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It's Hard to Type from a Horizontal Position

I've now got three embryos on board (graded as B, B- and C). The transfer went smoothly. However, the nurse said I'm dehydrated and that my ovaries are very enlarged, so I've been upgraded to a high risk of hyperstimulation. I've been put on bed rest for 3-4 days, and I have instructions to add two bottles of protein shake to the 40 oz of water and 60 oz of Gatorade I was already drinking each day.

So now my daily intake of fluids and medications goes something like this: a 5000 unit heparin shot, a large glass of Gatorade, and an antibiotic and breakfast; water and protein shake throughout the morning; baby aspirin, prenatal vitamin, and another large glass of Gatorade with lunch; more water and protein shake during the afternoon; antibiotic and a glass of Gatorade with dinner; a 5000 unit heparin shot and a 1 mL progesterone shot right before bed. And I'm supposed to add estrogen patches to all of that in a few days. Phew!

My three embryos, it's all for you! Please grow and stay awhile.


5-4-3... and let's just stop the countdown right there, please.

Yesterday, the clinic called to let me know that, out of the 28 eggs retrieved, 25 were mature. They froze 20 and attempted to fertilize five with ICSI. Of those five, only four actually did fertilize.

Today, the clinic called to say that one of the four embryos had arrested at one cell, two of them had progressed to two cells, and one had progressed to three cells. The three still-growing embryos all showed some signs of fragmentation and were graded at B-. We're going ahead with a day-3 transfer tomorrow morning, and we'll transfer all of the embryos that are still developing.

When I first heard today's news, I was discouraged by the fact that we seem to have such poor quality embryos from this cycle. But then I remembered what I read and meditated on from Psalm 62 this morning. My soul waits for God alone, not for embryo development or a successful IVF. God is my refuge; I can pour out my disappointment in our embryo growth to him, and he won't let me be shaken by cell numbers or embryo grades. I can trust in him at all times, even when faced with what seems like a sub-optimal transfer, because all power and steadfast love belongs to him. And as Aaron reminded me when I called to pass on the embryo report to him, this could be an opportunity for God to show how great his power is by bringing a pregnancy out of even low-quality embryos. I still find myself needing to fight discouragement, but I'm trying to shelter myself in the Lord.

Please join me in praying that all three of embryos will be thriving tomorrow morning at transfer time, and that at least one of them would implant and become a healthy baby. Thanks, friends!


With all this talk of eggs, Aaron asked if I feel like a hen.

Today didn't go quite as expected.

We showed up at the clinic at the requested 30 minutes before retrieval time. After a few minutes in the waiting room, they took me back to the prep room. Aaron was not allowed to come along. Once I had changed into the hospital gown, the IVF coordinator and the embryologist came in to confirm how many eggs we wanted to fertilize. I told them five and asked if the doctor had decided to go ahead with a transfer this cycle. The IVF coordinator had no idea what I was talking about.

While I've liked this clinic overall, my one concern is a sense that the left hand doesn't know what the right hand is doing; the personnel in different departments don't seem to communicate with each other very well. I've had to keep track of many of the details and advocate for my own care. Thankfully, I have enough experience under my belt to do so. But on egg retrieval day, it would have been nice if everyone was sharing information.

So the IVF coordinator scurried off the ask the doctor. Then she came back and brought me into the operating room. "What did the doctor say?" I asked. She replied, "Oh, he was interrupted by a phone call and couldn't talk." Um, this is kind of important stuff, determining whether we'd be fertilizing any embryos or freezing all the eggs. By now, I was on the operating table, getting an IV inserted and a blood pressure cuff and heart rate monitor put on, and having my legs tied into the stirrups.
I desperately wanted my husband with me, but I comforted myself with the truth that God was with me.

Then the doctor came in. There I am, bound to a table by various tubes and tethers, feeling rather vulnerable. And Dr. Werthers starts questioning everything - saying we shouldn't fertilize more than 3 eggs, that maybe we shouldn't fertilize any, saying if we fertilized 5 eggs we might end up with 5 embryos which he absolutely could not transfer, and so on. I challenged him, asking what the odds were that we really would have all 5 eggs develop into viable embryos, bringing up our history. I asked him point blank for his recommendation, which he didn't want to give. I said, "We've been up front with you about our preferences from the start; why is this all coming up now?"

Finally, the doctor asked if I would like Aaron to come to the operating room so that we could make the final decision. When I said yes, he went off to the waiting room. In the meantime, the IVF coordinator started releasing me from the table so that I could sit up. As she did so, she kept rolling her eyes. "Are you rolling your eyes at me or at him?" I asked. "Don't let him pressure you," she said. "You go with your gut. You stick to your plan." Then the anaesthesiologist added a relaxer to my IV drip. "Your heart rate has gone up," he said. No kidding.

Dr. Werthers came back and said Aaron wasn't in the waiting room. (I had encouraged him to go get some lunch.) It was about 1:20 at this point, so time was becoming an issue. We needed to retrieve those eggs before the trigger shot induced ovulation. After a little back and forth and a couple phone calls to Aaron, we decided to go ahead and retrieve the eggs. When I woke up from the anaesthesia, Aaron and I would make the decision about fertilizing eggs.

The egg retrieval went smoothly. Remember how I said my follicles were immeasurable on the ultrasound? Well, they aspirated 40. From those 40 follicles, they got 28 eggs. No wonder I've felt so much more uncomfortable during this IVF!

Shortly after I woke up, Dr. Werthers came back and so did Aaron. Dr. Werthers seemed much calmer, and he said that fertilizing 5 eggs would probably result in 1-3 embryos, which he would feel comfortable transferring. We will go ahead with a transfer this cycle, Lord willing. My progesterone levels are borderline but not so elevated as to cause problems. With so many follicles, I am at some risk for hyperstimulation, but my estrogen levels are low enough that hyperstimulation is not too likely. At the IVF coordinator's urging, I'm drinking lots and lots of fluids to minimize the risk of hyperstimulation even further, trying to ensure that we will be able to transfer the embryos. I'm very achy and swollen, but glad to be through with the hardest part. I should get the first fertilization report tomorrow.

So all's well that ends well, I guess. I'm grateful for the presence and care of my good Shepherd today.


Egging Me On

Tomorrow (Wednesday) at 1 p.m., my ovaries will be relieved of their eggs. And I do mean relieved; I feel so tender and swollen that I can't wait for freedom from the twenty-plus follicles crowding around inside me. Granted, I probably won't feel better immediately, but I'll at least be on my way back to some sort of normalcy. (Oh Lord, please let it be a new normal of pregnancy!)

At yesterday's appointment, my largest follicle measured 21 mm, with many others in the 16-19 mm range. The nurse suspects that even the ones that measured under 15 mm are probably really larger and containing mature eggs, but they're too squashed together to show their true size.

I did get some disconcerting news. My progesterone levels are elevated, which means Dr. Werthers may not want to do a transfer during this cycle. He hasn't made that call yet. If he does want to postpone transfer, we'll proceed with egg retrieval and freeze all the eggs. Then, next month we would do the same process as a frozen embryo transfer, only we'd be thawing eggs and fertilizing them. At first I was pretty disappointed that we might not get to do the embryo transfer right away. But then I realized that I would much rather be patient for another month or so than send our embryos into a hostile uterine environment. We'll see what the doctor says tomorrow about my progesterone levels and the plans for transfer...

Scheduling the retrieval time for 1 p.m. meant I had to take the trigger shot at 1 a.m. last night (this morning?). I've always used subcutaneous trigger shots in the past, but this clinic prescribed an intramuscular (IM) injection of HCG. So we set the alarm for 12:45 a.m., I sat on an ice pack for 10 minutes while I mixed the medicine and prepped the syringe, and then Aaron gave me the shot. It's been two years since he last administered an IM injection, but he did a superb job, especially remarkable considering how bleary we were in the wee dark hours. It was painless!

We appreciate all your continued prayers, support, and encouragement. I'll try to post an update tomorrow evening, once the grogginess of the IV sedation has cleared.



I had appointments yesterday and this morning, and I have another tomorrow morning. My largest follicle has reached 18mm, with a lot trailing close behind. I asked the nurse how many follicles I had, and she told me that the machine only allows her to record 11 measurements per ovary, and I have more than 11 follicles on each side. No wonder I'm feeling swollen and tender!

At this point, it's likely that the doctor will instruct me to trigger tomorrow night, with egg retrieval on Wednesday. But of course, I won't know with any certainty until after tomorrow morning's appointment.

I still have a hard time imagining a successful outcome from this IVF; two previous failures have set my expectations low. But a friend reminded me last week that God is "
able to do far more abundantly than all that we ask or think" (Eph. 3:20), and that has been coming back to my mind this weekend. I may not imagine a positive pregnancy test coming in a couple weeks when all of this is done, but the Lord's immeasurable power can do more than I can dream possible.



Trigger time is getting closer, and that means my appointments are getting closer together. After today's bloodwork (right arm didn't cooperate) and ultrasound (follicles ranging from 7 to 13mm), the nurse thought I would need to come in again on Sunday and might trigger on Monday. This afternoon, I got a phone call saying the doctor wants to keep a closer eye on me, so I'm going in tomorrow morning. I was instructed to drop my Follistim dose down to 175 units and to continue all other meds at the same dose.

I've been feeling kind of "been there, done that" about this IVF cycle, but I'm starting to get a little excited about the possibilities now that I've reached the point of daily monitoring. We still need to decide about how many eggs to have fertilized, so I'd appreciate prayers for that.

Have a great weekend, friends! I'll probably post little updates after my appointments, and I'll definitely let you know as soon as we know the trigger and retrieval days.


What I Did After Monday's RE Appointment

My friend from Texas, Amanda, visited last weekend; her husband surprised her for her birthday by sending her to Chicago. We had a wonderful time! Most of the time I forgot to take pictures, but I did take plenty on Monday, when Amanda and I drove into the city, walked around Millennium Park, and took a river cruise with the Chicago Architecture Foundation. Here are some of my favorite shots from the day.



Today's ultrasound showed signs of progress. Not much had happened when I went in on Monday, which is normal as the follicles develop slowly at first. This morning, the scan showed three 6mm follicles, five 7mm, one 8mm, and two 9mm (as well as some too small to measure yet). I've continued on 225 units of Follistim, 10 units of Lupron, and 10,000 units of Heparin (two 5,000 unit injections a day). Stretching across my stomach, the semi-circle of bruises from the Heparin resemble a snowman's coal smile, with my bellybutton in place of the nose. I'm definitely wearing the most comfortable waistbands possible; thank goodness for working from home! I go back for bloodwork and ultrasound on Friday.


Let's Catch Up

So, a few things happened while I wasn't blogging.

I had another saline sonohysterogram, because Dr. Werthers thought he had seen a possible fibroid during the ultrasound at my initial consultation. Results: a free and clear uterus; no fibroids in sight.

The IVF coordinator called and said I could go ahead and start the month of suppression - a surprise to me, as I thought we would have to wait for more testing and further review of all my records. But I had no objections to beginning the whole IVF process sooner, so I started a prescription of BCP and we scrambled to get the rest of the blood work and testing done for me and Aaron. I also received the notorious big box of IVF medications, and I began the Lupron shots about two weeks ago.

I got more information about egg freezing (or oocyte cryopreservation, if you want to be technical). The out-of-pocket cost, while not insubstantial, seems worth it considering that it provides another option if the IVF doesn't work. Since we limit the number of eggs fertilized so as to avoid freezing embryos, oocyte cryopreservation means that the rest of the eggs I produce during an IVF cycle don't go to waste; we can save them for future fertilization, rather than having to go through the whole IVF process from scratch.

The clinic has recommended fertilizing 7 eggs; they say that should result, statistically, in 1-2 embryos to transfer but may leave some embryos to freeze, which is not acceptable to us. They also probably won't allow us to transfer more than 3 embryos. Ideally, we would like to stick with the guidelines of transferring 1-2 embryos, but we also want to know we will be able to give all of our embryos a chance to grow, if we happen to have an abnormally high percentage of viable embryos. We're leaning towards fertilizing 5 or 6 eggs. Fertilizing 4 in the past obviously resulted in nothing. Fertilizing 7 seems high, if we don't want to transfer a risky number of embryos. Fertilizing 5 or 6 should give us enough to aim for a blastocyst transfer of 1, 2, or 3. We're praying and will decide soon; we just need to let the embryologist know by retrieval day.

That all brings us up to today, when I went in for day 3 labs and a baseline scan. Everything looks good, so I decrease my Lupron and start Follistim tonight (10 units and 225 units respectively, for those who like those details). The doctor did decide to add Heparin to my protocol; it's a medication that increases blood flow and addresses any antibody issues, and it's common to use when a patient has a few failed IVF cycles. I had to get some extra bloodwork done for that, and then I had to track it down at a local pharmacy. I'll be on 5000 units twice a day. I go back to the clinic on Monday to see how everything's progressing.

IVF #3 is underway!


Yes, I really haven't posted since Easter. The blogging guilt is great, but I'm just going to pretend I haven't been gone.

Guess what? I was blessed by Mother's Day this year.

(No, I'm not pregnant.)

I went to church with the usual expectations: All the moms will be asked to stand, everyone will clap a lot, I will sit and feel a knot in my stomach and a desire to sink into the floor.

During the singing time at the beginning of our church meeting, I tried to prepare my heart. We sang songs with a focus on the spread of God’s kingdom and glory, asking him to “use us as You want, whatever the test.” That reminded me that my trials are about something bigger than myself. In ways I can’t always see, he is using the troubles in my life to spread the gospel. As we sang, God brought to my mind these words from 2 Cor. 4:

For God, who said, “Let light shine out of darkness,” has shone in our hearts to give the light of the knowledge of the glory of God in the face of Jesus Christ. But we have this treasure in jars of clay, to show that the surpassing power belongs to God and not to us. We are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be manifested in our bodies.

What a precious reminder that while I am afflicted, perplexed and struck down by infertility, I am not crushed, driven to despair, forsaken, or destroyed. Not even on Mother's Day. I was encouraged to think of that moment of sitting down while mothers were honored as a small way of dying to self and sharing in Christ’s sufferings, and as a way to show the life of Christ in me by sitting in peace rather than in shame or self-pity.

But God still had more encouragement in store for me.

Our church is in the middle of a series on Proverbs, and that morning we skipped ahead to Proverbs 31. Tab (our senior pastor) shared some words of praise for various moms in our church that their husbands had sent in at his request. But then he highlighted three single ladies (one with a teenager, one with grown children, and one who has never married or had kids) and how they have been fruitful women. My heart lifted to know that those of us ladies who are in the demographic minority among the women in church were remembered and honored. Then, at the end of his message, Tab asked ALL the ladies – young, old, single, married, moms or not – to stand and be honored and prayed for. I started crying happy tears. For the first time in five years, rather than battling for faith during the entire Sunday morning of Mother’s Day and feeling isolated by the lack of children that I so desire, I experienced a Mother’s Day at church where I felt uplifted and encouraged and joyful.

I'm so grateful for such a tangible reminder of God's favor for me, secured to me by his Son!


For another, better post on Mother's Day, please read Molly Piper's "Do you want to die this Mother's Day?" If you've lost a child or experienced infertility, you'll identify and be spurred on. If you haven't experienced either of those things, it will help you understand a little bit more of what goes on in the hearts of your friends who have.