We tried for 13 months to get pregnant, but early on realized that it would not happen naturally because I do not get my period regularly. It turns out that I was diagnosed with PCOS, a condition that affects approximately 10% of women. In my case, it means that I don't ovulate regularly (not even once in 6 months); rather than having my ovary release an egg each month, it fails to release and becomes a little cyst in my ovary.
So, for about 5-6 months we tried the least invasive type of "assisted reproduction" which was taking a pill called Clomid to induce ovulation. We also had tried one Clomid/IUI cycle (Intra-Uterine Insemination) but that also did not work.
By January 2007, we were feeling impatient, and also knew that because AC was changing jobs, our medical insurance would no longer cover fertility treatments. So, we decided to pull out the big guns and try IVF (In Vitro Insemination). We worked with SRM or Seattle Reproductive Medicine, the clinic that has the best success rates in Seattle.
IVF basically consists of 4 major phases. Here are the highlights and lowlights of each phase:
1. Suppression (February 2007): I gave myself daily injections of Lupron in my tummy to coordinate timing of all of the follicles (eggs to be) in my ovary, to prevent ovulation, and to coordinate all of the hormones.
2. Stimulation (first half of March): In addition to the daily Lupron shots, I also gave myself daily shots of Follistim(also in the belly), which stimulates egg production. During this time, I needed to go into the clinic almost every day for a daily blood draw and ultrasound to monitor my hormone levels and egg development. This phase was the worst for us, mainly because I experienced OHSS (Ovarian HyperStimulation Syndrome). Typically during stimulation, about 5-15 follicles grow in the ovaries (each follicle should contain one egg). In my case, I produced 95+ follicles (after a while they just stopped counting). This was accompanied by a very high surge of estrogen (they wanted it to be about 400, and mine was over 8000). This was super stressful because the doctors were saying that they may either have to cancel the cycle and/or I'd be hospitalized. I was put on bedrest immediately, which was good because the whole thing was very painful. I also gained 8 lbs in 3 days from bloating and distended ovaries. I could feel my ovaries from stomach to back, and they were touching in the middle of my body, and I looked at least 4 months pregnant. It was miserable!
The stimulation phase ended with AC giving me a "trigger" shot of HCG which promotes egg maturation. 36 hours later I went in to SRM for an egg retrieval procedure (March 12). While I was under anaesthesia, the doctors inserted a large needle into each ovary and removed all of the follicles. Very painful and scary. On the funny side, though-- under anaesthesia, I kept asking the doctors about Greys Anatomy --how embarassing!
3. Embryo Transfer: After egg retrieval, we found out that we had 17 good eggs (so many bad follicles!). Each of these eggs was fertilized with AC's sperm (also collected on the day of the retrieval). Out of those 17, 8 fertilized normally and reached embryo stage. Some IVF patients wait for 5 days for the embryos to reach "blastocyst" stage; the thinking is that a more fully developed embryo has a better chance of surviving. But in our case, the doctors suggested a day 3 transfer because the risk that the embryos would not develop healthily was too great (the low yield and difficulty they encountered at egg retrieval made them concerned about egg quality). So, on March 15 we did the embryo transfer. We went into the clinic, they showed us our 2 best embryos (both developed to 8 cells and rated highest quality), and we watched on the ultrasound as they were placed into my uterus. We froze the remaining 6 embryos, and they last up to 9 years (should we need them for siblings...). After the transfer I also was on self-imposed bed rest, trying to give the embryos the best chance to implant and also still recovering from the OHSS.
4. Waiting: After the embryo transfer we had to wait about 2 weeks before doing a pregnancy test. The day after the egg retrieval, we began shots of Progesterone in Oil, an intramuscular shot in the butt administered by AC every morning. This is to keep the lining of the uterus thick and healthy for the embryos. These shots continued until 10 weeks into the pregnancy (May 7). This was also a hard time because I developed a strange reaction (bad rash on my face and body)to the PIO shots which the doctors could not figure out. I tried 3 different forms of progesterone (in sesame oil, vaginal suppositories, and finally settled on in olive oil). The rash did not end up going away until about week 11 of the pregnancy.
But all of the shots, stress, and pain was worth it because on March 27 I went in for a blood test, and that afternoon they called back to say that the HCG levels indicated that I was pregnant! I had to return 2 days later to make sure that the HCG levels were doubling at the desired rates. Finally, at week 7 (Apr 16) we went in for an ultrasound, and were delighted to see a tiny little embryo with a beating heart! At that appointment, we learned that we were having one baby (not twins), and that the due date would be December 3 (one day after AC's birthday!).
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