Fingers Crossed

Last night Chris took the bus home from Edmonton and got in at 9:45 p.m.

This morning we were up early and got him to the clinic for 7:15 to give his sperm sample, so they could 'wash' it, and have it ready for me later.

In case you forgot: 'washed' sperm simply means that they separate Chris's sperm from the rest of his semen. They then put it into a small catheter to inject into me later. 

After his appointment we had breakfast and then I drove him to the bus station so he could travel back to Edmonton. (To say that he was exhausted would be an understatement.)

Then I had to drive back for my own appointment.

Although they normally start performing IUIs at 10:30, the nurse we saw on Sunday told me if I got there at 10:00 they may be able to get me in early... and they did!  

In fact, it was the same nurse who told me to go early who actually did the procedure. She was so kind and it was really nice to have it done by someone familiar.

Too much information?- (You may or may not want to read the following paragraph!)

To get started she inserted a speculum into my vagina- just like when you get a pap test. This was used to keep my vaginal walls apart. Then she inserted a small catheter and tried to get it to reach my cervix. Unfortunately, the catheter was too soft and she wasn't able to get it inside. Apparently we have small skin tabs on and around our uterus, and she was getting it caught on one of mine. By switching to a less flexible tube she was able to insert it into my womb where she then inserted Chris's sperm. (She told me that it was a good sperm sample.)

Believe it or not the whole process only took a few minutes and was pretty much painless. There was a few small twinges when she finally inserted it, but other than the normal uncomfortableness of a pap, it was fine. She told me I may have some bleeding and would probably experience cramping later. 

I could have gotten up and left as soon as she was finished, but I asked if I could just lay and wait a few minutes. I understood that I could get up right away, but I still wanted to stay laying down for a few minutes just in case.

After about five minutes, I went to the pharmacy and picked up my Endometrin. It is an effervescent progesterone tablet that I will need to insert into my vagina three times a day starting tomorrow. 

Because I was on so many different drugs to stimulate my egg follicles, I was prescribed Endometrin to prepare my uterine lining so it is ready to receive and nourish a fertilized egg and support early pregnancy.

I will continue to take the Endometrin until we either get a negative pregnancy test or until my 10th week of pregnancy.

So we have now done everything we possibly can, and the hardest part is about to begin... the waiting! 

Staying Grounded

Since yesterday's surprisingly happy news I have been on an emotional roller coaster.

I had been praying that when we went in for the ultrasound my follicles would have grown, but I never imagined that they would have grown big enough for her to tell me to trigger!

So at 11:00 p.m. last night I took my final two injections for this cycle. I was given 10, 000 IU of HCG, which I needed to divide into two different syringes. 

Human Chorionic Gonadotropin (HCG) is used to mature the eggs and 'trigger' ovulation. My eggs are supposed to be released from their follicles 40 hours after the shot. I go in for my insemination between 10:00 - 10:30 a.m. tomorrow, which is 35 hours after the injection. (This allows the sperm to already be present in my uterus so once the eggs are released they can hopefully be fertilized.)

I am trying to be optimistic, but also realistic. 

(I am just so afraid to get my hopes up too much and then be crushed if we don't end up pregnant.)

I also know that it won't be just Chris and I that will be disappointed if this doesn't happen. When I called my family to tell them how the ultrasound went they were overjoyed to hear that we still had a chance. My friends and family have been so supportive and invested in this cycle with us that I feel somewhat guilty. I don't want to let them down.

As per normal, I've read everything I could find online about IUIs, including some animated videos, so at least I feel like I am as prepared as possible for tomorrow's insemination. 

In my research I also found an interesting article that focused on visualizing the outcome you are hoping for. Similar to the book The Secret, this article talked about how you can make things happen just by visualizing them. Wouldn't that be amazing if it was true?

I'm not sure, but I figure it can't hurt trying to imagine (visualize) us getting pregnant. I think it may be similar to the power of prayer. When I spoke to my father today I mentioned that if you only needed people's prayers and best wishes, Chris and I would have nothing to worry about.

This evening while taking a walk I came upon a family. The dad was helping his daughter ride her bike, the mom was walking with a baby in a baby backpack carrier, and she was also walking a dog! They appeared to be the perfect family. I couldn't help but wonder if they realize how lucky they are.

Cautiously Optimistic

Finally we got some good news!

Just when it looked like there was no hope for this cycle... I went in for my ultrasound this morning and found out that two of my follicles have grown big enough to be triggered!

Because there are only two eggs, our doctor told us that the odds of us conceiving are now the same whether we do IVF or IUI. Once we heard that we decided to go ahead with the IUI. (Since Chris has been working in Edmonton this was the first ultrasound he was able to come to.)

Part of the reason IVF has better results has to do with the larger number of egg follicles that are retrieved. Since I only have two the odds would be the same.

I have so many mixed emotions rights now: complete and utter joy, nervousness, fear, but most importantly hope!

After my appointment on Thursday I didn't think that this cycle even had a chance of succeeding. Now at least we have hope. The odds still aren't the best, but for right now there is a chance.

How Did This Happen?  Well on Friday when my follicles hadn't grown very much they switched one of my injections from Luveris to Menopur.

I also read online that full fat organic dairy, lots of protein, and a hot water bottle can help to make follicles grow. Now I'm sure it was probably the Menopur, however, for the past two days, even though it has been 30ºC, I have been using a hot water bottle and have drank almost 2 litres of organic homogenized milk.

Tonight I will give myself two trigger shots.  Then on Tuesday morning Chris will go in at 7:30 to give his donation, and at 10:30 I will go in and they will insert his sperm into my uterus.

*I am asking anyone who reads this to please say a prayer for us and keep your fingers crossed!

Blame Game

I am 6 years older than my husband. Six years can make a huge difference when you want to have a child. This haunts me sometimes and I can't help but feel guilty.

Its funny because age was never something that I really thought about.

Now it consumes me.

That and the myriad of what ifs:

What if we'd met earlier?
What if we didn't wait so long to get married?
What if we tried to get pregnant before we got married?
What if we had tried IVF right away?

What if... What if... What if...

These questions are enough to drive a person crazy. At times they are all I can think about. If I'd let them they could completely take over my life.

So what do I do?

I let myself think them, feel the pain, and then move on... at least for a little while.

Then I start the cycle all over again.

Sometimes When It Rains...It Pours.

Yesterday morning I went to have another ultrasound and blood work taken. As I mentioned in a previous post, it wasn't my doctor who performed the ultrasound on Monday,  and yesterday it was yet another doctor. (The doctors at the RFC do rotating shifts so you may or may not see your doctor for your ultrasounds.) 

Luckily I had called ahead, and when I found out that it wouldn't be my doctor, I made an appointment to meet with her in the afternoon.  

I had so many questions and I felt like I need to have an appointment with my actual doctor to find out some answers. I needed to know if the IUI didn't work what our next steps would be. Would we do another IVF cycle? How long would we have to wait before starting it? Would there be a different protocol? ...plus a million more questions!

Little did I know my ultrasound would bring more heartache and even more questions! 

Have you ever heard the saying: 'when it rains, it pours'?

Well apparently I need an umbrella!

This ultrasound showed a few more really small follicles, but before I could get excited the doctor told me of his concern that my three previous follicles had hardly grown at all.

Egg follicles typically grow 2-3 mm a day. Mine had grown less than 1 mm in three days.

This is not a good sign.

So just as I got myself psyched up to do IUI, it looks like we won't even be able to do that!

The doctor who was working prescribed Menopur instead of Luveris to try and see if we can get these follicles growing. (Menopur has FSH in it whereas Luveris does not.)

Later in the afternoon I met with Dr. F. and she reiterated that it didn't look good, and that the Menopur would be our best bet.  (another $370 dollars)

She also talked about other options for Chris and I.

If this round doesn't work then we could wait a month or two and try again, although, the odds are not good.

We could buy an egg from the United States (it is illegal to purchase an egg in Canada), and try an IVF round in which they would use Chris's sperm. This would cost us around $22,000 everything in. It would give us a mid to high 60% chance of conceiving.

We could also see about buying an already frozen embryo that another couple has donated. They cost $2000- $5000 plus there would be IVF costs. I'm not sure what the success rate would be for this. UPDATE: We wouldn't be purchasing the embryo- the $2000-$5000 is actually for lawyer's fees.

So again, we are in limbo. I have another ultra sound with blood work on Sunday and will hopefully know whether this round is going to work or not.

Life on Hold

For the past two years I feel as though I have been living my life on hold. I have been afraid to make long term plans, have too many drinks, or even make what should be simple decisions... just in case!

My biggest regret was when I missed a family holiday, my nephews' first trip to Walt Disney World, because I was afraid (hoping) that I would be pregnant.

I have recently decided that I will no longer live my life like this!

One of the major inconveniences about taking injections for fertility is that I have to take four a day, and they always have to be at the same time.

My schedule looks like this:

7:30 a.m.- Suprefact shot
7:45 a.m.- medications and vitamins
12:00 p.m.- prenatal vitamin (can't be taken with other 'medications')
5:00 p.m.- Gonal F and Luveris Shots
6:00 p.m.- more vitamins
7:30 p.m.- Suprefact shot

* for a week I was also taking an antibiotic twice a day that needed to be taken with a meal, but couldn't be taken within an hour of dairy.

At times this schedule seemed overwhelming, as though I was living my life around these different medications.

I am proud to say that I have not let this stop me from having dinner with family, going to my pottery class, celebrate father's day, or go out to dinner with friends.

At first I was really nervous about leaving the sanctity of my washroom (where I have everything spread out on our countertop!)

But I did - I have taken my shots in other people's homes and yes even in PUBLIC WASHROOMS!

Some Advice: If you ever have to give yourself an injection in a public washroom try to find the stall that has a baby's changing table. It gives you a lot more space and allows you to spread everything out on top of it. It's also a good idea to bring an extra alcohol swab.

No Woman is an Island

When I first decided to write a blog about our IVF journey, and the fact that I was trying to conceive over the age of forty, I was hesitant. 

Part of me was still embarrassed and ashamed that we were having to do IVF in the first place.

I was also concerned that I wouldn't be able to put into words what I was experiencing, and wondered if anyone would be interested in what I had to say.

But I am so glad that I did.

A few days ago, just before heading out to have dinner with family, I quickly wrote a post about my blog on my Facebook page. When I got home a few hours later I became completely overwhelmed by the love and support that I received from everyone.

Most touching was the numerous messages I received from former colleagues, acquaintances, friends and even family members who wanted to share their personal experiences with me. 

When I started this blog I thought it would be therapeutic to be able to write down my experiences, and hoped that maybe I would be able to help someone, an unknown stranger, who was going through a similar journey. I never imagined that I would be opening the door for someone that I already knew. 

One of my colleagues, who experienced a loss before having a beautiful healthy baby, shared what her father said to her after she gave birth. He emphasized how strong and brave women are... and how men would never be able to go through the things we do! 

His comments touched me so much... and I have to agree with him. 

If you want to see true strength you only have to look at your mother, grandmother, sister, daughter and best friend. 

Bruised But Not Broken

After yesterday's bad news, I had a lot of friends and family asking how I was doing. I couldn't seem to express all the emotions that I was experiencing until I was laying in bed last night and the phrase

'bruised, but not broken' popped into my head.

Bruised- not only the physical bruises on my stomach and legs from the daily injections, but also the emotional bruises. 

This has been, and continues to be, such a difficult journey. 

I've read so many other women refer to IVF and infertility as a roller coaster ride, and I think it perfectly describes the constant ups and downs that we experience.

As with most things in life it is not the bruises that you can see that hurt the most.

Not broken- After a lot of tears and 'why me', I was able to pull myself together and begin to look at the positives:

I have three follicles... that is three possibilities that we will get a mature egg, and that one of them will fertilize. 

After all it only takes one healthy, fertilized egg! 

And if it doesn't happen then we can try again.

Quiet Ovaries

Today was not a good day.

I had my first ultrasound to see how I was reacting to the fertility drugs I have been taking.

As I mentioned in previous posts, the RFC has a first come first served policy on ultrasounds and blood work. So even though they don’t open until 7:30, I arrived just after 6:30 to line up in the stairwell… and ended up third in line.

By 7:30 there were about 10 people behind me.  After checking in at the reception, I quickly went into the washroom to give myself my Suprefact shot.

After getting my blood work I was quickly called in for my vaginal ultrasound with a new doctor that I had never met. Before starting the ultrasound she mentioned that we were looking for a minimum of 4 follicles.

My right ovary had 1 and my left ovary had 2. 

That’s only a total of 3- the average is between 5 and 12.

This is when the doctor commented that I have Quiet Ovaries, hence the title of this post. (I'm not actually sure what that means, but I assume she meant my ovaries just don't produce many eggs.)

So where do we go from here?

She then told me that Chris and I need to discuss whether we want to continue this IVF cycle or switch over to an IUI.

Although, the success rates are better with IVF, the fewer number of follicles means we have less chance of it succeeding. Three follicles do not necessarily mean three eggs. Not all follicles will completely mature.

If we switch to the IUI we will get a refund of about $5,900.  We would still have a chance of getting pregnant through the IUI, and if it didn’t work we could try for IVF again in a few months.

In case you don't know: 

An IUI, intrauterine insemination, is where the doctor would take Chris’s washed, prepared sperm and inject it directly into my uterus, near the eggs at the time of my ovulation. (Washed means that the sperm has been separated from the seminal fluid.)

The RFC don't have detailed IUI success rates like they have for IVF. The general success rates are 25%, but that includes all ages. 

So after many tears, and a long discussion with Chris, we have decided that the best thing for us to do is to switch over to an IUI cycle. Best case scenario it'll work, and if not we will try to do IVF again in another couple of months.

We are asking for as many prayers and fingers crossed as you can manage. 

IVF, TTC, 2WW... WTF!!!!

When I first began looking online and reading IVF and TTC forums and blogs I was completely overwhelmed by a whole new world of acronyms and trying to conceive lingo. 

If like me you are TTC (trying to conceive), and are having a hard time trying to understand other people’s forums and blogs, I’ve created a cheat sheet for you:

IVF- In-Vitro Fertilization

TTC- Trying to Conceive

2WW- Two Week Wait (time period before you can take a pregnancy test)

CD- Cycle Day

DPO- Days Past (Post) Ovulation

ET- Embryo Transfer

DPT- Days Past Transfer

DPR- Days Past Retrieval

BBT- Basal Body Temperature

BCPS- Birth Control Pills

BD- Baby Dance- (sex)

AF- Aunt Flow or your period

HPT- Home Pregnancy Test

BFN-Big Fat Negative (after taking a pregnancy test)

BFP- Big Fat Positive (after taking a pregnancy test)

EDD- Estimated Due Date

CM- Cervical Mucous

FSH- Follicle Stimulating Hormone

LH- Luteinizing Hormone

LP- Luteal Phase

OPK- Ovulation Predictor Kit

BA- Baby Aspirin

PNV- Prenatal Vitamin

POAS- Pee On a Stick (take a home pregnancy test)

MC- Miscarriage

MMC- Missed Miscarriage

D&C- Dilation & Curettage

DH- Darling (or Dear) Husband

SO- Significant Other

DD & DS- Darling Daughter and Darling Son

BD- Baby Dust- (good luck for pregnancy)

*These are just the most common abbreviations I could think of... most forums have a page that can fill you in of any others of which you are unsure.

Sometimes Public Opinions SUCK!

It always shocks me the way people feel as though they have the right to tell people how they should or should not live their lives. As though the people to whom they are speaking even care about their opinion. 

Trying to conceive after 40 is another controversial topic to which too many people have an opinion.

In several of my many online searches I have come across hateful sites in which people discussed the selfishness of 35+ year old women wanting to have children at such a geriatric age...

GERIATRIC AGE?

Are you kidding me? Yes, I understand that there are higher risks, but really- geriatric? I didn't realize that we now considered people in their mid 30s and 40s to be elderly.

Some of the strongest arguments are that these moms will leave their children orphans at an early age.  As though accidents or health problems don't happen to women in their 20s or early 30s.

I'm not sure if these people realize it or not, but the average life span for a Canadian woman is now 84. 

I also love that nothing is ever mentioned about the age of the father even though their life span is shorter than that of a women's. (The average life span for a Canadian male is 80.) This is another example of sexism at its finest.

The problem is that it is no longer just random people who are saying that women over a certain age shouldn't conceive. I recently found out that Quebec, one of only two provinces in Canada that currently funds IVF, is trying to prevent women over 42 from having IVF.

Initially they were trying to pass a bill which would make it illegal for women in Quebec over 42 to attempt IVF. (I can't even believe that they were trying to do this in Canada!) Then they decided to no longer try to make it illegal, however, they wanted to refuse to pay for it. It is my understanding that they have now created a bill so that they will no longer pay for IVF, but will provide tax benefits to those families who meet their criteria and are between 18 and 42. (The criteria has not been made public yet.)

Now I am a realistic person and I understand that the government (and tax payers) could not afford to pay for couples to have indefinite rounds of IVF. I do feel, however, that rather than setting an age limit they could have limited the amount of times a couple could have it funded.

If you are interested in finding out more you may want to read the following articles:

http://www.theglobeandmail.com/life/health-and-fitness/health/in-vitro-fertilization-age-limit-spurs-debate-in-quebec/article21964436/

http://news.nationalpost.com/full-comment/vardit-ravitsky-banning-ivf-for-quebec-women-over-42-is-ivf-is-good-old-fashioned-paternalism

http://www.theglobeandmail.com/life/health-and-fitness/health/quebec-to-allow-ivf-for-women-over-42/article24644081/

Side note: As I mentioned in my 'About Me' section, both my grandmothers had children into their forties. They were healthy women who went on to have healthy, happy children. Now I've never asked my aunts and uncles if they wished that they had been born to younger mothers, but I'm pretty sure if I did, they would simply respond they were just happy to have been born!

Weight Time

Not only do I come from a long line of fertile women. I also come from a long line of emotional eaters! After our miscarriage, and month after month passed without getting pregnant, I steadily started gaining weight.

Now if I had an hour glass figure like Scarlett Johansson or Kim Kardashian I wouldn't mind so much. Unfortunately, I am not that lucky. 

When I first went to the RFC to get help trying to conceive I asked about diet and exercise. I was told to eat healthy and do moderate exercise. Unfortunately, in my mind, that meant 'go ahead- eat whatever you want.' 

Did I mention I tend to be 'all or nothing' when it comes to diet and exercise? I would have been much better off if she had given me a 'diet' to follow, because I would have followed it to the letter- no matter how strict it was. 

Again the internet was no help. There are so many contradictory 'fertility diets' out there. Of course, the majority talk about eating fresh fruits and vegetables, but then it gets confusing. Some recommend whole grains, some say to stay away from them. Others recommend a high protein diet and yet others suggest you should become vegan. Then there are the low-fat versus good-fat, full fat organic dairy versus dairy free, and just about every other kind of diet you can imagine.

And then I found this article... 

http://www.scientificamerican.com/podcast/episode/0a73aa1c-e7f2-99df-3a31caef18d3a33e/

Eating full fat ice cream at least twice a week could increase my chances of becoming pregnant!?! 

Well I love ice cream so that got me thinking about the 'at least twice a week'... does that mean if I ate some everyday I'd even have better chances? 

See my logic? 

Hmm... as tempting as this seems somehow I don't think it is a good idea. 

So now I am trying to eat 'healthy,' and yes I am adding in those two servings of ice cream a week... just in case!
Next question does a pint of Ben and Jerry's constitute a serving?

Money, Money, Money Isn’t Funny… when you're doing IVF!

Ok, I know that I shouldn’t complain about the cost of IVF when no one forced us into it.

And yes, I understand that women in the U.S. and in other parts of the world pay significantly more than we pay here in Canada.

And of course, I also realize that I am extremely lucky to have amazing drug coverage from my work- 80% for almost all the drugs!

But, can I still say OUCH! It is not cheap!

Here is a break-down of what we have paid so far… not including the three previous rounds of Clomid, prenatal vitamins, low dose ASA, or our uncompleted IUI.

The nonrefundable IVF Registration fee                                           $310

The Basic cost of IVF treatment                                                     $6300.00

IVFC Embryo Cryopreservation-                                                     $925.00

(this also includes the 1^st year of storage)

HATC Assisted Embryo Hatching                                                     $440.00

Drugs (so far)                                                                                $921.21

If you're not great at mental math I worked it out for you...

We are at $8,896.21… and we’re not even finished yet!

Even though my husband, Chris, was recently laid off we are the LUCKY ones. There are couples all over the world, and even here in Canada, who would love to try IVF, but they simply can’t afford it. 

In fact there are only 2 Canadian provinces that provide funding for IVF- Ontario and Quebec. Here in Alberta it was on the table to discuss until our economic downturn when if was quickly snatched back off.

So what can YOU do? 

The RFP has a program entitled Generations of Hope Fertility Assistance Fund where patients who cannot afford IVF treatments can receive some financial support. They are always looking for donations. Even a $25 donation could make a big difference. Call (403) 284- 9103 http://www.generationsofhope.ca/site/includes/pdf/GOH_Gift%20Form.pdf

OR

Let Alberta’s Premier, Minster of Health and Wellness, and your MLA know you support full coverage of IVF and other fertility treatments by clicking onto their link :

http://www.generationsofhope.ca/site/raise-your-voice.php

AND/OR

You can also sign the RFP’s petition urging the Alberta Government to support full coverage of IVF and other fertility treatments.

http://www.generationsofhope.ca/site/includes/pdf/1in6_Petition_May24.pdf

*If you don't live in Alberta I'm sure there are similar petitions in your province.

Getting Pregnant or Winning the the Lotto... The Odds Are About the Same!

Let me start by saying I was very naive to IVF. Before Chris and I looked into it I thought that couples that did IVF were pretty much guaranteed to get pregnant and have a child. Imagine my shock when the success rates were not the 80% + that I was imagining, but were actually around 24% for women my age.

Now 24% doesn’t sound like very good odds, but if you compare it to the 5% chance per cycle I have now,  it starts to look a lot better.

In case you didn’t know here are the average stats for women actively trying to conceive per cycle by age group:

20s-            20-25%

30                 15%

35               <10%

40+                5%

It is really quite amazing that anyone gets pregnant at all. I remember reading a funny comment from another blogger (Sorry I can't remember who). She stated that it was nearly impossible for anyone to get pregnant unless of course they were a cheerleader having sex in the back seat of a car!

Here is the Calgary Regional Fertility Program’s IVF Success Rates for a fresh egg transfer:

And here are their rates for a frozen transfer:

*Fresh transfer meaning having the eggs transferred during the same cycle. For frozen transfers the eggs are frozen, and then thawed to be implanted later. Frozen transfers often occur two months after the last IVF attempt or after a successful pregnancy.

When I looked at their success rates there was one thing that immediately jumped out at me . The rates for women my age in the frozen transfers section is significantly higher than those of the fresh transfer section. It goes from 25.5% to 42.8%! That is almost double the success rate!!!!

So I did a little online research and found this Wall Street Journal article:

http://www.wsj.com/articles/SB10000872396390443862604578030600949336888

Although they don’t know for sure why the rates are higher for the frozen transfers, they do have two different theories. One is that the different IVF medications are no longer in the woman’s body for the frozen transfer, and the other theory is that only the strongest embryos survive the freezing/thawing.

This is definitely something that I want to discuss further with Dr. F.!

p.s. If you are wondering about all the movie actresses that are getting pregnant past 43. It has been suggested that many of them are using donor eggs.