Tuesday, December 17, 2013

In Vitro Fertilization update

  Hello friends.  It has been a pretty busy couple of months for the Slaterys.  After our last failed injectables attempt, I was devastated and really took it hard.  After consulting with our doctor and praying a lot, we decided before we went on to IVF, we wanted to to do another laparoscopic procedure to check and make sure there wasn't something we were missing such as scar tissue regrowth or new endometriosis.  But first, on Friday, September 13, my family and I welcomed a wonderful blessing...my new niece Ingrid Elizabeth Larsen born heatlthy and beautiful to my sister Katie and brother in law Johan.  She came out with a full head of gorgeous light hair and looked very much the "Scandinavian princess" meant by her name Ingrid.  Three months later, her hair remains full and uncontrollable.  She has been a true joy and blessing to our family.  I love being an aunt!

 Three days later on September 16, as my sister and new niece were being discharged from the hospital, I was getting prepped for my procedure.  I was incredibly nervous, knowing that the results of the surgery would dictate our next steps in our journey to have a family.   The procedure went well and my doctor came to see me in recovery.  He did find some new scar tissue and a small amount of endometriosis but he said overall he " was not impressed" by his findings, meaning that what he saw, found, and removed didn't really explain the cause of our inability to get pregnant or warrant trying more rounds of injectables or inseminations.   Again, I was pretty devastated.  I had so many mixed emotions those first few weeks. I was elated to be an aunt and to see my sister as a mother.  I loved holding Ingrid and looking into her beautiful big eyes, but I was sad and felt hopeless, wondering  if I would ever hold a child of my own.  It took me a few weeks to come to terms with the fact that we really had come to the point where IVF would be our next step.  After a few weeks, lots of tears, and countless prayers, I made the call to Nashville Fertility Center to make our appointment for our consultation and testing.

  Our consultation appointment was October 30 at 7:30 in the morning. We dropped of our dog Reese with my parents on our way to Nashville the night before.  As my mom told me a couple days later, she said she could see the worry and fear on both our faces.  I was an emotional mess in the couple days before the appointment. Because we would be "distance patients," our appointment would be a marathon day of testing, doctors, and a class on IVF.  The first thing we did at our appointment was meet with the doctor, Dr. H., and talk about our history and everything we had already tried.  He agreed that IVF should be our next step.  I went through a physical exam, an ultrasound, and a trial transfer where they practice performing the embryo transfer so there are no surprises or complications on the day of the real thing.  Then, we went to a class with a few other couples and learned what a typical IVF cycle looks like and went through each step in detail.  After we almost literally signed our life away on a packet of consent forms, we met with the nurse practitioner who we would be working with and learned more about our specific plan.  Then we both had practically gave all the blood we had for testing.  The whole appointment lasted almost 7 hours.  It was a very long, exhausting day, but it couldn't have gone better.  I felt so at peace after the appointment.  I felt confident that this is the right step for us and very comfortable with the doctors, nurse practitioners, and nurses we would be working with.   One thing I have learned during the past two years of infertility, is the importance of feeling comfortable and having a connection with the medical professionals who are taking care of you.  You see them so much, sometime every other day, and they know every detail of a very personal situation.  They are with you through every step of a complicated process and cry with you when you get the negative results.

  At our marathon appointment, we learned that the IVF cycle is actually two months or eight weeks long, give or take a day or two.  The first four weeks are spent doing "hormone suppression" using birth control (I know it seems counterintuitive to use birth control to get pregnant but hang with me...) and shots with a drug called Lupron to even further lower your hormones.  The rationale is that they want to get your hormones as low as possible so that when you start the hormone stimulation phase, you have the best response possible. With hormone stimulation, you walk a very fine line of being under stimulated versus overstimulated.

  Once they get your hormones basically as low as possible, then you start a medication called FSH which makes your ovaries go into overdrive and produce as many egg follicles as possible, usually around 15 (keep in mind that you usually produce one egg follicle on one ovary during a normal cycle so having 8 or so on each side will be like having a tennis ball or grapefruit on each ovary, so it's not going to be very comfortable.) Fortunately, this part of process only lasts around 12 days. I will go into my doctor here every day or two and they will measure the size of the egg follicles and take blood work to measure my estradiol (estrogen basically) level.  Once the follicles get to the right size (about 15 mm each) then I will do an shot called a trigger shot with Hcg which will make me ovulate 36 hours later.  We will schedule our egg retrieval in Nashville and make the trip to have the procedure almost 36 hrs after I do the trigger shot.

  The embryologists and specialists in the lab will take sperm from a specimen Harrison gives and all the little eggs the doctors retrieve and will put them together.  We did learn from a specialized test that our problem and reason we haven't been able to conceive may be because of an important step in this part of the process that for us came back abnormal.  Because of this test result, instead of just letting nature take its course a put a sperm next to the egg in a dish,  we will do a step called ICSI (intra-cytoplasmic sperm injection) where they will actually inject a single sperm into my eggs to fertilize them.  Then they will watch the fertilized eggs grow for usually 5 days.  They will then pick the best one or 2 eggs and transfer the back into me in a easy and quick procedure.  They will freeze the rest of the eggs. This procedure will also take place in Nashville.  I will be on bed rest for a day or two.  And then we wait.  All we can do at this point is pray.  It is completely up to nature and the embryo at this point.  We will pray that it attaches to my uterine wall and buries itself deep.  Ten days later, we will take a blood test to find out whether or not the process was successful.  We can not take a normal pregnancy test because there is a high likelihood of both false negatives and false positives.

  So where are we in the process you ask?  Well I started birth control at the beginnng of December and I just started Lupron injections yesterday.  As of right now, our retrieval will be the week January 13. I won't know the exact day until a couple days before because again, it will depend on the growth of the follicles and my blood levels.  I will keep the blog updated with where we are in the process and how things  are going.   Please be praying for us as we go through this complicated, delicate, and emotional process.  Hopefully we will have good news to share after the new year!! Thank you all for the love, support, and prayers.

Tuesday, August 13, 2013

The Results are In...

Well friends, I'm sure many of you are wondering what the results were from our last fertility cycle using injectable medications.  We had an insemination done on July 21 and then had the dreaded two week waiting period before we would find out if this round was successful or not.  The drugs worked well this round and I had a few good egg follicles and our insemination went well.  I was really hopeful this time around and felt really good about our chances.  Unfortunately, it was not successful.   I was devastated and heart-broken because I really felt that we would have success this cycle.  I was very depressed and cried for several days.  It was definitely the hardest I have taken the negative results, I guess because I knew what the implications were and that it meant we would be faced with starting the IVF process.
     After a lot of time in prayer and many discussions with Harrison, we decided that before we jump into IVF we wanted to first pursue the option of my doctor performing another laparoscopic procedure to check for the recurrence of scar tissue or endometriosis. I have just had a nagging feeling that we maybe missed something and don't feel like I can go into IVF wondering if there is a bigger problem going on that needs to be addressed.  The way I think about it is that if nothing is found during surgery, then we can go into the in vitro process knowing that whatever our fertility problem is, our best chances of it being solved would be through doing IVF.  If something is discovered in surgery, then we may some other options or try a few more cycles before IVF.  I saw my doctor yesterday and he completely understood my concerns and justified the need for surgery since I have been having some pain and discomfort the last few months and since my body has had so much hormonal manipulation in the past year and a half.  Its alot been 3 years since my last laparoscopy so he said that there is a chance that something could have easily changed in the past 3 years such as scar tissue reforming or endometriosis appearing.  Another good point he made was that since insurance will cover a laparoscopy and won't cover anything for IVF, we would be making our investment in IVF more valuable, which is definitely true.

     I schedule my surgery for September 16.  Our next steps will be determined by what my doctor finds in surgery.  I am anxious but ready for this step.  I definitely feel like this is the best decision for us right now and I have faith in my doctor and in the process.  I feel very much at peace with this decision and am trusting in God that whatever the results of the surgery, that this is part of a bigger plan God has for our journey to becoming parents.

      I found this quote the other day based on Matthew 21:12 that says " Have you prayed about it as much as you've talked about it?" I really thought long and hard about this quote and realized that I find myself talking about our struggles more than I have prayed about it.  I have prayed about having a child so so much but I think maybe deep down, my type A personality still wanted to maintain some sort of control over the situation and over each round of treatment.  With the heartbreak of this last cycle, I found myself completely broken and crying out to God for help and comfort.  I realize that no matter how hard I tried to dictate the results of each cycle by doing everyone humanly possible to get a positive result on a pregnancy test, ultimately it isn't up to me. It's all in Gods hands. Strangely enough, it kinda takes some of the pressure of me if we go down the IVF path.

    So that's where things stand right now.  We are leaving on Saturday to go to the Bahamas with Harrison's parents.  It is a make up trip for us having to miss out on the Hawaii trip over Christmas when I had to have my gallbladder taken out.  I plan on enjoying this trip as much as possible and indulging in things I wouldn't be able to if we had gotten pregnant this round....wine at dinner, mimosas with breakfast, tropical beverages on the beach, fresh sushi and seafood just to name a few.  We are also going to be able to check a major item off my bucket list...swimming with dolphins!  I am super excited.  I will take tons of pictures and will post all about our trip once we return.  Thank you for all the love, support and prayers.

Tuesday, July 2, 2013

Continuing Our Infertility Journey...

Prologue: This post will discuss details of our struggle with infertility and our journey to try and start a family. Personal details may be discussed. If you are uninterested in this aspect of our lives, feel free to not read this post. I will not be offended. I chose to write about our journey for reasons including it is therapeutic for me and also to hopefully be able to touch someone who may also be struggling with this unfortunate circumstance in hopes that they will find some comfort in knowing they are not alone. One of the positives of our infertility is that it has brought us in contact with other couples who have had challenges, some of whom have become close, personal friends.

     So I haven't written in awhile because not a lot has happened the past 6 months.  Ok, we'll that's not exactly true. Most of you probably know that back in December I had to have my gallbladder removed. Well, what you may not know is this circumstances that surrounded the surgery and my hospitalizations. Yes, I said hospitalizations , as in I was admitted to the hospital two seperate times.

    Harrison's parents had been talking about doing a big trip with us, his sister Frances and her husband Jeremy for some time and after a lot of conversation and  planning, we were booked to go to Hawaii for 10 days over Christmas. I have always wanted to go to Hawaii, so this was truly a dream vacation for me. On December 14, four days before we were supposed to leave, I started having some sharp pains under my right arm between my ribs. I had an appointment with my pain doctor that day anyway, so I told her about it and there was a little concern with all the hormone injections from our most recent fertility cycle might have caused a blood clot in my lung. I had undergone an insemination about 10 days before so I was about due to find out if I was pregnant or not right when we would be leaving for Hawaii. The pain wasn't unbearable but bad enough where my nurse practitioner was concerned and suggested just to be safe, it was probably a good idea to go to the ER.

      So I called Harrison and told him it was probably nothing but my mom was going to take me to the hospital and that I'd probably be home in time for dinner. Way wrong. Upon getting to the ER and telling them I might be pregnant, they immediately did a blood test to check before they would do any X-rays or tests to see what was going on. The test came back negative. I was disappointed but kinda too preoccupied with the pain and everything else going on to really get upset at that point. After some tests, it was determined that I had a large gallstone and some other digestive issues.  I was admitted to the hospital that evening.  I didn't have surgery till 2 days later on Saturday and was released feeling pretty good on Sunday. I was sent home with a drain but my doctor said once I got that out on Monday at his office, that I could probably still go to Hawaii a few days late on Wednesday.  Harrison and I talked a lot about it and while I was cleared to go, something about it just didn't feel right and we decided it would be best not to push myself too hard and not go on the trip. Well, that ended up being the right decision, because on Thursday night I started experiencing the most intense pain in my side I have ever had and we rushed back to the ER. More tests revealed that my stomach and intestines had basically shut down from the anesthesia and weren't digesting or processing anything I had eaten. I was readmitted to the hospital and spent 4 days there, being discharged on Christmas Eve afternoon.
     The whole ordeal completely and totally sucked the life out of me emotionally and physically.
It took me several weeks, probably close to 2 months before I felt normal again and regained my energy. During those two months after meeting with my current doctors and some new digestive specialists, I was diagnosed with a couple mild to moderate stomach and digestive issues.  Harrison and I decided with all my body had been through emotionally and physically, it was time to take a break from fertility treatments for a little while. We had done 9 straight months of drugs with 5 inseminations and I just wasn't emotionally ready to start that all over again. Plus, we had met with our doctor and had been told that we had only one injectable cycle left before he would recommend that we pursue in vitro fertilization (IVF).  So the past six months we have just been living life and enjoying each other.

     Once June rolled around, I decided that maybe I was ready to start things up again.  The only downfall to taking a break for six months is that I had had six months to think about "our last chance" and to let negative thoughts get the best of me. After a few breakdowns, lots of tears and prayer, a meeting with our doctor to calm some of my fears, and waiting 2 weeks to get our fertility medications from England, we are ready to begin what is most likely our last shot at conceiving before IVF will put on the table. (The reason for this is because after doing 3 injectable medication rounds, the chances of becoming pregnant via this method begins to decline. My doctor explained to us that after 6 months of clomid and 3 rounds of strong injectable medication, if you haven't gotten pregnant and your infertility is unexplained, which mine is, then you most likely have an issue that will only be addressed and solved with IVF.)

     So here we go. I go to the doctor today for a progesterone shot to induce a period becuase I havent had one in 12 weeks. I will be have an ultrasound before I start the medications on day 3 of my cycle. I will be getting blood work and ultrasounds done every couple days to monitor things and we will do an insemination in about 2 weeks.  Then there is the dreaded waiting period of 2 weeks before I find put if I am in fact pregnant or not.  All I can ask of each of you is to pray diligently for us during the next month. Pray that I can remain calm, relaxed, and as anxiety and stress free as possible. Pray for Harrison as he has to deal with me and the inevitable mood swings that are the lovely side effect of the massive amounts of hormones. Pray that we continually seek and trust God, his timing, purpose, and plan for our live and our journey to parenthood. I love you all and thank you so much for your support and prayers.