The past few days Travis and I have been in a bit of shock. We still cannot wrap our brains around how this happened. Going over to Miami was nice and glad we did it. It was refreshing to see my dad, Maria, and my little sister Chelsea who was down for the summer from Boston College. We wanted to stay over on Monday and just hang out in Miami but around 11 a.m. I started having very strong cramping, especially on my left side. I was so uncomfortable. We returned back to my dad's house, took some Alieve and started heading back to Naples.  The pain had not let up after two hours and I was worried that it was hyperstimulation. Called my IVF doctor and she wanted me to come in as soon as I got back to Naples. Great! This is all we want to do. We are still in an emotional daze and we have to go to the doctor to make sure I am not in danger of hyperstimulation:

The most worrisome complication of IVF is that of ovarian hyperstimulation syndrome (OHSS), because of superovulation. The cause of "ovarian hyperstimulation syndrome" is that superovulated ovaries contain many follicles which are loaded with estrogen. After ovulation, a huge amount of estrogen-rich fluid is poured directly out of the enlarged and fragile ovaries into the abdominal cavity. This fluid also contains chemicals like kallikrein-kinin and VEGF (vascular endothelial growth factor), which then coat the lining of the abdominal cavity (called the peritoneum) and cause it to become very permeable (leaky) . Fluid (serum) literally pours out of bloodstream into the peritoneal cavity because of the "leakiness" of the abdominal cavity's lining. The ovaries balloon in size, the abdomen swells, and some women may get lightheaded with relatively low blood pressure, or dizzy because of the decreased blood volume. From:
http://www.drmalpani.com/ovarian-hyperstimulation-syndrome.htm

After conducting an ultrasound my doctor was confident I did not have OHSS and the pain was probably caused by blood in my abdomen which is normal when ovulating as many eggs as I did.  The pain will go away when I get my period.

Seeing the doctor gave us an opportunity to ask questions as well. There was a 3% chance of this happening. Mostly premature ovulation happens with older woman doing IVF and seeing it in a patient like myself is even more rare. Not so comforting news.

Also not so good news was that we are expected to pay to start over. There are four phases.
Phase 1: Monitoring and stimulation (drugs and shots)
Phase 2: Egg retrieval and stimulation
Phase 3: Embryo transfer and stimulation
Phase 4: Past embryo transfer monitoring and stimulation

Each phase costs money. We never got to Phase 2 so we need to do phase 1 over again. We do not feel it is fair to have to pay 'x' amount of money because we did nothing wrong. We followed all the instructions perfectly and they should not charge us at all since we will have to repay for the drugs which cost thousands of dollars as it is. Travis left a message with the head guy at the clinic today. Because this is so rare and again, we did nothing wrong, they should give us a break. Pray for favor.

Starting over means, waiting until I start my cycle, then on day 3 starting the birth control (to calm my ovaries down so we can start at ground zero again), taking it for 3-4 weeks, monitoring and going from there. This puts us at egg retrieval around the end of August, beginning of September.

Please pray for Travis and I. We are thankful that we did not lose any embryos and did not receive a negative pregnancy test. On the other hand, this is a hit. We were not expecting it and it is taking some time to get back on track. It is hard to focus on everyday tasks, work, and other things when we have yet to process what really happened. I feel like crying but there are no tears.  I don't want to be sad but being happy doesn't feel natural either.  This evening, we had planned on going to church but I got home from work around 5:45 p.m., laid down and did not get up until after 7 p.m.  Travis didn't want to wake me.  I feel tired and restless at the same time.

I know each day will get better.  I have hope that it will.  If you know me, and if you are reading this blog than you most likely do, you must know that this has not shaken our faith. We believe God will turn this situation into something good. Something perfect. Like a baby for example!

Thank you for your prayers.

Love,
Lauren

I ovulated early.
My blood work this morning showed it.
My doctor called me this afternoon at 4:30 p.m. as we were rushing home to get ready to go to Miami to tell me the news.
"What? I don't understand. How is that possible?"
"Faulty Cetracide shot."
"So we're not coming to Miami?"
"No. Lauren, this rarely happens and when it does it is really hard. Bring in your Cetracide shot because we are going to file with the company."
"So I have to go through everything again? Shots? Blood work?"
"Yes."  She continued talking but I didn't really hear what she was saying. Something about how everything was looking perfect and not sure how this happened.
"I gotta go."
Called Dana to cancel watching Ben.
Called Nicole to tell her the news. Cried on the phone with her.
When Travis came home our hearts were heavy.
We cried it out. Sad because it is very disappointing and difficult to hear.
It could be worse.
Instead of sitting here at home and crying it out, we are packing up Ben and still going to Miami. It will be a nice change of scenery.

We need time to process it and gather up strength to do it all over again.

Thank you for your prayers.

Lots of love,
Lauren

This morning, Sunday, at 9 a.m. we had another appointment for blood work and ultrasound.  The blood work, thank GOD! went well and only had one stick. The ultrasound was a bit more exciting.  I had 14 follicles that were size 14 mm or higher and considered mature.  There were 10 more that could possibly have eggs in them. However, we needed to wait and see what my estrogen level was before deciding to wait another day before getting the 'trigger' shot (tells my body to ovulate).  It is a balancing act between growing as many mature follicles as possible and keeping my estrogen at a safe level.

This afternoon, my doctor called to report that my estrogen level was 2,700 (abnormal would be anything over 4,000). To give you an idea, on Friday, my level was 1,780 so to wait another day to see if those 10 follicles would mature to give me 24 is too risky. To have 14 mature follicles is a really good number anyways! To retrieve 24 eggs is a lot!

So, this means, Nicole will give me the normal shots, minus the Menapure, tonight at 6:30 p.m. and the trigger shot at exactly 7:45 p.m. 

Let me explain the exactly part. My doctor was very and repeatedly clear that it is to be given at this time. The reason, is that they need to time it just right because if they do not, I could ovulate before they are able to get the eggs and that would be no bueno! It would spoil the whole cycle and all that we have done up to this point. On the voicemail she left me, she said 7:30 p.m. but then the lab called her back and said 7:45 p.m. so she called to notify with me. Fifteen minutes? Really. Apparently yes it is that big of a deal. 

This shot is gonna hurt. It goes in my upper butt area (inter muscular) and has a big honking needle. Thanks to the advice of Rachel, I will be icing the area to help numb it. "Small price to pay!" is what I will be thinking. 

Tomorrow morning at 9 a.m. I have a blood work appointment only to ensure my body absorbed the trigger shot and to check my estrogen level again. Travis and I will both work full days tomorrow and then head over to Miami. Tuesday morning at 7:45 a.m. we will go in for my egg retrieval. Exciting!  Since I will be on bed rest, I took Wednesday off as well as Tuesday.

Our good friends, Dana and Jeff will be watching Ben for us. We debated on bringing him over but he usually drives on my lap and that probably would not feel so good going over or heading back. Plus, he loves playing with their Puggle, Harley! We love our Ben! This picture was taken a while ago. He is such a good doggie and cuddler!

Ben is always very sensitive to when I am upset and is quick to bring comfort! So glad he is in our family!

They will retrieve all of the eggs, whether mature or not. And then my empty follicles will fill up with fluid again so the bloating and pressure feeling stays.

Just because they retrieve 14 plus eggs does not mean we will have 14 embryo's to choose from. At each stage, some do not mature enough to move on. Half of the eggs will be directly injected with Travis' sperm which is called icksee and the other half will be given the opportunity to 'hook up' naturally. They will put one egg in a pastry dish of one million sperm for example, and let them do their thing. Then they watch both the icksee and natural method embroy's and measure their growth.  The embryonologist (sp?) will give us updates along the way with their progress. 

THEN, we go back to Miami on Saturday for our embryo transfer which will take place on Sunday, July 2nd.  Yes, Michelle, this means, I could be getting pregnant on your birthday!

Travis and I are very happy to be graduating to the next step. 

Praying my anesthesia goes well and I do not wake up horribly nauseas! Please say a prayer on Tuesday at 7:45 a.m. for a great procedure and smart anesthesiologist!

More to come! The best part actually - mid July and beyond!

Lots of love,

Lauren

My ovaries are full! They feel full.  My second appointment today went just as good as Monday. Unfortunately had the same problem with my veins. Stupid rolling veins. Ugh. Getting blood taken is worse than the shots!

Okay, I'm not complaining because I am happy to have a plan and seeing the end result in sight! So, add to the prayer list that my veins stop jumping out of the way of the needle and that my arms heal before they take my blood again on Friday.

Thankful to report my right ovary has 14 follicles and my left has 13 follicles. It is not always the number that matters but if they are all around the same size, growing together, and they are. My right side ranged from a whopping 13 mm down to about 9 mm. My left is still smaller from around 9 to 11 mm.  As Wendi so knowledgeably commented on my previous post, it is better for slow and steady than over-stimulation.

Once we are ready for retrieval the good ones will be over 14 mm.
You can understand why having 27 follicles can make a girl's ovaries feel full. It is pretty cool to have my ovaries feel something other than empty. Now on to a healthy embryo living inside and growing strong!

I am getting ahead of myself. One day at a time. Tomorrow I start the third shot which will continue up until retrieval. Three shots. Another appointment on Friday at 8 a.m. which Travis will be able to attend, followed by an appointment on Saturday and possibly Sunday.  They are expecting the egg retrieval to be on Monday or Tuesday.

I must say I could not have had a better friend in Nicole to give me these shots. I have to tell you what she did for me tonight!

It is Wednesday and we have church. I am on the worship team and was scheduled to sing. Practice starts at 6 p.m. and we have been consistent with shooting me up at 6:30 p.m.  When I explained to her my dilemma she enthusiastically came up with the solution.  Travis and I packed the drugs, separating out which one had to be refrigerated and wrapped it in an ice pack from my shoulder surgery. After practice, around 6:45 p.m. we rushed to the 'Family Bathroom.' Just like at her house, she gave me the shots, sang to me 'Twinkle, Twinkle, Little Star' when giving me the Metapure (because it is 1cc of meds, goes in slow and stings). I can't laugh or sing along because it makes my stomach muscles tense up. It is hard not to do one or the other. Meanwhile, several people knocked and tried coming in. It was funny to think that this was our secret meeting to help get me pregnant and stay that way. Travis was in on it too obviously because he carried around the bag which was really a large purse the whole service. What a trooper!  As a sidenote, he was not in the bathroom with us. It probably appear odd enough for Nicole and I to walk out of the bathroom together. Even more if Travis did as well!

When she finished we laughed and celebrated the memory we just made. It is going to be a great story.

This may all seem overboard to go to such lengths, but there is no control in infertility.  Whatever I can, I try and make it perfect. It is soothing to the anxiety to have some say in the process. If we have been getting the shots done evening at 6:30 p.m. and it has been working beautifully, why not do everything we can to keep it that way?

Tonight was a great service and it was worship pretty much the whole time.  For the first time in over 6 months, I used the handheld mic rather than the headset. Very exciting. My shoulders are very tired but it felt good.

God is my everything and when we do get pregnant, deliver a full term and healthy baby, I never want to stop relying on Him. He is faithful and I love him a whole bunch!

Today was my first appointment to gauge how the stimulations are doing. Getting my blood work done was not so fun. Note to self: stay hydrated before getting blood taken. My veins were rolling and the first nurse could not get the needle in my vein. The second nurse was able to get it after some 'digging' which made me want to be sick. Usually I have great veins and there are no problems. Well, I take that back. When I was the ER a few years ago my vein rolled after they put an IV in and I wanted to yank it out. Other than that my veins are good! he he.

After blood work came the ultrasound. Right ovary was the star with 10 follicles ranging from 6 - 9 mm. The left ovary had 6 follicles ranging from 3 - 7 mm.  It is normal to have one ovary dominate.  Each follicle is measured individually in width and documented.  They will get much bigger, at least 12 mm.  This is all on schedule and looks good including a beautiful uterine lining happy to say.  None of my meds need to be changed up to this point.

This is not a picture of my ultrasound but pretty much what it looks like.

There was a number I was given to call and retrieve the message from the nurse. My own personal voice mail  system.  However, for some reason when I called the number they gave me, it went to a live answering service.  The operator knew nothing of a voice mail system so they paged my doctor. She called me back to deliver the news of maintaining the stimulations as is. Why is nothing easy with this office? Not sure.

Happy to report my visit went well. My next appointment is on Wednesday at 9 a.m. for the same routine. Then again on Friday and Saturday.  Saturday we will be able to pinpoint the retrieval date of either Monday, Tuesday, or Wednesday of next week. Exciting!

Lots of love,
Lauren

Happy Father's Day!
Thankfully I will get to see my dad soon! When we go to Miami for the egg retrieval we will be staying with him. Love you, dad! This picture is of him when he became a Grandad! Looking forward to him meeting our baby!

Today will be my third day with stimulation shots. Thankfully they do not hurt as much as I expected!  My sweet, lovely, blessing of a friend, Nicole has been giving me the shots. She is an LPN and just like nurses do, she says 'ok, you are going to feel a little pinch' and bam, shot is in my skin and it is over before I know it. We have a good system down.  I pinch my stomach skin together to form a little pouch and she handles the shooting part.  To make things easy, I put together a basket full of the supplies so I can grab it and go. I am greeted at the door by one of her daughters who every time, is eager to open the door and welcome me inside.

I am most thankful for Nicole! She lives down the street and gives of her time to shoot me every evening around 6:30 p.m.  Here she is posing with the needle. Now, doesn't that face make it so much nicer to get shots?

So, I am on my way to her house shortly, with my medicine in tow.

Tomorrow, I have a doctor's appointment at 9 a.m. for blood work and I believe an ultrasound.  Then again on Wednesday, Friday, and Saturday.  The doses of what I am taking may vary depending on how well my follicles are responding to the stimulation.  Also started taking prenatal vitamins today.  My doctor recommended Pregnitude but have been unable to find it at CVS, Walgreens, Publix, or the Target pharmacy.  It is the best for egg health so we will find a way to get it. In the meantime, I'm taking the regular prenatal vitamins.

God continues to be faithful in carrying us through this process. We feel Him closer each day. As the process intensifies, so does the reality of his promises.

Thank you for your prayers!

Lots of love,
Lauren

Because of my work schedule, my Friday baseline appointment happened this afternoon at 3 p.m. The appointment was to get baseline blood work done and an ultrasound to count how many follicles I have. My left ovary had 7 and the right, 11 or the other way around. Not completely sure which number goes with which side but either way those numbers are very good.

While I initially waited in the examining room, I closed my eyes and invited God into the room and the appointment. This was it. We're starting IVF.  (Well, it was official the day we wrote out the biggest check of our lives.) But this appointment was another step closer. It was exciting and I needed God sitting right next to me.

Our Pastor spoke last night about not giving place to the devil and his lies. Just like in the movie theatre you say when reserving a seat for a friend, 'this seat is taken.' Well, the seat next to me through this process is taken with Jesus who is full of hope, life, and good promises.

When my doctor walked into the examining room she smiled really big and said, "Are you excited? I am!" She is such a sweetheart and makes up for her on-and-off-again-nice staff. She is genuine and very thoughtful. After doing the follicle check, she told me the ANA Panel she ordered last week as part of my blood work came back.  Three out of the 7 checkpoints (normal is 0-1) for hi-risk miscarriage patients came back positive. As she explained, every woman, every time they are pregnant are at risk for a miscarriage but because they have this advanced information, they will take the extra precautions. Now, we already knew some of this information from previous tests. This was a more detailed look and could direct her more specifically on the drug doses.  Mostly, I will be on blood thinners after the embryo transfer to ensure it gets the nutrients it needs.

Speaking of which, here are the "stimulation drugs" for the next few weeks. Some are pills and other shots. I get my very own 'home sharps container.'

Beginning tomorrow, Friday, my friend Nicole will administer two stimulation shots in my stomach each evening around the same time.  As we get closer to the egg retrieval (see calendar from previous post), they will increase to three a day. After the embryo transfer, we change up the shots and begin steroids and blood thinner medication.  The nurse sat down with me (thankful Travis wasn't there because he's not so keen on needles) and went over how each needle worked, medication, and dose.  The ones she said 'you won't need this one till later and we'll review again then,' I gladly shelved in my mind. There is only so much room in my brain for this stuff. One day at a time. 

After my doctor's appointment I had an event for work Downtown. Some of the meds were in an ice pack. Being so terribly hot outside, I took my delicate, expensive drugs in with me. Why not? I hid the box under a table and walked it out with the rest of the decorations afterwards. he he he.

I am looking forward to mid-July and hearing the positive news that we are pregnant! Kindof takes out the picture I had in my head of surprising Travis with a positive pregnancy test but at this point, I would take the news written on a sticky note!

As you are saying your prayers, I have some specifics for you to pray:

 - Medications work as they are supposed to and for balance in my body (as much as possible).

 - Wisdom for my doctor to know how to adjust and guide the process.

 - Strong uterine lining; perfect and snuggly for an embryo to want to implant and grow.

 - Healthy and full-term pregnancy. 

 - Travis. For obvious reasons!

Thank you! Lots of love! Lauren

Processing. I've been processing since last Wednesday.

We had our official IVF consult on Wednesday. Very glad Travis was with me just in case, but turned out everyone (including rude nurse) behaved well. Between the calendar with my appointments and the notes I took on when the drugs start, I put together the below so you can get an idea of the plan:

The consent appointment is preceded by a DVD we have yet to watch but will before the appointment. Basically it will include our legal preferences. For example: what are our wishes for embryo's we do not use in this cycle, how long are they to be kept, if something happened to both of us how would we want the embryo's handled etc. We haven't watched the video so this is our guess.  I can tell you right now:

• We will be transferring one embryo for this cycle. Transferring two does not increase our chance for a pregnancy. Basically either it is a good cycle and whatever you put in takes, or it doesn't.  If God decides to split the one we put in to give us twins, than so be it but we will only be putting in one embryo.
• We will not be 'disposing' of any mature embryo's.  No baby of ours is going to get tossed.
• We will use however many embryo's we have left. It could be none, two, or 8. We made this decision a long time ago. 
• If we have more embryo's than we transfer, we would opt for a non-stimulated cycle transfer for each one.
• 'Snow-flake' babies is an option where you put the frozen embryo's up for adoption for the couples who do not have strong enough sperm or eggs to create one on their own. We will not be using this option. 

Okay, back to the calendar.

The stimulation shots will be given in my stomach (by previously mentioned, gracious nurse friend of mine and neighbor). There is one shot, the Novarel, that is a one time shot and will be given in my thigh. I think this is the 'Trigger' shot, which tells my follicles to release. The steroids will continue through the first couple weeks after the embryo transfer to help it grow. This is part of it that is customized for me as mentioned in previous posts.  

As you can see there are lots of appointments. This is to monitor the growth of my follicles and how quickly they mature to time everything just right. Lots of blood work done in there as well. All the medications are flexible and will be altered depending on how my body/uterus/follicles respond. We do not want too much growth or too little. My doctor told me it will feel like my ovaries are going to burst.  That should be interesting.

A normal cycle produces one egg. The stimulations will produce several so the weight of it will be noticeable. 

The hardest part, I am predicting and letting myself get ready for, is from July 3-16. 

Waiting for the blood test results. 

I can take a home pregnancy test.  However all the hormones and steroids I will be on, the likelihood of a faulty positive is high and I don't want to do that to us. I would rather wait for the blood work which will be a sure thing. Of course, I may take a pregnancy test, who knows. But right now, I am planning on waiting for the blood test results. 

Thank you for your prayers during this time for me and for Travis. This journey is already emotional. Add anticipation, nervousness, a full calendar, hormones, and steroids, and things can get interesting. I wish it could all be condensed down to a week's time. Five weeks seems like forever. One day at a time is all I can fathom right now. One day at a time. One step at a time. One appointment at a time. Looking too far ahead makes me dizzy. Just focusing on what is ahead of me.

Right now I am excited about choir Sunday tomorrow. I get to direct my first A Capella part! This is very exciting! It will be on www.napleschurch.com then 'media' and 'past services' if you want to check it out and are reading this after Sunday morning.

My immediate future holds getting a good night's sleep for tomorrow.

To all my friends who have given me really good hugs since reading this, thank you. They feel good!  Keep 'em coming!