My Egg Retrieval and Embryo Status

My egg retrieval was Wednesday, September 30th.

I've done this before so I wasn't scared or nervous. I did have a little trouble sleeping the night before, just because I felt a bit anxious and excited. In fact, I had a dream that we were in the mall and some bad guys were holding the whole mall hostage. I was scared at first and then I was mad that they were making me wait around. Finally, I threw my hands up in the air and said, "Ya know what, I have an egg retrieval to go to and it's imperative that I be there on time. I'm outta here." So I risked my life and walked right out. I wasn't going to miss my appointment and lose these eggs!

Thankfully, we had no such hold up in real life. We got to the clinic on time and I went in to have a consult with the doctor that would be performing the surgery, a doctor who I hadn't even met before. I thought my own doctor would be available to do it but I guess not. It really didn't matter since I'd be asleep anyway!

He was actually a very nice doctor and was trying to accommodate me in getting some footage of my egg retrieval. We had planned for Nick to take some footage so I could share that with all of you (not any footage of my sleeping body, mind you, but of the ultrasound screen), but the doctor was telling me that some policies would not allow my husband to be in there. We arranged for one of the nurses to take my camera and do the footage herself, which was fine with me.

I got dressed in my beautiful hospital gown and went into the operating room. The nurses and anesthesiologist were there. I think the anesthesiologist didn't waste any time pumping his sleepy juice into me because I swear the lights on the ceiling were moving around the moment he got me hooked up to his IV. I'm thinking, "Sheesh, dude, lemme get situated first!"

The embryologist came in to talk to me. I've actually never met anyone who handles the embryos. I said, "Wow, hello, you have the most amazing job!" She asked me to verify some information and to confirm that we are doing ICSI, which is short for intracytoplasmic sperm injection. Basically, instead of putting the sperm and the embryos in the same little dish together, they actually pick out the best looking sperm and inject it into the egg. Pretty crazy, right? I said yes to the ICSI (pronounced ick-see), and told her not to pick any two-headed sperm. My anesthesiologist said, "But haven't you heard? The two-headed sperm is all the rage right now!" Haha!

Yes, these are the jokes you make when you do in vitro fertilization.

And yes, there are two-headed sperm, and sperm with two tails, and a whole lot of other abnormalities. When they do a semen analysis, they check for sperm count and also check to see how many sperm look normal, how many are swimming straight, what the pH balance is, etc. If your numbers are slightly off, then they recommend ICSI just to increase your chances of picking out the best looking sperm and making a healthy embryo. You can see some of the typical sperm abnormalities here.

I found this fantastic little video showing the ICSI process. We don't talk much about sperm and if we do, we're usually joking about them. But I actually got a little emotional watching this video, just to be reminded of how incredible this process is. It's remarkable, miraculous, and mind-boggling that we all started from this tiny egg and itty bitty sperm. So I recommend watching it just to appreciate the miracle that you are. The link is right here.

I think the egg retrieval took about a half hour. They go through the vaginal wall with a needle and aspirate the follicles out, using an ultrasound to see the ovaries and guide the needle. The nurse took some footage of my egg retrieval so you can actually see this process on a video right here.

I woke up from my egg retrieval and was thrilled to hear that we'd gotten 24 eggs. What a fantastic start to our journey! I took some video explaining our result, which you can see right here. I had a good laugh at it since I don't remember taking that video and I'm so groggy-looking. Kind of amazing that I had the wherewithal to talk on a video, take a selfie and post it on Facebook, all while being completely out of it. Next time, do not give me my phone until I'm coherent. 

Nick had a good time laughing at me, especially since I was asking him the same questions three or four times: 

"Have you ever gone under before?" 

"How many eggs did we get?" 

"Did we get video of the egg retrieval?" 

"Was I still asleep when you got here?"

They sent me home pretty quickly and I took a few naps throughout the day. I was definitely feeling some pain all over my pelvic area. But I'm feeling pretty good now, so the recovery wasn't too bad.

The nurse called me this morning, the day after my egg retrieval, to tell me how my embryos were doing. This is one of those big calls you feel a little anxious about, waiting to see how many eggs were able to be fertilized and how many are progressing. Those numbers are everything. They represent your chances, your hopes of having a baby. Still, I was pretty calm, especially because we started with such a good number of eggs.

I was in the grocery store when I got the call. The nurse told me that 16 of my eggs were mature enough to be fertilized, which is about what I expected. Remember how we were measuring those follicles to see which ones were ready, and I knew we had about 15 or so that were the right size. But I wasn't too happy with what she said next. After 24 hours, five of those embryos had broken apart, leaving me with 11 embryos altogether. That may sound like an excellent number, but I had 20 embryos at this point last time. I'm sad to see so few progress from my original egg count of 24.

Anything could happen at this point. They will be watching the embryos each day to see which ones progress, with the cells dividing like they should. You can watch a quick video of this incredible process of embryo cell division right here. And here's a picture of the growing embryo.

We know that we will lose a few others during these next few days and this is where I'm hoping with all my heart that we don't lose too many. I admit that I'll be disappointed if I end up with three embryos or less. I'd love to see a number closer to five or six. But, of course, it's the baby that we really need, so even if there are only three embryos, there may be a baby in there. Heck, all three may even work out. Ya just don't know until you get there.

It's amazing how so much hope can be contained in something so small, the size of a grain of sand.

They have me scheduled to put embryos in (called an embryo transfer) on Saturday morning, the 3rd. If my embryos are doing really well, then they'll let them incubate a little while longer and do the embryo transfer on Monday instead. So we're in the "wait and see" game right now.

C'mon, little baby of mine. Mommy and Daddy want you so bad, and you will just LOVE Gavin, I know it! :)

Eggs Last Dose - Getting Close!

I was slightly nervous about my ultrasound today. I have all those follicles growing and am beginning to feel it a little bit, feel some pressure from my over-sized ovaries. I felt that same pressure the last time I did in vitro, but it wasn't until the day before my egg retrieval. So I'm worried things are moving too quickly, that all my eggs are going to bail on me or something.

Not only that, but my estrogen levels are through the roof. Remember that the growing follicles produce estrogen, so it makes sense that my levels would be high since I have so many follicles growing and producing all that hormone. Normally, a woman will have her estrogen levels peak at around 200 to 250. What's my level? About 1700!

Couple things I'm worried about here. Since estrogen builds up the lining of my uterus, and my estrogen levels are crazy high, am I going to have a Great Wall of China built up by the time I put some embryos in there? The theory is that too much lining can actually be a bad thing.

Also, I do worry about hyper-stimulating my ovaries. It's a real thing where your body can have this reaction to all the hormones and you can end up with some serious bloating, abdominal pain, shortness of breath, and the list goes on. I'm not too worried about getting hospitalized or anything, but it does happen and it will mess up our plans a little bit. There are a couple of signs that your ovaries are hyper-stimulating and high estrogen levels are one of the signs.

I wouldn't call it worry. I'm not obsessing about it or wringing my hands over any of it. Curious is a better word, and a little anxious just to see how it's going to play out.

But after my blood work and ultrasound today, I'm feeling excited again. My follicles are looking excellent. The doctor measures all the major ones so we can get an overall picture of what's happening in there. He had the data up on his laptop and I told him I'd love a print out of that. So here's what happening in my ovaries.

All the numbers represent the measurements. A follicle that's ready for egg retrieval will measure at 17 or 18, which is about the size of a penny. So you can see that we have five follicles ready to go already, and about nine others that are getting really close, measuring at 14 or above. We have a few others that are close but may not fully develop. No matter the size of the follicle, the doctors will get out everything they can at the egg retrieval so I could still end up with 20-something eggs. But at this point, I'm expecting about 15 to fertilize, which is a great number. If I have 20 or more fertilize, I'll feel pretty lucky!

Here's the link to my ultrasound video. But I took some still shots from my video so you could see what's going on and compare with where we started.

This is my right ovary when we started. Little follicles just waiting to be showered in FSH.

And this is my right ovary now! Wowzahs!

 This is my left ovary at the beginning.

This is my left ovary now!

Remember that they watch the embryos grow over a period of three to five days and there will be plenty of embryos that stop developing at that point. That's a good thing because we don't want to put in embryos that are destined to fail. So I may end up with 15 eggs fertilized, but I expect to have three to six good embryos left after that waiting period.

They keep an eye on my estrogen levels so we did more labs today to see whether they shot through the roof again. If they do continue to rise dramatically, they will worry about hyper-stimulating so we'll have to do things a little differently. They'll still get the eggs out and fertilize them, still watch them to see who progresses, but they won't put any embryos in. They'll freeze them all and let my body cool down from all those hormones. They don't want me getting pregnant while my body is having a severe reaction to all these injections and wacko hormone levels.

After a month or two, we can thaw the embryos and put them in, after my body has normalized. It's a lot less involved, none of those FSH injections and crazy hormone levels. We just make sure the uterus is good and ready and we put the embryos in. Studies have shown that frozen embryos actually do better, with a 10 or 15 percent increase in success rates. But it's not the embryos so much as the woman's body. All those hormones we use for in vitro may be messing things up a little, making things a little haywire. An embryo going into a a more normalized atmosphere will do better without all that craziness going on.

A lot of doctors are pushing for women to do this now, to freeze everything and do an embryo transfer later on, and I won't lie that it's appealing because of the research done. But, of course, it costs more money so that's my hesitation. Still, I need to be open to it in case my estrogen levels skyrocket.

Thankfully, my estrogen levels went down a little bit, from 1700 to about 1500. They had me on a lower dose of FSH last night and they also had me take that Cetrotide so I wouldn't release those eggs. They're guessing that's why my numbers went down.

So, the plan is for me to go back to my 300 units tonight, which will be my last night of stimulating those follicles. That should be enough to bump those mid-range follicles up to where they need to be, and we may gain a few more too. Fingers crossed. I will have another ultrasound tomorrow morning, plus more labs to keep an eye on the estrogen, and then I'll take a trigger shot that evening. That gets those follicles ready for their big debut and is timed very specifically so that they don't release on their own but are just ready to go when I do my egg retrieval. My egg retrieval will be Wednesday morning, September 30th!

And the doctor told me that your uterine lining will usually stop building up after a certain point, so I'm not worried about my Great Wall of China anymore. What a relief!

My Eggs Are On Fire!

I had my second ultrasound this afternoon, after one week of injections.

Two days ago, I had my first ultrasound and we could see that my eggs were growing quite nicely. I was thrilled to see so much activity and the doctor agreed that I was having a "great response."

We still see a good amount of follicles progressing, about 25 or so. But we have about 12 follicles that are really soaking up those hormones and taking the lead. At this point, I could end up getting 10 eggs or I could end up with 30. We won't really know until the day of my egg retrieval, after it's all said and done.

What really shocked me was to see one follicle much larger than the rest. While the other follicles were measuring around 11 to 14 millimeters, this one was measuring at 18 millimeters! That's how big they get when they release, or when we get them out at egg retrieval! We have one anxious baby in there!

My ultrasound video is right here. Click ahead to 2:40 if you want to see the one follicle showing a little bigger than the rest. That's my baby in there! Crazy, right?

That big follicle made me a little nervous, of course. I don't want that little bugger to release on his own before we can get him out of there. Maybe that's my winner embryo in there! The doctor agreed and we decided I should go home and immediately take my Cetrotide injection, which will stop any eggs from releasing. We also decided that I should come back sooner than later to check how things are progressing. So I will be returning tomorrow, Sunday afternoon.

My egg retrieval was originally scheduled for Thursday, October 1st. But I have a feeling it will be a day or two earlier since things are progressing so quickly. My uterine lining is building up fast too, which makes sense since I have all those follicles producing estrogen. That's a lot of estrogen! It's going to be fun to see what happens these next few days and how it all plays out!

I'm still feeling very calm. I continue to keep my expectations low and I suppose I've gotten so used to this roller coaster ride that it really doesn't phase me anymore. For me, this is what making a baby is about. This is my normal.

Keep an eye on the blog. Things are getting real and happening fast!

Excellent Start - Eggs Are Growing

Today was my first ultrasound!

Normally, we hear ultrasound and we think about a baby in the womb. Well, hopefully that’s coming. But right now, we’re looking at follicles and wanting to see growth!

This is where your education comes in, where it’s going to help for you to know about eggs and follicles, about hormones, about the uterus, and about the injections I’m doing. Now that you understand this process and how it works, you can get a more excited about what you’ll be seeing on my ultrasound!

Remember that I’m injecting 300 units of FSH (follicle-stimulating hormone) every night. You can watch me explain the medication and injection process in this video in case you missed it. I’m giving myself about eight times the normal amount of FSH that a woman produces, which means my follicles are going to be a lot more active than they normally would. Every month, we have only one follicle that ends up taking the lead, growing big, and releasing its egg. But with all that FSH, we’re going to be seeing a lot more than that!

As a reminder, this is what an ovary looks like on a regular cycle with normal amounts of FSH, where you have just one follicle taking the lead. You will appreciate the contrast between this picture and my ultrasound video! Or you can watch my first ultrasound video from a week ago and see the difference between now and where we started.

My doctor told me that at this stage in the game, I should have a few follicles measuring at about 10 millimeters. That would tell him that my dosage is good and we’re right on track.

I wasn’t quite sure what I’d see on the ultrasound, whether I’d have much of a response yet. At this point, I’ve had five injections and my dosage is lower than it was before. So are my expectations. With the lower dose, I’ve set myself up for having lower numbers than last time, and I’m fine with that as long as I end up with good quality eggs. Remember, it’s quality over quantity.

So I figured there might be just a little bit of activity.

But I was very pleasantly surprised by my ultrasound. Right away, you could see that my follicles are soaking up all that FSH! Lots and lots of good-sized black dots. Hooray! The doctor was measuring them on the screen and the nurse was keeping track. I ended up with 10 follicles measuring right where they should be, at about 10 millimeters, and 23 other follicles that were a bit smaller than that. That’s 33 follicles total!

Here’s a video of the ultrasound right here!

It’s no guarantee that all those follicles will continue growing. I think I had a similar number with my last round of in vitro, and they ended up with 27 eggs and 22 that fertilized. So we lost a few along the way. And we ended up with only one baby out of all that.

Still, that is an excellent number to start with and much better than average. Even if I get only half of those fertilized, I’ll be thrilled. And if I end up with one baby out of those 33 follicles, I will be overjoyed.

After that ultrasound, I was asking questions and talking to the doctor and I had this moment of excitement, the first moment since I’ve started all this. The thought just came to me, “Oh my gosh! This might actually work!” I kinda smirked at my own giddiness. But I have good reason to hope. That was a great ultrasound, much better than expected.

So stay tuned! Because I will be very closely monitored at this point, with ultrasounds and blood work every two days. I will post all the ultrasound videos so you can watch those follicles grow, all those mini-me’s inside of me, waiting to be taken over by Nick’s DNA, haha! If all goes according to plan, we will be getting those eggs out in a week, on October 1^st! Woohoo!

So Calm

Last time, I talked about our hormones and how they all work together. I also talked about how I'd be giving myself shots of the follicle-stimulating hormone (FSH) so we get all those eggs growing. Here's your chance to join me on the shot process if you click here. Really, it's kind of an entertaining video because I'm such a clutz.

I had the pleasure of hanging out with a bunch of lovely women this evening. I spent a good part of it snuggling with their tiny babies, smiling at them and soaking up all their preciousness. Yes, I am completely baby crazy. Guilty as charged! It's such a leap forward for me to enjoy these little babies instead of feeling miserable and uncomfortable around them. And it reflects where I am with my emotions right now, which is a much better place than I was before.

I guess I've really run the gamut with my emotions, since I started out so hopeful when first doing in vitro. Never did I imagine things could be so hard, so draining, and so dark. After all that loss, I was so jaded. I had no capacity to hope anymore. I was numb, just going through the motions and waiting for the next ax to fall.

Things are so much different this time. More than anything, my life is so much fuller than it was before. Honestly, my life was really quite awesome in Hawaii. I absolutely loved living there. I loved my job, my friends, the mountains, and the ocean. My life was full and rich in so many ways.

But I didn't have Gavin.

Gavin fills my heart and my home with joy. He makes me smile and he makes me laugh. I get so excited to see his bright smiling face because it brings me so much happiness. You know the orange juices that brag about being 100% juice? This is like 100% freshly-squeezed happiness right into my heart and soul. I cannot think of a happiness more pure than that.

I could go on and on about how adorable he is and everything he does that makes me smile and laugh. He's made such a difference in my life and it's really influenced where I am today and how I approach this next round of in vitro. My life is so much fuller now so I don't feel as obsessive about the outcome, how it's all going to play out. More than anything, he has taken away that horrible anxiety of wondering whether this will ever work, whether all this money and shots and procedures will ever amount to a baby. It will. Maybe not this time, or the next time, but it will. Gavin is proof of that.

And I know I have the perseverance to keep going, to continue until I reach the prize. That was my attitude throughout my entire journey, that I had to feel like I gave everything I had, that I fought for my kids until I had nothing left emotionally, physically, spiritually, and financially. I had to know that I gave it my all. And I did. I sacrificed so much for Gavin. But it was worth it and now I know that patience and perseverance can pay off.

So I'm not obsessing. I'm not anxious. And why should I be? At the end of the day, there's nothing I can do to change the outcome. I've done my part to ask questions, find answers, and do my best for my eggs. Now all I can do is let nature take its course and see what God has in store for me.

I guess you could say that I've given it all into God's hands. And there's kind of a peace in that, a release. Life doesn't work out how you plan and some things are beyond your control. All I can do is move forward, hope, trust, and believe that I am capable of surviving whatever is next. Heck, instead of learning to survive pregnancy loss, maybe I'll learn to survive twins!

The point is, I am calm. I've been through this before and I'm stronger now. So is my support system. My expectations are different, more realistic. And my life is happy and full.

I think that's a pretty good place to be.

Keeping Things in Perspective

Have you ever heard of opportunity cost? It means that every time you make a choice, you’re giving up the chance to do something else, the chance to benefit from some other course of action. All moms know about opportunity cost because they have to choose how to spend their time when the kids are down for a nap. Do I gain more from taking a nap myself or from getting something done around the house? Whatever you choose, you lose the benefit of the other option. You can catch up on sleep, but the house will still be messy. Or you can have a tidier home, but now you feel extra tired. Nothing is free, including your time, and you have to make those choices and decide which opportunity cost hurts less.

People who do in vitro, we know all about opportunity cost. Last week, I went into our fertility clinic, slapped my checkbook down on the front counter and declared, “I’m here to donate my arm and leg.” I wrote a few checks, swiped my credit card, and spent about $13,000. How much is that even? Well, if we put away $100 a month for our fertility fund, it’d take us about 11 years to get the money needed for one cycle of in vitro. Eleven years!

What is my opportunity cost? Well, I can think of a whole lot of things I could do with $13,000. That’d be a great travel fund right there. We could go to New Zealand, Spain, and maybe even Africa. We’ve never been on a cruise before so maybe we’d give that a try. More than anything, I’ve been really itching to settle down and would sure would love to buy a home. One of these days, we’ll have some savings and be able to put a down payment on a house. We’ve also been a one car family for about two years now, with Nick riding his bike to work, 26 miles roundtrip. That kind of money would make an excellent down payment on a car. We’d probably even have some left over if we wanted to buy used. Really, the list goes on and on. There’s just so much you can do with $13,000.

But that money is going toward making another baby. We hope so anyway. That’s the thing with in vitro. Ya never know what you’re paying for until it’s over and done with.

Still, I can’t help but count my blessings and it’s good to keep things in perspective. Infertility is really taxing and emotional and will bleed you dry, but there is so much we enjoy that many people don’t. We have a steady income. We may not be loaded but I can buy myself a pair of pants and not worry about making it through the month because of my splurge. I can buy good food for my family and afford to make healthy meals. We can afford a gym membership so I can stay in shape. We can afford a little two-bedroom condo. Yes, it’s small. But it’s a nice neighborhood and I feel safe and I love my neighbors. Heck, even the clubhouse and the pool are pretty darn nice! That’s worth a lot, and I’m sure this place a whole lot bigger than many other homes around the world! I have a reliable car and can afford the gas for all my excursions. I can afford to go to lunch with friends every once in a while. I can afford to buy some scrapbook paper or a tube of paint and enjoy my hobbies. I can stay connected with my friends, with the world, and with all kinds of knowledge because I can afford my internet and phone service. Heck, I can turn my water on and make it hot! I can even drink it and not have to worry about getting some horrible sickness from it. All I do is twist a nob! I have these two machines in my house that wash and dry my clothes for me. And how magical is this? If my little boy gets sick, I can take him to excellent medical facilities with very sanitary conditions and know he will be treated with the latest and greatest medical knowledge that is far beyond where we were even fifty years ago! How about the fact that I love my husband and he loves me and we’re really good friends? How about the fact that I have an amazing network of friends and family who support me and make me happy? How about the fact that I have a ridiculously adorable little boy who makes me smile and laugh and is the light of my life!?

Yeah, perspective.

And that’s just scratching the surface. If I really wrote out a full list of blessings, it would HUGE.

There’s always so much to be thankful for, especially here at this place and time we live in. So much! For me, my life is nearly perfect. I just need to twist a few things around to get it there. So, I’m basically pouting because I’m a few twists away from a perfect life when so many people would be dumbfounded at all that I have.

Think of all the women, all throughout time, who had fertility problems and never even had any sort of a chance to do something about it. They just prayed and hoped and waited and that’s all they could do.

It’s all about perspective…

Yes, I’m giving up a lot with that money. And I’m not even sure what I’m getting yet. It’s like I’m standing in front of Door #1, Door #2, and Door #3, and I’ve paid $13,000 just to pick a door and see what’s behind it. And only one door has the prize. It’s a pretty huge opportunity cost, but I have this chance to get another child and nothing can benefit me more than that. Not a home, not a car, and not a trip to Spain or Africa or New Zealand.

Eventually, I’ll pick the right door and it will be worth it. In the meantime, I am happy, I am blessed, and I am ever so grateful for all that I have. Anything beyond that is icing on the cake.

Hormone Control - Why Hormones Have Everything to Do With Making a Baby

Tonight will be the first night of injections, the first night of our journey toward making a miracle. What will I be injecting? A hormone called follicle-stimulating hormone (FSH). Lots and lots of FSH.

I really wanted to do a post about hormones, because hormones play such a huge role in all of this. The only way to really appreciate the in vitro process is to understand the hormones involved in making a baby. It’s interesting how each hormone has its specific job, but more than that, I find it so fascinating that the hormones communicate with each other, and take their cues from each other on when they need to be active and when they need to slow down. It blows my mind.

If you'd rather see me explain about hormones on a video, then you can click on this link to watch the youtube video I made on the topic. Otherwise, read on!

We’ll be talking about four main hormones:

(1) Follicle-stimulating hormone (FSH) fuels the growth of the eggs. Remember that the eggs live inside sacs called follicles and the egg and follicle need to grow and mature before they can be released and ovulate. It’s the FSH that fuels that growth.

(2) Luteinizing hormone (LH) has the specific job of triggering the egg to release from the follicle and out of the ovary. In other words, LH is what triggers ovulation.

(3) Estrogen is in charge of building up the lining of the uterus.

(4) Progesterone helps the lining of the uterus to get all the nutrients and enzymes it needs to be a healthy and welcoming place for the embryo.

At the start of a cycle, when a woman is on her period, her estrogen and progesterone levels are very low. That sends a cue to the FSH, essentially saying, “We have no baby on board. So we need to start making another egg.” So the FSH kicks in and starts nourishing those eggs. They grow, mature, and get ready to ovulate. This process of growing and maturing usually lasts about two weeks, and makes up the first half of the cycle.

Interestingly enough, the growing eggs produce estrogen! As they grow and grow, the estrogen levels get higher and higher, and the lining of the uterus gets built up. So the growing egg is essentially in charge of building its own home, which is pretty cool. By the time it ovulates, the lining should be in pretty good shape for accepting that embryo.

So how does ovulation occur? Well, as the estrogen levels get higher and higher, they eventually reach a point that cues the luteinizing hormone (LH) to do its job. The LH recognizes the high estrogen levels and says, “Wow, we’ve got an egg that’s ready to roll! Time to open the gates!” The LH kicks in and, about two weeks into the cycle, helps the follicle to release its egg. So, not only does the egg build its own uterine lining with the estrogen, but it also uses the estrogen as a keycard to get itself outta there! Crazy, huh?

And after all that hard work, that precious little egg has only 24 hours to be fertilized. That’s right, twenty-four hours! We are all here because everything was at just the right place at just the right time. If only the rest of our lives were so serendipitous!

Now remember that the progesterone is needed to get that uterine lining really rich in nutrients. It’s pretty important in helping to make a friendly environment for the embryo, which is why it’s called progesterone, meaning pro-gestation. So where does the progesterone come from? Are you ready? Because this is fascinating! After the follicle releases its egg, it turns into a different structure, called a corpus luteum. Now that it’s released its egg, it has a whole other job to do – get that uterine lining super healthy and friendly for that egg! So this follicle, now the corpus luteum, actually stays on board and starts producing progesterone! Basically, the follicle is responsible for a whole lot and is an amazing structure! It helps incubate and mature the egg, helps release the egg, and helps build up and enrich the uterine lining. High five, follicles. Five gold stars for you.

So, the egg is floating around hoping to get fertilized. When it meets up with the sperm and becomes an embryo, then it’ll find its way down to the uterus and implant. This can actually take about a week, so you usually have an embryo implant about three weeks into your cycle, or a few days before you’d have your period.

As the embryo nestles in and gets comfy, the cells around the embryo are having a big ol’ party that their guest of honor has arrived. Those cells produce a hormone called HCG, which probably sounds familiar! That’s the hormone we measure when we are checking if a woman is pregnant because those cells are whooping and hollering and letting us know that there’s a baby in there!

But the HCG does more than let us know we’re pregnant. The HCG also sends a signal to the corpus luteum, saying, “We do indeed have an embryo here so we need to keep this uterine lining up and running and in tip top shape. You’re gonna need to stay on board and keeping sending us progesterone until we can get a little more self-sufficient around here.” So the HCG and the corpus luteum communicate with one another, with the HCG requesting more progesterone from the corpus luteum to keep the embryo nourished.

So we’ll see the HCG levels rise and the progesterone up at a healthy level as we progress through a pregnancy.

Now, if there was no fertilization, no embryo, and no implantation, then about two weeks after releasing its egg, that corpus luteum will turn in its notice and retire. Without a baby to support, there’s no longer a need for that progesterone so the corpus luteum is officially done with its job. As a result, progesterone and estrogen levels will go down, farther and farther. Without the support of those hormones, the uterine lining will break down and shed. Ta da, here comes your period.

And what else happens? Oh yeah, that FSH wakes back up because the progesterone and estrogen levels are low again. Time to get going and build up another egg! And the cycle continues.

Isn’t it all amazing how all the hormones communicate together? So much work all in an effort to make a baby each month.

What will we be doing differently for me with in vitro? First of all, I have been on birth control over this last month because they don’t want any kind of activity happening in my ovaries. With birth control, you’re giving yourself progesterone and estrogen hormones. With those hormones elevated, your body thinks you’re pregnant. So your FSH never kicks in, you don’t grow any eggs, and you don’t ovulate. This is what we wanted, for my ovaries to be inactive and quiet before we get started.

On Friday, September 18^th, I went in for an ultrasound, or a “suppression check.” They wanted to make sure that my ovaries looked like they were inactive and I had no growing follicles in there, that everything was indeed suppressed from my birth control. Everything checked out okay and they were able to count my follicles. I had 18 on my right ovary and 8 on my left, so 26 follicles overall!

If you want to see the video of my ultrasound, click here.

Normally, my body would produce enough FSH so that one egg would end up becoming the dominant egg, or dominant follicle, and would be the one to be ovulated in hopes of fertilization. And that’s a good thing. Our bodies are meant to carry one baby and it would be a disaster if we were dropping twenty eggs every month!

But, with in vitro fertilization, we are going to be dousing all those follicles with a big ol’ dose of FSH, because we want as many eggs as possible for a chance at fertilization. I will be giving myself 300 units of FSH each night for the next week and a half or so, clapping and cheering for all those eggs to grow and mature! 

When I did in vitro a few years ago, I was giving myself a daily dose of 450 units. But current research shows there's not much of a benefit once you go past 250 or 300. Basically, my ovaries are pretty saturated at that point. Not only that, but too much FSH can create a higher risk of hyper-stimulation and may cause a loss of egg quality. So we're shooting for the lower dose at 300 units, which I'm hoping will produce better eggs. Not only that, but it's better for my wallet anyway. My FSH medications cost $45 for every 75 units, so I just saved myself $90 a day by bumping things down.

As you can imagine, all those follicles will be producing quite a lot of estrogen. Remember that high levels of estrogen lead to ovulation and we don’t want that. We don’t want all these precious eggs to get released! So, about five or six days into this process, I will be taking a medication to suppress the luteinizing hormone and make sure those eggs don’t release prematurely. Not until we are ready to get them out ourselves!

Just like any other pregnancy, it’s going to be important for my progesterone levels to be high and my uterine lining to be nutrient-rich. So, once we are about to put those embryos in, I will start doing progesterone injections to make sure everything is as healthy as can be. Frankly, this is the worst part of the whole process because I have to do it every day for six weeks, it hurts and gets more and more sore, and I do the injections into my butt. Don’t worry, there will be no video blogs for the progesterone shots.

That’s it, folks! Now you know all about hormones, how they communicate, and the jobs they have to do. And now you know what I will be doing over these next few weeks – lots and lots of shots! All in our effort to make another miracle. I hope you learned something and I hope you feel more and more wonder at how amazing your body is!

By the way, I did a video of our first injection but it was kind of a learning process so I won't post it. Once we have it down, I will let you in on my world of mixing potions... I mean, hormones.

The Power of Empathy

When I was just out of high school, I dated a guy who was sweet and kind, but way too short for my tastes. We were opposites in a lot of ways, including our complexion. He had perfectly clear skin and here I was this girl who’d struggled with acne since the 6^th grade.

One day it came up, me and my on-going battle with acne. I guess he had no idea I struggled with it so bad. When I told him more about it, he suddenly smiled, embraced me, and let out a sigh of relief. What in the world!? Turns out he’d had acne too! He’d had it so bad, he wouldn’t even go to school because he was so embarrassed.

We both opened up about the damage acne does. It’s so wretched to see others repulsed by your face, even your own friends. That crap will mess you up for life. But you don’t blame them. You don’t enjoy looking at your face either. It’s gross and that grossness is you. Mirrors are a cruel reminder of what you get to present to the world – to your teachers, your classmates, your friends, the cute guy at the grocery store, and the UPS man knocking on your door. “Here’s your package. Yikes!” Hiding in your bedroom is way better than knowing people are seeing you and not liking what they see. And this is how you feel every day with every interaction. And, in my case, for decades.

Lucky for my boyfriend, he’d been able to get an aggressive treatment done and was all cleared up, something none of my doctors were ever nice enough to do for me. I was so jealous. He didn’t have the physical scars but he did carry the emotional ones and felt so relieved to share that with me, to know that I understood what he’d gone through.

There are those rare and beautiful moments in life when you really connect with someone, when someone really sees you - who you are and what you’ve been through - and they get it. It can be as simple as sharing the same silly quirks, the same sense of humor, the same unique likes, or similar childhood experiences. Maybe you are the one person who likes black licorice and you can’t believe you’ve found someone who loves that as much as you do!

But that connection runs a lot deeper when there’s more emotion involved. In our case, we’d both been so severely damaged by acne that we felt a lot closer after sharing that trial together, knowing the hurt it causes. I’m fascinated that we work this way, that we feel so much stronger just in being understood by someone. We are meant to create these emotional networks with people, to gain strength and comfort in finding a common bond with others. Somehow it makes you feel more sure of yourself, more grounded. It makes you feel okay to be human, to be flawed, and to struggle with this and that, because you know someone else is too. It feels a little easier to carry your burdens because you’re not alone anymore.

And loneliness is one of the all-time worst feelings. When we feel connected, we feel stronger. When we feel isolated and invisible, then we feel weaker and our burdens are harder to bear.

I felt that isolation after my three miscarriages and struggled so badly to be seen, to be understood. I reached out for those emotional connections, for a little bit of strength, but I kept coming up empty-handed. I didn’t know anyone who’d ever lost three pregnancies in a row. Nor did I know anyone who’d lost three pregnancies after doing in vitro. Heck, I didn’t even know anyone who’d done in vitro! And all of my local friends had children. Every one of them. I was the only childless woman around.

I suffered so much and kept wondering what I could learn. And there are a few lessons.

First, to recognize the strength in connecting with others. Maybe I can’t relate to the woman who’s gone through a divorce, or the mother who’s child is suffering from a terrible illness, or the elderly woman who’s angry at her old age. But I can try. I can let myself be vulnerable, let myself feel what they are feeling. Because I want to really see them, to make sure they know that I care enough to walk that path with them. Sometimes that’s all it takes to lend a little strength.

I understand there are people out there who can’t give that much. We all have our own burdens to bear. If we put ourselves out there to feel the burdens of someone else, it can be overwhelming. For most of us, we think about someone, we worry about them, pray for them, and probably feel a little sad for their situation, but all we can really give is an “I’m sorry.” We know we can’t fix their problems and can’t fully understand their emotions, so we leave it at that.

Sometimes the connection doesn’t have to be too grandiose, though. Of all the comments made, there was one that stuck out to me and made me feel a bit of relief in my time of trial. One friend told me that she’d experienced a miscarriage herself and it’d been terrible. It was one of the hardest things she’d ever gone through. With that in mind, she figured I was suffering pretty badly having to do that again and again and again.

Just that one comment let me know that someone out there was attempting to understand how I was feeling and what I was experiencing. It didn’t create a huge emotional bond, but it did help me feel a little more connected to this person, helped me feel validated. It’s strengthening to have someone really see you, to have them step outside of themselves and take the time to be with you.

I had another friend who called me from across the ocean. She said to me, “When I was going through my divorce, it really helped to get a call from someone, even if they couldn’t do anything for me. Just to know they were there for me and thinking of me really helped.” She wanted to do the same for me. She had no advice or any way she could really comfort me or take away my problems. But she showed me that she saw me, that she wanted to be emotionally available to me.

I could have used a whole lot more of that at the time. It would have made a big difference. I remember being in my home and thinking, “If they knew how I was feeling, someone would be here with me." There was no way in heck that anyone would feel those feelings and think it was a good idea for me to be alone. But my resources were limited. My local friends were busy with their own families. There were people who were anxious to reach out to me, but they were an ocean away.

Still, I yearned for those connections and now I understand their incredible value and impact. My compassion for those who are hurting and lonely has increased so much and I feel drawn to help them however I can. Because I don’t want anyone to feel the way that I did – horribly heartbroken and terribly lonely.

Maybe I can’t take away the pain but I can help lift the loneliness.

I also learned how wrong we are to judge others. The right answer is so much easier to see when you’re on the outside looking in. But you’re not feeling the way that they do and you may not fully understand the situation.

The truth is, trials can completely overwhelm us sometimes, can change us into a completely different person. I had some people tell me to go out and do service or to try and keep my chin up, have a good attitude, count my blessings, etc. All well-meaning comments that might have been good for someone just having a bad day or a bad week. But for someone struggling to even get out of bed in the morning, someone who feels like they are suffocating in a storm of sorrow, these comments just got swept away by the storm.

It relates to the first lesson about connecting with others. When we try to understand how someone is feeling, we‘ll feel more compassion for their situation and understand their thoughts, feelings, and actions a little better. In my case, there may have been too many things for people to try and understand – not being able to get pregnant, doing all the expensive treatments, and losing so many pregnancies. That’s a lot to absorb.

I can’t excuse everything I said or did during that time. I know there are some people who thought I was being a little melodramatic and that’s probably true. But I understand now how some people lose the faith and get really angry at God. I understand how strong bitterness is, how your rosy glasses can turn black. I understand how people can feel exhausted at the unfairness of the world, throw their hands up in the air and yell, “This is too much!” I understand how people can feel so weighed down by heartache and depression that they drown themselves in something else – drinking, drugs, whatever helps dull the pain, dull the whole world.

I know that sometimes, life is just too hard and you no longer want to be a part of it.

I often think I have all the right answers. In fact, one of my all-time top frustrations is seeing the way people live their lives and knowing they would be so much happier if they did this or that. But I know that life isn’t as easy as making a few calculated moves. Sometimes things trip you up, crap happens, and your emotions get the best of you.

So I try to be a little more patient, a little more understanding and compassionate. I don’t always have all the answers nor do I know everything about that person. Granted, I’ll still roll my eyes and groan in frustration when I see people in their destructive behaviors, traveling down a road to nowhere, playing the victim, or whatever else. I can’t stop caring and hoping the best for people. But I can’t let myself think that I would do any better in their shoes.

For me, I probably could have done better. I could have been more patient, more hopeful, more prayerful, more thankful, and more faithful. But I wasn’t. I struggled. I stumbled. I was broken and am still picking up the pieces. I just hope that people can forgive that, can try to understand and have compassion. I know that would help me and I hope to pass that on to others who are struggling to put one foot in front of the other.

People sometimes ask me what they could do for their friends who struggle with infertility. It’s a really hard question, and especially frustrating because the list of don’ts is much longer than the list of do’s. Not only that, but people do grieve differently. I know people who keep their infertility completely to themselves and I understand why. Yes, there may be some strength gained from sharing with others, but that kind of vulnerability is super risky. Instead of feeling connected and validated, you may find yourself feeling misunderstood or ignored. It’s very painful to feel lonely, then risk putting yourself out there only to find that no one is really listening. It just solidifies your loneliness and you end up worse off than you were before.

Unfortunately, there's no perfect method for approaching your infertile friends (or anyone who is suffering) because everyone is different. That’s going to require some careful discernment from you – some caution and sensitivity - and will be different depending on your relationship too.

But in every scenario, I would apply those lessons: Don't think you have all the answers for them, or would react any differently if you were in their shoes. Be slow to judge and instead choose patience, compassion, and forgiveness. Above all else, SEE THEM. Try to understand and really listen to them. Don’t ask how they are feeling but what they are feeling. Let them know that it’s okay to be angry, frustrated, and sad, that they don’t have to be strong for you. If they want to cry, cry with them. If they want to scream, scream with them. That is the power of empathy, to be that emotional connection for them, to give them your strength, compassion, and understanding. It may not be easy, but you can have a powerful impact.

As with most trials, there isn’t much you can do to solve my problems. That connection is about all you can offer me, but it makes the world of a difference. Maybe it still hurts and I still struggle. But I’m not doing it alone.

The Battle of Emotions

A few weeks ago, I reached into the bottom drawer of my bed stand and pulled out something near and dear to my heart – my fetal Doppler. This was one of all-time favorite purchases, a little treasure I’d bought when I was pregnant with Gavin.

At our 18 week appointment, we saw we were having a baby boy. Somehow it felt more real after that. We were having a son and he was going to make it! I felt a flood of relief wash over me. I’d been holding my breath for four months and could finally let it out!

Still, the worry would always be there. I’ve heard too many scary stories to know that scary things do happen and when you’re someone like me, you know they can happen to YOU and not just someone you know or a friend of a friend.

What better way to put my mind at ease than a fetal Doppler? I spent the fifty bucks and was so glad I did. Every day I would listen and feel so happy and peaceful knowing there was still a little life inside of me. It was very comforting.

But the Doppler wasn’t for me this time but for one of my friends. I pulled it out and started working my magic, trying to find a heartbeat on her pregnant belly. The little bugger couldn’t be found but we did hear him moving around in there with the Doppler and could feel his movements too. It was so fun to hear and feel him. I lent her the Doppler so she could keep an ear on him and enjoy the fun of it.

I’m so excited for her. This is her first child. She showed me his ultrasound videos and I loved it. I love thinking about names with her. I love asking her how the pregnancy is going and keeping tabs on her. And I’m so very excited to hold him when he comes.

This is huge for me - to be happy about her pregnancy, to enjoy it with her, to be excited to meet that little boy. I’ve come a long way from where I was.

Truth be told, I was never much of a baby lover. Everyone always seemed so enamored with them but I rarely found them that exhilarating. I could never get on board with all the oohing and ahing. It felt awkward, phony, and unnatural because the adoration was never really there for me. Not to say that I hated babies or thought they were ugly. I was mainly indifferent.

I loved my independence too. It’s pretty easy to feel good about your child-free life when kids are throwing tantrums in the store and you don’t have to take them home with you. You get to enjoy the peace and quiet of your well-kept home and do whatever the heck you feel like doing instead of putting the toddler in a time out or trying to soothe a fussy baby. Reading a book sounds better than that. Better yet, how about a nap!

I had a friend once ask me if I was mad at God about being infertile. I said no. I figured I’m a pretty good candidate for infertility as opposed to the woman who drools at every baby and wants ten kids.

Still, that’s a surprising response for me since I’m a champ at comparing myself to others and feeling a little jilted at times. That makes me look bad, I know. In my defense, I’m often counting my blessings when I see what others go through, so it goes both ways. I’ve become much more aware of what lies beneath the surface, that others are often suffering through things we know nothing about. At the root of it, I’m just interested in the human experience as a whole and love to hear the stories of others, just to see all the different ways life can be lived, both the good and the bad.

So, every once in a while, I can’t help but notice when someone’s story sounds a whole lot better than mine! Don’t lie and say you’ve never felt that way. Maybe you’ve even been jealous of me!

Ugh, jealousy. What a horrible emotion. On the one hand, you know it’s not a righteous feeling. Does jealousy ever lead to anything good? I suppose it can fuel success if it leads you to pursue what others have and you don’t. But it can carry a whole lot of other baggage with it, like bitterness, anger, and ingratitude. Seems like many of the villains in story books and movies are driven by jealousy. Snow White got tricked with a poison apple because the queen coveted her beauty. We can all relate. Everyone has felt second-best, unlovable, untalented, devalued, or whatever else. It’s real, it’s raw, and it stinks.

Still, we know that acting out those feelings is usually a bad idea, especially if poison apples are involved.

On the other hand, there are times when you’re jealous for something that IS righteous, or just something that is normal. We’re not talking about being the best at something, being the most beautiful or talented, seeking praise from the masses, or whatever other prideful motive. Maybe you just want to have companionship and be married. Maybe you just want to have children. Maybe you just want to be healthy enough to run, talk, eat, breath, whatever! There may be some selfish motives in that, but all in all, these are righteous, normal, and healthy desires.

Sometimes it feels like the only way to remove the jealousy is to stop having the desire in the first place. In fact, quite a few philosophies and religions preach this very thing, that happiness is the absence of desire. Without the turmoil of unmet desires, you feel gratitude and peace for what is.

This is a pretty good philosophy and makes a lot of sense to me. Seems like the happiest people I know have few expectations out of life and are able to find peace in the moment. I’m very jealous of these people. (Ironic, I know, considering our discussion.) They have a peace beyond anything I ever hope to experience, except perhaps in my later years when age forces me to slow down. It may be the reason I enjoy the outdoors so much. Out in nature, my expectations go away and I find peace. I don't need to see a perfect tree or a perfect rock or a perfect stream because there is no such thing. Nature is chaotic yet beautiful, perfect as is.

There's a part of me that would love to live my life out in nature, to experience that kind of peace and contentment, without all the expectations, needs, and demands.

But having few expectations is something completely unnatural for my highly driven self. I want to make the most of every moment, to find fulfillment in all that I do, and experience all life has to offer. For me, being a mom is a huge part of that life experience and not something I can put in a box and put on a shelf because it’s causing me pain.

And it was so very painful at times, the jealousy all-consuming.

The thing about infertility is that you can’t escape the reminders. Everywhere you go, there are pregnant women and little children. This is especially true at my church because Mormons love to have babies, love to talk about parenting, motherhood, and the family. My favorite are the conversations about family size, where women talk about how many kids they plan on having, how close in age they want everyone to be, and when they’re planning on trying for the next one.

It makes me think of people in a wheelchair. Everywhere they go, they see people walking. It’s effortless and normal for everyone else, but for them it is a struggle and a yearning in their heart. In a world where making babies is easy and commonplace, I feel like the cripple.

Normally, I can go through my day to day without feeling too much pain. I keep busy, fill my life with other things, and find fulfillment in other ways. Then there are times when a comment, photo, video or announcement can cut right through and pierce my heart and soul. It’s a constant up and down with infertility, a wrestling of the emotions.

When things got more difficult for me, I started to envision this very real battle of emotions inside of me. I imagined these warriors in white and black, representing the good and bad emotions that were battling for dominance: hope vs fear, peace vs anger, gratitude vs bitterness, happiness vs heartache, faith vs doubt. It’s an ongoing battle that is really quite exhausting, both spiritually and emotionally. 

Most of the time, I felt like the battle was pretty even, cut right down the middle. There's the ups and downs but I could keep it all in check, for the most part.

But the ultimate trial came with my third miscarriage, when darkness won it all. I was living in Hawaii at the time and good friends with another woman my age. She was far ahead of me in the family department with three kids of her own. The both of us had lost pregnancies in 2012 and then both got pregnant again at the same time in February 2013, with me doing my third in vitro. I thought it’d be neat for us to have our babies together and help heal the losses.

But her pregnancy was headed south. The gestational sac was much larger than it should be, which usually leads to the loss of the pregnancy. I vividly remember my friend confiding her fear and anxiety to me. There were tears and hugs from the both of us. It was strange to be on the other side of it, comforting another woman for pregnancy problems. But I knew all too well the feeling of a pregnancy on the rocks, the tension in your body, the anxiety in your heart. It’s like watching your child do some rock climbing with no ropes. You’re waiting for the worst to happen but hoping and praying it doesn’t. It’s impossible to relax or think of much else.

Sometime later, my friend called me and we talked for a long time. She shared that everything was working out okay. The sac was normal and the baby was fine. It was truly a miracle and a huge relief!

 

But my pregnancy was not going as well. I was actually just about to leave for my ultrasound to see how things were going. My friend asked me how I felt. Was I nervous? Was I worried? No, I was actually feeling quite hopeful. Losing this pregnancy felt like too much of a nightmare for it to be real. I couldn’t fathom something so tragic and God could not possibly be so cruel. It just didn’t make sense. So it had to work out. It was going to be okay.

But it was not at all okay.

I knew it as soon as I looked at the ultrasound. Things were falling apart. I sat there in a daze, feeling a numbness come over me. I miscarried while driving, stuck on the freeway, in excruciating pain.

That’s when darkness won. Anger, bitterness, heartache - that’s all I was able to feel. I had no more light to fight with. They were too stunned, too drained. They laid on the ground in submission and gave up.

I had some very difficult questions for God. Why did my friend deserve a miracle and I didn’t? This would be her fourth child. Was I not worthy of just one of my own? How could I rid myself of this horrible jealousy when everything seemed so unfair?

What could I possibly learn from this incredible pain? How could my Heavenly Father want his daughter to hurt so horribly? Why would you choose to bruise a heart that is already broken? Was I not already sufficiently humble? Sufficiently hurt?

Would I ever have a child?

The emotions were horrible and overwhelming. The grief of a lost baby is terrible enough. Pile on a little extra angst and devastation for all the time and expense of in vitro. Now add fear, doubt, and hopelessness that you may never have a child. Sprinkle some confusion and frustration as to why this has to be so hard and why there aren’t any answers. Now slather on some severe jealousy because everyone you know is getting pregnant and having children. Add a good helping of helplessness on top because there isn’t much you can do about any of it. Serve on a plate of bitterness.

Yeah, the darkness definitely won.

Thankfully, the ebb and flow continues and my warriors found some life again. Gavin was a huge help in that and turned everything around in so many ways.

He gave me the gift of pregnancy, birthing, and motherhood, all beautiful and wonderful experiences that I could now share with other women, share in the joy of it. The inescapable smile that comes from the kick of your baby. The warmth in your soul when you see the baby wiggling around on an ultrasound. The excitement you feel when the birthing is near, when the baby is almost out. And the magic of holding a brand new baby, of seeing his face for the first time - the preciousness, the tenderness, the overwhelming love. All the clichés are true. It really feels like heaven.

Now I get it. I understand the oohs and ahs and I join in whole-heartedly. In fact, I have a very special place in my heart for babies now. Having a tiny adorable baby of my own made me feel so protective of them. That kind of purity and tenderness I have never found anywhere else and my desire is for all babies to be loved and cherished as I love mine. If ever I hear of any tragedy befalling a baby, my heart hurts terribly. I sometimes purposely avoid sad-looking baby stories because I hate crying over them.

But I feel enriched by the tenderness that’s grown within me. I feel blessed to experience that kind of love. And I’m thankful to join with so many women in enjoying all of fun of motherhood and to have that camaraderie with them, and with my friend who is pregnant for the first time and discovering the joys of a heartbeat and a kick. It’s all a magical experience that I hope to have again.

But I still don’t want ten kids.

Three or four sound good to me.

Look at me, talking about family size.

I do still get jealous. I still get affected here and there. But I feel better equipped to handle the trials of the future, whatever they may be. Gavin has added his warriors to mine and that’s a huge bulk to my army.

As for the pain and my questions for God, I don’t have too many answers and I may never get them. But I’ve certainly had a few revelations, things that I’ve learned because of my trials, and I’ll delve into that on my next post.

My friend from Hawaii did get her miracle baby boy. And I got mine too. We are still very good friends.