Club Med

Well...I finally got all my medications squared away today after pouring over price lists from various specialty pharmacies for days and weeks. It's amazing how much once pharmacy can vary from another on the same drug-and I'm paying cash!

Anyhow, for those of you that are interested, here is a listing of the drug regimen that I will have to follow. I should be starting this sometime around Thanksgiving. So say some prayers for me that I can handle giving myself the injections (I HATE needles) and also for my family that they can deal with all these hormonal changes that are going to happen. Very interesting that the whole family is going to be exposed to our ordeal since we'll be seeing them all over the holidays. Best of luck to them. ;)

• Bravelle 75iu injections + Menopur 75iu injections - these are the FSH drugs that stimulate the ovary to make mature eggs as well as inducing the development of multiple eggs
• Ganirelix Acetate - this is a GnRH antagonist which controls ovulation and prevents premature ovulation until triggered by a HCG injection
• HCG - human chorionic gonadotropin - induces ovulation
• Crinone 8% gel - a vaginal progesteron it prepares the lining of the uterus for implantation of a fertilized egg. Since women going through IVF likely will not produce enough progesterone on their own because of the drug to control ovulation this is needed to provide that necessary hormone to thicken the uterus for our little embryo.

And So It Begins...

In the words of the old saying, "No news is good news."

My apologies for not updating anything here in such a long time. I was waiting on my next cycle to begin so that I could get dates for the procedures/stimulation meds.

So-after this last weekend, I am officially on schedule for a fresh cycle of IVF.

My protocol is as follows:

- birth control pills from now until Nov 20 in order to control the length of my cycle
- begin my follicle stimulating hormone (FSH) daily injections along with daily Menopur injections. These will stimulate my ovaries to make mature eggs and induce the development of multiple eggs. I will do these injections every day for about 1 1/2 - 2 weeks.
- the week that Dr. Fritz does my egg retrieval I will take injections of a gonadotropin-releasing hormone antagonist (GnRH antagonist) called Ganirelix Acetate. This controls ovulation and prevents premature ovulation until the trigger shot is given.
- the night before my egg retrieval I will take a shot of human chorionic gonadotropin (HCG) to induce ovulation
-somewhere from 3-5 days after the egg retrieval, I will have the embryo transfer.

It's all very surreal that it's actually happening after all this time. I'm excited and nervous at the same time. I'm definitely NOT looking forward to giving myself shots but maybe after the first 2 or 3 it'll get easier.

I have sort-of a No Fail attitude about everything. This can either be very good (because I believe that your mindset controls a lot of the outcome of things) or bad (when I'm devastated if it doesn't work). However, for now, I choose to remain positive that God has his hand on my life and is working through me to fulfill his will.

Prayers are much appreciated over the next month or so. I look forward to (hopefully) sharing good news in the near future.

Bringing You Up to Date

I wanted to take a quick moment to update everyone on where we are as of today.

Earlier this afternoon, I sent the signed forms and payment information off to Attain IVF program.  This came after lots of prayer and asking for God to take care of us emotionally and even financially.

We do not have any further appointments at this moment but I will share what I can when things start moving forward again.

Thank you to all those that have been praying for us along this journey. JGIII and I are both excited about what the future holds and know that as long as we trust in the Lord's plan we will see His spirit shining down on us.

Mock Transfer & Saline Ultrasound

Things have been moving along "normally" over the past month since my last visit which has been fantastic news. I was able to have a somewhat normal cycle (for me) this month although it was while I was out of town which made it slightly more difficult to manage. The pain was definitely increased from last month but still nowhere near as bad as before the surgery.

I had an appointment scheduled for yesterday, the 17th, for the saline ultrasound and mock transfer. It needed to be done as early in my cycle as possible so that the lining of my uterus was the thinnest.

When I got to the office yesterday...it was the most crowded I've ever seen it. Apparently, this meant that Dr. Fritz was also extremely backed up. We ended up waiting over an hour for the appointment. SO FRUSTRATING! I couldn't even reschedule because I needed it done this month and I can't do it any other day this week.

The actual meeting with Dr. Fritz went fine and we all concurred that we are on track to move forward with IVF. When it was time to do the actual procedures, Dr. Fritz asked if it was ok for the other doctor at the practice to perform them because he was so backed up. While it wouldn't have been my first choice, I said yes because they were supposed to be easy and quick. I should have known better. Nothing I do is ever easy and quick when it comes to this.

First, we were doing the mock transfer. It involved placing the speculum to insert a catheter into the uterus to measure the length and depth. As it's similar to a normal pelvic exam, I'm already not a fan of this. I thought well at least it won't take long. Problem was my cervix apparently had an odd angle to it that was preventing the catheter from going in the way it should have. She had to add an additional clamp onto my uterus itself which she referred to as a "mean clamp". That device truly lived up to it's name. I'm pretty sure it was some sort of medieval torture device that was dug up in a closet. After 2 failed attempts, the doctor said she would give it one more try and then get Dr. Fritz if it didn't work. The good news was that it went straight in on the last attempt and we were done with that portion. By the end though, I was in tears because it had me so stressed out from the pain & cramping. Not to mention the thoughts that kept running through my head about having to go through this again on the day of the actual transfer.

Next up was the saline ultrasound to determine if my uterus is healthy enough for a pregnancy. The doctor said this should be the easy part. By now, I should have been able to predict that there would be nothing easy about this either. Again, the speculum was in place in order to insert a catheter into the uterus. About 10cc's of saline were to be injected through the catheter into the uterus after removing the speculum. The problem was that every time the speculum was removed and they started to inject the saline, the catheter would pop. This was repeated 5 times. Unreal. On the last attempt, the doctor was able to get 2 quick pictures of my uterus. Not optimal but enough to get an idea of what everything looked like.

Apparently, my cervix has an "S" shape to it or curve which was the problem with the mock transfer. Good news is that she confirmed that my uterus still looks great which I'm hoping is a wonderful sign for pregnancy. She went and got Dr. Fritz to come in and talk to me about everything and look at the images she had captured. He was super positive about everything and just told me to think of it as being "special". I think I could handle not being special right now. He gave me a big hug and told me to try not to worry. The reason for doing all these tests is so that on the day of the actual transfer, we have NONE of these issues arise. He said that I won't feel any cramping like I did during this because they have little "tricks" they can do to prevent that.

So, I still don't know when we are to actually start the meds. I'm emailing the practice today to tell them which payment option we decided upon and find out what we need to do about that. I guess we'll get more information after that.

At least, I'm another step closer to having our dream become a reality...

Short Term Plan in Place

Great news....we've made another step forward and now have a plan in place!

JGIII and I met with Dr. Fritz yesterday for a post-op appointment as well as to develop a plan to move forward. He remains so upbeat about the results from the surgery. The pathology came back showing that he did in fact get the left fallopian tube disconnected from the uterus, however, the right side was inconclusive. Doesn't mean that it's not disconnected but the pathology cannot prove that it was. Dr. Fritz actually joked that my insides were like "Where's Waldo". I love that he shares my sense of humor.

The next step is coming on June 17...the day I get back from Girls State. He needs to do a mock transfer as a way to completely map the shape of my uterus and a saline sonogram which uses ultrasound to look at the walls of the uterus.

We also have to decide by that date how we're going to pay for this process. The interesting thing about the cost options we were given is how different it was from Carolina Conceptions. The price for 1 IVF ("Fresh") cycle and 1 frozen cycle together at UNC Fertility is the same as the cost of 1 fresh cycle at CC. Amazing how 2 offices that offer the same services can be so different. UNC Fert also participates in a program called Attain IVF which offers packages for reduced costs. I don't qualify for their refund program (if you are unsuccessful you get a refund up to 70%) because I'm not "normal". Go figure. LOL The program that I do qualify for gives a discount of 32% for 2 fresh and 2 frozen cycles. We now have to weight out whether we think we might need 4 rounds of IVF. It would definitely be cheaper if I get preggo the first time and don't have to pay anymore. At this point, I think we'd pay whatever to be able to have our own little baby.

Finally, in July I will start with injectable shots of Lupron. I actually had been reading about this drug yesterday because it is used by a lot of doctors to treat endometriosis as it brings on menopausal symptoms which should lesson the development of the endo. I will only be on this for a short time to prevent an early surge of LH which would cause my ovaries to release eggs before they are ready to be retrieved.

I'm so excited to have things start falling into place! I can't wait to see what God has in store for us next. Wish me luck!

Unexpected Answers to Prayer

My apologies for not writing this earlier and waiting almost 4 days after surgery to give a complete update. Mostly, I didn't write because I felt like poop over the weekend. Thursday's surgery sure took a lot out of my body and definitely took some recovery time that I hadn't counted on.

Getting up Thursday morning, I thought I knew exactly what I was headed into as I took my last sip of coffee before I was NPO 2 hours prior to being at UNC for the procedure. We arrived at the Ambulatory Care Center (quite large outpatient surgical facility on UNC's campus) exactly on time and met my mom and dad there. It's nice to have so much support from family that they are willing to be there no matter how small the process is. It probably helps that I'm the only one. :)

We got checked in at 10:45 AM but UNC was fairly backed up when we arrived so we still waited until after noon before they finally had a pre-op bay ready for me. Once in pre-op, there was plenty more waiting around. Dr. Fritz had a surgery prior to mine that took a little more time than he had planned. Knowing that he took his time with that patient, I knew that would do the same for me. Dr. Fritz came and spoke with me before they took me back along with 2 other doctors that were consulting with him and working on his team. The plan was to do a VERY simple entry into my abdomen (probably into the upper left quadrant of my stomach area rather than the belly button because of the concern about the pelvic adhesive disease and scar tissue). There was to be 1 other incision to put the tools into place to leave the clips on the tubes at the place where they came into contact with the uterus. IF he opened me up and saw too much scar tissue, he was going to pull right back out and not "stir anything up". The surgery was to take about 1 hour.

The last few things I remember were getting the anesthesia in my IV line and being wheeled in to the OR. It seemed like there were SO many people and I thought to myself-wow, there sure are a lot of people here just to take care of me. They got me moved onto the table and I don't remember anything else.

Next thing I know, they are waking me up in recovery and I overhear someone saying that it was 5:30. I was clear enough to think that couldn't possibly be right because my surgery was supposed to only an hour. They brought JGIII and my parents in right away which was good. Dr. Fritz had been able to go out and talk to them several times during the surgery as well as on his way out of the hospital when it was over. What was supposed to have been fairly short and uncomplicated, turned into a 3 and 1/2 hour surgery with some bumps along the way but ultimately a good outcome.

Dr. Fritz observed that I did have a large amount of scar tissue and adhesions but, wanting to give me the best chance at IVF possible, decided he had come so far that it wouldn't be fair to just stitch me up and not do anything. A great thing about being somewhere large and having the research basis that UNC does enabled him to call in a surgical specialist that had dealt with issues like this adhesive disease before. The specialist was able to move the scar tissue out of the way so that Dr. Fritz could actually be in contact with the tubes at the site of the uterus. Instead of putting the filshie clips in that we had discussed, he clipped them. This way the fluid that I was worried would then accumulate in the tube would spill out into the abdominal cavity and be absorbed by my body anyhow. Yay! Prayer answer #1.

While he was looking at this area, Dr. Fritz was given a much better picture of the cysts that we had been dealing with. On the left ovary, I knew that I had a considerable in size cyst that had not gone down in size after the abscess was treated a year ago. What I didn't know, and no one else did because it's not visible on an ultrasound, is that it was a chocolate cyst (or endometrial cysts). Rather than grossing you out with a description of this, I'll just give the wiki link for it...http://en.wikipedia.org/wiki/Endometriosis_of_ovary.

As I've mentioned in earlier posts, I live most every day with some degree of pain-usually requiring a constant regimen of ibuprofen. Of course, my GI doc doesn't want me taking the ibuprofen but Tylenol just doesn't cut it. Dr. Fritz was able to drain these cysts which have been the cause of all of this pain for months and months. Yippee!! Prayer answer #2.

This was totally not the purpose of my surgery but the benefits are two-fold.
1. I should have much less (maybe none) pain going forward towards IVF. Knowing that the stimulation of the ovaries to prepare for egg retrieval causes greater pain in and of itself, I wasn't sure how I would be able to deal with this combined pain. Now, I shouldn't have as much to worry about.
2. With the chocolate cysts removed, Dr. Fritz will have an easier time sending the needle into the follicles around my ovary when they are ready for egg retrieval.

Needless to say-I'm not complaining AT ALL about the extra time it took to finish the surgery. Recovery was a not much fun over the weekend but I learned the anesthesia takes a while to work out of your body and apparently a nerve gets aggravated when they inflate your diaphragm with air to perform the surgery. That nerve takes a little time to settle down but in the meantime, your neck and back ache like crazy.

I am so elated that some "extra" things were done to increase my IVF chances and so hopeful for a positive experience.

Right now, I have a follow-up appointment in 3 weeks to have x-rays and determine that in fact, the tubes were cut from the uterus. If Dr. Fritz determines that they didn't actually cut the tubes, there is another procedure that goes through my uterus to get this done. Then he is looking at mid-July as starting the initial IVF process. He has a concern that if we wait too long, the endometriosis will start to come back and cause the same complications that we tried to tame down already.

So new at this....

I'm sure there is some fancy way to do this but I really don't know what I'm doing so...

I wanted to give a back story to this journey for us. I have written several other posts on my other blog but they really didn't fit the "creative" aspect that I started that one for.

I'm "pasting" them here because, again, I'm an idiot when it comes to this blogging stuff and I have no idea how I can just share them.

Uncertainties
Wednesday, March 27, 2013 (1)
I wasn't sure how I felt about blogging about this process but I have been reminded that there are so many people that have gone through this scenario before me and have lifted me up with their experiences that I would like the opportunity to do the same for someone in the future. I feel like that's one of the reasons that God has put me here on earth.

A short back story...I have had painful periods for as long as I can remember. My doctor originally put me on birth control to make it ease up and for years I was fine. After JGIII and I got married and we decided to start a family, I was no longer going to be on these pills. I began having worse and worse pain every month but thought it was something we (as women) just had to live with. I refused to ever let that be a reason for missing work or not being able to do something. Fast forward to 2 years ago. In a routine visit with my endocrinologist about bmy thyroid issues, she discussed with me the possibility of having Polycystic Ovarian Syndrome (PCOS). No one had ever mentioned that to me before and after a simple blood test for my hormone levels, it was determined that I did in fact have that. I was put on Metformin (a diabetic drug) that has been shown to help with PCOS. After being on that for only 2 months, I ended up being in the hospital diagnosed with Ulcerative Colitis (a whole 'nother ordeal lol). While I was there, they confirmed that I didn't have quite a few cysts surrounding both of my ovaries. I got the UC under control and was seemingly fine. However, I was still not able to get pregnant and having those painful cycles. Each month that went by was more frustration and heartache that it hadn't worked.

Fast forward to 1 year ago. I was at home with the flu (the real flu-it'll teach me not to get a flu shot) and of course started my cycle at the same time (Murphy's Law). I was having such bad pain that I finally had to go to the emergency room. They decided it was my appendix which they removed but made sure to tell me that the cysts that had been on both of my ovaries were now abscesses. I left the hospital from the surgery and returned right back the next week because the pain had actually increased. Turns out those abscesses were causing high fevers and LOTS of pain.

My ob-gyn finally saw me and did an ultrasound. Something had to be done immediately. I was admitted for my 3rd hospital stay within a month and placed on high intravenous antibiotics. They also attempted to drain the abscesses around my ovaries. This was all the doctors combined efforts to save the ovaries as I was still trying to get pregnant for the first time. The procedure worked on my right ovary but not on the left. They successfully got the infection under control and happily I've had no fevers since then. However, in the past 2-3 months, the pain has been coming back with a vengeance. Some days I can go with only taking Advil/ibuprofen at bedtime other days I have to be on it every 6 hours or I can't function.

Because of the problems with the abscesses, my ob-gyn said I will have to see a fertility specialist to assist in our getting pregnant. I had my first appointment with a local clinic that many people I knew had used and were successful at. I met with the doctor on the first visit who told me there would be nothing they could BUT in vitro fertilization. I was totally not prepared for that. Because of the damage that was done by the infection, much of the area surrounding and including my ovaries is damaged. My fallopian tubes are at least partially blocked and the fluid that is supposed to be absorbed by your body is instead cycling around through my tubes, uterus, etc. This fluid will be instantly toxic to any egg or sperm that encountered it. The doc wanted to perform a sterilization procedure on me to seal off the tubes and keep this fluid out of the uterus. Wow! Imagine going in thinking they would go over the several steps you could take before in vitro but being told they wanted to "sterilize" you. Needless to say I was shaken up. I had been at this appointment alone because JGIII couldn't leave work and I was falling to pieces. I honestly felt hopeless at this point. To top everything off, before I left I had to meet with the financial person. I felt like they were just there to take my money.

As I am not one to relinquish control on anything, I decided to get a second opinion. I had several other people who recommended UNC Fertility. I did some online research and decided to give it a try. My meeting with Dr. Fritz was awesome. He spent SO much time with me and made sure I understood everything that he was talking about. He didn't rush or act like he had something else to do. He was totally honest with me that my body is really failing me in this area. He told me the same things that I had been told at the other clinic but I didn't feel like all hope was lost.

We are taking everything one step at a time.

Today is the first step. I had my AMH (Ovarian reserve) levels tested to see what my total number of egg storage is like. As long as it's good, it means that if we go through with the in vitro, the stimulation would be able to produce eggs. I'll be meeting in a short little while to get these results.

I'm saying lots of prayers today that things work out. I know this is in God's hands and I need to, as they say, "Let Go and Let God". Easier said than done sometimes.

Quick Update to "Uncertainties"
Wednesday, March 27, 2013 (2)
I wanted to write a quick update to my earlier post today...

Just got back from my appointment with the fertility clinic. Again, I can't stress enough how great Dr. Fritz is. If anyone is reading this, or knows someone who needs a reference on a fertility clinic I will definitely back them for everything I've had up to this point.

I had asked that other fertility clinic to send over my medical records (really just the results of the AMH blood test I had done) to UNC Fertility. As a reaffirmation of why I was NOT in the right place when I went there, they sent over records on a completely different person attached to my release. After calling and relaying my frustration to them (I was polite lol) they did manage to find the correct information and fax it over.

The good news....my AMH levels were great! Dr. Fritz couldn't have been more pleased. For those of you with a medical background, it was 7.4. Not sure what "normal" is but it was good news all the same. Before I left, Dr. Fritz wanted to do an ultrasound to get an idea of what my reproductive anatomy looked like.

He also had some concern that the ovaries had been moved out of place and were behind the uterus. More good news-they were right where they were supposed to be. :) The left ovary is VERY large (7 cm - 8 cm/normal is 2 cm) which presents it's own problems.

The next step is a surgical procedure to clamp off the tubes from the uterus. This will keep the fluid from getting into and possibly damaging the uterus. It also means that the fluid will not be there when they attempt to implant an egg down the road.

Overall...I give this appointment an A+. Dr. Fritz was encouraged by the news we had today and, like me, is taking this one step at a time.

God truly has answered all my prayers up to this point and I will continue to trust in Him that His will for my life will be done.

By telling my story, I have been reminded what terrific friends I have in my life. Those of you that I don't get to see or talk to on a regular basis, know that you are just as special to me and that your prayers and thoughts mean more to me than you know. To those of you that I lean on each and everyday (you know who you are)-thanks for always being there for me. Love to you all!

Under the Knife
Wednesday, May 1, 2013
I had NO idea what to call this blog post but I did want to share this part of my journey here since I have had so many people supporting me and reaching out to me throughout this journey.

I mentioned in my last post, after my most recent doctor's visit, that I would have to have a surgical procedure done to close off my fallopian tubes in order to keep the fluid that is created in them, out of my uterus. This fluid has been described to me as "toxic" to both my eggs and any sperm that are introduced as well as similar to oil in that if the doctor was to implant a fertilized embryo into my uterus, it would be very difficult if not impossible to implant along the uterine wall.

The process for rectifying this situation, is by inserting a clamp on the fallopian tube at the point in which it meets the uterus. Bluntly, this is a tubal ligation. However, I like to use the medical term of bilateral tubal occlusion because it doesn't sound as if I am electing to have the procedure done. Trust me when I say, if there was any other process I could do, I would.

1. I don't love the idea of having surgery (who does?) and
2. I'm completely distraught over the idea that I am not going to have the option of getting pregnant naturally after this is done.

All this being said, I have now been told by 2 doctors that my chances of getting pregnant without any intervention, would be almost impossible.That coupled with the fact that we have been trying to conceive for over 2 years (with breaks for the health issues I've encountered), leads me to the decision that this is the best course of action for us to proceed with IVF. I have prayed about this over and over and really have achieved a sense of peace about this procedure.

Worst case scenario (according to Dr. Fritz) is that he gets in there and finds way more scar tissue than he expects. If that's the case, and he can't get to the tubes. He will stitch me back up and not do anything. He assured me that it's OK if this happens, we can still move forward with IVF, it'll just make the journey that much harder. As he puts it, we want to "tip the balance as much in our favor as possible" before starting the process. I'm praying for nothing less than a perfect surgery and for everything to be better than he expects. From my lips, to God's ears...

So, tomorrow, Thursday, May 2, I will be heading over the Ambulatory Care Center at UNC to have an outpatient, laparoscopic surgery done by Dr. Fritz. The surgery should take less than an hour and I should be fine by the weekend, only having "discomfort" as he calls it. We'll see. At least he's giving me some prescriptions in case the pain is more than he's expecting it to be.

There are thousands of women every day that are going through the very same thing if not something much worse. It still can feel lonely at times with no one to share your feelings, etc. with (aside from JGIII of course-although he's probably tired of hearing me talk about it lol).

As always, I am grateful for each of you that has taken the time to read this and support me along this path. For those of you that have reached out to me, either in the comments or on Facebook-a huge thank you. I know that I am not alone in this journey.

New Blog

I've moved to a new blog to start posting about my IVF process. My story didn't really seem to fit under Ashley's Creative Corner so here's a new place I can share the journey that JGIII and I are going on.

Shortly, I'll post the update to my surgery from last Thursday but I wanted to introduce this new site first.

Thanks again for following and keeping up with us!