My baby-in-a-box arrived today!!

Here at my apartment, the FedEx guy always seems to arrive with packages around noontime. The UPS guy always seems to deliver between 4pm-6pm. When I saw the FedEx truck pull around the parking lot at 12:43pm today I just knew he was stopping by with my precious cargo, and I was right! My baby-in-a-box had arrived!

So when combining today's shipment with what I already had, the picture above is the astounding amount of meds that I will use for this IVF cycle.

For stims, I have 9 boxes of Bravelle and 6 boxes of Menopur. This is a ridiculous amount of stims but they are anticipating my low response so they ordered accordingly. These two medicines have to be reconstituted before use. So each box has 5 - 75iu vials of the med and 5 vials of sodium chloride to use as the diluant (Bravelle vials in the pic below.) Once I get started on 10/8, I'll find out how many vials of the med I need to one vial of the diluant (e.g. If I have to do 225iu of Bravelle, I would need to mix 1 vial of diluant into 3 vials of med.) The every-other-day u/s and blood work is what guides them into adjusting the dosages as needed. All I can say is thank god they have videos for mixing and injecting these meds or I think I'd get lost in it all.
9 boxes of Bravelle = $2047.75 (after $200 coupon)
6 boxes of Menopur = $1977.00





For the antagonist injections, I have 4 pre-filled injections of Ganirelix. Towards the end of the stim period (usually when follicles reach a certain size) I'll use these injections in addition to the stims to prevent ovulation from occurring on it's own. 4 injections of Ganirelix = $344





For the trigger (done exactly 34-36 hours before egg retrieval), I have 2 Ovidrel pre-filled injections (1 shown below). This is the only med I need to keep in the refrigerator.
2 Ovidrel injections = $100



Also displayed on the table:

• 1 pack BCPS (only a few more days of those to take) = $3
• 2 packs of azithromycin (antibiotic - 1 pack I'm almost done with, 1 pack I'll start before E/R) $23
• a bottle of 90 estradiol tablets (estrogen) - these start around the time of transfer, I believe until I'm 12 weeks pregnant - if I don't get pregnant, I stop taking them the day of the negative beta. $40
• a bottle of 5 methylprednisone tablets - no clue what this is for, but at my appointment on 10/18 I'm supposed to bring all of my meds so they can review them with me...so will know more then. $15
• 2 boxes of Endometrin vaginal suppositories - each box contains 21 suppositories and 21 "plungers". Nice. I'll start inserting these hard tablets into the poor hoo-ha 3x a day from time of transfer until I'm 12 weeks pregnant (yeah, like I said poor hoo-ha) - if I don't get pregnant, I can of course stop these the day of the negative beta. $159.98 (after $20 coupon)
• 3 sharps containers (I certainly don't need 3, but since they came from 2 different pharmacies on 3 different occasions, I now have 3 of them) - $0
• Assortment of syringes and needles - the syringes with longer needles are used to suck up the Bravelle & Menopur out of the vials. Then right before injecting myself, I can switch the needle out to a small one since the injections are sub-cutaneous. $10
• Alcohol pads, guaze pads, etc - gotta keep it sanitary you know - $0

And so that's what $4719.73 worth of medications look like (and hey, when I add it all up it's $10 less than I estimated yesterday...bargain!!) Pretty crazy, huh?!?

May I please have more antral follies???

Today's appointment was good, well, for the most part. I'll describe what the process was like and point out the good and bad highlights as we go.

So the appointment starts like most GYN appointments with the good old speculum...always a fun contraption (yeah right!) The trial transfer was done - basically the RE inserted a catheter just like the kind that will be used to transfer the embryos into the uterus on transfer day. Every woman's cervix is slightly different so this kind of tells them the path they're going to take (also beneficial to find out any issues now instead of on transfer day.) So this went well! I was a bit worried about my scarred up cervix, but the catheter went in nice and smooth so we're all good there. Cultures were also taken to check for gonorrhea and chlamydia as is routine.

The saline u/s (sonohysterogram) consisted of them inserting a small catheter through the cervix and running saline solution into the uterus while performing a vaginal u/s. So you feel like this little tube is falling out of your hoo-ha while at the same time a condom covered probe is poking around in there. God, this is all so much fun! The good news from this test - my uterus is free of polyps and fibroids so we're good to go.

Now the not so great news. Back in July, my antral follicle count (resting follicles) was 9, which is pretty good for my age considering I only have one ovary. The antral follie count is used as part of how they gauge ovarian reserve and gives the docs an idea of what they're up against (if you have lots of follies, you may over-stimulate so they may have to watch you closely for that; if you have too few follies, you may end up not getting enough follicles during the stim portion of the process and have to cancel mid-way through.) Today's antral follie count for me was 4. Four is pure crap!! It truly sucks!!

To explain why this could be an issue further - as I do the stim injections, the goal is to get multiple, good-size follicles on my ovary in the hopes that there will be a mature egg in each follicle. That's right, just because there is a follicle, all big and juicy in there, does not necessarily mean there is an egg in it. So lets say there are 4 follicles that are nice and big and plump. On retrieval day, they aspirate each follicle and then see how many eggs were retrieved - so it's very possible that you get less eggs than you had follicles. There is also the possibility that an egg they retrieved isn't mature enough - goodbye to any of those.

So the "mature" eggs retrieved are put with DH's sperm to see if they fertilize. Typically, only a portion of them will fertilize. Then those that do fertilize, need to continue to grow to 3-day, 4-day, or 5-day embryos in order to be "healthy" enough to transfer back into me. So you could have a scenario where we have 4 follicles, 3 have eggs, 2 fertilize, but only 1 makes it to transfer. Or perhaps all 4 make it. Or perhaps none.

It is possible that when I go for my baseline u/s & start stims on 10/8 that I will have more than four antral follies, but it's possible that I won't. I know the docs are planning on loading me up with stims to maximize whatever I can get out of that ovary. So I can only hope and pray that whatever I am able to produce is great quality since I'll be lacking in the quantity department. I know everyone says "It only takes one" so say a little prayer that that stands true for us.

WOW, that stings the wallet!!

So, my baby-in-a-box (medications) will be arriving on Thursday! YAY!! I'll be sure to lay all the meds out and take a nice pic for you so you can see the ridiculous amount of stuff this will be. I'll also itemize everything I got at that time, but in the meantime, I'll tell you what the damage is on these meds.

• Now, if you recall, I've already purchased some of the stims, progesterone, and one trigger shot which came to $1023 and change
• The BCP's and antibiotics I bought last week = $6
• The additional meds I still need = $3700

SAY WHAT????? YES, you've read that correctly - an ADDITIONAL three thousand seven hundred smackeroos. My grand total for meds for this 1 cycle will be $4729 and change. OMG, I seriously wanted to puke when I heard that! So now that we know what the meds cost and barring any unexpected additional charges - our total for this one IVF cycle will be $12270...oh God, my stomach is rolling again, someone grab me a bucket!

Somehow, some way, in some form, I have to make sure I don't get stressed out about this. This will be our only chance for a fresh cycle but I cannot let the pressure get to me. Friends and family - please don't let me go to crazytown! Throw me a line if I start going down the path of negativity! Remind me to BE POSITIVE!

Ok, I'm done pleading for your help in keeping my sanity during this process...for now. Tomorrow I get my saline u/s and trial transfer done so I'll report back tomorrow night with what that's all like. Until then, I'm just going to remind myself that empty bank account = a bun in the oven...see, I really can be positive! ;-)

Fall has arrived, so has some doubt

As you may have noticed I've changed the appearance of my blog. I figured with the fall season upon us now, we needed some fall colors around here so a template change was in order. It certainly doesn't feel like Fall here yet - yesterday's temperature was 93 - but soon it will be time to dig the jeans and sweaters back out.

Pretty quiet yet busy week here. Lots of work, homework, and today add house work to the mix. I had PT for my leg three times this week and next week will have 3 more PT sessions. I'm definitely seeing some improvement in that calf muscle so hopefully in the coming week the limp will be gone.

So far, so good with the BCPs. I'm not used to taking pills on a schedule (I take my prenatal vitamins daily, but whatever time I feel like it) so to make sure I don't forget, I have the alarm on my cell phone set for 7:15pm every night to take my pill. On Monday, we'll add the antibiotics to the mix so I think I'll just make it easy and take those at that same time.

I had a rough night last night...I laid in bed for what seemed like hours trying to meditate away the nagging feelings of doubt. Doubt that IVF will even work, doubt that I'm a good enough mother, doubt that I even deserve to have more children, doubt that DH would want to spend a lifetime with me if he can't have children, etc. Part of this I'm sure is quite normal and part I think is me still dealing with that negative email I got from a family member. It's kind of tainted things for me negatively and I need to just let that go and keep my positive attitude going.

So DH was his wonderful self and talked me back out of my doubt-filled funk. We don't know that IVF will work, but we have to try. I was never a perfect mom, but I love my children and there's no doubt about that. DH didn't marry me for children, he married me for me. And if having children together just isn't in our future, it's not going to change the way he feels about me. We'll just switch gears and enjoy our lives together - get our house, travel, etc. I felt so reassured by the time we were done talking, I drifted off to sleep peacefully. Thanks DH!

Getting the party started - yahoo!!

YAY - we have our "IVF calendar" and the action starts tonight! I updated to the timeline on the right of the page, but to recap:

Tonight I'll start taking the BCPs...yes, tonight! WOW! Next Monday DH & I will start our 5 day course of antibiotics, then my saline u/s and pelvic evaluation/trial transfer will be Wednesday 9/29. I'll stop the BCPs on 10/4 and go on 10/8 for my baseline ultrasound. If everything looks good, I will start my stim injections that day. The target dates for egg retrieval/embryo transfer will be the week of 10/18 but of course that will vary based on how my follicles are growing and after fertilization, how the embryos are doing.

My meds are being ordered so I should hear from the pharmacies involved within a week. I'm certainly not looking forward to the giant price tag that comes with those meds, but receiving them and then watching the videos again on how to mix the meds and do the injections will remind us that this is all happening really, really soon! I'll be sure to describe and photograph all of the meds involved so you have a better picture (pardon the pun) of the quantity of stuff we're talking about.

To say I'm excited would be an understatement. Excited, nervous, hopeful - all at the same time...and I'm sure there'll be a lot more of emotions to come.

Some positive updates today!

It is REALLY nice to have some positive updates to report today!

My first positive update...drum roll please...Aunt Flo arrived yesterday! YES! Can you believe I'm excited about this when normally I curse her name and her appearance at my doorstep?? But yes, this is really good news after all that spotting and wondering when she would appear. Now we can really start getting this IVF show on the road, YAY!

My second positive update - we went to the IVF group session today so we can cross that off the to-do list. It was basically us and two other couples in a board room at the fertility center. One of the nurse practitioners walked us through a PowerPoint presentation of the process, the protocols, etc and answered any questions we had. Poor DH was so tired from getting up at 4am, working all day, then sitting through "death by PowerPoint" in a warm room with a low-talking speaker, I didn't know if he would make it through the presentation. He was afraid when he leaned forward to hear her, he may just fall over and fall asleep. But he made it through and it was a nice refresher of the process.

My third positive update - I spoke with the IVF nurse this morning (now that Aunt Flo had made her appearance) and she'll call me back tomorrow to schedule my saline ultrasound and pelvic evaluation/trial transfer. She called in our prescriptions for our antibiotics - we both have to take Zithromax before the procedure to make sure we're free of any bad bacteria and for me it's also a precaution before the two screening tests I have to do. And she also called in my birth control pills. I found it funny that I have ZERO chance of getting pregnant, yet was at CVS picking up my birth control pills...crazy! I'll only take them for a couple of weeks to calm things down in there and allow us to schedule the next steps.

Which brings me to my fourth positive update - The nurse I spoke with seems quite confident that I can start my IVF cycle during this cycle instead of having to wait for another visit from Aunt Flo. She was going to double check with the doctor and let me know my "calendar" when we talk tomorrow, but if so I'd be starting my BCPs this week, start my stim injections 10/8 and have my egg retrieval approximately 10/18 (this of course will vary depending on how my follies are growing in there.) But wow, wow, wow - this may be moving right along!!

So, I'll post again tomorrow to report on my screening test dates and whether or not the "calendar" is official. Fingers, toes, legs, everything crossed that the new dates are a go!

It's my birthday & I'll cry if I want to

Yes, it is my birthday today (the big 3-8) and no, I haven't really cried...but I almost did. And not because there will now be 38 candles on my cake. Birthdays don't bother me and I'm not sad about turning a year older. It's just been a supremely shitty week! I don't air the dirty laundry of those close to me, but let's just say it's just been a tough few weeks lately for my children and it's been breaking my heart. And then another person added additional shit onto the already heaving pile o' crap with an email that was sent with love but riddled with sideswipes. So it was a very emotionally charged week and I think I'm still drained and deflated from all of that.

On top of that, I've been having pain in my left calf for weeks now - nothing major, it just felt like a really tight muscle that wouldn't loosen up. But twice in the past week I had a horrible popping sensation in the calf which caused me to immediately cry out and hobble to the house to put an ice pack on it. So I saw an orthopedist yesterday and she thinks it may actually be tendonitis where one of the calf muscles attach to the back of my knee. When she pressed on where that tendon is I yelped and broke out in a cold sweat, so that was a pretty good indication that something's going on in there. Needless to say, the thrice weekly physical therapy appointments for the next month start on Tuesday morning. But having had 5 surgeries on my left ankle over the years and tendonitis many times - think left ankle, right knee, right inner elbow - I'm no stranger to physical therapy. And I've always responded very well to PT so I'm hopeful this will be a temporary pain in the ass, I mean leg.

And finally, no surprise here, I'm still spotting. WTF!!! Seriously!!! Can Aunt Flo just freaking show up now, please??

So back to the fact that it's my birthday. DH & I went out for breakfast at the diner this morning...fancy dinner was not one of my desires given my down-turned mood, but a yummy breakfast of french toast with a side of corned beef hash was spot on! My poor DH is at a loss for what to get me present-wise. If my brain could actually function after this past week I could be of more help in letting him know what I want, but I seriously have no freaking idea. In all honesty I really have everything I want, but I reserve the right to finally decide on presents at a later date. :-)

For all my friends and family that have sent birthday wishes through cards, facebook, text messages, phone calls, message boards, etc - Thank you all!! The wonderful birthday messages have brought a smile to my face today and that's the best present I could get so thank you! And I'll post again Monday after DH & I return from our IVF group session at the the fertility center to let you know what that encompassed. Ciao for now!

Still spotting, still waiting

Still spotting...what a surprise...NOT!! Good gravy this is annoying!! It's bad enough to be PMS'ing but I tell you this really adds to the unpleasantness of it all, that's for sure.

DH and I went yesterday for our infectious disease blood work. I've become a pro at waiting for everything - waiting for AF, waiting for this IVF process to kick into gear, waiting through 20+ 2ww's, waiting at the way-too-many appointments I've had this past year, etc. So sitting in the waiting room at the lab facility for quite some time (think forever and a day) is not a real change of pace for me. I actually find waiting room time is a great time to burn through my library books or magazines that I received but didn't read yet. DH on the other hand was quite perturbed at the slow service. Ah well, he's done with his tasks now until egg retrieval day so he can't complain too much about it. And in the end the short-staffed workers finally called our names, took our blood, so now we've got one more thing crossed off the to-do list.

I added a little timeline to the right of my posts to note all of the steps in our IVF process. Seeing some dates on there makes me feel like we're making progress. Ok, I admit, the progress is really crawling and you're sitting there thinking, "Will she ever have anything interesting on this blog again? Why am I still reading this dribble?" Believe me, I feel you're pain. I seriously can't wait to start filling in dates where there are currently "TBD" placeholders! I can't wait to write about the excitement, the worry, the needles, and all the nitty gritty. For now though I offer you my deepest apologies as you suffer through the talk of my incessant spotting, my frustration with pantiliners, and my desire for dear Aunt Flo to arrive soon so we can get the last couple of screening tests checked off the list.

Yoo-hoo, Aunt Flo...come on over and help us get this show on the road before I bore my readers to death!

Wishing for a day free of Carefree

Can I just say, I am so freaking sick of having to use pads & pantiliners!?!? Remember how in my last post I mentioned my weird bleeding that started last Sunday and only lasted for a day? Well, since then I've been spotting every day.

Now this normally would not be enough to piss me off, as I knew I could have a wacky cycle after the ectopic, but come on! Remember, I started spotting, then bleeding as soon as I found out I was pregnant so that started 8/3. Then of course it continued after the ectopic as my uterine lining shed and now the spotting started up again last Sunday. So since 8/3, I've only had 10 days where I DIDN'T have to use some kind of pad or pantiliner. And since Aunt Flo should be here sometime in the coming week, I don't see a day free of Carefree in the near future either. Can anyone say frustrated???

Quiet week on the IVF front

Hi there! Not too much action on the IVF front this week. But before I get into our next task in the process, Sunday night was a bit weird. It seemed as though Aunt Flo had shown up a week and a half early so I was like WTH?? But it only lasted until Monday evening then changed over to spotting now so I'm thinking it might just be some kind of weird mid-cycle bleeding after my ectopic? Who knows! Your guess is as good as mine.

Anyways, over the next week or so DH and I will get our infectious disease bloodwork done. They'll run a CBC and run tests to check for diseases like HIV, hepatitis B & C, and syphilis. These are checked so that if any come back positive they would take additional precautions during the fertilization process and for HIV cases, counsel the patient as needed. The bloodwork I have done will also check for immunity to rubella and chicken pox. If I were not immune, I would need to postpone the IVF so I could be vaccinated for these prior to the cycle since exposure to these during pregnancy can cause birth defects. Guess I'm glad to have suffered through chicken pox as a kid.

So we'll probably have a quiet week or two on the IVF front, but I'll keep posting as I have updates! For now, gotta run pup out for his post-lunch walk then it's back to editing user manuals for work (insert giant SIGH). IVF talk is much more interesting than my job so you're lucky I don't bore you with the details of work. :-)

The sample

The fertility center waiting room normally has a number of women in it, particularly in the morning as they go in for blood work, ultrasounds, and the like. And as a patient myself, when a man walks in alone, you pretty much know what he's there to do...give a semen sample for analysis. So as you recall from my last post, today was the day of DH's semen analysis and like the journalist I like to pretend to be, I sat down with him when he got home to get the real story.

He noted that the "number of women" in the waiting room paused in their reading as he signed in at the front desk (I'm sure they all thought the same thing I do - "I know why he's here.") When they called his name, they took him back to "the room" to do his business. They handed him a sterile cup and gave him his instructions. Then he was alone.

The room itself was tiny and contained the following: a toilet, a sink, a chair (I guess in case you're more comfortable jerking off in a seated position), a table with a couple stacks of porn magazines (think Hustler), and a muted TV with a DVD all ready for him to press play.

So he picked up a magazine - some International something - and started purusing. As he flipped the pages two thoughts came to his mind - 1) there are an awful lot of ads in porn magazines, specifically tranny ads and 2) he stumbled across a picture of a hot chick but found he was spending his time reading the article. As he put it "hey, she's alright...and oh, she's a Detroit native." WAY TOO FUNNY!!!!

So since the magazine was a bust (pardon the pun) he moved onto the DVD. So in the movie, a good looking babe (a little on the heavy side which thank god he likes or he would have looked right past me) strolls around the pool area wearing a bikini. The bikini comes off and a couple minutes later DH is handing his sample off to the lab tech.

Now during my interview with him, I tried to maintain my journalistic composure but it was just not happening. He was a great sport about the whole thing and I really appreciate him being interviewed for my blog. And hey, other than having to go through this same process again when it's time for E/R and getting some blood drawn next week, he's got it pretty easy in this IVF process. But again, thanks DH for letting me and our readers know what a semen analysis is really like!

Life is nice & busy

As the subject line says, life is busy and that's a good thing! I don't do well with boredom so I'm all for staying busy. Busy with what you might ask? Well, a number of things.

Classes started today again for me. For those of you that don't know I've started taking classes at our local community college to eventually try to someday get an English degree under my belt. I took two online classes over the summer (got A's in both, YAY) and am taking two classes online this semester. So, being the completely anal student that I am - I of course had to read all of the emails, discussion threads, syllabus, calendar entries, etc. for both classes, then proceed to read Chapter 1 for my Art History class immediately after dinner, do my discussion post, and take my chapter 1 quiz. Yes, I'm ridiculous I know! Tomorrow, I'll start cranking through my Ancient and Medieval History assignments for week one. I'm always afraid if I don't stay on top of things, I'll let something slip but I guess having a bit of OCD around work/school isn't a terrible thing.

Work's been hella busy thanks to having to pick up the slack of a co-worker who will not be named. But in the end, a busy day makes for a day that flies by so I won't complain about work being hectic (though I will often complain about the slacker who will not be named.)

So now onto our IVF updates. DH goes for his semen analysis this Friday morning which means yesterday's afternoon delight is the last we'll see until after Friday morning. Grrrr...we just got to start the love train up again this past Monday (since we had to wait a couple of weeks after the surgery before we could um, resume relations) but it's all for a good cause. Prior to the semen analysis and then prior to egg retrieval, there needs to be 2-5 days with no ejaculation so we get a good amount of healthy swimmers. I'm just happy that he will have an official room at the RE's office to "produce his donation" in vs. the bathroom stall at the VA hospital that he had to use last time. I've asked him to come home from his visit with a description of what this room is like so I can share it with my faithful readers.

I also spoke with the IVF Nurse Coordinator today and DH & I will be attending the IVF group session on 9/20 so we're looking forward to that. She's also mailing out our slips to get our infectious disease blood work done so we'll get that done as soon as we get the slips. I find that even when we have nothing going on in the IVF area, I stay pretty busy with it by participating on an IVF message board. As the "list keeper" for our fall cycle group thread, I keep everyone's progress updated & posted on our daily list and welcome newcomers, cheer on our thread participants, and learn a TON from the ladies who have gone through this so many times.

So, after spending all day working then doing some schoolwork I'm going to say goodnight to cyberspace. Tune in Friday for whatever details I can pull out of DH on the semen analysis process...admit it you're just as curious as I am to hear this LOL.