The Lone Ranger

I’ve probably attempted to write this post now several times but the truth is I don’t really know what to think about The Lone Ranger.

So I go back to the beginning. For weeks we prayed about doing IVF. There is still no doubt in my mind that God widely opened that door for us. There is still no doubt in my mind that God lead us to IVF.

We got the okay from God.

Then we had our consult appointment with Dr. L.

I started Birth Control.

Then came the stimulation drugs.

I had never really put a number to the amount of follicles I hoped would be in there. Sure, 15-20 would have been a great start, but with all my issues, I was honestly hoping for at least ten follicles to work with.

And here we are today … with The Lone Ranger … the one and only follicle that ever woke up and smelled the Follistim and Menopur!

I refuse to allow myself to think that this IVF cycle is a complete bust because I know that this IVF turned IUI cycle is going precisely how God planned it before I even drew my first breath almost 28 years ago.

Your eyes saw my unformed body. All the days ordained for me were written in your book before one of them came to be.          Psalm 139:16

The Lone Ranger may have surprise me and everyone else, but it certainly didn’t surprise God.

Beth brought up a very complex question in one of her comments:

I’ve been wrestling with hope and how hope and reality go together … So where do we merge hope and reality in our lives?

If only there was an easy answer!

I certainly hope God will choose to answer the cries of my heart and allow The Lone Ranger to become Baby. This has been my prayer since learning this would be our only follicle this month.

Reality tells me that the odds are not in our favor.

One follicle.

Endometriosis which has more than likely done a number on the quantity and quality of my remaining eggs.

Not the hopeful circumstances I was hoping for with 10 eggs and at least 2 beautiful, perfect blastocysts to transfer!

It’s obvious this one follicle is a complete let down. I do find peace in the following verse, however:

Why are you downcast, O my soul? Why so disturbed within me? Put your hope in God, for I will yet praise him, my Savior and my God. Psalm 42:5

I guess this verse has spoken so much to me in the past several days because it reminds me where my hope is and Who my hope is in.

I don’t have to be discouraged about The Lone Ranger even though I feel completely blind and clueless as to what God is up to with the outcome of this IVF cycle and from my eyes, things don’t look too promising.

God has lead us here now. Our plans for the IVF outcome are just that … our plans, our hope of what would happen. BUT …

Many are the plans in a man’s heart, but it is the Lord’s purpose that prevails. Proverbs 19:21

As long as I keep my mind and heart focused on the fact that God does have a purpose and plan in all this to prosper me, no matter how bleak my circumstances continue to get, I’ll always have hope.

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Currently, there are 7.2 million fresh motile sperm (not previously frozen) waiting for the debut of The Lone Ranger.

Tomorrow we will return and use the 115 million sperm frozen for our IVF cycle. (The number won’t be that high tomorrow as many will be lost during the unfreezing process.)

I have more to say about The Lone Ranger but I’ll write more later.

IUI Schedule

Here’s our schedule for our 4th IUI (5th if you count the one that was cancelled):

Tonight 9:30pm – hCG injection (to induce ovulation)

No, I will not be giving myself this shot. It must be done with a much longer needle and must be injected in the lower back area. I am not that brave. My parents’ neighbor, who is a nurse, will be giving it to me.

Thursday, March 12 – Insemination at 2pm

Friday, March 13 – Insemination at 9:30am

Friday, March 27 – Blood Test

Sometime soon, I hope to write about my thoughts towards this one follicle who I am affectionately calling The Lone Ranger.

IVF and “Playing God”

There is still one follicle maturing and growing in the left ovary.

Today it measured 15mm.

I am waiting for a nurse to call and let me know when I am to have the hCG injection (to induce ovulation) and when the IUIs will be.

For now, I leave you with a post I actually wrote on Saturday. I think this post will help you understand the biggest factor for us in deciding if we should try another IVF ovarian stimulation and hope and pray for more follicles.

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Some people call IVF “playing God”.

I, however, see IVF as a genius medical intervention that allows a woman to essentially combine a number of menstrual cycles into one, thus allowing the medical field to sift through the harvested eggs and then embryos and find the ones that have the most potential to produce a viable pregnancy.

In order to understand why I do not believe doing IVF “plays God” in any way, you need to first understand what naturally occurs in a fertile couple trying to conceive.

I’ve mentioned that I am reading the book In-Vitro Fertilization: The ART of Making Babies by Geoffrey Sher, M.D. in a previous post. (Excellent book!) When I read the part of the book about natural conception, it blew my mind away and helped me realize that IVF adapts the principals of human reproduction to achieve pregnancy in a faulty reproductive system!

Only about one out of every three embryos implants in the uterus long enough to delay the menstrual period. This means, in two out of every three pregnancies, a woman is not even aware conception has taken place! (Sher, 2005, page 29)

The actual fertilization process is such a complex process that many times egg and sperm do meet but something goes wrong in the fertilization process and the embryo is just not capable of producing a viable pregnancy. In other words, the woman has conceived, but she will never know it! In other cases, a woman may miss her period, but will have a very early miscarriage because the embryo isn’t capable of producing a viable pregnancy (among other reasons also mentioned in the book).

One reason IVF gets a bad reputation from some people is because people have a problem with embryos being discarded. (Please understand I am not referring to discarding frozen viable embryos.) Maybe people would have a different point of view if they understand the high rate of embryo wastage and early miscarriages that occurs even in natural conceptions!

These facts should only encourage someone standing on the brink of an IVF cycle.

While a woman’s natural menstrual cycle produces on average one mature follicle, a woman (under the age of 40) undergoing IVF produces an average of 10-15 follicles. (Sher, 2005, page 63) The way I see it, IVF essentially takes approximately a year’s worth of monthly menstrual cycles and combines them into ONE cycle.

For example, let’s say a woman undergoes IVF and at retrieval, twelve follicles are aspirated from her ovaries. Of those 12, maybe only 10 follicles actually contain a mature egg. Of those 10 eggs, let’s say 8 fertilize normally after being left overnight with sperm in a petri-dish.

Of those eight fertilized eggs, more than likely, a number of them will not continue to grow and divide properly and will not be able to produce a viable pregnancy. These embryos would be the ones in a “natural conception” that would float around in the woman’s reproductive tract but would not implant for one reason or another.

In an IVF lab, embryos are carefully monitored. When the embryologist finds embryos that are not growing after several days, the embryos are discarded just like non-viable embryos are discarded in nature without the woman ever even knowing she has conceived. In the example, let’s say of the eight fertilized eggs, three of the embryos stop growing by day three after retrieval. We are now left with five embryos.

The remaining five embryos continue to grow in the IVF lab and are carefully monitored for proper growth and cell division. On day five after retrieval, the embryos are now at the blastocyst stage and embryologists look for the healthiest embryos to transfer to the woman’s uterus.

If this example was me, most likely at my age of 27, the two most viable embryos would be selected for transfer. The remaining three embryos would stay in the IVF lab and would continue to be monitored. Let’s say of the three remaining embryos, one stops growing and there are two viable embryos left. Those two embryos would be frozen for a future IVF cycle and considered an added “bonus” to the overall IVF cycle.

Do you see how IVF weeds out the follicles with no eggs, the eggs not capable of normal fertilization and the embryos not capable of producing a viable pregnancy (most likely because of a chromosomal defect that occurred during the very complex fertilization process) in the time span of one month compared to the many more months it would take for a woman’s natural menstrual cycles to do the same?

Playing God? No.

In my own personal infertility case, we believe our ability to do IVF is a gift from God. It is a well-known fact that the largest playing factor in ANY woman’s fertility is her AGE. Throw endometriosis into that mix and that woman’s biological clock is ticking louder than Big Ben because it is also believed that egg quality in a woman who has (or has had) endometriosis declines sooner than a woman who has never had endometriosis. At the age of 27, I am standing in my “window of opportunity” to conceive and give birth to a biological child. That God would put together every necessary detail to proceed with IVF at this particular time in my life is nothing short of a miracle, in and of itself.

We see this IVF cycle as a blessing from God in that IVF will allow me to harvest a number of eggs, and hopefully, at the end of this month end up with at least one viable embryo capable of implanting in my uterus and producing a viable pregnancy.

There is something else that must be taken into consideration when doing IVF. At the end, when it comes to transfer time, it is not so much the number of embryos that you have available to you, but your embryo quality, that is extremely important.

In other words, while I am praying earnestly for “lots of follicles to be retrieved”, in the end our goal is not “lots of embryos in the IVF lab” but “several GOOD QUALITY embryos available for transfer”. I would rather only have two perfect, good quality embryos at transfer time than TEN not-so-good or even poor quality embryos.

The simple fact here is that we need “lots of follicles” to start with in order to increase the odds of weeding out the “bad eggs” and continuing the IVF process with the “good eggs”.

It is not the number of embryos you have at the end of an IVF cycle that matters – it is their viability that makes all the difference in whether the IVF cycle ends in a pregnancy or not.

That and, of course, if God wills to bring another life into the world. Even taking all the meds required for an IVF cycle, harvesting many eggs and paying the big bucks to do the cycle does not guarantee a pregnancy.

In an IVF cycle, God is still the creator and sustainer of life and He will never hand that role over to any medical professional.

*****

Side Note:

Knowing what we know now, apart from a miracle of God, my ovaries are never going to produce enough eggs for my IVF cycle to mirror that of the example I gave above. Dr. L predicts, if we choose to go through IVF ovarian stimulation again, we can expect no more than three follicles to mature.

If even one, two or three follicles mature, are retrieved, fertilized and even produce one viable embryo, we have good odds of a pregnancy.

The thing is, we won’t know the quality of the eggs in the follicles until the follicles are retrieved. Retrieval is one of the most expensive aspects of IVF, which is why we cancelled before retrieval this time. At this point, I can’t justify going to retrieval for one follicle that may or may not have an egg in it!

I know God has placed this deep desire in my heart to be a mother. There is no experience that can possibly compare to pregnancy and childbirth. I was the little girl growing up with pillows constantly shoved up my shirt playing “pregnant” and dreaming of the day I would actually “have a baby in my tummy”.

I think it is pretty obvious that I am willing to fight and do whatever it takes to make this dream become a reality. However, I am surrendered to the fact that my dream may not be God’s marvelous plan and ultimately, I desire His plan, not mine.

Until He says “stop”, I will persevere and claim the promise found in Psalm 37:4.

Delight yourself in the Lord and he will give you the desires of your heart.

Picking Up the Pieces

What can you do but pick up the pieces after a day like yesterday?

It’s no joke that the road of infertility is full of ups and downs. While yesterday was probably the lowest of the lows for us in our journey so far, I still found myself watching the clock and waiting for the day to end so a new one could begin.

I know a new day signifies a fresh outlook and while we never assumed the outcome of our first attempt at IVF would be this bad, we can only move forward from here and deal with the new set of circumstances that have been given to us.

I decided long ago that I am going to choose to set my mind on God and not my circumstances that seem to grow dimmer and dimmer with each passing treatment.

However, this blow knocked me down hard. Yesterday put me that much closer to the reality of having to accept that I may actually never be pregnant and give birth to a baby.

But yesterday also made me realize once again that I am not in control here and neither is my doctor. God is in control and yesterday did not take Him by surprise at all.

Now, more than ever, I must trust that God has a perfect plan that somehow involves the bleak circumstances of yesterday. If I don’t believe that simple truth, I literally have nothing.

As for now, we are converting this IVF cycle to an IUI. I will go in tomorrow at 8am for another ultrasound to monitor what this solo follicle hanging out in my left ovary is doing. I’m predicting (based on how the three IUIs before surgery went) that we will be ready for insemination towards the end of this week. Assuming, of course, that this one follicle doesn’t decide to take a leave of absence as well.

Honestly, I’m not allowing myself to think too much about this IUI and the possibilities that lie within. I just can’t allow my mind to think that this could be it.

As far as our next step beyond an IUI goes … we are once again at a crossroad of decision-making and need your prayers as we make (another) big decision.

When not-so-great odds, a huge sum of money and a deep desire to be a mother are all thrown into making one decision, it makes for a very complex decision to be made.

I know without a shadow of doubt that the prayers of many faithful prayer warriors is what pulled me through yesterday. Thank you, from the bottom of my broken heart, for all the prayers, comments, emails, Facebook messages and phone calls.

I could never convey to you in words how much it means to me to know that I have an army of prayer warriors lifting me up to the Father on a consistent basis – especially on a day like yesterday when I literally just didn’t know what to pray.

We will probably never fully understand this side of heaven the complete impact your prayers have made.

But I am completely confident that one day we will all be able to look back on this entire journey and see a beautiful outcome that is far better and far greater than anything we can even imagine today.

I, for one, am looking forward to that glorious day!

One

I am still trying to process the sequence of events that have occurred over the past 4 hours.

There is still just ONE follicle in the left ovary … only. When Dr. F was doing the ultrasound and found the one follicle only, I told myself I needed to remain calm so I could clearly think and ask questions.

I was thinking, This is not the results we were expecting but we can try again and hope for a better response next time.

And then Dr. F began to explain something called a hypothalamic component and the world began to unravel all around me.

When someone (like me) is underweight the part of the brain responsible for FSH and LH production shuts down. FSH and LH are the hormones that are responsible for stimulating follicles to grow and mature. This is something that has been around since the prehistoric ages to prevent a “starving” species from being able to procreate.

Dr. F said that with my particular circumstances the normal range of number of eggs retrieved during an IVF cycle is anywhere from 0 to 6. I definitely fall into that range with only one follicle maturing.

I immediately told Dr. F that I wanted to cancel this IVF cycle. There is no way I am paying these big bucks for one egg. Dr. F told me they have gone through with an IVF cycle before with low egg numbers and have still been able to achieve a pregnancy.

Let me just say that I was prepared to go in there and have only 1 or 2 or 3 eggs. My gut feeling was that my ovaries were not producing what they should for an IVF cycle and we would just adjust my protocol and try again later.

However, I was not prepared to hear that because of this hypothalamic component, the best we can hope for at this point is 2 eggs, possibly 3 even with all the IVF ovarian stimulation meds.

The tears won’t stop because for the first time it is looking like I just may have to give up on this dream I’ve had since childhood to conceive, be pregnant and give birth to a baby who is half me and half my husband, yet uniquely an individual person.

I can’t explain how I feel other than to say that it feels like a death has occurred in the family.

I know it’s not all over yet. However, things are growing more and more grim by the day that I will ever actually have life growing inside of me.

The plan for now is to convert this IVF cycle into an IUI cycle. I would like to discuss my options with Dr. L on Monday as he was not on call today. I am grateful for Dr. F’s input and am anxious to know what Dr. L’s opinion is. It never hurts to hear the opinions of two excellent doctors.

This is one of those very dark days. However, I can still see a glimmer of hope found in God’s Promise in Jeremiah 29:11.

“For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.”

I still firmly believe that with all my heart and know one day I will look back on this day and see once again the faithfulness of God iron out all the wrinkles of a very ugly day.

I think it can go without saying that I need prayers, but I’ll say it anyway. I need your prayers.

Please pray for wisdom to know if we should shoot for another IVF cycle in June and hope for at least a few more eggs or if we should throw in the towel and seek other options that are equally overwhelming to think about.

Happy Birthday … to my blog!

It was exactly one year ago today that I started this blog.

I never imagined on March 7, 2008 that this blog would …

  • become an integral part of my infertility journey.
  • be a place for me to sort through the many thoughts and feelings that accompany something like going through infertility.
  • be a place for me to be a witness to anyone who reads that God IS faithful through even the darkest trials life has to offer.
  • connect me to many incredible other women walking this road.
  • be the “Command Center” for initiating masses of people to pray me through this season of my life.

Honestly, I started the blog because I wanted a place for family and friends to come to receive updates so I wouldn’t have to spend hours on the phone giving updates after doctor appointments!

And, as always, God’s plan for this blog has turned out to be way better and way bigger than anything I could have planned one year ago today.

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After injecting ALL OF THIS into my stomach twice daily for the past week, there have GOT to be follicles growing in there somewhere.

Don’t forget to pray the game of hide-n-seek ends tomorrow as I go in for another ultrasound.

*****

To anyone reading this and facing self-inflicted IVF injections in the near future, after a week of them, I can still say it really isn’t bad at all!

The injection sites do become tender after a couple of days and your stomach will begin to look like a pin cushion but other than that, it’s really no big deal.

Amazing, even if I do say so myself!

*****

I haven’t really allowed myself to do much thinking in the department of “If this works …”

But, if this works in one month from now I will actually be pregnant.

If this works, I will celebrate my 28th birthday 3-months-pregnant.

If this works, this Christmas will be spent with a newborn in the house.

It’s nice to think this way, but I can’t leave my mind there. For now, I must focus on one day at a time and I’m not quite there yet.

But it is, however, nice to allow myself to think about that if only for the few minutes it has taken me to write these sentences.

It’s like a spring flower shooting up after a long cold winter.

My time will come. All this is but for a season. This I do believe with all my heart … I will be a mother, one day.

*****

What would I do without my IVF Verses Scrapbook?

Flounder around aimlessly and drown in a sea of worry, I suppose.

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Action in Left Field

I’ve started to “feel things", especially in my left ovary.

Now right ovary needs to kick into gear!

Thanks for praying.

I am at peace with whatever the outcome of Sunday’s ultrasound is.

Just keep up the prayers and pray there will be enough follicles playing the game to continue past Sunday.

Again, I cannot say it enough …

Thank you so much for your prayers and support.

Freak Out Session

Today’s been rough even though I know a lot worst things could have happened.

Estrogen level = 40

In the words of my nurse, “That’s on the low side, but it’s okay because it means you definitely don’t have a dominate follicle in there.”

At that point I am thinking, Well I’d just like to know that there is a follicle in there and having, you know, maybe TEN would be fine and dandy considering I AM DOING IVF!

Of course I didn’t say that, though! 🙂

So here’s the deal: Dr. L increased my menopur dosage to 375ui every night. Follistim is still the same dosage (100ui every morning). I will go in on Sunday at 9am for another ultrasound.

PLEASE PRAY MANY FOLLICLES ARE FOUND AND GROWING ON SUNDAY!

So tonight was Freak Out Session One for IVF. I basically second guessed my protocol because of things I’ve researched and from what someone else told me. The Freak Out Session eventually brought me to this conclusion:

I need to stop thinking, stop researching and just trust that Dr. L knows what he’s doing. I know he knows what he’s doing. That’s why I chose him as my RE! After all, he is a doctor that went through the schooling to learn what he knows and is even now involved in many research projects. This doc knows his stuff. I have to trust that 100ui of Follistim and 5 vials of Menopur are just what my ovaries need to produce some follicles.

End of discussion. End of Freak Out Session.

The comments received today were the icing on the cake and just what I needed to hear tonight to help get my mind refocused. So, THANK YOU to everyone who commented in one way or another. Thank you to everyone who prayed. God is still at work. God is ALWAYS at work – even when it seems your follicles will never grow!

I finished my “IVF Verses Scrapbook” today. Just in time to look over it and read God’s Word and allow it to soak in and put my mind at ease! If only I could resort to doing this before resorting to a Freak Out Session! I don’t know if that will ever be possible this side of heaven.

Keep the prayers coming. IVF is definitely an uphill battle all the way but I WILL persevere.

Come out come out wherever you are!

The news we received today was not the news we were expecting, but it wasn’t bad news either.

If you remember, I have stubborn ovaries that like to play hide-n-seek with the ultrasound probe.

Today we couldn’t really see any follicles. (Dr. L did find and measure one follicle that was 8mm.)

As I was beginning to panic, Dr. L calmed me down by saying that it is still early in the stimulation process (today is day 5) and I shouldn’t be upset. Dr. L said he would be worried if he saw a huge follicle measuring 20mm because that would signal that there is a dominant follicle and the ovaries are not responding in the way they need to for an IVF cycle. He said we need more time to allow what’s there to grow and once the follicles grow, it will be easier to pick them up on the ultrasound.

Dr. L also said that follicles grow at different rates. Some women are ready for retrieval after only 8 days of stims, whereas others need 12 or so days. That makes sense to me because if you remember, when I did the IUIs my trigger date was always later than the predicted date on my calendar.

So, like I said, not what I wanted to hear today, but not bad news either.

Dr. L also wanted my blood drawn to measure my estrogen levels. My estrogen level will give a good indication on what is going on in there as well.

Getting the blood drawn was a fiasco today.

I sat down in the chair I’ve sat in countless times before to have blood drawn. My veins looked really good in my right arm so the nurse pricked and then I heard, “On no!” I always look away when they are drawing blood but I couldn’t help but look when I heard, “On no!”. I looked for only a second because there was a stream of blood running down my arm with a small puddle on the table. EKKKK! I had to turn away and quickly focus on something else or I knew I would get queasy thinking about blood pulsating out of my arm.

The plan worked and I held it all together while she tried again (same arm). This time, blood wouldn’t flow at all. Lovely! So she moved to the left arm. And finally, with no drama involved, she got what she needed.

So now I am waiting to get a call from my IVF nurse, L. She will call me later today with my estrogen level and doctor’s orders for what dosage of Follistim and Menopur I need to be on now.

I equate the events of this first IVF ultrasound to God lining things up just right so I will have to just trust that He is in control of what is going on in those ovaries. I have to just trust that God has placed Dr. L as my IVF doctor and Dr. L knows what he’s doing. Dr. L says not to worry, so I need to pray and not worry and trust things are going okay.

Mama went with me to this ultrasound and I was so glad she was there. We sat in my car after leaving the office and there I knew I had to just keep my focus straight on God. Mama reminded me that the devil will use the events of that appointment to plant seeds of worry and anxiety, but I do not have to give in to them if I keep my eyes on the Lord and the knowledge that He is in control here. Mama prayed with her hand over my ovaries that the follicles will GROW and then we left.

 

PRAYER REQUESTS

Pray that LOTS of follicles WILL GROW and show themselves at the next ultrasound!

Pray that God will grant Dr. L the wisdom he need to be able to know the exact dosage of meds that will be best for me.

The Nightly Ritual

ERIN UPDATE!

Everything is fine!

Erin’s beta came back today at 231, which is a 60% increase in 48 hours. Praise the Lord! She’s scheduled for her first ultrasound on March 12th!

Thank you for praying.

*****

The Nightly Ritual

 

Mix the four vials of Menopur together…

mail

 

Prepare needle and syringe…

mail

 

And poke!

mail

There’s really nothing more to it than that!

Quite simple.

*****

So tomorrow’s the first ultrasound.

I will have an ultrasound to see what my ovaries are producing.

Let’s pray for many follicles with the potential to grow and develop!

I’m a little nervous, but just trying to stay focused.

*****

It is time to update my Blog Roll!

If you are not on my Blog Roll and would like to be, please let me know and I will add you!

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Keep the prayers coming, Prayer Warriors!

Thank you!