IVF: Suppression Ultrasound and Blood Work

On November 22, Adam and I went to our fertility clinic for a suppression ultrasound and blood work.  The purpose of the ultrasound and blood work was to check that my reproductive system had been completely suppressed, or basically shut down.  The doctor wanted to be able to have as much control as possible over when and how quickly my eggs would grow.  

I started out getting my blood drawn.  This was the first of many blood draws.  I was lucky that our fertility clinic had a lab on site, which apparently isn't always the case.  So I got to know the nurses who drew blood really well over the next few weeks.  And I was super thankful that they were good at drawing blood, which made the process pretty painless each time.

Then came the ultrasound.  They did a vaginal ultrasound, which doesn't hurt or anything, but isn't exactly pleasant.  It's essentially just a wand thing they stick up your vagina.  Pardon my bluntness, but that's what it is.  I just like to clarify these things in case you are really wanting to know what to expect.  

The ultrasound showed that my uterine lining was thinned out, which is what they want at this point in the process.  And that my ovaries weren't actively growing follicles.  It also showed that there were no cysts on my ovaries and that my uterine lining didn't have any cysts or polyps, which was thanks to the polypectomy that I had back in June.  

Since my ovaries and uterus were cooperating, we could move onto the next step in the IVF process.  The next step is the Ovarian Stimulation Phase.  I'll chat about all the fun injections that are a part of that phase in my next post.     

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IVF: Lupron Suppression Phase

The official start date of our IVF process was October 24, 2016.  The first step was to call our fertility clinic on Day 1 of my cycle.  Day 1 is considered the first day of your period.  Neither one of us was surprised when my period arrived, it was just what we expected to happen each month by now.  I wasn't upset this month because I knew we had IVF to look forward to in our future.  

After calling the clinic, they sent us a basic timeline of the different steps of the IVF process.  Each person's timeline is a bit different, includes different medication and can change depending on how they respond to the medications.  I will share my timeline with you so you can get a general idea of what the IVF process looks like:   

LUPRON SUPPRESSION PHASE 
10/24/16- Date of menstrual period. Call to report menstrual start and schedule any testing/labs required prior to starting fertility drugs. Outstanding testing / labs still to be performed include: 
1) Please fax maternal fetal medicine consult note
2) Order IVF medications ordered. Please be in contact with them to schedule delivery. Also check with insurance to see if you have any drug coverage. 

10/26/16- Start oral contraceptive pills. Take home pregnancy test prior to starting oral contraceptive pills. You will be taking only the active pills, not the placebos (placebos are inert pills and are usually a different color). You may not use the full pack or may require an additional pack (refills have been made available on your prescription).

11/15/16- Begin evening (between 6 p.m. and 10 p.m.) Lupron injection 10 units once daily subcutaneous in the abdomen. 

11/20/16- Last active oral contraceptive pill. NOTE: You will have another menses after stopping your oral contraceptive pills. 

11/22/16- 8:30 am Suppression ultrasound and blood tests. You will be instructed on self injection of medication on this date. Down payment and signed consent forms required today. These forms can be notarized here or elsewhere. If done here, patient and partner are required to be present at the time of signature. 

With the start of my period, the IVF ball officially got rolling!  And it didn't seem to stop once it started. Looking back, it really did go by pretty quickly (with the exception of the 8 days we had to wait to find out if we were pregnant!).  

One of the hoops we had to jump through was meeting with a Perinatologist, aka Maternal Fetal Medicine Specialist.  I'm greatly simplifying their jobs, but basically they know how to deal with high risk pregnancies.  I think it's pretty standard to be required to meet with one before embarking on IVF.  They want to make sure you understand the possible risk factors you or your baby might encounter.  Adam and I felt like this was pretty redundant since we've had all kinds of genetic testing.  We even did the Counsyl Family Prep Screen.  This was a blood test that Adam and I both did.  The results share the likelihood of your offspring inheriting all kinds of different genetic disorders.  There was nothing concerning that came from the results and we felt pretty knowledgeable about what the results were telling us.  

Despite all this, we still had to schedule an appointment with a Perinatologist.  So we did and showed up for our appointment, which was a couple days before I was supposed to start my injections.  When we showed up, the nurse told us there was a mix-up with the scheduling and that we would need to meet with a genetic counselor.  Of course the genetic counselor wasn't there that day.  I think steam started to come out of both Adam and my ears.  Without yelling, we tried to explain that we were on a strict timeline, had both already taken off work to be here and simply needed this appointment to happen today so we could move on with IVF.  We must have been pretty convincing, because a very flustered Perinatologist came right back to speak with us.  I think we did more talking than she did.  We explained all the testing we'd done and were able to coherently speak about the results.  She said she would send our fertility clinic a note saying we spoke and we could move forward with IVF.  Thank goodness!  

The other thing we needed to take care of right away was ordering our medication.  We were responsible for contacting the pharmacy, ordering our medication, paying for it all out of pocket (unfortunately my insurance didn't cover any fertility medication) and scheduling it to be delivered.  I'm not going to lie. This part stressed me out.  I think Adam could tell and he kindly said he would take over the responsibility of getting the medications ordered.  Even though our fertility clinic had a contract with one pharmacy, you can get your medications ordered through any pharmacy.  Adam called several different pharmacies and ended up ordering medications from two different pharmacies, which ended up saving us money.  This was definitely a lot of work on his part and took a lot of phone calls, but IVF is expensive and saving every dollar you can helps.  

While this was going on, I started taking birth control bills.  This sounds very counter-intuitive, I know.  But the birth control pills actually help prevent any cysts from forming on your ovaries and helps give doctors control of the timeline.  I ended up taking birth control pills for about a month, until November 20th.  

I also started my first injections during this time period.  I started Lupron injections on November 15th. I'm not going to lie, I was very scared to start the shots.  I am scared of needles and the thought of having to do this myself was even more nerve-wracking.  I could have asked Adam to give me the injections, but I wanted to maintain some sense of control.  So I opted to give them to myself.  

The Lupron shots ended up not being a big deal.  You administer them in your stomach fat and the needles are very skinny and not that long.  It was also pretty simple to prepare the shot.  There was a vial of Lupron that you draw up the medication from and there's no mixing involved.  My mother in law is a nurse and I had asked her if she had any tips for giving shots.  She told me to make sure I stuck it in my stomach as fast as possible, like a dart.  This would make it much less painful and help prevent bruising and bleeding.  Putting pressure on the injection site afterwards also helped prevent bruising and took care of the minimal bleeding that occasionally happened.  

All in all, the Lupron Suppression Phase was pretty straightforward and easy.  The next step in the process was to go to the clinic to have my blood drawn and have an ultrasound to make sure my hormones and ovaries were cooperating.  I'll share more about that appointment in my next post.  I've blabbed on long enough!    

Preparing for IVF

Note: I wrote this post back in November, right after Adam and I decided to move forward with IVF.  I am sharing it so you can get an idea of what it was like for us to make this big decision.  

Adam and I decided to move forward with IVF.  I'm feeling all sorts of feelings right now.  

I am excited and giddy with the prospect of IVF giving us a healthy pregnancy.  I really feel like this will work for us, the odds are certainly in our favor.  

I am worried about giving myself shots and going through the egg retrieval surgery.  I am overwhelmed with trying to wrap my brain around the whole process.

I am nervous about how I'll respond to the all the medications.  And I'm nervous about how the egg retrieval will go.  Yep, definitely a lot of feelings!      

But above all, I am hopeful.  This is our absolute best chance of getting pregnant.  And I think being hopeful is super important right now, so that's what I'm going to be.  

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Jazzy's New Gig

Jazzy will soon be stepping into the new role of big sister.  No, we are not getting another dog.  We are pregnant with twins! 

Say what!?!  I know this might come as a bit of a shock since I haven't said a word here on the blog about how things were progressing with our baby-making efforts.  You might have even been wondering where I had gone to since I haven't posted much of anything lately.  The fact of the matter is that I was taking a break to focus all my energy and attention on moving forward with IVF.  Then it actually worked and I started growing two babies, which takes a surprising amount of energy.  I was just too exhausted to work on other projects or blog posts.  But trust me, I am not complaining!  

I know that some of you who read this blog are struggling with infertility and I know how crushing other people's pregnancy announcements can be.  I know all too well that kick in the gut, heart-pounding, tears springing to your eyes (and not happy tears) feeling that takes over when you see that yet another person who is not you gets to have a baby.  And I know the questions that start running through your head...why does she get to have a baby and not me?...what makes her deserving and not me?...why don't I get to have a baby?  And I'm all too familiar with the guilt that follows...why can't I be happy for them?...why do I all of a sudden despise this person I love?...am I a terrible person?  At least that's what it was like for me. And it was perfectly okay to respond like this and it didn't make me a terrible person.  It just meant I was human.  

So if you are one of those people who are still struggling with infertility, my heart goes out to you.  I'm so sorry.  I know it doesn't really help to hear that someone else knows exactly how you feel, but I do.  Don't lose hope and keep moving forward.  And it's okay if you are having trouble reading this now because there are too many tears in your eyes.    

I plan to share all about how IVF went for us.  I'll get into the nitty gritty of the shots, the doctors' visits, the waiting, the exciting parts and the scary parts.  I also plan to take you along for the ride of being pregnant with twins.  

So stick along for the ride!  (Unless it hurts too much. ❤)    

Jazzy's DNA Results

Way back in the beginning of January, I talked about the DNA test Jazzy and I got for Christmas.  I was so excited to finally learn exactly which breeds make up our sweet little Jazzy!  

About two weeks after I sent off her test swabs, an email arrived in my inbox from the DNA testing company.  I couldn't click on it fast enough!  Sadly, the email didn't contain Jazzy's test results, but a message saying that the swabs didn't contain enough DNA to perform the tests.  Bummer!  However, the company offered to send another test to me free of charge so I could try again.  They also included some more in depth directions on how to get the best sample.  I guess most people can figure it out without the detailed specifics, but I certainly needed a little more direction.  

In case you are doing this test on your pups, the best way to collect the best sample is to put the swab between their top gums and cheek.  Then swirl it around for 20 seconds while pushing on their upper gum area from the outside of their mouth.  I had Adam help me out this time around and it definitely helped to have another set of hands.  Plus, we woke Jazzy up from one of her many naps to do this, so she was a bit sleepy and didn't put up a big fight.  

Once we had the appropriate sample, I sent off the second test and did some more waiting.  This weekend, I finally got the results!!!  Adam and I looked through the results together and were pretty surprised with the outcome.  Even though it was surprising, it did seem very plausible and trustworthy.  

So here's the big news about Jazzy's breeds...

...she's 50% Japanese Chin, 25% Russell Terrier and 25% mixed breed groups!  That means one of her parents was a purebred Japanese Chin and her other parent was a Russell Terrier mix.  I'm not really sure why that surprises me so much, but it does.  I can just imagine Jazzy's Japanese Chin mother sneaking out of the house to have a fling with the Russell Terrier down the street.  Ha!  After looking at some photos of Japanese Chins, I can definitely see the resemblance.  

The results gave a brief history of the breeds and some characteristics of each breed.  Apparently back in the day Japanese Chins were considered dogs of royalty and could only be owned by aristocracy.  I guess that explains why Jazzy is so refined.  Some of the common behaviors of the Japanese Chin that were listed that we recognize in Jazzy are: 

-She's an active, alert and intelligent dog. 

-Although described as stubborn this tendency may be reduced via a reward-based approach to training. 

-Japanese Chin enjoy participating in dog sports such as agility and both rally and competitive obedience.  

We definitely think she's active, alert and intelligent.  And she can certainly be stubborn at times and pretend she doesn't hear us calling her, but if you mention a cookie she suddenly puts all her attention on you.  She also seemed to enjoy the obedience class she took and learning new tricks.   

Some of the common behaviors of the Russell Terrier that were listed that we recognize in Jazzy are: 

-Very intelligent, obedient, active, agile, highly energetic, and watchful dogs. 

-Reputation as a good family dog, but with careful training needed to avoid development of "small dog syndrome."  

Again, we see the intelligence, obedience, activeness, agility, energy and watchfulness.  She always seems to be aware of what's going on and like she's trying to figure things out.  And she does have a tendency to want to assert herself when we come across bigger dogs.  That's something we are always working on.  

The results screened her for several genetic disorders, which all came back negative, thankfully.  There was also an indication for what her adult weight should be, which is 8-18 pounds.  Jazzy weighs 17 pounds right now.  While that's on the higher end, it is within the suggested range.  The vet has always had some difficulty deciding what her ideal weight should be since we didn't know her exact breeds.  

I would highly recommend the Wisdom Panel test to anyone who might be curious about their dogs' breeds. Once I got the hang of collecting the DNA sample in the correct way, it was pretty simple.  The customer service was spot on and the results seem to be spot on, as well.  

Now when people ask what kind of dog Jazzy is, we can answer with certainty that she is a Japanese Chin/Russell Terrier mix.  It's the best mix of breeds, if you ask me!