Friday, December 30, 2016

I will trust in him and not allow this process or any medication to steal my Joy



Tonight, I was forced to go face to face with something dark and sinister. I had a dream like I have never had before. I won't describe it, but I was forced to do horrible things, and watched death and destruction in a manner and on a scale that is unimaginable. When I finally was able to wake up and get away from the dream, I was so frightened I was shaking uncontrollably. Not just my limbs, but a tremor shake in my organs and muscles. I have been awake for a while now and I am still not able to get the shaking to stop. I have never been this frightened in my life.

I laid in bed, trying to pray, but my mind was too tormented.  I woke up my husband and told him to hold me and to pray for me. This helped, but I was not able to get back to sleep. The images and general feeling of that dream are still too close to close my eyes.

I decided to get up and try to do some reading. I looked up verses for comfort and specifically for bad dreams. I prayed for God to be with my family and for me to trust in Him and to surrender them into His hands. One of the things I read that really helped me was this quote:
"Rest in God’s unfailing love, commit your life into God’s hands, and go forth in joy – Don’t let anything steal your joy!" ~Jolly Notes 

My mom has always said that happiness is an emotion, but joy is a lifestyle. Joy. I have not had JOY. I have been trying to trust and trying to put all of this in God's hands, but I have held on to it, obsessing about it and trying to control every aspect of it. I have let this process steal my joy.

Now, that does not mean I have been going around completely sad. I am quite good at faking happiness. I think I am just getting so dragged down in the emotions of what is going on that I have allowed my brain to think I am happy, but it hasn't been reaching my heart. For a couple of weeks now my husband has been asking me if I am ok, and has been commenting that I am sighing a lot, etc. He is concerned about it. I was at the point of being annoyed with him even. This morning, I told him that I don't even notice it (I really don't) and that it is nothing. However, it is quite possible that my body is showing signs that my brain is not recognizing.

I feel completely out of control. My child, my family, this IVF process, stressful situations, I have prayed over them, for them etc. I have in word given them to God and surrendered them to His care. However, I have not let go. I have clung to them tightly.

This is hard. As a parent, as a patient going through IVF, as a citizen of a fallen world, it is hard to love something or want something so fiercely and to 'let it go.' Of course, I have daily physical responsibility for these things. I am held accountable for what I do with them. But, I am actually commanded not to worry. That is my biggest problem. While I know worry is a sin, it is the area of my life I struggle with more than anything. My mind, creative and imaginative, conjures up 'what if' and 'maybe' worlds all the time. Without conscious or deliberate thought, I am suddenly in an imaginary situation and trying to think myself out of it. How should I react, or what should I do.

Maybe some of this is a good thing as a parent. Maybe I am just being prepared. However, having this happen all the time, and causing panic, almost as if I am in that situation and then causing worry and fear to come into my life about a situation that has never happened and could never happen is wrong.

I had such a strong reaction to this dream that my bowels are upset. I feel like I could throw up and I am still shaking. It is very difficult for me to feel I have given all over to God when I still have the physical symptoms. That is why this IVF process is so difficult. As with any health related issue, you pray about it, and you try to 'let go and let God' but you still have to give a large part of your brain to it. I recently read that IVF is physical and mental torture, and I am convinced that is about right.

These strong dreams, the feelings I have been having of anxiety and a little depression are partly just me. The other 90% of it I believe is the medication. Before getting on this medication (it is just birth control) I had a really good handle on my anxiety. I really felt pretty good about it. I was noticing that I hadn't been having as many symptoms, etc. Since being on this pill for about half a month, I have noticed a climb in my symptoms.

The other day I burst into tears for no reason. There was also a situation at Christmas that wasn't pleasant, and yes, it wasn't perfect, but I reacted to it much more strongly than I think I would have without the medication. I am not saying that the medication is an excuse, exactly the opposite. Because I have this issue, I feel like it is my responsibility to fight even harder. Satan will use any avenue to get into my head and to steal my joy.

Here is an article I found that explains a little what BCP can do to a woman as far as mental health is concerned.
For women who are already experiencing mental health problems before taking contraceptives, it can be a gamble to starting taking pills with hormones.                           ~ EmpowHer.com
I call them crazy pills for a good reason. However, God is bigger than this tiny white pill, and I will not let it control my life. I can get through this stage of IVF and move on. I will not let it drag me down. I will continue to give my life and that of my family to God, even if I have to do it 100x a day. I will trust in him and not allow this process or any medication to steal my Joy.

Thursday, December 29, 2016

PGS is a serious decision you will have to make when going through IVF


PGS testing.This is something I honestly didn't hear much about when we did our first IVF cycle. This time, it seems to be everywhere.

Preimplantation genetic screening (PGS) for aneuploidy is a powerful genetic test that may be performed on embryos during IVF treatment to screen for numerical chromosomal abnormalities. PGS is performed on a small embryo biopsy prior to transfer and identifies which embryos are chromosomally normal.
Last time they recommended Cam and I get tested for cystic fibrosis. Since neither of us are carriers, that was all the genetic testing they were concerned with. It was a simple blood draw before we did IVF. This time, we were asked if we were wanting to do any other genetic testing. We had the option to have PGS and we had to sign a paper saying that we were not wanting any other testing done on our embryos. It could be that we are a couple years older (I'm still in my twenties though) or that it is more mainstream now.

PGS is a serious decision you will have to make when going through IVF. If, like us, you believe that all life is sacred, you have to approach the PGS testing from this perspective: will the results make any difference in the end if I use the embryos or not? For us, the answer was no.

"Before I formed you in the womb I knew you, before you were born I set you apart; I appointed you as a prophet to the nations."Jeremiah 1:5
We couldn't just create these lives and then discard the ones that were not perfection. I understand the there is a LOT of money and time involved in the process. The argument for being financially responsible is out there. I get it. However, this test costs about $5k. In my book, that $5k could go a long way toward another round of infertility treatments, etc. However, this can open you up to spending way more money than you would have, so that argument almost negates its self.

As I said, PGS is a big thing right now. Lots of ppl ask about PGD/PGS on the support groups I am a part of. One of the ladies found this article and posted it. It is a very concise list of pros and cons.


READ THE ARTICLE HERE
After reading the article, I am even more convinced that we came to the right conclusion to not do PGS testing. We are under 35 with no known issues beyond a non-genetic male factor fertility issue.

Research has shown that taking embryos out to day 5 blastocyst (most dr.'s -ours included - do day 5 transfers) indicates a genetically strong embryo. I can't help but think that the few cells they take to test could be normal, but cells left behind could still be abnormal in that embryo. If you choose to do this testing, you are paying for something that's not 100% accurate. (as stated in the article) 

I have read stories of people who are devastated because they get this testing done on their three embryos and two come out with a flaw and one doesn't make it through the process. They end up with nothing to transfer. They have lost one baby and chosen to discard two. To me, that is unthinkable and (in my opinion) shows little regard for human life. 
"You made all the delicate, inner parts of my body and knit me together in my mother's womb."~Psalm, 139:13
To me, no matter how the sperm met the egg, God allowed the life to be created. ALL life, even life that begins in a lab, is created by God. Yes, it could be devastating to go through IVF only to end up with a sick or disabled child, but that is what God gave you. It is no less devastating when the life is created naturally. However, I know many down syndrome children that have been an incredible blessing to their parents. I know children that were given a 0% chance of living outside the womb that are alive and thriving. If they were created through IVF, and their parents had chosen to do PGS, they may not have had a chance to meet this incredible person. 
"My thoughts are nothing like your thoughts," says the LORD. "And my ways are far beyond anything you could imagine."~Isaiah 55:8
From what I have seen, many couples choose to do this testing in hopes that it increases their chances of pregnancy and decrease the chance of miscarriage. HOWEVER, based on what I have read and the posts from IVF mamas I have seen, this is not the case. "Never implanted, and didn't work" seem to be the case many times. I feel that having this test, spending the extra $ ($5k is on the cheap side. doing testing on 3+ makes it incredibly expensive) sets couples up to think that they are guaranteed a baby. The heartache of having a 'perfect' embryo not make it and feeling there is nothing else that can be done would be incredible. 

I believe it is for this reason that many RE's I have read about are actually encouraging couples with little to no risk factors to not get the testing. For one thing, the testing makes a fresh transfer impossible. You would have to do a frozen transfer (FET). With the 20% chance of destroying the embryo in the testing process and the 35% chance they won't survive the freezing and thawing process, your chances of a successful IVF have significantly gone down.


Especially if you are dealing with very few embryos, this is something to consider. We had 3 embryos when we did it the first time, and two of them didn't make it to day 5. We only had one embryo that we could have done testing on and frozen for an FET. We got pregnant with our perfect son with that one embryo. Had we done testing, there would have been a 55% chance that he would not have survived the process. We would have been taking a huge risk with the life of our baby. 


IVF success rates have increased in recent years, from the 10% success rates in the 80s. However, it is still not guaranteed and the success rates are still (to me) too low to add more risk factors. 

"Women with top chances of IVF success have per-cycle success rates of 40% or higher, while the majority of women have per-cycle success rates of 20-35%. Having this perspective may help you think about trying more than one cycle, and feel less discouraged if the first one doesn't work." ~Resolve
While we are on the subject of statistics, lets talk accuracy. As stated in the article above, the test does not mean that you are guaranteed a healthy child. In the same way you can get a false 'positive' you could also get a false 'negative.' You could be tossing a perfectly healthy embryo that has a good chance of surviving based on a flawed test. Yes, the chances of that are probably low, but it happens.The new protocol is to do PGS (day 5) not PGD (day 3) testing and to only take trophectoderm cells (cells that should only be the placenta). They don't take the inner cell mass which becomes the embryo. As they are testing only the placenta, and not the actual baby that makes me question how much it reflects the baby. Also, they could (in theory) take an abnormal sample that could then divide off to be the placenta, not the embryo. 

As I said, there are too many ways the test could be wrong, and, while I am choosing to use IVF to help build our family, I really want to leave as much of it to God as possible. 


Here is where I * MIGHT* advocate for PGS testing:IF you are older, have known genetic issues or had multiple unexplained miscarriages, you could get this testing so you know exactly what you are dealing with. (while considering the risks above) 


HOWEVER, As I said before, our decision was based on "would this change our minds and would we use this embryo?" our answer is no, and yes. We would approach the pregnancy as high risk from the beginning and take all precautions, etc. to help ensure a successful pregnancy. If God has this life for us, we would do everything we could to take care of it.

With these same principles in mind, we did not get any testing done while I was pregnant with H, and we plan to do the same with any future pregnancies. We will get ultrasounds, and if all looks normal, we will proceed as if everything is fine. If there seems to be a legitimate concern and more testing is needed, we may get it as a diagnosis, but only so we know how to prepare for and take better care of our baby. We absolutely will NOT terminate a pregnancy based on any tests. If we have preterm labor and the baby does not survive, at least we know that we did everything we could for this life. I would be sad, but I would be able to live with a clear conscience. 


This has been a bit of a heavier post. I have tried to include links to the info I have talked about. Some of my sources are private. Some of my information is gleaned from reading extensively on message boards and Facebook groups about the subject. Most of this post is opinion, and from my very specific Christ-centered worldview. I will not apologize for this. This blog is for me. Yes, I hope that others who are experiencing infertility are able to get help from it, but in the end, I am writing it as a way to cope with my infertility and to document the process.


Having said that, as with all things, I am not telling you what you should do. I am gathering up facts and opinions and telling you what we have done with them in our own journey. Approaching IVF from a christian perspective is different. Some of the decisions and issues you will face that are not hard decisions for others will be extremely difficult for you. 


I am writing this blog and sharing my story not to tell you what to do but to provide a resource that might be counter-cultural and help you to make your decisions. 




Sunday, December 25, 2016

Looking at the sleeping face of my son, I feel so inadequate for such a huge task

"The Son of God became a man to enable men to become sons of God."
~C.S. Lewis
I wrote this two years ago after a long first month of taking care of my infant son. Never before had Christmas felt so real to me. As I was laying in bed writing this on my phone I was in awe of how close I truly felt to God because of my new role as a mother. 
Merry Christmas friends! 
•   •   •   •   •   •
This Christmas has so much more meaning for me now that Henry is here. When I was pregnant with him, I was in awe of the miracle growing inside me. The kind of love a parent has for a child is understandable, but not fully comprehended until you are a parent. 
Being a mom is an incredible joy, and a huge responsibility. That Mary was chosen to be the mother of God's Son is amazing. She and Joseph kissed the face of God, changed his diapers, and held tiny fragile hands that would perform miracles. 
A parent dreams of what their child will become, and hopes they can train them, and give them the best version of themselves they can be. Looking at the sleeping face of my son, I feel so inadequate for such a huge task, and I can imagine Mary, on similar long nights, feeding a fussy Jesus who finally falls asleep on her Brest. It's dark, and she is alone and having an incredibly intimate moment, listening to the sleeping sounds, feeling the tiny movements and watching the sleeping face of God.
The phrase, "Mary kept all these things and pondered them in her heart" has so much more depth of meaning as a parent. 
Finally, I think of the sacrifice God made for me. He sent his Son to die an incredibly painful death, that I can have eternal life with Him. Again, that sacrifice is not lost on any human. Before becoming a parent, it is a powerful thing that God did this. After becoming a parent, it's unimaginable. 
Even being God, and knowing how it would turn out, to know what he would suffer as a sacrifice would be torture. Even as much as I love my friends and family, if I was asked to give Henry over to certain death to save them, I'm almost positive I could not do it. 
The gift of love God gave us on that first Christmas is enough to bring me to my knees. It changed the world, and brought hope and love to mankind. This Christmas my heart is full with the knowledge of that gift. I hope it remains that way far beyond December 25th.

Friday, December 23, 2016

Maybe I'm just cheap, but I really don't want to pay for a service I am not going to get


This was one of my Facebook posts this week: 
Well... this just happened.
This week the IVF train is really picking up speed.
Our medications have been ordered. We are waiting to hear back from some prescription discount places to see if we qualify and then we will be paying for the meds as well. The deadline for all payments is Dec. 27th.  
If you are praying for us, please pray that we qualify for at least the minimum discount of 25%. Our out of pocket expense for the medications is about $3400.00 (which is great, considering it could have cost $5,000+.) Any discount would be amazing. It would be awesome to qualify for the 50% or even better yet, the 75% discount, but I'm trying not to get my hopes up.
As I said in a previous post, we did qualify for the 25% discount, which saved us about $1k off our medications. This isn't as much as I wanted to qualify for, but I am not complaining. getting a $1k discount is amazing and I am incredibly thankful for it. 

One thing I had mentioned in my previous post is to always be your own advocate. We were originally quoted $10,530.00 for our IVF procedure. When we got the bill, it was $100 more than that. I tried several times to contact the office, trying to confirm that we didn't have to pay that exrtra $100. I already knew that the extra fee came from the $100 patient education class that we are not required to take (because we are old pros). Maybe I'm just cheap, but I really don't want to pay for a service I am not going to get. 

Since I had never heard back from the office, we went ahead and got our cashier's check for the whole amount. I took it to Tulsa and hand delivered it to the clinic yesterday. When handing over a check this large, it is hard to let go. As much as I want this IVF cycle to happen, it was hard to give it up. While I was there, I spoke to them about the extra $100. I did hold up the line a bit, but luckily, I had my son with me and he was being *ADORABLE* he had on a jingle bell bracelet and was shaking it and singing jungle bells. In some instances, that could be considered rude to let a kid do that in a waiting room, but in an infertility waiting room, he was a complete hit. Everyone loved him. (I digress... back to the $100.) 
They agreed that I should not have to pay that amount, and my account was credited for the amount. There will be more expenses after IVF is over, so this worked for me. 

Worrying about $100 might seem silly to some. I know that I have been guilty of just paying medical bills and not actually looking at what I'm paying for. However, money is tight while we are going through this procedure, and if I can save $1k here, and $!00 there, it really starts to add up! 

Wednesday, December 21, 2016

There have been many times in this process that I have had to ignore that voice inside myself telling me to not be annoying


There are several things I feel I need to write about, but I am not sure of a good way to present them. Being a list person, I have decided to just go at it that way. It may not be the best blog post ever, but I will get the information across.

1. Progesterone In Oil (PIO) - see my post about IVF terms to learn more about this and more.
The first time I did IVF, I was terrified of this shot. Okay, I was pretty scared of all the shots, but this baby sat there for weeks, in my IVF meds box, taunting me. It is a LARGE, 2" needle, and I'm not exactly sure of the gauge, but it ain't small.

Once I finally started to take those shots I realized that they weren't that bad. I mean, they weren't pleasant, but I easily survived them. I did end up with a nasty itchy and bumpy rash on both of my hips. (they say it is your bottom, but it is more like lower back/ hip area.) I have enough info that I need to do a whole post about that shot, but I will save that for another time.

The prescription I was originally given was for PIO in sesame seed oil. This is a thicker oil and it really has to go in slow and be warmed up really well in your hands in order to make it a more pleasant experience. After a couple of weeks of this shot is when my rash developed. It was really pretty nasty. I was at my parent's house, and I was going crazy. I called the Dr. and they gave me a new prescription for PIO in olive oil. This was MUCH better. It still caused some irritation, but it was not half as swollen, etc. Wearing my jeans was actually an option, where before, I dreaded getting out of my yoga pants.

This time, I asked for olive oil to begin with. Well, that put a kink in my prescriptions. They used a different specialty pharmacy this time, and they do not carry PIO olive oil. They were having to try to find an alternate option for me, which was holding up the process. They offered me another alternative, but it was over double the cost of the original prescription. NO THANKS. In an effort to just move the process along, I told them to just give me the sesame seed oil. I guess we will deal with the rash when we get there. I'm going to be praying that I don't get it this time.

2. Medication discount programs
We were told to apply to two discount programs. They both have the same basic application process and qualifications, but they said that you can apply for both in hopes that one gives you a better discount.

The two programs are DesignRx First Steps and Compassionate Care. I didn't remember applying for these the first time, but I guess I did. I just had to renew my application by sending in the first two pages of my ta return. (1040) TOP TIP: They do not need your social security number, bank account or routing information or your federal tax id (PIN) number. They just need to see the numbers that have to do with your financial situation. However you can, before sending, I would recommend blacking out that information. I opened mine in photo shop and put little boxes over the information to block it out. It's not that I don't tryst the company, but that is super sensitive information, and I like to take precautions. 

These programs are AMAZING! If you qualify, you are able to save up to 75% off of the cost of your fertility medications. Now, don't be silly, like me, and think that because you are guying a medication for a fertility treatment that it is a fertility medication. There are I think only 3 actual fertility medications and they are what you will get the discount on. 

After many attempts to get our information to the compassionate care program, and several phone calls to them, we finally gave up trying to apply. I'm sure it was a fluke, and they are a great company. We just couldn't seem to connect with them. 

We did get everything in to First Steps, and we had approval from them within 24 hours. We didn't get that big 75% discount, but we did get 25% off old two of our medications. The two meds are what drives up the cost at the pharmacy stage of IVF, so I am very happy and thankful for even that 25% off. 

3. Be a squeaky wheel
If you have ever dealt with a stressful medical situation, you know that you are your own best advocate. It is your job to stay on top of everything, and you don't have to wait for some office to contact you. 

There have been many times in this process that I have had to ignore that voice inside myself telling me to not be annoying, and made myself push for what I want. Instead of waiting for the pharmacy to call me to confirm the prescription, I called them, and it was a good thing I did  (See list item one.) 

Faxing in paperwork and then calling in a few hours to confirm the receipt is not over kill. It is making sure your cycle doesn't get delayed or canceled because of some stupid clerical error. I'm not saying that clinics are irresponsible, or that they don't care about you -our clinic does a pretty good job of putting up with me and taking care of my needs. I am saying however that no one cares about your situation as much as you do. Even those doing a bang up, super job are simply doing their job, and sometimes you are not the priority. 

Being on top of things, knowing and understanding your financial obligations, etc. Calling and talking to people with any questions you have, even when they seem silly, can save you a lot of time and even money in the end. I have saved us over a thousand dollars so far and lots of time by being the squeaky wheel. 

4. Facebook groups can be a nightmare 
Stay away from them. Really. I must say that I am a part of at least three IVF groups, and they are a good place to vent and to feel like you are understood. For that reason, they are good things. People, especially when they feel incomplete or damaged, as is sometimes the case with infertility need to feel like they are not alone and are a part of a community of people who completely get them. 

HOWEVER

They can be so incredibly depressing. It isn't a good idea to be a part of a group and just post your own stuff and never participate with other's posts. Even if you tried that, you can't avoid the newsfeed posts of members. Out of curiosity, you scroll through the group page and some days it is encouraging, but most days it makes me want to curl up in a ball. Miscarriages, failed IUI's, IVF's, depression, negative pregnancy tests, and all other matter of depressing content seem to dominate. 

Even on days when the good posts, IVF baby pictures, ultrasound images, positive tests and the like abound, it can be depressing. If you are struggling with infertility and especially if you have come to the point that you are considering IVF, you do not need me to explain this one. 

The groups can be a good thing. They can be a great source of encouragement and they have helped a lot of people. BUT, if you are like me, and you struggle with anxiety or you obsess over things, it might be better to stay away from them. 


These four items are just a small bit of the list I could come up with. They are not earth shattering or revolutionary in the least. However, if you are going through IVF or considering IVF for your family, these and many other issues are going to be what consume you. If you are going through infertility or IVF treatments, I would be happy to talk to you about it. I know I could not have made it the first time without the support of some friends who had been in the situation. 

Tuesday, December 20, 2016

It is sometimes hard to find things to be grateful and thankful for in this process

Feeling gratitude and not expressing it is like wrapping a present and not giving it.~William Arthur Ward

December 20, 2016 - CD 11
Yesterday I had my trial transfer and saline infused ultrasound. We also had our financial counseling appointment. I was in pain the entire length of the counseling, which thankfully was not long.

The last appointment I had, they had a difficult time finding my veins and I had to be stuck multiple times. It was an early appointment and I hadn't had enough water yet. I wasn't going to let that happen this time. I also had to have a full bladder for the trial transfer, so I chugged water all morning before my appointment.

About 5 minutes from the clinic, my body really needed to get rid of that water. We got there, checked in and took seats in the waiting room. Our 10:45 appointment turned into an 11:05 appointment and I was sitting in the waiting room trying not to cry.

I'm sure there was a lot of information I glazed over at our financial appointment, but between H being a little unruly (ok, he was pretty good, just loud) and my urgent need to relieve myself, my brain couldn't take in all that was being said.

We finished that appointment, and promised to pay about $16,300 by Christmas. (*YIKES!*) We already knew how much it was going to be and were prepared for it. Had it been a complete shock, I would have still been non-pulsed by it because I was concentrating on not wetting my pants.

When I finally got to the examination room, I was a bit put off because I was dressed in heavy winter clothes and had my cell phone in my pocket and about 5 lbs of water inside me, which made me look like I was SO much heaver than I actually am. Yes, I've gained weight because of recent holiday food indulgences, but not THAT much! (*double YIKES!*)

It felt like an eternity before the Dr. came in to perform the procedure. I had a cold speculum shoved up there, a catheter filled with saline shoved up there and injected into my uterus. There was lots of poking and prodding and pushing from the outside too from the ultrasound.

I did my best to talk through it and concentrate on talking and not the pain going on in my nether regions. This procedure is no joke. It wasn't horribly painful, but it was way worse than a PAP. Oh, and I also had to pee so bad. I seriously thought I might go right on the table in front of the Dr.

Here's the good news:
While I was enduring this pain, and discussing the merits of YETI coolers vs. the many cheaper versions (yes, a fascinating conversation to have while your lady bits are exposed to two people and you are trying to forget about it) the Dr. Said to the Ultrasound Tech: "Oh my, look at that." Of course, That was enough to make me momentarily forget that I was in pain. I was expecting to hear him say there was scar tissue from my first pregnancy and delivery, etc. I was bracing myself for the bad news. Instead, he continued: "That is beautiful. Textbook perfect uterus."

Of course, I was relieved to hear that there was nothing to stand in the way of this IVF cycle. I must admit too, that I was kinda proud to have such an ideal organ. Had I not already been pretty puffed up with urine, I would have found a place for pride.

I don't know the exact stats on the issue, but I have to think that with my really good follicle count and my Mary Poppins uterus, our chances of a successful cycle should be way better than average. We do have severe male factor infertility, but that is pretty much taken care of at the fertilization phase of the procedure. We don't have issues with my fertility or my ability to carry a baby.

It is sometimes hard to find things to be grateful and thankful for in this process, but I was reminded that we have 'the best' form of infertility (If there is such a thing.) Yes, MF infertility is the only thing I can think of where someone else has to get treatment for your issue, but it is treatable -and relatively easily. I am grateful that we don't also have female infertility issues to deal with.

I have much more to say on the issue, but I guess I will save it for another post.
This is Christmas week, and there is a LOT I have to get done. Remember friends to find time to think about why we are celebrating CHRISTmas. This time of year can be more stressful than fun or relaxing. Stop, breathe and thank God for sending His Son to live among us so he could eventually save us from our sins.

Tuesday, December 13, 2016

One more hoop to jump through that gets us a little closer to our goal

12/13/16 - Cycle Day 4

Taking medications for an STD you know you don't have seems a little odd, but that is just another step of IVF that we have to do. One more hoop to jump through that gets us a little closer to our goal.
Today I filled Z-packs for both Cam and myself. The purpose is to treat chlamydia  - you know, just in case you are lying and the infectious disease labs didn't detect it.

I also picked up my birth control pills, which I will begin taking in the morning. I am supposed to only take the active pills, so I put an 'x' on all the blisters that I am not to take. I finally found out exactly what they are intended for in the IVF process:

  • Helps to shut down the ovaries so that they are not stimulating prior to your IVF cycle. They are usually started on Day 3 of your menses and last for 2 to 6 weeks. Birth control pills also help us with the flexibility in scheduling your cycle.
  • Lupron protocol: you will start BCP’s on day 3 of your menses and continue on them for several days after you start Lupron.
  • Ganirelix & Micro Lupron protocol: you will start BCP’s on day 3 of menses and stop them on the day prior to starting stimulation medications. 
I'm not sure yet which protocol I will be on, but I was on the Ganirelix protocol last time.

Today I also received a message from our IVF coordinator with our consent forms, check lists, a sample timeline (which is actually pretty close to what I came up with in the last post) and patient education information. 

We still have to pay for our IVF cycle and the medications before the end of December, and attend the online education they offer on the IVF cycle, but other than that, we are all set! 

I am getting more excited every minute. The anxiety I have had is still there, lurking in the background, but I must say, having something productive to do, a checklist to work off of and complete has made today much better.

Also helping me to cope with my anxiety is my knitting, I said before that I have been teaching myself to make socks. I am almost through with my first one! I have no idea if it will fit, but... it has helped me pass the time. I had to watch a lot of YouTube videos in order to understand the pattern, so I think I am going to write a post about it - just in case any of my friends decide to give it a try. (It is quite relaxing) 

**UPDATE**
I didn't feel this warranted a post on its own. 
I HATE BCP PILLS!! 

I really hate them. I feel bloated and like I could toss my tacos at any minute. I also have a weird, almost dizzy headache that won't go away. I just keep telling myself that it is worth it and it will not last long. I've only taken three pills and I would really like to just be able to skip this part. (Of course, I won't as silly as it seems, it really is a vital part of the process.) 

"It is worth it, it is worth it, it is worth it, it better be worth it, I hope it's worth it, it WILL be worth it..." 

Monday, December 12, 2016

Cycle Day 3 - First Ultrasound


"Plans are nothing; planning is everything."
~Dwight D. Eisenhower

Sunday, unlike Saturday, I managed to only check my messages on the portal twice. Considering I was constantly checking it Saturday, I consider that a victory over my anxiety.

I was able to go to bed Sunday night, feeling much better about our situation. We prayed about it with one of the pastors at our church and then our small group prayed about it that evening. Knowing that a group of believers knows what is happening and is lifting us up in prayer helps to settle my soul more than anything else has.

We woke up this morning at 7:40 (lazy people!) and I immediately checked to see if they had responded - and they had!! I was grateful that I had checked it first thing, because they had scheduled me for a 9:45 appointment. That was two hours to get up, get us all dressed, feed the baby and drive almost an hour to the clinic. I was about to have a transvaginal ultrasound -  I HAD to have a good shower.

At the appointment, they drew blood and sent it off to Reprosource for my Ovarian Assessment Report (OAR TEST.) They also did an ultrasound to see the number of follicles I had. The Dr. sounded really happy about what he saw.  He didn't go into detail, but said that he was seeing about 7-8 follicles on each ovary.

Our next appointment is one week from today (December 19th) and we will be having more blood work, doing a trial transfer (where they map out the uterus for the best placement of the embryos next month) and ultrasound much like the one we had today.  Dr. Prough will also be going over the results to today's lab work and ultrasound in more detail.

This week, we are both starting an antibiotic (not something I am a fan of - I think they are way over prescribed - but, I will do what I am told in order to get this baby.) and I begin birth control on the 15th (Wednesday.)

Having a timeline to look forward to and feeling like there is progress being made feels wonderful. Yes, there is still a lot of waiting, but I feel like it is good waiting, as I have a specific date and time to wait for, and not an unknown.

Based on what I (THINK) I know about the process, and this sample generic treatment plan, (and this one too) here is what our next couple of weeks might look like:
Ovarian Suppression Stage:

  • 12/15 - Begin birth control - active pills only
  • As early as 12/29 or as late as 01/12 -  Could begin Lupron (Or other medication) injections

Ovarian Stimulation Stage: 

  • As early as 01/12 or as late as 01/26 - Could begin STIM meds and injections (taken for 8-12 days)
  • As early as 01/20 or as late as 02/04 - HCG trigger shot
Retrieval / Baby stage: 
  • As early as 01/22 or as late as 02/06 - 36 hours after trigger shot, is egg retrieval (ER) surgery 
  • As early as 01/25 or as late as 02/09 - 3-5 days (beginning the day after retrieval) after ER  - Embryo Transfer (ET) 
Beta Test: 
  •  As early as 02/08 or as late as 02/23 - Beta Test #1 Two weeks after ET is a blood test to check my HCG levels and get a pregnancy result. 

Add in here lots of blood tests, several more ultrasounds, etc. and you have a pretty good picture of what my life is going to look like. I may be crazy for having spent the time to come up with this timeline, when it is probably not accurate at all. It could be much sooner than this, but at least it gives me a kind of 'worst case scenario' calendar to help me while I wait.

**UPDATE**
I received a timeline from my clinic, and I wasn't far off in my estimation.

Saturday, December 10, 2016

I woke with cramping that could only be one thing

December 12, 5:00am
I just sent this message to my IVF coordinator:
Good early morning!
I woke a few minutes ago to find my period had started in the night! This might be the one and only time I was excited for it and I may have even cried a tiny bit.
I am told that along with letting you know this, I am to tell you that I need to schedule my SISTT & Trial Transfer.
I will try calling in the AM, but thought I would notify you on the Portal now, since I am not getting back to sleep any time soon. :D 
I woke with cramping that could only be one thing. When I went to the restroom, I cried a couple of tears of joy and immediately began shaking with nervous and excited anticipation.

My job at this point is to inform my clinic of my cycle starting. Being a literal person and a rule follower, I of course, went straight for my computer and sent the message. I am nothing if not thorough.

Hopefully I know soon What the next step is and when I have my ultrasound. I am incredibly thankful that I will get a lot of the testing done in December. our insurance has unexpectedly covered more of the testing this time, and it would be lovely to have everything possible out of the way before the new year and a new insurance and a new deductible.

I guess I am going to go try to get some more sleep now. It was a late night for us and the toddler will wake up soon, ready or not.

** UPDATE**
My clinic is fantastic, and I understand that they need a weekend too. That being said, I am going CRAZY! Having started my flow Late Friday / Early Saturday, that means that by the time they check their messages on Monday morning, (Their voice mail says that phone and portal {their patient communication site} messages will not be checked until office hours) I will be on day 3 already. I typically only have a 5 day period. Not knowing if I am going to have an appointment for day 3 (Monday some time...?) or day 4 (Tuesday) and not having a firm date or time to give dh so he can go with me is driving me nuts. He is being calm about it, and I really appreciate him being the logical, centered one in this relationship and situation. It is what is keeping me sane.

I have also began to knit socks. I just learned to use double pointed needles. and as a way to take my mind off of all of this, I have decided to teach myself how to make socks. Maybe by the time I deliver this baby I will have a cute pair of hand made socks to wear in the hospital. Maybe.

I really am trying to battle this urge to check my inbox 1000x an hour, looking for a response. It seems completely insane to do so, since I KNOW they won't get the message until Monday. However, I have admittedly refreshed my patient portal about a million times total today, hoping that someone was industrious and decided to check their messages on their day off.

If you want to pray for us (me specifically) right now, please pray for my nerves. Pray that I do a better job giving this over to the Lord and trusting him and his timing for this IVF cycle. There are a lot of medical interventions, etc. but no life will begin if HE is not a part of it. He is still the creator of life and is in charge of this process. I need reminded of this several times a day, as I am very tempted to worry and obsess over things that are completely out of my control.

Tomorrow is Sunday, and I am going to go to church and try to worship with a clear head and not let this stress take away from what I may need to hear. Pray that I can relax and enjoy the service and learn something. It is hard to shut my brain off, when it comes to this situation, but I really need to do so and just have some time with God. In my heart, I know that will also help with some of this anxiety.

I am going to bed now. My fingers are numb from knitting and I have stayed up too late for the second night in a row.

Wednesday, December 7, 2016

Guess what!?!? Ready or not... Or not.


WARNING: TMI POST AHEAD! 

Today started out as any other day. I cleaned the house, got dressed, went on some errands and planned to do some Christmas shopping.  At the first store we went to, I had to use the restroom. One second I was fine and the next, I HAD to get to the bathroom. 

This is never a fun thing with a toddler in tow, but you do what you have to do. Soon, I discovered, Merry Christmas, Hallelujah - I had started my period! The one time in my life I was glad to see red. 

As happens every month, once my brain knows I have started my cycle, my body immediately begins to display symptoms. I get that nauseating, cramping feeling and start to need ALL the food. Of course, all this began immediately upon discovering I had started. I knew I would be starting soon, as I have been having a few PMS symptoms, but I'm actually a couple of days earlier than expected. 

As I was sitting there, realizing I didn't have a tampon or anything in my purse, my first thought was to scream "YES!", that it had finally arrived. The wait was over. My second thought was to question the reality of this 'gift'. 

One thing no one warned me about when I was TTC our first son was the little gift that pregnancy and child birth gives some mothers. Hemorrhoids. I had a mild case right after H was born and then never had them again, until two years later. I have been battling them for over a month now and quite frankly, they are a gift I want Santa to take back.

Sometimes, these little varicose veins rupture and there is bleeding. (I warned you, this is a TMI post)  Despite all the obvious signs that indicated a period, my body and my brain were at war trying to decide what was actually happening. When you are waiting to start your IVF cycle, you question everything, even your own body, and this is no exception. 

I left the store, and called DH. "Guess what!?!? Ready or not, I started my period!!!" He was excited and we talked for a moment about what the next step was before I added, "Or, I have a bleeding hemorrhoid..." I'm sure he thinks I am crazy for not knowing the difference and I might actually agree with him. 

So here I am, a couple of hours later, still having the internal debate. Do I call the office and let them know I started, so I can schedule my appointment for tomorrow? Should I wait it out and not call about a false alarm? What happens if I don't call now and I don't get an appointment for my ultrasound?! 

The ultrasound... Not just any ultrasound, but the transvaginal ultrasound. The most uncomfortable and embarrassing kind, made even more embarrassing by being on your period. Yes, my friends, there are many such gross and embarrassing things that happen during an IVF cycle, and this is just the tip of the disgusting iceberg. 

The reason for it is to check the ovaries and measure the thickness of the lining and make sure everything is as it should be at this point in my cycle. They will also be doing blood work too to verify my hormone levels and checking to make sure I have no cysts and to see how many resting follicles (eggs) I have at the beginning of my cycle. All of this sets the stage for the actual IVF procedure that will be taking place in January. Based on this appointment, they will determine what medications I will have to be on and what dosages I will have to take. 

BUT, none of this can happen until I determine if I am actually on my period. Here's to all my fellow IVF mamas who question their own bodies and who understand why this is driving me insane.

For now, I am going to try to forget about it and go and snuggle with my toddler. We have a tractor book waiting for us. At least getting to hold and love on my son is something wonderful I can do to pass the time until I know for sure what the heck my body is up to. 


**UPDATE**
9:45pm - The flow is a no show.
Oh well. Tomorrow is another day.

Monday, December 5, 2016

Instead of focusing on the negative emotions of what I am going through I searched for verses that spoke truth


"She holds onto hope for God is forever faithful."
~ 1 Corinthians 1:9
As we have gone through this journey of infertility and IVF, I have been making a Pinterest board called Infertility Feels. Mostly, there are memes about infertility. There are some tips on financing, etc., but mostly, it is a collection of pretty sarcastic and even negative posts.

Some days I think it just made me feel better to pin these memes that were voicing what I wish I were brave or bold enough to say in real life. Some days, seeing something that described my feelings made me feel better.

A couple of days ago, I realized that although, there is nothing exactly wrong with this board, I needed to add some positivity to it. After all, my faith, my hope in my God is what sustains me. I know that beyond a shadow of a doubt, I have hope. Even if this cycle does not end up the way we anticipate, I will praise Him. I really felt I needed to praise Him more publicly, and on this board about infertility. Instead of focusing on the negative emotions of what I am going through, I began to specifically search for and pin verses that spoke truth into my situation.

I'm not going to tell you that I immediately felt better about it and I felt baby dust and hope rising in me. I did have a subtile shift though. I am more at peace with myself and my emotions about doing IVF again.

Here are a few of my favorite verses I found that really spoke to my heart about God's promises to me about our infertility. If you have a favorite verse you feel would be applicable, put it in the comments.

"Trust in the Lord with all your heart and lean not on your own understanding..."
~ Proverbs 3:5

"He heals the broken hearted."
~ Psalm 147:3

"He performs wonders that cannot be fathomed, miracles that can not be counted."
~ Job 5:9

"Wait, my daughter until you learn how the matter turns out."
~ Ruth 3:18

"And so it was... that she, having waited long and endured patiently realized and obtained what God had promised." 
~ Hebrews 6:15

"She confidently trusts in the Lord to take care of her."
~ Psalm 112:7

"He will cover you with His feathers and under his wings you will find refuge."
~ Psalm 91:4

"The Lord will fulfill His purpose for me."
~ Psalm 138:8

A quote I pinned that really spoke to me as I was gathering verses is what drove me to write this post. I have never believed in a health and prosperity doctrine. I do not believe that because I am a child of God that when I pray, I get my wishes granted. I don't serve a genie, but a loving Father who wants the best for his children. Sometimes, His best doesn't line up with my best. Sometimes, I am tempted to question Father on his motives for situations I am in. This quote drove all those these verses home for me.
"Faith is not about everything turning out okay. Faith is about being okay no matter how things turn out."
~Unknown
No matter the outcome of our upcoming procedure, I will confidently have faith in the Lord to take care of me and my family.


Saturday, December 3, 2016

Great Expectations

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, …"
~Charles Dickens, A Tale Of Two Cities

For my literary friends, please forgive me the purposeful confusion of the two Dickens references that have been made so far. I love both these books and thought that many lessons from both of them were applicable for what I am going to talk about. I won't go into a literary analysis and compare and contrast in this post though. This is a post from the heart.

We are in the process of waiting to start our IVF cycle. Really, we have been waiting to start this cycle since the birth of our son, just over two years ago, but the final countdown has begun and time is nearly standing still as we anticipate the start of this cycle.

As I have said before, sometimes I wish I didn't know now what I didn't know then. knowing how it should go and just exactly what kind of pain and emotional trauma I am voluntarily and gladly putting myself through makes me question my own sanity if I take time to really consider it.

This waiting time isn't good for my health. I am still trying to get some extra weight off and most days I do great, but I am a stress eater. Without even realizing I was stressing out about this upcoming cycle, and before I could give it much conscious thought, I had consumed a bag of pretzel sticks (they are gluten free, so that makes them healthy - right?) and a whole bowl of crasins and almonds (a great snack I love to make). I then gain a ton of weight from water retention (salty snacks! UGH!) and get depressed about the water weight, so stress out about it and turn once again to the snacks. I'll go great for a few days, lose that weight and head toward my goal before I start the process over.

While I wait and dream and plan, I can't keep from making decisions about what room the new baby (or babies) will have. I'm not even pregnant, and I am stressing about putting all the kids in one nursery, making two nurseries or having three rooms, ready for our three kids. I stress about the changes that will come to our lives, and in those times, I question rather I actually want to do IVF again. Yes, as set as I am on this, and as much preparation, emotionally, financially, and other wise we have done, some days I still doubt our decision.

One day this week I was going through a hard time emotionally, dealing with all these thoughts and also with some looming work for a client that was stressing me out, and I was suddenly struck with the realization that, if this cycle goes as planned, I will be the mother of three kids under three years old. I was tempted to take a nap, or get into the fetal position just thinking about that. I mean, I knew this all along, but I had never thought of it in that light. Friends, your prayers are coveted as we go through this process, and especially if we get twins. It is going to be crazy town at our house.

While, there are many horrible expectations (and expecting them is incredibly stressful) there are so many GREAT EXPECTATIONS. This time of waiting really is the best of times and the worst of times. For every frightening and negative thought, I assure you, there are at least double the good ones. Many of the thoughts and doubts I am having most mothers experience at the possibility of adding to their family, IVF or not.

Here is where those worries are unique to IVF: This time before your cycle officially starts has been compared by many IVF families as being worse than the TWW. (Two Week Wait - See my glossary of terms in my previous post for a ton of great fertility related abbreviations and definitions) While I am trying to enjoy this calm time before the IVF storm begins, It is difficult to not waste it with anxiety. I know that as soon as I get dear AF, my life will be forever changed, no matter the outcome of the procedure.

It is difficult not to get caught up in all this. It is good for me to stop for a while, reflect and to remember that life is going on outside of my own conflict. Friends, please, don't think I am selfish. I do care about you, and I do try to listen to you and what you are going through I care about those things - but be patient with me. If I always change the topic and bring it back to me and my upcoming IVF, or life with three kids, etc. I am not meaning to dominate conversation with my own life. I promise. It's just that I am so completely consumed with all of this and dealing with so much right now that it is incredibly hard to not talk about it or not relate it to just about anything anyone 'in the real world' has to say. Give me grace as I go through this process. I know you might be frustrated with me, but I promise, this will not last forever.

If you never have to experience this, I am incredibly happy for you, but as many who have similar situations as mine will attest, waiting is really what IVF is all about. You wait for your cycle to start (where we are now) then, you wait for your meds to get here and for your trial transfer. You wait for your retrieval and for news on your little embryos. You anxiously wait for news as to when you will have your transfer and then after that, you wait for your Beta Test (pregnancy test.) This is about a month and a half (at least) full of nothing but waiting, only interrupted by Dr.'s appointments (SO MANY DR's APPOINTMENTS!) Passing time is only marked by which medication you are on and your medication schedule.

To go back to Dickens, I literally feel like I have England and France, Paris and London inside me. The contrast of the two are at war with each other and something big is about to happen. At the same time, I am Pip after moving to London. I am doing my best to live in a world that I don't fully understand and expecting such great things from my future. (And, I promised there would be no literary comparison... oops)

IVF Terms Explained


The process of trying to conceive, infertility and infertility treatments is overwhelming enough on its own. Add to that the stress of having to learn an entirely new vocabulary and it can be maddening. It seems the entire world shifts and everyone around you begins to speak in abbreviations and acronyms.
I have complied a list of common words (with their acronyms and definitions) you may encounter while reading one of my blogs, or if you are having to go through this process. Some of these are self explanatory, but for thoroughnesses sake, I included them. Yes, some of them might make you blush, but I guarantee you, after a round of IVF, you will get over that.


2ww | Two Week Wait: Waiting to take a pregnancy test; the average length of the Luteal Phase [from ovulation to menstruation] is 14 days (or 2 weeks).

AF | Aunt Flow: Menstruation, period.

Androgen: Hormone that stimulates the activity of the accessory male sex organs and encourages development of male sex characteristics. Also produced in low quantities in females.

Adhesion: Scar tissue that abnormally attaches to internal organs, such as the fallopian tubes, ovaries, bladder, uterus or other internal organs. Adhesions can wrap up or distort these organs, limiting their movement, function and cause infertility and pain.

AI | Artificial Insemination: The depositing of sperm in the vagina near the cervix or directly into the uterus, with the use of a catheter instead of by sexual intercourse. This technique is used to overcome sexual performance problems, to avoid sperm-mucus interaction problems, to maximise the potential of poor semen, and for using donor sperm.

AH | Assisted Hatching: Placing a small opening in the “shell” that surrounds every embryo. This assists the embryo in breaking out of this shell and extruding itself to implant in the endometrium. This is done my embryologists in the laboratory prior to embryo transfer in IVF cycles.

ART | Assisted Reproductive Technologies: A variety of procedures used to bring about conception without sexual intercourse, including IVF, and GIFT.

BBT | Basal Body Temperature: The body temperature at rest taken in the morning before arising from bed. Successive BBT’s can be measured orally each morning and recorded on a calendar chart. These charts can be studied to help identify the time of ovulation, or even if a patient is ovulating at all. Menstrual calendar information is also an important part of a BBT chart. An ovulation predictor kit (OPK) can be used instead of daily temperature readings.

BD | Baby Dance:  Sex.

Beta | Beta hCG:  Blood pregnancy test that measures a beta chain portion of the human chorionic gonadotropin (hCG) hormone emitted by the developing embryo.

BFN or BFP | Big Fat Negative or Positive: Pregnancy test result.

Blastocyst transfer: A recent advance in infertility treatment, in which embryos develop for 4 or 5 days (until they reach blastocyst stage), rather than the usual 2 or 3 days in IVF.

Cervical Factor: Infertility due to a structural or hormonal abnormality of the cervix. This can be induced by previous surgery on the cervix (such as a LEEP or cone procedures) that leaves the cervical canal scarred or closed, termed stenosis. Also applied when there are factors associated with the cervix which inhibit sperm function such as thickened mucus which prevents the sperm from traveling through the cervix into the female reproductive tract. Cervical factor infertility can usually be overcome using inseminations of sperm past the cervix in to the uterus.

Cervix: The lower section of the uterus which protrudes into the vagina and serves as a reservoir for sperm. Its anatomical functions include being a natural barrier to the inner uterus, and also keeping pregnancies from delivering prematurely.

Chemical Pregnancy: A positive pregnancy test, but with levels of pregnancy hormone (beta hCG) too low for ultrasound documentation of a pregnancy. Typically this definition includes pregnancies that have low beta hCG levels that spontaneously decline without any further development.

Cleavage: Division of one cell into 2, 2 into 4, 4 into 8, etc. This is measured in the embryology laboratory during IVF cycles.

Clinical Pregnancy: A pregnancy in which the beating fetal heart has been identified by ultrasound.

Clomiphene Citrate (Clomid  or Serophene ): An oral medication used to stimulate the ovaries and/or synchronize follicle development.

Corpus luteum: A structure that forms at the site of an ovarian follicle after it releases an egg. The corpus luteum releases estrogen and progesterone, two hormones necessary for maintaining a pregnancy. If pregnancy occurs, the corpus luteum functions for five or six months. If pregnancy does not occur, it stops functioning.

CD | Cycle Day: Cycle days are numbered starting on the first day of your period.

CM | Cervical Mucus: Fluid excreted by the cervix, stimulated by estrogen. Becomes more fertile and receptive to sperm just before ovulation. Paying attention to the changes in CM can help a woman conceive. Not useful in determining whether pregnancy has occurred.

CP | Cervical Position: Changes throughout the cycle, in a predictable pattern. Not useful in determining if pregnancy has occurred.

Cryopreservation: Storage of organs or tissues at very low temperatures. Embryos that are not used in an ART cycle can be cryopreserved for future use.

DH | Dear/Darling Husband: Sometimes used sarcastically.

Donor Egg Cycle: The use of donated eggs from an anonymous or known donor. These eggs are harvested via an IVF cycle performed on the donor. The resultant eggs are inseminated with sperm and then form embryos which are transferred into the womb of the intended parent.

Donor Embryo Transfer: The transfer of embryos resulting from the oocyte (egg) and sperm of another patient, who may be anonymous or known, to an otherwise infertile recipient

Donor Insemination: The introduction of sperm from an anonymous volunteer donor into the vagina, cervix, or uterine cavity in order to achieve a pregnancy.

DPO/DP#DT | Days Past Ovulation/Transfer: Days are numbered starting with the day after ovulation (1 DPO), or after the date of embryo transfer. Example: 7DP5DT = 7 days past 5 day transfer, meaning the number of days that have elapsed since a day-5 embryo transfer (in other words, 12 days past egg retrieval).

VAS | Ductus Deferens: A thick walled tubular structure running from each testis into the ejaculatory duct. These structures carry sperm from the testicles to the epididymis to the penis for ejaculation. The vas deferens can be scarred or damaged by surgery, trauma or infection to the point where it does not allow sperm to pass through.

Ectopic Pregnancy: A pregnancy implanted outside the uterus; most often in the fallopian tube. This is also termed a tubal pregnancy. This can usually be diagnosed in its early stages by following the pregnancy hormone, beta HCG, very closely during the early part of pregnancy. Left undiagnosed and untreated, an ectopic pregnancy can have serious medical consequences.

EC or ER | Egg retrieval: A procedure used to obtain eggs from ovarian follicles for use in in vitro fertilisation. The procedure may be performed during laparoscopy or through the vagina by using a needle and ultrasound to locate the follicle in the ovary. This is done under light anesthesia so that patients are sleeping during the entire process. Typically takes about 30 minutes total.

EDD | Estimated Due Date:  When a baby is expected to be born. Based on last menstrual period (LMP), date of ovulation or day of retrieval.

Embryo: Term used to describe the early stages of fetal growth, from conception to the eighth week of pregnancy.

Embryo transfer: Placing an egg fertilised outside the womb into a woman's uterus or fallopian tube. It occurs on the third or fifth day after an egg retrieval.

Endocrinology: The study of hormones, their function, the organs that produce them and how they are produced.

Estrogen: Hormone that stimulates secondary female sexual characteristics and controls the course of the menstrual cycle. Also produced in low quantities in males.

Endometrial biopsy: The extraction of a small piece of tissue from the endometrium (lining of the uterus) for microscopic examination.

Endometrial Cavity: The space in side the uterus that is created by the inner lining of the uterus that responds to female hormones during the menstrual and treatment cycles. This lining, when properly prepared, forms the area of attachment and implantation of the embryo. Commonly referred to as the womb.

ENDO | Endometriosis: The presence of endometrial tissue (tissue that normally lines the uterus) in abnormal locations such as the ovaries, fallopian tubes and abdominal cavity. These lesions lead to local irritation and inflammation that can cause scarring to occur which can bind-up pelvic organs to the point of dysfunction and pain.

Endometrium: The inner lining of the uterus that responds to female hormones during the menstrual cycle and treatment cycles. This lining, when properly prepared, forms the area of attachment and implantation of the embryo. A portion of this lining is shed each month with menstruation.

ET | Embryo Transfer:  Final step in the IVF process. Embryo(s) are transferred into the uterus using a flexible catheter.

Epididymis: Portion of the male genital tract next to the testis where sperm maturation is partially accomplished. Receives sperm from the testis and continues as the ductus (vas) deferens.

Estradiol: The principal hormone produced by the growing ovarian follicle. It is frequently measured in the blood to gauge the strength and development of your follicles during treatment cycles.

EWCM | Egg-White Cervical Mucus: The most fertile type of CM. Having sex when you have EWCM is one way to increase the chance of conception.

Fallopian tubes: Ducts through which eggs travel to the uterus once released from the follicle. Sperm normally meet the egg in the fallopian tube, the site at which fertilization usually occurs.

Fertilization: The combining of the genetic material carried by sperm and egg to create an embryo. Normally occurs inside the fallopian tube (in vivo) but may also occur in a Petri dish (in vitro). (See also In Vitro fertilization.)

Fertility specialist: A physician specializing in the practice of fertility. The American Board of Obstetrics and Gynecology certifies a subspecialty for OB-GYNs who receive extra training in reproductive endocrinology (the study of hormones) and infertility.

Fertility treatment: Any method or procedure used to enhance fertility or increase the likelihood of pregnancy, such as ovulation induction treatment, varicocele repair (repair of varicose veins in the scrotal sac), and microsurgery to repair damaged fallopian tubes. The goal of fertility treatment is to help couples have a child.

Fibroid tumor: Benign (not malignant or life-threatening) tumor of fibrous tissue that can occur in the uterine wall. May be totally without symptoms or may cause abnormal menstrual patterns or infertility. Overgrowth of the muscular tissue of the uterus. Fibroids are typically knotty masses of benign muscle tissue that can distort the shape and function of the uterus. They are typically classified in to three categories: sub-mucosal, intramural and serosal. Sub-mucosal fibroids are found in the uterine cavity and impair implantation. They need to be removed in order to conceive. Intramural fibroids are problematic when they become severely enlarged or impinge on the uterine cavity. Sub-serosal fibroids generally are left alone during fertility treatments.

Fimbria: The soft and supple finger-like extensions of the fallopian tube that aid in gathering in the oocyte (egg) at ovulation.

FSH | Follicle Stimulating Hormone: A pituitary hormone that stimulates follicular development and spermatogenesis (sperm development). In the woman, FSH stimulates the growth of the ovarian follicle. In the man, FSH stimulates the Sertoli cells in the testicles and supports sperm production. Elevated FSH levels are associated with gonadal failure in both men and women.

Follicles: Fluid-filled sacs in the ovary, which contain the eggs released at ovulation. Each month an egg develops inside the ovary in a follicle.

Follicular Phase: The menstrual cycle is divided up into two main parts- the follicular phase and the luteal phase. The follicular phase refers to the first half of the cycle, from onset of menses to ovulation, and lasts approximately 14 days. It is associated with developing follicles that produce estradiol.

FET | Frozen Embryo Transfer: frozen embryo transfer (FET) is a cycle where a frozen embryo from a previous fresh IVF cycle is thawed and transferred back into a woman's uterus. This means you won't have to undergo another cycle of hormone stimulation and an egg collection .

Gamete: A reproductive cell. Sperm in men, the egg in women.

GIFT | Gamete Intrafallopian Transfer: After egg retrieval, the eggs are mixed with sperm and then placed, using a minor surgical procedure (laparoscopy), into the woman's fallopian tubes for in vivo fertilisation.

Gestation: Pregnancy. Gonadotropin: Hormones that stimulate the ovary.

GnRH | Gonadotropin Releasing Hormone: A substance secreted every ninety minutes or so by a part of the brain called the hypothalamus. This hormone enables the pituitary to secrete LH and FSH, which stimulate the gonads.

Gonadotropins: Hormones that control reproductive function: Follicle Stimulating Hormone and Luteinizing Hormone.

HCG | Human Chorionic Gonadotropin: The hormone produced in early pregnancy that keeps the corpus luteum producing progesterone. Also used via injection to trigger ovulation after some fertility treatments, and used in men to stimulate testosterone production. A hormone of early pregnancy that is monitored to determine viability of the gestation. This hormone is also used as an injection to induce ovulation and maturation of the oocyte (egg) in ovarian stimulation protocols. This is the pregnancy hormone detected by at-home pregnancy tests.

HPT | Home Pregnancy Test:  The stick you pee on.

HMG | Human Menopausal Gonadotropin: A purified extract of LH and FSH, the hormones secreted by the pituitary gland to stimulate the ovary. It is a commercial preparation used by injection to facilitate development of multiple follicles in treatment cycles.

Hypogonadism: Inadequate ovarian or testicular function as shown by low sperm production or lack of follicle production, as well as low or absent levels of FSH and LH.

Hypothalamus: A portion of the brain that stimulates the pituitary gland to secrete LH and FSH in order to stimulate ovarian follicle development. The hypothalamus acts as the “pacemaker” for many important hormone-driven processes, controlling the production and periodic release of hormones from the pituitary gland.

HSG | Hysterosalpingogram: An x-ray procedure to examine whether the fallopian tubes are patent (open) or not. This test helps determine if the tubes are blocking sperm from reaching the ovulated eggs through the fallopian tubes. Special x-ray dye is gently injected through the uterus and then x-ray pictures are taken to see where the dye travels.

HSC | Hysteroscopy: A visual examination of the uterus using an instrument called a hysteroscope, which enables the doctor to see into the organ without making a large incision. a small telescopic camera, much like a laparoscope, is placed through the cervical canal into the uterine cavity. This allows direct visualization of the endometrium, the lining of the uterine cavity (the womb) – where pregnancies implant. This surgical technique is minimally-invasive, well-tolerated and performed in a day-surgery center. It allows removal of any impediments to implantation such as polyps or fibroids in the uterine cavity.

Implantation (Embryo): The embedding of the embryo into tissue so it can establish contact with the mother's blood supply for nourishment. Implantation usually occurs in the lining of the uterus; however, in an ectopic pregnancy it may occur elsewhere in the body.

Insemination: Transfer of sperm for the purpose of establishing a pregnancy. Inseminations are performed by placing a small, soft catheter through the cervix into the uterine cavity and depositing the concentrated and activated sperm.

IVF | In Vitro Fertilization: Eggs produced by administering fertility drugs are retrieved from the woman's body and fertilized by sperm in a laboratory. The resulting embryos are transferred by catheter to the uterus. A powerful procedure to help patients conceive pregnancies. IVF entails stimulating your ovaries to develop multiple follicles. This is achieved with injectable medications. The goal of IVF is to produce a large number of growing follicles, then harvest the eggs inside the follicles through a short surgical procedure performed in our office. The eggs are then inseminated with sperm in the laboratory, sometimes using ICSI, in order to create embryos that can then be transferred back to the endometrial cavity (the womb) of the patient. The name in vitro fertilization refers to the fact that the oocyte is fertilized by the sperm in the laboratory, rather than inside the female reproductive tract.

IF | Infertility: The inability to conceive after a year of unprotected intercourse (six months if the woman is over age 35) or the inability to carry a pregnancy to term.

IM | Intramuscular injection:  Given directly into a muscle.

ICSI | Intracytoplasmic Sperm Injection: A micromanipulation (occurring under the microscope) procedure in which a single sperm is injected directly into the egg to enable fertilization with very low sperm counts or with non-motile sperm (sperm that don't swim effectively toward the egg). The embryo is then transferred to the uterus. ICSI is also used for patients who have had previous IVF cycles with failed fertilization.

IUI | Intrauterine Insemination: A procedure in which a doctor places sperm directly into the uterus through the cervix using a catheter. It bypasses the vaginal and cervical defense mechanisms of the female reproductive tract and allows better sperm delivery to the fallopian tubes. This allows the sperm and egg to interact in close proximity. It is a very common treatment for mild and moderate deficits in the semen analysis. IUI is typically used in conjunction with medications that increase the number of eggs per cycle and triggering of ovulation. The goal is to have more ÒtargetsÓ for the sperm (eggs), perfect timing and better sperm delivery.

LAP | Laparoscopy: Examination of the pelvic region by using a small telescope called a laparoscope.

LupronTM: A synthetic form of GnRH (gonadotropin releasing hormone- secreted by the hypothalamus) used to suppress ovarian function.

LP | Luteal Phase: The menstrual cycle is divided up into two main parts- the follicular phase and the luteal phase. This refers to the second half of the cycle, usually the last fourteen days of an ovulatory. It begins from the time of ovulation to the onset of menses, but is prolonged during pregnancy cycles. It is associated with progesterone production from the corpus luteum that facilitates implantation of embryos and supports early pregnancies.

LH | Luteinizing Hormone: A pituitary hormone that stimulates the gonads. In the man, LH is necessary for spermatogenesis and for the production of testosterone. In the woman, LH is necessary for the production of estrogen.

LPD | Luteal Phase Deficiency: Also called luteal phase defect. A deficiency of progesterone in the second half of the menstrual cycle when a pregnancy begins. Treatment involves supplementation with progesterone and other measures.

LH Surge | Luteinizing Hormone Surge: The release of luteinizing hormone (LH) that causes release of a mature egg from the follicle.

MetrodinTM: Human FSH prepared in an injectable form for ovarian stimulation.

Media: Fluid containing nutritive growth substances enabling cells to survive in an artificial environment.

Medicated FET: In a medicated (also commonly referred to as a "programmed" FET), the patient takes a course of hormone medication that ensures that the patient's endometrium (lining of the uterus) is prepared to receive the thawed embryo(s). *See Also: FET  &  Natural FET*

Menses: A “period”. Cyclic (monthly) flow of blood (menstruation) signifying ovulation, but failure to achieve pregnancy. Onset of bleeding is considered cycle day 1. The purpose of a natural menstrual cycle is to produce one follicle and ovulation per month, each and every month that pregnancy is not achieved.

Micromanipulation: A variety of techniques that can be performed in a laboratory under a microscope. Anembryologist manipulates egg and sperm to improve the chances of pregnancy. (See Intracytoplasmic Sperm Injection, ICSI.)

Miscarriage: Spontaneous loss of a viable embryo or fetus in the womb.

Natural FET: "Natural" FETs by use blood testing and ultrasound to plan the embryo transfer. Natural FETs require minimal or no medication. *See Also: FET  &  Medicated FET*

OB or OB-GYN | Obstetrician-Gynecologist: Trained physicians who diagnose and treat female reproductive health issues, and care for women during pregnancy, childbirth and during post-birth recovery.

Oocyte: The female germ cell often called an egg.

OPK | Ovulation Predictor Kit: Detects LH surge, which typically means ovulation will occur in 12-36 hours.

Ovarian failure: The failure of the ovary to respond to FSH stimulation from the pituitary because of damage to or malformation of the ovary, or a chronic disease such as autoimmune disease. Diagnosed by elevated FSH in the blood.

Ovary: The female sex gland with both a reproductive function (releasing oocytes) and a hormonal function (production of estrogen and progesterone).

O or OV | Ovulation: The release of the egg (ovum) from the ovarian follicle.

Ovulation Induction: Medical treatment performed to initiate ovulation.

Ovum (ova or egg): Mature oocytes.

Pap test: A screening test to determine the presence of cervical cancer. It is done by gently touching a swab to the cervix to collect cells for examination by a pathologist.

PergonalTM: A purified extract of LH and FSH, hormones secreted from the pituitary gland which stimulate the ovary. It is a commercial preparation used by injection to facilitate development of multiple follicles in reproductive treatment cycles.

PG | Pregnancy, pregnant: Does this one really need further explanation?

Pituitary Gland: A small organ at the base of the brain that secretes many hormones, including LH and FSH in response to signals from the hypothalamus.

Polyp: An overgrowth of the glandular surface of the endometrium. Polyps are often removed by hysteroscopic surgery to remove any impediments to implantation.

Polyspermy: Abnormal condition where the oocyte is fertilized by more than 1 sperm.

PCT | Post-Coital Test: The microscopic analysis of a sample of vaginal and cervical secretions that has been collected after sexual intercourse. This test allows your physician to see if sperm survive in your reproductive tract. It has largely been superceded by the semen analysis, but there are still some clinical indications for the PCT.

PGD | Preimplantation Genetic Diagnosis: A technique for identifying genetic or chromosomal information about embryos before transferring them back to a patient’s endometrial cavity (the womb). It entails taking a biopsy of the embryo on day three after egg retrieval. PGD can be employed to identify embryos that carry a genetic disease that may be asymptomatically carried by the parents, or it may be used to identify explanations for Recurrent Pregnancy Loss and improve pregnancy outcomes in selected patients.

PROG | Progesterone: The hormone produced by the corpus luteum during the second half of a woman's cycle. It thickens the lining of the uterus to prepare it to accept implantation of a fertilized egg. A supply of progesterone to the endometrium continues to be important during pregnancy. Following a successful implantation, progesterone helps maintain a supportive environment for the developing fetus. After 8 to 10 weeks of pregnancy, the placenta takes over progesterone production from the ovaries and substantially increases progesterone production. Some women may need to take progesterone supplements in the form of PIO or a vaginal suppository.

PIO | Progesterone in Oil:   One of the many injections an infertile can look forward to. Typically administered during IVF cycles, but can also be prescribed to anyone needing extra progesterone support during early pregnancy.

Pronucleus: A specialized stage of the oocyte and sperm nucleus before they join to create a genetically unique embryo. After this union the conceptus is referred to as a zygote.

Recombinant DNA: DNA that has been modified so that it contains genes from two different sources. Recombinant technology is often used to produce highly pure therapeutic drugs.

RE | Reproductive Endocronolgist:   Doctor who specializes in fertility issues.

SA | Semen Analysis: Examination of the male ejaculate under the microscope to determine the number of sperm, their ability to move forward (motility) and their shapes (morphology). The semen analysis is a cornerstone of the evaluation of couples experiencing infertility. The sperm counts, motility and morphology all provide important information about how the sperm will perform in treatment cycles.

SET or eSET | Single Embryo Transfer or Elective Single Embryos Transfer: A specific definition of only transferring a single embryo at the culmination of an IVF cycle. This is different from the conventional practice of transferring more than one embryo. Traditional embryo transfer strategies include the idea of transferring as many embryos as is deemed safe in your age group. This ensures the highest pregnancy rates, but also exposes you to the possibility of having more than one baby, such as twins or more. Not every patient is a candidate for eSET.
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SHG | Sonohysterography:   Imaging the uterus and uterine cavity using ultrasonography while sterile saline is instilled into the uterine cavity. The purpose of sonohysterography is to detect abnormalities of the uterus and endometrial (uterine lining) cavity.

Sperm: The microscopic cell that carries the male's genetic information to the female's egg; the male reproductive cell; the male gamete.

Sperm Antibody Test: In some couples blood, semen and/or cervical mucus contain substances which hinder sperm action through an allergic or immune reaction.

Sperm count: The number of sperm in an ejaculate. Also called sperm concentration and given as the number of sperm per milliliter.

Sperm motility: The ability of sperm to swim. Poor motility means the sperm have a difficult time swimming toward the egg.

SPA | Sperm Penetration Assay: A test where sperm are incubated with non-viable hamster eggs to determine the capacity of the sperm to fertilize.

Sterility: An irreversible condition that prevents conception.

Stims | Stimulation medications:  Medications that stimulate the ovaries to produce multiple follicles for IVF. Examples include injections such as Follistim, Gonal-F, Bravelle, and Fertinex. Usually does not refer to oral medications, like Clomid and Femara, even though they are also ovulation stimulation medications.

Sub-Q | Subcutaneous injection:  Given just under the skin with a very small needle.

TESA | Testicular/Epididymal Sperm Aspiration: The surgical removal of sperm directly from the testis or the epididymis using a needle for aspiration. This procedure is used for men who have no sperm in their ejaculates or have had vasectomies in the past. Sperm obtained through TESE requires ICSI to ensure fertilization of the oocyte (egg).

Testosterone: The male hormone responsible for the formation of secondary sex characteristics and for supporting the sex drive. Testosterone is also necessary for spermatogenesis (sperm development).

Transvaginal: Through the vagina.

Tubal Patency: Lack of obstruction of the Fallopian tubes.

TTC | Trying To Conceive: Typically refers to those actively trying to get pregnant; also applies to anyone who has sex without using contraception.

US | Ultrasound: A test used instead of X-rays to visualise the reproductive organs; for example, to monitor follicular development. Ultrasound is especially useful for visualizing the female reproductive organs and pregnancies. In the TTC universe, the most common type is the transvaginal or t/v ultrasound, whereby a probe is inserted into the vagina in order to get a better look at the uterus and ovaries.

Unexplained Infertility: Inability to identify the cause of infertility despite a complete evaluation of semen, ovarian reserve, ovulation, endocrinologic disorders and pelvic anatomy.

Uterus: Womb. The reproductive organ that houses protects and nourishes the developing embryo and fetus. It consists of the cervix, the endometrium and the muscular layer that comprises the body of this reproductive organ.

Varicocele: A varicose vein around the ductus (vas) deferens and the testes. This may be a cause of low sperm counts, motility and morphology and lead to male infertility.

Zygote: A conceptus in which the genetic material (pronuclei) of the egg and sperm have united.

ZIFT | Zygote Intra-fallopian tube Transfer: Oocytes (eggs) are aspirated, are fertilized in the laboratory and surgically transferred into the fallopian tubes before cell division. This procedure has largely been replaced by standard IVF.