Random thoughts...

I just ate a fortune cookie from our dinner last night (yes, I know it's only 8 AM), and my fortune said, "You will get what your heart desires." Cool! Too bad the cookie didn't tell me when! So, how do I feel about going through IVF...well, I have so many mixed emotions...it's very complicated. Before I get into my feelings, it might be helpful to explain the entire process.

The first step in most IVF's and mine will be the suppression phase. This is done with a combination of BCP and Lupron. Lupron is an injectible med that essentially induces menopause and supposedly comes along with all those fun side effects. In preparation for IVF the dosage is very small, but it is administered daily. When these cysts that we are trying to resolve go away, I will start another round of BCP and 2 weeks into that, I will start Lupron and continue for another 2 weeks. Once AF arrives, which will happen sometime during that fourth week of suppression as a result of stopping the BCP, I will have a suppression check, which will be an u/s and probably bloodwork to make sure that my body is quiet and that my ovaries are prepared to grow a bunch of eggs at hopefully the same rate.

So, assuming that everything is cool, I will then start stimming. This again involves daily injections (these are in my belly and will probably be with the same meds that I used for my IUIs). I will start going for u/s and bloodwork probably at least every other day, and maybe everyday. I will probably also continue injecting Lupron during the stimming phase. This will prevent my body from ovulating on it's own. I'll probably stim for 7-10 days, as in my previous experience, I am a good responsder and tend to grow pretty quick. The difference this time will be that we are trying to get many follicles that are around the same size, ideally 15 or so total but not too many, whereas with IUI, we were trying to encourage only 2-4.

When enough follicles are measuring a mature size, I will trigger which is the shot that makes you ovulate within 36 hours. This will give all the follicles their final "boost" and they will be ready for retrieval in just about 36 hours! The retrieval is out-patient surgery as I will be under general anesthesia. My Dr will go in with an u/s probe and a giant needle and will basically drain each follicle and try to "catch" as many eggs as possible. When the eggs are retrieved, the lab will evaluate them and take all the mature eggs and basically combine then with Brad's sperm in a petri dish and wait. According to my Dr, about 2/3, maybe more will fertilize. When they fertilize and start dividing, they become known as embryos. The embryologists will watch the embies very carefully and will grade them based on all kinds of criteria, like number of cells, shape, etc. During this waiting stage, you begin to take more daily shots, and these are the dreaded progesterone in oil (PIO) shots. They are done in the butt and with what is apparently a pretty large, scary needle. These are often done daily until 10-12 weeks, fun fun. Back to the embies, when they are ready, they will be transfered back into the uterus. The transfer is generally done without anesthesia and is pretty similar to an IUI. I will then be on bed rest for at least 24 hours. My lab generally tries to do 5 day blast transfers which means that 5 days after the retrieval, the little babies are hundreds of cells and are known as blastocysts, but sometimes if the embies just aren't looking so good and the embryologist feels that they would do better in mom than in the petri dish, then a 3 day embryo transfer will be done. At 3 days, embryos are about 8 cells. Our goal is to transfer 2 high quality 5 day blasts because at 5 days, you have weeded out most of those that will not make it and they have the best chances. There are a lot of twin pregnancies in IVF which would be just fine with us!

If there are any blasts left after transfer, then they will be frozen for future use. We're not counting on having any frozen, as my RE said that only 1 out of 3-4 women will have any to freeze, because their philosophy is not to get as many eggs as possible, but rather to get a good number of high quality ones, ideally that magic 15 number. As I mentioned in a previous blog entry, my Dr's pregnancy success rates are 67%.

Ok, so how do I feel about going through this process...

While it feels so good to be moving on to something that has such a high success rate, and I truly believe that this will work for us, hopefully on the first try of course :), I am pretty sad that we have come to this stage. It's definitely scary that we are here staring our "last resort" in the face. When you start treatments, you always say, well there's always IVF! Of course, you never really think that you will actually need to do it. I feel broken and defective, as if my body can't do what it was made to do. I feel like an outcast among friends and family who have moved on to start their families, like I have nothing in common with them anymore, and I'm well aware that my self-imposed distance from preggos and babies is a major culprit here. I hate the bitter/jaded person that I have become and so wish that I could go back to the way I was before all this started, but I'm certain that I'll never completely be that person again - the pain of this experience will be with me always. I very rarely feel pure happiness anymore - there is a constant sadness that I carry in my heart. I am angry that we have already spent $2,000 on wasted treatments and will end up spending at least $6,500 more to get what the "rest of the world" gets for free. I'm really not looking forward to the weeks on end of daily injections of hormones and the wild mood swings that will inevitably come with them. Finally, I am sad that it will literally require a team of Dr's, nurses and scientists to get us pregnant, so much for romance - of course we gave that up a long time ago. Hopefully this will all be worth it in the end!