Stress!

I posted yesterday that I have been struggling emotionally with stress and depression. Last night my husband sat me down and basically challenged me to get some more help and to try to cut back on stress.

The number one thing that stresses me out is my job, and although I would quit in a heartbeat if I could, I consider my job a blessing as it provides the income and security in terms of benefits that I would otherwise not have.

We decided that I should drop the Marketing class I had started this week (I am about 2/3's of the way through an MBA in Accounting right now). I plan to start back up in October after the pregnancy test results.

I also am going to try to see a psychiatrist to get my medications straightened out. I'm thinking the meds I'm on right now are just not hitting the right neurotransmitter to make the difference I really need. I've been seeing a family practice doctor, but I really think I need to see a specialist. I have a few names to call on tomorrow.

Marty wanted me to consider cancelling the IVF cycle, but I feel very strongly that we need to proceed. I'm a little nervous about it though because pregnancy makes me feel anxious and stressed anyways, and if it doesn't work, I could be in for a crash.

So life goes on. It is not always easy. I suspect that many mothers in my position go through the same kinds of ups and downs.

It's official now

As of Sunday we have officially begun our cryo-IVF cycle! Friday I picked up all the medications, which cost a total of about $240. I also hit the hospital to complete my blood tests. They wanted to run a rubella immunity test and a thyroid test.

Sunday I had my first shot. Right now I am only taking BCP’s and Lupron and prenatal vitamins. In a few days I will stop the BCP’s and start taking oral estrogen pills. I have to check my IVF plan every day to make sure I take the right dose of the right drugs because the dosages change from day to day. I screwed up and took the wrong thing on Sunday!

Monday I visited the clinic and picked up the supplies I need for all of my shots, and paid the bill ($2175).

I have been feeling so stressed out about life in general that I have not had much energy to stress about the IVF cycle. I have so many responsibilities between work and family and church that I really struggle to keep up. For our 16th anniversary, Marty and I enjoyed a wonderful retreat in Midway, Utah at a resort called Zermatt. It was so nice to take a break from the kids and the stress. By the end of the two days I felt very serene, but it was short-lived. I’ve been fighting major depression since last fall, and it seems the past few weeks that it has really hit me hard, despite me taking my medication regularly.

On a brighter point, we have had a lot of milestones in our family this month. Marty reached the ripe old age of 39. Next birthday will be the big 4-0. Joseph turned 8 and was baptized and confirmed last Saturday. We held a family service for Joseph and his cousin, Clark. It turned out to be a very special experience. Tomorrow Caroline will start her first day of Kindergarten. Joseph is in 3rd grade, which means he can ride his bike to school now.

August is always a momentous month at the deLannoy home, but this year it seems especially so.

The Trial Run

Yesterday Marty and I went to the clinic for my sonohysterography and "trial transfer." Dr. H. actually did the trial transfer first. This is done by inserting a catheter through the cervix to make sure it can fit through, and then checking it with the ultrasound to determine the best placement. Dr. H. and Dr. G wrote down the results of the trial run to basically make a map of the path the catheter should follow and to determine what size of catheter to use.

It went pretty smoothly (better than I remembered) and he was able to repeat the results easily.

Next we did the sonohysterography, which is a uterine ultrasound. Dr. H. was checking for any polyps or growths that might interfere with the success of the procedure. That was mighty uncomfortable, especially since I had forgotten to take Motrin before I went. But it was over fast. We were there about an hour all together.

Marty and I are still wondering whether we should use the day 1 embryos or the blastocyst embryos. I would like to talk to the embryologist to see what he thinks, given that I don't really know if the blastocysts we have are considered good quality or not. I also think we have more options with the day 1 embryos (we have 10 of them versus 3 blastocysts). If we have more to choose from, we have a better chance of success if some don't survive. Marty is leaning toward the blastocysts, and that is what Dr. H is recommending as well (because blastocysts are more likely to result in pregnancy).

I was amazingly calm and happy during and after the procedure. I went home and laid down, and felt well about an hour later. Well enough to hit Crown Burger with my family.

In the meantime, every day Martin and I often wonder why we want to have another child when the two we have are such monsters. Then they do something darling and we remember.

This week is a big week for our family. We have Martin's birthday Friday, our 16th wedding anniversary on Monday, and Joseph's 8th birthday on Tuesday. Joseph is going to be baptized and confirmed on the 26th. Needless to say we have a busy week!

Taking the next steps

I called the clinic today and got all setup on a schedule for all the upcoming events.

August 14th-- I'm having a test called a sonohysterography to look at my uterus and check for any abnormalities, cysts, etc. I had a similar test once before that involved both the uterus and ovaries. At the same appointment, I will have my trial transfer, which is basically a dress rehearsal for the embryo transfer to make sure they know what to do when there are embryos sitting there waiting to be transferred.

August 27th-- We officially start the IVF cycle by paying out the $2375 and starting the injectible drug, Lupron. Marty will be giving me the shots. The Lupron shots are not that big of a deal because it is a small needle and it doesn't go in the muscle.

Around the 18th or so of September we will have an ultrasound and a blood test to make sure everything is ready for the transfer. We might need to go back another time or two if the numbers are not quite ready yet. I expect the transfer to take place around the 21st of September. The last two times we did a transfer, it was followed by bedrest for the rest of that day and all of the next day. I found out Dr. Hatasaka is not doing any cycles in September, so most likely Dr. C. Matthew Peterson will be running the cycle. Dr. Peterson is great so I have no problem with that option.

One point I have always wondered about with the so-called "Trial Transfer" is why they give you a sedative for the actual transfer, but not for the trial transfer. I remember it being somewhat painful both during and after the procedure. I have been through so much intense pain lately though I doubt it will even register!

Yesterday I started checking around pricing some of the medications I need to take since insurance is likely not to cover them. So far, it's not looking too bad. Costco has the following prices on the medications:

$6.99 Doxycycline (2)
$6.94 Estrace (60)
$146.89 Leuprolide Acetate 2 week kit

They don't do compounding so I will have to get the progesterone in oil from a compounding pharmacy like University Pharmacy.

Marty and I have really wanted to try to go to the Temple together. We both feel that we need to, but we have not been able to get a time when we can both go and we can get a babysitter for the kids. This weekend is busy with a ward party, a cousin’s birthday party, and all the usual weekend activities.

Lead Kindly Light

I am officially starting my "birth control month" tomorrow. I have to remember to pick up my pills and make the appointments I need to make.

I am already feeling the stress of it-- I have broken out in a rash on my legs and hands!

My husband and I have been praying for strength and to have the knowledge we need to make the right decisions throughout this whole process. I have been very anxious and unsettled about the possibility of losing a baby due to a multiples pregnancy (there is about a 1 in 5 chance of multiples with IVF).

I received reassurance in response to my prayer when reading the scriptures last Wednesday. I spent an hour or so taking this whole issue to the Lord and seeking His help by reading the scriptures. My friend Jennifer wisely says, "If you want to talk to the Lord, pray. If you want the Lord to talk to you, read the scriptures."

This is the answer that I got:

"For, behold, it is I that speak; behold, I am the light which shineth in darkness, and by my power I give these words unto thee. And now, verily, verily, I say unto thee, put your trust in that Spirit which leadeth to do good--yea, to do justly, to walk humbly, to judge righteously; and this is my Spirit. Verily, verily, I say unto you, I will impart unto you of my Spirit, which shall enlighten your mind, which shall fill your soul with joy. And then shall ye know, or by this shall you know, all things whatsoever you desire of me, which are pertaining unto things of righteousness, in faith believing in me that you shall receive...Wait a little longer, until you shall have my word....And then, behold, according to your desires, yea, even according to your faith shall it be done unto you. " (D&C 11:11-17)

This echoes some other advice that I received in a priesthood blessing as well as reassurances I received recently. I was struggling in mighty prayer with these same issues a few weeks ago when I went to the LDS Temple. Later that weekend I realized I had heard the hymn Lead Kindly Light three times Saturday. First as I was eating my breakfast on Saturday, it was the first song on the CD that was in my kitchen CD player. Later, I heard it in the Temple, and that night I heard it on a program on BYU TV. The words to that hymn are so appropriate to what I'm feeling right now.

I was not ever thus, nor prayed that thou shouldst leave me on.
I loved to choose my path; but now, Lead thou me on!

So I am taking my burdens to the Lord, and striving to live so that I will hear the answers when they come, and so that I will have the strength to endure through whatever is going to come. Even if it is a healthy pregnancy and baby, it is still a marathon. And if it's disappointment and sorrow, I will need the Comforter more than ever.

Our first appointment

Here's an update on our IVF situation. We went to the clinic yesterday to get the lowdown on starting a cryo-IVF cycle (that is, using embryos we froze the last time we did IVF). Here's how it went.First, we met with the RE, who is a fellow, and relatively new to the clinic. He had another new doc join him for the consult.

We went over what is involved in the cryo cycle, reviewed our options for using the embryos we have left from last time (we have 13-- ten are very young, just 2-3 cells, and 3 are blastocyst level which are 150-200 cells). We can do only one type of embryo per cycle from the way he explained it. He stated that we could actually re-freeze any of the early stage embryos that survived the thaw if we did not need them. He explained the meds routine is 1 month of BCP, followed by 3 weeks of Lupron shots (which stops you from ovulating).

At some point during this three weeks, you start taking estrogen pills to artificially simulate a cycle (because the Lupron is supressing the natural estrogen). About the time you would normally get ready to ovulate, you start taking progesterone shots. Depending on which type of embryos we use, that is for 3-5 days. At that point they measure the lining of the uterus (using ultrasound) to make sure it is sufficient to sustain the embryos, and if it is, the embryo transfer takes place.

Right before the transfer, I take a few days of antibiotics. I continue taking progesterone shots up through the day of the pregnancy test. If it is positive, I take it until the end of the first trimester. The progesterone is double the dose of the fresh-cycle IVF because you don't have the benefit of hyperovulation to create lots of follicles to produce the progesterone.

This new RE, doctor Huang, was fine, but not anything like our previous doc, Lawrence Udoff, (he moved away) who was the most kind and gentle and caring doctor I have ever met. He came in on Easter and Thanksgiving to attend our previous embryo transfers, even though he was not "running" the cycles that week.

At the appointment, they did an ultrasound to measure my uterus, check it out, look at the passageway required for the embryo transfer, and to check out my ovaries for any concerns. My right ovary was "very healthy" the doctors said. However, I did not seem to have a left ovary (funny I had one last time!). Maybe the surgeon took out something besides my gall bladder! My uterus is tipped forward and my cervix turns at almost a right angle, so the transfer may be tricky. (My last RE didn't remember my name, but remembered my cervix at our second attempt!)

Because I am at a point in my cycle where I could theoretically be pregnant (as if!) I have to go back for two more tests-- one is a dye test to check for polyps or growths on my ovaries/uterus. The other is a "Trial Transfer" which is inserting a catheter through the cervix to make sure they can get in and complete the transfer.

After the ultrasound, I met with the nurse coordinator, Gail, who was with us for both of our prior IVF attempts, who went over everything again. She gave me all my scrips, and a lab request to check my TSH and rubella titers. From what I understand, my insurance *may* cover half the cost of my visit yesterday, which was $395, and *may* cover half the cost of the dye test (don't know how much that is).The total cost of the IVF cycle is $2375 plus the cost of medications (under $200 she thought).

Gail said that I can time my cycle to make sure I get the doctor of my choice to run the procedure (yes!). I want the same doc that did it last time, Harry Hatasaka.

I should start my period in the next 5 days, so we will be underway. I estimate the embryo transfer will be about the last half of September, which puts my due date at the end of June, first of July. I think an Independence Day baby would be about perfect. Parades and fireworks on your birthday every year!

In the meantime, I also need to get a mammogram on the recommendation of my OB, and also I have to finish my bladder treatments at the urologist's office.

Overall it was a good experience. DH and I are hopeful. Our kids were such monsters yesterday that we are wondering why we want anymore.

My kids went on an outing with my mom and sister, so after the appointment, DH and I went home and had a nice long conversation about it, I did some serious praying and scripture reading to try to get some direction about all the details, and then I had a lovely nap!

My IVF Journal

Hi- My name is Laura Jane and this is my IVF journal. My husband and I have two children, a son age 7, and a daughter age 5. They were conceived during our two previous IVF attempts in 1997 and 2000.

During our last IVF procedure, I was a very prolific producer, and we ended up with 13 frozen embryos to use in a future cycle. Six years later, we are back to claim those embryos and attempt to have another child.

Our first appointment with the Fertility clinic was yesterday, August 2, 2006. I intend to use this blog to journal our experiences both the physical process, and the emotional process.

To my readers, thank you for caring about our IVF journey. I appreciate all the good thoughts, hopes, and prayers extended on our behalf by friends and family members from far and wide.