Friday, August 29, 2008

Negative results

Well, fuck.

Pretty much sums it up. Jessica and I are floored at the moment. We're digesting these results and will be giving ourselves time to figure out what our next steps will be.

The only decent news today is that I had my follow-up appointment for my surgery. I'm healing just fine and the doctor informed us that if we decided to do another round of ICSI, my right testicle will be recovered sufficiently in 3 months to proceed. My left ball wasn't touched last time, so that guy is ready to go already.

So, we still have options and hope (but, of the substantial kind, not the Obama kind). But, dear friends and family, bear with us as we process our grief.

Thursday, August 21, 2008

First Day Back at Work

I'm not going to lie-I'm pretty pooped. I worked from about 7:30-5:00 today but was operating at a very a languid pace. Nonetheless, I didn't feel particularly great so that made my day pretty long. I also got a lot of concerned looks, questions and statements that I looked tired (no woman, no matter how true it is and how bad she feels, wants to hear that!).

I woke up feeling woozy-my stomach was churning and I was dizzy. I thought food would help but actually, I nearly lost my cookies after breakfast and left the house with an emergency plastic bag and a cup of chamomile tea. Then, when I got to work I almost fell asleep while one of my co-workers worked on my computer. Nonetheless, I pepped up, fell into a rhythm after a while and was pretty happy. I did a lot of slow breathing exercises too. Clint insisted on calling me every hour to make sure took breaks and was calm. Frankly, I take a lot of breaks given the number of bathroom stops I make during the day.

Right now Clint is making dinner and I'm watching the news in my PJs while sitting on the couch where I'm sure I'll reside for the next 4 hours or so until bedtime. I'm quite relaxed and happy. Clint is being very selfless and cute, worrying over me. He has stepped up a lot around the house despite still be not quite 100% himself. I have a fantastic husband and friend in him!

I hope to God this feeling of discomfort is due to a pregnancy and not my nervousness. I'm trying to be calm and let this worry go but letting go is something I generally struggle with. I will continue to take care of myself, slow down and give myself lots of TLC but whether my embryos stay and grow is truly in the hands of God. Clint and I have worked hard and done all the right things but at some level, I feel as if it is no longer up to us. Keep praying with me my friends!!!

Wednesday, August 20, 2008

In my defense!

I was a very very good girl and only moved from the couch over the past 2 days when (a) I had to pee or (b) Clint said so. For those of you who know me, you know how hard this has been for me. Sitting still for days on end is generally not my forte. Yesterday I didn't do much other than eat, sleep and watch TV. Today, I did a bit of work but then Clint yelled at me for stressing out and we got that relatively sad bit of news from the doctor, so I put the rest of my work aside. I spent the remainder of my day reading (and finished!) my new book club book which I simply devoured. Speaking of devouring, I've been constantly growly hungry today. Not ravenously hungry, just this odd persistent gnawing at my insides. I hope its a good sign but not trying to read too much into it, or create psychosomatic symptoms.

I also have done a lot of praying and talking to my embryos, convincing them they are in a good place and they should stay and grow. That probably sounds a little crazy but every little bit helps. My family is concerned about me going back to work tomorrow. They think I will push myself too hard, but can't sit on a couch for another week waiting to take a pregnancy test. I would go crazy if I had to do that. I promise promise promise to take breaks, slow down, come home at a reasonable time and then do NOTHING.

My mantra for this time period involves the three P's- Positiveness, Placidness, and Prayerfulness. I will need to remind myself of this mantra during the day to combat my compulsiveness because, unfortunately, when I get stressed I become slightly manic.
Above all else I have drive and will power so I will rely on that to keep myself in check. This is too big of a journey and a commitment for me to risk it for a few more hours at work. I don't live to work, I work to live.

First bit of not the best news

Just got a call from the biologist, who informed us that the remaining embryos did not advance sufficently to justify freezing. So, the result of yesterday's implantation is our only shot, unless we want to go through the process again in the future. But, that's a decision for a later time that could be proven moot with a successful implantation. That phone call just made the wait until the pregnancy test next Friday all the more difficult.

Speaking of successful implantation, Jessica's been mostly good about keeping still. I'm still having to threaten to sit on her to keep her down, though. Allowing her to bring home work was something to which I conceded too easily. She was all in a tizzy about not being able to get her work laptop to connect properly or some such shit, which made me a nervous wreck trying to keep her pinned to the couch in a prone and relaxed position. But, she's moved on, calmed down, and will wrap up her work in just a few minutes and relax the rest of the day. I think that phone call scared her as much as it scared me.

Tuesday, August 19, 2008

Implantation photos
















Here's Jessica, all ready for the implantation procedure. What is that that she's reading?...

















Necessary literature for such a procedure, US Weekly. I'm so glad she's taking this so seriously.






















Fuzzy Clint in a bunny suit, ready to offer nothing but moral support. Sorry for the quality of the photos, my phone camera's not the best, and neither was the lighting.

And, they're in.

Clint here, logged in on Jessica's account until we can figure out the permissions to let me post. Jessica is nearby, watching Olympic volleyball while doped up on Valium, screaming at the US team like she knows what she's talking about. Oh, yeah, she does know what she's talking about...

We went up to Carmel for the, hopefully, final time today. Turns out we did it on a totally flat driver's side rear tire. Whoops. Obama would have our heads for that one. The implantation procedure went very smoothly. I'll try to post the photos of us in our gear later this afternoon, if I can figure out how to send photos from my phone. They gave us a picture of the blastocysts they were implanting and told us there were three other ones they are thinking will continue to mature and be frozen tomorrow.

The procedure was very swift and uncomplicated. We watched on the ultrasound through Jessica's abdomen as Dr. Colver implanted the two cell clusters out of a very long syringe-type instrument. And that was that. We cried and hugged each other before going back to the prep room to put our clothes back on.

Jessica is now on 48 hours of bedrest. The dogs are at daycare, thanks to Jessica's parents. They were getting quite a bad case of cabin fever with us lazing about for the past week, so it's good to get them active for a while and give Jessica some peace today.

The next step is a pregnancy test a week from Friday, so we're in a long period of waiting, hoping, and relaxing. Jessica will still be taking her endometrin thrice daily, but otherwise treating herself as if she's pregnant.

I'm doing a lot better myself. Well enough to drive, at least. I'm still sitting on ice and avoiding 100 meter dashes, but I'm able to move around a lot better. Which is good, as school activities start Friday, if I'm able.

As I said, I'll try to post some photos today. 'Til then.

Sunday, August 17, 2008

Good News


The lab just called to let us know the zygotes are looking very good, so they're going to push back the transfer until Tuesday. This is really good news and increases our chances of a pregnancy. With the transfer on Tuesday, the zygote should now be a blastocyst, which according to Wikipedia, "possesses an inner cell mass, or embryoblast which subsequently forms the embryo, and an outer cell mass, or trophoblast which forms the placenta. The human blastocyst arises after compaction and comprises 70-100 cells." For your viewing pleasure I have attached a photo of a blastocyst (not ours). The ICM label stands for inner cell mass, which will become the fetus. The C stands for blastocel cavity.

Its far better to transfer a blastocyst then a zygote because a healthy blastocyst that has hatched out of its shell will implant itself in the uterus within 1-2 days of the IFV transfer.

Having the transfer on Tuesday is also good news for Clint and I because it gives our bodies more time to recuperate. Clint is still not very mobile and it would be very difficult at this stage for me to be on 48 hours complete bedrest. We are hoping that by Tuesday, he is able to walk about the house and up and down stairs to care for all the animals as well as myself. Plus, I'm still pretty crampy and sore so a few more days of down time is heartily welcomed. I plan on spending the entire day on the couch, sleeping, watching the Olympics or Movies, knitting and playing Wii.

Saturday, August 16, 2008

New Beginnings

Clint and I decided to create a blog in order to help us process some of our thoughts and emotions as we go through Assisted Reproductive Technology (ART). We also thought our friends and family could use it to keep in touch with us throughout the process.

As background:

2 years ago, Clint and I decided we would try to start a family. Like most people, we thought we would conceive right away, particularly since we both come from relatively fertile families. We thought that if we had trouble, it would be on my end because my brother and I were both the products of Clomid. Nonetheless, we tried diligently for about 1 year. I became concerned so we went to see a gynecologist in the office where I had been seen since I was 13. He suggested that before we went poking about with me, that Clint be tested. Unfortunately, his test did not come back with very good results. He was crushed, particularly so because the gynecologist did not offer very much to be positive about. Nonetheless, he referred us to a local Bloomington urologist. This urologist examined Clint and was very kind and helpful. He referred us to the premier male infertility specialist in the state of Indiana, and went so far as to make an appointment for us the very week he made the referral. Needless to say, we hold the local urologist in very high esteem so if you ever need one, let us know and we'll give out his name and location.

The specialist in Indianapolis suggested that Clint have surgery to eliminate 2 large veins in his system and to determine what, if any, sperm making ability he had. So, this past December Clint underwent very serious surgery that involved cauterizing those veins, removing some fatty tissue and have a bilateral testicular biopsy. It took him three very long weeks to recover from the surgery but he was a trooper.

About 4 months after the surgery, the specialist started talking to us about options other than natural conception. We decided to use a fertility group located in Carmel and started meeting with the excellent doctors there to examine me. They determined that we needed to use a procedure called IVF with ICSI (in vitro fertilization with intro cytoplasmic sperm injection). This essentially entails hyper-stimulating my ovaries, harvesting the eggs, aspirating sperm from Clint and physically inserting the sperm directly into the the eggs. This would also mean that Clint and I would undergo surgery at the same time.

In July it was determined that my uterus was well positioned to begin the IVF procedure. So, on I began daily injections of a drug called Lupron. Lupron essentially threw my body into menopause, suppressing my ovulation and all hormones associated with it. After a week or so of the injections the office took blood to ensure my hormones were sufficiently suppressed. Then, on August 1, I began my twice daily injections of the Follicle Stimulating Hormone (FSH) in addition to continuing the once daily injections of Lupron. The FSH made me feel very hyper, aggressive, and crazy. It reminded me of being 16 years old wanting to drive very very fast with the top down, eating cheese fries and toilet papering houses. Not that I ever TP'd anyones house when I was 16, but it made me feel like I wanted to.

I didn't really mind the shots other than 1) I had a u-shaped pattern of track marks and bruising around my belly button, 2) my belly felt very swollen and uncomfortable, 3) I felt like I had to pee all the time from the pressure of my growing ovaries, and 4) the FSH is ridiculously expensive (think $700 per 60unit tube--I went through 5 tubes) and not covered by insurance. yeah.

After 5 days of the FSH I had blood work done to see where my estrogen level was along with an intrauterine ultrasound to see how many follicles my ovaries were developing and their respective sizes. They both the ultrasound and the blood work to determine how much FSH to give me and when to schedule the retrieval. From August 5 through the 13th, I went up to Carmel every other day for blood work and an ultrasound. Finally, I was told this past Monday that I would receive my hCG shot on Tuesday night and the retrieval was scheduled for Thursday morning. The hcG shot is a deep tissue shot in the upper hip that essentially triggers my ovaries to send those developing follicles into overdrive. A very sweet Doctor friend of mine agreed to give me the shot. She did a great job and I had no bleeding or excessive pain.

Currently:

Clint and I both had surgery bright and early Thursday morning. They retrieved 18 eggs from me and a very good tissue sample from Clint. In fact they were so happy with the tissue sample that they did not tap his left testicle. This is very good for him for 2 basic reasons: 1) he was worried that they would not find ANY sperm and we would have to use our backup donor sperm, and 2) his recovery will be shorter.

Yes, I did say donor sperm. We thought long and hard about whether or not we were going to use any as a backup in case they could not find any sperm from Clint Initially, Clint did not want to use any. Over time, and with the help of counseling, he realized the chance they would not find any sperm from him was relatively small (20% ) but he would love any child as his own. Therefore, we agreed to have a vial as backup, both sincerely hoping that it would not have to be used. In the end, we were blessed and did not have to use the donor sperm. Telling my husband that they got a good sample from him was one of the happiest moments I have shared with him to date.

In fact the sample was better than either one of us expected. We learned from the biologist yesterday that of the 18 eggs retrieved, 15 were inseminated, and 10 were showing signs of fertilization. Clint was so happy and relieved to know they found enough sperm to inseminate 15!!!

They will continue to monitor all the eggs this weekend. I am scheduled to go up to Carmel tomorrow for transfer of the best 2 eggs at 9:30 am. However, they will check on the eggs at 7:00 am. If they are at a particular stage of development, they will leave them alone and the transfer will be postponed until Tuesday morning. I don't really understand this stage very well but I basically understand it is better to implant a blastocyst, which is further along in development, then an embryo. Nonetheless, if things are not progressing as fast as they want, they will go ahead and get the embryos in my body on Sunday. Either way, we won't know until tomorrow morning at 7:00am.

I'm not done with drugs by the way. I started this morning taking something called endometrium, which looks like a Monistat Suppository. Its a tablet of some type of hormone that is supposed to assist my body prepare for handling an implanted embryo, to make sure that I get certifiably pregnate. I have to take it 3 times a day through my first pregnancy test at the end of this month. I don't know if it was the drug or the fact my body is still sore from the retrieval surgery but my first dose this morning made me incredibly crampy. So, I curled up on the couch for an hour then took a nice hot bubble bath. I feel much better now but I'm still going to take it easy today. I need to prepare my body for the baby/ies I'm going to receive later this week.

Once the embryos/blastocysts are transferred to my body I have to be on strict bed rest for 2 days. I swear I am going to honor this directive to the T. See, I'm not the best patient. I'm too much of my father obey the request "take it easy" very well. I was supposed to take it easy following the retrieval surgery Thursday but I'm not doing so well with that one. I walked around a lot Thursday afternoon/evening and went to work on Friday from 7:15am to 6:00pm. I also walked from my office on College to the First Christian Church on Kirkwood and Washington and back, which was probably too much walking for me. I think my mother wants to strap me down to a couch and only let me up to go see the doctor. But Clint and I have gone through too much, and we have too much at stake for me to play fast and loose with the implanted embryos/blastocysts. I don't want to risk anything, so I will only get up when absolutely necessary!!!

We are so blessed to have great friends and family to help us out. My parents chauffeured us on Thursday and my mom will drive me again for the transfer. They also brought dinner over for us last night, cleaned the kitchen and even emptied my dishwasher. My mom is also going grocery shopping for me this morning. She doesn't want me walking around too much, pushing the heavy cart or lifting the grocery sack. My parents are great and I think they're getting the tiniest bit excited about having a grandchild/grandchildren. My friend Chelsea is being a dear too. She came over Thursday night and made Clint and I dinner. She is also going to hang out with me later today and when I'm on bed rest too.

That's the other thing. I mentioned we have 10 fertilized eggs and that they're going to transfer the best 2 later this week. Given my health and age, the doctor thought the likelihood of us having twins is around 60%. That information is blowing my mind. In 1 year, we have gone from the probably of not having any children at all, to the possibility of having 2! CRAZINESS!! I would be ecstatic to have just 1, so 2 would be out of this world amazing.

I just don't quite know how to express my thanks and appreciation to all the people who have supported Clint and I through this process and who helped make it possible. I also don't know how to express my gratefulness that we have achieved so much. A simple thank you is insufficient, but for once, this lawyer is at a loss for more appropriate words.