Technical Information

Fertility Drugs: Injectable Gonadotropins

What are injectable gonadotropins?Injectable gonadotropins are medical preparations of naturally occurring hormones that the brain produces to stimulate the ovaries to produce hormones and to prepare eggs for release. The two hormones are follicle stimulating hormone, or FSH, and lutenizing hormone, or LH.

What do these two hormones do?Human eggs wait in the ovary in a partially mature state. Early in each menstrual cycle, the brain sends FSH to the ovary, which in turn selects a group of eggs to begin the maturation process. The FSH stimulates the maturation of the eggs, and stimulates the release of increasing amounts of estrogen. LH is released along with the FSH, and stimualtesthe ovary to release additional hormones that also play a role in egg development. Typically, only one of the recruited eggs becomes fully mature. When this single, dominant egg is ready for release, a great, one-time release of LH, known as the LH surge, tells the overy to release the mature egg.When we use HMG (Human Menopausal Gonadotropin) or FSH as a medication, we bypass the body's normal process of egg development and release. In this way, we can induce ovulation in women who do not ovulate on their own, produce more than one mature egg each cycle and fix faulty egg developing systems. These medications are either used by themselves, in conjuction with intrauterine insemination procedures, or for in vitro fertilization.

What are Pergonal, Humegon, Fertinex and Repronex?Pergonal, Repronex, Humegon, Fertinex are commercial names for the naturally derived HMG and FSH preparations available in the United States. They are all manufactured by purifying the secreted hormones from human urine. Pergonal is 50% LH and 50% FSH. It is given by injection only, using a 1½ inch needle injected deep into the muscle, usually in the backside. Humergon is virtually identical to Pergonal, but is manufactured by a different company. Repronex can be injected subcutaneously with a smaller needle (approximately ¼"). Fertinex is newer form of FSH. Its advantage is a better purification process, making it also injectable using a smaller needle.What are Gonal-F and Follistim?These are recombinant forms of purified FSH, manufactured by a biosynthetic method. Due to increased purity, both products can be given subutaneously with a small needle similar to Fertinex and Repronex.

Is one preparation superior to another?In theory, FSH is more important than LH in the development of mature eggs. However, purified FSH and HMG seem to work equally well in terms of pregnancy rates. Some centers use a combination of the two preparations in patients' cycles. The E2 may rise more slowly or to a lower peak level in the very beginning of the cycle with the recombinants. This does not appear to affect the outcome.

How is HMG given?HMG is given by intramuscular (IM) injection either once or twice daily. Repronex, Fertinex and the recombinants require a smaller needle injected just below the skin surface.How is the cycle monitored?Cycles typically start on the third day of the menstrual cycle, although day four or five starts are not uncommon. The development of the eggs is monitored by blood test for estradiol and transvaginal ultrasound examinations for follicle size and endometrial thickness.

Please define estradiol, progesterone, follicle size and endomentrial thickness.Estradiol is the most important hormone in the estrogen family of sex steroid hormones. It does many things to prepare the reproductive system for pregnancy. It rises in a predictable way in a natural cycle, and provides important information about egg development in a gonadotropin cycle. Progesterone provides support for the second half of the menstrual cycle, after ovulation, supportin and stabilizing the uterine lining.Prior to ovulation, progesterone slowly rises, providing information that the more mature eggs are approaching readiness for release.Follicle size refers to the appearance of the egg- containing areas of the ovaries in the days leading up to ovulation. The eggs themselves are too small to see on an ultrasound, but the small, fluid-filled follicles that contain the eggs are easy to see and measure. Typically, follicles start at less than 10 millimeters and increase to at least 18 millimeters just prior to the LH surge. In addition, the appearance of the lining amy change from a homogeneous white line to a characteristic three-lined (also known as a Type 1 or trilaminar appearance) prior to ovulation. The subsequent release of progesterone further changes the appearance of the lining.

Does the Lh trigger come naturally during gonadotropin cycles?Since the normal communication between the brain and the ovary is affected by the use of HMG or FSH, we trigger the LH surge ourselves. Since pure LH is difficult to prepare and rapidly loses its effectiveness after injection, we use human chorionic gonadotropin, a naturally occurring hormone that looks and acts very much like LH in this situation. Other names for human chorionic gonadotropin are HCG (generic name), Profasi, Pregnyl, Novarel and Ovidrel (commercial names).

What are the risks of injectable gonadotropins?The principal risks are multiple pregnancy and ovarian hyperstimulation syndrome.Gonadotropins constitute the family of medications most associated with multiple pregnancy. News reports of high-order multiple pregnancy - quadruplets, quintuplets or even higher - are almost always related to the use of injectable gonadotropins. Since gonadotropins bypass the body's usual mechanism for limiting the number of mature eggs available in any given cycle, the possiblility of multiple pregnancy is always a foremost consideration in managing a gonadotropin cycle.Ovarian hyprestimulation syndrome (OHSS) refers to a combination of symptoms created after ovulation by the very stimulated ovaries. The principal problem is a release of large amounts of fluid by the ovaries coupled with a leaking of fluid from the blood vessels into the abdomen. Symptoms include bloating, decreased output of urine, nausea and vomiting. Serious cases can include fluid around the lungs and imbalances in electrolytes (principally sodium and potassium). The most serious cases can require intensive care and be life-threatening.

Are these risks preventable?They can be minimized, but not completely prevented. Thankfully, a small number of eggs will fertilize and develop in any gonadtropin cycle, usually one or two. The risk of a higher level multile can be decreased by adjusting the medication dose to provide fewer eggs, withholding the HCG and abstaining from intercourse to prevent pregnancy completely in a cycle with too many mature eggs, or performing an in vitro fertilization procedure, removing the eggs and limiting the number of resulting embryos returned. As a last resort, high level multiple pregnancies can be reduced after the pregnancy has been established.

Do these medications increase the risk of ovarian cancer?The honest answer is we do not know yet. Because these medications bypass the body's normal mechanism for controlling egg development, one can theorize that they may stimulate abnormal as well as normal development. No study has definitely implicated injectable gonadotropins in higher rates of ovarian cancer, but research has not disproved a potential link either. For this reason we try to limit HMG use to a reasonable number of cycles.

Is there an increase in birth defects or pregnancy complications?None other than those associated with the higher multiple pregnancy rate.

edited by:David Sable, M.D.The Institute for Reproductive Medecine and Science of Saint Barnbas Medical Center Livingston, NJOwen Davis, M.D.The Center for Reproductive Medecine and InfertilityThe Cornell Institute for Reproductive Medecine New York, NY

To Inject or Not to Inject

So I called and talked to the nurse at my RE's office. I explained the place that we were in emotionally. We have done 8 cycles of Clomid with no result. She said that it is definitely time to move on to injectable medication. She said that at this point I had 4 options. #1 was to just walk away and enjoy the three kids that I have, #2 was to adopt, #3 was to try injectables and #4 was IVF. I told her that we had talked about adoption and it just wasn't the choice for us and that we would not do IVF. So she told me more about the injectables. She said that they do not have the s/e that the Clomid does. Their main s/e is hyper stimulation of the ovaries, resulting in a canceled cycle. She said that there is a lot more monitoring with injectables. You go in for a baseline scan and an estrogen level on cd2 and then you start the medication that day. You have to come in 3 days later for another scan and blood draw and then sometimes daily after that to monitor your follicles and your estrogen levels. Your appointment has to be before 1pm because of the estrogen levels, and so I would have to tell my work what was going on. I asked her if it would be worth it to do just one cycle of the injectables or if it was something that had to build up to work. She said that it definitely would be worth it and she would strongly suggest it because she thinks that if it didn't work that I would have better "closure" knowing that we did all that we could. So I hung up and called Rich to get his feedback. He said that it sounded like a bunch of trips to the RE and he thought we were done and what if we do it and then we have to cancel the cycle because of over stimulation. Then what? So now I'm confused. It would really be a huge undertaking. The RE's office is about an hour away and it is such a long trip. If I tell my bosses at work, I could risk losing my job. I just don't know what to do.

I talked with Rich about it again today and he said that he would do whatever I want to do. A friend suggested that I ask my RE if I can have the monitoring appointments done at my OB/GYN's office since it is right down the street from where I work. That would be so much easier! I don't think the my RE will go for that though. I have an appointment on Tuesday for a progesterone draw and injection teaching, I will ask then. They wanted me to come in for the teaching appointment even though we haven't decided what we are going to do. That way, if we decide to go through with it I will be ready. At this point, right at this very minute (this changes so frequently!!) I feel that we need to take some time off. I feel that we need to walk away for a while and re-group, and then if I still feel so strongly about this in 2 or three months, then maybe we will try injectable medication. This will also depend on Rich's schedule though. If he is going to be far away in a few months, we may need to make a decision earlier. I will include some information about injectable medications in the next post.

Crossroads

I stated in a previous entry that we were at a crossroads. The next day, this was my devotional reading that is automatically e-mailed to me each morning...

"Crossroads"
Susanne ScheppmannProverbs 31 Speaker Team Member, Co-online Devotional EditorKey

Verse:Jeremiah 6:16, "This is what the Lord says: "Stand at the crossroads and look; ask for the ancient paths, ask where the good way is, and walk in it, and you will find rest for your souls…" (NIV)Devotion:"I don't remember the bushes on the side of the road looking so green," I thought to myself. The next thing I knew, I was driving over a bridge high above a large river clearly identified on the sign as the Colorado River. Not long after, a large yellow sign welcomed me to California. I was supposed to be entering Nevada! Somewhere, at a crossroads, I made the wrong turn and didn't realize my mistake for over an hour.

Sheepishly I called my husband to tell him my news:
"Hi, it's me"
"Hi, Honey. Are you almost home?"
"Not exactly, I'm in California."
"What? Are you lost? Didn't you read the map?"
"No, I didn't look at the map. I thought I knew the right direction, but I must have made a wrong turn at the crossroads in Arizona. I am turning around.
" My "detour" added an additional two hours to my long drive home. If only I had read my map or asked for directions, I wouldn't have found myself in California. I wouldn't have lost valuable time and energy.Often, I make the same mistake in my spiritual life. Big decisions loom ahead. I think I know the right course. So off I go without taking time to pray or read my Bible, and my choices go awry. Once I have strayed too far down the wrong path,I usually realize: "Oops, I should have sought God's advice." God promises that when we stand at a crossroads He will guide us. We need to stop and listen with our spiritual ears for the correct course to take.

Proverbs 3:6 advises us to acknowledge Him in all our ways and He will make our paths straight. I prefer my path straight over crooked, don't you? So the next time life presents a quandary, let's stop at the crossroads of our decision. Let's ask Him which is the better way. Let's reach for our Bible and let God's Word become our roadmap. "Your word is a lamp to my feet and a light for my path," Psalms 119:105 (NIV). God's Word promises to show us the right way to proceed in life.
Power Verses:Isaiah 58:8, "Then your light will break forth like the dawn, and your healing will quickly appear; then your righteousness will go before you, and the glory of the Lord will be your rear guard." (NIV)
Isaiah 30:21, "Whether you turn to the right or to the left, your ears will hear a voice behind you, saying, "This is the way; walk in it." (NIV)
Proverbs 3:6, "…in all your ways acknowledge him, and he will make your paths straight." (NIV)
Isaiah 35:8, "And a highway will be there; it will be called the Way of Holiness. The unclean will not journey on it; it will be for those who walk in that Way; wicked fools will not go about on it." (NIV)
John 10:9, "I am the gate; whoever enters through me will be saved. He will come in and go out, and find pasture." (NIV)

I received a note from a friend that day asking about our crossroad. I explained to her that I feel that is where we are right now on our TTC journey. We have been traveling down this road for so long, just going forward. I think it is time to turn left or right. So with this month’s IUI results we will turn. Left takes me back to the gym and back to college to peruse some sort of career, right takes me to the place that I have been wanting to be as long as I can remember… staying at home and raising a family. How appropriate that left has me leaving a dream behind and right just feels right. I just can’t keep doing the same month after month. The drugs are really getting to me, I just can’t handle it anymore. Not to mention the emotional rollercoaster that I am on each month. Building up two weeks for the big O and then building up two weeks to test… it’s just all become to much for me to handle emotionally and physically. The shots, the drugs, the 1 ½ hour drive to the appointments 2 or 3 times a month, the temping, the charting, the testing… it has all finally beat me after 5 long years. I feel it is time for a change. The definition of insanity is doing the same thing over and over and expecting different results… well I am tired of being insane. I don’t feel that “peace” that I expected to feel with this decision, I will keep searching and praying for it, but I know that something has got to change.

Her response has got me thinking... here is a portion of what she had to say:
"It's not about giving up. It's more like trying a different approach. Maybe you should go "back to the gym and back to school" Not because you can't or choose not to have more babies. But just because it's what you need to do now. You know as well as I do that people have children older and older. You're not old! So don't roll over and say you are.

Try something new, perhaps it will bring you the answers you're looking for in the most round about way you ever imagined.And don't forget... going forward doesn't mean you can't go backwards. That story from the devotion about the lady who had to turn around. It should be noted that had she not taken that "wrong turn" she wouldn't have seen the sites she'd seen, nor would she have learned that there was a road that she was "meant" to be on. Sure it cost time and energy, but it made getting home to her final destination that much sweeter.Being where I've been, I'd go for the Gonal-F... just one round. And at the same time i would plan to take a course or go to the gym or whatever.For now you're going to go from a 2 lane road to a 4 lane road so you can enjoy a little more along the way.When you exit, the exit will be more of a crescent with the option to get back on further down the road. Who knows, maybe when the time comes to get back one the road, you'll find out that you were on the right one all along.

Good luck my friend. I feel that you are carrying a great weight right now. I hope that you're able to alleviate some of the pressure soon."

So I called my RE's office to fill them in on where we are at and what I have been feeling. That takes us to the next entry.

A blog that touched me

I was chatting with a friend last night and she referred me to a list of TTC blogs. I started to brows through one and there were so many things that this Christian woman had written that touched me. I wanted to share some...

She writes"but each Christ follower (if you'd consider me that all along) has the day when they experience the depth and agony found during a crisis of faith. a crossroads. a decision.will i hinge my devotion...on winning my way?can i say thank you...while losing everything?will i believe what i cannot feel?will i surrender...even though, only a fool would go on fighting a war...when all of his weapons have been stripped of him.it took 46 months for me to realize, surrender isn't really a choice.take away my swords and shields and strength......and my options are pretty limited.i had met my match.to say i had lost control puts it too simply. it sounds so elementary.but control is all i've ever had.and so my loss is infinite. bottomless. consuming.almost as deep as my loss of fertility."

46 weeks of:
pills
shots
ultrasounds
blood drawings
sonograms
conference calls
dietary adjustments
suppliments
timed interourse
ovulation predictor kits
pregnancy tests
ovulation watches
ovulation monitors
saliva strips
holistic practitioners
artificial insemination
....only to end up exactly...where i would be...had i never lifted a finger....yes.2007 was tumultuous. exhausting. and all vanity.seeking to force the very thing that was never meant to be."

"and you can in a miraculous way, when you cannot even find the words to even express it, know when looking back across the plain of 2007, embrace that my life this year was no Plan B to God enthroned over all things.this was His perfect will for my life -- these were His plans for me to prosper.this was His divine way for caring for me.this was His best interest for me.the last 6 weeks have been an evolution of sorts...though surrender is humanly devastating...and crushing to the point of choosing death over it...we are all given perseverance in Christ Jesus."

"i pulled out my journal this morning and at the top, as i do every morning, wrote the date.December 31, 2007day #365 of 365.praise the LORD, i exhaled.but the devotional led me to I Peter 5:10 --And the God of all grace,who called you to his eternal glory in Christ,after you have suffered a little while,will himself restore youand make you strong,firm andsteadfast.....
though we suffer....
He is all grace.
He is all glory.....
in a sense....how can this not be acknowledged as the best year of my life...."

"we had the most heartfelt three hour lunch i think i've ever had.the four of us...perfect strangers...reaching out to each other in an effort to help.she had undergone an IUI the very day before on Saturday, yet, she ended up ministering to me in ways she'll probably never understand. i was so amped on talking her through the ropes...giving her advice...pumping her up with stats...high-fiving her on giving herself shots...telling her all the ways she could better evaluate her physical condition.......and it became painfully evident to me -- she simply didnt need it........her heart was as still, and crystal-clear as a placid lake at sunrise. she had it.she not only had it....she owned it. His peace.she had allowed herself to be captured by His everlasting peace......and i was captivated by her...or God in her...this freak thing that was going on with her...she was a boisterous, energetic, fun, outgoing, adorable 29-year old girl....yet in the weirdest way i've ever seen...perfectly quiet at the same time. her brain....was quiet. her heart....was still. her soul....was...at....rest.......and my heart ached instantly for all of it...there was so much about her attitude, her outlook, her council, her everything...that dripped of Christ. her husband is in the military so, essentially, ALL of her fertility treatments are free. she was on her 4th round of clomid (first three rounds she was unresponsive) and had done her trigger shot for the first time this past week. it was her first IUI. the military will only allow you to do 6 rounds of clomid. PERIOD. if she's not pregnant in 6 rounds....they automatically force you into IVF territory. and after extensive counsel from our pastoral staff and Christian counseling force at church -- they've already decided to forgo IVF. so basically she was looking down the barrel of a gun....with two months left of Clomid after this IUI.....and she's done. she kisses her human child-bearing capabilities goodbye. she's been trying for 1.5 years. and is about to see it through and have closure in 2mths if this doesn't work.....and the waters of her heart...are so perfectly calm."

"and i have no doubt she meant every word. and it was beyond astonishing to me. at first i wondered if she was crazy.for a women to be able to even utter these words in the depth of what has to be some of hardest moments of your life....being unable to BEAR CHILDREN....is only of God. his astonishing mercy poured out on her.....it left me speechless.and breathless.and awe-struck.she continued, "we've already signed up with an adoption agency and are probably looking at a 2-year waiting list...and we've just purchased a 5-bedroom house that we'd love to have children in...but if the IUIs don't work....i'll probably go back to work and make good use of my 2-year wait for a baby to be placed with us....

"not even a pinch of resentment. bitterness. eye-rolling. second-guessing. apprehension. discouragement. or disbelief.
....and i was fully dumb-founded. so deeply grateful for her witness....yet feeling so vile for the emotional freakshow i've put on over the last 9mths. my endless kicking and screaming and STRAIN and discontentment and finger-pointing at God. when i could have just as easily traded it all in....for what she has.
what on earth was i thinking. it's MINE already...but i locked it out. i stiff-armed it all away. and i was left with the raging storm in my heart...and the endlessly choppy waters....and the black skies....she had everything....everything that i didn't have. and then she said, ".....and if i never have my own biological children....i have to believe that God is ...still good...."i felt such shame in that very instant.how as Christians....no. how did i get to a point in my faith where i fully believed that God is not good. what does the path look like....that winds around the difficult seasons of our lives...and takes us to places darker than ever before....at which "Y" in the road did i wander off in the wrong direction....i wonder exactly which crossroad took me to the idols of self...and doubt and desperation...and fierce indignant anger....when exactly did i sacrifice the bedrock of my beliefs for things so obviously outside of my control....at what point did getting out of the boat in the middle of the storm to walk on water....sound like a great idea, without God....?....when i believed that in my natural capabilities, i didn't need God to perform the supernatural....rather, i could do it all on my own...by my own rules...all by my perfect, fallen, sinful, self.....and i sank.
and i drowned.
and i died a million deaths this year.

i could have sworn each death was a piece of my faith...chipping away...proving fruitless...but He used it for my good....

Gen 50:20....but God meant it for my good...... the death was actually mine...a painful dying of my will...i could have learned faster...i could have cried 'uncle' sooner...but my CONTROL just wouldn't give way. so some deaths are slower than others...and sometimes we choose our torture. but under His watch -- we will all eventually die to self.....and that is always, ...always a good and glorious thing....
2 Cor 3: 18And we, who with unveiled faces all reflect the Lord's glory, are being transformed into his likeness with ever-increasing glory, which comes from the Lord, who is the Spirit."

I know it's a lot of reading, but there is so much to share. I sat there reading, tears sliding down my face, breathless. I could have written some of this with my own words. I have lived this with my own heart, and yet there are so many lessons here that I have yet to learn. I love the line where she asks "can I say thank you...while losing everything". Wow! Is that a powerful question or what. This question reminds me how much growing I still have to do in my faith. Saying thank you doesn't usually cross my mind when I am losing. I also love this... "....only to end up exactly...where i would be...had i never lifted a finger." This is me. I am exactly where I would have been, had I not lifted a finger. So many years and emotions and hopes and dreams and struggles and questions and arguments with God... only to be right where I am today, had I never lifted a finger. Amazing.

This peace that she talks about... this is what I have been searching for. I believe her when she says the we already have it.. I just can't seem to be able to figure out hom to grab onto it! I know I need to "die to self" as she speaks of but I struggle with how to let go and still be proactive about my health. I still have much to learn. Her words are inspiring to me. I have posted her link in my list.

"The rest is up to You"

Our day started at 5:30am! Ugh! We hit the road at 6am and the temp read 1! Brrr! We collected the sample at the RE's office and then went to Dennys for some breakfast. We returned to the clinic for our 9am appointment. Dr. McRae did the u/s first. There was only one mature follicle on the left side. This was a bit disappointing as we had double the dose of Clomid. She said the lining was nice and thick and that we were ready to go. Rich's s/a numbers were so great!! Below is a comparison.

Original Count:
Motility: last time 29% this time 45%
Morphology: last time 54% this time 83%
Count: lat time 19.4 million this time 30 million

Final Count after processing:
Motility: last time 43% this time 65%
Morphology: last time 65% this time 83%
Count: lat time 30.2 million this time 117.2 million

The counts were much better this time! YAY Richard! So she did the insemination, gave me the shot of hcg in my hiney and I stayed on the table for 10minutes and then we were on our way. Rich drove home and I laid down in the back seat. I was just praying and looked up to the heavens and thought, "the rest is up to you". That is the attitude that I am going to try to maintain during this 2ww. It's in God's hands now and if it was meant to happen then it will and if it wasn't then it won't. I was listening to "How Great is Our God" the other day and the tears were just falling. Our God is so great, and I know that He loves me so much, He only has plans to prosper and grow me and not plans to hurt or destroy me. I know that all things God works for the good of those who love him, who have been called according to his purpose. I know that He loves me and I am his daughter and that He will only do what is best for me.

We have come to a crossroad. A negative pregnancy test will take us down one road and a positive pregnancy test will take us down another. It's time for a change. We've been on this road way to long.

IUI #2

We are scheduled for our second IUI tomorrow, 01/02/07. What a way to start off a year!!

Update on this cycle for us… I started 100mg of Clomid in Jamaica and finished on cycle day 9. The side effects are TERRIBLE this time! The mood swings, the hot flashes and the worst is that I am having irrational fears and worrying about crazy things happening. I do this normally, but it seems like the meds are just making it so much worse. I have come to a point that I am ready to say that we are done. We will do this IUI tomorrow, but after that I think we will be done. This is the first time in 5 years that I have been ready to say “The End”. It’s not the “ahhhhhhhhh” kind of peace that I have been praying for, it more like I just can’t do this anymore. It has been such a long long road, and I am out of gas. The emotional and physical strength just isn’t in me anymore. I’m tired of the doctor appointments, the 90 minute drive three and four times a month, the shots, the meds, the thermometer, the u/s, all of it. I just can’t do it anymore. I cannot deal with the heartache and let down that I prepare myself for each month. I spend two weeks telling myself that I am not pregnant, so don’t get your hopes up… and then it is just overwhelming devastation each month. It’s something that I cannot prepare my heart for. My head knows, but my heart just won’t accept it, and I just can’t take the heartache anymore. We won’t do anything to prevent for a while, but in my head, I am giving up. I am not going to say we are done TTC and then play the TTC game anyway. “Well maybe since we aren’t ‘trying’ it will happen”. Nope, we are done. This is what we are thinking for now. I don’t know what the RE will have to say about it, she may be able to talk me out of it, but right now I just don’t think I can keep this up.

I will try and post the sperm counts tomorrow and let you all know how it goes. It's all or nothing for us tomorrow!

Negative Beta

I got the news this morning. Beta was a 2. I cannot even begin to explain my emotions because I am walking out the door for Jamaica with my family to celebrate Christmas! I will be updating our family blog with pics from the trip, blogging from Jamiaca. When the RE called with the results, he asked if I drank. I said "no, but I just might!" So I leave you with this song...

I was feelin’ the blues
I was watching the news
When this fella came on the TV

He said I’m tellin’ you
That science has proven
That heartaches are healed by the sea

That got me goin’
Without even knowin’
I packed right up and drove down

Now I’m on a roll
And I swear to my soul
Tonight I’m gonna paint this town

So bring me two pina coladas
One for each hand
Let’s set sail with Captin Morgan
And never leave dry land

Troubles I forgot ‘em
I buried ‘em in the sand
So bring me two pina coladas
She said good-bye to her good timin’ man

Oh now I’ve gotta say
That the wind and the waves
And the moon winkin’ down at me

Eases my mind
By leavin’ behind
The heartaches that love often brings

Now I’ve got a smile
That goes on for miles
With no inclination to roam

I’ve gotta say
That I think I’ve gotta stay
‘Cause this is feelin’ more and more like home

So bring me two pina coladas
One for each hand
Let’s set sail with Captin Morgan
And never leave dry land

Troubles I forgot ‘em
I buried ‘em in the sand
So bring me two pina coladas
She said good-bye to her good timin’ man

10dpiui

What do you think? What do you see?

8dpiui

Today's test. The line is fainter, that is a good thing at this point. My mood swings are back in full force. I had forgotten how bad things really get from being pumped full of hormones. It is really hard, and I am struggling. I feel so bad when I yell and scream and over react. I can see it in the faces of the kids, they know when mom is about to lose it. I explained to them tonight how the hormones and medicine that I take makes me a little more crabby. I told them that it was from the medicine that Mommy takes so that we can have another baby. I asked them if they want me to stop taking the medication, or if they just want to deal with the crabbiness and they all immediatly said keep taking the medicine. They didn't even stop to think about it. It brought tears to my eyes. The fact that they would deal with a crabby mom (and I have been soooo crabby), just so they can have a little brother or sister, that is just priceless to me. I love those little kiddos!

Here is my test 7dpiui. There is a faint test line, that means that there is still trigger in my system. I will test each day and watch this line dissapear. Once it is gone, I will know that if I see a second line again it is a BFP!

7dpiui

One week ago today was the insemination. Time is not going by quickly! I did have my progesterone draw done yesterday, however, the lab said it would be 5-7 days before the results would be available. I called the RE to let them know that and to beg them for a beta blood draw before I leave. They agreed to do a blood draw on Saturday and then they will call me Monday and leave the results on my cell phone. I will have to have someone in the states retrieve the message and call me in Jamaica with the results. I am hoping that if I go in to the lab at 6am they may get the results to my RE sometime that morning and they may have a chance to call me on Saturday. It would be so great to know before I leave!

I am not reading into symptoms, my PMS symptoms are the same as pregnancy symptoms. Just trying to trust in the Lord.

I will try to update before we leave for Jamaica. We fly out on 12/16.

3dpiui

A picture of my three Miracles tonight.

That is 3 days post IUI for those not of the TTC world. That is where I am in my cycle, 3 days past the IUI. Nothing new to report. I am not tracking symptoms, it only makes me crazy! I will be sure to post the numbers from the progesterone on Monday. I do not feel overly optimistic about this attempt. Rich and I have actually been talking about the next cycle already. I think he is going to start on some vitamins and herbs, and I believe that I will go with the full dose of 100mg of Clomid next time.

Two of the ladies that I am in a "group" with on the infertility board I frequent got their long awaited BFPs this week! It was a very exciting board this week. I am so happy for them, and I hope and pray that these pregnancies will bring them their long awaited child next August!! I am hoping the pregnancy travels in threes!!

Here is a "poem" that I came across tonight on another blog.

There are women that become mothers without effort, without thought, without patience or loss and though they are good mothers and love their children, I know that I will be better. I will be better not because of genetics, or money or that I have read more books but because I have struggled and toiled for this child. I have longed and waited. I have cried and prayed. I have endured and planned over and over again.

Like most things in life, the people who truly have appreciation are those who have struggled to attain their dreams. I will notice everything about my child. I will take time to watch my child sleep, explore and discover. I will marvel at this miracle every day for the rest of my life. I will be happy when I wake in the middle of the night to the sound of my child, knowing that I can comfort, hold and feed him and that I am not waking to take another temperature, pop another pill, take another shot or cry tears of a broken dream. My dream will be crying for me. I count myself lucky in this sense; that God has given me this insight, this special vision with which I will look upon my child that my friends will not see.

Whether I parent a child I actually give birth to or a child that God leads me to, I will not be careless with my love. I will be a better mother for all that I have endured. I am a better wife, a better aunt, a better daughter, neighbor, friend and sister because I have known pain. I know disillusionment as I have been betrayed by my own body. I have been tried by fire and hell many never face, yet given time, I stood tall.

I have prevailed.

I have succeeded.

I have won.

So now, when others hurt around me, I do not run from their pain in order to save myself discomfort. I see it, mourn it, and join them in theirs. I listen. And even though I cannot make it better, I can make it less lonely. I have learned the immense power of another hand holding tight to mine, of other eyes that moisten as they learn to accept the harsh truth when life is beyond hard. I have learned a compassion that only comes with walking in those shoes. I have learned to appreciate life.

Yes I will be a wonderful mother.

~ Author Unknown ~

This touched me. With my first children I think I took many things for granted. They were all so small at the same time and I was so busy and overwhelmed. Some days I didn't even get my teeth brushed. Oh what I would give to go back and do it all again. To watch them sleep more often. To smell them, to nurse them just a bit longer. I long for one more chance, one more miracle.

What are the odds?

Q: What is the success rate for IUI?

I am so confused by this question! I can't seem to find an answer that makes sense! This is what I found...

A: Searching through about a dozen medical journal articles and a number of web sites resulted in a rather wide range of statistics. Basically the odds of success are reported to be just under 6 percent and as high as 26 percent per cycle. The low statistics are with one follicle, while multiple follicles resulted in as high 26 percent success. Another influencing factor is sperm count. Higher sperm counts increase the odds of success; however, there was little difference between success with good-average counts and those with high counts. The overall success rate seems to be between 15-20 percent per cycle, judging from the articles which will be abstracted below. The rate of multiple gestation pregnancies is 23-30 percent.

There is a 25% to 30% chance of conceiving in any given cycle without medical intervention.

So this is where I get lost. If my chances are 25-30% on a natural cycle, then why do they drop to possibly 6% with a IUI? I guess that factors infertility in... I'm confused. I just need to trust in God and forget about the numbers... it only takes one, right?!

Super Socks

I couldn't help but go to this site and look this up…
Due Date Calculator: Your baby will be born on or around
Tuesday, August 26, 2008. You are about 2 weeks pregnant.

Thank you Misty for wearing the super fertile socks! Keep them on for two weeks ok!?

Mission complete!

This was my Richard this morning!

The procedure went well. Rich and I met at 7:00am, (thanks Mom for keeping the kids!)collected the sample and then went for breakfast. The counts were 29% motility, 54% morphology with a total count of 19.4 million per ml. We returned to the office and waited for our turn. They called us back at about 9:20. The counts after the sperm prep were 43% motility, 65% morphology with a count of 30.2 million per ml. The doctor inserted a speculum, inserted the catheter with the sperm, injected it and then put a cap on my cervix. I laid there for 10 minutes and then we were on our way. He headed to work and so did I. We were out of there by 9:40.

I am so tired now, I don’t do 5am very well. I am planning on taking it easy tonight. I considered driving to Rich for one more BDing session, but decided that it would be better for me to just rest. It only takes ONE sperm, and right now there are 30 million swimming around up there. If God wants it to happen, it will happen. I am trying so very hard not to obsess this time. There is nothing I can do to change or control the situation, so I am trying to relax and give it to God. It is going to be brutal not to be able to test for 14 days! I was talking to a friend of mine today that is a surrogate and she was able to get a BFP 5 days after her transfer!!! 5 days is a bit more my style!!!! I go in for progesterone draw on Monday. I will post results as soon as I have them. Keep praying for us!!

Our Christmas IUI

The big day has finally arrived. I went today to have the follies measured and we have one mature follicle. There were several others, but they were not fully mature. So tomorrow at 7am I will meet Rich at the RE's office. We will collect the sample and then go for breakfast. We will return to the office at 9am and have the insemination done at 9:15. I will lay on the table for about 10 minutes after the procedure and then we will both be off to work! I will have a progesterone draw done one week from today. They wanted to do a blood test to check for pregnancy 2 weeks from tomorrow, but we will be in Jamaica! I hope they let you take pregnancy tests in your luggage!! I will be testing two weeks from tomorrow!!! I am nervous. I will update tomorrow with details!!

Inter-uterine Insemination

The day is drawing near for our impending IUI. We went ahead and did half of the dose of Clomid, and I will finish that tomorrow. I will start OPKs Friday and most likely have an ultra sound to check the follicles on Monday. If there are less than 4 developed follicles, we will go ahead with the HCG injection and have the IUI on Tues or Wed! The closer it gets, the more excited I am, but also the more nervous I get. The risk of multiples is actually higher with IUI than it is with IVF. I am so torn about my feelings of multiples. I have prayed so long and so hard for a child, I feel if God gives me three then I should be thankful because I wanted to be pregnant. However, I really want this pregnancy to enhance and enrich our current family and if Mommy got pregnant with 3 or 4 I just don't feel that would be best for our kids. I know it is a risk that you take when you are dealing with fertility treatments. At this point, I guess it is a risk that we are willing to take.

Rich did have his repeat sperm analysis and the results are below:
January sample:
Motility (how fast/straight) 50%
Morf (how normal of shape) 77%
Count 45 million

Early November sample:
Motility 31%
Morf 79%
Count 8 million

Repeat sample two weeks later:
Motility 50%
Morf 80%
Count 18.4 million

She said that they consider 20million a normal sample so the IUI is a very good thing to do for the next step. She said that for the IUI they will do a s/a before they "spin out" the bad guys and then another one on the sperm after the "spin out". I'm relieved that things look better.

So I will post with details of the IUI as it gets closer! I just can't believe that we are doing this!!!!

Here is some FAQ about IUI... http://www.fertilityplus.org/faq/iui.html

A few updates to report

Since the surgery there have been a few updates, but nothing to exciting. I did see a neurologist about me leg and I have Femoral Nerve Neuropathy. Basically that means that the nerve was damaged during the surgery. He was confident that it would continue to improve, and said that things should be back to normal in about 6 months or so. That is about what I had expected.

Rich and I went last week to have our ASA test done. Here is the technical information:
Anti-Sperm antibodies (ASA) is a test to assess the presence and level of antibodies against sperm components both in the male (direct IBT) and female (indirect IBT). These are two separate tests using two different specimens: semen from the male and blood or serum from the female. Both tests provide a reliable test to evaluate the cause and the reasons for infertility.
Clinical Significance and Test Methodology
For the male, the test is a direct immuno-bead assay that checks the presence of auto-antibodies directed to the sperm, including two Lg. classes: immunoglobulin G and immunoglobulin A. If excessive amounts of anti-bodies are bound to the surface of the sperm cell, they may mask receptors or other functionally important proteins, interfere with mobility and the sperm-egg interaction and thereby reduce the potential for successful fertilization. A positive test result may indicate of past exposure of the male reproductive system to his own immune system in the course of injury, inflammation or past vasectomy.
For the female, the test is an indirect immuno-bead assay and will measure antibodies to the sperm cells in the woman’s serum, including as above, Immunolglobulin A (or IgA) and Immunoglobulin G (or IgG). Such antibodies would interfere with the ability of the normal sperm to move up the female reproductive tract and fertilize the egg.
Our test came back negative, which is good. They did run a sperm analysis at that time and that was not so good news. Rich’s count was over 45 million in January, and last week it was 8 million. That is considered infertile. He has to go back in two weeks for a re-test. The RE still want to go ahead with the IUI in December. If do that it will be done in about 3 weeks. EEEEK!! I did ovulate on my own this month, so that was good to see. We will have to make a decision if we want to use Clomid next month to stimulate multiple follicles and produce multiple eggs. We’re not sure on that yet. Stay tuned, I will update more as information becomes available!

Hi all! Sorry for the delay in posting. I had my post-op appointment with the RE yesterday and I wanted to get a full report from her before posting. I went in for the lap Thursday morning. They took me back right around 10am. I was shaking I was so nervous. Rich and I were reciting bible verses and I kept humming hymns to try and calm my nerves. Once in the operating room they gave me some happy meds and then put me under with the gas. I was in surgery for two and a half hours, wolk up around 12:45 wanting my Richard. All I remember the RE saying was the word endometriosis. I came out of the anesthesia pretty good. Rich tried to explain what they found, but he was a bit unclear. All he knew for sure was endometriosis. Recovery was a lot harder than I had anticipated. I was totally dependant on Rich the whole weekend. I was in a lot of pain from the gas, and from all of the work they had to do internally. I had three abdominal incisions.

Official word from the RE is this: I had stage 4 (the most severe) endometriosis. I had lesions on my ovaries, my bladder, my bowel, and my uterus. My left ovary was fused to the back of my uterus, the broad ligament, meso salpinx, omentum, ovarian fossa and the utero sacral ligaments. I don't even know what half of those things are, but it sounds pretty messed up. The nurse explained that the left ovary was so distorted, that even though it was producing eggs, they were not going anywhere because the ovary was not connected to the fallopian tube. It would not have mattered how many times we babydanced, there would not have been a baby. There was so much work to be done to free that left ovary, that there may have been some damage to one of the nerves in my left leg. I have been experiencing numbness and pain in my left leg since the surgery. After meeting with her yesterday, she explained how fused that left ovary was and said that the work to free that may have done some damage to one of the nerves in my leg. She said if it was not improved in a week that I would need to go see a Neurologist. Great! Also, each month when the egg was released, there was toxic infection present from the lesions and the egg landed into the infection and was killed before fertilization was even possible. The RE was able to laser all endo areas away.

These are a few pictures of my insides. Cool huh? The top right shows a band of scarring going from top left to bottom right. My whole abdominal cavity was filled with these scar bands. In one of the pictures ( I didn't get that one), it looked like a large spiderweb with the scar bands going every which way. The RE lasered all of the scar tissue away.
The bottom left is one of my ovaries. You can see the dark spots on there, that is the endo that she lasered off. I'm guessing that this little ovary is my right one, because the left one was in bad shape.

So part of yesterday's appointment was to talk about what the next step is. She wants us to take two cycles off. :-( She said that there was so much work done inside, that she wants my body to have plenty of time to heal. In December, she recommends doing our first IUI (inter uterine insemination). When she did the after intercourse test several months ago, the test indicated that there were few sperm present and the ones that were there were slow and sluggish. By doing the IUI, you give the sperm a head-start by placing it directly into the uterus. This eliminates the journey of the sperm to try to swim through the cervical fluid, through the cervix and through the uterus and to the egg. With the IUI, the sperm is inserted with a cathater directly into the uterus. Now the sperm's only job is to swim to the egg!

I was not expecting this diagnosis. I was very surprised that I had endo at all, especially stage 4! It took a few days to sink in. I can't believe that we waited so long to seek medical help. If we would have done this years ago, we would probably have our child by now. There was no way that we were going to conceive without medical intervention. I just wish I would have pursued this years ago! I am happy that we had the surgery done. I am still in a bit of disbelief about the results. I had not expected something so severe. I am thankful for friends that prayed with us about the decision to go ahead with the surgery and I am thankful for a God that guides us every step of the way.

Please pray

After much prayer between Rich and I and much prayer from many friends, Rich and I have decided to go ahead with the Lap. I will have it done tomorrow at 10:00am. I would appreciate prayers. I will possibly have three procedures done... the lap, another hystosalapingography and a hystoscope. If she finds any blockages she will laser the scar tissue and if there are any polyps or cysts she will remove them. I will have to have a breathing tube and I have never had one of those. I think that is what I am the most nervous about. I hear that the gas that they extend your pelvic area with is the worst part. My doctor (I love her sooo much, she is just great!!) told me to expect three to five days for recovery. I have the rest of the week off and Rich is home to take over with the house and kids. I hope and pray that my recovery is quick! Please pray that all goes well and that all blockages/cysts/polyps will be able to be taken care of. I know that many of my wonderful friends will be praying for me, I will be thinking of that tomorrow. I will update as soon as I can manage to make it back on here!!

No magic

The was lots of magic at Walt Disney World but none in our room! Sharing a room with three kids and full days in the park leading to falling into bed at night from exhaustion did not leave much room for BDing! There was no magic going on there!

So AF showed up today, as I knew she would and now I would appreciate your prayers. Rich & I have to make a decision about having a lap done this cycle. If we go ahead, then we need to commit to another 6 months or so of TTC and we were supposed to be done at the end of this year. Studies show that if there is a 6 year or more difference between your youngest and your baby that the baby is raised as essentially an only child. That is not what we want for our family. Our kids are 10, 8, and 6, I just wonder if there is to much of an age difference. We want a sibling for our other children, not an only child. I am really, really struggling with this decision. I wonder if the scaring is God’s natural birth control… I just don’t know what to do. I would appreciate any prayers today. We have to let the clinic know what our decision is today.

We have been praying about this for a while, and I still don’t see a clear answer. Please pray for clarity for both of us so that we know that we are making a decision that will honor the Lord and will be the best decision for our family.

We could use a little magic!

I've been bad about keeping this up... I'll give you the short version of what has been going on in the TTC area of our lives. I did go for my cd14 u/s the Friday before our Recommitment Ceremony. There were four mature eggs, two on the good side, two on the bad side. I had the hcg shot to release the eggs and on my way I went.

We had our ceremony on Saturday and it was beautiful!

This is our prayer circle. We asked 6 couples to be our "sponsor couples". We asked them to pray for us continually, to counsel us when we need it, to hold us accountable and to participate in the ceremony. This is a wonderful group of friends that we both hold very close to our hearts. They mean so much to us and we love them a lot!

We went to a wonderful bed and breakfast afterwards. It was such a relaxing time! We had plenty of time to relax and enjoy each other.

Me in front of the B n B.

This is one of my favorite pictures.

My handsome Richard.

This is the B n B and the lake. This place was georgous and so relaxing. The food was out of this world. I have never had such delicious food. The inn keepers were wonderful Christian people. Here is a link... http://www.missionoakinn.com/ I highly reccomend this place!

Drew’s birthday was Sunday, and then we left for vacation on Monday. We had a really great time on vacation and I tried very hard not to worry about what may or may not be going on inside my body. I did things that I normally would not do because I would be worried that it would hinder implantation. I tried very hard to leave it in God’s hands and trust that if it was meant to be it would be. Many were praying that God would bless us with the extra special Recommitment baby.

I did not take a HPT last cycle because of the trigger shot. The trigger shot is a synthetic form of the hcg hormone that your body produces when you are pregnant. A HPT tests for the presence of the hcg hormone. So if you take a HPT after the trigger, chances are you will get two lines because the test will detect the hormones from the shot. So I did not test last cycle because I did not want to get a false positive.

I was not so strong this cycle. I could not shake my HPT addiction, and tested at 11dpo. I got a very, very, very faint second line. I called the RE and they said that the trigger hormone is usually out of your system at 11dpo, and they suggested having a beta blood draw. I cannot tell you how many times I have had the beta done and ever time it is a BFN. I just couldn’t face another phone call with bad news. I knew that it could be lingering trigger, so I opted to wait and see if AF showed over the weekend. My head knew it was the lingering trigger… my heart wanted this so bad! Sure enough AF showed on Sunday. On to another cycle.

I called the RE to report cd1, the start of a new cycle and they wanted to do the lap this month. I told them that we were leaving for vacation on the 1st, and they suggested waiting until next cycle because I would not be fully recovered and feeling like traveling by then. So they told me to continue the 100mg of Clomid this cycle and then I will have the cd21 progesterone draw done once we get back. I won’t be able to have the cd14 u/s or the trigger this month because I will be gone. Next month they want to do the lap. So that is where we are at this time. Rich and I need to make a decision if we are going to have the lap done or not. It is an expensive test ($6000) and there is about 3-4 days of recovery. Since we said that we were going to wave the white flag and admit defeat at the end of this year, that would only give us 2 cycles to try after the lap. It hardly seems worth it. So either we extend our time… again, or we don’t have the surgery and continue to do what we are doing for three more months.

Wow, that wasn't a very short version at all!! Well we are off for Disney World in a few days. I should ovulate while we are there. I have heard it is a magical place, we could use a little magic!

On your mark, get set, OPK

Nothing to exciting to update in the TTC world. I should be ovulating in the next several days. I will start OPKs today. Once I get a + OPK I go to Springfield for the u/s to see how many follicles I have. Then we will decide what the next step is. Rich was able to be home last night which was such a treat!! He was so funny! He would not BD, no matter what I tried! He said he wants to save all of the good sperm for ovulation! It’s so cute to me, because it shows me that he wants this just as bad as I do. He would pass up an opportunity to make love on a TUESDAY (which we never have the opportunity to do!!) for the sake of having a better chance of conceiving a child on Thursday!

We have a big week/weekend this week. We are busy preparing for our Renewal Ceremony on Saturday, Drew’s birthday on Sunday and our vacation starting Monday!!! It’s a busy time, but that keeps my mind off of TTC!! I will also be busy during the first part of the 2ww, and that is great too!!! That is the time that I tend to obsess and worry the most. I am looking forward to relaxing on vacation next week. I’m not sure if I will have internet access, so I will try to update before we leave!

My sitter cleaned a lot today, so we were able to enjoy a night out for a bike ride. The kids each took turns being first and getting to take us all anywhere they wanted. I was always last. As I was watching my three precious children in front of me, I was thinking of how glad I was that I had put the flags on their bikes. Before the flags, I would be afraid that they would be hard to spot and would get hit (I sometimes have very irrational fears). With the flags, I feel that they are "well marked" and easy to see, so I feel safer on bike rides. I was thinking tonight how I wish they could have "flags" in all areas of life. "Flags" that would set them apart and keep them safe, what a burden would be lifted if I didn't have to worry that my children would always be safe. I often forget that God loves them more than I do, I often forget that they are just on loan to me, and I very often forget not to worry, in general.

This picture is special (although not very clear, as I only had my cell phone to use). The kids are playing in the creek that I loved playing in as a kid. I even took my shoes off and got in and splashed around a bit with them! We had a good time tonight with some good family time. I thanked God for the patience I had with them, and for the special time we spent together.

We were watching home videos this weekend. It started with our wedding. That was so neat to see again. We hadn't watched it in a long time. The kids loved it. We also got out a movie that was Khloe's birth to her first birthday. It was amazing to see how much my girls have grown. I literally felt like I was watching someone else's life. I cannot believe how fast time flies. It was amazing to see myself, so calm and encouraging and confident in my mothering. I can't believe how different I am now. Life moves at such a fast pace these days. Back then, my one and only job was to be a mom and wife. All I had to worry about was making my family happy and being the best Mommy ever! I had a husband that was home every night, I cooked and cleaned and taught my girls their ABCs and so many songs that even I had forgotten. It was amazing to glimpse into that former life. It tore at my heart. It made me long for that even more. If I were to have another child, I would quit my job and be a stay at home mom again. I would love to quit my job tomorrow, and Rich always tells me to do it, but I just don't have the courage and can't quite justify it with three kids in school. If I had another child at home, I would get that life back. That Mommy life.

Growing up, if you were to ask me what I wanted to be when I grew up, my answer was always the same, a Mommy. Not a teacher or a nurse or a singer or a movie star, a Mommy. I lived my dream for a long time, and then Rich lost his job and I was forced back into the work field. Now I have been at my job for almost 4 years, and I just can't quit. I have the perfect hours, I drop the kids at school in the morning and pick them up in the afternoon, I make good money, I work with pretty good people, I am pretty much my own boss, it's a great job. I would give it up in a split second to stay home with my baby. I have told God this, and it is another thing that baffles me. Doesn't he want me to be able to stay at home?

Laparoscopy

How It Is Done
Laparoscopy is done by a surgeon or a doctor of women's health (gynecologist). General anesthesia is generally used, but other types of anesthesia, such as spinal anesthesia, may be used. Talk with your doctor about what choice is best for you.
About an hour before the surgery, you will empty your bladder. You will get fluids and medicine through an intravenous (IV) in a vein in your arm. You may get a medicine (sedative) to help you relax.
Several procedures may be done after you get your anesthesia and are relaxed or asleep.
An airway will be placed in your throat to help you breathe if you get general anesthesia.
A thin flexible tube (urinary catheter) may be put through your urethra into the bladder.
Some of your pubic hair may be shaved.
Your belly and pelvic area will be washed with a special soap.
Your doctor may do a pelvic exam before putting a thin tube (cannula) is put through your vagina into the uterus. The cannula lets your doctor move your uterus and ovaries to get a better look at the belly organs.
During laparoscopy, a small incision is made in the belly. More than one incision may be made if other tools will be used during the surgery. A hollow needle is put through the first incision and gas (carbon dioxide or nitrous oxide) is slowly put through the needle to inflate the belly. The gas lifts the abdominal wall away from the organs inside so your doctor can see clearly.
A thin, lighted tube (laparoscope) is then put through the incision to look at the organs. Other tools can be used to take tissue samples, fix damage, or drain cysts. A laser may be attached to the laparoscope to help with the surgery.
After the surgery, all the tools will be removed and the gas will be released. The incisions will be closed with stitches and covered with a bandage. The scar will be very small and will fade over time.
Laparoscopy takes 30 to 90 minutes, depending on what is done, but can take longer if a condition (such as endometriosis) is found and treated. After the laparoscopy, you will go to the recovery room for 2 to 4 hours. You can usually do your normal activities the next day, but do not do any strenuous activity or exercise for about a week.
How It Feels
If general anesthesia is used, you will be asleep and feel nothing. After you wake up, you will feel sleepy for several hours. You may be tired and have some pain for a few days after a laparoscopy. You may have a mild sore throat from the tube in your throat to help you breath. Use throat lozenges and gargle with warm salt water to help your sore throat.
If you have other types of anesthesia, you may have pain for a few days when the initial numbness wears off.

Update

I had the biopsy on Friday. Bloodwork was BFN, as expected. The biopsy was not as bad as I had thought overall. It hurt really bad for about a minute, and then a full night of cramps, but then AF showed, so the cramps all just blended together. The nurse was so companionate. I had told her that I was fearful, and asked that they cover the instruments so that I could not see them. They had everything covered when I got there and she held my hands through the tough part. She was a big comfort. The doctor too was very gentle and told me what to expect each step of the way. After she was done I went to get up and she told me to lay there and rest and relax for a few minutes. She applied some pressure to stop the bleeding and while we were waiting, we talked about the next cycle. She wants me to have a laparoscopy done to check out that right tube and see if it is indeed blocked. I will include info on exactly what that is. She cannot do it this coming cycle, so she wants to do a treatment cycle for August. We will know biopsy results next week sometime.

So this is the plan. She gave me a script for 100mg of Clomid to take cycle day 5-9. I believe she is doing this to hyper stimulate my ovaries to produce multiple eggs, because I Oed on my own this past cycle. I will go in for an ultra sound on the day of a + OPK. If I am developing follicles on only the right side we will then just BD when the days are right and nothing more. This is because that tube is probably blocked and the fertilized egg most likely won't make it to the uterus to find a home and grow. If I have follicles on both sides, we will have to decide if we want to do an IUI or not. If the follicles are only on the left side, I think we will probably do our first IUI. Then we will plan the laparoscopy for September if the need be. Our timing is good next month because Rich will be home just at the right time and we are taking a vacation at that time too, so we will be able to be together as much as we want/need to! This visit was probably the most uplifting one that I have had. I had such a tough week, and it was good to feel the RE's optimism!

My mood has improved. AF is here, but that just means that we can go onto the next cycle. I'm dealing with that! I have some spiritual thoughts, but I will share them later this week. Rich is home and we are going to spend our evening together.

So still to come this week (for your info as well as so I don't forget what I still need to share!) I will share the conversation that Rich and I had regarding trusting the Lord vs questioning the Lord and I will also share about our home movie marathon this weekend! Stay tuned!

Waiting... still

These are a pair of hammocks waiting for me...

So the title of my blog is Waiting for His glory to be revealed. Well I'm just about tired of waiting. Today has been a terrible day. I am PMSing, feeling sorry for myself, being jelous, being short tempered, fed up, feeling hopeless and not feeling much like a good christian at all. I am feeling like giving up. Giving up on it all. And I would. Today has been an overwhelming day, and I am convinced that the only thing that has kept me here is God himself. Have you ever had one of those days? One of those days that you just cannot tolerate one more minute of your own life? I have never came to a point in my life that I have felt that way, but I got there today. Outsiders looking in will say 'but you have so much to be thankful for, you have such a wonderful family and husband and house and cars and blah blah blah'. But I feel like I am failing at every single thing in my life, and I don't see a way out. I have been WAITING and PRAYING and I still suck!

Another friend of mine found out that she is pregnant today. She and I were on the same cycle. She had and IUI and a trigger shot the day before I did at the same RE. So we have been in this 2ww together and going through symptoms together, and today she got her beta #s back, 202. Those are very good numbers. She may be having twins. I cheered her on every step of the way through this 2ww. Then today when she told me she was pregnant I was so happy for her... for about three seconds and then I just sobbed. I sobbed and I couldn't stop. The jelousy and the envy... oh it is terrible. I don't want to do that!!! I don't want to be jelous of the babies that others have!!! I truly am so happy for her and her husband. I have been praying for them for such a long time! So why does the big green monster of envy have to pop out?

My house is a total mess. My yard is about 14 inches high, and weeds have long since taken over my flower gardens. My pool is green, my van is broken. My husband's taxes for 2006 are not paid. I snapped at my kids, AGAIN! I did not read the bedtime story or say bedtime prayers. They had microwave meals for dinner. I'm not pregnant. and I don't know where to start to climb out of all of this. I just want to sit and watch the world go by and do nothing and say nothing. Just take me to heaven and make me an angel or something because I am sucking at being a mortal. That's not normal is it?

I was thinking today that I am tired of waiting. I am tired of waiting for a child, I am tired of waiting to have patience with my kids, I am tired of waiting to be the perfect wife, I am tired of waiting to feel better, to have more energy. I am tired of working and coming home to a whole other job to start for the day. I'm sure that God is so not happy with me right now. I went to a friend's blog, and she too was having a bad day. So I looked up some verses to share with her that I knew I needed to hear today too. This is what I found... it may be a bit messed up because I cut and pasted and had to edit a bit...


Psalm 27:14Wait for the LORD; be strong and take heart and wait for the LORD.
Psalm 27:13-14We wait in hope for the LORD; he is our help and our shield.
Psalm 33:19-21Be still before the LORD and wait patiently for him; do not fret when men succeed in their ways, when they carry out their wicked schemes.
Psalm 37:6-8 Wait for the LORD and keep his way. He will exalt you to inherit the land; when the wicked are cut off, you will see it.
Psalm 37:33-35 I wait for you, O LORD; you will answer, O Lord my God.
Psalm 38:14-16 I waited patiently for the LORD; he turned to me and heard my cry.
Psalm 40:1-3 See how they lie in wait for me! Fierce men conspire against me for no offense or sin of mine, O LORD.
Psalm 59:2-4 I wait for your salvation, O LORD, and I follow your commands.
Psalm 119:165-167 I wait for the LORD, my soul waits, and in his word I put my hope.
Psalm 130:4-6 My soul waits for the Lord more than watchmen wait for the morning, more than watchmen wait for the morning.


So what else is there to do but wait? I'm tired of waiting. I'm tired of praying to God and straing to hear his answer and hearing nothing. I'm tired of wondering what in the world he is doing with my life. Why has he made me this way? Why do I fail him so much? Why can't he just FIX ME? I feel like I am constantly arguing with myself inside of my own head. The battle of good and evil. "think positive, pray about it, take your troubles to the Lord" "forget it! You have done this for so long and what do you have? No baby, no peace, no patience with your kids, no organization in your life, you suck, you fail, give it up!" I don't know what else to do. For tonight I am going to take a shower and then look up all of these verses. I can't hear God, so I guess I will just read his word.


PS~ Pregnancy blood test tomorrow, it will be negative (I took a hpt tonight and BFN) so then I will go for the biopsy at 3pm. I'll let you know how that goes and what we decide to do from here...

Wishing

I love the book of 1 Peter. That is where my title verse comes from, and I like this verse as well...
1 Peter 5-10 And the God of all grace, who called you to his eternal glory in Christ, after you have suffered a little while, will himself restore you and make you strong, firm and steadfast.

I think that gives hope to all who are suffering, or have suffered, no matter what the issue. That promise that we will all be restored because He is our savior. He is the God of Grace. We will be strong, firm and steadfast. I can't wait!

I received my progesterone levels back. 12.8, this indicates that I did ovulate, but it is not high enough to indicate pregnancy. I need to look on the positive side and be thankful that I did ovulate on my own without medication, well, a little dose of hormone to help the egg release, but no Clomid.

I have felt crampy, I guess AF is on her way. This is a big let down. I just can’t put into words how badly I wanted this to work. The kids are getting older, Rich and I are getting older, and I just want this to happen so badly before we run out of time.

I will keep you posted on the biopsy. Hopefully I won’t have to have it done!

PS~ The picture above is where I wish I was. Those chairs are just waiting for Rich and I!!!

Nothing new to report. I am 9dpo (9 days past ovulation) and nothing much going on. I usually start to take HPTs at about 8 or 9 dpo, and then drive myself crazy testing until AF showes up. Well since I had the trigger, I cannot test. The trigger is a synthetic HCG hormone, and HCG is what is detected on a HPT, so if I was pregnant or if I was not, the HPT would detect the trigger and I would get a positive result. So no testing for me!

I am not having any symptoms, just mostly PMS symptoms. I'm thinnking that I may start AF sometime in the next few days. If I do I don't think that I can have the biopsy. I think that has to be done before AF. So I guess God will answer that prayer in his own way!

I have the blood test to detect pregnancy scheduled for Friday morning. We should have results by Friday afternoon. If AF showes up before then, obviously I don't have to do the blood test.

I will be sure to keep you posted! Continue to keep us in your prayers.

Finally, the egg has hatched

I went to the RE yesterday for my second u/s this week. My folicle Tues was 15mm, today it was 21mm so they gave me a trigger shot of HSG hormone in the hip (ouch!) and said to BD Friday, Saturday and Sunday. I am so glad that this cycle wasn't a bust!!! I have my beta (blood test for pregnancy) the 20th and if it is negative I have to have the uterine biopsy which I do not want to have!! I was telling God that he could answer two prayers at once if he would give us our baby this month. 1st, a baby and 2nd, no biopsy!! Rich said that he doesn't think God is into bargins!

I got a positive ovulation test last night and my much anticipated temp spike this morning meaning that I ovulated last night on cycle day 19. I have never taken that long to ovulate! Let's hope that my body took so long because it was growing a strong healthy egg!!!!!

I'm hopeful that this month is the month!!! If we did get pregnant in the next few days our due date would be on or around March 29th, 2008. That is close to Khloe's birthday, so it must have been this time 8 years ago that we got pregnant with her!

Morning all. I have not had such a wonderful day so far today. My best friend called me bright and early to tell me that she got her BFP today with her surrogate child. I knew this was coming, but it doesn't make it any easier. It was so hard to hear that she has gotten a BFP and it isn't even her child. She went in for IVF, and *poof* she's pregnant! I've tried for 4 1/2 years and nothing. It hurts bad. I am not looking forward to listening to her complain for the next nine months. I just feel like telling her that I don't want to hear about it at all. I don't want to hear the complaints of morning sickness, I don't want to hear the complaints about the shots, I don't want to hear about the kicking and how her clothes don't fit and how she found the cutest maternity top! *sigh* I'm not being very nice am I? She is my friend and I talk to her at least twice every day. It is inevitable that I am going to hear all of this stuff... I just hope that God gives me the grace and patients to deal with it for the next nine months.

To top off the good news, I still haven’t Oed. Cd18… no O. Rich is HOME, we can BD whenever we want/need to and no O in sight. This has never happened. I go for another u/s tomorrow. I don’t know why, if I haven’t Oed there is nothing they can do about it. I’m just about ready to throw in the towel and admit defeat. This TTC rollercoaster is a bit to much for me, and I’m thinking I may just be done with the ride.

Pray for wisdom, please.

First cd14 U/S

Hey all! I just got done at the RE’s office. No temp spike yet, no + OPK, but they said they need to see me by cd15, and I am cd16 today so I had to go in. She did the u/s and looked at my ovaries and checked the follicles in each ovary. She said that perhaps I had Oed last night or this morning, but she was unsure. She did a progesterone blood draw and that will tell us if I did or not. I will have the results after 1 today. She also did and after intercourse test and said it looked “okay”. Not great, but not to bad. She said my lining looks good. If the progesterone blood draw comes back negative, I have to go back on Friday (for another $300 appointment, ugh!). I’ll let you know when I hear what the progesterone is. I don’t think I have Oed, so I expect a negative.