On Tap For This Week

I have been on basically the same meds for awhile now. Lupron, aspirin, and prenatals everyday, delestrogen Mondays and Fridays. My med schedule is about to get a bit of a shake up later this week.

Tomorrow is my last Lupron shot (only two of these left!). Wednesday night I will be starting PIO (progesterone in oil). While the Lupron was to keep my body from ovulating, the progesterone is to make my body think I did ovulate so it’s ready to accept the embryo. Those are also hip/IM injections like the delestrogen, but these will be every night.

I go in for a blood test on Thursday morning to check my estrogen and progesterone levels. As long as that all looks good I will continue the PIO and start Doxycycline and Medrol that evening (an antibiotic and a steroid). I will continue those two meds in the morning and evening through the day of the transfer. The delestrogen will continue on Mondays and Fridays. The aspirin and prenatals will still be taken everyday.

I’m a little nervous about the PIO because it can be more painful to inject and cause knots to develop. I think it has more to do with the fact that you do them every night instead of twice a week like the delestrogen. Repeatedly injecting the same place, even with rotating sides, is bound to make the area sore. I was trying to think about how I will do them when I have to do PIO and delestrogen on the same night. I think I will do them on opposite sides and have the delestrogen go on the side the PIO was the night before so that I don’t do PIO in the same side two days in a row. Keeping track of all that may be a hassle and I will not be surprised if I mess it up LOL

That’s where we’re at this week. I’m so excited to be moving on to the next meds even if I’m a little nervous about the PIO.

I haven’t heard anything about travel plans yet. I’m not sure if our coordinator at the agency will book soon or wait until after the blood test on Thursday. I’m okay either way, although it would make it easier with more notice. I totally understand wanting to wait until we’re for sure going in next Tuesday before booking. Otherwise you’re out the airfare money for two people.

I was trying to think if anything could pop up on the blood test on Thursday that would cause them to cancel the cycle. The only thing I could think of would be if my levels show that I ovulated. When I was in for the lining check on Friday my ovaries were nice and quiet with no signs of my body wanting to ovulate. I’m still taking the Lupron so I really can’t imagine something changing between now and then. Other than that, if either hormone level isn’t where they want it to be they would just adjust the dosage. I’m feeling pretty confident that we will get the go ahead to show up for transfer, but I will be holding my breath until the embryo is transferred and then again until the Beta test (blood pregnancy test) then again until heartbeat confirmation….basically I don’t relax a little until I can feel the baby moving LOL At least I know that about myself and am prepared to deal with it. It’s my type A personality that struggles with the unknowns. Again, choosing to be cautiously optimistic that we will get to transfer next week!

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We’re a Go!

Yesterday I received the med calendar for this transfer cycle. I start my meds on Monday (8/19) eek!! I was laying in bed freaking out about the fact that I have two intramuscular injections this time and that my husband won’t always be around to do them for me. The more I thought about it the more I came to the conclusion that I won’t be able to do them myself…enter my backup plan LOL She’s a friend/coworker who lives just a couple minutes from me and she’s already agreed (in fact I think she’s looking forward to it) to come help me when I need it 🙂

The format of this calendar is not one I’m used to so it seemed a bit overwhelming. Aside from a difference in medication protocol from my previous clinic, I will be only having one lining check and it will be at the clinic itself. The last time I had a baseline ultrasound a few days into my period (and actually a second baseline about a week later) to make sure my lining was thin. Then two more ultrasounds to make sure it was getting thicker. This time I only have one on 9/13 to make sure it’s thickening. It is nice to not have to go in so many times, but this one ultrasound will require a 30min flight to Portland, a 45min train ride, and a 30min flight home. That sounds like a lot, but honestly it’s easier to do that for just one day than to have 3 or 4 different mornings that I have to try to get into the imaging clinic and have the husband go into work late so he can stay with the kids because I go in before they’re awake. This way it’s just one day that he has to do that and I actually should be able to be home in time to pick up the kids. Benefits of a close clinic!

I’ll post pictures of the calendar, but they’ll be hard to read because there is so much information. On Monday I will start taking Lupron (which suppresses the ovaries as we don’t want me trying to ovulate), baby aspirin (I believe this is to help with blood flow to the uterus, although I’m unsure why I would need to start it before my next period), and Doxycycline (this is an antibiotic to make sure my uterus is nice and clean LOL I’ll actually start another round of it just before the transfer). I take my last BCP (birth control pill) on 8/23 which should start a period. I’ll have a blood test then continue w/ the same meds (Doxycycline ends on 8/28) until 9/2 when I start the estrogen injections that are meant to thicken my lining. I do those twice a week, Mon & Fri. Those I will continue until around 10 weeks of pregnancy if the transfer sticks or until a negative Beta test (blood pregnancy test).

On 9/13 I go to ORM for the lining check ultrasound and another blood test. If my lining is thickening appropriately I’ll continue meds. If it’s not then we’ll come up with a plan. There are a lot of old wives tales out there among IVF patients about how to help your lining thicken. The only two I do are drinking pomegranate juice. There’s not scientific evidence that this helps, but it’s full of antioxidants and is supposed to be an anti-inflammatory. I did it last time and I’ll do it again, if nothing else it tastes pretty good (I dilute it with some water though otherwise it’s pretty strong). I’ll drink it from around CD 1 until the lining check on 9/13. I also do a couple yoga poses that are supposed to help with blood flow to the uterus. I came across this website during my last journey and the poses were easy enough so I decided to give it a shot. The one I did the most was the feet up on the wall pose. I would lay there for 5-10 minutes. It was nice to take a minute and relax and feel like I was doing something to help my lining. GC’s don’t have a lot of control over whether their bodies cooperate or not so it feels good to be maybe helping a little.

If the lining check goes well on 9/13 I will start progesterone injections on 9/18. These are also intramuscular injections so on Mondays and Fridays I will be getting two shots in the backside. These PIO (progesterone in oil) injections are to trick my body into thinking it ovulated so it’s ready to accept an embryo. We’ll fly up to ORM and have the transfer on 9/24 then I’ll be on strict bed rest for the rest of the day after the transfer and the next day. That means I will be in the hotel bed with just my shoulders propped up for what will seem like a long time LOL It will be a great time to catch up shows and just hang out with the husband sans kiddos (we don’t get to do that very often at all).

If all goes well (there are so many checkpoints that have to be passed) 9 days after the transfer (10/3) I will go in for a Beta test. This is a blood test where they test for HCG, which it the hormone present when you’re pregnant (that’s what at home pregnancy pick up in urine). If that’s positive I go again on 10/7 and 10/9 for the same tests. The number should be double every 48 hours to indicate a healthy pregnancy. If the test is negative it’s likely that I would stop all medications and wait for CD1 (when a period starts). Then we would try again with a transfer date either late December or early January. It takes a lot of effort and energy to even make it to transfer so of course everyone always wants it to work the first time. That’s not always the case. I’m usually a realist and tend to say “if” instead of “when”, but I’m trying to be more of an optimist. Obviously I know the possible outcomes, but why not just put the good vibes out there? So while I’m cautiously optimistic, I am being optimistic.

Let’s do this!

Ba da bing ba da boom!

Remember a few weeks ago when things were taking forever and I was writing post that barely had any updates to them? Yeah, well now things are moving so quickly I haven’t been able to keep up, which is great!

I had to go back and look where I left off last time because we’ve had so much going on in just the last week. Last Friday the husband and I had our first psych evaluation. It was basically just her reading back her previous report from 2 years ago, making sure it was all still correct and making some updates. I think my husband said literally 2 words…actually I think it was the same word twice haha!

A and O had already had their meeting the day before so all we needed to do for psych clearance was do the group session. Her assistant was Johnny on the spot with getting it scheduled and we were able to do it Tuesday afternoon. Also kudos to the IFs for responding to her emails so quickly that we were able to make the appointment before the end of business on Friday since Monday was a US holiday.

We completed the group session with no hiccups. I honestly hate those appointments because I get put on the spot with having to answer a question that I have literally never given a thought to. She asked what went well in my last journey and what would I have liked to change or what would I like to do differently. Um…I don’t know. Most of the things that changed were things that my previous IFs did or didn’t do that I didn’t even realize I had a preference on. Most of the things that “changed” were just matching preferences because I didn’t realized I had a preference before. So I answered like that, but then she asked for more detail about the pregnancy and stuff and I started rambling like I do sometimes LOL I was going on about how I like that they trusted me enough to not micromanage me because I’m pretty independent and obviously know how to grow babies (smacks head, no shit). Then I tried to backtrack saying that I always welcome parent involvement however/whenever they want (which I absolutely do) and that I certainly don’t get a micromanage vibes from them so I’m sure we’ll be just fine. Overall I hated my answer and like I do, replayed about a hundred better ways I could have handled that LOL I do no do well thinking on my feet like that. I need to process the question and think about an answer otherwise I ramble out some nonsense. Oh-well I guess, I haven’t gotten an email saying that they want to back out so I think we’re okay haha!

On Wednesday I emailed the fertility clinic to let them know that is was CD (cycle day) 1. Medical screening appointments are almost always scheduled on certain cycle days so I wanted to make sure we didn’t miss this month’s window and have to wait until next month. I didn’t hear back that day so I sent an email to another contact at the clinic because, again, I didn’t want to miss this cycle’s window. The coordinator at the clinic called me yesterday and we were able to get the medical screening appointment set up for next Tuesday. So in a week and a half we’re going to have had all 3 psych appointments and the medical screening appointment. It’s going to be great to have all this checked off the list.

The medical screening appointments always make me a little nervous. A lot of what ifs run through my head until the clearance comes through (around 2 weeks after the appointment). What if there’s something going on in my uterus I didn’t know about? GCs had polyps found all the time during screening and have to have them removed before they move forward. My thyroid levels are always on the back of my mind because I’ve always been told I have a large thyroid. Every doctor I’ve ever seen comments on it (thanks for that insecurity everyone). I’ve had tests run, ultrasounds on it, and the like, but it’s always been just fine. I mean the tested it with this last surrogacy and my numbers weren’t wonky. There’s just always the worry that something has changed and I just don’t know about it yet. I will be more than happy when the appointment is over and the final blood test results are in. I’m choosing to be optimistic that everything will be just fine.

Upside to this go around is that the clinic is only a 40min flight from here so I can fly up in the morning and home in the afternoon. This makes it much easier on my husband with kids needing to be dropped off and picked up. Other upsides is that it saves IFs some money because I don’t need a hotel and I was able to schedule it on a day I already have off so no lost wages to cover, just a small amount for an extra day of daycare for one kid. My oldest is still in school for a bit longer so we don’t have to have childcare for him.

If all goes well we should be able to start legal before the end of June. I’m thinking September is a more realistic goal for a transfer which would be fine. There’s never going to be a perfect time to be due and when we (the husband and I) decided to start this journey earlier than we originally planned we knew that we may have to rearrange plans or not be able to do everything we normally do. We’ll just wait and see how it plays out. If they make me do a mock cycle (which I personally think are dumb, for lack of a more politically correct term) then it will push it back further. There’s no use in planning everything out because there will be changes and set backs and you just have to roll with them.

I’m excited to have things moving along so quickly and hopefully they continue to do so. Fingers crossed for on time flights and a smooth appointment on Tuesday!

Happy Weekend!

1st Psych Eval Scheduled

The counselor’s office contacted me via email yesterday and I was able to set up the first evaluation appointment for Friday morning. This appointment is done via Skype and is just the hubs and I. The next one will be all four of us. I was right in thinking this is the same person who did the eval last time. She personally sent me a quick note to say that since I did an eval 2 years ago that this appointment should just be about 15 minutes as we just need to update my previous record. Luckily the hubs and I both already took Friday off because we’re leaving for the coast that day so we don’t have to take any extra time off work for this appointment.

I’ve been trying to get an answer as to whether the fertility clinic requires psych clearance to be completed before they will schedule for the medical clearance, but my case manager hasn’t gotten an answer from them yet. I went ahead and emailed them myself using the email on their website. I doubt I’ll get an answer any faster than our CM, but it’s not going to hurt so why not. I don’t have a problem being proactive in getting things done, at least in the surrogacy process.

In other news I’ve been emailing back and forth with A and O getting to know them a bit which has been great. One thing I like about the agency we’re with is that they give our email addresses right after matching so IPs and GCs can start working on building a relationship right away. Other agencies make you communicate through them until after medical clearance or even after contracts. That would be so awkward! Every time you wanted to send IPs an email you would have to email it to the case manager who would then read it and forward it to IPs. Um…no thanks LOL I’m an adult and don’t need anyone screening my emails.

The agency also conducted a review of my insurance to see if it will cover a surrogate pregnancy. Apparently they have a “clear exclusion” which I though was interesting considering this is the same insurance plan that covered my previous surro pregnancy unprompted. IFs had purchased a surro friendly plan through the same company I have my regular insurance. The pregnancy stuff was only billed to the surro friendly plan. A few months in we got notice that my regular insurance was picking up a bunch of the bills. Since they were both through the same company they had caught that I had two insurances with them and both of them paid on the bills…who knows, insurance here is confusing AF. Since they already thought IFs would need to purchase a new plan for me my insurance coming up with an exclusion doesn’t mean anything in terms of moving forward. It was more just me trying to help out IFs to save them a little bit of $.

Next update when I have more info!

Guess What’s Happening Friday!

I haven’t mentioned that we started a new cycle yet because I didn’t want to jinx us LOL

My last update left off with me taking medication to induce more bleeding to thin my endometrial lining some more. I took the last dose on a Friday evening. It was supposed to take 5-7 days to have more bleeding. By Monday I had started spotting. Tuesday there was more, heavier spotting. I thought for sure I’d wake up Wednesday to a regular period. Wrong, it completely stopped. I was so disappointed and frustrated. I figured the 5-7 days hadn’t passed yet so I’d just have to wait.

Thursday afternoon I decided to update my nurse coordinator at the clinic. She wrote back about 5pm that the heavy spotting I had could be all the bleeding I would have and the only way to know would be to go in for an ultrasound the next morning to see. She let me know that if we decided to start it would put me at a transfer date of 12/22 and wanted to know if we could make that work. I was absolutely shocked that transferring before Christmas was even was an option. I had just assumed that the earliest it would be was the end of December/beginning of January. Nope!

I of course said we could make it work and after some stressful back and forth with the imaging place and the fertility clinic between 5:15-5:45 I got scheduled for an ultrasound Friday morning.

Friday morning I went in and my lining was 4.6mm. That’s kind of borderline for going forward. Some clinics want under 5mm some under 4mm so I just had to wait. I got an email in the later afternoon saying that we were okay to move forward.

On Friday I had woken up to an email from B & R as we typically email at least once a week. This one mentioned that B is taking a trip to visit family for Christmas and was leaving on 12/21. I didn’t reply right away because I knew they had wanted to attend the transfer and obviously the timing would throw a wrench in their plans. I didn’t want to stress them out or worry then unnecessarily if we didn’t get the green light to go ahead. Once I got the green light I sent them an email and let them know what had transpired. The problem is by the time I get the results it’s the middle of the night for them so they have to wait until morning to get any new information. I let them know that we were more than happy to make the 12/22 date work, but if they really wanted to attend we could wait and do a cycle in January. I only wanted to go with 12/22 if they wanted to. They emailed me back later saying that they’d love to go with the 12/22 date if we were okay with then not being there. Its a bummer they’ll miss it, but none of us want to wait unless we have to.

I had another ultrasound on 12/12 to make sure my lining was increasing and it measured 10.6mm (it went up 6mm in 4 days!) I was a little worried it was moving too fast, but the clinic said it looked great. My last ultrasound was on 12/15 and my lining had gone down to 9mm. I thought for sure we’d have to cancel the cycle since it had dropped, but I also knew that usually they only want it above 7 or 8mm so it was still good from that standpoint. I worried all day, but got an email around 3pm saying everything looked great and we were good to go with the transfer (pending a blood test on 12/19) on Friday!!

Last night was the last injection of Lupron

In a bit when we get home it will be time to start progesterone injections. These are ones that go in my backside 😏 wish me luck!!

Slightly Intimidating

My box of medications arrived today. I knew there were a lot and that there would be a huge stash of syringes, but when the box showed up at the office today the size of it was still slightly intimidating 😲

After unloading it it’s actually less medication than I thought, the syringes took up half the box by themselves.

Injections start Saturday, wish me luck!

Transfer is Scheduled!

This is going to be lengthy so if you’re looking for the short version here you go:

Our embryo transfer is scheduled for December 14 at 11:45am!!

Now here’s the long version….

After we signed our contracts on Wednesday Nov. 1st, a form stating that we now have legal clearance was sent to the fertility clinic. I knew it would likely take a few days to hear from them and get the ball rolling with a medication schedule. I still hadn’t heard anything by Monday so in the afternoon I emailed the assistant I had previously been in contact with. She said that she had not received the clearance yet and when they did a new contact would email me. I wanted to get things going so I had S & R’s lawyer send the clearance directly to the assistant.

So Tuesday I still hadn’t heard anything so I emailed the new contact person to make sure she got the clearance. She emailed me back rather quickly with some questions. I emailed her right back then silence. After another email she replied. As the day went on it seemed like she only ever responded to every other email. It was weird and obnoxious.

The other really obnoxious thing is that there is apparently no communication between the staff at the clinic. They either don’t make notes about conversations with patients or they don’t read them. This has been the case since I first started working with them.
Back in August when I went down there for medical screening the assistant told me afterwards to stay only on active birth control pills (BCPs) so that once we had legal clearance we could start the cycle whenever we wanted. Fast forward to my conversation last week with the newest contact (who is the 4th person I’ve had as a “case manager” there) she is acting like I’m supposed to have been taking BCPs as normal including the placebo pills so that I’m still regularly getting my period. She then goes silent for awhile until I email her again asking her if I’m supposed to be stopping BCPs or staying on them. She finally gets back to me saying that the doctor now wants me to do a mock cycle so we can see how my endometrial lining (uterine lining) responds to the IVF meds. Basically you do all the work of a regular cycle, meds, blood draws, and ultrasounds, but you don’t do an embryo transfer at the end.

Now, when I was there in August the doctor who did my screening said that a mock cycle wouldn’t be necessary because my lining looked good that day. You can imagine my frustration that the other doctor in the practice (the owner as well) comes back several months later when we’re ready to transfer saying we need a mock cycle. Not only that, but as much as I can tell it’s only because I’ve been on active BCPs for so long PER THEIR INSTRUCTIONS!

So case manager #4 tells me that case manager #5 will be in contact soon to set up the mock cycle…grrrr

I hadn’t heard from #5 by the next afternoon (Thursday) so I emailed her to see if I should be staying on BCPs or not. I wanted to get this all sorted out before the weekend. She got back to me saying she was “just going to contact me” yeah, right…She asked me a few question about my schedule this month which I answered right away.

Out of the blue later she sent me an email that since we already have contracts done we’re going to go ahead and just proceed with a regular IVF cycle and as long as all my test results look good we can go ahead and transfer at the end of the cycle. Wait, what?? I was so confused, but so happy that we’d still be able to transfer next month. I don’t know what went on at the clinic to warrant the change or if my case manager at the agency said something that changed their minds. Whatever happened, I’m just so glad that we have a chance of being able to transfer next month.

#5 referred me back to #4 and I was completely prepared to have to wait until after the weekend to get a med schedule, but surprisingly #4 emailed me on Friday evening with a schedule from here until the anticipated date of 12/14.

I have my first blood draw tomorrow morning and I start injections in 1 week! I can’t believe we’re actually starting to prepare for a transfer. It’s no longer some way out there vague goal, it’s actually here! I would be lying if I said I wasn’t nervous. There’s a lot of pressure for my body to do what it’s supposed to, especially since now we’re skipping the mock cycle. While I had no desire to do one, I’m stressed that they thought I needed one and now we’re not doing it. I just keep telling myself that this is just like a mock cycle except with the option to transfer at the end LOL

So keep all your fingers crossed and send lots of good vibes that everything goes like it should and we can transfer one beautiful girl embryo next month…oh did I not mention that R & B have decided that they want to transfer a girl? Isn’t it crazy that they can decide?

All right, let’s do this!

 

Officially Medically Cleared!

I just realized that I never wrote a post about getting my medical clearance… oops!! Last Monday I emailed my nurse at the clinic to see if I was okay to donate blood or if I should wait. I got an automatic reply that said she was out of the office until the next day. Fairly early on Tuesday she sent me an email letting me know that I could go ahead and donate and that they had received my medical clearance!!! Woohoo! It was such a weight off my shoulders to read that! I’ve been worried that something would show up on the blood work and I wouldn’t be able to continue. Fortunately everything looked good!

So now that’s behind me and we’re moving onto the legal/contract stage. While we’re in this phase B & R are going to plan a visit to Bend to meet all of us in person! I’m so excited to meet them face to face. They’re going to be coming up with some dates that work for them and we’ll see which ones work for us.

I have selected a lawyer to represent me in the contract process. I spoke with him on the phone last Friday and he seemed like a really nice guy who will make sure I get a contract I’m comfortable with. For those who don’t know it’s very important that the GC (gestational carrier) have a lawyer separate from that of the IPs. It’s to make sure that her interests are represented and that the agreement does not take advantage of the GC. This lawyer is paid for by the IPs, but they are not the client. Last week I spoke with K (case manager at my agency) about a few contract points just to make sure that we’re all on the same page before the contract is drafted. I thought that might help minimize the back and forth with the contract. I don’t really foresee us running into any issues that will make this process longer just because we had to talk about the major things (how many embryos to transfer, termination, IP involvement, etc) before we matched and again during the psych screening. Also the compensation is set by the agency as long as other fees so there’s not really anything to negotiate there. I think it will mostly be clarification in language and that kind of thing.

I’m hoping we can get this busted out by October so I can get on meds and transfer before November 10th. If we can’t, I’ll ask if we can wait unyil mid December to transfer due to us having a very busy August next summer. Fingers crossed we get this done quickly!