And the IVF continues... this is a long one so hang in there!

  

Before I start talking about the next part of the IVF, I want to mention something I forgot in my last post. When we did all of the IVF meds in June/July and we were leading up to the retrieval, I also did accupuncture. It was offered by RMA and was covered by my insurance! They told me studies showed that doing the acupuncture with the treatments proved to make it more effective. Even if I didn't quite believe in it, I had to try everything possible! One other quick thing, before we had started the IVF procedure back in May, the Dr. had done something called a saline sonogram. This was to make sure everything was clear "up there" and there weren't any polyps or fibroids in my uterus so we would know the embryo had a great chance of attaching. Well guess what, I had a nice big polyp on my left side! They did another saline sonogram after the retrieval thinking it might clear up, but no. So on September 14th, I had a procedure done called a hysteroscopy. I had to be put under and took the day off from school. Honestly, at this point, I was so determined I would do anything and wasn't going to give up!



So here we were, the middle of August 2011, and my body was finally healing and I was feeling like myself again. I had lost some of the weight I had gained, we had 6 frozen babies waiting for us, and now we had to wait some more. Even though we consciously made the decision to wait on the transfer part of the IVF until October, I was having a hard time. I wanted to be pregnant NOW! In the meantime, before I went back to work, we went to San Francisco for my childhood friends' Liz Watson's wedding. We stayed for 5 days, went wine tasting in Sonoma and Napa Valley, and felt we really deserved this trip after all we went through and we did have a great time!

Once I started back at school, I was so busy again that I didn't think about it all the time. I had also started my new part-time job as a Cantor and was preparing for the High Holidays that started at the end of September, so needless to say I was preoccupied! It was nice once again to take a mental break from meds because there's only so much my body can take! So the way we figured it out, I wanted to be able to do the FET (frozen embryo transfer) the week after the last Jewish Holiday in the fall (sukkot), which would get us a mid summer baby, so that meant starting the meds again while I was doing the High Holidays. I was fine with this because it meant being able to do it soon! So September 28th, the 1st night of Rosh Hashanah, I started my 2 weeks of growth hormones. It almost felt like I never even had a break, but was strangely comforting because I knew we were getting closer to our goal. Then, a few days later I went off the BC pill! All I kept thinking to myself was "please let this be my last BC pill for a VERY long time!" Then on October 7th, the night of Yom Kippur, I started some more meds. I took this as a sign since Rosh Hashanah and Yom Kippur are the holiest Jewish holidays of the year. It HAD to be a sign, it WAS going to work! This time, it was a lot less shots and a lot more pills, but the side effects were still there. The goal now was to just grow my endomitrium lining to be nice and thick and ready for those babies to attach! So they monitored me but not nearly as often, which was nice. I went in about every 4 days and things were progressing nicely. We were aiming for a transfer date of October 25th, but just like the retrieval, it wasn't an exact science. This time, I would have to take off 2 days from work, the day of the procedure and the day after so I could be on bed rest to ensure it would work!

So a few days before the procedure, I started on progesterone suppositories and progesterone in oil shots. If I had to name the worst part, this would be it. This medicine was in oil so it took forever going in. One more thing, it had to be given in my upper butt muscle! I was terrified because this time, I had to let Ari give it to me since it's a little hard to spin the top half of my body around to see my butt! We were on an every other day thing where one day I did 3 suppositories, the next day I did one suppository with the shot. I was told that icing the area before hand would help so it would be numb and not hurt because I forgot to mention, the needle was an inch and a half long! Then I had to sit on a heating pad for about a half hour afterwards so the oil would absorb into the muscle better. I know what you're thinking at this point, you wouldn't go through all of this just for a baby. But trust me, if you wanted a baby that badly, you would! I never thought I could do it either, but I became the strongest person ever and infertility has changed who I am for the better!

So the day of the transfer arrived, October 25th. I was more than ready and I had such strong faith that it was going to work. Like the Dr. had said when we first met, he didn't see a reason for it not to work. I was hopeful but also holding back because if it didn't work, I didn't want to fall apart. So we didn't have to go in until 1 in the afternoon. I got to relax in the morning and get my head where it needed to be. We went in and I got an acupuncture treatment first, then the whole procedure took not even 15 minutes! All that medicine and pain and tears for just 15 minutes to pop in 2 embryos... and now we wait. I was told to take it really easy and be on bed rest that day and the next day so I would have the best chances of it working. During my 2 week wait, which would be over November 4th, I was tormenting myself! Did it work? Did it fail? Was that a pregnancy symptom I felt? I wanted this more than anything I've ever wanted in my life and I was going to stop at nothing to get it! So a week went by and even though I knew it was WAY too early, I broke down and bought a pregnancy test. And my eyes couldn't believe it either.... it was faint, but it was POSITIVE!!

It was hard to believe, surreal even after all we went through! I had never seen a positive pregnancy test in my life! I called Ari immediately and he didn't believe it either. He wanted to wait until we got our blood test which wasn't for another 3 days. I knew it was real though. I went and bought 2 more tests and took one the next day, and another one the next day... all positive! I called the nurse and asked if I could come in for my blood test a day early because I got a positive test at home. She was so excited to hear that and said of course I could come in! So Thursday November 3rd, I went in for my blood test. They said I would get a call anytime after 11 am. I knew I would be teaching a class, but at exactly 11 on the dot, I saw my phone ring. At 11:25 when I was done teaching that class, I called back and got the best news of my life... I was really pregnant!! All of my dreams had finally come true!!! :) IT WORKED!!!

Let the IVF begin!

So here we were, ready to start the IVF in July 2011. We had made it through an entire year and were finally ready to get pregnant! I felt healthier in body, mind and spirit! Now, even though it was nice to take a year off from fertility meds, all of the worries about negative pregnancy tests, and constant Dr's visits, it didn't mean the pain went away. It was just as fresh as ever and maybe even worse because it felt like an open wound that just wouldn't close until we got pregnant. Every time I found out another friend was pregnant or went to a little kid birthday party, it was just another reminder. For example, a friend who's wedding we went to in 2009 had their baby in 2011, or a 2 year old birthday party of a kid who was conceived when we first started trying. Those kind of things stung because it reminded me of just how long we were going through everything. Even though we weren't technically "trying" for the entire year, we were still not pregnant and still didn't have a baby in our arms and were therefore still struggling.

So about 2 weeks before we were ready to start the IVF meds, a huge box showed up at our house. Some of it had to go right into the refrigerator and some had to stay out. Now when I tell you that I was overwhelmed when that medicine showed up on my doorstep, that's an understatement. It arrived in such a huge box, I couldn't believe it. The person from the pharmacy who had shipped it to me had warned me it might be overwhelming when I opened everything and she was right! It took every bone in my body not to break down and just push it aside. Even though I wanted to just put it away somewhere and deal with it later, I couldn't do that because we just spent $5000 out of pocket for all of these meds! You better believe I had to make sure everything was there! There were pills, bottles of powder, bottles of liquid diluent to mix into the powder, a follistim pen, syringes, needle tops, gauze pads, suppositories, bottles of progesterone in oil, and so much more. All I kept thinking as I was making sure everything was there was "all of this just to make a baby? Seriously??" It hurt my heart so much, but again, I had to put that behind me and push forward. We had agreed to go through this and I WAS going to go through it. I was not going to give up until I had a baby in my arms!

So the plan was: 2 weeks of just growth hormones, then start a shot called luveris, then add follistim and double the dosage of luveris, then about 5 days before we were ready for the retrieval, add an antibiotic to make sure I had no infections anywhere in my body. Once I had enough follicles and they were nice and big, I did the trigger shot called ovidrel and the night before the retrieval, I used a progesterone gel (you can use your imagination as to where it went). Sounds like a lot, right? Well it was! I was so thankful I wasn't working because man on man did all these meds make me feel like crap! Not only was I feeling all the side effects, but my poor belly felt like a pin cushion. I had so many bruises and was running out of space to put the shots. At one point, I did 3 shots in one night because I couldn't mix everything together. But the good news, I was responding beautifully! Right on schedule! My follicles were growing nice and big, and so many! So the day had finally arrived, we had to trigger for ovulation, and wouldn't you know it... the retrieval fell on my 31st birthday- July 30th. I was really sad about it at first, but I had to take it as a sign. We were going to be "creating" our babies on my birthday. It was meant to be!

So that morning, we woke up bright and early for the procedure. Happy Birthday to me, I get to be put under! It was a good thing... it was a GOOD thing... at least that's what I kept telling myself. Even as I'm writing this, I'm getting emotional all over again because so much lead up to this, and now we were finally here! I wanted as many follicles as possible because the more follicles there were, the more eggs there were, the more embryos there would be, the more tries we would have. But at what expense? Would I hyperstimulate again? Our Dr. seemed to think if it happened twice, it would happen again. At least I knew what to expect this time, right? So the procedure lasted no longer than 30 minutes and as I'm coming out of the anesthesia, the first thing I asked Ari was "how did your part go?" Why I was so concerned with him, I don't know! He just said, "it went fine and there were 17 follicles with 14 eggs!" No wonder I felt like my uterus was going to fall out the last couple of days. 14 eggs was definitely above average and we were very happy with that number. Now we had to wait and see how many fertilized, then how many were nice and strong to implant!

Before we did the retrieval, we had decided that we were going to wait on the second part, the transfer, until October. Since we knew I would hyperstimulate, we needed to give my body time to heal before getting pregnant. Also, we wanted to time it so we would have a summer baby because I'm a teacher and that worked the best. One last thing, I have a part-time job as a cantor in a synagogue and I didn't want to be pregnant during the High Holidays which happen in September/October, when I really needed to be in my best condition. It involves a lot of standing and singing and I didn't want to be feeling nauseous at all. So we were able to take out the eggs, create the embryos, then freeze them all. Then when we were ready for part 2, thaw those puppies out and pop them in! :)

So after the retrieval, I got to go home and rest. We had asked the nurse if she thought I would feel up to going out for my birthday that night and she said she thought I'd be feeling fine. As long as I rested for most of the day, it would be ok. So we went out for Hibachi and it was towards the end of the night that I wasn't feeling great. When I woke up the next morning, I felt like a balloon was being blown up in my stomach. I felt so bloated that I was having a hard time moving. I pushed through and was excited when we got our phone call from the lab to say that 12 out of our 14 eggs fertilized! Woohoo!!! Now we just had to wait a few more days to see how they progressed.

Me with my friend Naomi at dinner

As time went on, I felt worse and worse. Just 3 days after the retrieval, I gained about 5 pounds and couldn't even breathe. It got to the point that I had to sleep sitting up at night on the couch because the fluid built up so much in my belly. I called the Dr. to let them know how bad it got and they had me come in. At that point, she said it was mild OHSS (ovarian hyperstimulation syndrome). Mild?? It felt severe! She told me to go home and see if it got better, or worse. I called 2 days later because I couldn't breathe AT ALL and I had gained a total of 8 pounds, all in fluid. Imagine 8 pounds of fluid in your belly! I looked about 5 months pregnant and I wouldn't dare step foot out of my house. I went back in and this time, they decided to drain some fluid out. Yes I know, it sounds as horrible as it is. I was awake and they inserted a catheter and drained almost a liter of fluid out. It made me feel so much better! Still not great, but better. Now I just had to wait for my period to come to feel completely better.

In the meantime, we got daily calls about our embryos. 3 days after the transfer, we had 5 nice strong embryos, grade A, that were ready to freeze! They let the other 7 grow out to see if any others could be frozen. One more embryo proved itself and was frozen 2 days later, making it a blastocyst. So now we had 6 total embryos that were frozen waiting for us when we were ready in October 2011. Now it was up to me to heal, yet again, and get ready for the second part in just a few months!

And the journey continues...

Before I even talk about any more of our journey, I need to back up a little. When we were going through the last part with all of the shots, our family was incredibly supportive. Since Ari and I tell our families everything, they knew about what we were going through. There was no way we could have gotten through it emotionally or financially without them and I thank them so much for not thinking twice, but just helping us when we were in need. We felt lucky to have that kind of support and that's what helped us get through it!

Now onto the IVF... we were told in May of 2010 that we needed to move onto IVF. All I wanted to do was jump right in. I felt like I was running a marathon and couldn't stop! We finally figured out how to get me to ovulate and now we needed to seal the deal, medically that is, but we couldn't. We knew there was no way we could afford IVF and we didn't feel comfortable asking anyone to help us pay for it. It was about $20,000 per try in PA. That's insane! Just to make a baby!! We knew we needed to put the breaks on things and figure out what was next. When Ari got a job in CT in June, then I got one in July, then we found a great condo to rent just 10 miles from my job and 15 miles from his job, I knew it was the start of good things to come. It seemed like everything was just starting to fall into place and I felt hopeful. Now the hard part was the waiting. This time we weren't just waiting a few months, but a whole year!! How was I going to survive? All I wanted was a baby, but now I had to wait longer! I knew it was the best decision for us and it made sense, but it made my heart ache so much. 

So I started my new job at the end of August and tried to focus on work instead of getting pregnant. It wasn't too difficult because I was very busy and it was actually REALLY nice not to think about fertility meds and just focus on me for once!  I felt like I became a happy person again and wasn't as angry as I used to be. It didn't mean all the pain went away, but I was able to deal with it much better than before. In the meantime, I went back on the pill but this time, I was put on seasonique. This is the pill you take for 3 months on, 1 week off, instead of getting your period every month. The headaches would come back every time I got my period and I couldn't deal with it so I needed it to happen less often. It was just a reminder that my body had issues and I didn't want to deal with it!

So before we knew it, it was January of 2011 and we thought it was time to find a new RE (reproductive endocrinologist) so we could plan things out. We found a great RE right down the street from us called RMA, literally 1.5 miles away. So here we were, on January 14th exactly 8 years after we met, sitting in the Dr's office, telling him our entire story since January 2009. We told him about my pituitary gland, the clomid, the follistim, the IUI's... and his first comment was "well of course the clomid didn't work... you don't have a working pituitary gland so it wouldn't respond to that medicine." I can't even tell you how it felt to hear that, but I couldn't harp on it. It was in the past, it didn't matter. He agreed that we were great candidates for IVF and felt very confident it would work on the first try. He said that because my only issue was the ovulation and everything else seemed to be working properly, I had great chances. I was also on the lower end of the age range so he felt good! So we came up with a plan... as soon as the school year was over, it was go time.  He told us that he wanted to include growth hormones in the process because that would stimulate my pituitary the same way it did when I was a kid. Then we would move onto the fertility meds which would lead up to the retrieval (removing all the eggs). Hearing that we needed to start with growth hormones struck a chord with me... it was hard for me to swallow. It brought me right back to being a kid. It took me a while to get over that part but I knew I had to. So we had a plan in place and it felt good! In the meantime, he wanted me to meet with the nutritionist to try and lose some weight, or at least start eating really healthy before getting pregnant. This clinic also offered weekly fertile yoga as well as support groups once a month, all free of charge! I felt like I hit the jackpot! I took advantage of everything they offered and I was glad I did. I also went to a therapist on my own to help deal with the previous disappointments we had been through and to get emotionally ready to go through more. I was so scared for the IVF mostly because I didn't know what I was going to do if it didn't work. I felt like we were now putting all of our eggs in one basket, no pun intended, and if it didn't work I'd be devastated. I couldn't imagine going through all that and having it not work. This was after all the mother-load, it was our last shot. If this didn't work, there was nothing left. But I just had to trust my body and trust that there was hope. So that's what I did! For the next 6 months, I got my mind and body in shape and by the time the school year was over, I was ready!! June 28th was the day we'd start the meds and I was more than ready, excited even! 

3rd time's a charm?

So here we were, sitting in the Dr's office after our 40 day cycle, another failed round of follistim and our first failed IUI, and I was ready to jump right back on the horse without taking a breath! The first thing they do before starting a round of meds is have you come in on day 3 of your cycle. They check your baseline and make sure everything looks good by doing an ultrasound and blood work. So I was getting my ultrasound done and what do they see? A huge cyst on my left ovary that developed from my one big follicle from the last round of meds. They couldn't start me on the next round of meds because they were scared it would burst, which can be very dangerous. She suggested going back on the pill for a couple more months to let the cyst go away naturally, then we'd pick up where were left off. Seriously?? This was the most ready I had felt and now I had to wait... AGAIN! I felt defeated and left the office in tears so frustrated. All we did was wait! So I did what the Dr. ordered, went back on the pill to let my body heal... again. 

Two months later, April 2010, we were right back in the Dr's office hoping for good news, and we got it! The cyst cleared up and we were ready for round 3! This time she was going to be a little more aggressive with the meds so I would make more follicles, which leads to more eggs, which increases our chances. She didn't want to be as aggressive as the first round because of the hyperstimulation, so we had to find a happy medium. We were off to the races andI felt like an old pro by now with the shots! This cycle went a little more smoothly and things happened quicker than last time, but I developed tons of follicles again. There didn't seem to be a happy medium with me... either I developed one measly little follicle, or tons of them. Right around day 14 I was ready to trigger with about 10 follicles total. We planned to do another IUI and with so many follicles this time, it just HAD to work, it HAD to! So we did the IUI in May and I convinced myself it worked. I needed to be positive about it, but how do you be positive and not totally get your hopes up at the risk of being crushed?? It's nearly impossible! About 5 days after the IUI, I hyperstimulated AGAIN! It was worse than last time, or so I thought. If not worse, then just as bad. I felt horrible, but was still hoping for the best. I felt like I just couldn't catch a break! During the 2 WW, we went to my friend Lindsay's wedding. I felt like crap and was hoping that I was pregnant, but tried to keep my mind off of it so I could enjoy myself. This picture from the wedding captures it all... you may not see it but I had pain in my heart. I was so scarred by all we went through, but was trying to have hope at the same time. 

So we waited the 2 weeks and this time, my period didn't show up early... but right on time! I was absolutely devastated. 3 strikes, you're out! How could it be?? With all those follicles, not ONE of them fertilized? I couldn't believe it! So believe it or not, I was ready for a round 4. By now you may be thinking, "how could you keep going after all this?" I didn't believe it myself, but I was ready for another try. So we went back into the office on day 3 and sat down with the Dr. before the other stuff. This was when she said the 3 letters I had been dreading since the beginning on this journey... I V F (invitro fertilization)! I knew it might come to this someday, but I never thought it would be this soon. Remember, even though we had been through almost a year and a half of this, we had only technically "tried" 3 times. Even though it crushed me to hear those 3 letters, I had a sense of relief as well because I knew IVF had a much higher success rate than anything we had done so far. At the same time, I was also terrified because I knew that this was it. If this didn't work, then what?? She explained that I would be a great candidate for IVF because I had so many eggs and could ovulate so much, but the IVF would give us more tries. She explained how they would try to make as many eggs as possible, then take them all out, fertilize them, and put the embryos back in. It was a more controlled procedure so the risk of high order multiples was less. Also, we could freeze the embryos we didn't use for future children after hopefully getting pregnant with our first. Now we had one big issue on our hands... IVF wasn't covered in Pennsylvania. Surprise surprise! 

At this point, I was going to be graduating from grad school in just 2 weeks and then needed to find a full time job. We had gotten so wrapped up in everything over the last year and a half and needed to get back to "us," we thought it was a good time to regroup and figure out what our next move would be, literally and figuratively. I immediately researched states that covered IVF and found that Connecticut was one of the mandated states to cover it! Being from CT and always wanting to move back there someday, we felt it was time! One important thing first though, we both needed new jobs! Ari immediately started looking for a new job and at this time, and was also switching careers. He had been in non-profit theater and was going into life insurance. He got a job with NY life, but had to start it before I was finished with work or had found my own job. He had to move in with my parents for a month or so before we got everything worked out, but I did find a job with GREAT benefits that covered IVF! We moved on July 19th, 2010 and we were ready to start a new life, that involved having kids finally! The first thought that went through my mind was, "let's do this IVF!" But after a lot of discussion, we decided it was best to wait a year before doing the IVF so we could both get established in our new jobs. Yes, more waiting, AGAIN! So the year actually flew by and in July 2011, we were finally ready to get the IVF started. For lack of better words, I was scared shitless but the way I looked at it was, it couldn't be any worse than what I had already gone through, right? Wishful thinking...

Stay tuned for our IVF journey!

http://www.fertilitylifelines.com/payingfortreatment/state-mandatedinsurancelist.jsp 

Slow and steady wins the race

Ding ding ding... round 2 has begun! So after our ordeal in October, we were more than happy to take a few months off. Being on 4 months straight of infertility drugs was A LOT on my body. Not only did I gain about 15 pounds, but I needed to give my mind a rest. It became so consuming that I needed the break to get back to "me." We told the Dr. we'd be back in a few months when we were ready and she suggested it might be good to try and drop a few of the pounds I had gained. I looked at her and said "I'm going to lose 15... ALL of them." She said that wasn't unnecessary and I didn't need to do that, but I was determined. So as soon as I was feeling all better, I went back to the gym. I hadn't been this determined to lose weight since losing 30 pounds for our wedding. I got high school thin for our wedding, and I had that determination back! I went back to my weight watchers regime and went to the gym or hopped on our treadmill at home at least 3 times a week. The weight began to melt off as well as the raw emotions I felt from the failures. As I entered the new year, I felt renewed, rejuvenated, and ready to start the fertility drugs again the next month. In the meantime, I had gone back on the birth control pill just so the headaches wouldn't come back and I could be "regular."

So in February of 2010, we went back to the Dr. on day 3 of my cycle in preparation for round 2. She noticed I lost the 15 pounds and was very proud of me! I felt so much better about myself than I had 3 months earlier and I was back in the ring with my gloves on ready to fight! She explained that we would have a different strategy for this month, which would be slow and steady. The last time with the follistim, she was so aggressive with the dosage because she just wanted me to ovulate and wasn't sure if I would. Now that she knew I COULD ovulate, she wanted to control it more so I wouldn't ovulate as much. She explained that she would be much more careful with the dosage and adjust it every two days depending on how I was responding. Sounded good to me! So we started at a lower dosage and I went in for my first visit, and NOTHING was happening! We're back here again?? So she upped the dosage just a little, I went in 2 days later and there was one measly little follicle developing. She explained that it was good, just what we wanted. She backed off the dosage again, but then 2 days later, it wasn't getting any bigger. So the trend continued, back and forth, slow and steady to make that one little follicle grow. If I remember correctly, that month I went in for 12 visits! 12 VISITS!! Towards the end, it was every day because like I said before, we needed that follicle exactly the right size. But finally by day 24 of my cycle, 10 days after last month, I was ready to trigger! This time, she recommended we do an artificial insemination (also known as an IUI). She said our chances would be that much better for getting pregnant. So after spending almost $2000 on the meds that month because we were on it for so long, what was another $500 for a procedure? I just kept thinking "$2500 to get us pregnant, just not fair!" One thing that helped me through that month was my little puppy. She's the most loving dog and knew I wasn't feeling well. She was always there to kiss me and make me feel better!



Another thing that really effected me that month was the side effects. I was on the shots for 21 days straight and I was really feeling every side effect. The only way I can describe it was that I felt crazy. I didn't feel like myself at all and I felt that at any moment I could cry, yell, laugh hysterically... I just felt like I was going nuts!

So on day 27 we triggered to make me ovulate and exactly 36 hours later, we went into the office for our IUI. The whole process was so surreal. The fact that we had now reached the point where we didn't even need to have sex to get pregnant was upsetting enough, but now it became a medical procedure. I had to put that out of my mind and push forward. So the IUI was done and now we wait. I was SO positive it would work. I had one nice big fat follicle and everything went smoothly, besides the fact that it took forever to get there. But no dice, we didn't even make it through the end of the 2 week wait because I got my period. Strike 2... game over! Surprisingly, even though I was devastated, the first thing I said when I got my period was, "let's go again." I was so determined and didn't want to give up and was ready to go again! Bring on round 3!

Follistim- my new best friend

So let's see, where did I leave off? Oh yeah, we were about to start the injectables. So the next month, October of 2009, we geared up to start these shots. I had no idea what to expect, just that I would be giving myself nightly shots starting on day 3 of my cycle, then I would be monitored the same way as before. I wasn't told anything about side effects, but sometimes it's better to just not know, or so I thought. I went into the Dr. on day 3, was given a 30 second "tutorial" from the nurse about how to give myself these shots with the follistim pen, then went to pick up my VERY expensive medicine at the pharmacy. I usually have a hard time spending a lot of money on something, but spending $900 for an inch and a half size vial of this medicine really hurt... especially because so many girls didn't have to go through this. Just taking my credit card out of my wallet to make this purchase reminded me again of how I was "different." It just wasn't fair!!

The $900 vial of follistim- next to a quarter to show how tiny this thing was!

I was told to do the shot around the same time every night because it would be better that way.  We  decided on 8 pm. We figured it would be a good time because I would be home at that time every night and it would give me some time to process before going to bed. Having to be home every night at a certain time to get a shot brought me right back to when I was around 10. I couldn't always go to sleepovers at my friends' houses because of my shot; I also had to go to the infirmary at sleep away camp every night just to get my shot. Again, it made me "different" and I hated it! 

So there I was, the night of my first shot, and my heart was beating out of my chest. Was I ready to give myself a shot? Would it be better for Ari to do it? He was certainly willing to, but I concluded that I needed to have the control over it. I needed to know exactly when it was going to be injected instead of it being a surprise. So I read the instructions for the follistim pen about 10 times, made sure I screwed the needle on correctly, put the tiny vial of medicine in, dialed the end to the correct dosage, checked the dosage about 10 more times, and then there was nothing left to do but give myself the shot. I had to do it in my lower abdomen and there was plenty of padding down there so I wasn't worried about it hurting. I don't know what I was most nervous about... the shots not working like the clomid, getting horrible side effects, getting bruises from the shots, or all of the above. I worked up the courage, and I did the shot! I was so proud of myself, but then I got really upset. It just wasn't fair! That's all I kept repeating in my head: "it's just not fair!" 

So fast forward about 5 days to my first appointment. This was the moment of truth when I would see if the $900 we spent on this medicine was worth it. I planned for the worst, but hoped for the best. And there it was, finally some good news! My body was starting to produce follicles and hearing that was like music to my ears! In a regular cycle, a woman produces one follicle either in the left or right ovary, and this houses the egg. Around day 14, the egg is released from the follicle and travels down the fallopian tube to be fertilized, thus what we call ovulating. Not only was my body responding, but it was responding incredibly! I had about 6 follicles on the right and 7 on the left. I know it sounds like a lot, and it certainly freaked me out, but she explained that not all of the follicles will (a) have an egg inside, and (b) some of the follicles grow faster than others and these will be the ones to release mature eggs. The follicle has to be at least 18 mm. in order for it to have a mature egg inside. So now I just had to go back every other day so they could check my progress to make sure they grew to just the right size. Compare it to making a hard boiled egg, no pun intended. If you boil it too long, the egg will become over cooked or might even explode out of the shell. If you don't boil it long enough, it will be soft and not ready to eat. But if you boil it for just the right amount of time, it'll be perfectly soft and delicious! 

So I went back in on day 10, 12, 14, but now we had another problem. Every single follicle I mentioned before was getting huge! She had been pretty aggressive with the dosage because I had no response to the last 2 meds, and now she was worried. She discussed the possibility of having multiples with us, which I knew was a possibly with fertility meds, but not like this. We're not talking about twins or triplets, we're talking about 5-6 eggs becoming fertilized. She then discussed the possibility of doing selective reduction... yes it's what it sounds like. If we became pregnant with more than 2 or 3 babies, we would have to "abort" some of them in order for me and the remaining babies to be healthy. This couldn't be done until after 12 weeks by the way because it could abort the whole pregnancy if it was any earlier. This was shocking to us, but we were ready for whatever we had to do. Some people might think it's crazy to agree to this, but we wanted a baby so badly and after all we had gone through, we felt we could deal with the consequences. She decided to do the trigger shot early, the medicine that would make the eggs release from the follicles, to avoid so many of them being mature and getting fertilized. The only problem was that there might have been no mature eggs at all because she triggered early. It's kinda like a catch 22, either you have slightly immature eggs with the hopes of just one of them being fertilized, or you have tons of mature eggs and have to deal with multiples. She told us to get busy exactly 36 hours after doing the trigger shot, which is what we did. We really thought it would work! We were so happy I finally ovulated, we thought there was no way I wouldn't get pregnant with all those eggs in there. So after getting busy, we had to do the dreaded 2 week wait (2WW). This is the amount of time you have to wait before you see if you got pregnant or not. For us, it didn't even get to 2 weeks because I got my period. Game over, we were heart broken! 

Because I ovulated SO MUCH, I had a reaction that happens very rarely to women who go through fertility treatments, ovarian hyperstimulation syndrome (OHSS). http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004549/ 
In case you'd like to read about it.
Basically what happened was after I ovulated, the follicles filled back up with fluid and each one got huge. Remember, I had about 12 follicles in there, so I was hurting! It's worse than the worse period cramps you've ever felt. I couldn't go to work, I didn't even leave the house. My belly became so engorged with fluid, I looked about 5 months pregnant and gained 8 lbs. in the matter of 3 days. The only thing that would make it better was time. I was advised not to drink too much water because it would make it worse. For those of you who know me know that water is all I drink! I have a water bottle attached to my hand at all times! It took about 2 weeks but it finally got better. After this traumatic experience, we decided to take a break from fertility drugs. We did want to try another round of the follistim, but I needed some time to heal, both physically and emotionally. We took about a 3 month break and it felt so good! We picked back up in January of 2010, exactly 1 year into our journey. Stay tuned for round 2 of follistim! 

Bring on the drugs!

Let me start out by saying thank you to those who have read my first post and are reading this one as well. Just writing one post has been extremely cathartic for me and I can't wait to keep writing! Something that bothered me more than ever while going through my journey was that infertility is a silent disease. I always felt like I just couldn't talk about it, which made me feel so alone in the process! No one completely understands unless they're going through it themselves. They can try to understand and offer support, but they don't really get it. Don't get me wrong, I wouldn't wish infertility on my worst enemy... but I always wished there was a way for people to really understand what I was going through. I really hope that by writing this blog, I can let people out there know who might be going through it that they're not alone! I also hope to make other people more aware of how many people struggle with this silent disease and how sad it really is. Infertility is so common and there's no reason to keep it in. People don't understand what they don't know, so it's my job is to educate!

Just a side note as a follow up on something I wrote about in the last post before I talk about my drugs, my vocal issues. I know I had said that they took a back seat, but I want to let you know that it did clear up in about 6 months with lots of medicine (nexium and singulair) and some vocal and speech therapy. It was a struggle but my voice did return full force and I was so relieved!

Now onto the start of what we never thought would be such a long road, fertility meds! What was so unique about our story was that we never even got to "try" naturally. We weren't even given that option because I had to take meds just to keep the headaches away and get my period. This was already upsetting enough for me because my body wasn't "working", but I was ready to take on whatever we needed to do to have our first baby! So here we are, July 2009, and our Dr. started us on the lowest dosage (25 mg) of clomid. She said she thought I'd be an "easy fix" and I sure hoped so! I knew a bunch of people that took clomid and got pregnant their first or second try and I thought for sure that would be me. I mean, how simple is that? You take some pills, ovulate, get busy, then get pregnant? Sounded too good to be true! Well it was...

Something I really wish the Dr. had explained to us before starting these meds was that once they put you on any type of fertility meds, they need to monitor you about every other day for close to 2 weeks. They need to see how your body is responding by doing an ultrasound (internal by the way- not fun!) and bloodwork to check the hormone levels. Well the first time I went in was about day 10 of my cycle, nothing was happening. The only thing I felt were the side effects from the meds, which were AWFUL!! If there's a side effect for something, it happens to me! I immediately started getting hot flashes, I was nauseous, I felt incredibly moody, and I was just miserable. I went back in on day 12, 14, 16, 18, 20... still nothing was happening. It was like a full time job, I was always at the Dr! My side effects were just getting worse, but my ovaries weren't responding one bit! The Dr. said she wasn't surprised since it was the lowest dosage and we would just try a higher dosage. We gave up on that cycle and I was given more meds to bring on my period.

Now for a slight tangent before I continue: One thing that Ari and I had decided before we began the fertility meds was that we were going to take a summer trip. We wanted to go on one more trip together just the two of us, at least we thought it would be our last trip, assuming we'd be getting pregnant within a year. We took a carnival cruise and made stops at:

Isla Roatan: Hanging with a cute monkey! 

Belize: Standing on top of the Mayan ruins

Cozumel: We took a Mexican cooking class!

Grand Cayman: Under water in the submarine ship!

One of the professional ones- My favorite of them all!

We had such a blast on this trip and waited until we got back to try another round of the clomid. We didn't want to worry about it while on vacation, we just wanted to have fun! So we got back and we went right back to the Dr. This time she tried 50 mg. of clomid and I was hopeful. After all, it was twice the dosage so it had to work.... right? Well, the same thing happened... I went into the office about 8 times and nothing was happening but the same horrible symptoms. At this point, she wanted to add another kind of medicine called metformin. This was supposed to balance out my blood sugar levels and apparently the mix of clomid and metformin was supposed to work wonders! For out next round, which brought us into September, I was now back at grad school and working as a part time music teacher. I was afraid I couldn't balance school, work, and the side effects of the drugs while going into the Dr. so often, and I was right. It was so difficult but I had to push forward because I had my eye on the prize. I was determined at this point just to find a medicine that would make me ovulate. I became so wrapped up in that part, I forgot that we were trying to get pregnant! I just wanted my body to work! The addition of the metformin still didn't work and only added more symptoms of horrible stomach aches, so as our Dr. said, it was time to pull out the big guns. She used an analogy saying that infertility was like Harry Potter trying to find the right broom. You had to just keep trying until you found the right one that worked.

Our next step would be injectable meds, something called follistim. This meant I would have to give myself a shot every night for about 2 weeks straight to see if I would ovulate, which brought me right back to my childhood. I didn't realize until later on that this whole process brought up a lot of unresolved issues from my childhood. When I was taking my growth hormones from the ages of 7-13, I always felt "different" because all of my friends grew naturally, and now it was happening again. I was going to have to take shots just to make my body do what it was supposed to do, but couldn't. It made me so sad, but again, I was ready to take on the challenge. Only thing was, these shots wouldn't be covered by our insurance and would run us $1000-$2000 per month without any guarantee of it working. I felt like we were so invested at this point that we had to push forward and try the shots. So we planned on starting them the next month, and we did! More to come...

All about me!

Never in a million years did I think I would be a blogger... but lately I've been feeling the need to speak out about the last 3 years of my life, so here goes! Let me start by telling you a little back story. Ari and I met 9 years ago on January 14th 2003 on Jdate (an online Jewish dating website). The day I met him, I knew he was the one. I know people may say it's not possible to know that soon, but I just knew! We were inseparable from that day, got engaged 3 years and 1 day later on January 15th 2006, and married 1 1/2 years after that on June 24th 2007. It was absolutely the happiest day of my life and I know Ari would say the same! At the time, I was attending full time grad school and we were living in Philadelphia and loving it! Things couldn't be any better! Until the fall of 2008 that is... As Ari likes to say, it all started with a sore throat...

In the fall of 2008, a little over a year after Ari and I got married, I started having some vocal issues. I'm a singer and was in cantorial school at the time, so my voice is sacred to me! After going to a very well known ENT in Philadelphia, it was determined that I had a cyst on my left vocal chord which was causing the hoarseness. In the process of all the testing, I had a scan done of my throat to make sure everything looked ok. From that test, they found a small bump on my thyroid gland and sent me to an endocrinologist to have it looked at. It was at that point that I told him my entire endocrine past.

Long story short: I have an underdeveloped pituitary gland. At the age of 7, I hadn't grown much since I was 3. My parents kept hoping I'd just be late bloomer, but I just wasn't growing so they took me to an endocrinologist at Yale New Haven hospital. They ran tons of test of me including a few MRI's, which I was NOT happy about as a 7 year old, and determined that there was some kind of growth covering my pituitary gland which didn't allow it to fully develop. They decided the best thing for me would be to go on growth hormones, which at that time were still experimental. My parents fought and fought to get them covered by insurance and won! I stayed on the growth hormones from 7-13, it was my decision to go off because I had enough. It was a shot in the butt every single night and I felt at the age of 13 that 5'2" was tall enough, and I have never regretted that decision! After that I went on with my life and my parents hoped I would develop normally. Well I did physically develop, but didn't get my period. While all my friends were getting their periods at the age of 13, 14, 15, 16... still nothing for me. So at the age of 16 I went on the birth control pill just so I would get my period. At one point they took me off, but nothing happened so I went back on. Now fast forward 12 years to the fall of 2008.

So we're sitting in the endocrinologist's office telling him this story and he asks "are you ever planning on having children?" Of course we were, but hadn't thought about it yet. I still had a year and a half of grad school left and wanted to get a full time job before thinking about a baby. I knew that would make me 30 years old, but that seemed fine to me. He made it very clear that it could take us years to get pregnant or to just figure out how to get me to ovulate and I wasn't getting any younger, so starting earlier would be a wise decision. We left the office very overwhelmed... what we thought was a visit for a small bump on my thyroid (which he said was no concern) turned into me thinking I would never be able to have a baby! Suddenly my vocal issues took a back seat and our focus shifted. We went home and talked a lot... we made the decision that I should just go off the pill and see what would happen.It didn't mean we were going to start "trying," just that we would wait and see what happened. So in January of 2009, I went off the pill. I was hopeful and thought  I just might get my period, I was 28 after all so maybe my body would regulate. Well, no such luck. I was off for the pill for about 4 weeks when the migraines started. What was happening, which I didn't realize until I saw a few other Dr's, was that my body was going through hormone withdrawal. For 19 years of my 28 years alive, I was dependent on hormones and now I had none. The headaches got progressively worse and I eventually went to see a neurologist. I could barely function at work, they were so debilitating! I still didn't realize it was hormone related. It wasn't until I posted something on facebook about having bad headaches and a friend who is an OBGYN suggested that was why. He knew a very good reproductive endocrinologist in Philadelphia and got us an appt with her. We went and met with her in April of 2009 and told her my whole story. She said "well of course it's hormone related!" She suggested we just start with some hormones to bring on my period, then go from there. So that's what we did. The hormones made me get my period and my headaches magically disappeared! She suggested we try again to see if I regulate normally, but no such luck. It was at that point that we decided to officially start "trying" with fertility drugs, but we were going to wait until the summer so I wouldn't be in school or working. I just continued to take the hormones monthly just so I would be regular, even if it wasn't natural. In July of 2009, we started simple with our first round of clomid and thus the journey of fertility drugs began! To be continued...