Tag: Menopur

Dropping Genes and Making Babies

Ten years ago, MS high school graduates had to have 2 lab sciences under their belt in order to qualify for a 4 year university.  I think its more than that now.  I don’t know.  I’m done with that mess.  I ended up with 4 anyway, because I’m a nerd.  I took Biology I and II my freshman and sophmore year.  I broke my chemistry teacher’s heart and my mother’s heart (who is also a chemistry teacher…Sorry Mom and Mrs. Malone) when I took one year of that mess and had a strong “EW no thanks” response my junior year, and my senior year, I went back to my happy place of AP Biology.
One of the only things I remember from Biology II (sorry Coach) was a genetics unit we did where Coach had us “dropping our genes and making babies.”  Coach was so scandalous and punny.  We had different gene traits on paper slips, we’d drop our genes (ba dum ching), record the answers on our punnet square, and then end up with a randomized “baby”.

I feel like that’s what we’re doing this week.  I can’t drop my actual jeans, as I can’t get them past my hips these days, but we’re fixing to drop both of our genes off in a lab and in just over a week, we’ll be parents.  How crazy is that?  Science is so cool.  Medicine is wild.  And God is so, so big.
On Friday, after a green light from our doc, we started the twice daily hormone injections of Menopur and Follistim.  I’m taking 3 doses a day right now, but thankfully can mix two of those in one shot, so I only get stuck once in the morning and once at night.  I loath the shots, but Mister hands me a seasonal Little Debbie after every stick, and that makes me a little bit less of a grump.  I’ll start a 3rd medication later this week (an estrogen suppressant, joy!), and we’re on track to have our egg retrieval on February 3.
We’ll be going back and forth to Jackson every other day for ultrasounds, blood work, and monitoring.  Our first monitoring appointment was today.  Doc found 14 follicles on my right ovary, and 13 on my left.  One follicle houses one egg.  Math is hard sometimes (which is why me and chem didn’t jive), but that’s 27 follicles.  During IUI, I only ever had 2 follicles develop at one time, and I thought I was bloated then.  This probably explains why I feel like a blimp.  We are thrilled with that number, but also a little overwhelmed.  Of course that number will drop by the time we get to mature eggs, fertilized eggs, and embryos that continue to grow until Day 5, but we don’t know how much.  It could drop by 6-8, or it could drop by 15-20.  Either way, we’ve got a solid number to start with.

We’re really doing this and its blowing my mind.  The human body is blowing my mind.  What my body is doing is incredible, and I am super impressed with it.  I make sure to cheer on the belly button zip code every day, and apologize for the bruising.  I’m gaining 2 lbs a day.   I feel like an over inflated balloon.  I am eating ALL THE THINGS, and by 7:45 I’m yawning, by 8:00 I have crashed.  I couldn’t even hang with the girls Saturday night for an early dinner at our favorite spot.  Sorry, y’all.  But I know this (the stims) will be over in a week, and this whole cycle will have an answer by the end of February.

We are continually blessed by those who are praying for us, rallying with us, and constantly encouraging us.  After my “gangsta socks” post in early December, my mailbox was overwhelmed with ridiculous socks from some of my favorite people.  I think I have enough pairs to carry me through a full-term pregnancy, and each one reminds me specifically of the wonderful folks that sent them.

We are marveling at what God is doing now, and wait with great anticipation on what he has for us in February.

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IUI

This is a compilation of questions that have been asked of me by many friends and family.

Warning: Names of specific organs that only women have will be used. If that makes you uncomfortable, I don’t really understand why you want to know more about IUI.

What is the difference between IUI and IVF?
IVF = in-vitro fertilization
IUI = intrauterine insemination
IUI does not require the FE to put sperm and egg together to create or handle an embryo.
The sperm is collected, “washed”, and treated. The doctor is able to determine if the sample is of adequate quality.
A catheter is inserted through the cervix, into the uterus, and the sperm is injected. This allows the sperm to bypass the majority of their required journey, giving it a longer life and a higher chance of meeting the egg.

Do they knock you out? Does the procedure hurt?
No, and it’s not comfortable. You are fully conscious for this procedure. It’s very short, and not completely awful, but not something you’d choose to do in your free time. It’s a lot like a Pap smear, but more invasive, more uncomfortable, and it takes a little longer.

Are you on any medication?
A few. I have taken estrogen-binders in the past (Clomid, Framara) that were ineffective for me.
When I start a cycle, on the third day, I take subcutaneous (in the skin) injection in my lower abdomen of Menopur. It burns like a million fire ants all bottled together.
When I have follicles (release an egg) that reach the right size after several days of Menopur, I receive an intramuscular trigger shot of HCG (causes the follicle to release the egg) in “the hip”.
A day or so after the trigger shot, we go in for the IUI procedure.
After the IUI procedure, I immediately start progesterone, twice a day. This helps the uterine lining stay thick, and gives me a greater chance of “catching” and “keeping” a embryo, and sustain the pregnancy during the first trimester.

Is it covered by your insurance?
Yes and no. We are abundantly blessed with amazing insurance that covers almost everything. Our insurance has covered all of our visits, lab work, and ultrasounds. That may not sound like much, but when you are doing it multiple time a week, it adds up.
Our insurance does NOT cover our medication (shots, syringes, needles) or the actual procedures. That is a significant cost.

Are your chances of multiples increased with this treatment?
Yes. So far, all three treatments I have had have been with two follicles at the ready. Two follicles = two eggs. Two eggs = possibility of fraternal twins. We have a very responsible and conscious doctor, and he will not trigger or perform the IUI procedure if there are more than three follicles. The risk to the potential mother is too great, and he cannot guarantee a healthy mother and that many healthy babies past three.

How many time will you do IUI?
Four. Past that, we feel as if our funds, time, and energies would be better used towards IVF.

What is your chance of pregnancy with each round?
10-25%.

I think I’ve hit most of the major questions regarding IUI. I hope to address
more questions on different subjects at a later time. Did I miss anything?

Look out, Jackson town

Every time we get in the car and head to Jackson to see my FE, I get Jackson stuck in my head. Good thing I love some Johnny and June Cash.

Our first visit with my FE was at the beginning of April, 2014. My Mister now goes to every “uterus themed” doctors appointment with me. At the beginning, that made him super uncomfortable. The whole idea of “the chair” completely freaked him out. Like the champ he is, he got over it. REALLY quickly. He’s a fantastic support system, and takes his job very seriously. When seeing an FE and starting fertility treatments, both players have to be all in. All chips are on the table. It’s high stakes, and there is no room for wishy-washy.

Our first visit was just suppose to be a consultation. “Regular” chairs, everyone keeps all of their clothes on, no funny business. DocJax (FE) is wonderful, supportive, and explains our options to us. With pictures!. Mister akinned it to a Madden play illustration. Yay, football!
After our chat in regular chairs, all of our clothes, and no funny business, DocJax decides he’s ready to get started that day, if we’re in.
Chips on the table… All in.
Mister enters the room with the chair. Like a champ. Shows no sweat. I had my first fertility focused ultrasound.
Where we discovered a fist sized cyst, just hanging out on my right ovary.
huh.
I named her Medsua. She got a “Good Lord!” from DocJax, and he’s seen a lot of scary stuff.
I name a lot of things. Maybe it’s a coping mechanism? That’s for my therapist to decide at a later date.
On the other estrogen blockers I had been taking, follicles (that’s what releases the egg) had developed, but never ruptured (released an egg). When that happens, they just keep growing, and growing, and growing… Until they rupture.
I’ve had cysts rupture before. It sucks. It’s excruciatingly painful, usually involves significant blood loss, and no ER will do anything for you unless you can prove to them that you are hemorrhaging to the point of losing vital functioning. They’ll pat you on the head, give you some pain medicine (maybe), monitor your vitals for a bit, and wish you luck in the horrible lot of life that is “ovarian cysts.”
This cyst was bigger than anything I’d ever had. We needed it to rupture, but we needed me NOT to end up in the hospital. We gave it a week, with a surgery to drain it as the ultimatum. Within a week, I woke up with excruciating pain in the middle of the night. I knew what it was. Enter learned pain management techniques of alternating pain relievers, yoga, heat, deep breathing, and pleading with the Good Lord for mercy and relief.

Fertility treatment is expensive, and you’re lucky if your insurance covers even the doctor visits. You can forget coverage of medication and actual procedures, especially in the forward-thinking State of Mississippi. I say all that to say, I went to work. The Bushes have bills! I grabbed a giant protein packed smoothie and started to replace fluid volume. I continued my pain management regimen. Thankfully, I got to sit at my office (where I am the only one there) most of the day. I was quite dizzy and in a good bit of pain, but I got through it.
God will always give you exactly what you need, when you need it. That is a recurring theme in our story.
We saw DocJax the next morning. Our ultrasound showed the Medusa had indeed deflated. And I did it with out the hospital, or missing work. That earned me a DocJax high five. We had our medication shipped overnight from a special Fertility Pharmacy in New Jersey.

DocJax accurately assessed that estrogen-blockers didn’t work for me, so he went straight for the big guns. He started me on 75 mg of Menopur (highly purified and concentrated LH and FSH), injected subcutaneously (in the skin, similar to how insulin is injected) daily, for several days. I was monitored every other day, to make sure Medusa did not return, and to make sure my ovaries didn’t all of the sudden have an identity crisis and think they belong to OctoMom.
Being monitored every other day means driving to and from Jackson. Every.other.day. As stated before, the Bushes have bills! If we’re going to pay for these treatments, we’ve got to work. So all of our Jackson appointments are bright dark and early in the morning. It makes for rather long days and frequent oil changes.

After 8 days of liquid fire ant Menopur injected into my belly by the greatest sorority sister/friend/roommate/neighbor a girl could ask for, I had two follicles ready. Sister Nurse gave me my trigger shot (10,000 units of HCG) right in muh buttocks (thanks, Forrest Gump). I was pleasantly surprised when that one didn’t hurt, initially. Twenty minutes later, I thought I’d been shot with a bullet rather than an IM needle. I sat funny for 3 days.

We had our first IUI procedure 12 days after Medusa bade us farewell, and I started heavy progesterone supplements immediately afterwards.

One week later, I had my progesterone checked, per doctors orders. My numbers topped the chart. Actually, the chart didn’t go high enough to support my numbers. I’d ovulated, and DocJax and his wonderful nurses were thrilled and incredibly hopeful. It was the first time Mister and I had ever received any good news regarding Ursula (the uterus… I name things). I almost didn’t know how to respond to good news!

A week after that, I went for the test.. The HCG and progesterone test. This would tell us if we were finally pregnant. I cannot pee on a stick, due to the outrageous amounts of hormones I am on, and expect an accurate answer. The blood test came back negative.

We were devastated. We had hoped for the first time in so very long, and we were crushed. I cried a good bit, got a box of Cheez-Its, and had a slob night. I read about Hannah and Rachel and Elizabeth and Sarah and the great women of scripture that struggled with being “barren.” I read how God sustained them, how He blessed them, how He kept his promises to them, even if it wasn’t how they’d planned.

Five days after our first negative, we started our second round. More shots. More visits to Sister Nurse. More monitoring. More bruises. Same song, new verse. The good news was my body responded even more quickly to the meds than it did the first time, with two more fresh follicles. Our second IUI procedure was three weeks after our first. My progesterone came back with fantastic numbers. All of this is very encouraging.
We still were not pregnant.

Because of the drugs, my usual month-long cycle speed was amped up to 3 weeks. In six weeks, we had done two fertility treatments. We needed a break, physically, emotionally, and financially. Did I mention we had to buy a washer and a dryer in the middle of all this? And that we were paying cash for the treatments?
God will give you exactly what you need, when you need it.

We took a much needed two month break. We worked, we prayed. We sought wisdom from friends and family. I didn’t count days or record temperatures or over analyze every pain and discomfort and feeling. I ran more. We did a LOT of weddings (Mister is the greatest photog). We gave Sister Nurse a break from seeing us before her nightshift every day. She loves me. I’m the best patient, really. And she doesn’t judge me when unladylike words jump from my mouth because those shots burn like crazy.

We took a collective deep breath, and geared up to start again…