It's time.
I have spent every moment of sanity since my failed IVF meditating, praying even, about what our next step should be. I truly just internally let myself feel the experience, listen to my heart, and embrace the outcome. Before, I thought, How in the hell does anyone make a decision like this? How do you figure out what to do next?
You stay quiet, and you listen. I'm not sure what I listened to. I don't know if it was my heart, or God, or some bigger sense than me. I don't know. I don't feel a need to identify it. But as time went on, it has become completely clear to me that I know what's next and what is right for J and I. We are ready.
My heart began to fill with warm feelings about adoption. This is something my husband and I have always been open to. My entire life I've envisioned a family made up of biological and adopted children, all my children to love and to raise and to hold forever. I couldn't shake this need to read about adoption, to consume all of the information. I felt excited as the days went on.
It hasn't even been very long since my IVF failed. Approximately one month. I should still be mourning all of the loss I've experienced over the past two years. And I am in some ways. But I am mostly looking forward for some reason.
Our post-IVF consultation was scheduled with my doctor for March 4th. I received a call last week that they could now get me in two days later, and I was ecstatic. I was so ready for some answers and to put all of this behind me. I knew I couldn't expect any kind of definitive information. I knew my doctor wouldn't say that I should definitely do IVF again because next time it definitely would work. I knew he wouldn't say there was no chance in hell it could ever work, and I should just move on. I was expecting something along the lines, "Odds just weren't in your favor this time. If we try again, we can hope for better results."
But I really wanted answers. Something that would allow me to let go, to forgive myself.
And so at the appointment, my doctor explained that he believes my endometriosis was so severe for so long that it essentially destroyed the quality of my egg reserve. He couldn't have known this without trying the IVF, so it was very informative. He said if we were interested in trying IVF again, his recommendation would be to put me on Lupron injections for 1-2 years. These would return me to that menopause state from this past summer (which was fairly miserable) and would really force my immune system to reset and get rid of any remaining endometriosis. He would also suggest I eliminate gluten from my diet and begin CoQ10 supplements. After that two-year period, he would change my IVF protocol to one that he would be more likely to use with older women who have egg quality issues. I asked if he felt confident that this approach would change things for us, but he couldn't say. There are no guarantees. I only asked for confirmation of just that. We can't know anything for sure.
I can't explain it, but I left that appointment feeling so happy and satisfied. I felt I had done what I could. I did what I owed myself and my husband and my future family. We did what we had to do to learn what we know now. And what we know now is that no matter what, J and I will probably never have biological children. It makes me sad, but it's okay.
We will have children. They will be our children, and we will love them so much. So much. I can't even begin to imagine how much because I can hardly comprehend it. I could burst.
I left that appointment knowing what was next. We would adopt our babies, and we would be happy parents full of love. I left feeling like I had permission to want these things, permission to move forward, to make things happen.
I left feeling encouraged even though I was delivered bad news. I left feeling relieved that I could for once know a certain path.
Sometimes I wonder if on some level I've always known I wouldn't be pregnant. I wouldn't give birth. From the moments our first attempts at conceiving didn't work, I felt a sinking feeling. Everyone told me to calm down. They told me I was ridiculous. Even as we made progress through fertility treatments and approached IVF time, I didn't feel incredibly positive. I tried to; I forced myself to. When it didn't work, I wasn't at all surprised. I was devastated. That's for sure, but I wasn't surprised.
Sometimes I wonder if on some level I've always known I would be an adoptive mother. Adoption stories have always held my attention and my heart. Nothing gets me moved and emotional like a woman telling the story of bringing her adopted baby home and into her family. My favorite baby dolls as a child were always of different ethnicities. (Which I thank my parents for. So progressive and awesome!) Even as I was preparing for IVF, I was blogging about seeking out conversations with adoptive mothers and learning as much as I could from them. I even wondered aloud why that was my focus when I should be concentrating on IVF.
Sometimes I wonder if on some level I've always known this was my path. I ignored it, or maybe I just did what I needed to do to get here. But now I know what it is, and it feels so good. I'm going to be a mother. My husband is going to be a father. And we can't wait to meet our children. Can't. Wait.
Last night I started crying for the first time in days, maybe even a week. It hit me that this road probably won't be simple or easy, either. I'm tired. We're both tired. And it would be so wonderful if something could go smoothly for us in our journey toward parenthood. But if it doesn't, we will be okay. Because in the end, we will be parents, we will have children, and we will be a family.
I'm going to keep listening to my heart.
Showing posts with label endometriosis. Show all posts
Showing posts with label endometriosis. Show all posts
Tuesday, February 25, 2014
Wednesday, October 16, 2013
worries.
I was on three months of Lupron shots over the summer to shut down my reproductive system and clear out any remaining endometriosis that wasn't caught during my April '13 laparoscopy. My case of endometriosis was classified as advanced -- Stage III, so my uterus and bladder were affected, and my doctor wanted to be sure that everything was taken care of.
I think I've written before about my laparoscopy and my particular experience with endometriosis. I never really experienced much pain with it -- or not pain that I acknowledged -- and I was very fortunate in terms of symptoms. My laparoscopy revealed that I was riddled with endometriosis, and my doctor was especially shocked by how much he removed from my bladder. Apparently he has rarely, if ever, seen such a thing in a 26-year-old.
Prior to my surgery, I had had pain that I didn't recognize as pain. I'm not really sure why. My pain was related to my bladder, and I often felt it after emptying my very full bladder -- kind of a stretched-out discomfort -- and when holding my urine mid-stream (like when you have to pee in a cup at the doctors office). I really didn't think anything of it and only recognize that it was pain in hindsight. In fact, during my medical history interview with my RE, I answered that I never experienced pain, and I was being honest.
Once my surgery was complete and I was on the Lupron injections, my bladder pain was completely gone. And that's when I realized that I had indeed been uncomfortable. At my August 7th appointment where I was completely checked out by my RE and where I confirmed I was no longer feeling any bladder pain, I was telling the truth.
I'm worried now, though, because I'm experiencing some of that same discomfort again. And I don't know why, and I don't know how that's possible.
It's not all the time. In fact, it's not even every time I have a full bladder. And it's not as uncomfortable as it was. I can't predict when it's going to hurt and when it's not. I'm not even sure if I should call it pain. But it doesn't feel like it did when I was on the Lupron, and I'm afraid it's either going to affect our ability to move forward with IVF or the outcome of IVF.
I will of course bring this up at my mapping appointment next week, but each time I experience that discomfort, I can't help but wonder if somehow my endometriosis is back. But how could it be? I've been on Lupron injections and then gone straight into birth control -- both of which remove and then prevent endometriosis. Maybe it's all in my head? Maybe I'm just worried in general?
Has anyone else out there had bladder pain related to endometriosis? I've done my fair share of googling, but really I need to stay away from all that. I don't need to start wondering if I have cancer (and believe me, I will wonder that!).
I think I've written before about my laparoscopy and my particular experience with endometriosis. I never really experienced much pain with it -- or not pain that I acknowledged -- and I was very fortunate in terms of symptoms. My laparoscopy revealed that I was riddled with endometriosis, and my doctor was especially shocked by how much he removed from my bladder. Apparently he has rarely, if ever, seen such a thing in a 26-year-old.
Prior to my surgery, I had had pain that I didn't recognize as pain. I'm not really sure why. My pain was related to my bladder, and I often felt it after emptying my very full bladder -- kind of a stretched-out discomfort -- and when holding my urine mid-stream (like when you have to pee in a cup at the doctors office). I really didn't think anything of it and only recognize that it was pain in hindsight. In fact, during my medical history interview with my RE, I answered that I never experienced pain, and I was being honest.
Once my surgery was complete and I was on the Lupron injections, my bladder pain was completely gone. And that's when I realized that I had indeed been uncomfortable. At my August 7th appointment where I was completely checked out by my RE and where I confirmed I was no longer feeling any bladder pain, I was telling the truth.
I'm worried now, though, because I'm experiencing some of that same discomfort again. And I don't know why, and I don't know how that's possible.
It's not all the time. In fact, it's not even every time I have a full bladder. And it's not as uncomfortable as it was. I can't predict when it's going to hurt and when it's not. I'm not even sure if I should call it pain. But it doesn't feel like it did when I was on the Lupron, and I'm afraid it's either going to affect our ability to move forward with IVF or the outcome of IVF.
I will of course bring this up at my mapping appointment next week, but each time I experience that discomfort, I can't help but wonder if somehow my endometriosis is back. But how could it be? I've been on Lupron injections and then gone straight into birth control -- both of which remove and then prevent endometriosis. Maybe it's all in my head? Maybe I'm just worried in general?
Has anyone else out there had bladder pain related to endometriosis? I've done my fair share of googling, but really I need to stay away from all that. I don't need to start wondering if I have cancer (and believe me, I will wonder that!).
Tuesday, October 15, 2013
fucking call me back.
I'm going to warn you... I'm a little angry.
And this isn't my usual what-did-I-do-to-deserve-infertility anger. Which is worse, I think. But still. I'm pissed off.
You see, I'm due for my first IVF attempt at the beginning of December. My last appointment with my RE was on August 7th where they decided I didn't need my remaining three Lupron shots because I had responded so well and there seemed to be no evidence of my advanced endometriosis. At this appointment, they talked to us about IVF, and my husband and I decided to go for it. All of our questions were answered, we discussed the financial side, and we put a tentative schedule together with my doctor and nurse. I left feeling completely overwhelmed and anticipating the next four months as we made our way to the weeks of IVF process.
I was referred to my RE last spring after 14 months of trying (and it was a battle to get that referral -- something else that still pisses me off!). At the time, I had no idea who he was or why he was so great. Come to find he's one of the most successful in the nation and was actually on the team who achieved the first IVF pregnancy back in the 80s. This boosted my confidence in his knowledge, ability, professionalism, etc. and so I've always felt that I'm in good hands.
During my first visit, I came to know the receptionist/office manager and all of the nursing staff, as well as my doctor. I will say that my doctor is not the most personable. He has never once offered consolation, and it's clear he doesn't have a whole lot of empathy. He's smart, he knows what he's doing, and that's why he's successful -- but he's just not a warm person. He would be even more successful, in my opinion, if he could express some compassion for his patients and could make it a more personal experience... Not happening as of now, so I'm moving on. His nursing staff, though, and his office manager -- amazingly wonderful women! They are kind, they give me hugs, they make me feel good. They express their understanding of how difficult this must be. They tell my husband and I that they've been thinking of us and hoping we're doing okay. They make me feel like a human being, and I am forever grateful for that. In fact, I've been going through complete withdrawals since I haven't been in for an appointment since August. I had been in every 2-3 weeks since March, and this absence makes me feel uneasy. And really, I kind of miss them.
What I'm really pissed about, though, is how my case has been handled in the past 3-4 weeks. You see, when I left my August 7th appointment, I left with several prescriptions -- Metformin to address my PCOS, Dostinex to address my elevated Prolactin levels, and three packs of birth control to get my hormone levels back up, to keep endometriosis away, and to regulate my cycles. My instructions were to call and schedule an appointment for mapping when I started my third pack of birth control pills. So of course I figured up the day of my first pill of the third pack and put a reminder into my phone to call and schedule the appointment (as if I would forget). Right on schedule, I called. I talked to the receptionist/office manager, and she took a message. She wanted to talk to the fertility nurse to make sure she scheduled it correctly. This was a Monday. She assured me I would be called back within a couple of days.
One week passed, and I hadn't heard anything. So I called again. I reminded her of my issue and that I needed to schedule an appointment for during my third week of pills. Come to find out, my doctor and the fertility nurse will be out of town that entire week. So the receptionist was going to talk to the nurse and figure out what they should do. I never got a call back.
The following week, 8 days later, I called again. I reminded her once again what was going on and that I hadn't heard anything. She assured me that the nurse would get back to me within two days.
I was beginning to panic. Everything with IVF is on a schedule. When my husband and I decided to go forward, we decided to go forward as soon as possible. Our fertility clinic is closed during the months of January and February, so if for some reason we didn't or couldn't move forward right away, we were going to have to wait to start this entire process until the spring. We didn't want to wait. Not getting answers in regards to my mapping appointment was making me worry about the entire schedule of this process. If they couldn't map when they planned to, could they even do the IVF procedures when they planned to? Was this going to push everything back?
Wouldn't you know it, I never heard back from the nurse. I called again four days later, and this time I assertively expressed my panic and frustration. I was kind, but I was irritated. I still didn't get to talk to the nurse. Once again I was told my call would be returned.
It wasn't. So I called for a fifth time yesterday. And on my fifth attempt to talk to someone, the receptionist told me that she had been left with instructions to schedule my appointment early next week and that she would call me to do so once their schedule was finalized. She assured me that everything would be okay, nothing would be pushed back.
I have to say this gave me a sense of relief. But I'm still pissed. Why did I have call so many times? Why did I have to fight so hard for such a simple answer? Why am I not a priority? Why don't they have a fucking nurse's line???
I just want all of this to work out. I want December to be here, and I want to strip away all of the mystery of this IVF process. I want it to work. I want to be happy. And I don't want my RE's office -- the only place that can possibly help me -- to be a major source of stress and anxiety. How can I relax and feel positively about this process and this experience when I can't get the answers I need?
I love these people, and they are so good to me when I'm receiving care in their office. It's hard for me to even reconcile that I have such trouble with them when I'm not there. We'll see if I'm contacted to get this appointment made for next week. We'll see if I have to advocate for myself as usual.
Fucking call me back.
And this isn't my usual what-did-I-do-to-deserve-infertility anger. Which is worse, I think. But still. I'm pissed off.
You see, I'm due for my first IVF attempt at the beginning of December. My last appointment with my RE was on August 7th where they decided I didn't need my remaining three Lupron shots because I had responded so well and there seemed to be no evidence of my advanced endometriosis. At this appointment, they talked to us about IVF, and my husband and I decided to go for it. All of our questions were answered, we discussed the financial side, and we put a tentative schedule together with my doctor and nurse. I left feeling completely overwhelmed and anticipating the next four months as we made our way to the weeks of IVF process.
I was referred to my RE last spring after 14 months of trying (and it was a battle to get that referral -- something else that still pisses me off!). At the time, I had no idea who he was or why he was so great. Come to find he's one of the most successful in the nation and was actually on the team who achieved the first IVF pregnancy back in the 80s. This boosted my confidence in his knowledge, ability, professionalism, etc. and so I've always felt that I'm in good hands.
During my first visit, I came to know the receptionist/office manager and all of the nursing staff, as well as my doctor. I will say that my doctor is not the most personable. He has never once offered consolation, and it's clear he doesn't have a whole lot of empathy. He's smart, he knows what he's doing, and that's why he's successful -- but he's just not a warm person. He would be even more successful, in my opinion, if he could express some compassion for his patients and could make it a more personal experience... Not happening as of now, so I'm moving on. His nursing staff, though, and his office manager -- amazingly wonderful women! They are kind, they give me hugs, they make me feel good. They express their understanding of how difficult this must be. They tell my husband and I that they've been thinking of us and hoping we're doing okay. They make me feel like a human being, and I am forever grateful for that. In fact, I've been going through complete withdrawals since I haven't been in for an appointment since August. I had been in every 2-3 weeks since March, and this absence makes me feel uneasy. And really, I kind of miss them.
What I'm really pissed about, though, is how my case has been handled in the past 3-4 weeks. You see, when I left my August 7th appointment, I left with several prescriptions -- Metformin to address my PCOS, Dostinex to address my elevated Prolactin levels, and three packs of birth control to get my hormone levels back up, to keep endometriosis away, and to regulate my cycles. My instructions were to call and schedule an appointment for mapping when I started my third pack of birth control pills. So of course I figured up the day of my first pill of the third pack and put a reminder into my phone to call and schedule the appointment (as if I would forget). Right on schedule, I called. I talked to the receptionist/office manager, and she took a message. She wanted to talk to the fertility nurse to make sure she scheduled it correctly. This was a Monday. She assured me I would be called back within a couple of days.
One week passed, and I hadn't heard anything. So I called again. I reminded her of my issue and that I needed to schedule an appointment for during my third week of pills. Come to find out, my doctor and the fertility nurse will be out of town that entire week. So the receptionist was going to talk to the nurse and figure out what they should do. I never got a call back.
The following week, 8 days later, I called again. I reminded her once again what was going on and that I hadn't heard anything. She assured me that the nurse would get back to me within two days.
I was beginning to panic. Everything with IVF is on a schedule. When my husband and I decided to go forward, we decided to go forward as soon as possible. Our fertility clinic is closed during the months of January and February, so if for some reason we didn't or couldn't move forward right away, we were going to have to wait to start this entire process until the spring. We didn't want to wait. Not getting answers in regards to my mapping appointment was making me worry about the entire schedule of this process. If they couldn't map when they planned to, could they even do the IVF procedures when they planned to? Was this going to push everything back?
Wouldn't you know it, I never heard back from the nurse. I called again four days later, and this time I assertively expressed my panic and frustration. I was kind, but I was irritated. I still didn't get to talk to the nurse. Once again I was told my call would be returned.
It wasn't. So I called for a fifth time yesterday. And on my fifth attempt to talk to someone, the receptionist told me that she had been left with instructions to schedule my appointment early next week and that she would call me to do so once their schedule was finalized. She assured me that everything would be okay, nothing would be pushed back.
I have to say this gave me a sense of relief. But I'm still pissed. Why did I have call so many times? Why did I have to fight so hard for such a simple answer? Why am I not a priority? Why don't they have a fucking nurse's line???
I just want all of this to work out. I want December to be here, and I want to strip away all of the mystery of this IVF process. I want it to work. I want to be happy. And I don't want my RE's office -- the only place that can possibly help me -- to be a major source of stress and anxiety. How can I relax and feel positively about this process and this experience when I can't get the answers I need?
I love these people, and they are so good to me when I'm receiving care in their office. It's hard for me to even reconcile that I have such trouble with them when I'm not there. We'll see if I'm contacted to get this appointment made for next week. We'll see if I have to advocate for myself as usual.
Fucking call me back.
Wednesday, August 28, 2013
fyi: endometriosis
All of us coping with infertility have in common similar struggles. But we've arrived where we are for different reasons. I want to explain one of my reasons. (And I'll explain the others later).
I have endometriosis. Stage III (Advanced) endometriosis to be exact.
Endometriosis is:
A condition where the lining of the uterus, which is usually shed during the monthly period, begins to grow internally outside of the uterus. There are different theories as to why and how this happens, but a common one is that the lining, at some points in time for certain people, flows back and out the fallopian tubs. Then, rather than my immune system taking care of these foreign cells immediately, they attach themselves to other organs and grow and shed there, often causing scar tissue.
My endometriosis was found on my abdominal walls, uterine walls, bladder, and ureters. Microscopic endometriosis was growing within my uterine walls causing it to be spongy to the touch. I had an endometrioma growing on my right ovary that was likely causing the pain I experienced prior to surgery, and my doctor was shocked at the advanced stage of my condition.
Because my endometriosis was extensive enough and because some of it was not removed during surgery (those cells in my uterine walls that were making it spongy), my doctor decided my best course of treatment would be to take six injections of depo Lupron over the course of six months. One shot would be given every four weeks. Depo Lupron is a GnRH agonist, and while I don't want to get into the specifics of how it works and what it does (not because it would be dull, but because I'm sure I don't totally understand), I will give you my explanation... Apparently GnRH agonists shut down your reproductive system and eliminate hormones from your system. They allow your system to rest while eliminating those microscopic cells. Depo Lupron essentially sends you into a temporary menopause for however long you continue the injections. I was prepared to be in a state of menopause for six months -- complete with all of the symptoms of menopause that women experience.
How does endometriosis cause infertility?
Many women diagnosed with endometriosis will find that cells have caused damage to their ovaries and/or to their fallopian tubes. Damaged ovaries could result in poor egg quality and/or prevent proper ovulation. Blocked fallopian tubes would prevent fertilization by keeping the egg and sperm from meeting. In addition, it is thought that certain toxins are released in the body because of endometriosis around the time of ovulation. These toxins can affect the uterine lining and the overall environment for fertilization and later implantation. Any interference on the part of endometriosis in this delicate process can be detrimental -- obviously.
It is widely recognized that IVF is the most successful option for women with advanced and severe stages of endometriosis. Many doctors will begin by offering IUI treatments when endometriosis is less severe, but research shows that success rates are low. Always do your own research but also consult your doctor when making these important decisions -- infertility is not predictable, so one case doesn't determine the outcome of another.
Some literature out there suggests that women with endometriosis have a slimmer chance of success with IVF than the average woman undergoing the same procedure but for different reasons. I've found some articles that argue this point and others that refute it. Those that suggest this lower success rate do seem to note at least a subtle correlation between those toxins I mentioned earlier and difficulty with implantation. IVF removes the whole process from the body, so obstructions in the fallopian tubes and influence of these toxins on sperm would not be factors. Either way, though, women with advanced to severe endometriosis have highest chances of conception through IVF.
My concerns lie in the fact that I do have advanced endometriosis and I did have an endometrioma (or chocolate cyst as they are sometimes adoringly called -- isn't that just the cutest name?). The literature that suggests my chances are lower than others undergoing IVF freaks me out. I should probably stop reading it, but I'm out of control. I wanted to go into this procedure with a realistic but positive outlook, and it's really hard to marry the whole realistic thing and the positive thing when we're dealing with infertility here. They just don't work well together.
Without really getting in there and beginning stimulation, we don't know how my ovaries will respond, how many follicles I'll produce, or whether or not those follicles will contain healthy, mature eggs. It's such a gamble. I know for a fact that my tubes aren't blocked (structural stuff was checked out during my lap surgery), so that's not my issue. We don't know my endometriosis's impact on my egg quality, and I'm afraid that these "NKa" toxins will inhibit implantation once we've done all the hard work.
In the meantime, in an attempt to ease my worries, I've been ignoring other pressing tasks in order to stalk message boards for evidence that there are women out there (and hopefully lots of them!) who have advanced or severe endometriosis and have gotten pregnant through IVF. And they do exist.
I just hope I can join them.
I have endometriosis. Stage III (Advanced) endometriosis to be exact.
Endometriosis is:
A condition where the lining of the uterus, which is usually shed during the monthly period, begins to grow internally outside of the uterus. There are different theories as to why and how this happens, but a common one is that the lining, at some points in time for certain people, flows back and out the fallopian tubs. Then, rather than my immune system taking care of these foreign cells immediately, they attach themselves to other organs and grow and shed there, often causing scar tissue.
My endometriosis was found on my abdominal walls, uterine walls, bladder, and ureters. Microscopic endometriosis was growing within my uterine walls causing it to be spongy to the touch. I had an endometrioma growing on my right ovary that was likely causing the pain I experienced prior to surgery, and my doctor was shocked at the advanced stage of my condition.
Because my endometriosis was extensive enough and because some of it was not removed during surgery (those cells in my uterine walls that were making it spongy), my doctor decided my best course of treatment would be to take six injections of depo Lupron over the course of six months. One shot would be given every four weeks. Depo Lupron is a GnRH agonist, and while I don't want to get into the specifics of how it works and what it does (not because it would be dull, but because I'm sure I don't totally understand), I will give you my explanation... Apparently GnRH agonists shut down your reproductive system and eliminate hormones from your system. They allow your system to rest while eliminating those microscopic cells. Depo Lupron essentially sends you into a temporary menopause for however long you continue the injections. I was prepared to be in a state of menopause for six months -- complete with all of the symptoms of menopause that women experience.
How does endometriosis cause infertility?
Many women diagnosed with endometriosis will find that cells have caused damage to their ovaries and/or to their fallopian tubes. Damaged ovaries could result in poor egg quality and/or prevent proper ovulation. Blocked fallopian tubes would prevent fertilization by keeping the egg and sperm from meeting. In addition, it is thought that certain toxins are released in the body because of endometriosis around the time of ovulation. These toxins can affect the uterine lining and the overall environment for fertilization and later implantation. Any interference on the part of endometriosis in this delicate process can be detrimental -- obviously.
It is widely recognized that IVF is the most successful option for women with advanced and severe stages of endometriosis. Many doctors will begin by offering IUI treatments when endometriosis is less severe, but research shows that success rates are low. Always do your own research but also consult your doctor when making these important decisions -- infertility is not predictable, so one case doesn't determine the outcome of another.
Some literature out there suggests that women with endometriosis have a slimmer chance of success with IVF than the average woman undergoing the same procedure but for different reasons. I've found some articles that argue this point and others that refute it. Those that suggest this lower success rate do seem to note at least a subtle correlation between those toxins I mentioned earlier and difficulty with implantation. IVF removes the whole process from the body, so obstructions in the fallopian tubes and influence of these toxins on sperm would not be factors. Either way, though, women with advanced to severe endometriosis have highest chances of conception through IVF.
My concerns lie in the fact that I do have advanced endometriosis and I did have an endometrioma (or chocolate cyst as they are sometimes adoringly called -- isn't that just the cutest name?). The literature that suggests my chances are lower than others undergoing IVF freaks me out. I should probably stop reading it, but I'm out of control. I wanted to go into this procedure with a realistic but positive outlook, and it's really hard to marry the whole realistic thing and the positive thing when we're dealing with infertility here. They just don't work well together.
Without really getting in there and beginning stimulation, we don't know how my ovaries will respond, how many follicles I'll produce, or whether or not those follicles will contain healthy, mature eggs. It's such a gamble. I know for a fact that my tubes aren't blocked (structural stuff was checked out during my lap surgery), so that's not my issue. We don't know my endometriosis's impact on my egg quality, and I'm afraid that these "NKa" toxins will inhibit implantation once we've done all the hard work.
In the meantime, in an attempt to ease my worries, I've been ignoring other pressing tasks in order to stalk message boards for evidence that there are women out there (and hopefully lots of them!) who have advanced or severe endometriosis and have gotten pregnant through IVF. And they do exist.
I just hope I can join them.
Monday, August 26, 2013
how we got here.
Let's go way back.
Since the time of my first period, they've been really painful. Like, I hadn't felt pain like that when I got my first period. One time when I was 16, I woke up in the middle of the night with the worst cramps. I didn't even think I could walk. I eventually made it up the stairs from my room in the basement to the bathroom and threw up. Because it hurt that bad.
After years of painful but very regular periods, I got on birth control when I got to college. They assured me that it would help with cramps and other PMS symptoms. And it did. Birth control helped the pain, and although it caused other issues I wasn't too pleased with, it was nice to have a break.
Fast forward six years to age 24, and I was married and thinking about starting a family. I knew from earlier experience that I wasn't one to return right to my regular cycle after stopping the pill, so I planned to go off of birth control earlier than I might want to so that I could be sure my cycles were back to normal by the time we wanted to start trying to conceive.
As expected, my cycles weren't normal right away. I think I got my first period off of birth control like eight weeks after finishing my last pack. From there the gaps got narrower, but they still weren't regular -- not even a bit. I had six-week cycles, 40-day cycles, 28-day cycles, etc. I kept track of my cycles on a calendar, knowing it might come in handy. This lasted more than a year. At my yearly appointment, I brought up my concerns. My doctor said some people just really responded differently to hormonal changes, but he thought checking my thyroid and doing other bloodwork might be informative. So we did. And everything came back normal.
My husband and I moved to a different state, and it was time for my next yearly exam -- and this time I wanted things figured out because we were ready to start a family. She echoed what my former doctor said. Birth control probably wasn't to blame, and maybe I just thought I had had regular cycles pre-birth control but really didn't. Just to check things out, she wanted to do some bloodwork also and check my various hormone levels at specific times in my cycle. So we did. And it came back normal.
I bought ovulation strips on Amazon so that I could try to figure out if I was indeed ovulating. You know, it would be awful if I wasn't. I didn't want to waste any more time, so I started peeing on those things right away. And obsessive me became obsessed. I downloaded an app on my iPhone that would help me to keep track of my cycle. Guess what? I got a positive ovulation test strip two days in a row. I was ovulating, and I was so excited. In my mind, my doctors were proven correct. Everything was working fine, and we should start trying.
So that month -- the month I got my first positive OPK strip -- we had unprotected sex and thought wishfully about having a baby together. But I got my period a couple weeks later.
No fear, though. That was our first shot. Being the researcher and reader that I am, I got online to really figure this whole process out. I read everything. I learned about taking my basal body temperature, checking my cervical mucous, looking for signs of ovulation like mittelschmerz and egg white mucous, and charting all of the info on my phone and paper and pencil charts. I had one on my fridge. Every morning I woke up to the sound of my 6:30 alarm -- weekdays and weekends, on vacation or at home -- and took my basal body temperature. I recorded my findings on my phone immediately. I woke up and checked my cervical mucous. I even checked my cervix. I noted all of this. Then I would transfer it to the paper copy. It was such an involved process. We timed sex; we did everything perfectly.
After six months of doing everything right and timing everything right, we still weren't pregnant. That's okay, though, right? A majority of people are pregnant by then, but we will definitely be pregnant by the year mark. I didn't really believe my self-talk or the shit everyone else said to me, either, though. I scheduled an appointment with my OB/GYN because I thought maybe six months of trying might warrant some investigation. Nope. I'm fairly certain she thought I was crazy. She told me to come back at nine months if it was really worrying me. So I did, because I still wasn't pregnant then either. But I don't think she remembered telling me to come back at nine months, so it was just kind of frustrating. Then she told me to come back at the one-year mark. That's when I would be officially infertile and could be referred to someone who actually knew what the hell they were doing. But stay positive! she said as I left. Don't let this stress you out. Just enjoy the trying! It'll happen, she told me.
Then it was February -- the one-year mark -- and I still wasn't pregnant. I knew it. Something was wrong, and everyone just wasted a year of frustration and hope and disappointment. No one listened to me, and now they were going to? Because I had hit a magic number of months of being childless?
I met with another doctor in her practice, and she didn't seem to know much either. She looked at my charts and asked me some questions and said that it sounded like I was ovulating and that everything was probably fine. Had my husband been checked? she wondered. Nope. No one ever offered to check him, and oh yeah, semen analysis isn't even possible in the town we live in. So she was going to refer me to a specialist in a larger city. Did I want Dr. So-and-So or Dr. What's-His-Name? I don't know -- what the hell is the difference?
I was referred and was able to make my own consultation appointment within a couple of weeks. Luckily they had a cancelation, and I could get in two weeks later. The anticipation was killing me.
At my very first appointment with my brand new reproductive endocrinologist, I was first interviewed. They wanted medical history, they wanted family history, and they wanted to hear about what I knew about my cycle. They made copies of the 12 charts I had so meticulously kept, they took several viles of blood, and then I was able to meet the doctor in his office. He read through my information and asked me what I thought was wrong. I don't know... maybe I have low progesterone?
(Did I mention that by this time I had read every article and blog and message board on the internet that even mentioned infertility? Also, I had read three books about infertility and several on conception and pregnancy. I was definitely hypothesizing myself...)
He agreed that it could be a possibility, but he didn't think that was my only issue. We discussed my slight pain during intercourse. (I didn't get it all the time, just when circumstances were right). We discussed my mom's experience with endometriosis before conceiving me. We discussed my dad's sister's experience with endometriosis before conceiving her kids. We discussed my aunt's inability to have children because of premature ovarian failure. (And it was beginning to look like heredity wasn't working in my favor...) We discussed my irregular cycles. And then he sent me down the hall to change into a gown for a pelvic exam and transvaginal ultrasound.
I couldn't believe they were being so thorough so quickly. He started with the exam -- with nurses and resident in tow. Immediately he found the spot that caused me to wince with pain. He wasn't surprised. And look at this, and look at that. All signs of what he thought might be endometriosis. Next, he did the ultrasound and immediately found a total of 27 cysts on my ovaries. I wanted to cry right then and there. The term poly-cystic ovaries was thrown around, and then I really wanted to cry. I knew people who didn't have children because of PCOS, and here I was.
They sat me up, and I asked questions. They got out pictures of endometriosis. They explained the cysts. I would be scheduled for surgery in two weeks to investigate the presumed endometriosis and to check on the cysts. If endometriosis was found, they would remove it with a laser. If the cysts were too big, they could be drained. After surgery, a treatment plan would be developed and pursued.
I still felt very emotional, and so I asked if this was going to be the end of the road for me. They smiled and said no -- this was all very mild compared to what they see on a daily basis, and things were very hopeful for me. This could all be treated.
YES. I was on a high like I hadn't experienced in a long time. Not only did I have answers, but they were treatable answers, and I would have my baby. I would have to be patient and endure a little bit, but it would be worth it.
My surgery was exactly two weeks later. My husband went with me and was there to speak with my doctor when it was over. My husband recorded my doctor's comments on his phone so that I could hear exactly what they found.
I did indeed have endometriosis. I also had an endometrioma (bad news). There was endometriosis on my abdominal walls, my uterine walls, my bladder, and my ureters. It was bad. It was Stage III Advanced, and my doctor couldn't recall ever seeing such an advanced case on someone my age. 26 years old. After he reviewed all of the photos and information, he would determine a treatment plan and would be able to discuss it with me at my post-op appointment. That's all the information I had for two weeks.
At my post-op appointment, he reiterated the extent of my endometriosis. He was shocked I wasn't in more severe pain for the past several years. He couldn't believe it was so out of control because I was so young. (None of this shock and awe was helping my psyche at the moment...) My cysts were small and nothing had to be done with them during the surgery. They decided to start me on six rounds of depo Lupron the following month to further address the endometriosis. I would receive one injection of the drug in the rear every four weeks, and as a GnRH agonist, it would shut my reproductive system down and allow it all to rest. Microscopic cells of endometriosis that remained in my uterine walls (causing my uterus to be "spongy") that could not be removed with the laser during surgery needed to be taken care of, and the Lupron would eliminate them. I was nervous about these shots because they would send me into a temporary menopause -- and at a very accelerated rate. For six months I would be without estrogen, which could in turn reduce my bone density. Side effects such as hot flashes, headaches, mood swings, depression, and insomnia were to be expected.
I got my first shot in May 2013 and experienced very few side effects. I got my second shot in June 2013, and the hot flashes began. They were miserable, and the midwest heat and humidity didn't help a thing. In the meantime, my husband went in for a semen analysis, you know, just to make sure everything with him was okay and to confirm that we only needed to focus on my issues. Well, he ended up with a severely low sperm count, poor morphology (3%), and low motility. We were both devastated because we felt our chances of conceiving were slashed again. He went in for further bloodwork and a karyotype to see if we could get some answers. Everything came back normal, and I was reminded of how frustrating "normal" can be when you know it's not. "Normal" just meant that we wouldn't get any real answers, and there was nothing to treat. No way to make it better.
My doctor offered to refer my husband to a urologist who specializes in male fertility and partners with him on IVF. It was our only shot at figuring this thing out. We received a copy of the referral letter in the mail, and it was the first time I had seen or heard my doctor say anything about IVF. And he was indeed saying that IVF was his recommendation for us if we wanted to conceive. That was our answer. This was worst-case scenario material only two months before, and here we were. Reality. IVF.
At my appointment to get my third Lupron shot, I was met with information I hadn't expected. At next month's appointment -- the appointment that would normally be reserved for my fourth shot -- we would have a consultation with the doctor. My husband should plan to be there, and I could expect to have another pelvic exam. If my husband and I decided that we were interested in moving forward with IVF, the doctor would check me out and consider forgoing the final three shots in pursuit of IVF. From there I would be sent home with drugs to treat my cysts, birth control to keep my system dormant and to reintroduce estrogen levels, and all of my vitamins. We would even discuss a schedule of when to do IVF.
This was big news, and it was a lot to wrap my mind around. I thought I had three more months on these shots and several months even after that before we'd have to make a decision.
After talking with my husband, we decided IVF was a path we wanted to take. At least once. Because it's our only option, we feel we owe it to ourselves and our efforts to give it a shot.
We arrived at my fourth appointment armed with dozens of questions we needed answered. We knew that we could be leaving there officially beginning the IVF process, or we could end up just continuing the shots based on what my doctor found. My RE began the consultation by answering all of our questions and explaining the process and the timeline. He explained that a pelvic exam would give him a good idea of how my body has responded to the Lupron, the condition of my uterus, and my current pain level. The exam revealed that I was no longer experiencing any pain, he felt my uterus was firm and healthy, and he was impressed with how well I had responded to the injections. Three months of grueling hot flashes (this shit was no joke) paid off, and really, I had been so lucky to not experience some of the more severe side effects.
SO. We could move forward with IVF if that's what we wanted to do. He explained that the success rate is 50/50; it's the national average. He explained that there's no way of knowing what issues may come up until we're in the middle of it. He explained the travel schedule, the time commitment, the time management involved, and the procedures. I had read about all of this before. I knew all of these answers.
But I was completely overwhelmed.
He stepped out of the room so that I could get dressed and we could meet with his fertility nurse to go over details. As the door shut behind him, I buried my face in my husband's shirt and cried.
This was wonderful news. We could move forward. Maybe we would be pregnant in four months time. This was awful news. We can't have our own children naturally. The future of our family will ride on this one procedure that is just as likely not to work as it is to work.
Fuck.
I composed myself and we gathered our things and made our way to her office. She was very good with us and explained the financial side, the scheduling, the time frame, etc. I felt informed, and I felt good about the decision we were making.
I was given three prescriptions to take for the next three months: birth control, Metformin to help treat my cysts, and Dostanex to treat elevated Prolactin levels. I would continue taking vitamin B6, fish oil, prenatals, and calcium supplements twice daily. And I would continue taking my prescription vitamin D weekly. I was to continue drinking lots of water and asked to consider gaining five pounds or so because "it couldn't hurt." I committed myself to abstaining from alcohol, exercising daily, and trying to eat right while adding some calories to my diet. I was told to come back in October 2013 to be checked over and to do a "trial run" of the egg retrieval/implantation process so that they could measure the dimensions of my uterus (more on why later). From there, they would schedule my tentative egg retrieval day -- sometime in early December -- and determine when to start me on my IVF drugs. The fertility nurse gave me a hug, asked me to try to stay positive, and sent us on our way.
And we walked out the door...
The process now begins.
Since the time of my first period, they've been really painful. Like, I hadn't felt pain like that when I got my first period. One time when I was 16, I woke up in the middle of the night with the worst cramps. I didn't even think I could walk. I eventually made it up the stairs from my room in the basement to the bathroom and threw up. Because it hurt that bad.
After years of painful but very regular periods, I got on birth control when I got to college. They assured me that it would help with cramps and other PMS symptoms. And it did. Birth control helped the pain, and although it caused other issues I wasn't too pleased with, it was nice to have a break.
Fast forward six years to age 24, and I was married and thinking about starting a family. I knew from earlier experience that I wasn't one to return right to my regular cycle after stopping the pill, so I planned to go off of birth control earlier than I might want to so that I could be sure my cycles were back to normal by the time we wanted to start trying to conceive.
As expected, my cycles weren't normal right away. I think I got my first period off of birth control like eight weeks after finishing my last pack. From there the gaps got narrower, but they still weren't regular -- not even a bit. I had six-week cycles, 40-day cycles, 28-day cycles, etc. I kept track of my cycles on a calendar, knowing it might come in handy. This lasted more than a year. At my yearly appointment, I brought up my concerns. My doctor said some people just really responded differently to hormonal changes, but he thought checking my thyroid and doing other bloodwork might be informative. So we did. And everything came back normal.
My husband and I moved to a different state, and it was time for my next yearly exam -- and this time I wanted things figured out because we were ready to start a family. She echoed what my former doctor said. Birth control probably wasn't to blame, and maybe I just thought I had had regular cycles pre-birth control but really didn't. Just to check things out, she wanted to do some bloodwork also and check my various hormone levels at specific times in my cycle. So we did. And it came back normal.
I bought ovulation strips on Amazon so that I could try to figure out if I was indeed ovulating. You know, it would be awful if I wasn't. I didn't want to waste any more time, so I started peeing on those things right away. And obsessive me became obsessed. I downloaded an app on my iPhone that would help me to keep track of my cycle. Guess what? I got a positive ovulation test strip two days in a row. I was ovulating, and I was so excited. In my mind, my doctors were proven correct. Everything was working fine, and we should start trying.
So that month -- the month I got my first positive OPK strip -- we had unprotected sex and thought wishfully about having a baby together. But I got my period a couple weeks later.
No fear, though. That was our first shot. Being the researcher and reader that I am, I got online to really figure this whole process out. I read everything. I learned about taking my basal body temperature, checking my cervical mucous, looking for signs of ovulation like mittelschmerz and egg white mucous, and charting all of the info on my phone and paper and pencil charts. I had one on my fridge. Every morning I woke up to the sound of my 6:30 alarm -- weekdays and weekends, on vacation or at home -- and took my basal body temperature. I recorded my findings on my phone immediately. I woke up and checked my cervical mucous. I even checked my cervix. I noted all of this. Then I would transfer it to the paper copy. It was such an involved process. We timed sex; we did everything perfectly.
After six months of doing everything right and timing everything right, we still weren't pregnant. That's okay, though, right? A majority of people are pregnant by then, but we will definitely be pregnant by the year mark. I didn't really believe my self-talk or the shit everyone else said to me, either, though. I scheduled an appointment with my OB/GYN because I thought maybe six months of trying might warrant some investigation. Nope. I'm fairly certain she thought I was crazy. She told me to come back at nine months if it was really worrying me. So I did, because I still wasn't pregnant then either. But I don't think she remembered telling me to come back at nine months, so it was just kind of frustrating. Then she told me to come back at the one-year mark. That's when I would be officially infertile and could be referred to someone who actually knew what the hell they were doing. But stay positive! she said as I left. Don't let this stress you out. Just enjoy the trying! It'll happen, she told me.
Then it was February -- the one-year mark -- and I still wasn't pregnant. I knew it. Something was wrong, and everyone just wasted a year of frustration and hope and disappointment. No one listened to me, and now they were going to? Because I had hit a magic number of months of being childless?
I met with another doctor in her practice, and she didn't seem to know much either. She looked at my charts and asked me some questions and said that it sounded like I was ovulating and that everything was probably fine. Had my husband been checked? she wondered. Nope. No one ever offered to check him, and oh yeah, semen analysis isn't even possible in the town we live in. So she was going to refer me to a specialist in a larger city. Did I want Dr. So-and-So or Dr. What's-His-Name? I don't know -- what the hell is the difference?
I was referred and was able to make my own consultation appointment within a couple of weeks. Luckily they had a cancelation, and I could get in two weeks later. The anticipation was killing me.
At my very first appointment with my brand new reproductive endocrinologist, I was first interviewed. They wanted medical history, they wanted family history, and they wanted to hear about what I knew about my cycle. They made copies of the 12 charts I had so meticulously kept, they took several viles of blood, and then I was able to meet the doctor in his office. He read through my information and asked me what I thought was wrong. I don't know... maybe I have low progesterone?
(Did I mention that by this time I had read every article and blog and message board on the internet that even mentioned infertility? Also, I had read three books about infertility and several on conception and pregnancy. I was definitely hypothesizing myself...)
He agreed that it could be a possibility, but he didn't think that was my only issue. We discussed my slight pain during intercourse. (I didn't get it all the time, just when circumstances were right). We discussed my mom's experience with endometriosis before conceiving me. We discussed my dad's sister's experience with endometriosis before conceiving her kids. We discussed my aunt's inability to have children because of premature ovarian failure. (And it was beginning to look like heredity wasn't working in my favor...) We discussed my irregular cycles. And then he sent me down the hall to change into a gown for a pelvic exam and transvaginal ultrasound.
I couldn't believe they were being so thorough so quickly. He started with the exam -- with nurses and resident in tow. Immediately he found the spot that caused me to wince with pain. He wasn't surprised. And look at this, and look at that. All signs of what he thought might be endometriosis. Next, he did the ultrasound and immediately found a total of 27 cysts on my ovaries. I wanted to cry right then and there. The term poly-cystic ovaries was thrown around, and then I really wanted to cry. I knew people who didn't have children because of PCOS, and here I was.
They sat me up, and I asked questions. They got out pictures of endometriosis. They explained the cysts. I would be scheduled for surgery in two weeks to investigate the presumed endometriosis and to check on the cysts. If endometriosis was found, they would remove it with a laser. If the cysts were too big, they could be drained. After surgery, a treatment plan would be developed and pursued.
I still felt very emotional, and so I asked if this was going to be the end of the road for me. They smiled and said no -- this was all very mild compared to what they see on a daily basis, and things were very hopeful for me. This could all be treated.
YES. I was on a high like I hadn't experienced in a long time. Not only did I have answers, but they were treatable answers, and I would have my baby. I would have to be patient and endure a little bit, but it would be worth it.
My surgery was exactly two weeks later. My husband went with me and was there to speak with my doctor when it was over. My husband recorded my doctor's comments on his phone so that I could hear exactly what they found.
I did indeed have endometriosis. I also had an endometrioma (bad news). There was endometriosis on my abdominal walls, my uterine walls, my bladder, and my ureters. It was bad. It was Stage III Advanced, and my doctor couldn't recall ever seeing such an advanced case on someone my age. 26 years old. After he reviewed all of the photos and information, he would determine a treatment plan and would be able to discuss it with me at my post-op appointment. That's all the information I had for two weeks.
At my post-op appointment, he reiterated the extent of my endometriosis. He was shocked I wasn't in more severe pain for the past several years. He couldn't believe it was so out of control because I was so young. (None of this shock and awe was helping my psyche at the moment...) My cysts were small and nothing had to be done with them during the surgery. They decided to start me on six rounds of depo Lupron the following month to further address the endometriosis. I would receive one injection of the drug in the rear every four weeks, and as a GnRH agonist, it would shut my reproductive system down and allow it all to rest. Microscopic cells of endometriosis that remained in my uterine walls (causing my uterus to be "spongy") that could not be removed with the laser during surgery needed to be taken care of, and the Lupron would eliminate them. I was nervous about these shots because they would send me into a temporary menopause -- and at a very accelerated rate. For six months I would be without estrogen, which could in turn reduce my bone density. Side effects such as hot flashes, headaches, mood swings, depression, and insomnia were to be expected.
I got my first shot in May 2013 and experienced very few side effects. I got my second shot in June 2013, and the hot flashes began. They were miserable, and the midwest heat and humidity didn't help a thing. In the meantime, my husband went in for a semen analysis, you know, just to make sure everything with him was okay and to confirm that we only needed to focus on my issues. Well, he ended up with a severely low sperm count, poor morphology (3%), and low motility. We were both devastated because we felt our chances of conceiving were slashed again. He went in for further bloodwork and a karyotype to see if we could get some answers. Everything came back normal, and I was reminded of how frustrating "normal" can be when you know it's not. "Normal" just meant that we wouldn't get any real answers, and there was nothing to treat. No way to make it better.
My doctor offered to refer my husband to a urologist who specializes in male fertility and partners with him on IVF. It was our only shot at figuring this thing out. We received a copy of the referral letter in the mail, and it was the first time I had seen or heard my doctor say anything about IVF. And he was indeed saying that IVF was his recommendation for us if we wanted to conceive. That was our answer. This was worst-case scenario material only two months before, and here we were. Reality. IVF.
At my appointment to get my third Lupron shot, I was met with information I hadn't expected. At next month's appointment -- the appointment that would normally be reserved for my fourth shot -- we would have a consultation with the doctor. My husband should plan to be there, and I could expect to have another pelvic exam. If my husband and I decided that we were interested in moving forward with IVF, the doctor would check me out and consider forgoing the final three shots in pursuit of IVF. From there I would be sent home with drugs to treat my cysts, birth control to keep my system dormant and to reintroduce estrogen levels, and all of my vitamins. We would even discuss a schedule of when to do IVF.
This was big news, and it was a lot to wrap my mind around. I thought I had three more months on these shots and several months even after that before we'd have to make a decision.
After talking with my husband, we decided IVF was a path we wanted to take. At least once. Because it's our only option, we feel we owe it to ourselves and our efforts to give it a shot.
We arrived at my fourth appointment armed with dozens of questions we needed answered. We knew that we could be leaving there officially beginning the IVF process, or we could end up just continuing the shots based on what my doctor found. My RE began the consultation by answering all of our questions and explaining the process and the timeline. He explained that a pelvic exam would give him a good idea of how my body has responded to the Lupron, the condition of my uterus, and my current pain level. The exam revealed that I was no longer experiencing any pain, he felt my uterus was firm and healthy, and he was impressed with how well I had responded to the injections. Three months of grueling hot flashes (this shit was no joke) paid off, and really, I had been so lucky to not experience some of the more severe side effects.
SO. We could move forward with IVF if that's what we wanted to do. He explained that the success rate is 50/50; it's the national average. He explained that there's no way of knowing what issues may come up until we're in the middle of it. He explained the travel schedule, the time commitment, the time management involved, and the procedures. I had read about all of this before. I knew all of these answers.
But I was completely overwhelmed.
He stepped out of the room so that I could get dressed and we could meet with his fertility nurse to go over details. As the door shut behind him, I buried my face in my husband's shirt and cried.
This was wonderful news. We could move forward. Maybe we would be pregnant in four months time. This was awful news. We can't have our own children naturally. The future of our family will ride on this one procedure that is just as likely not to work as it is to work.
Fuck.
I composed myself and we gathered our things and made our way to her office. She was very good with us and explained the financial side, the scheduling, the time frame, etc. I felt informed, and I felt good about the decision we were making.
I was given three prescriptions to take for the next three months: birth control, Metformin to help treat my cysts, and Dostanex to treat elevated Prolactin levels. I would continue taking vitamin B6, fish oil, prenatals, and calcium supplements twice daily. And I would continue taking my prescription vitamin D weekly. I was to continue drinking lots of water and asked to consider gaining five pounds or so because "it couldn't hurt." I committed myself to abstaining from alcohol, exercising daily, and trying to eat right while adding some calories to my diet. I was told to come back in October 2013 to be checked over and to do a "trial run" of the egg retrieval/implantation process so that they could measure the dimensions of my uterus (more on why later). From there, they would schedule my tentative egg retrieval day -- sometime in early December -- and determine when to start me on my IVF drugs. The fertility nurse gave me a hug, asked me to try to stay positive, and sent us on our way.
And we walked out the door...
The process now begins.
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