The End is Near!

Monday, I finished my last day of injectables.  Yay!  I was quite happy to finish my injectables as I was starting to have heaps of side effects - excessive vaginal discharge (so much that I had to wear a panty liner because I soaked through 2 pairs of scrubs!), really tender skin where it was beginning to hurt to give subq injections, bruising on my stomach after injections, extremely tender and sore breasts, constipation and an irritable mood.  At first the injectables just made me happy with no symptoms.  In the end, they were really starting to wear on me.

Monday at 2230, I took my hCG trigger shot (35 hours prior to retrieval).

Tuesday, I began my antibiotics.

Wednesday was egg retrieval day.  My sister took me to my appointment at 0830 for a retrieval by 0930.  My blood pressure was sky high for me (140/85) at admission because I was so nervous about being put under anesthesia and waking up in pain.  Luckily, I had my sister there to make me laugh and comfort me.  My anesthesiologist was phenomenal as well.  He put me at ease right away with his good nature and humor, and he really listened to me regarding my anesthesia fears.  I was under anesthesia previously for a tonsillectomy and had the worst time coming out of anesthesia - difficulty waking up and staying awake for over 24 hours.  I have the same issue when I take any prescription narcotics or other meds that say "may cause drowsiness".  In me, they ALWAYS cause drowsiness and it is typically a drowsiness I cannot easily shake.  I will often sleep for 12-18 hours straight after taking those types of medications.  So, it was wonderful to actually have him take me seriously and listen to my concerns instead of blowing me off.  He then gave me only 1/2 of the versed and fentanyl right before the procedure instead of the whole dose.

Before the procedure started, I asked my RE to look and make sure my eggs were still there prior to going under anesthesia.  I did not want to go under if I had already ovulated!  Thankfully, the IVF round was not a loss and I had not ovulated.

I was given versed in the pre-op room in order to calm my fears, and then I was given fentanyl when we were back in the procedure room.  After that, I do not remember a thing.  I was given propofol (yes, the Michael Jackson drug) and I went off to sedation land.

I woke up in my pre-op room, now a recovery room dimly lit with my RN sitting at my bedside charting my vitals.  She asked the usual questions - how did I feel?  was I in any pain?  did I feel nauseous?  I felt fine, actually.  Just a bit foggy in the brain, but otherwise, no pain and I woke directly after the procedure with no hangover.  That was the best thing!  I drank some apple juice and ate some pretzels and then they brought back in my sister.  The RN monitored my vitals for some time until all was good (BP now 114/72), gave me my post-op instructions and gave me my first progesterone injection - 0.25 ml with instructions to give myself another 0.25 ml that evening.

My RE popped in with the news that there were 7 eggs.  I was disappointed in hearing that as we had hoped that there would be at least 10-12.  It was disheartening, but I tried to think positively and hope for the best.

Going home, I was to continue with my antibiotics for 5 days and give myself 1 mL of progesterone every evening. They said they would then call me the following day with news of my eggs.

My sister then took me to Whole Foods for lunch, which was lovely.  I had a nice pretzel sandwich with field roast and a white bean and kale soup.  Yum!  It was nice to spend time with my sister and have someone with me who really cares about me with my husband being gone. She took really good care of me too!  My sister then drove me home, and I spent the rest of the day sleeping and resting - hoping that I would receive good news the following day.

Re-entry Syndrome - like a car crash

I have been back almost a month now from Ghana, but it has taken this long for things to settle down and for life to get back to a semi-normal state.

Re-acclimating to home after being abroad has been quite tough.  Especially after being abroad in a developing nation and being exposed to things I could not help with or change.  Ghana was a life changing experience that was amazing and wonderful, but at the same time heart wrenchingly sad and depressing.  Returning and re-entering into my own country in just 14 short hours door-to-door was a complete culture shock - bright lights, consumerism galore, excessive waste, loud noises, an array of different smells... even the cleanliness was overwhelming.  Trying to acclimate back into my "normal" life was hard.  I felt sad for all those in Ghana whom I left behind that had so little.  I felt guilty for how much we have in our country and how over-indulgent we are without apology.  I felt isolated because no one I know here can actually understand what I have been through and then there are others who are purely not interested.  I met up with one friend who said she wanted to hear all about my trip, but then talked about her life the entire time.  It felt surreal - like all this was not really happening to me; as if Ghana never happened.  It was a sudden jolt, like a car crash, back into my life that I have known for a year, but yet, it was all different.  I am now different.   

This is what is called re-entry syndrome.  It is a real, psychological response that many people - aid workers, soldiers, prisoners - experience when returning to their former life.  It is quite an adjustment.

To top it all off, I came home to find out that my husband was not leaving in the middle of October like we thought, but rather 3 short days later.  That was a hard pill to swallow.  I ended up crying for 3 days straight.

The day my husband left was my first official day of IVF.  I dropped my husband off at the airport in the morning and then went for my IVF counselling alone.  My RE and her nurse were beyond supportive, giving me big hugs and trying to make me laugh.  It was so sweet that they were there for me when I was at my lowest, feeling so alone and bereft.  

My RE took a look at my ovaries via ultrasound (US) and found that my right one had a dominant follicle.  Even though I was taking OCPs, my body was still trying to ovulate.  This was going to postpone the beginning of my injectables and my egg retrieval.  My RE gave me another prescription to take - Aygestin, a progesin - daily with my OCPs to further suppress my follicular development for another week and 3 days.  I have had 2 more US since then and my follicle has slowly decreased in size with my estrogen levels lowering as well.

Today, I had another US and my follicle, which was 20 mm, is now 16 mm and collapsing in on itself.  My estrogen levels are down as well, and that means we are good to go to start the injectables!!!

I start my Lupron, 10 units subq, tonight and then 10 units in a.m. and p.m. until Saturday.  Then Saturday is D-day where I begin my Gonal-F and Menopur.  All fingers and toes crossed for a successful egg retrieval around 8-10 of November and embryo transfer 3-5 days later!

Wow.  This month has been a whirlwind.  I have struggled with transitioning back to my life from Ghana, then 3 short days later I had to re-transition to living life without my husband, my best friend, and finally now - almost a month later - I am getting back on my feet, I am feeling like things are flowing again, and I am having hope for the first time that I may just get lucky and have a baby in 2012.

Latest Update

We have decided not to do a 4th round of IUI.  I would have had the scan this past Monday with intrauterine insemination on Wednesday, but we have weighed the pros and cons and decided against it.  Our RE said that she has seen many successful pregnancies happen with the 4th round, but there were just too many cons to consider.  My thought process was that I did not want to be pregnant in Ghana in case I -

• have severe nausea
• have an ectopic
• have a SAB (spontaneous abortion/miscarriage)
• need a D&C

I also was concerned because I will have to take anti-malarial tablets and of the 3 kinds that are recommended for Ghana - Malarone, Mefloquine or Doxycycline - none are safe during the 1st trimester.  I definitely do not want to contract malaria whilst I am there, but I also do not want to cause undue harm to my unborn child.  Which, I guess in theory, could happen with not taking anti-malarials and contracting malaria AND with taking anti-malarials.  According to the WHO, pregnant women are more vulnerable to malaria as pregnancy reduces the immunity to malaria (an immunity of which I have none of) and increases ones attractiveness to mosquitos due to hormones and pheromones.  Contracting malaria in pregnancy increases risk of illness, severe anaemia and death.  Maternal malaria also increases the risk of a SAB, stillbirth, premature delivery and low birth weight, which is the leading cause of infant mortality in Ghana.

All these thoughts culminated in us skipping our last round of IUI.  

We met with our RE this past week, and told her our decision.  We discussed doing a 4th round when I return from Ghana, but we are already booked for an IVF start date of 27 October, so there was not a way to squeeze in both the IUI and IVF start in October, especially with having to take anti-malarials for 2 weeks post-return.

So, we now are set for the following schedule, some of which has been completed:

1. Husband do pre-IVF infectious disease blood work 
2. Re-apply for Springstone IVF financing at end of August
3. Leave for Ghana beginning of September
4. Husband donate sperm for freezing on 2-3 separate occasions during September
5. Return from Ghana early October
6. IVF counseling 3 October
7. Husband leave for 6 months
8. Begin IVF cycle 27 October

I know there are many more steps between 3 October and 27 October, but I do not know what they are yet.  We will find out on the 3rd!  I know I do need to let Attain know that we are beginning our treatment on the 27th.  They are providing us four rounds - 2 fresh and 2 frozen - for $16,000 USD.  I also need to work out our financing.  Our clinic wants the money up front, so we are going to go through an IVF financing company called Springstone.  We applied earlier with them and were approved for the IVF amount with monthly payments of $300 for 60 months, $335.97 for 48 months, $412.44 for 36 months or $573.50 for 24 months.  It IS quite expensive, like a monthly car payment (which thank goodness, we do not have), but we are going to have to use the financing route as we do not have $16,000 in cash to pay up front by October.  Unfortunately, our application was only good for only 60 days, so we will now have to re-apply.  I hope we are able to secure as good of a rate and financing for the whole amount when we reapply at the end of this month.  

It's nerve-wracking thinking about all that needs to be done and the possibility of not having a successful outcome whilst being out $16,000.  I am trying to be positive, of course, but the fear is still there.  I had a dear friend who just went through her 4th failed IVF attempt.  It is heart breaking.  I am truly hoping and praying for success on the first go-round.  I'd like to get our money's worth, but really, I'd much prefer early success.