and fertilized - Day 5 transfer of 3 blastocysts 2 where expanded and 1 full  - Froze 5 on day 6 - Results: Chemical Pregnancy/miscarriage 

#4 Cycle: 29 eggs - 10 mature and 11 fertilized - 8 where doing well all week but day of transfer only 1 was full and rest early blasts. Day 5 Transferred 3 1 full and 2 early blasts.  Results - ? Freeze - ?

FET Cycles

#1 Transferred 2 Blasts - BFN

#2 Transferred 3 Blasts - BFN

  

IVF#4 Embryo Update #3 (4DPER)

Our morning update. We still have like 10-11 embryo's going, 8 on track to blast, but out of that 8, 5 are really good they are already compacted morula. After talking to my RE it does sound like out of our 4 cycles this one is on track so far to have the best embryo's even with less of them the quality of 5 already going to compacted morula is excellent. A lot can happen between now and tomorrow morning's transfer though but the hope is we get some hatching blastocysts as those are the best blasts you can get and shows the strongest one's best growers to transfer.

I have no idea what to transfer. I was leaning towards 4-5 this time around. Won't know our final decision till tomorrow when we talk about how they are looking in the morning. Have to be at our clinic by 6:30am with transfer around 7:30am. So early UGH! It's a drive to to get there so it will be up VERY early for us. 

I feel a little excited for once maybe this is it! :)

IVF#4 Embryo Update 2 (3DPER)

Was a nice day. Went and got a haircut as mine was getting kinda long. My regular lady is out so I had another one not sure if I like how she cut it lol. Then I went and had another Intralipids IV infusion done to keep my NK killer cells lowered this afternoon. Doing that took up most of the day by the time we drove to Coram and I sat there while it dripped. Think we arrived at 3pm and left close to 6pm. I am glad I went and had a second one done as with the cycle being pushed a little longer it would of been over 10 days since last lipids and I just was not feeling good about risking my NK killer cells going up before transfer day.

I did get a call from our clinic, was a message when I got home, that we have 11 embryo's of which 8 are still on track to grow to blasts. They didn't tell me much more than that like grades of them. That I don't know yet.

I guess I am at peace about it right now. I know I have done everything possible to make my body ready for transfer treated everything we could and I had prayed that we would have quality over quantity as that was most important so hopefully somewhere in that bunch is our one. Got to let go and let God only he can create life.

Still unsure how many to transfer struggling with that yet? Don't think we will know for sure till Sunday morning when we arrive and we go over how the embryo's are doing which one's look the best. 

One more day to wait, have a long list of chores still to be done so hoping to get to bed and up early to get things done. I am so much more tired while on the PIO shots though it makes it hard to want to do anything but sleep. The one this morning was torture as my hips are already getting sore from them. 

Hopefully the clinic will call again tomorrow for another report on the embryo's and how they are looking.

IVF#4 Embryo Update #1 (2DPER)

Egg Retrieval was 2 days ago now. Did not hear from my clinic yesterday but figured it was cause of the holidays. Was getting worried felt in my gut maybe things did not go so well. RE just called. Out of 29 eggs only 10 where mature and only 8 fertilized and are growing. The 8 we got look good but he wanted to know if I wanted to do transfer tomorrow or wait till Sat. for a 5-day. Said it was up to me as their protocol is 8 or less they may do a day 3 instead of a day 5. Also said it was probably due to my age lack of mature eggs. Don't know if it's that or what happened? Can't help but wonder if we missed something with my stimming plan.

I said we would wait as it does not make sense to transfer unless they grow to day 5 to see which one's are going to be the best. We do still have 2 frozen as back up so if nothing else we transfer those 2 if they un-thaw ok or we transfer a combination of those 2 frozen and 2 fresh?

Just really bummed out right now. They will call tomorrow and update me on how the 8 we got are doing, a lot can happen between now and tomorrow, they can keep growing or we can lose some or all of them. 

This IVF is our last shot at becoming parents so if it does not work that's it. I can't help but feel it is not going to work, my RE just didn't sound that hopeful to me on the phone. Scared, nervous, upset, anxious all rolled up in one. Lord please keep those 8 embryo's growing and dividing and make it to day 5 and be of good quality!

Right now transfer is planned for Sunday morning at 7:30am which means we will have to be there at 6:30am. Also looks like the other RE is going to do the transfer not my normal RE. 

IVF Cycle Comparisons:

#1 Cycle: 32 eggs - 20 fertilized and were mature - Day 5 Transfer of 1 full blastocyst and 1 almost. 2 blastocysts on day 6 frozen - Results: Chemical pregnancy/miscarriage

#2 Cycle: 18 eggs - 14 where mature and I think it was like 10-12 that fertilized - Day 5 transfer 3 almost blastocysts transferred on day 5 - none made it to day 6 to freeze - Results:BFN

#3 Cycle: 28 eggs - 20 mature  and fertilized - Day 5 transfer of 3 blastocysts 2 where expanded and 1 full  - Froze 5 on day 6 - Results: Chemical Pregnancy/miscarriage 

#4 Cycle: 29 eggs - 10 mature and only 8 fertilized

IVF#4 Retrieval Day

Finally made it to retrieval day. Was a little behind getting out the door this morning to the clinic as I also had to get things packed and in the car for also going up north to see my husbands family for Christmas Eve get-together. But we got there on time even a little early at 8am. The got me set up in my room and changed, IV in. My husband didn't come back till later they had him wait in the waiting room till they where ready for his part then took him to a room for his sample. Wheeled me in the operation room around 9am. Got me set up in the wonderful stirrups that are so fun for my back to be in. They wrap your legs all up and get sterile cloths everywhere. Dr. came in and did my catheter and started sterilizing the area before I was out. I don't think they gave me as much meds in the past as I do remember some things and they said I dozed in and out. I kinda heard them say we got 20 eggs then I think I was out till they where waking me up in my room and saying Scott was coming in. The nurse then told me the lab tech said the final count was 29 eggs, she said when she was looking at them during retrieval many where nice and juicy looking, her words lol. Tomorrow we find out how many where mature, how many fertilized (doing ICSI again). I think my RE was surprised we got so many cause he estimated 16 last ultrasound we did. I don't know if I was as suprised as even though I am now 40 and it's two years since we did a egg retrival all my testing came back well. Our first IVF we had 32 our second 18 and third we had 28 so having 29 with round 4 is great but does not mean much. Over the next 5 days many will not make it that is normal and just how IVF works. Just need to pray that this time the quality of the embryo's is outstanding cause of all the extra things I've done and there is one embryo in there that will stick and stay this time.

After we left the clinic around 10:45am I was starving so we stopped for Chicken for lunch. Then I slept in the car while my dh drove up north to his family we got there in record time and where able to be there before dinner to visit. Just got back to our hotel room around 11pm and it's all hitting me how tired and sore I am . I did drink like 3 liters of smart water and 2 liters of regular water and ate some chips for salt to help head off any issues. I think the meds for putting me under are messing with my tummy some and hope they flush out soon. I can not wait to get on the road tomorrow and get home and in my own bed to rest up for transfer day. This part and waiting for numbers and after transfer are so nerve wracking.

12/25 - Christmas Day 
Never been happier to be home. The hotel last night was hot woke up sweating to death, dh says it's hormones lol as he was freezing. Beautiful Christmas morning with snow falling lightly. I've been suffering since last night with gas pains and constipation from the anesthesia meds really bad bloated up, it sucks. I just took a big glass of prune juice and miralax in hopes it cleans it out and settles this down. Been drinking a ton but it's like I am retaining it so don't know if I should really keep drinking more or what right now. Ate some salt in case that help. I hope we hear from the clinic tomorrow am anxious to know what is going on. I think they called while we where gone today but left no message :( . Kitties where happy we came home, happy to eat too lol. Watching the Bible on history channel and chilling out. Two days to recover and get some house cleaning done before transfer day. So nervous not sure how many to transfer, would be so wonderful if they would get to 5-day expanded or hatching that is the best quality, still thinking about doing 4, this just has to work.

IVF#4 Follicle Check #4 (Trigger Day)

Woke up this morning to a white out of snow everywhere. Think we got  6-8inch. Very thankful we have a Jeep with 4 wheel drive or I don't think we would of made it to the clinic. As it was it took us almost 3hrs in the snow going slow to get there was about 15min late but they understood. Left this morning at 6:00am got home around 11:30am went and had lunch and I came home and passed out for most of the afternoon felt so good to sleep and rest.

Check up today went great. :) After 12 days of stimming (doing shots to stimulate ovaries to produce follicles) we are ready for egg retrieval.

Estrogen
1341.1
Progesterone
1.56
Lining was around 10

Follicles Left: 21.28, 20.92, 19.72, 19.54, 18.39, 17.94, 17.52, 15.18, 14.79, 14.72 < 10mm 5 to 7
Follicles Right: 23.41, 20.07, 19.52, 18.93, 18.9, 12.7 < 10mm 8 to 9

RE said he expects to get at least 16 eggs this time around and thought that was good numbers. I think out of all 4 IVF cycles I have the biggest follicles on the last day before trigger this time. You want them to be over 18 for best maturity.

Progesterone has stayed under two YAY! and estrogen is doing well too didn't get too high. So as long as we have embryo's that fertilize (doing ICSI again) and get to day 5 we will get to transfer fresh one's. I still am undecided on how many to transfer if I want to push it and go with 4 this time around as we know that only 1 in 6 will be normal in someone of my age with PCOS and we could not afford the PGD genetic testing on the embryo's that would of helped us rule out which one's to transfer. Praying on what to do.

Tonight at 10pm I do trigger, two shots of Ovidril HCG 250ug each shot so 500ug total, to help mature and get the eggs ready for retrieval. I did question if that was enough as my BMI is 34 and it suggests online doing 3 shots with BMI over 30? Hoping I won't get too sick from the triggers, in the past I have gotten sever cramps the night of trigger.

IVF hCG Trigger

The hCG trigger injection is one of the most critical parts of the IVF medication protocol. After the eggs have been stimulated to grow and develop, the hCG trigger is the final medication given before the egg retrieval.

The hCG trigger has several functions:

• Induce final maturation of the eggs
• Cause the resumption of meiosis
• Loosen the egg's attachment from the follicle wall
• Allow for the timing of the egg retrieval

Tomorrow I get a break from all shots including the Lovenox as I am to hold that till after surgery. I will be glad to not have to poke myself with something for one day. Although the PIO shots are coming up next and I am not looking forward to having to have my husband poke me in the hip again I hate those shots.

Retrieval will be Tuesday at 9am and my RE thinks we would be out by noon at the latest so we may then drive up north another 4hrs to be at my husbands family get-together on Christmas Eve. I'll just sleep in the car. Tuesday my husband also has to do his thing in a cup, been giving him Fertilaid for men to help his swimmers RE said supplements can't hurt so hope it helps him have some good numbers.

Transfer will probably be Sat. Dec. 28th be a 5-day. Praying now I can make it through egg retrieval the holidays, get some rest, lots of great eggs and embryo's and some good blastocysts. Praying we have the best blastocyst's ever for transfer day.

Medications day of transfer, start in on antibodies for 5 days, Estrace pills 4xday, PIO shots 2CC in the morning and 2 Progesterone Pills at night. I am suppose to hold on the Lovenox and start day of transfer but am nervous about stoping it for that long. My RE said it's ok to do baby aspirin day after egg retrieval already so not sure why my RI said no Lovenox other than they said it's better to not risk bleeding, going to ask my RE see if he has opinion on it if I can start it again day after then stop night before transfer maybe. Just don't want to risk my blood flow going down when it was borderline normal the other day on the shots.

Dear Lord, the pain of infertility is so deep. All of our lives, we dream of being mothers, of raising children with loving hearts to do your will on this earth. Month after month when that dream does not come true, it so painful, Lord. We feel like our dreams die each month with empty arms. Please guide us to trust in your plan for us. We desperately need you in our lives. Thank you for all the blessings we do have, knowing through you all things are possible. Amen

Our view of the snow in WI leaving to the clinic this morning. Thank you Lord for getting us there safe and home today!

IVF#4 Follicle Check #3 (day 10 of stimming)

Woke up this morning to a layer of ice all over the streets and car. By the time we had to leave for the trip to our RE it got better but I was pretty nervous about travel on the road. Thankfully it was good there and back home. Check up went ok, was disappointed that it seems I have less follicles then in the past and my RE wants to go a extra 2 days to let the one's I do have grow more. Thankfully a follower of my blog was kind enough to send me two LH shots or I'd be sunk as I did not have enough meds to go 2 - 3 more days. So thank you so much for that. My RE reminded me I am also 2 yrs older and 40 now so for my age I am doing well. I just worry that with 1 out of 6 embryo's for someone of my age only being normal we won't have enough follicles to get to that 1 good one. Talked a bit about how many to transfer still up in the air will have to see how they fertilize and how many get to blasts this time around. We still have our two frozen as back up.

Numbers for Today:
Estrogen 732.2
Progesterone 0.94
Right Follicles - 18.24, 17.37, 16.92, 14.62, 12.26, 10.66
Left Follicles - 17.4, 17.12, 16.6, 16.4, 15.23, 15.23, 14.15, 12.93, 11.05

I was told when I started IVF that we would be using Lupron to trigger and they would be giving it to me didn't need a prescription for trigger, then they mentioned using Ovidrel the other day now. I figured no problem I got two shots in the fridge. I just checked my two shots expired on 7/2013. I emailed them tonight to tell them and it's too late to get them thru my mail pharmacy and I don't know if I can get them at a local pharmacy now or not. Talk about stress right now not having meds I need. Now I just hope we can get a trigger shot in time. Mad at myself for not checking expiration dates sooner this week but then I didn't think I 'd need them either. UGH!

We go back Sunday for next follicle and blood check and then from there he thinks we will be a go for ER on Christmas Eve day now. I know my dh was not happy about that as we had planned for Sunday or Monday at the latest and his side of the family all gets together on the 24th this year for the Holidays. I told him I will just have to go anyway that ER is usually early in the morning and your out by noon or so and I can just sleep the 4hrs trip to his Mom's and will do my best to do Christmas and survive somehow. We have not told his side we are doing a IVF cycle and don't feel the need to. It will be difficult for me for sure going from surgery to yay it's Christmas when I will probably be tired, sore and want nothing to do but be in bed. I wish it had not timed out this way but it did and not much I can do but go with the flow and pray God provided the strength to get through.

I am pretty much exhausted. I have Sat. to recover from all the trips this week and plan on wrapping up Christmas gifts, catching up on laundry and maybe do a bit of cleaning but overall I need to just sleep!

Isaiah 40:31 Amplified Bible (AMP)
31 But those who wait for the Lord [who expect, look for, and hope in Him] shall change and renew their strength and power; they shall lift their wings and mount up [close to God] as eagles [mount up to the sun]; they shall run and not be weary, they shall walk and not faint or become tired.

12/21 Search for a Trigger Shot:

Took us ALL DAY but I got the two shots - we had to drive an hour to a Costco only place with them. Insurance would not cover it cause I didn't get pre-auth for it so I had to pay over $200 for them - I am so upset that I cost us money for meds and gas we did not have.

Finally getting to sit down and I am so tired I can't see straight and am feeling dizzy but I have to do bills and a few other things that I did not get done today cause of this situation.

Snow storm rolling in tonight so getting to the clinic in the morning is going to be a challenge, talked to them today and they said if for some reason we just can't to call and they will try to figure out a plan of action, will this all timed and being this close to ER time it may mess everything up, so please pray that we get there and home safe. Will take our Jeep so that will help some with 5-9inch of snow but it's still a long way from us to the RE and back. Scott figures we will have to leave here by 6am at the latest to give us enough time to go slow there.

Honestly can't handle much more. I kept getting told this week all in God's timing and I am like well if his timing is not now then it's not going to happen for us, we don't have anymore resources to keep going and I am burned out. All I've wanted is to be a mom for so long that to hit the end with very slim chance of this IVF working and trying to cope with the emotions of having to move on if it don't is bringing me to a all time low.

IVF#4 Intralipids - Blood Flow Ultrasound RI Visit

Two Long days in a row and still more to go till transfer day. Yesterday we went to Coram Infusions so I could get my Intralipids IV done. Takes around 2 to 2 /12hrs plus travel. It went well no side effects or anything. Now it can go to work and start lowering my NK Killer Cells in anticipation of transfer day.

Today was my Blood Flow Ultrasound and follow up with Dr. Kwak-Kim's office. Took us 10hrs to go there, do my apt and get home. I am so tired of being in the car. 

Doing a load of laundry and relaxing for a bit then off to bed to be up early for another trip to the RE on Friday. Only issue is ice or snow is coming tonight now into this weekend so could be bad roads for traveling kinda nervous about that. Should be RE tomorrow then Sun then egg retrieval Monday depending on what they find tomorrow.

My apt today went great, my lining is already over 9.28 and it's never been that thick when they u/s me there, also nice 3 layer, no cysts nothing all clear, blood flow was 57 needs to be under 60 so it's still good, blood flow in zone 2 too. Went over meds will up my predisone after ER to 30mg and 2 Lovenox a day after Transfer. If or I should say when this one works I have to come back as soon as I can for a blood flow u/s to keep a eye on it make sure it's still in normal range. They didn't count follicles left that for my RE but she said there is quite a few on each side.

Feel a little more hopeful with such a good report from them today. :)

IVF#4 Follicle Check #2 (day 7 stimming)

Ultrasound and Blood work this morning. Had some follicle growth to start to measure today. My lining looked excellent it had a really nice 3 stripe layer going on which was missing in my FET's. I did get concerned when they mentioned we need to keep my progesterone under 2 and if over 2 on next check on Friday they would suggest freezing embryo's and doing a FET later. I kinda looked at them and was like we can't afford to go into Jan. Only reason we are doing this IVF is cause we could get it in this year and not go into a new deduct etc. It's like I understand freezing methods are better and they also talked and came up with a better FET plan for me going without Lupron and having me cycle where I would ovulate and use more of my natural hormones instead but I need to get to transfer this cycle this month we are so tapped out right now I can't see us coming up with another $6800 and travel to go again next year. Got really worried now about this all working out for us.

*My progesterone on my other IVF's 2yrs ago first one was above 2 it was 3.30, second one was 1.72, third IVF was 2.07on trigger day.

IVF#4
Left side follicles: 13.34, 12.82, 12.08, 11.76, 11.64, 11.08 < 10mm 0 to 2  
Right side follicles: 13.94, 12.58, 12.34, 10.14 < 10mm 0 to 2

Estrogen
IVF#4 - 316.3
Progesterone
IVF#4 - 0.69

This was my follicles on Day 7 from my other 3 cycles and my blood work. Is interesting to compare them. Not sure we will get as many eggs this time around will have to see.

Follicles
On Day 7
IVF#3
L - 14.75, 12.7, 12.22, 10.54 < 10mm 3 to 4
R - 13.24, 12.94, 12.57, 12.12, 12.05, 11.98, 11.27 < 10mm 5 to 7
IVF#2
L - 15.68, 13.92, 13.88, 13.58, 13.54, 12.49 < 10mm 3 to 4
R - 15, 13.74, 12.57, 12.36 < 10mm 5 to 7
IVF#1
L - < 10mm 5 to 7
R - 10.09 < 10mm 5 to 7

Blood work Day 7 
Estrogen
IVF#3 on day 7 - 147.5
IVF#2 on day 7 - 643.4
IVF#1 on day 7 - 200.6

Prayer request is that my progesterone stays below 2 and we get to transfer day with some good embryo's.

Plan for the rest of this week's IVF is Intralipids IV on Wed. Thurs. I have a apt. with my RI Dr. Kwak-Kim for a blood flow ultrasound but the weather is not looking good for that day snow, icy mix is forecast, not sure if we will make it to my apt. which sucks as I really need to know their opinion and if the Lovenox is doing the job. Hope the weather changes so we can make the 3hr one way trip there and home safe. Friday is my apt. with my RE for follicle check again and talk about when to trigger, egg retrieval. I did ask if we where going to use Lupron or the two Ovidril shots I have and sounds like we may go with the two Ovidril will know more next apt.

Stimming is going ok. I am starting to get really sore. Every bump on the road to the RE and cough or jerk I can feel my ovaries like they are going to explode already and I still have a few more days to go. Almost forgot how this felt and the over tiredness of it all. Have not had much time to get in extra sleep with getting ready for the holidays, running HBW and doing orders and taking care of my dh from his surgery. We had his second follow up apt today and he's doing well but still a ways to go for his shoulder to heal. Need to get some rest tomorrow in between wrapping gifts and house cleaning want to finish that as I know by this weekend I won't want to move with these follicles getting larger. I am sure I will be so ready to get the eggs out by this weekend. ER is looking to be Sun or Mon estimated so far. Nervous about that part going thru it all again and feeling ok to still see family for Christmas Eve. We have not really told anyone we are doing IVF again feel like it's just better to keep it to ourselves we get to may questions etc. so hope I feel up to traveling the day after ER or not sure what we will do.

Well will update again after Intralipids. Got a movie to watch for the 2hrs of sitting there on Wed.

Continued prayers that God finally blesses us!

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*Doing some research on why progesterone levels need to be lower before trigger as this is the first I've heard of it today:

1. The progesterone level needs to be below 1.5 (1.7-2 depending on the lab) before trigger (or ovulation). When you trigger (or ovulate in the natural cycle) the corpus luteum (or the follicle in the ovary) will start to produce progesterone. This progesterone tells the uterus to get ready and within 3 days it will be ready for an embryo to implant. There is really only a small 3 or 4 day window there for the environment in the uterus to be perfect! Higher amount of progesterone exposure to the uterus too early make for an undesirable environment for embryos to implant during a fresh cycle.

2. Progesterone is the hormone that creates the chemical balance in the uterus that makes it the perfect environment for implantation. You do need progesterone, but you need it only a certain amount and certain times.

You do need progesterone, but you need it only a certain amount and certain times. It is a bit confusing to read about progesterone level on the internet, because most places are from the US where they use the old British units and the levels are totally different from the Canadian numbers , where the SI metric system used. ( 1 ng/ml =3.18 nmol/L)
This is the normal ranges:

follicular phase (before ovulation) below 5.0 nmol/l in Canada( <1.5 or 2 ng/ml US)
luteral phase (after ovulation) between 15.00 and 90.00 nmol/l inCanada ( or between 2 and 28 ng/ml in the US)
1st trimester : 30-150 nmol/l in Canada ( or 9-48 ng/ml in the US) ( Here 1st trimester really refer to the time after you have your missed period)
2nd trimester: 50-450 nmol/ l in Canada ( 47-147 ng/ml in the Us)
3rd trimester: 175- 650 nmol/ l in Canada ( 55-200 ng/ml in the US)

Practically progesterone should drop almost to close to zero when the uterine lining sheds and you get your period. On the baseline (CD3) and during the stimulation it should be below 5 ( very often US sites refer to be below 2, but because of the different units used). Normally when we ovulate a single follicle release an egg and the follicle became a so called corpus luteum, which starts to produce progesterone at that point. Progesterone level increases at a fixed level per day ~ 2-5 nmol/ l. Normally progesterone is not produced before ovulation, and this timing ensures the perfect level at the time of implantation. Around 1 week after the ovulation the progesterone level peaks, and start to drop unless implantation occurred. When it drops to a very low level as a response the uterine lining shreads and you get your period. When implantation occurs the body keeps producing progesterone. 

During IVF women often get extra progesterone support, because the stimulation can mess up things and you may or may not produce enough progesterone on your own. Usually this level won't be too high even with the added support, UNLESS you already have high level before ovulation.

Usually the too low level of progesterone is the problem. If the progesterone is not high enough the lining starts to deteriorate and the women may miscarry.

3. ARTICLE 

IVF#4 Follicle Check #1

Today is cycle day 5. AF is still hanging around some which normally is gone by now but maybe due to taking the provera this time around.

First Follicle check this morning. Left side had around 11 and right side around 7 under 10mm follicles so around 18 total so far. Dr. said I am responding well again to stimulation. My estrogen rose from 45.8 to 86.7 and progesterone of 0.25 all good. My TSH was well under to was like .7 so that also is great.

Continuing with 450IU of Follistim at night, 1 Centrotide and/or Ganirelix shot in the morning, and 1 Lovenox 40mg at night along with the rest of my supplements etc.

Next Follicle check is Monday, then probally Thurs then Sat. estimated egg retrieval for the 23rd and transfer on the 27th.

I go Wed. Dec. 18 to Milwaukee Corum Infusions to do my Intralipids IV and then Thurs. Dec. 19th to Chicago to see Dr. Kwak-Kim and do the blood flow ultrasound, blood work, follow up etc.

I've been feeling pretty good so far, just the normal bloating and pressure is starting in and very tired, few mild headaches all to be expected. I almost feel like doing a fresh IVF is less stressful than a FET. It goes faster too less waiting time from start to transfer.

Giving it all I got and trying to remain hopeful.

(1 in 6 embryo's in a 40 year old are chromosomal normal - 35% chance mc - makes me wonder if we even have a chance - also makes me think about how many we should transfer in the past we have done 3 maybe we need to do more than 3)
Great Video on IVF

IVF#4 Baseline

Baseline visit today. Trial transfer followed by ultrasound. All looked good. Blood taking was not fun I don't know why but they always struggle to take my blood in one poke, took 3 this time. :(

Estrogen is at 45 so we are good to start. Did my cetrotide shot earlier today then follistim 450IU and lovenox shots tonight. Didn't know if I would remember how to do the follistim pen but it all came back once I got it out and ready to go.

Hard part is remembering I now need to drink 3-4 liters of fluids to help while stimming and to up my protein intake next 12 days.

Friday morning I go back for first follicle check so we will see how it goes hopefully we will have some activity by then.

Never heard back from Dr. K to see if she would still monitor me even though I did not get down to IL this time. Think for now I am on my own. May have to go to my family Dr. and do my thyroid and chem panel next week if she does not reply. 

Other than that was a pretty normal day for also being my 40th Birthday. Spent the afternoon with my hubby watched Despicable Me 2 and he made dinner and got me a cake. :)

IVF #4 BEGINS :)

AF is finally here. Showed up this afternoon. Called the clinic and set up baseline for tomorrow morning. Think AF is going to be nasty this time around, been sick since yesterday, nausea, diarrhea, sure the provera is going to clean me out. I don't like doing baseline while you have AF that part is uncomfortable but I am SO HAPPY we can get things going. And tomorrow is my 40th Birthday too IVF#4 here we go.

Have to go this cycle without the PGD testing as it was denied and my insurance denied 5 more cetrotide so we will have to mix cetrotide the 7 they allowed me and the 5 ganirelix I already have. But at least we can get this all in before the 31st so only out of pocket is to freeze any embryo's that make it to day 6 and of course gas travel to the RE etc. Hope I can do a few acupuncture too this time around will have to see what the budget allows.

Looking at estimated er on Dec. 23rd and estimated transfer on Dec. 27th. Tomorrow if baseline is good, I will start in on Lovenox blood thinner, Follistim for stimming (makes the eggs), and one of the LH shots (prevents ovulation), and up my predisone to 20mg. Already on baby aspirin and tons of supplements yet. Doing intralipids IV again this cycle getting that set up for a week from now. 

Not sure if I am ready for this all again it's a lot to go through just for a chance but I know if we don't try we never know if it will work. Thankful my husband can drive some now after his shoulder surgery cause I don't do so good in WI snow and him being off work we don't have to worry about that part. 

Well everyone wish me luck and keep me in prayer this is our last shot at this. Praying this is it!

Still waiting for AF

CD 30 and Day 10 of taking Provera, no sign of my period yet. Still waiting. With the PGD testing denied feeling pretty hopeless that this IVF will even work, no way to know now if any of the embryo's we make are any good. Don't get why nothing works out in our favor. Been a struggle and fight to get my IVF medications. I had plenty of Follistim left but I needed the medication that prevents ovulation while stimming. My insurance changed how they do things and I had to go through a whole process of pre-authorization got that all done and then the insurance nurse will only approve 7 of the 12 cetrotide shots when I need 12, to get 5 more I have to do the pre-auth all over again. It's like daily calls between my insurance and my clinic to get this done all before my period. It's been beyond stressful and hard to not get depressed right now. Dealing with infertility is hard enough without also fighting your insurance for coverage. Tired of it all, really feeling like even though I push and fight to get another chance that it won't work for us anyway.

PGD info submitted to insurance for review

After a ton of run around (and much stress) I finally got things submitted to our insurance for review to see if they will give me authorization to do the PGD testing (embryo testing, (do it on day 3) that helps us see which one's are chromosomal normal to help our chances of pregnancy and no mc - at my age 1 in 5 embryo's will not be normal so this will help us determine which one's we should transfer, give us better chances). 

They are reviewing the information from my Dr. and should have a answer in a week or so. 

PLEASE PRAY they approve this testing and will pay for it. Doing this test will really improve our chances and being this is our last fresh IVF we really need this to be something we can do. After all the stress I went through to get this information submitted to them I just need them to say yes and give us authorization for this testing.

12/4 - Totally bummed - Insurance denied the PGD genetic testing. Without this testing no way to know if any of my embryo's are any good could be going thru IVF for nothing. Starting to feel like it does not matter what we try we won't end up parents. :(

Started Provera

CD22 today. Started in on Provera yesterday for the next 12 days to bring on my period. Meds usually work pretty fast on me so I am thinking by next week we will be getting this IVF going. Not looking forward to winter here in WI and snow and trips back and forth to our clinic almost 2hrs one way. Had a dusting of snow already this week just praying it all holds off for us. Scott should be able to do some driving soon his shoulder is getting better, if nothing else I can shift for him if the weather is bad he is better at handling it then me. I don't see us being able to consult in IL with Dr. K this time around just too much travel and I won't drive there. I'll just have to go off what we did in the past for starting my blood thinners, predisone and setting up the intralipids. I can't really do the NK killer testing anyway as my insurance is bawking at paying for repeated testing right now and being stuck with $900 lab bills each time they test is not what we can do.

The main issue now is getting my IVF medications. I have most leftover I can use but there is one I still need. I've been going crazy dealing with my insurance's new policy that says I need pre-auth to get my IVF medications now. My Clinic had to re-fax them the information as they said they did not get it all the first time. I've been on the phone Friday, Monday and Today going back and forth and about to pull out my hair just to get my meds. And the specialty pharmacy is closed for the holidays on Thurs and Friday so I don't know if I will even get my meds shipped out this week. Thankfully I have 5 shots of a similar med Ganirelix we can use if the Cetrotide does not show up in time. Also still dealing with getting my insurance the information they need to review for the PGD testing pre-auth they said they never got that fax also and I had to have my clinic re-fax. It's enough to drive one crazy dealing with this all and some of my insurance reps are down right rude and you never get the same rep so I have to explain the situation every time I call. Right now I am waiting to call again as they did finally receive the fax for my medications but the nurse has to review it yet today.

Thanksgiving will just be me and Scott. My sil passed away in Oct of cancer and she always hosted thanksgiving for my husbands side of the family and with her gone it seems they won't be getting together this year. My mom is gone volunteering to help with a community meal. We don't really have any other family so it gets lonely for the holidays and not something I even look forward to anymore. More than likely we will end up with a close to Christmas transfer again this time around. Our #3 IVF we transferred on Christmas Day. Making any Christmas plans is hard to do till I get my calendar.

Getting very weary of  the constant stress of ttc. My 40th Birthday is coming up Dec. 10th closer we get the more down I've been feeling. I think last 6 months I really been feeling my age and looking at friends with kids almost grown makes me feel even older and sadder while we have none. Tired of having a empty nest and nothing to look forward to especially around the holidays. So ready for our Christmas Miracle!!!

Karyotype Tests

Very happy my dh and I karyotyping genetic testing came back normal. Guess it's one more thing ruled out as the problem. So now we are just waiting on getting my IVF meds and see if insurance will approve PGD testing of embryo's. Should be starting provera soon to get things going waiting on a call from them yet to tell me when to start. Really hoping a fresh cycle will be it for us that things will work this time around.

 

Sonohystergram

This past Friday I had my Sonohystergram test done with my RE. Everything looked good, the tiny cyst was gone but no guarantee it won't return when I start meds again. This time around it was very painful lots of cramps but thankfully it didn't last long. They put me on antibodies for 5 days but I've had lots of spotting and period like cramps since Friday, can't remember if I had this last time they did this test or not. Hopefully it goes away soon or I may have to let them know. Now it's just waiting for our Karyotype tests to come back.

Nov 12th - one year of loss

Today has been a difficult day. One year ago we found out baby H or Uriel as I named him/her had no heartbeat and didn't grow past 6wks. It was one of the saddest days of my life and one year later it has not gotten any easier. My dh says we can't live in the past but for me I won't ever forget the life that was and could of been and continue to pray my arms won't remain empty forever. 

It's made even harder as I had really thought by now we would of been pregnant again. Never would of imagined we would still be trying and looking at doing IVF again. All I have of Uriel is a one ultrasound pic and bfp hpt to show he/she even existent. I do wonder if someday in heaven I will see the children we lost if they will all be there so I can meet them and get to know who they where suppose to be. 

"When you lose a parent you lose your past. When you lose a spouse you lose your present. When you lose a child you lose your future. When we lost our child. We lost the child, we lost all the hopes and dreams we had for that child. We live with the would of, could of. We long for, miss and love our child as long as we take breath." 

Lab Results for IVF#4

Fertility clinic called getting my meds called in for IVF. I still have follistim left from last IVF we can use so just needing the cetrotide and antibodies and valium for transfer. Plenty of PIO and Estrogen left too. Will be on blood thinners and predisone and do intralipids again too.

Told me that my AMH is 5.0 (which is ok for PCOS just means I don't ovulate every month) and my FSH is 3.92 - so both normal and good for someone who is turning 40 in a month. So one less thing to worry about should be good to go for eggs this time around. 

The FSH results will also go into my insurance to see if we can get approval for the PGD testing. Really praying they do as I know it is something that can really help determain which embryo's are normal to transfer and drastically reduce chance of mc.

Now it's on to Friday's sonohystergram and hoping no cysts still lingering or anything abnormal.

Then it's just waiting for Karyotyping tests results if normal I start in on provera to bring on a period and we get going.

I am enjoying the time off from ttc right now. Taking care of my dh from surgery and giving him time to heal also. I just hope we get our Christmas miracle finally as every year that goes by I keep thinking this will be it. 

IVF #4 and Life

Yesterday was a LONG day. Up at 5:30 to get my husband to his PT apt. PT went well he can't really use his arm at all no lifting of anything hardly any movement it has to stay in the sling, just can move his hand and do a few exercises with his shoulder shrugging, he won't be able to even start back to lifting till almost end of Dec. and then through Jan work on building back strength so this is going to be a long process.

Then I drove to my RE apt Scott helped keep me awake and focused but it was really hard to get there and back driving. We decided to do the karyotyping testing and had blood drawn for me and Scott, only bummer is it can take a few weeks to get the results and we can't move forward with IVF till we know if something genetic is wrong. Talked over a plan to start in on Ganirelix or Cetrotide right away with the Follistim (instead of day 5-6) to keep the LH surge down as it may help PCOS patients have better egg quality and that they also only use lupron now to trigger to prevent OHSS. My RE is going to send in the info to my insurance to see if we can get approval for the PGD/PGS testing of the embryo's that is another thing that may help just in the aspect of telling them which one's would be normal and which one's not meaning I would probably mc those not normal one's so we don't transfer them. Also means all of them could be abnormal too. Don't have the results of my AMH or LMH in yet but he said either way we would start at the max of Follistim 450IU again. So right now it's more waiting and praying that the karyotyping is normal and if we see any issues during the sono like the tiny cyst that we can just drain it, and this all getting done before Dec. 31st.

Figure my goal next few weeks while waiting is eat healthy and lose the weight I put back on so back to exercise and a detox. Also will give my dh some time to recover from his shoulder surgery before we start in on stimming and apt's etc. for IVF. I don't think I will be able to get to IL to see Dr. K this time around with my dh not able to drive there so not sure if I will get her opinion on things yet or not this time around. Hoping to get some much needed sleep today and tomorrow as I am so exhausted from this week's activities my body really needs it.

DH Shoulder Surgery Day

Today was my husbands shoulder surgery. Had to be at the surgery center by 6:15am to check in and then we where there till after 1pm. The surgery went well but the damage to his shoulder was worse than what the Dr. thought when he got in there. His bicep in the shoulder area was 50% torn and out of the grove it's suppose to be in so he had to cut it and reattach it in the right place repairing the tear etc. Also did the AC joint and cleaned up the bone spur arthritis area. After recovery he should be pain free in that shoulder we hope.

Now the recovery process begins. Since things where worse it looks like he will be off work longer then the 8weeks we thought maybe more like 12 now to allow the bicep to heal cause of the kind of job he has he can't go back till he can lift again. Little worried how we make it that long on less pay with his disability will be a few lean months for us. Friday starts his PT already. Right now he is hooked up to a ice machine that is attached to his shoulder and pumps cold water over it 24/7 to keep the swelling down. I have to fill the machine up with new ice and water every 6hrs or so. So far the only pain is in his back, he has a nerve block on his arm and it has not worn off all the way yet so for now his shoulder is not too bad.

Going to be a challenge to help him through his recovery and also do our IVF. After we got home today I ran into town to the local lab to do my FSH labs tonight. Friday after I take dh to his pt he is riding along with me to see my RE, I'll have to do the driving for now which is hard on me as I have driving anxiety so praying the weather is good. Got to think of questions and what I want to go over with my RE for this IVF cycle so we can have a good plan going forward.

Thankful that tomorrow we have no apt's and we can both rest. Before his surgery I had him help me with a ton of cleaning and pick up outside etc. cause I knew he would have no use of his arm for awhile, so glad we got stuff done. I am worried about snow though still need to find help if it does snow for removal.