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.

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…

Prepare needle and syringe…

And poke!

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!

*****

Keep the prayers coming, Prayer Warriors!

Thank you!

My husband, Dave asked if he could write a post concerning the ethics of infertility treatments. I thought it would be a great idea to hear it from a male’s perspective. I think he did an excellent job in explaining how God brought him to the decision to proceed to with IVF.

Also, please be sure to read the special prayer request below.

Written by Dave, my wonderfully understanding and supportive husband:

How I discovered infertility
The first time I ever heard infertility mentioned was when I was in high school. A couple at my church had been trying to conceive and had been unsuccessful. They were told that the only way they would be able to conceive would be by going through In Vitro Fertilization (IVF). Despite the wife’s father offering to pay for the procedure, the couple decided they would rather put their faith in God alone. Amazingly, God was faithful to them! The last time I saw them they had 2 children with a 3rd on the way. Although I didn’t really know much about infertility, seeing that miracle happen before my eyes really shaped my early thinking on the subject.

Of course, the first thoughts I had as Elaine and I struggled to conceive were that we needed to just put our faith in God and trust Him to give us a child, and that was definitely a good place to start. I wasn’t completely closed to the idea of some kind of treatment if we needed it, but my main concern was keeping our focus as a couple on God. Fortunately, I can say that our stance on that has never changed.

Diagnoses and treatments
As Elaine and I went to the doctor and found out more about ourselves from a fertility standpoint, we began to realize that our problems conceiving stemmed from more than just some hormone imbalance. When Elaine was diagnosed with polycystic ovaries, I was told my sperm were a little below average, and the RE recommended intra-uterine insemination (IUI). This was really the first time I had to decide for myself whether I thought the treatments were right for us or not.

I ended up being fine with IUI more quickly than I would have thought. The first positive I thought of for IUI was that only God can form a child from a sperm and an egg. IUI essentially just helps put the two together. It’s not trying to play “God” in my mind to do that, especially in the sense that the procedure was more in the realm of corrective medicine. Like stitching up a cut helps to correct the alignment of skin tissue and ward off infection, IUI helps a higher percentage of sperm reach the egg.

After four failed cycles of IUI (1 of which was a cancelled cycle), the next step was to do some exploratory surgery and look specifically for endometriosis. I had no problem with this even from the start for the same reasons I had come to grips with IUI. When the doctor found and removed endometriosis I was glad, knowing we had made the right decision to do the surgery, but after learning more about the effects of endometriosis and learning that IVF would probably be our best option going forward, I had three main issues to work out.

I don’t want quintuplets!
The initial problem I had with IVF was all those TV shows you see where someone had 5 kids through the procedure. This concern was quickly dispelled when I found out that they would only put 2 eggs in Elaine at a time. Those irresponsible doctors that put a lot of eggs in at once give the other REs out there a bad name. If the IVF cycle is done right (i.e.. the appropriate number of eggs transferred depending on the age of the patient), scenarios like the woman who recently had 8 children from a single cycle just don’t happen, and since our doctor is so conservative, we are confident that he will protect us from that type of thing.

What about the extra eggs?
The next problem I came across when thinking about going into IVF was what would happen to the extra eggs if we ended up having any. Knowing that Elaine might produce upwards of 20 eggs for one retrieval, and that they would only put in 2 at a time, I was starting to do the math and get a little scared.

Then I remembered that not all of the eggs the doctors retrieve will successfully become fertilized. Those eggs don’t bother me because if they won’t fertilize surrounded by my sperm in a lab, I doubt they would do any better trying to swim through Elaine’s tubes. Besides, every month that Elaine isn’t pregnant another egg dies. It’s not a baby yet.

Also, as I learned about the process of IVF, I learned that just as many “naturally” fertilized eggs don’t implant or miscarry, many lab-fertilized ones die in the process as well. And because Elaine has had endometriosis, its adverse affect on egg quality will make having extra eggs after one cycle a miracle in and of itself (although, we would welcome that because we’d like to have 3 or 4 children).

It’s just not natural!
The biggest conflict I had with IVF was the fact that it just seems to go against nature. I felt that man is not supposed to go messing around trying to create life in such an unnatural way. I could rationalize IUI since everything was still happening inside of Elaine’s body, but to take everything out and put it in some science lab seemed crazy to me.

However, once the initial shock of that wore off, I began to realize a few things. We do things every day that are not natural. From simple things like shoes to more complicated things like building automobiles, open heart surgery, and even the keyboard I am using to type, we people do things that go against nature every day. Nobody says to the auto mechanic, “How dare you mess with God’s Creation and put those parts together that way to make people go really fast! That’s just playing God!” Likewise, nobody criticizes the doctor who performs a bypass on a man’s heart.

So how could I wake up to an alarm clock every morning, drive to work in my car, sit at a computer for 8 hours creating programs for others to use and be against taking advantage of the problems solved by reproductive medicine? I concluded that while God’s Creation is exactly as he intended it, we are part of it. He gave us brains to be able to solve problems that arise from every day life. Problems like travel, heart-attacks, and information dispersal have all been helped along by man-made inventions, and those advancements are still glory to God because he gave us those wonderful brains!

So, I decided that the area of fertility is no different. If one person can have surgery to correct a faulty valve in his heart, another can undergo a medical procedure to correct or help along a faulty reproductive system.

We’re ok with IVF.
This is for the people who were like me before going through this with Elaine. The decision to go through with IVF was definitely not one that we went about flippantly. I know if I were on the outside looking in I would have some misgivings about the morality of the whole “test-tube baby” thing. Honestly, it all comes down to having walked in the shoes we have walked in for the past year and a half. While a year and a half ago I thought much differently about IVF, I’ve learned that when it comes to complex decisions such as our decision to go through with IVF, it’s best to withhold judgment about what is right and wrong until I’ve walked a mile or two down the path.

*****

Now it’s me again…

I want to request prayer for a blogger friend of mine.

Erin went through her first IVF cycle last month and on February 25th she found out she is pregnant!

Her first beta was 86 and her second beta (yesterday) was 137. Those of you who have gone through this before know everyone looks for doubling numbers and these numbers did not double over a 3 day period.

PLEASE PRAY for Erin and her baby(ies). Please pray for God’s peace upon her heart at this time. Pray that her numbers continue to rise and she does not loose the pregnancy.

For those of you that don’t know what “betas” are all about…

When it would be time to take a home pregnancy test, women who have undergone an infertility treatment go have blood work done to measure the pregnancy hormone hCG in their blood. Typically, if a woman is pregnant and the pregnancy is viable, the beta level doubles every 48 hours or so.

Just pray for Erin, please.

So I made it through day one of ovary stimulation. And can I just proclaim a miracle here??

It was almost a year exactly that we had our very first appointment with our RE. If you would have told me that in a year I would be at the point where needles don’t bother me AND they don’t bother me to the degree that I am capable of taking a syringe with a needle and sticking in in my own stomach, I would have told you there are definitely screws loose in your head.

In March of 2008, I was the girl who wouldn’t go to the normal doctor because I was afraid he would demand that I had to have my blood drawn. I couldn’t imagine voluntarily sitting down and allowing some nurse to poke and prod my vein. Then, the thought of blood coming out literally make me weak in the knees. I couldn’t stand the thought.

But now, can I even count the number of times I’ve had my blood drawn? Um. No. There are too many occasions to count.

Then it came time for injectible IUI cycles and I soon learned it was expected that I was to inject myself! No, thanks! I had about three different nurses that I knew lined up to give me my injections. And my first injection went something like this:

I sat with shirt pulled up and face turned away. I could not bear to look at the shot. And then, whoever happened to be around at the time, had to scratch my arm as a distraction mechanism. Then, I braced myself for the shot, grit my teeth and breathed a sigh of relief when it was done.

And then came IVF.

I have given myself the first two shots, no problem. Miracle.

This also makes me realize something more.

Infertility has a way of stretching us in ways we never thought possible. Infertility has forced me to do things that I never dreamed of being able to do. Infertility has taught me God’s grace and strength are there. All we have to do is go to the Source and draw it up. The account never runs dry.

This shot business also shows something else. Putting mind over matter really does make all the difference in the world.

Our minds really are a powerful thing. Yesterday morning at 7am when it was time to administer the first shot, if I had allowed myself to panic, or allowed myself to dwell on the fact that I was about to give myself a shot, I would have freaked out and not been able to do it.

Instead, I told myself, “I can do all things through Christ who gives me strength.”

I say all that to encourage anyone out there reading this and facing IVF injections soon. If I can say giving yourself shots isn’t bad, it isn’t bad!!

And like my nurse told me, they try to make it as easy as possible for patients. The needles are very, very tiny and honestly, I have never even felt the prick. It just slides right in because it is such a “baby” needle.

So day two of injections are in order for today. And then again on Tuesday and Wednesday. Thursday I go in for an ultrasound to see what my ovaries are producing.

*****

Prayer Requests

1. The number one request is always going to be to pray against the attacks of Satan. He will try to attack me by planting seeds of fear. However, if my prayer warriors are praying, I will have a protective shield against these attacks.

2. Pray for lots of healthy follicles to start developing. This is our prayer focus from now until Thursday’s ultrasound.

Friday was not a good day. Satan attacked from all angles and planted seeds of fear in my heart at a rapid rate.

I knew the choice was mine of whether I was going to sit down and allow him to continue this destruction rampage or if I was going to stand firm in Christ and stand up and fight.

I chose to stand up and fight in the name of Jesus Christ and rebuke Satan’s attempts to have any sort of control over my life whatsoever.

I know what my two most powerful weapons of defense are:

1. The Word of God
2. Prayer Warriors

The Word of God is my first line of defense. The Word of God proclaims and declares that my strength comes from God. God’s Word promises peace and joy in the midst of a trial. God’s Word declares God has a perfect plan and purpose for every circumstance of my life – including infertility.

This is where my focus must stay as I run this race set before me. I cannot place my focus on injections, doctor visits, ultrasounds, ovarian stimulation, egg retrievals, embryos, transfers and pregnancy tests. If I put my focus on those things I will surely fall to the ground in defeat before the race is even over. I’ll have to be pulled off the track before I am trampled over.

If I keep my focus on what the Word of God says in the Bible I will be empowered with God’s strength and power to be able to persevere through every injection, doctors visit and ultrasound. I will persevere and run through ovarian stimulation, egg retrieval and transfer.

I will run with confidence knowing I can do all things through Christ who gives me strength!

I love to scrapbook. So I am making a scrapbook of “IVF Verses” that will be easy to access in times of need!

My second weapon against Satan and fear is YOU – my prayer warriors. Knowing people are praying will bring comfort to me knowing that I am not running alone. I will run knowing I am surrounded by my prayer warriors interceding on my behalf to God, lifting me up daily to the Lord in prayer.

Just knowing you are praying gives me the will-power to press on, to persevere – even when it gets so tough.

I hope you understand that even though I am the one going through IVF, YOU play a very critical role in this process!

There is tremendous power in prayer. I have experienced it before during the time we did IUIs.

My last IUI was especially difficult as I knew that if it didn’t work, we would possibly be taking steps towards surgery and IVF. Not where I wanted to go! For what was at stake, I was dreading a negative blood test that time more than I ever had for the previous two IUIs cycle.

Sure enough, blood test came back … negative. There was deep sorrow and deep pain in that time, but there was also an unmistakable peace.

Later I learned my 80-year-old Grandmother had prayed continuously no matter what the outcome of the cycle, I would feel God’s peace surrounding me.

That was also the cycle where I had a “Day of Prayer for Baby”. Numerous people signed up to pray for us throughout that day.

Don’t think for one minute that your prayers don’t matter. They do.

Now is the time. God has brought us to the place. We have made the decision to do IVF. Tomorrow, we begin.

It will not be easy. There will be bumps along the way. However, if I keep my focus on the Word of God and you pray me through everything, I know it will make all the difference in the world. Satan will have absolutely no reign in my life as I will be filled with God’s perfect strength.

It’s time to walk to the starting line. The gun will sound, signaling the start of this race, bright and early tomorrow morning as I (attempt) to give myself that first injection at 7am.

Ist IVF prayer request: Pray I will be able to give myself the shot at 7am and then again at 7pm!

UPDATE: Just gave myself the 7am injection and it was no big deal! Easy as pie. Please do pray for me at 7pm as I am a little more nervous about that injection because it is with an actual needle and syringe. This shot was with the “epi-pen” and less intimidating.

*****

Here is the traditional IVF meds picture:

To look at it all is overwhelming.

I must remember, even though it is a lot of meds, I am not taking it all in one day!

One day at a time!

*****

My parents came over today and Mama helped me get everything organized so I will know what meds to take on what day. We are both big organizers so we had fun and I feel a lot less overwhelmed having everything organized and ready to go.

The system we used to organized was really quite simple! Every day’s meds (and necessary supplies) were placed in a zip lock baggie with the date and med dosage written on the bag. Now all I have to do it take one bag at a time!

  Here’s a picture of Sunday, Monday, Tuesday & Wednesday’s bag. After the ultrasound on Thursday, I’ll put together more bags with the meds I’ll need after Wednesday.

Here is a picture of “The Pharmacy”, which also happens to be in the future nursery:

Little did I know what I was in for during the consult appointment with the IVF nurse who we will call “L”.

The appointment started with her going over every step of the IVF process and then showing me my IVF schedule which told me when and where I would need to take every medication.

It was at this moment I panicked because I could see on my schedule that a shot in the morning and one at night was necessary. The plan was for my mom to give me all my IVF shots and with her living 20 minutes away, this arrangement, I could see, just wasn’t going to be practical. Especially on days I worked.

Little did I know what L had up her sleeve (or should I say shirt?)!

I expressed my concern about all the necessary injections. L responded by saying, “Oh, don’t worry about that.”, to which I responded, “Um. I have a confession to make. I know I have been through three injectible IUI cycles, but I have never given myself one shot.”

L told me, “I’ll walk you through it. 99% of my patients, no, wait, 100% of my patients can give themselves shots if they can just get over that initial hump. They all say it really is no big deal.”

I nodded my head thinking, Well you are about to see an exception to that rule today!

L left and went to get her Shot Kit leaving me to sit and contemplate how this was all going to work out.

L returns, opens her Shot Kit and proceeds to demonstrate how to mix the meds and draw it up into the syringe. After the shot is “ready” she gets up and walks over to my side of the table.

I immediately blurt out, “Are you going to give me a shot??”

To my shock, L smiles, plops down in the chair beside me and hands me the shot saying, “No! You’re going to give me a shot!”

I literally laughed out loud and warned her, “Let me make this clear. I have never given anyone a shot. I am going to hurt you.”

“No you won’t. Just pinch some skin and poke.”

So there I was. Holding a shot in my right hand and pinching some of L’s stomach skin with my left hand, still warning her, “I’ve never done this before. It is going to hurt.”

“Just do it.”

“How???????? Do I jam it in?”

“You don’t have to jam it in. Just push it in.”

And I did. I was so surprised at how easy it really was. I guess I had this preconceived notion that you had to jam the needle in and that just wasn’t my cup of tea.

After breathing a sigh of relief, L gets back up and walks back to her side of the table. She pulls out the Follistim Pen and shows me how to assemble it. It looked like a diabetic pen that people use to give themselves shots of insulin, only the needle was longer than any diabetic pen I’ve ever seen.

L stands up again and while walking back to my side of the table announces, “Now it’s your turn to try on yourself!”

With my heart beating out of my chest and sweaty palms I said, "I really don’t think I can do this today.” Come on, poking her was enough for one day right??? Nope!

I knew I had to try. There was no escaping.

L handed me the Follistim Pen, with the needle part still covered.

I pulled the cap off the needle and gasped. “Um. This is crazy. I can’t do this.”

Philippians 4:13 popped into my head. I blurted it out loud … twice!

“I CAN DO ALL THINGS THROUGH CHRIST WHO GIVES ME STRENGTH. I CAN DO ALL THINGS THROUGH CHRIST WHO GIVES ME STRENGTH.”

L said, “Yes you can.”

And there I was. Follistim Pen in my right hand, with a needle that looked to me like it was as long as the Follistim Pen itself, and my left hand pinching skin on my stomach.

One more Philippians 4:13 quoting and BAMB …

I pushed a needle into my own stomach skin.

And now I must also confess … It was easy as pie.

So I wasn’t the exception after all!

I think I can now administer all necessary injections (except hCG) for this IVF cycle myself.

I guess the real test of whether I passed Needle Phobia School will be on Sunday when it is time to administer the first injections.

Can we say the world needs more nurses like Nurse L in it? Talk about a compassionate nurse able to see the needs of her patients and even going to the extreme of allowing a completely novice shot-giver practice on her own flesh!

I asked L, “Do you let every patient stick you like that?”

She replied, “No.”

She saw I needed that and her guidance throughout this whole ordeal will not soon be forgotten.

Anybody want to step up to the plate and let me practice again on YOU before Sunday? (hehehe … just kidding!)

I will not lie and tell you that I am all chipper, excited and ready to get started with this IVF cycle.

Today I am overwhelmed with the finality of it all. This is it. Before doing IVF, there was always IVF as a last resort. Well, now we are here. At IVF. At our last ditch effort to actually see two lines on a pregnancy test.

I know I am overwhelmed today because my focus all day long has been on that very moment. Finding out at the end if I’m pregnant or not.

I cannot allow myself to think that way or the next four weeks of my life will be pure misery.

The important thing about running a marathon is not winning the entire race and coming in first. It’s instead all about how you run the race.

No matter how many times I tell myself this or write it in my blog, it is still extremely hard to keep my mind focused on that.

We are going on 18 months of this. I know some people go through infertility way longer than that. We are reaching the end of our possibilities. There is no IVF Cycle 2 (unless by some miracle of God we have frozen embryos at the end). This is it. The weight of that truth as been heavy on my heart yesterday and today.

This only proves to me that I cannot do this unless my eyes are fixated on Jesus and everything He has taught me in the past 18 months.

I wrote the following in my IVF journal last night:

I feel so weak right now. Honestly, I feel like I want to run to the side line and quit. I’m scared and nervous. I want everything to go perfectly and at the end of the month I want to finally see two pink lines and one word: PREGNANT. But I may run this race at full speed and not end up with that result.

It’s all about focus and keeping my eyes on the Lord. I can’t take my eyes off for a moment or I will stumble.

I can do all things through Christ who gives me strength. I can do whatever is coming my way in God’s strength. Whatever God is going to ask of me next I know He will equip me with the strength and power – HIS STRENGTH AND POWER – to do it.

God, I want a baby at the end of this marathon!! But not my will, Lord. Not my will. May Your will be done.

On this very night I surrender this cycle to you, God. When something “doesn’t go right” I can know I’m not the one in control. You are.

God, give me strength to run this race in a way that only serves to point people to You. I pray this IVF cycle will be used for your glory.

The time has come. It is time to do IVF. I’m at the starting line just about to take off.

*****

Here is my tentative schedule/Antagonist Protocol:

March 1 – 4: Ovarian Stimulation – 10 tabs of Letrozole (only on March 1) plus daily injections of Follistim and Menopur

March 5: Ultrasound at 8:30am to monitor and evaluate ovarian response to fertility drugs

March 6 – 9: After ultrasound evaluation I will be told how much more Follistim and Menopur I will need to take to continue the ovarian stimulation process of IVF.

During this time I will return to the doctor’s office for more ultrasounds and blood work to again monitor and evaluate ovarian response to fertility drugs.

March 9: Estimated date for hCG injection (to finish maturing eggs before retrieval)

March 11: Estimated Retrieval Day

The day after retrieval, I’ll be on Methylprednisolone (steroid) twice, daily for five days. I will also start Doxycycline (antibiotic) twice, daily for seven days. I will be on Prometrium (vaginally) three times a day.

March 14: 3-day transfer

(or)

March 16: 5-day transfer

Not sure when the Blood Pregnancy Test will be, but probably sometime towards the end of March.

Today I literally spent the day in the fertility clinic. I had a brief appointment with Dr. L (I had a few questions I wanted to ask him concerning my protocol), a consult appointment with the IVF nurse, a mock transfer and a baseline ultrasound.

Oh, yes … and one more thing. Unbeknownst to me, part of the consult appointment with the IVF nurse was going through Needle Phobia School. It was quite an experience and I will share about it tomorrow!

Everything is on go for a March IVF cycle!

I pray 10 months from today I wake up on Christmas morning and celebrate my very first Christmas ever with my husband and our newborn baby girl or boy!

More details to come tomorrow … it is late and I’m tired. Going to bed.

This post is meant to serve two purposes: 1) to help family and friends who have never been through in-vitro fertilization (IVF) to better understand the process and 2) to help me better process in my own mind what I am about to go through.

There are five main phases of the IVF process. The process is completed during the same amount of time it takes to complete a normal one-month menstrual cycle.

1. Ovarian Stimulation
2. Egg Retrieval
3. Fertilization
4. Embryo Culture
5. Embryo Transfer

Ovarian Stimulation

During ovarian stimulation the ovaries are stimulated using powerful fertility drugs with the goal of having as many eggs as possible mature. Having as many eggs as possible mature is necessary because some may not fertilize at all while others will fail to develop normally after they are fertilized.

The ovarian stimulation drugs I will be on are Letrozol, Menopur and Follistim. While Letrozol is taken orally, the other two drugs must be administered through daily injections. Yes, IVF patients essentially become a pin cushion when it is all said and done!

I will be on a Step Down Protocol. This means that I will start out on very high dosages of these drugs (because our goal here is many mature eggs) and will step down on the dosage once we see how my ovaries are reacting and how many eggs they appear to be producing.

During ovarian stimulation my ovaries will be closely monitored by frequent ultrasounds.

There is a condition called Ovarian Hyperstimulation Syndrome (OHSS) which can occur during ovarian stimulation. I am at a higher risk for developing this condition because I am young, lean and have polycystic ovaries. The ultrasounds will also allow my doctor to watch for OHSS developing during ovarian stimulation. And I fully intend to have all my prayer warriors praying against OHSS!

I’m sure the stimulation drugs have all kinds of lovely side effects. However, I’ll just have to take what comes, knowing the side effects will only be temporary. Again, we will be praying against negative side effects!

Egg Retrieval

As the eggs mature I will have one last injection: an hCG injection. I had this injection during all three IUI cycles to induce ovulation. The purpose of an hCG injection during IVF is to mature the eggs even further before they are retrieved (instead of ovulated).

The egg retrieval procedure is performed in the surgical unit a floor below the infertility clinic. The procedure takes approximately 15 – 20 minutes.

Eggs are retrieved by a transvaginal ultrasound-guided aspiration procedure. Basically, during the procedure an ultrasound probe is inserted into the vagina to identify mature follicles. Then, a fine needle is guided through the vaginal wall and into the follicle where the egg is aspirated (retrieved) through the needle.

Ouch?!?! Don’t worry. I will be fully sedated throughout the whole procedure although I have to admit, I would love to witness the whole thing.

There are many variables that influence the number of eggs that will be retrieved from any one woman.

Fertilization

Shortly after egg retrieval, eggs are placed with motile sperm in a petri-dish (hence the name, in-vitro fertilization). And then, well, it’s quite simple. The number of eggs that successfully fertilize is completely up to God, since He is the creator of life.

Prayer warriors, this will be a HUGE praying day!

Depending on the quality and quantity of the sperm sample a procedure called intracytoplasmic sperm injection (ICSI) may be performed. During ICSI, a single sperm is injected directly into the egg, however, fertilization is still not a guarantee because, once again, fertilization is God’s business. God is the creator of life!

The day after the egg retrieval I will receive a report on how many eggs fertilized successfully. Fertilization is documented by the presence of two nuclei. One nucleus is from the sperm and one is from the egg.

Embryo Culture: A Three to Five Day Process

Day 1: After fertilization, the nuclei from the egg and sperm fuse and the cellular division process of the newly created embryo begins.

Day 2: The embryos are carefully monitored for growth and proper cell division. The embryos are growing from a two-cell embryo to a four-cell embryo.

Day 3: The embryos are in the six to eight-cell stage now. Depending on the number of embryos, day three may be the transfer day (will explain what “transfer” is below.) If three or more eight-cell embryos are present, a 5-day transfer is very possible. Five-day transfers allows for better embryo selection since some of the embryos will not progress beyond the eight-cell stage. The decision on whether to do a 3-day or 5-day transfer is largely dependant on the number of embryos present and their quality.

Day 4: Eight-cell embryos that continue to grow and develop will now be at the morula stage (15-32 cell embryo).

Day 5: The embryos who make it to day five, form a cavity called the blastocoel (which is why the embryo can now be called a blastocyst). s of a blastocyst organize themselves into outer cells, which will form the placenta (labeled “T” in the picture below), and inner cells, which will form the baby (labeled ICM). The blastocoel cavity in the center is labeled “C”.

Blastocyst 

Everyone going through IVF prays for embryos that are strong enough to make it to a 5-day transfer. Prayer warriors, we will be praying the same!

(Click here to see one of my blogger friend’s blastocyst picture. She just recently went through IVF, had 2 perfect blastocysts transfered and is now 7 weeks pregnant with TWINS!)

In summary, there are three critical development points that must occur if a 5-day transfer is to take place:

1. Fertilization
2. Four to eight-cell embryo stage
3. Morula to Blastocyst Stage

Embryos are “graded” using a numeric grading system with a Grade 1 embryo being the best and a Grade 4 embryo being the worst. It is important to know that the grade an embryo receives is no indication whatsoever about whether it will become a healthy or unhealthy baby. The grade is meant to only give doctors and their patients a means by which to measure the viability of any one embryo. In other words, a Grade 1 embryo has a much higher chance of actually implanting into the uterus and becoming a viable pregnancy whereas a Grade 4 embryo’s chance of becoming a viable pregnancy is not impossible, but very unlikely.

Obviously, we will be praying for many Grade 1 embryos that can make it to a 5-day transfer!

Embryo Transfer

During the embryo transfer, the doctor inserts a catheter through the cervix into the uterus and transfers one or more embryos. The embryo(s) is/are strategically transferred to the particular place an embryo would naturally implant in the uterus. If the embryo continues to develop in the uterus, it will hatch from the egg’s outer layer and implant into the uterine lining approximately six to ten days after the egg retrieval.

Depending on a woman’s age and the viability (grade) of her embryos, the American Society for Reproductive Medicine recommends transferring one to three embryos.

Cryopreservation – What to do with any “left over” embryos

Any remaining embryos following the embryo transfer can be frozen for future use.

This is perhaps the most controversial aspect of the in-vitro fertilization process. I believe the only unethical aspect of the cryopreservation process is discarding left-over embryos because “we are done having children”. I also believe that the moment sperm and egg unite, new life is formed.

In my particular situation, it will be a miracle if we have any left-over embryos. Because of my endometriosis we really do not have a clear picture of what my egg quality really is. We know that having had endometriosis declines egg quality sooner. Quite frankly, we will be praying for enough eggs and enough quality embryos for just this one cycle. Any “extras” at the end will be considered an extra blessing from God.

If there are any “extras” and the first cycle of IVF fails, we will not have to go through any of the first four steps described in this post. A certain number of frozen embryos will be “unfrozen” and then transferred into my uterus at a fifth of the cost that this first, fresh IVF cycle.

Since childhood, it has always been my dream to one day be the mother to four children. Consequentially, being faced with the decision to discard left over embryos will never come into play with us. To have four children through IVF, an extremely large amount of good quality embryos would have to be present; which is why, for now, if this IVF cycle results in Dave and me having one biological child, I will consider that baby my miracle baby.

*****

There really is so much more I could have included in this post. But I chose to stick with the basics so as to not make this post any longer than it already is.

Today is Day One of a new cycle.

Which means today I start taking Birth Control Pills (to supress ovaries before they are superstimulated).

Today is the first time, in 18 months, I am not sad to see my period.

Let the games begin.

I am ready to run this race.

Prayer warriors, you ready????