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.