Sad... very, very SAD!

Today is a sad day in America!
A day no woman should ever have to confront.
A terrible enough day to destroy many lives and spring on immediate depression.
Today....I'm having to convert my Shoe Room into a nursery.

MY SHOE ROOM!!!!

I spent many a days designing, constructing and decorating this room to display the most amazing, eclectic collection of stilettos, thigh high, knee high and calf high boots, booties, sandals, even hush puppies.  It had freshly painted lavender walls, a newly designed, compartmentalized closet with lots of different-sized shelving, a fancy decorative futon with purple, green and gold throw pillows to bring out my shoe collection, a wall-mirror to rival all wall-mirrors, pink frilly curtains, and a light violet carpet.  The most colorful, coveted, in-season heels were cleverly laid on rows of horizontal wall shelves lining an entire wall, perfectly positioned as one's first sight upon entry into this shoe haven...it begot instant 'oooohs' and 'aahhhs'.  #egoboost.  It was MINE!  ALL MINE!

"Honey, against which wall?"  bellowed my husband, almost spitefully and mischievously, as he positioned one of the newly-constructed department store DIY bookshelves in the basement.  They were to be the new home for my shoes.
(He was never a fan of that room.  He thought it rather braggadocious and a waste of space.  He, is what we refer to as A HATER!)

Ughh!  The Basement!  Three whole floors down.  Below ground-level.  Sharing a space with non-fashion-friendly items...such as laundry and old books and suitcases and blue carpets.....UGGGHHH!

So............. we're having a baby, huh?  This is really happening?

Sucking the Life Out of Me...

"Where have you been?"

Me? ....busy!  Very busy!  Let's play catch up...

I've been pregnant for many months now, and it's been a joy.....well, NOW it's a joy but it hasn't always been so blissful.  Take a walk down memory lane with me back to week 8, first trimester...

9am  -- I had a routine ultrasound.  It was to be my second to last visit to the fertility institute before graduating to my obstetrician for regular prenatal check-ups.   I had cramps, lots of uncomfortable cramps.

No heartbeat.  No picture of a baby.  Nothing.  

"What's wrong doc?  You look worried."
"uhmmm...I can't seem to find....can you slide to the left?  No wait, don't move.  Ok, now to the right.  Hmm....I can't.......I'll be right back".

In walks the attending doctor and she attempts to perform the ultrasound.
"Hmm....we can't seem to find the baby abdominally...let's try a pelvic ultrasound.

She tried and couldn't locate the fetus, instead a huge mass that had grown significantly larger since the last ultrasound and was incredibly painful to the touch.  She could go no further into my uterus.

"I'm afraid the baby may have stopped growing and the gigantic fibroid has sucked the life out of it.  I'll need to send you to the lab for an advanced ultrasound with better technology....ASAP.  Cancel your afternoon plans."

That day ended up being one of the most horrific scariest stressful interesting days of my life.  

Many, many slow-moving hours later of waiting and panicking and crying and praying and lots of tests....we found the baby....chilling in the corner, completely unfazed.

Yep...I was nurturing twins.  Nooo....no no....slow down.  Not twin babies...more like twin organisms growing in my body at the same rate.  One, welcomed with open arms, and the other...the bane of my existence!  Yes, FIBROIDS!  One particular fibroid had grown to about 7 centimeters (from mere millimeters the week before) as a result of my increased hormone levels and was competing with the baby for blood supply.  I later discovered it was something called 'fibroid degeneration'...a rather common occurrence amongst many women with fibroids during pregnancy...the baby was going to win this fight and the fibroid was not going down without a fight.  I paid for it with my sanity!

I spent the next two weeks in and out of the ER for intense, gut-wrenching, extremely unbearable pain.  The pain was so bad, I couldn't walk, eat, sleep, or even urinate.  Yes, peeing was excruciatingly painful....every tinkle felt like I was being sliced open with unsanitized, red hot sharp razors and the wound immediately being doused with salt.  PAINFUL!  I was given a few doses of morphine just to quell the pain while in the hospital, then a low dose of Percocet every few hours as needed, for about 2 weeks until I was no longer suffering.   I couldn't help but obsess over the impact of all these narcotics on my unborn child's development ....but there's still a God, right?  At some point, my faith had to kick in.

Say a prayer.
Pop a pill.

Wait a few minutes....
Ahhhh....feel the high!  I'm floating....pain free.  
What's showing on Lifetime?

Why?

I refilled my last set of syringes today....counting down until I graduate from the fertility medical team to my obstetrician.  #bittersweet.  Two more weeks.  Today's hug with my nurse was a bit more emotional...love her!  I wish I had more time with her (but that actually has more dire implications....so #GIRLBYE!) .

"How did it feel to document it for all of us to see?"  ...asked a girlfriend last week.

It's one of many questions I've gotten about my blog.

"What if you have a miscarriage, will you blog about that?"
"Aren't you afraid of what people think?"
"Don't you think this is too personal to share?"

All valid points but none impactful enough to sway my decision to share this very intimate, painful yet exhilarating and amazing experience of a lifetime.  The inspiration to share one of the most naked experiences of my existence was divine, as like many, I was just as ashamed to open up. I was documenting my experience on a private blog so I could later reflect and gain clarity, but it quickly became a forum/guide/reference/conversation-starter for people of all walks of life -- couples undergoing fertility treatments, newlyweds in their early thirties not sure if they should get fertility testing before losing too much time trying to conceive, pregnant women, men/women who know nothing about infertility and IVF and have always been curious, the list goes on.  It's encouraging!

But you didn't answer their questions. 
Oh... right!!!

Miscarriage:  if this happens to be my fate, then I'd be thankful to live to tell it.  Not much more than God's Will.
Afraid:  no!  I've never been driven by fear.  I come from a culture where fear and the stigma of being imperfect drives people to do the unthinkable to keep up appearances.  I made the decision to LIVE fearlessly a very long time ago.  It's much more liberating.
Personal:  yes.  I also think it's too important 'not' to share.  Importance trumps personal ;).  If in my lifetime, my painful testimony helps just ONE soul thrive and get through a tough time in life, I'd say life was worth living!

Happy Birthday!

"Happy Birthday Mom" as we sang in unison.
"Thanks honies"
"Ready for your birthday present?"
"As ready as can be!!!"

Our gift to her this year was something Hallmark didn't have in stock.....it was a trip to the doc's office for our baby's first ultrasound.   picture...heartbeat....breathtaking.....God's creation...PERFECTION!

hehee....s/he looks like a bean

She didn't faint this time. 

About 2 months pregnant.  So far, so good.  All but morning sickness, thank God!  I just found out my girlfriend is also pregnant -- 2 months -- fabulous!!!  We symptom-swap every few days :)

So I'll remain under the care of my fertility team until about 10 weeks, then graduate to an OBGYN of my choice.  In that time, I'll continue using estrogen patches every other day, and daily progesterone injections in my tush.  Both hormones are needed for the lining of my uterus as the baby implants and grows (they would have been produced in my body had the unfertilized eggs not been harvested -- as they would have disintegrated and produced the necessary hormones preparing my body for pregnancy.  This is usually the case in a non-IVF pregnancy).  At around 10 weeks, the fetus will begin making its own progesterone, at which time I can stop the hormones and just remain on prenatal vitamins.

*important*  most women would opt to use their usual gynecologist after discovering a positive pregnancy test but buyer beware!   Lately, many OBGYNs have chosen to drop the 'ob' portion of their practice -- meaning they no longer deliver babies  -- for a number of reasons (ie: malpractice insurance premium, cost, etc).  Your OBGYN may in fact just be a GYN who only sees/treats women who are 3 months pregnant or less.  In this case, you must find an obstetrician to help you deliver.   So, if you find out you're pregnant, call your OBGYN and ask:  "Does Dr. Smith deliver babies?".  If not, time to go shopping.....for a new doc!   But here's the trick:  a lot of practices won't accept a mom-to-be beyond 3 months.  So start shopping EARLY!

OTD

"Hi Honey"
"Guess what?"
"What?"
"You're gonna be a grandma"
loud thump.  silence.

"Hello?............Mommy?........Are you there?............Mother??.......Hello????"

Either she fainted, or accidentally dropped the phone.......then fainted.  Hmm!

Too much too soon?
Ok.  Ok.  I'll back up a bit.

If you recall a few days ago.....ate delicious whole fish....lip swole....heightened sense of smell......rushed to hospital to examine lip....everybody walks into examination room with a creepy stare and smile.  Over a swollen lip????!?
Nope!
Nurse asked me to pee on a stick.  "What? Why? It's too soon.  My OTD (official test day) isn't until Wednesday.  Will my body produce enough hormones to detect anything this soon?  I'm scared.  I don't want to get my hopes up.  Can we wait?"
"JUST PEE ON THE STICK DAMMIT!"

minutes later

"It's faint but I see a line...."
"a faint line? what does that mean?"

can you spot the faint pink line right above 'T'?

"You're producing low levels of hCG.  I'm pretty sure by Wednesday your blood test will confirm you are very pregnant as you'll produce more."

Indeed it did.
By Wednesday morning, my breasts were incredibly sore and huge.  I was on my 2nd ice cream sandwich at 9am (a very weird craving for ice cream lately).  I had many sudden urges to relieve my bladder.  Hair...lots of it.....body hair....I hate body hair.  I'm having to shave yet again.  ....and a nap, I now need naps, I'm constantly exhausted.....very, very exhausted!

"Mommmmmmm WAKE UP.  You're going to be a grandmother!!!!!!!"
"oh my God.  oh my God.  OH MY GODDD!  We have to go shopping!!!!!!"

Yes.  Shopping.
If there was ever a doubt that we were related....here's your proof!  Ha!

Ugghh....what's that smell?

"ughhhh....what is that smell?"

"I don't smell anything.  You've been on a sniffing frenzy lately...what's the matter with you?

courtesy of theysayimnuts.blogspot.com 

For the last few days, I've been smelling the most incredible scents as well as the most pungent in my home.  From what seems like the most amazingly delicious freshly baked cookies ...to an incredibly inviting mango candle I've had forever whose scent seems to have been revived overnight....to the most disgusting, pungent, rotten banana peel in the trashcan that seems like it's been there for 7 months and counting.....I'm not sure why.  My heightened sense of smell isn't the only thing awry.

On Saturday evening, I met with a few girlfriends at a nice Cuban restaurant for dinner.  There's something so refreshing about outdoor seated dinning during warm weather.  The hour-long drive was exhausting, but I made it home in time for a midnight snack -- an ice cream bar -- I was starving... then off to bed.  No sooner than 5 hours later, I was awakened by a sudden urge to eat (I was starving)....and pee.....and for some reason I had an itchy, swelling bottom lip.

Did I get bitten by the mosquito I accidentally let in last night while fiddling with the front door?
Perhaps.
But ....why on my lip???  Rather odd location for a mosquito bite.

Ohhh nooo....perhaps I'm having an allergic response from the ginormous fried whole white fish I devoured the night before (I was starving!).  Afterall, my lip is swelling by the minute.

That can't be.   I have zero food allergies....!  Plus, I eat sushi or some kind of fish-based dish just about every day.  I live on this stuff.  If I died and had a chance to reincarnate, I'd come back as a mermaid so I can eat all the fish I could get my hands on.   That's how committed I am.   So I can't just develop an allergy to fish all of a sudden.  I'd die!!!!!!

I sent a picture of my swelling lip to my nurse in a panic and asked for advice.  I'd have to come in for an inspection of the area and a culture if necessary.

When I arrived for my impromptu visit, not only did my nurse walk in the consultation room but she was followed by a whole team of medical professionals.  All were smiling and glaring at me.  Creepy!

"Let's take a look at your lip.  Oh my, it's huge!"
"What do you think it is?  I'm scared.  My body has been doing weird things lately.  I feel like I'm under attack."

FREEZE! don't move....

that's what embryos 2, 3, 4, 5 and 6 are doing.....freezing!
 If you recall, #7 stopped dividing and #1 went on to the next step 

So after harvesting my mature eggs as a result of grueling hormone therapy with ovulation-inducing drugs, the last thing I wanted to do was let them go to waste.   The goal is to not to have to start over with stimulation of ovaries with injectable medications if we needed to repeat the IVF process.  That's why it was crucial, as painful as it was, to adhere to dosage instructions and injection times (down to the minute)...to give my body the best chance at producing as many mature follicles as possible for a one-time harvest.  It worked!  We ended up with enough remainders for cryopreservation (freezing).  The need for multiple harvests is not only taxing on one's body (and marriage) but can be very expensive, especially since most insurance plans max at 2-3 harvests a lifetime.

Cryopreservation, in this case, is the process of freezing embryos in sub-zero temperatures, which preserves the integrity of the eggs at the division stage and allows them to be thawed at a later time to continue dividing/growing.  It's an advancement in science that has greatly improved the IVF process, in that embryologist can select the highest quality eggs to fertilize, knowing they can be stored for later use.  It also no longer pressures doctors and couples to transfer multiple 'good eggs' into the patient for fear of losing them.  When that used to be the case, couples would end up with multiple births...triplets, quadruplets, quintuplets, etc.  So the solution to infertility was....you either had 'no children' or seven, eight, nine you could barely afford to raise.  Too many extremes.

Sometimes, the first embryo transfer doesn't end up in a pregnancy, or does but ends in a miscarriage.  In this case, there'd be 5 more chances for embryo transfers and increased rate of a birth.  The cryopreserved embryos can be stored for years and thawed for use when needed.  The process is usually not covered by insurance, so it's an out of pocket expense to consider but generally inexpensive -- between $500 - $2000 per year depending on number of embryos.

There's a catch though with cryo.  Unless you're a cancer patient opting to cryopreserve your (unfertilized) eggs before chemotherapy, there are strict rules that govern the freezing of fertilized eggs.  In our institution (and I imagine everywhere else), I had to be with a committed male partner (whose sperm I was using) and he had to express written consent of his desire to have biological children with me in the future.  Of course the consent form was 17,000 pages long, it seemed, and we had to sign off on our desired actions for the frozen embryos should a number of unforeseen life events happen (i.e. divorce, death of patient, death of partner, separation, death of both, change of heart).  In each scenario, I had to decide if I'd discard my eggs, donate to an infertile couple, transfer to ex-husband and his new wife (HAAAA!!!!!)!

no seriously.....HAAAAAAAAAA!!!!!!!!!

The Expense

You're probably wondering why we chose now to move forward with IVF.  How do you know when and if it's right for you, and when to start?  How expensive is the process?

Well, I've always known I'd have to address the unknown questions of fertility as a result of my aggressive chemotherapy years ago.  Its impact on my unharvested eggs was a huge question mark.

The general rule of thumb is that if you're married and have engaged in sexual activity (with no form of contraception) for over a year and have had no pregnancies, then make an appointment for a consultation with a fertility doctor.  A consultation with a fertility doctor could be the first step to either ruling out or discovering any issues in the woman's reproductive system that could hinder a successful pregnancy down the line (i.e. fibroids, endometriosis, blocked Fallopian Tubes, cancer, etc), or ruling out a potential male factor (i.e. injury, chronic health issues, lifestyle choice, genetics).  One of the most important aspects of your fertility consultation should be that your doctor is as equally vested in your partner's reproductive health as s/he is yours, since about 40% of infertility issues are due to a male factor of some sort.  Do not make the mistake I once made of seeing a doctor who isn't interested in your partner's health....it's a waste of money and time.  If the application/form you complete on/before your first visit does not ask about your partner's health, family history, etc....tear it up and cancel the appointment! They won't have enough information to be fully equipped to diagnose infertility issues, if any.

Our first experience with a fertility doctor was self-funded.  Our health insurance plan had a provision for the 'diagnosis of infertility' but not 'treatment'.  Basically, our health insurance covered the first visit or so, in which the doctor concluded 'yes, I believe there is a fertility issue'.  The expense from any lab work, medication and treatment (IUIs) thereafter was on a cash basis.  It was not ideal but we hadn't done much research at that point and didn't know of any other options.  I would not recommend this route unless you have no other choice and a healthy savings account.  We probably wasted about $5k - 7k in blood work, ultra sounds, IUI cycles, and eventually male factor diagnosis and countless hours from work...until I had enough. They also offered us a chance to receive free or subsidized fertility treatments in exchange for donating some of my eggs....I was the least bit interested.  The entire experience was nothing short of a nightmare....from feelings of inadequacy from the medical staff to disorganization and lack of comfort, I was convinced that if 'this' is what was required to conceive, I wasn't interested!  They somehow managed to remove all aspects of humanity from this very intimate, sensitive and delicate process and turned what was once a renowned and bustling fertility institution into a baby factory.  No, thank you!

A few years and a number of life events later, we had opportunities to change insurance plans and this time were very selective.  We selected a health insurance plan that had a provision not only for infertility diagnoses but for treatments.  Ours provided for two Invitro Fertilization cycles in a lifetime.  This meant that we could visit a fertility institution, begin fertility treatments, have my eggs retrieved then fertilized and receive embryo transfer....twice in a lifetime.  I've also seen insurance coverages make provisions for '2 egg retrievals in a lifetime', etc.   For those people, it could mean begin fertility treatments, have surgery to harvest as many mature eggs as possible -- two times in a lifetime, but have multiple opportunities to transfer as many frozen embryos into the womb as needed without insurance restrictions (3, 4, 5, 6 children just from one/two cycles of IVF).  It's all in the details of your insurance benefits.  Depending on the contract between the insurance provider and the employer, the patient is responsible for some or no portion of the treatment (i.e. copay, deductible, percentage of procedure).  This is a big deal and a big financial break for many couples.........but........there's a catch!

Fertility treatments haven't always been included in insurance benefits...it's a relatively new phenomenon and came as a result of the adoption of the Affordable Health Care Act.  With this, insurance companies often require you to jump through a few hoops before qualifying for IVF treatments.  They use a formula called 'lesser before the greater' meaning, you'd have to exhaust a list (predetermined number) of lesser effective means of fertility treatments and only after having been unsuccessful will they then approve an IVF cycle.  I've heard of some couples being required to complete 6 IUI (artificial insemination) cycles before qualifying for IVF.  We're talking at least 6 months of hormone therapy (less intense than that of IVF...mainly pills, but nevertheless mood-altering and undesirable effects)....it's kind of crazy.  Luckily for us, the threshold was 3 IUI cycles, and credit was given for previous cycles.  Coverage for each IVF cycle (about $25k) was sufficient for us and our out-of-pocket expense was manageable.  Expect to pay about 30% of expenses between office visit co-pays, medication/prescription co-pays, travel, and cryopreservation of embryos (if you choose as this is not covered by most insurance plans).

It's perfectly normal to ask within your first few visits, how much an IVF cycle costs with that particular institution and if there are any included (special) services you'd otherwise be expected to cover (i.e. ICSI, video embryonic development, preimplantation genetic diagnosis).  Each institution's IVF cycle will differ in cost based on their technology, methods, expertise of their staff, whether they're an extension of a research or teaching hospital or a university.  We deliberately chose a research hospital within an Ivy League institution as we felt we'd benefit from the best technology, cutting edge methodology that may not yet be ready for commercial use, and handled by some of the best trained fertility specialists in the nation.

Lastly, ask if they devote time for a detailed info-session for IVF patients.  This is very crucial to your success rate and for us, led to desirable outcomes.  Knowing exactly what IVF is, what happens with each process, what role your medical team plays versus the roles you/your partner play is the key to a successful IVF process.  It'll help with decision-making at each juncture, and help you understand why some medical recommendations unique to your situation may be for the best (or not).  Also understand 'who' makes the final call....patient/partner, or doctor. The info-session, if done correctly, should last a number of hours and provide adequate time for a Q&A session.  Ours was 5+ hours long, facilitated by the Chief of Staff of their Reproductive Endocrinology and Infertility division, and I raised my hand about 17 times in 5 hours ......a distant but fond memory of my 4th grade teacher reminding me there was no such thing as a stupid question.   Hey....it's my body, and I needed to feel very comfortable before moving forward.

• 
  

The Wait

   

For many women, the most agonizing time during any fertility period is the dreaded 'two-week-wait'.  It's the two weeks in between your ovulation date (and hopefully conception date) and the day you're supposed to start menstruating............... or..............miss a period and test positive for pregnancy.

Many of us slow down our activity to give our bodies enough preserved energy to aid in the conception process.  Some of us try to distract ourselves by engaging in as much work/activity as possible, that it leaves no time to think about the inevitable.  Others with very obsessive tendencies practically LIVE on 'two-week-wait' websites and blogs. These sites are usually dumping grounds for women's symptoms during the waiting period ...and how to detect if you're pregnant.  I highly recommend against this....they can drive you crazy!  Instead, focus on eating well and treating your body as if you are pregnant (as you very well could be).  Curtail strenuous activity, cut out alcohol, and stay away from tobacco.

For me, the first two were the hardest.  Curtailing strenuous activity was a mandate from my doctor, and not being able to work out was challenging.  I felt useless and ....fat.  No Yoga, Kickboxing, Zumba and definitely no sex.  Virtually zero calorie-burning! *yawn.    As for wine...I'm still struggling from withdrawal symptoms.  Occasionally, I'd pour a glass of juice in a wine glass and sip slowly with cheese and crackers....to feel whole again.  At a social event recently while out with friends, they all ordered wine and cocktails and I ordered......green tea.  My girlfriend 'tried' her hardest not to laugh at me.  It was quite challenging.

D-DAY!

 

"Drive fasterrrrr....c'monnnn step on it!!!!"
"I'm driving as fast as I legally can on an interstate babe, calm down!"
"Our appointment is at noon....think we'll make it?"
"Relax.  We'll be fine.  Sit back and take a nap....you'll need all the rest you can get!"


I nagged him the entire six-hour drive back home.  It was the big day -- EMBRYO-TRANSFER DAY!  Three days before that, we sneaked out of town for a short vacation while the fertilized eggs were maturing....we were determined to get at least a day on the beach before all hell broke loose. We even left a day earlier than planned, knowing the trip would be cut short as we'd have to depart at the crack of dawn a few days later for the procedure.

The medical team was ecstatic to see us.  We'd been the subject of many round-table discussions amongst well-renowned physicians and medical professionals in the area.  Our case was rather interesting to them and made for great research.

I was giggling so loudly when Dr. ***** walked in to discuss and finalize plans for the number of blastocysts to transfer.
"What's so funny....I want in on the joke?"
"....well, we're at a stalemate here and maybe you can help us out.  What do you think of the name Coral?" I asked.
With a straight face, he adds "I ....like it.  Is that for a boy or a girl?"
My husband falls out of his chair in laughter!  I guess that settles THAT dispute.

Be very leery when a person says "I like it" with ZERO facial expression.  Not a blink, a smile, a twitch...nothing!  He really didn't need to lie.  I have three to five pages full of other names from which to pick. No need to placate me Doc!


"Lie back and spread 'em open"  says the doc.
"hehehe....that's what she said"   blurts out the comedian in the room my husband.
(no one laughs!)
(well actually, the nurse, doctor, and embryologist chuckled, but I didn't find that joke funny at all.  FOCUS PEOPLE!!!!)

"ouchhhh"
"that was just a clamp...you've felt this before.  I need you to relax"
"ok doc"
"see THAT on the monitor?  That's your embryo.  It's in!!!"
"whoa...!  that was quick"
"yep!  lie on your back for a few minutes...we'll return with some post procedure instructions"
"hahaha....that's what she said" blurts out the comedian

He seems to be on a roll today!

A few minutes later, I was discharged and ordered off my feet (bed-rest) for 24 hours to allow the embryo to implant.  I was to exert the least amount of energy in those 24 hours -- only get out of bed to eat and use the bathroom if need be.  For someone who is always on-the-go, this was PURE TORTURE for me.  It was 88 degrees outside, beautiful, sunny, breezy, birds chirping, perfect day for the beach and the sun didn't set until what seemed like well into midnight.  The hours passed soooo slowly.   I wasn't tired at all...yet I laid in bed.  I watched sports and Reality TV and newscast and movies ad nauseam!!!!  I played so much Candy Crush on my phone until it overheated and needed to cool off before it was rechargeable.  It was pure misery!

On the 59th second of the 59th minute of the 23rd hour the next day, I BOLTED OUT OF BED, hopped in the shower, grabbed my keys and headed to the beach.   FINALLY............in my element!

Clear Your Calendar...

"....so, don't make plans this week, since everything will depend on how your body responds." 

"hmmm....but we already have vacation plans out of town from Friday - Tuesday.  We planned it months ago.  Is there anyway we can administer my trigger shot on Friday, so we can harvest the eggs on Sunday and be ready for embryo transfer on Day 3 instead of Day 5?  Basically....is there anything you can do to NOT disrupt our vacation??"

"Sorry babe....it doesn't work that way.  This entire process is absolutely out of our control. We give you hormones, and then follow the progress your body makes.  If your body decides to make mature eggs on Monday, that's when we move.  Embryo transfer depends on how fast they grow/divide.  You just cannot make plans during this process.  You have to pick one....baby?  or vacation?"

DAMMIT!

I guess I better get used to the idea of my plans being derailed changed if I'm going to bring a life into this world, huh?!

sidebar...it is virtually impossible to maintain a job with a steady schedule while undergoing IVF.  The demands are heavy and schedule quite unpredictable.  My appointments are almost always a game-time decision (maybe 12-48 hour's notice).   The result of each ultrasound determines when you're summoned for blood work, which determines the doses of your next set of medications, which drive the date of your procedures, etc.  You cannot miss a beat....or the entire process/cycle would have been in vain.  Very demanding!  If you're considering venturing down this wonderful path, try going on a hiatus from work....or consider not working if your household can survive on your partner's income.

Spilled Milk

At what point do you mourn the loss of a....

Wait.   

First we have to define what '____' is!  So let's give you some background.

So septomom is no more.  The embryologist advised the seven well-performing embryos are now down to six.  Six went on to the next stage -- blastocysts, and one's cell stopped dividing at around 5pm.  The cells of an embryo will stop dividing (growing into specialized cells which eventually develop into human parts) for a number of reasons, the main one being that something went wrong with its chromosomes.  Nature will find a way to self-abort (if it can), rather than perpetuate or introduce a potentially detrimental defect into the gene pool.

(I paraphrase)

"We lost one", he said.
"WHAT?  HOW?  I worked really hard to produce that egg!"

"It happens....part of life.  Can't cry over spilled milk.  Let's focus on cryopreserving the best performing embryos"

"....did you just call my dead embryo spilled milk???"

"hmmm.....I see you need some time alone.  Let's ...uhmmm.... I ....have a ....uhmmm....thing to do....uhmmm"

"....Have a good evening!"

Reminds me of some of those very heated debates I used to find myself in....about 'when life begins' and whether abortions should be considered murder.  

So what do you do when a 4-day old embryo stops dividing?  Cry?  Mourn?  Plan a funeral service?  Clean up spilled milk??? 

Septomom!

superstar embryo with 8+ cells

Yep!  3-days after fertilization 7 out of 8 eggs made it to the next phase.
7 embryos....dividing wonderfully.   Six of them have 8 cells and one embryo already has more than 8 cells (like any other living organism, if all goes well, they'll continue dividing into millions of cells that will eventually become specialized over the months, some of those cells forming the heart, others forming toes, some the elbow, and so forth).  If for some reason, something goes wrong in the growth phase of each of these embryos, the cells will receive a chemical signal to stop dividing, and that would be the end of life for that embryo.  It's kind of up to God at this point...science can only take you but so far.

The next stage in this IVF process is to determine what day to transfer the embryo(s) back into the womb and 'how many'.  The most advanced fertility centers are generally very conservative in their approach.

The first goal is to select the best-performing embryo as it will have the best chance at leading to pregnancy.  The second goal is to prevent multiple births as much as possible -- so transfer the least number of embryos possible.  Having unexpected twins/triplets/quads, etc comes with its set of medical, financial, and psychological burdens on families.

When embryos are transferred on Day 2 or 3, it's tough to select the best embryo as they may all be dividing at the same rate.  On Day 5, they would have reached the blastocyst stage and would already begin to differentiate between placental and fetal tissue --- then it's easier to tell the superstars from average 'embies'.

Shots, Shots, Shots!

Remember back in the "I'm Huge" post, where I broke down what happens to non-dominant follicles that don't go on to ovulation, but instead disintegrate and produce necessary hormones in a woman's body... mainly progesterone?

Hold that thought!

So because all the eggs I produced grew to a considerable size -- essentially no particular one was dominant -- they were all harvested from my body leaving nothing behind to disintegrate and produce progesterone.  It's a hormone that gives support to the lining of the uterus and is needed to maintain an early pregnancy.  At around 12 weeks, the placenta starts producing its own progesterone and can sustain itself.

Sooooo....what does that have to do with the gigantic 22 gauge needle pictured above?  THAT bad boy goes in my ass every night....(too graphic for ya??? put yourself in my shoes!).  I get a shot of progesterone every night until the medical team says stop!  The ENTIRE needle must go in as it needs to penetrate into the muscle.  [He] gets to do the honors.  I get to numb the area an hour before the shot with Lidocaine, but funny enough, on days when I've managed to get on every one of his last nerves, I seem to feel the pain of the needle.  Somehow the numbing cream doesn't work when he's mad at me....

Coincidence?

*disclaimer:  I'd recommend taking a break from reading this blog for anyone with delicate sensibilities, an inability to cope with death, in-vitro abortions, miscarriages, and the likes.  As these tend to be the realities of many (not all) infertility treatments, many may find it difficult to keep up with future posts. I'll try to keep it light, however keep in mind this is just one person's experience and perspective*

He Quits

It's been a few days since I was on daily ovulation-inducing drugs in preparation for my egg harvest surgery.  The experience was nothing short of hell.

The most difficult part of the process wasn't the dreaded daily (multiple) self-injections into my belly and thighs, nor the random weight gain (most of which was in my stomach), nor the soreness in injection areas, or the extreme nausea and constant migraines, nor the disruption in my daily routine -- my schedule was no longer mine; at an instant I'd get summoned to the hospital for blood work or an ultra sound and would have to cancel everything to make that hour-long drive (each way!).  The most difficult part of this process was the stress on my marriage!
Yep...the hormones completely stripped away the essence of who I was/am and made me a raging BITCH and he had to put up with every minute of it!

After a long day at work....3rd day in a row pulling a 12-hour work day...he came home, exhausted!  I'd been crying...for no good reason....sending him emails and text messages on how miserable I was feeling at random hours of the day.  I begged him to come home, so he did.

"Anything to eat upstairs?  If not, I'll go pick up some Thai food. I'm starved" he inquired.
"hmmm...there should be leftovers in the fridge"  I added, completely situated in the comfortable position I had assumed on the couch hours earlier.

Minutes later, he came down with a hot plate of leftover food.

"Sooo...you didn't think to make me any?" I snapped
"....you didn't exactly express you were hungry.  You've been home for hours.  Why haven't you eaten?"
"You're sooo insensitive and selfish and don't care about me..."  as I burst into tears.
"Oh goodness!  Here, you eat this, I'll make another plate"
"hmmm...I'm not in the mood for lamb or corn or spinach"
"Would you like me to grill some chicken for you?  Or salmon?
"hmmm.....no, not in the mood for that either"
"Then what do you want?"
"STOP PRESSURING ME!!!!"
"WHY ARE YOU YELLING??? I'm just trying to appease you"
"omg.....you don't understand what I'm going through.  You never have.  If you cared, you wouldn't offer me leftovers.  I'm going through so much right now.  I need someone who'd understand me. You don't"
"....I can't do this right now.  It's been a very long week.  We're out of wine...I'm going to go grab a few bottles, while you calm down".
"...so you're leaving me?  In this very vulnerable time?  I knew it.  You crack under pressure.  No one loves meeeeeeeee"

"WHAT?!!!?   Please stop!  I do love you.  I always have.  Relax.  I'll be back in a few minutes.  Calm down".
"so you're really leaving?  fine!  Go and don't come back.....ever!!!"
"What do you want from me?  I can't win"  ...as he gives in and proceeds to take off his shoes and ditch the whole idea of running out for wine.

"You're not going anymore?  I really want some wine now that you mentioned it"
"WHAT??!?  You're an emotional wreck and I can't deal with it. One minute, it's stay, then it's go.  Which is it babe?  Help me help you!"

I cried myself to sleep that night.  Not exactly sure why.  I felt so misunderstood.  ...or was I?
The hormones were making me sensitive and vulnerable and paranoid and emotional and ....you name it, I felt it!  He didn't stand a chance.  He was in the line of fire just by his mere existence....and couldn't win. This was one of many stupid, intense, emotionally draining arguments....that had no beginning and no end, seemingly.

A few days after my surgery, I seemed to be regaining my normal hormonal balance.  I'm much calmer and happier.  "Welcome back" he said.  We're never going through this process again....I don't think you can handle the pressure....I QUIT!!!

7-11

"Hello?"
"Hiiiii honeyy!  How are you feeling?  Sore?  Good news.  Out of 11 eggs harvested, 8 were mature, and this morning the embryologist advised that 7 of those eggs were fertilized!  I'll call you tomorrow to alert you of their progress and advise what time you'll be coming back for the embryo transfer."

FABULOUS!!!

So the other day, at 8:45am, we arrived at the hospital for surgery check in.
"Consent forms signed?  Living Will on hand? Have you had bad reactions to anesthesia before? Please take off your wedding rings and any other valuable jewelry.  Put these on...lay on the table...spread your legs, and count down from ten, nine, eight, seven......"

"Wake up princess.  All done.  How do you feel?"

Out of 29 follicles and eggs, 11 were harvested during surgery.  8 were mature.  7 were fertilized.  Now we wait to see which of the fertilized eggs begin splitting and progress to blastocysts.  Within a few days, we'll return for an embryo transfer procedure, at which time, we'll decide how many to transfer into the womb, and how many to cryopreserve (freeze for future use).

Secrets...Suicide

A few days ago, I shared with a few people my blog to give them an insight to my struggle and perhaps give a voice to this silent suffering.  Many young women and couples are plagued with infertility issues but seldom share....often because it is such a raw and emotionally taxing process and sharing is just another way to relive the horror.  But mainly because it's a taboo in most cultures....the concept of infertility is misunderstood by most, and many draw inaccurate conclusions as to the reasons -- a curse? a result of a mishap in one's adolescent years? side effects of smoking? drinking? etc.  ALL of those couldn't be further from the truth...
The stigma is unbearable for many, so they end up suffering in silence.

Soon after sharing it, I began receiving a ton of private messages from friends.  Some had no idea my struggles with cancer and chemo 7 years ago and felt left out.  Some appreciated the detailed posts as they had no idea how intense the process was....although they may have known someone who went through the process.  Others wanted to share their personal experience with IVF, that until now, they've told no one (besides close family members, if that).  I was inspired.  Many of the stories were from young African American women in my age group -- to think infertility issues were so rare.

Hey! I hope all is well! I just wanted to reach out to you because I came across your blog link as I was scrolling through Facebook which I rarely do anymore and I see what you're going through and I totally understand and am thinking of you and praying for all the way. I've been through IVF myself which hardly anyone knows but if you ever need support through the process you can feel free to reach out to me. I've done it all seems like, 2 IUIs, 2 fresh IVF, and one frozen IVF cycle so trust me...I know exactly what it's like to be a human pin cushion.

She and I chatted for days on end swapping stories and sharing our experiences.  She's a great girl with a gentle soul, and I wish her the best in her future sessions.   Perhaps we'll have back-to-back baby showers ;)

My dear, you are brave and amazing for sharing your journey. Unlike you, I couldn't go through the fertility process. On January 7th at the age of 32--I had a hysterectomy. My journey is not yours but I say all of this to say--keep fighting for the sisters who can't--that includes me! I have an essay that I have been working on for a while now--maybe one day, when it's all said and done, I will share. Keep fighting honey! You both can do this together. Sending love and light to you and your husband.

This woman is strong and amazing and courageous!  She shared details of her decision with me and we commiserated.  She shared her sorrow and how many tears she shed before finally making the decision.  She's no longer plagued with the pain of bleeding daily...and is much better off.

Hey honey, I wanted to reach out to you after I read your IVF post. I am sorry...I didn't know you had cancer. But hey, I did IVF. No one knows. Not my mom, not my sister....just you now. I just didn't want anyone to judge my husband. I needed to preserve his image.

My heart breaks at the thought of living this horror alone.  It's taxing on one's mental state and on a marriage...not having anyone to confide in has to be that much tougher.  Their beautiful baby just turned one :)

 So the other day, I was doing my normal scrolling and came across your post. I wanted to say I admire your courage to share from a very deep place. It takes real strength as a woman, even as a black woman to share from a private place. That's amazing. You've inspired me to push through the daily stressors in life. To be honest, I have been in very low points in life and the other day, I was having a 'what am I here for' moment. You single-handedly talked me off the edge. Your story made me realize there's nothing that can stop your stride. Again, thank you for sharing....you have no idea how you've saved me.

.... and THAT took the cake!
I received many more inspiring stories and messages and encouragements.  Thanks to all the women who were brave enough to share their stories with me.  Perhaps we can slowly chip away at the stigma and begin building a stronger community and a support system for this silent killer.

Trigger!!!

2pm
"Hello?"
"It'sssss D-DAY!  Your ultrasound shows just enough mature eggs for us to move forward, and your blood test shows your estradiol at 1762 -- it didn't spike as we feared, so you're good to go.  Tonight, you're going to give yourself the two trigger shots -- Lupron and HCG.  Do so precisely at 11pm.  We'll test your blood tomorrow to monitor the effects, then in exactly 35 hours, come in for surgery to harvest your eggs."
"Great...".

That afternoon, I met my girlfriend for lunch to catch up on details from her amazing trip to Barbados.  We chose a nice Indian restaurant near her home. So much catching up to do...we spent hours chatting and eating and snacking and chatting some more.  I had nothing on my schedule...so spending 6+ hours catching up wasn't unusual.  8pm...time to part ways and get ready for the upcoming week.  I was excited but nervous to take the hour-long drive home, and mentally prepare for my last two injections -- the culmination of a long, painful IVF treatment and the beginning of new life hopefully.  I'd have just enough time to get home, pour a glass of wine, prep the injections and chill them in the fridge before 11.   ....or so I thought!

"What's wrong....your headlights aren't on?"
"uhmmm....my car won't start".  I remembered earlier in between snacks, I tried to get into my car to grab my portable phone charger but the remote wouldn't work. I assumed its batteries needed replacement and opened the car with the physical key instead.
"Do you have jumper cables, because I can align my car with yours and jump your battery?"
"Sure".  Finally....a chance to use my Christmas gift....I've had them for 3+ years...they were beginning to collect dust.

"I have never jumped a car before...but have seen it done on TV"  I said to her.
"Oh it's easy...just hook two ends to your battery and two ends to my battery, start both cars together and VIOLA!".

25 minutes later...we were reading the Audi manual trying to locate her car battery.  It wasn't exactly intuitive.

We spent about 1.5 hours on this process.  In that time, 3-4 different families emerging from the Indian restaurant offered to help.  One guy read the manual front to back and insisted the car battery was either in the trunk of the car or under the passenger-side seat.  Bizarre!  Another guy insisted that Audis don't have car batteries, instead moving his car into that spot would serve us better.  We obliged.  Nothing!
Another guy brought his car over and claimed to have been a pro at jumping cars, and that my spark plugs were damaged.  His mother, insisted cars usually don't start when the wheels are crooked (they needed to be turned facing forward before the car can start).  That was my first hearing this new myth!  Others claimed my starter was damaged and battery was perfectly fine.

It seemed not one person in the entire Indian population in Central Jersey knew much about cars.  It was almost 9:30pm and I was getting very nervous.  I wasn't nervous because I'd possibly be without a vehicle for a few days but because I needed to be home precisely at 11pm to inject my trigger shots or the ENTIRE IVF process this cycle would have been in vain.  The trigger shot would cause the follicles to release the mature eggs (ovulate) and the medical team would have to extract the eggs exactly 35 hours later (10am a day and a half later).  I had to do my part, in order for this to work.  Being an hour away from home where the drugs were, didn't help.  I called my husband to alert him of the problem and advised he make the trip to me with drugs in hand.  Meanwhile, our roadside assistance dispatched a mechanic who ...within 20 mins, arrived and successfully started my car.

And the race begins....as my husband was arriving, we were finishing up.  It's 10pm.  We both raced home in our respective cars...made it home in 49 minutes.  Ran upstairs.  Washed hands.  Mixed injections...no need to refrigerate...prep alcohol wipes....wait. 11pm -- pinch skin, wipe with alcohol, stab skin, inject!  11:03pm -- pinch skin, wipe with alcohol, stab and inject #2.

Inhale glass of wine.  Get seconds.

....and a third!

I Can't Laugh

....or cry.  or sit.  or stand.  or cough.

.....or do much that requires the use of my lower abdomen without cringing in sheer pain!

Why?
There are two orange-sized ovaries in my body...carrying 24 gigantic follicles with eggs.

just a really cute picture of
 almonds and a sliced orange

Let's put things in perspective for you:

• In a normal cycle, those ovaries would be the size of almonds.  ALMONDS!  So imagine the abdominal pressure.  
• and yes, theoretically, I'd be pregnant with 24 babies if each of those eggs were fertilized with sperm.
• do that math on THAT childcare bill!

So here's the timeline:
1.  Each of those follicles are measuring an average of 15mm
2.  They'll keep growing and we'll consider them mature around 22mm or so....any day now.
3.  Once that happens (ultrasound will show this), I'll inject myself with a trigger shot which will cause them to release the eggs.
4.  35 hours later, I'll go in for an egg retrieval surgery.
5.  ***still on the fence about how I want them fertilized during this period***
6.  Go back in for surgery 5 days later for embryo transfer
7.  Wait.......


No seriously...wait for an update ;)

Access Denied!

Dear Patient,
We're writing to inform you of a coverage denial. 
This request is denied as not medically necessary because: there is no available documentation of a current problem you or your partner have that indicates you meet criteria for needing intracytoplasmic sperm injection (ICSI), which is generally required if there has already been a problem with fertilization during in vitro (IVF).  Your partner's only recent semen analysis is normal.  Therefore we cannot approve ICSI for you at this time.

.. my insurance company wrote that in a letter to me this week.  Bast**ds!

So, remember in 2012, we discovered a Crohn's Disease maintenance drug produced toxic antibodies in his semen?  Well, we ditched that drug and he went for a biologic that not only kept the disease at bay (remission) but has no effects on reproduction (that we know of).  Latest semen analysis is normal.  POOOOF!!! goes the male factor!

But, there's still the question of the quality of my eggs....since I had aggressive chemotherapy treatments at 25 years of age.

Since it's 'unexplained' infertility....the lovely insurance company won't cover the ICSI portion of the procedure.

Luckily, we're in a research hospital so get the benefit of most of their cutting edge science without additional costs.  Nurse responded back to my text about the coverage denial saying "we'll eat the cost, because we feel you're a perfect candidate for this".

Now we just have to decide if it's worth it.... is it?

I'm huge...

after a week of 3 daily injections
(2 in abdomen below belly button and 1 on thigh)

Routine ultrasound yesterday showed my right and left ovaries have produced huge follicles....hence the semi-pregnant, bloated look and feel on my otherwise flat belly.  Next week, they'll mature (hopefully no later than Monday so I can go on a previously planned vacation....more on this topic later!)

So, you probably have a ton of questions....one being 'what the heck is a follicle and what does it have to do with IVF?'  

Remember you (a woman) are born with all the eggs you'll need for a lifetime....about 5 out of 6 million disintegrate while still in your mother's womb (science hasn't figured out this weird phenomenon ...yet).  So we're down to about one million....and you've hit puberty and now menstruate monthly.  At the beginning of every cycle (day 1 of your period), you have several immature follicles that will start to mature - which means they develop an egg inside them) -- at some point one will become the dominant follicle and make it all the way through ovulation.  The non-dominant follicles eventually disintegrate and produce a bunch of odd hormones your body needs, i.e. progesterone. 

But when you're on ovulation-inducing meds for fertility treatments, instead of one follicle being dominant and reaching maturity, there'll be several.  A mature follicle means it's a follicle ready for ovulation -- the developed egg is ready to be released in hopes of fertilization taking place.  Once the follicle reaches a certain size (maturity size), it'll release the egg -- ovulation  -- around day 14 after your period.  If there's sperm present, they make sweet love...and you're stuck with childcare bills for a longgg time!  

*cringes at childcare bills....ughh!*

Where were we? 

Oh yes....mature follicles! 

So with IVF treatments, my medical team will determine a comfortable maturity size for those follicles (probably around 15mm+), then instruct me to give myself a trigger shot (hCG) to cause ALL mature follicles to release their eggs.  Within 12 hours of the shot, I'll be in surgery for egg retrieval.

to ICSI or not to ICSI...

"Hello?"
"Dr. **** here.  Got a minute?  Let's chat.  I reviewed your history with the team and the consensus is you two should undergo ICSI.  You don't have to make the decision now...talk it over with [him] and you can change your mind as late as the morning of your embryo transfer".

So a few weeks ago, we were in a mandated IVF educational session with four other couples.  This 5+ hour catered session was facilitated by the Chair of the department and a very well respected, accomplished, and published OBGYN.  This particular fertility institute prides themselves in the partnership between patient and doctor -- at each juncture in the process, a discussion between all parties is held and a decision is reached no matter how difficult.  At no point does the medical team impose or force their recommendations on a patient unless the alternative is deemed medically unethical.  [This was not the case in our dealings with the previous fertility clinic]  In the session, we learned everything one needs to know about IVF -- and since we're in a research hospital, we also learned their particular techniques and madness behind their unique methods.

Where as IVF generally involves exposing harvested eggs to motile sperm in a dish hoping for fertilization, ICSI takes it a step further.  An embryologist selects a single sperm from the sample, clips off the sperm's tail and injects it directly into the egg, then monitors the progress hoping for fertilization within 2-3 days.  If it takes, they let the egg mature (another 5 days) then transfer the blastocyst into the woman and hope it implants -- if so, you're pregnant!  This process is usually recommended for a number of reasons...in my case, because I have unexplained (or undiscovered) fertility.  If you recall, I had chemo at 25 years of age without having harvested my eggs  --- could they have been fried? (pun totally intended....lighten up people!!!!)  The quality of my eggs is unknown at this time...

ICSI sounds like a no-brainer!  Why come this far and not afford yourselves the best chances for success?
---------------------------
This juncture....this science.....is a huge point of contention in the field, the doctor added.  There's great debate on whether this process leads to higher rates of birth defects.  He added that normal IVF pregnancy birth defect rate is 1-2%, but with ICSI it's 2-4%.   Are one's chances indeed doubled? Or is the sample of IVF patients so small and that of ICSI even smaller for this statistic to be noise-worthy?

I love DRUGGGS!

Scroll down.  A little lower.  Yep...that's today's cocktail.....DRUGSSS!    Nurse called yesterday with results of blood test.  My estradiol levels are sky high -- apparently I'm responding very well to the hormones, so time to adjust one set of meds and add more.

1.  Ganirelix:  peel pre-filled syringe, tap and push out air bubble, find sweet spot on thigh, cleanse with alcohol wipe, stab thigh, push drug, enjoy the high!    Ahhh....air bubble on thigh.  Someday I'll get it right!
2.  Untwist cap, take doxycycline -- wait...remember the incessant vomiting spell on Saturday? Oh no, not falling for that again.  Spit out pill. Run downstairs for food....anything...ahh, a boiled egg.  Inhale boiled egg, grab water, try again....pill swallowed.  Success!
3. Hours later, adjust dose on Follistim pen, find sweet spot on lower abdomen.  Wait....did I inject on the left or right side last night?  Shyt...I can't remember.  Pick a spot, wipe with alcohol, insert needle cap onto pen, pinch skin, stab!  Ok...that stings!
4.  Pull out long needle from new syringe, discard in cute biohazard container.  Twist plastic cap, insert in liquid menopur, pull  liquid, then insert in powdered vial, mix, pull mixture, replace syringe with smaller needle, find sweet spot on abdomen......yet again.....stab, push medicine....try not to flinch!
5.  Take another doxycycline pill.
6.  Carry on with the day.

FYI:  I'm deathly afraid of needles.   Ha!  Gotta love God's sense of humor!
How do I feel today?  Crazy!  I'm pretty convinced half these drugs are stimulants and totally suppressing my appetite and the other half are depressants and make me want to eat chips and ice cream (specifically ice cream sandwiches) between the hours of 4:15pm - 6:35pm daily.   Weird!

While chatting with nurse, she asked if I watch the Lifetime Network (really awesome tv network full of sappy woe-is-me movies, great for a good cry after a nasty break up, and a sad depiction of Tori Spelling's train-wreck of a life....omg have you seen that show???  poor girl. anyway....I digress).   In any case, she cautioned against it, or making any important life decisions in the next 2-3 weeks, or engaging in emotionally charged discussions.  "The drugs will make you crazy.  Think about what's happening...we're completely manipulating your body with drugs, stopping it from undergoing normal processes in any given cycle, telling it when to produce eggs, how many to produce, how large to make them, and oh by the way, don't ovulate until we say so....you're not yourself, so don't try to be.  You're undergoing a major, albeit temporary, change and you'll feel and act out in ways you never have.  Best advice for [him] is to respond 'yes dear' to every single request for the next two weeks."

Ha!  This is going to be torture FUN!
The possibilities are endless....new shoes, new car, endless massages, breakfast, lunch & dinner in bed, ICE CREAM IN BED.....maybe even a new house....HA!    *insert evil laugh here*

Why IVF? ...a lil' background

You're probably wondering why a perfectly healthy 32 year old needs IVF to conceive, right?  No?  Well...I'll tell you anyway.

I'm 32, 5'4, 136lbs, in good health -- what gives?  Well, it's much more complicated than that.

At 25 years of age, I was diagnosed with stage 3 colon cancer -- random abdominal pains during happy hour that grew increasingly worse over night and led to a trip to the ER whose CT Scans revealed an interestingly exploding tumor just above my perfectly normal appendix -- I managed to finish all 6 martinis before heading to the ER though....I just don't believe in wasting alcohol!  Colorectal surgery and a ton of chemotherapy treatments later (March - November), I was free!  I gave up 12 inches of colon, a full head of hair, lots and lots of brain cells (a good chunk of my long term memory found the exit door).....for a clean bill of health!  But one very tiny important detail that will come to [haunt] me later on in life:  I didn't get to harvest my eggs!
Why?  There was no time. Surgery was on Jan 29th, and I was given 8 weeks to heal and warned that chemo needed to start IMMEDIATELY after healing so I could have the best chance at killing the cancerous cells moving aggressively into my lymph nodes and towards my liver.  Chemo started on the 57th day after chemo....exactly 8 weeks later!

In 2012 a routine gynecology visit, reviewing my healthy history, my ObGyn suggested I visit a renowned fertility doctor in South Jersey to rule out any potential issues from my treatments that may prevent [us] from conceiving should we choose to in the future. It was a horrible experience -- very much a factory, little to no humanity in the staff's or doctor's dealings with us, and their methodology was comprised of antiquated medical practices.  For something so personal and sensitive, one needs a more ginger approach.

Despite the horrific experience at Dr. *****'s practice, we discovered one key issue:  a male factor!
My husband had been nursing Crohn's Disease for many years, having only 3 hospitalized flares (at the time) in his life (one upon discovery at 16, the second while defending his Ph.D, and the third a month after our wedding.....and no I was not a bridezilla!)  The disease was seemingly under control with the treatment of Azathioprine (an immuno-suppressant), so we thought!  But it wasn't!  It was producing antibodies in his semen that essentially made his sperm toxic to me.....and him!   It had devastating effects (unbeknownst to us initially) on our efforts to conceive.  He ditched that drug, and switched to a biologic. but not before one last flare on new year's eve 2012....oh yes, I watched the ball drop from a very uncomfortable hospital recliner as he fought for his life ---- FUN!

PS:
I'm African with no family history of colon cancer; father died of lung cancer (non-smoker), paternal aunt died of breast cancer both in their 50s, siblings are alive and healthy.  Underwent genetic testing, which revealed inconclusive mutation in my genes for colon cancer, not enough data to make an absolute determination on impact on future offspring, and 12% chance of breast cells becoming cancerous -- again, data is just in the noise; not enough to cause panic.
Husband is 38, 5'6", healthy BMI, African American, no family history of Crohn's or cancer.  Siblings are alive and healthy.

Quest for New Life

I'm not even sure where to start so I'll start with now....

After many ups and downs and disappointments and probably blessings in disguise...I'm here, the fifth day of my IVF cycle.  Let's take you back to the first day.  I drove up to the hospital (I was summoned by my medical fertility team) completely in a haze/daze/total confusion and probably in the middle of a mental breakdown after yet another unsuccessful IUI cycle -- a nurse (now my nurse) and a doctor (apparently my new BFF) propped me up on a table, spread my legs, inserted ....quite a few instruments -- minutes later I heard "great, the mock embryo transfer is done, now draw her blood".
Then I was in a room (not sure how I got there or even how long I was there) being shown how to inject myself with the various drugs I'll need over the next 2-3 weeks in preparation of an invitro fertilization.  "You have to return with [your husband] so we can show him how to inject your progesterone....you look like a deer in headlights.  Do you have a living will?  Did you both sign the consent forms?  Did you absorb anything we taught you today?"  I just nodded anxiously (or perhaps frighteningly).   Everything was a blurr.

That afternoon....I returned my girlfriend's call, not because I was in the mood to talk or share ....but because I needed an escape from my torturously loud and disruptive thoughts racing a million miles per hour!  She was excited about her upcoming trip to Barbados and went on and on about her new hairdo and shopping and the anticipated lovely weather and the beach and the sunset...she probably heard the echo of my heavy tears splash on the tile floor of the library gallery I entered to hide from my reality....   She prayed with me.

At 10pm, I was to prep an injection pen with 150 units of Follistim and inject into my lower left abdomen.  ...but not before holding the needle dangerously close to my abdomen (accidentally stabbing myself a few times and drawing blood) as I trembled and wept for a good 35 minutes....out loud...while my husband stood by me, helpless.  He couldn't rescue me from this one....I had to learn to self-inject, as it would be one of many in our long journey ahead.  It would be one of many daily trips to the hospital for blood work and ultrasounds, to monitor my vitals and determine the injection dose for the next day -- sometimes up to 4 painful injections a day -- all working in tandem to stop my body's normal ovulation cycle, manipulate it to produce multiple follicles with multiple mature eggs, so they can be harvested, inseminated, then implanted back in my body.  By the way....that's essentially the definition of IVF.

Today -- I'm an emotional wreck.  The manipulation of my hormones has been quite challenging for me emotionally and mentally.  I'm sorrowful, tearful, half-present in conversations, depressed, incredibly tired often, vulnerable, paranoid (as hell), impatient, not confident....and the list goes on.  You probably need a little background...so please, tune in for more!