Wednesday, October 31, 2012

Monitoring Mania

I am already feeling like my car could literally drive itself to Shady Grove. This morning, I woke up and headed town the PA Turnpike once more for an appointment. I was supposed to go yesterday, but due to Hurricane Sandy's arrival, Shady Grove pushed my appointment back a day. 

The office still had no power today, but they did have strong generators which enabled the essential machines to work. I had bloodwork and an internal ultrasound to check out my egg stash. 

For the past few days, I have been feeling slight cramping, almost like bloating, on my left side. The Follistim and Menipur are working; I have eleven eggs on my left ovary and three on my right. 

Dr. Sasson said it looks good but he would like my eggs to be a bit larger and more numerous. He is increasing the Menipur from 75iu to 125iu. 

I head back for another monitoring appointment Friday and then another on Sunday. 

I asked Dr. Sasson if he could ballpark the egg retrieval and the embryo transfer dates. He estimated that retrieval would be next Wednesday or Thursday (11/7 or 11/8) with the embryo transfer the following Sunday or Monday (11/11 or 11/12). 

Side note: Sorry if today's post is a bit jumbled. As I sit to quickly jot down the past days' events, I am constantly jumping up to head to the door to great trick-or-treaters! Tonight is our first Halloween on Grampian. It is so fun to see so many families come out in this area. Even though I am not a huge fan of Halloween, I love seeing so many families out together! Perhaps next year we will have a chubby baby to dress up in some hysterical costume... We will see! 

Sunday, October 28, 2012

Two heads are better than one... right?

Last night, Chris and I met in the kitchen to get all of my meds ready. I am currently taking Menipur and Follistem- two injectable ovary stimulating hormones. I am supposed to take them each night before bed. Talk about a fun routine! While we did sit through an injection class at Shady Grove two weeks ago, apparently we forgot what we "learned". 

We picked through all the meds the pharmacy sent to find the Follistem and Menipur. The Follistem was pretty easy to get ready-- we just put the vial into the shot pen and dialed up to 225 miligrams. The shot didn't hurt at all; the needle was so small I could barely see it!

The Menipur was another story. We had two vials-- one with liquid in it and the other with powder. We mixed the two together. We were supposed to draw 75 miligrams from the mixed vial. To be honest, I think there are multiple ways to go about this process; Chris is a firm believer in only ONE right way. He was disinfecting everything with alcohol and was ranting about reading the instructions. We truly are the tortoise and the hare. He is Mr. Slow-And-Steady-Wins-The-Race and I am Hurry-Up-And-Get-It-Done! 

After a ten minute debate about proper injection protocol, we located the correct needle for the Menipur shot. The needle was so much bigger than the Follistem needle. The shot burned during injection, but it only lasted a minute or two. 

Each night, I am going to alternate which side I inject into so that my stomach won't be too sore. No one told me to do this, but I feel like it makes sense.

I have no doubt that mixing and administering the shots will get easier, especially now that Chris has written down a step by step guide for his own reference (diagrams included). I'm not kidding.

Where did I find this guy? :) 

Friday, October 26, 2012

The Drugs are Here

My fertility medications/shots came today via Fed Ex. Just in case you were wondering what $5,543 of medication looks like, check this out: 

As I take the meds, I will update you as to what each is specifically. I'll also let you know how each is taken. 

I am not afraid of the needles or side effects; I am afraid that I will miss a dose or mess up the drug progression. Shady Grove gave me a chart with all of that information on it, so that does make me feel a bit better. 

It's funny. Today I've had a song from one of my childhood Agape Fellowship church musicals stuck in my head. It is a catchy tune, one that can be borderline annoying. The key verse from the tune is Philippians 4:13: 

"I can do anything through Him who gives me strength."

I'm guessing God doesn't think He's annoying me with it today... He's just reminding me that I'm not alone.

 More updates to come soon.

Thursday, October 25, 2012

In the Thick of Things

I think it is easy for Christians to speak of times of insecurity AFTER they know the outcome. I hear it all the time: "God is so good! I got the job!" or "God is so faithful. My test results came back negative."

Is it necessary to speak of instances where God has blessed us and answered prayers? ABSOLUTELY. Is it easier to share about those instances after the fact, when a favorable outcome has occurred? ABSOLUTELY. 

Contrary to those instances, I have found the greatest solace and encouragement from those rare gems who share what God is doing, or maybe not doing in their lives, right in the thick of it.

Chris and I got back last night from a whirlwind trip to New Orleans. I attended an education conference during the days and Chris took a much needed break from work and toured the city. Each night, we went out on the town, exploring and eating melt-in-your-mouth, classic New Orleans' cousine. 

I was thrilled to have Chris with me on the trip, even though I did have to work for some of the time. It was a much needed change of scenery for us, and a way to help time pass more quickly as our IVF anticipation continues to grow.

We got back around midnight last night. This morning, I woke up at 5: 30 and drove to Philadelphia for a check in with Dr. Sasson. I had baseline ultrasound and blood work. Everything looks within the normal ranges and we are going to START. Finally, the real deal! 

On Friday morning, I will begin taking the new meds: Menipur and Follistem. Both shots will get my ovaries working overtime, hopefully to produce many eggs for retrieval. These stimulatory shots will last between 10-12 days. 

During the 10-12 days of shots, I will have frequent visits to Shady Grove for monitoring. Dr. Sasson will count and measure the eggs, and make sure I am responding appropriately to the drugs (we want multiple eggs, but not too many). 

Of course I will be writing with extensive updates about each phase, but here is my tentative outline:

  • Friday, Oct 26: Start stimulating shots (appointments every few days for monitoring)
  • Sunday, Nov 4: Trigger shot (to cause ovulation)
  • Wednesday, Nov 7: Egg retrieval 
  • Saturday, Nov 10: Embryo Transfer!!

As I was driving back from Philly today, I was trying to uncover what I really think of everything:

I am thrilled that things are finally getting started. I am scared that I will not fare well if we are not able to get pregnant during this round. I am fearful that it will never work. I am hopeful that this will be the final fix. I am nervous that something might go wrong as I start the new meds... It is a continual cycle of hope and dread.

And where is God in all of this? 

I keep reminding myself of the truths about God-- He is constant. He is faithful. But what if that doesn't manifest in the way I want to see it? 

Even as I write this, I have fallen into the trap of what ifs. I continue to fall intro the trap of needing to know what is coming down the road.

In moments of pure panic, (like the one I sense coming on now) I have to remind myself of this: He never promised a blazing spotlight at my feet, outlining every crevice and encounter I will face. He promised a lamp to my feet; He promised to light my path just enough for me to know what is coming just ahead of me, just at the next moment. In truth, He has never failed to light the path. 

I feel embarrassed and ashamed that my faith is not stronger right now. I'm clinging to a nightlight for heaven's sake.

At the beginning of this post, I admitted that people who share peppy, positive post-struggle stories are not necessarily the ones that help me get through tough times. It is not that I do not appreciate their stories, but as I am currently facing a mountain of insecurities, it's not exactly the Positive Pegs who make me feel better. 

The people who openly divulge their hopes and insecurities while they are in the thick of struggle are those who inspire me to hold tighter to my Savior. 

One of my favorite songs has a line in it: He uses the weak to lead the strong... It's certainly something to think about the next time you attempt to put up the traditional facade instead of sharing your heart. He wants to speak through you, even if it feels like you're the only one in the audience.

Sunday, October 14, 2012

Double Trouble or Double Blessing?

Last week I briefly mentioned the prospect of a two embryo transfer. Essentially, instead of picking one of our mature embryos for transfer, we could opt for two. Question of the year is: Is this a double blessing or double trouble?

At our last visit at SGFC, Dr. Sasson really cautioned us against choosing a two embryo transfer. He said many times, people outside of the IVF world see multiple births as being the hugely successful outcome. In reality, Dr. Sasson said that if a patient becomes pregnant with three or more babies, he views the IVF process as a complete failure. His ultimate goal is a healthy mom and a healthy baby. This becomes harder to achieve with more babies in utero. Even only two embryos (and I use the word only lightly) can cause problems.

He said it is his job to give us his best medical advice: a two embryo transfer is not out of the question, but a one embryo transfer is the safest choice.

 A two embryo transfer is an option for us, but he really put on the brakes and made us think a bit about the health risks that two embryos could entail:

- complications during pregnancy for me (possible bedrest)
- preterm labor
- delivery complications
- low birth weight/incomplete development of the babies
- risk of significant time in NICU after delivery

Are the aforementioned risks possible outcomes for a one embryo transfer? Yes, but the statistics are not nearly as high.

Then, there are the realistic, day-to-day consequences of two embryos to consider:

- financial impact (two kids at the same time)
- physical and emotional strain during first months (Can you say exhaustion?)
- time and attention split between two newborns

I will admit, the above two embryo outcomes do seem daunting. However, I am not completely ruling it out.

We have about three weeks until we have to make this choice.

To help with this decision, I asked for more statistics. (Shocking, I know).

One would think that two embryos being placed in the uterus would increase the odds for at least one successful pregnancy. In reality, mothers ages 30 and under, who had two embryos transferred instead of one had only a tenth of one percent higher chance for a pregnancy to result.

We have a 43% chance that we would have twins with a two embryo transfer. It's not like if we do two embryos that we are guaranteed that I will be pregnant with twins.

This afternoon, Chris and I went for a walk; it was the perfect fall day: 55 degrees, sunny, crisp leaves crunched below our feet. As we strolled, we talked about everything I've just outlined above. 

Our conclusion (for today): We are going to try for two. Complications and extra stress possibly included, we want to do a two embryo transfer. 

It's Chris's job to bring this up to Dr. Sasson at our next appointment. We'll see where we are at that point. 

Thursday, October 11, 2012

Watch Out for the Tough Guy

It is a difficult, exhausting cycle to work through: hopes high leading up to Aunt Flow's arrival (hopefully not!), complete devastation when she does arrive, hopelessness for a week, ovulation obsession for the next week, and then the optimistic two week wait again.

The whole process is exhausting! And one thing we've learned is that it is not just the woman's emotions strapped on the roller coaster alone. Chris's hopes and dreams are buckled in too.

Chris and I process differently, but both of us want to be pregnant equally. Each month, we dare to hope for a plus sign on a pregnancy test. The reality though turns into each of us resorting to our coping mechanisms; for Chris, it's running and work. For me, it's cleaning, cooking, running, reading, tv, watching... essentially anything to pull my mind away from the reality that for yet another month, we are not pregnant. 

Amazingly though, we find each other, and find our commitment to each other's needs. We are open books, even when it is painful. We hash it out. We set up the new game plan

While the roller coaster never stops, we do find moments where we LAUGH hysterically, and consequently, love each other even more deeply. 

Last month, when good old Aunt Flow arrived, it was 3 AM. I tried to quietly slip into the bathroom without waking Chris. I tried to stifle a deep, pained, devastating sigh. Walking back into our bedroom, I pulled the covers back and slid into bed. Chris pulled me close, and simply said, "It's okay. I love you immeasurably, even more than you love Christmas, and even more then you love the dog." 

I cried. Then laughed. And I fell asleep thankful for the man God gave me in Chris.

I clearly can't give advice on how to get pregnant. I can though, tell you that you can't experience infertility alone. Ladies: don't alienate your spouses. Communicate your needs. You think that he should know exactly what you are feeling (even though on the damn cycle coaster, it changes daily!). Tell him what you need. 

And, watch out for him too. 

Chris is not always Mr. Strongman. Last week, our friends had a baby. We went to the hospital to see them. I held the baby and chatted for a while. Then, Chris was asked if he wanted to hold the baby. 

I saw it in his eyes. He just couldn't do it that day. He just couldn't hold a perfect, beautiful baby--- a very visual reminder of what we do not have right now.

Usually, he puts on his armor and can make it through these types of situations. But I saw it. I saw his eyes, red and trying to hold it together. 

To cover it up, I suggested that Chris shouldn't hold the baby since he had just come from work and had a million little kid germs on him. For a new and overprotective mother, that worked, and no one pressed Chris's holding the baby any further.

On the elevator down to the parking lot, he grabbed my hand and thanked me for seeing that he needed an out. 

So, here's the take-away: Watch out for the tough guy. He'll watch out for you if you can remember to let him in on what's happening between your ears. Easier said than done I know, but I don't know where I'd be without Chris on this crazy ride. Who am I kidding-- probably vomiting profusely from excessive cotton candy eating. 

Sunday, October 7, 2012

Catch up!

I stated earlier that this blog would outline our steps through the IVF process.

For those of you who are considering IVF, or are just at the starting gate, you're not alone. And to help make those initial steps a bit less scary, I will be writing about each of our appointments at Shady Grove Fertility Center in detail, even if I feel completely embarrassed to include some of the details. Knowledge is power, and I hope that through our experience, you will feel less alone.

Friday, we went for our third visit to SGFC. First though, I want to include a bit about our initial meeting with Dr. Sasson on our first visit:

On Friday (9/14/12) Chris and I went to Shady Grove Fertility Center in Chesterbrook. The main office for SGF is in Maryland, but they just opened a new center in Chesterbrook. It was funny, as we drove to the clinic, we realized it was only a mile from the Howellville house. We felt like we were coming home. So many happy memories and wonderful times occurred in Wayne and Berwyn. It was a tangible reminder of how far we have come in our marriage and how close our bond is to that area. We researched beforehand and found out that insurance would not cover any of the procedures, should we choose to go ahead. We were lucky though, because the initial consult was free for the month of September (as the clinic had just opened in the new location). 

Our doctor, Dr. Sasson, greeted us and took us back to his office. I could tell he had already looked through our charts and info sent from Geisinger. He talked to us for a while and let us fill him in about our situation. He appeared to genuinely care about us, beyond the reproduction factor. He and his wife had encountered infertility and so he was very well aware of our emotions and feelings as we approached the topic. 

He outlined several options for us. The first three were options we had in one way or another, already explored. The fourth (and final) option was IVF. He explained about what IVF is and walked us through a typical cycle. He showed us the success rates for couples from SGF from 2011. For couples under 35, the success rate was 51%. This was certainly encouraging news, as we were in the 10-15% range with IUI and chlomid. At one point, he looked across the table and said, "I don't know why your faces appear to be so sad. You just seem like you have given up hope. Here's the thing: you guys are going to have a baby. Your own baby. Rachel, you will get pregnant and have a baby." To hear this was a complete shock. It was hard to process that a medical professional was telling us that we would have our own child. In fact, he asked how many kids we wanted... it was just so surreal. 

I feel like, even as I write this, I am doing a crappy job outlining the consult. It was way beyond words. There are obstacles in the way, but none that I hope will keep us from the promise he declared. Having to drive to Philly dozens of times and having to deal with meds and hormones and timing etc. are all annoying. However, if we agree to do this, we can start in two weeks when I get my next period.

The thought that I could be pregnant by Thanksgiving is unbelievable. I cautiously dare to think about having a baby next summer. It is just so unreal. I know, I'm a broken record. 

Added to my joy was the fact that if we want to do two embryos, we have a 43% chance of having twins. I am overjoyed and potentially overwhelmed by that fact. I just can't imagine that God would actually be hearing us after all this time. I feel like I have not trusted him or understood why He would make us walk down this painful and disappointing road.  I see that there is no way I could be doing IVF if I were still teaching at MHS. There would be no way that we could proceed forward with it under those conditions. Now, I see that I have the flexibility and the availability in my schedule to take a million trips to Philly etc. I just can't believe it. I am thrilled and scared beyond belief. I think about it constantly. Could this finally be it? Could we finally be pregnant and start a family? I am scared beyond words to hope that this could be my life.

Visit number two on 9/30, was a baseline ultrasound and blood work. Chris also was asked to do a some tests too (you can use your imagination there...).  We were told that we would have to come back in five days (10/5) for another appointment.

So, now we are up to speed. Our third appointment (10/5) involved more blood work, a baseline ultrasound, a fluid sonogram,  and we meet with a financial counselor. We also sat through an injection class (I learned how to give myself shots and about the meds I will take). Last, we met with Dr. Sasson to discuss all of the test results to date. Normally, these are spaced out, but because we are driving three hours, they are consolidating as much as possible, and we appreciate it! 

I do have some cervical scar tissue (which was seen during the fluid sonogram-- an uncomfortable, but not super painful procedure). This was a result of an earlier surgery (uterus resection due to septate uterus). 

To bipass this, Dr. Sasson is going to work some magic when we eventually get to embryo transfer day (will write more about this later).  He said the scarring was a bit of a speed bump, but nothing that would stop us from moving forward. My uterus is healed completely and looks great. 

I have to be on 21 days of birth control pills (what?!?, you say?). The pills make my brain stop communicating with my reproductive "area".  That way, the doctors can control everything, using meds, instead of my brain having anything to do with it. After I am done with the pills, I will start my hormone injections to begin the production of eggs... and I mean LOTS of eggs.  I will be monitored during this time and then we will pick the best day for the egg retrieval (when the eggs are numerous and sizable enough to be retrieved).  Dr. Sasson is hoping that I will produce about 15-20 eggs for retrieval.  To give you a visual, he said my ovary will go from being the size of a nickel to the size of a grapefruit. Hello stretchy waistband! 

The eggs will be harvested (I hate that word) while I am under anestesia. Then, the eggs will be fertilized, thanks to Chris, and then they will be embryos. After 3-5 days, the embryos will be big enough to be selected and transfered back into my uterus. The best embryo(s) will be selected. Don't worry- not all of the embryos will be transferred at one time. We will pick one or two and then the rest will be frozen for later (when we want to get pregnant again). 

We have not determined if we are going to choose one or two embryos on transfer day... we need to think on that. I will blog about the pros/cons of that soon. 

So, you're up to speed. For now:)

Thursday, October 4, 2012

Be Cautious of the Comma

Call me a nerd, but I like commas. I like the mechanics of the English language. Adding or subtracting a comma can TOTALLY change the meaning of a sentence. 

Today, I was chatting with God and once again I was asking Him to explain His plan to me. 

"God, I'd just really like to know what's up. A hint, or a complete outline of the next year of my life would be really beneficial."

Yes, I am a broken record:

" I don't understand, God. Why is this happening?" Yada yada yada. 

And then, it hit me. 

"I don't understand God." is different from, "I don't understand, God." 

Did you catch it? Did you catch the comma?

I understand God. I understand who He is and the promises He has for me. And that, friends, is what will help us to get through this. 

I may not understand WHY I can't get pregnant at the drop of a hat. But, I understand Him, His promises, and His declaration of who He is:

Isaiah 40:29-31
He gives power to the weak
and strength to the powerless.
Even youths will become weak and tired,
and young men will fall in exhaustion.
But those who trust in the Lord will find new strength.
They will soar high on wings like eagles.
They will run and not grow weary.
They will walk and not faint.

Philippians 4:19

And this same God who takes care of me will supply all your needs from his glorious riches, which have been given to us in Christ Jesus.

Romans 8:37-39
"No, despite all these things, overwhelming victory is ours through Christ, who loved us.
And I am convinced that nothing can ever separate us from God’s love. Neither death nor life, neither angels nor demons, neither our fears for today nor our worries about tomorrow—not even the powers of hell can separate us from God’s love. No power in the sky above or in the earth below—indeed, nothing in all creation will ever be able to separate us from the love of God that is revealed in Christ Jesus our Lord."

Proverbs 1:33
"But all who listen to me will live in peace, untroubled by fear of harm.”

John 14:27
“I am leaving you with a gift—peace of mind and heart. And the peace I give is a gift the world cannot give. So don’t be troubled or afraid."

Jeremiah 29:11
For I know the plans I have for you,” says the Lord. “They are plans for good and not for disaster, to give you a future and a hope.

Matthew 11:28-29
“Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls.

So, be cautious of the comma. Cling to what you know is truth, even when it doesn't feel good, even when you doubt. We are not infallible; we have hearts that break and doubt creeps in when we least expect it. However, if you remind yourself of God's promises, and cling to who He is, you can make it through. And trust me, this is a reminder that I must slam across my forehead.  Every. Single. Day. 

Tuesday, October 2, 2012

Futile Tips from Fertile People

For today's post, I decided to come up with a list of some of the things people have said to us since we started experiencing infertility. This is not a complete list, but we thought you'd enjoy the following Futile Tips from Fertile People:


  • "You guys need to just relax. You guys should go on vacation. I bet you would get pregnant on vacation." (I'd have had 10 kids by now if that were true)
  • "There are some really special positions you should try..." (Someone from my church gave me that nuget of wisdom. I promptly vomited in my mouth)
  • "Do you kids know there are some days that are just better than others to try?"
  • "What about your body temperature? They sell those neat kits that tell you when you are ovulating. You should try that."
  • "Dude, your boys need to breathe. Just wear loose underwear." (Stellar pearl of wisdom right there.)
  • "It will happen. Just be patient." (Go fly a kite.)
  • "Have you prayed about this? You should." (Only every hour of every day.)
  • "Do a handstand after sex." (Again, vomit in my mouth)
  • "You should think about adoption. Do you know how many people I know who have gotten pregnant after adoption!"
  • "You guys are so young; you have time!"


  • "You should just take one of my kids. They drive me crazy!" 
  • "My husband just looks at me and I get pregnant."
  • "Are you two just career people? You don't want any kids?" 
  • "It didn't happen for us on the first try. It took three months." (This is when I mentally poke their eyes out with the nearest writing utensil)
  • "You've been married for five years? Geesh. You know, your eggs aren't getting any younger." (Thanks, Genius). 

I know you think we've made these up. I wish we had.

Don't you recognize me?

That's me. Rosie the Riveter. Except my name is Rachel and I am currently not holding a baby.

 Rosie and I share some similarities, however. She is a symbol of self determination. Her image defines the "We can do it!" attitude of many American women. I think most people who know me would agree that I am stubbornly determined to succeed in most aspects of my life. I am an organized, Type-A, control freak. So what happens when the "We can do it!" motto turns into, "Crap. No matter how fiercely I try, I can't do it!" mantra? What happens when we are unable to rely on what has successfully accelerated us through life thus far: our gene pools, our relationships, our skills and talents? God shows up. That's what happens.

 My husband Chris and I have been pretty private about our struggles with infertility. We have watched as countless friends and family members have have gotten pregnant (some accidentally) and have shared in their lives as they have traversed pregnancy, deliveries, and child rearing. And we really do mean it when we say we are happy for them. But, as promised, this blog is an open book to what is looming in my heart and what God is doing with me. It's some tough stuff to sort out while trying to plaster on a happy face at baby showers, birthday parties, and family gatherings.

The purpose of this blog is really multifaceted. We don't want to sound bitter, complaining that our lives are unfair because we can't easily become parents. We do however, crave a deeper level of understanding. God has and continues to reveal so much about who He is and what role He should play in our lives individually and within our marriage together.

Our struggle to get pregnant is far from over. We have gone through multiple evaluations, medical procedures, surgery, and medications only to find out that we are reproductively challenged. With the very few whom we've shared our journey, some ask, "Whose fault is it? Who has the problem?" They really don't mean to come off that harshly, but for us, it's sometimes like salt in an open wound.

 From the start, we've taken some solid advice from a dear past college professor-- Chris and I have agreed that the blame game is a no-win situation, that neither of us is the problem. Neither of us is the reason why we are not able to have kids. Yes, there is a problem, but it is OUR problem. Not his. Not mine. Ours. And, we will conquer it with God's grace.

 So here is the super abbreviated version of where we are today: After trying local fertility specialists, we decided to make the trek to Shady Grove Fertility Center, located in Chesterbrook, PA. Because we have had many failed fertility procedures to date, we are going to try something we've not before: IVF. It is my hope that this blog will chronicle that process as well as shed some light into what God is revealing to us throughout the way.

 I apologize if this entry was a bit deep; not all of my entries will be so heavy-hearted! For real... you have to be able to laugh when you are constantly discussing ovaries, semen, eggs, and harvesting... Really. My life right now is a literal egg hunt.

All joking aside, thanks for reading this. And thanks for attempting to grasp what is going on in our life. We've not been ignoring you. We've just been processing. God doesn't waste suffering, so we know He's got something amazing down the pike.