Graduation.

On Friday, we went to our 8 week check-up at Shady Grove, our final appointment with Dr. Sasson. After a quick ultrasound to see the baby, Dr. Sasson asked us to meet him in the hallway where he presented us with a handwritten note and an ultrasound photo. What made the moment even more sweet was the fact that Gabe was with us. We had never brought Gabe back to meet Dr. Sasson or the nurses at Shady Grove so it was a precious, emotional moment as we introduced him to the nurses who helped us through our first IVF three years ago.

As we headed out the office doors to the car, I blinked back tears, just thinking about the amazing gifts we have in Gabe and this next baby. Of course I'm thankful for Dr. Sasson and Shady Grove, but most of all, I'm thankful that God directed our steps to such a wonderful place.

At this point, we are in the 5% miscarriage rate category. We hope to hold out for a few more weeks before telling the masses about our news.

Early heartbeat!

We got to listen to the baby's heart beating... 117 beats per minute. Dr. Sasson said the baby's heart just started to beat a few days ago. So surreal and amazing!

Waiting for a heartbeat

On Friday (2/26) Chris and I head to Shady Grove for the first ultrasound. I have a complete mix of emotions. I am thrilled at the thought that the ultrasound will show that there's actually something  IN my uterus, instead of the dark, fuzzy, empty screen I see every other visit. I am thrilled that we will be able to hear a heartbeat on Friday.

I am scared that something could be wrong. What if we don't hear anything, no heartbeat on Friday?

I think both emotions are normal.

I keep coming back to what I know to be true about God, His character qualities, who He is.... And that's where I have to rest until Friday.

There's a baby in there!

On Friday, after many hours of waiting, Dr. Sasson's office called to tell me my HCG number was 1447--- Which means there is a baby in there!

I went back to the lab yesterday to do a repeat of the blood work. We were hoping for the 1447 number to at least double. Today, I found out my HCG number was at 4400. Good stuff!  A baby is in there and it's growing!

More waiting. Why not?!

(9:52 AM) I went to the lab at 7 AM this morning to have my blood drawn. The lab tech told me they would "try" to get the results sent to Shady Grove by the end of the day today.

Shockingly, I have not taken a HPT in two days. My compulsive pee-on-a-stick nature subsided for two whole days. Now though, I am eagerly/anxiously awaiting the REAL DEAL results from the lab. Please be real. Please be still in there, baby Knipe!

So, yeah. More waiting today.

2 Days Post Transfer

Our transfer was Saturday morning. It went smoothly; we were the only transfer patients at the office that morning and it was nice to feel some undivided attention from Dr. Sasson before our transfer. Dr. Sasson was really "in the zone" and reviewed his notes about the transfer with the staff before we started. The whole process felt less rushed than the other transfers I've experienced.

We watched on the monitor as the embryo was placed in my uterus. It is such a surreal experience. One second there is no life in there and the next, there is this spot, this tiny mass of living cells that could grow into a Knipe.

My bloodwork for the pregnancy test is not until 2/12. That's 11 days from now.

In some ways, I want these days to FLY by. In other ways, I want to stay in this period of unknown because it's safer than a negative result. The unknown is better than a negative known. The logic there is not super strong, but hey, it's how I see it right now.

Last week, two of my good friends told me that they were expecting. I am happy for both ladies because each couple will truly be fantastic parents. Still, jealousy creeps up, like a punch in the stomach.

What if this doesn't work? What then?

Evey time I raise that question, I can practically hear God calling me back.

"Rachel! I'm here! I'm here. I know you don't get it but I do. Trust me."

Chris and I prayed last night and he said, "God please give us peace. Help us to trust you." That's really all we can pray right now.

FET Done!

I am so sorry I haven't written to update you on the FET process. It has been a crazy past week for sure!

Monday 11/23 was our transfer. All went well. We transferred in one, grade AA embryo.

Between decorating for Christmas, celebrating Thanksgiving, and learning my lines for our church Christmas musical, this past week has flown by. It seems though, that time is standing still today. I have one week until I go for my blood work pregnancy test.

Did I break down and buy pregnancy tests at Rite Aide yesterday? YES. Have I taken any? Yes. And... nothing.

I know it is early. I know I am mental about peeing on sticks. It's like torture for me. I DON'T want to know that it didn't work while simultaneously, I WANT to know if it did!

Chris is staring at me each day, analyzing me. I feel like I am under a microscope. I am glad he's in the woods hunting today. He needed some time away from the nuthouse.

Lining Check

I drove to the Harrisburg office this morning for a quick ultrasound and blood work appointment. The doctor there said my lining looked "Gorgeous" and measured 12 mm (anything about 8 mm is best). Good news. Now waiting for the call to see when I add in the progesterone shots into the mix. Transfer is still set for a week from today.

Surreal.

Though we have been "doing IVF" for a while now, I am still amazed at the reality of a tiny, little human being placed in my belly. Even at five days old, the miracle of life is beautiful, inspiring, scary... hard to put in words.

I've crammed my calendar full for the next fews weeks, with the hope that in the two-week-waiting period before a pregnancy test, I won't go completely insane.

I almost feel like even writing these words, I'm putting the cart before the horse. It feels like so long since we've gotten this far along in the process. Actually, thinking about it, it's been three years since Gabe's transfer. 

I just can't forget all of the wonderfully terrifying emotions that accompany a ride on the fertility train.

I came across an article "My Arms Are No Longer Empty, But My Heart Will Never Forget" posted by a friend this week. It speaks to the reality that infertility never really leaves you, even if you have ten kids in tow. Even if your family is complete.

And in my "I won't forget" promise to other women waiting for motherhood, I promise never to forget to point to a God who walks right with me even when I doubt. Who loves me exactly where I am, and smiles at my Type A nervous energy. He knows me. He loves me. His plan for me is perfect, even when it seems fuzzy and confusing to me.

Frozen Embryo Transfer Schedule

It's been a few weeks since I've posted. I wanted to update you all on my FET schedule.

I started birth control 10 days ago (I know. Weird. My nurse says that birth control helps settle everything down, and now that we don't care what my ovaries do or produce, we can use birth control to help us get my uterus on track for transfer).

I have two more days of birth control to take. Then, I will go in on 11/2 (Monday) for a baseline ultrasound and bloodwork, just to ensure that there are no cysts and that everything is good to go.

I'll start progesterone shots that night. Admittedly, I need to do more research on frozen embryo cycles because I don't know much! The progesterone shots are supposed to create a good lining in my uterus, preparing it well for the embryo.

I have an 11/16 ultrasound and bloodwork check up, and then our actual transfer day is set for 11/23. 

Only three total office visits for a frozen embryo transfer! 

We have three embryos that are frozen, but we plan to transfer only one in at a time. Here's to hoping there's a 2016 baby in our future.

Sunshine and Good Grades!

After getting the news Friday night that we would not be doing a fresh embryo transfer this month, we were admittedly bummed. We felt like we were just pushing and pushing to get to that ending point, so when the plans changed and we discovered Dr. Sasson didn't want us to do a fresh transfer (he was worried that we would "waste" an opportunity for pregnancy in a non-optimal uterine environment due to high estrogen levels) we felt like there wasn't any closure or ending to our latest IVF cycle-coster! 

Friday night, we did not know the three remaining embryo grades or even if they had made it to the full blastocycst stage.  We were told that three early blastocysts were remaining and that all three would be frozen. We did not know anything else.

Because I no longer needed to have my cell phone permanently affixed to my body waiting for embryo updates, I left it inside all morning on Saturday. We ran errands and worked in the yard. For a few hours, I forgot about hormones and fertility. I felt sunshine on my face (or at least recognized it) for the first time in a few weeks. Glorious.

We came into the house for lunch and I saw I had a missed call and voicemail from Shady Grove. What. Could. This. Be? 

Of course my hormonal mind jumped to all sorts of crazy:

- The lab caught fire. 
- The embryos were stolen.
- Maria (the embryologist) was in an accident and couldn't make it to the office to freeze them in time. 
- You get the point. 

I froze. Picked up the phone and played the message:

Hi, Rachel. It's Maria. I just wanted to let you know that we did successfully freeze three embryos at the full blastocyst stage. Two have AA grades and one has an AB grade, which is fantastic! Just wanted to let you know. Have a great weekend.

WHAT?! WE HAVE THREE AWESOME EMBRYOS?! 

I immediately started crying and jumping up and down. Chris was upstairs attempting to put Gabe down for a nap. I skipped up the steps and ran into Gabe's room. We have three--two AA and one AB! 

A high-five, jumping, hugging party ensued for a few minutes, Gabe included. (That kid will do anything to avoid a nap!)

What awesome news. What a relief! The night before, we were feeling down about how the events of this past week had played out. We were feeling uncertain and just on edge.

Now, we are feeling optimistic. Honestly. This is the first time this cycle that I say I feel confident in the outcome. 

In a world of statistics and odds, we just keep coming back to God's Will for us. We know He is sovereign and His plan is the one that He has hand picked for us because he loves us. It's hard not knowing what it is, but today, we can see how His plan has gotten us to where we are now. Who knows what these next months will hold, but I know who'll be walking right next to us.

Just Kidding....No Fresh Transfer

Dr.  Sasson called a few hours ago. He decided to freeze the three remaining embryos to implant starting next month. Now no transfer tomorrow. He said my hormone count is too high (estrogen =4000) and not safe for a baby right now. Not horrible news but I'm still kinda bummed. Just more waiting. God's gotten us this far. I know He'll be with us for another month of waiting.

It's tempting to Google and research but honestly, I'm just tired. Tired of the roller coaster. For tonight, I'm going to step off this ride.

Day 1 Post-Retrieval

Just got a call from the embryology lab:

We had 8 eggs retrieved yesterday, 7 of which were mature.

Of the 7, 4 were successfully fertilized.

So, we have 4 in the game right now.

I asked again about the frozen vs. fresh transfer situation. If we have 2 or more embryos on Thursday (3 days post retrieval) we would go ahead and do a fresh transfer this Saturday and freeze the remaining. If we have less than 2 remaining on Thursday, we would freeze the 1 or 2 and go for a frozen transfer next month.

One day post retrieval

Just wanted to write a quick update about the egg retrieval yesterday:

Dr. Sasson was able to get 8 eggs. We will know many fertilized today and then each day that goes by, we will be called with an update about how they are progressing.

We are shooting for either a Day 5 transfer (Saturday 10/10), or if we have a high quality embryo at that point, we will freeze it to be transferred in next month. This was a bit surprising to me, as I had heard that fresh transfers usually have a higher success rate than frozen transfers. Apparently, Dr. Sasson tells me, the statistics have changed in recent years. Frozen transfers at Shady Grove now have equal to or greater chances for success than fresh transfers, especially for women whom have had high dosages of stims in their most recent cycle (me!)

Right now though, I am just praying that many eggs have fertilized and that we will have something remaining by week's end. I hope some of my sanity remains by that point too!

Thanks for your positive thoughts and prayers. There is nothing better than waking up on egg retrieval day to texts from praying friends; thank you for lifting this cycle up to the Lord.

Twas the Night Before Retrieval...

It's the night before retrieval and I am eager to have this next procedure completed. I wouldn't say I'm nervous; I am just eager to know how many eggs Dr. Sasson can get from my slow-to-respond ovaries.

Chris and I spent the past few days in Philaldelphia. We had morning monitoring appointments each day, and we just didn't feel like driving back and forth 6 hours round trip multiple days in a row. Gabe stayed with my in-laws, and Chris and I got to have a few date nights; it was heavenly. The weather didn't really cooperate, so instead, we enjoyed just relaxing at the hotel, watching movies, taking NAPS( Oh naps, how I have missed you!). It was just what we needed to reconnect and gear up for tomorrow's retrieval.

Dr. Sasson said that I had 16 eggs, but he thinks only 8 of them will be the correct size to fertilize. It's still a bit of a guessing game at this point, so we shall see.

Missing Med Panic

We had such a crazy night last night. Let me start from the beginning: 

I knew I was running out of injections (Follistim) on Monday morning, so the specialty pharmacy was overnighting them to me so I would get them by last night at 5 PM. Well, 5 PM came and no meds from FedEx. We called them and found out that the meds were in a shipping container in NJ! There was a delay and they couldn't do anything about it.

Without the meds, I would have to cancel the cycle and all the money and time and energy would be wasted...

I of course, started crying and freaking out. Chris was too and it was just not pretty. We called all the pharmacies in our area and none of them had the med on hand because it is a specialty med and only specialty pharmacies can issue it....

Next, we called the on-call doctor. She asked if I had any leftover meds from previous cycles. I did have a box of a few meds in a closet, but they were not the same ones I was taking this round. She asked me to go get the box and list each med one by one to her. Apparently, I did have a generic brand of the meds (Bravelle) that I could take to replace the ones that didn't arrive via FedEx. The issue was, did I have enough in the leftover box to actually make it work?

She told me I needed 6 vials to take last night and 4 vials to take this morning to equal what my body needed. She said I needed 10 vials of the generic med to prevent a canceled cycle. 

I looked down and there were exactly 10 vials of the meds in the box that I almost threw away a few months back. 10 vials. Exactly what we needed. 

I am still in awe of God this morning! And I'm crying. Again. Amazed at Him.

Oh, the monitoring...

It has been one week since I started stims. I am lagging behind a bit in terms of my estrogen (880)and follicle counts (maybe 15 if we're lucky), but it's not a totally hopeless situation. It seems my ovaries are working, but just slowly. We actually had to order more meds because I ran out! It is such a bizarre experience to stare at a cartridge of medication, knowing that just one dose = $500.

On Sunday, we traveled down to the Towson office because Harrisburg was closed and Chesterbrook was crazy due to the Pope's visit. The Towson office was FILLED with women waiting to be monitored (as in, like 50 women).

It did feel like an assembly line of sorts. I think that if I had to experience that in my first cycle, I would have been really discouraged and felt super isolated. It was just such a cold experience. Women lined the waiting room with just hopeless looks on their faces. I tried to send warm glances to anyone who would actually make eye contact with me. I think that my multiple IVF cycles to date coupled with pure desensitization makes me less prone to feeling like I'm actually part of the reproductive cattle herding taking place a SGF.

That being said, I still feel though. I still feel for others who are on their journeys to motherhood without a sweet toddler at home to greet them after the cattle herding.

I was riding the elevator down after my appointment on Sunday with a woman who looked to be around 30.  She was beautiful and was wearing the best of everything. I saw her get into her new Mercedes, sobbing.

I walked up to her and asked if she needed to talk. She replied, "This is so hard. It just sucks."

Ditto.

I stood and talked to her for a while and tried to help her gain a grip before leaving.

Infertility touches EVERYONE, regardless of what you have financially. It is emotional. It is hard.

I am again ever so thankful for my husband, my son, my God. I keep reminding myself of God's sovereignty. It helps me to think about it, but it also scares me a little, to be honest.

As far as my meds to date:

I am taking the highest dose of Follistim (450) allowable each day, along with 125 of Menapur.

Tonight, I will take 450 Follistim,  225 of Menapur, and Ganirelix to prevent premature ovulation. This combo will last for the next four days, I think. It's looking like I would trigger on Saturday night, with egg retrieval on Monday, 10/5?

Starting Stims!

I trekked down to Harrisburg yesterday morning for my pre-IVF monitoring appointment. My bloodwork looks good and there were no signs of uterine issues on the ultrasound. They did count 13 antral follicles. I totally did not pay attention to antral follicle numbers in round 1 or 2--- Now, I'm being SUPER thorough because I want to just be informed and on top of everything each step of the way in this, our final round. From what my Google results yield, that number of antral follicles for an almost-31 year old is a little low, but hey, we're doing all we can!

Last night, I started on 300 iu Follistim and 150 iu of Menupur. This is the highest dosage I've ever taken, but what the heck, let's go!

I head back to Harrisburg on Friday for bloodwork and ultrasound to check on things.

As far as my headspace, I am peaceful. I'm anxious, but in a good way, like the anxiousness you feel for Christmas or your birthday, not the stressed-induced kind of anxiousness.

The meds are here... again

The FedEx delivery of my meds for the third fresh IVF cycle arrived a few days ago. As I unpacked the meds, I did an inventory to ensure they were all there. At the same time, I was taking inventory of myself, working through my mental checklist to prepare for this last and final round.

I am hopeful. I am excited to get started.

If this doesn't work, it will be hard, but we will know more surely that IVF and assisted reproduction is not in the plan for us right now. Adoption just might be, and that's something we will fervently explore should this cycle not work.

I have been assigned an Antagonist Vivelle Protocol this time around. This protocol is for women whose ovaries might not respond as well as they should to a more traditional protocol. For a woman my age, I should be producing between 20-30 eggs at retrieval. Instead, last cycle, we were only able to produce FOUR eggs. Not a great start to the cycle, once you consider that the eggs have to fertilize and then make it all the way to embryos.

To increase my odds of producing more eggs, I've been taking CoQ10 supplements on top of my pre-natal vitamins. I will start on a Vivelle hormone patch next week, followed by Ganirelix injections to bring on a period. Once the period begins, I will start the traditional Follistim/Menopur injections for two weeks. Then, its hopefully a retrieval of numerous eggs!

To conclude this post, I have to tell you a hysterical story:

I had to buy an ovulation predictor kit at the drug store last week. I needed to know exactly which day I ovulated so that I would know when to start my Vivelle patch (10 days post ovulation).

Anyway, I have my ovulation predictor kit and I am checking out and this song plays from the sound system: (fast forward to 50 secs in for main chorus).

I could not hold in my laughter. I started laughing and laughing and laughing. The clerk gave me a weird face, but then caught on and started laughing too.

Ah. The irony of it all! Thanks for the sense of humor and timing, God!

Peace in waiting

Even though we are in the dreaded two week waiting period, I am peaceful. I don't have anxiety (today). I think just having a few days of NO appointments, good meals, and sunshine has really brought me back to life! Chris still seems anxious, so for now, while I'm feeling more solid, I want to do my best to support and encourage him. 

Yesterday I played with Gabe all day. Like serious toddler playing. He is so intense; intensely happy, intensely angry, intensely curious, intensely awake, intensely tired...intensely Gabe! I love it! He recently started really HUGGING back when I hug him. For the first time, I feel him gripping his arms around my neck and back and tugging me into him. Best feeling in the world.

I'm not going to lie; I have started calculating when I should take a pregnancy test. I know SG says not to take one for at least 14 days. I'm thinking I won't last that long. Just being honest. I know I'll make it through the weekend without taking one, so that's good, right?

ROUND TWO: Day 2, after retrieval

Do you know what's weird and insanely hard to put into words? The feeling I have when I hear the phone ring and it's Shady Grove on the caller ID, calling us to update us on how many potential Knipe human lives are still living in their lab. As stated yesterday, we have three mature, fertilized eggs. Today, we have two four-cell embryos, and one two-cell embryo; still at 3 total.

I remember being nervous last time, wondering if IVF would work, but I don't remember being this nervous about this specific phase of the cycle. We had such good number last time so we knew we had good odds to get to transfer day with at least something to transfer. Now, Chris and I are on pins and needles just wondering if there is going to be anything to transfer on Monday.

We are still at three. Maria called from the lab and said she would hope to see 6-8 cell embryos tomorrow. She will call to update us tomorrow afternoon.