Thursday, July 12, 2012

Journey Through the Land of IVF Part 2: Success!!

After our failure with the first round of IVF I was an emotional wreck. My father had passed away while I was in the middle of the first IVF cycle and on top of taking all these hormones I was now dealing with the loss of my father; my last parent. My mom had died a week after my 21st birthday and had never met my husband. Now neither of my parents were going to meet my children ---provided I could even have them.

Ironically because my father passed away it provided Marc and I with the money to try IVF for a second time. I like to think of it as as a gift my parents were able to give me and even though they would never be here to hold their grandchildren; they were instrumental in their creation.

After the failure of the first IVF cycle we had to wait another two months to try again. We met with the doctor to go over everything that had occurred in the latest attempt. The doctor determined that egg quality was one of our biggest issues and he wanted me to try taking a nutritional supplement called DHEA. It is sold over the counter at GNC or your local drugstore. There had been several studies suggesting that woman with poor egg quality had better results after taking DHEA. My small ovaries indicated I had less eggs in reserve and as a result lower egg quality and less chance of successfully getting pregnant. DHEA is a mild male hormone, that, coupled with the fertility treatments, is meant to jump start the ovaries and hopefully produce better quality eggs that will be mature for fertilization.

There is now a lot of literature on the use of DHEA for use in conjunction with infertility treatments. At the time I was going through all this the studies were just beginning and it was not yet widely known whether there were actual benefits. Now it is being linked to use with infertility treatments for women who have been diagnosed with premature ovarian aging, a condition I was never specifically diagnosed with but is certainly consistent with my symptoms. More pieces of the puzzle were, hopefully, starting to come together. 

When I was giving even more of my blood for analysis, one of the nurses highly recommended acupuncture to me. She explained that she had seen many woman walk through the doors in similar situations to mine and after as many failures as I had, tried acupuncture.  Acupuncture resulted in more successful cycles. I took the recommendation and bought my DHEA and made my appointment with the acupuncturist (another thing not covered by insurance).

At this point part of me was really angry. Why was DHEA and acupuncture never brought up before? I know a lot of this was trial and error but how much failure could I take and how much money could we spend. Were these things I should have been doing all along?   I got over it eventually and moved on but I just had to have my angry moment.

I went into my first acupuncture appointment not knowing what to expect. I was glad I was able to do something while waiting to start another cycle. However, I am the type of person who has a lot of trouble relaxing. There are not many times during the day that my mind is not thinking of something that needs to be done, a decision that needs to be made or something that I have to remember to do. I generally cannot shut my mind down.
The acupuncturist went through everything for me. I was certainly not his first infertility patient. I explained that between trying to get pregnant, trying to work 50 to 60 hours a week and dealing with the recent loss of my father I was a great big ball of stress. The acupuncturist was very optimistic and besides sticking needles into various parts of my body he taught me to visualize and most importantly relax. The idea was to get the blood flowing to my ovaries and uterus. At this point I was willing to do whatever it took to get pregnant. I would go 2-3 times a week for about 45 minutes and I have to admit I enjoyed it. I found myself dozing off in the sessions I was so relaxed. It was really time I carved out for myself where I was not thinking about work or cleaning out my father's house or anything else generally stressing me out.  It was also something I could actively do while waiting to start the drugs again.

Finally it was time to start the drugs again. It was the beginning of 2009, a new year, and I was determined things were finally going to go our way. January 5th I went in for my first blood and ultrasound of the cycle, started my drugs that night and started my regular office visits 2-3 times a week. The cycle was going well. My follicles were growing in both of my ovaries and I had been taking my DHEA for the past couple of months.

Three weeks after starting I was getting close to retrieval time. I went to my final pre-retrieval acupuncture appointment and visualized blood flowing to my uterus. On Friday the 23rd I got the call --based on my blood work and ultrasounds the retrieval was going to be on Sunday the 25th. 
Friday night the 23rd at 10pm precisely my husband gave me my HCG shot to stimulate my ovaries and prepare my body for the egg retrieval. Unlike IUI, the timing of the HCG shot is critical and the doctor tells us an exact time based on when the retrieval will occur rather than a window of time given for the IUI. I also had to take a pregnancy test in order to make sure the HCG shot was administered correctly. For once I was going to see a positive pregnancy test but not quite what I wanted it for!

Sunday morning, the 25th Marc and I arrived at the doctor's office first thing in the morning (our doctor has the operating room on the premises so we did not have to go to a hospital). I was brought in to the OR and knocked out. Since we live about 30-40 minutes from the doctor, Marc got to do his part during my egg retrieval. Before I knew it they woke me up (it really does feel like you doze off for three seconds) and told me we had gotten NINE eggs. This was fantastic news. I couldn't believe we got so many.   They were going to do ICSI again (inserting one sperm into one egg) to increase my chances .  I went home to relax and wait for the call from the embryologist the next day.  Just like my first IVF cycle I was lucky and did not have any bad reactions to the anaesthesia or complications from the egg retrieval.  I followed doctors orders and rested but was not in any pain.

The call came around lunch time the next day. Of the nine eggs retrieved SIX were mature enough to be fertilized and SIX fertilized!! I could not believe it. This cycle was like night and day from the last one. The embryologist gave me more good news.  Based on how the embryos were growing we could wait until day 5 for transfer. YES! Day 5 transfer is what we wanted; this is what all the books and the Internet and the doctor aim for. Finally, I thought, we are on track. I took Thursday and Friday off from work and the transfer was scheduled for Friday January 30th which meant I could be home for three days and be on complete bed rest after the transfer without worrying about work.

Before transfer, my acupuncturist had me come in for a session.  Thursday afternoon I went and got poked with needles and did breathing exercises to visualize the blood flowing to my uterus.  I wanted to get my body as prepared as possible for my embryos to implant.  The morning of January 30th came and I was very optimistic, excited and VERY nervous all at the same time.  Upon arrival, we got into our OR clothes, me in a spiffy backless hospital gown and Marc in his scrubs (since he is allowed to go in with me for the transfer) and then waited for the doctor to come in and talk to us.  It turned out that of the six embryos that fertilized only three had made it to day 5.  Now it was decision time, how many embryos do we put in--two or three?  Typically two would be the answer but after consulting with my doctor and knowing how poorly I had been responding to the medication as well as the cost of already having done three IUIs and one IVF, Marc and I decided to go for it and put all three embryos in and the doctor agreed.  As much as we had viable embryos this time, it was by no means a guarantee that three, two or one would take.  Our hope was that we put three embryos in and at least one would take. 

We went into the OR and watched the doctor insert three embryos into my uterus.  The good news was this time my uterus was in a better place and the doctor was able to insert the embryos without any problems.  This also meant that I was not going to have to spend the next three days on my stomach.  Afterwards, the embryologist gave us a picture of the three embryos from that morning.  I also had the opportunity to speak with her and I asked her point blank, hold back nothing, tell me everything how did the embryos look.  She explained that they grade the embryos and that one was perfect and two were nearly perfect.  I will never forget her telling me that as far as embryos go, this was my best shot at getting pregnant.  So we left the doctor's office armed with the picture of our embryos and prepared to hunker in for the weekend.  I was not going to move from the couch except to go to the bathroom for three whole days.  Before laying down when I got home I put the picture of the embryos on the fridge.   

My three embryos on day of transfer (5 days old)

Now the wait began again--two whole weeks before taking my blood test.  I was going to acupuncture and putting my progesterone patches on every two days.  This was to help with implantation and promote pregnancy if any of the embryos took.  Finally the day came, Friday February 13th.  They took my blood around 8am and then I had to wait for the phone call.  I remember Marc was not working that day and, because we only had the one car, was hanging around White Plains that day waiting for me to be done with work so we could go home together.  Finally the call came around 2pm in the afternoon.  The doctor said, "I've got good news!  You are pregnant."  I could not believe it.  After all this time, it finally worked.  I asked him how my levels looked and he said they looked great.  I was to come back in for another blood test the following week.  My levels continued to look good.  I could barely contain my excitement but I knew it was early on and we still did not know if I was having one baby, two, even three.  Finally on Friday, February 27th, we had our first ultrasound.  We were nervous.  I was about six or seven weeks along and their was a possibility we could see the heartbeat but there was also a possibility we would not see the heartbeat.  It wouldn't mean that it was not a viable pregnancy, it could just be too early. 

I took a deep breath and the ultrasound tech was looking at the screen.  She asked me if we had done IVF and I said yes.  Then she asked, "How many did you put in?"  I, of course, answered with a whole explanation of how we decided to put in three embryos and how they were the only embryos we had.  She looked at me with a big smile on her face and said, "Well it looks like all three took!"  Marc and I couldn't believe it and the nurse was very impressed Marc stayed standing.  Not only could we see all three of them in there but we were able to see and hear all three heartbeats.  They were just little fluttery blips but they were my babies.  Finally, all the pieces came together and I was pregnant...with triplets.  Marc and I were going to have our family. 

After thousands of dollars, months and months of using drugs, trying acupuncture and even visualization/meditation, I was pregnant.  All the stars were aligned.  I like to think my parents were watching out for me and the pieces of my puzzle finally fit together, but if you ask my husband, he will tell you he just has magic triplet sperm.