Friday, November 30, 2012

Lining Check Update

Whoops, I never updated my blog after my lining check.  I'm actually not THAT tardy, because I didn't get the results until yesterday afternoon.  The monitoring clinic had faxed over results early on Wednesday, but they were apparently the results from my appointment last week.  By the time the coordinator in Chicago realized it, the local clinic was closed for the day.  After calling and faxing them twice each yesterday with no results, the coordinator ended up coming to me for help.  I got on the phone and had to get a bit bossy with the poor receptionist who tried to "take a message for someone to call me back."  But at least it worked, half an hour later I got a call from the coordinator that she had finally received them.

My lining was looking great, already up to 9.4 (8+ is considered transfer ready).  My estridiol level was at 283.  This number means nothing to me, but I figure I'll post it here for future reference.  Anyway, she said my numbers were really good and to continue my schedule as planned - no extra boost needed.

My next lining check is on Tuesday.  I haven't heard any updates on the donor yet, I'm not sure when her follicle check was scheduled.

In other news, we got approved for the backup insurance policy and life insurance policy we applied for.  The backup insurance is in case my insurance company (which does not have a surrogacy exclusion) finds out that this pregnancy is a surrogacy and decides they don't feel like covering it after all.  In addition, my IPs have purchased a life insurance policy for my family's protection should I die as a result of this pregnancy or delivery.  It's morbid to think about, but hey, it happens.  And it's comforting to know that my family will be taken care of at least monetarily if they lose their wife/mother.

Tuesday, November 27, 2012

Checking In

I don't really have too much to update, but I'm getting excited that transfer is right around the corner now!

I have been on the estrogen patches for a week now.  I haven't really noticed any huge side affects from the meds.  The headaches and weird sleep patterns seem to have gone away completely with the reduction in my lupron.  The only things I'm noticing from the estrogen is that my [TMI WARNING] discharge has increased to the point it normally is right before I ovulate on my own, and my sex drive has been given a nice little boost (which the husband is appreciating).  Also, I'm not sure if it's all in my head or not, but sometimes my uterus feels "heavy" - I don't really know how to describe it other than that.  I'm hoping that these signs mean that the estrogen is doing what it should and my lining will be nice and thick at my appointment tomorrow morning.

On the docket for tomorrow are a transvaginal ultrasound to check my lining thickness (8mm+ is transfer-ready) and pattern (something called triple-stripe is ideal here) and bloodwork to check my estrogen levels.  Assuming everything looks good, I bump my estrogen patches up from 2 to 4, and keep everything else the same.  Then I will have one more lining check a week from today to make sure it's thick enough for transfer.

In other news, the donor has started her stimulation meds without incident, and is expected to be ready for retrieval between December 4th and 6th...that means it could be as little as a week from today, people!  Depending on how many eggs they retrieve (10-20 is the normal range for an egg donor) and how many of those fertilize and begin to grow, I will either have a 3 day or 5 day transfer.  I can't remember if I explained this before, so if I'm being redundant forgive me.  The hope is for a 5 day transfer, because it gives the doctors lots of time to separate the strong embryos from the weak ones and allows them to put in the best ones, ultimately increasing chances of success.  However, if there aren't very many embryos to work with or they are looking weak, they will transfer them after 3 days.  The worry here is that they will all fizzle out before 5 days and there will be nothing to transfer - and a nice, warm, sticky uterus gives a weak embryo a better shot of making it than keeping it in a lab environment for too long.

I am working with my agency to try to book travel plans, which has proved a bit challenging considering we won't know when the retrieval will be until 2 days before, and we won't find out if it's a 3 or 5 day transfer until day 2.  Since I'm a wussy and I can't handle 5+ hours of night driving all by myself, I am going to fly up.  Luckily the best airline of all (I won't name names but it rhymes with Mouthrest), has lots of flights between St. Louis and Chicago and no change fees!  So our current plan is to assume the donor will be transferring the 4th and I will need a 3 day transfer, and then at the last minute pushing the flight back when that turns out to not be the case.  We know how to keep things exciting!

I will update once I get the results of my appointment tomorrow!

Thursday, November 22, 2012

Giving Thanks

It is Thanksgiving day, and tradition tells us we must recite a list of all the things we are thankful for.  I'm going to skip the normal list this year, and stop to ponder my thanks for something I'd never given much thought to before fertility.

My husband and I had an easy time getting pregnant.  We decided we wanted a child, went off birth control, and a month later we were holding a positive pregnancy test.  I sailed through my pregnancy without so much as a minor complication.  I delivered a healthy, perfect baby girl at 40 weeks gestation. 

Even before surrogacy took me directly into the world of infertility, all I had to do was look around to see couples who were not so lucky as us.  I had friends and coworkers who had struggled through multiple miscarriages or month after month of negative pregnancy tests.  People who were trying and hoping so desperately for what I had taken for granted.  It is these people who led me to fill out that first surrogate application 10 months ago.  Now, I have met my IPs, people I never would have known if it weren't for this journey.  I have heard about their years of struggling, their pursuit of every other avenue before turning to surrogacy.  I know that I am now their last hope for the baby they have been longing for.

I just wanted to take a moment to express my thanks to fate, or whatever, has given me the ability to not only be able to have my own family with such ease, but also to pay it forward to someone else.  I know I have complained about how slowly this journey has gone so far, but I know that when I see them holding their baby in their arms, it will all be worth it.

Happy Thanksgiving!

Tuesday, November 20, 2012

All is Well

Still going strong on my lupron!  Other than the one migraine and a couple of hormonal overreactions to minor situations, I'm feeling fine!  The shots have continued to be easy, and I'm getting to be quite the expert at stabbing myself in the stomach.

I had my baseline ultrasound and blood work yesterday morning.  The ultrasound was the transvaginal kind (you know, where they stick the weenie wand up your hoo-ha), and the point of it was to check for any cysts or fibroids that might interfere with implantation, as well as to measure my endometrial lining thickness.  The tech didn't say much while she was looking around, but I saw her write down that my thickness was 3.1mm.  That's nice and thin, meaning my lining had shed like it was supposed to after I stopped birth control pills.  The results of the ultrasound and blood work were faxed to the clinic in Chicago.  I received a call from them that everything came back great, and I am to lower my dose of lupron and start on my estrogen patches tonight as planned.

So now I only have to give myself 5 units of lupron instead of 20, and start applying two estrogen patches and replacing those every other day.  Eventually I will increase to 4 patches, and possibly add estrogen tablets if it looks like my lining needs an extra boost.  I am also beginning to take my baby aspirin tonight to help increase blood flow to my uterus.

My next appointment is scheduled for November 28, and it is another ultrasound to make sure my lining is thickening properly, and blood work to make sure my estrogen levels are rising appropriately.  From that point they will know whether they need to adjust my meds in order to help my uterus be ready for transfer.

I heard from the nurse coordinator that the donor will be having her baseline appointment tomorrow, and if all looks good she will start her stimulation meds on Friday.  They are expecting her egg retrieval to be Dec. 4-6, which will most likely make my transfer Dec. 9-11.  This could change depending on how fast she stimulates and how many eggs are retrieved.

I will be back to update once I have heard that the egg donor has started her meds OK.  In the meantime, I hope everyone has a wonderful Thanksgiving!

Monday, November 12, 2012

So Far, So-So

I have given myself three shots so far.  The shots themselves have been fine.  The needle is small, and I barely even feel it.  I have had a bit of stinging on the skin around the injection site for a few minutes after I give myself the shot, but I suspect it might be because of the alcohol I wipe on my stomach prior to giving  myself the shot.

Side effect-wise, I suffered my first ever migraine yesterday.  I've had headaches before, but never felt like something was trying to push my eyeball out from the inside.  Luckily I'd already run all the necessary errands earlier in the day, and I was able to nap during my baby's nap.  I have a headache again today, but it is much more manageable.  Since I'm not supposed to take anything but Tylenol for pain here on out, and Tylenol has never really done much for headaches for me, I'm pretty limited.  I plan to self-medicate with caffeine if it gets bad during work days.  It turns out I can't just crawl under my desk and take a nap if needed.

Aside from the headaches though, I haven't had any other side effects.  No hot flashes or hormonal outbursts yet.  : : Knocks on wood : :  I'm hoping that after a little while on these meds my body will adjust and I will start to feel better.

What's up next:
Tomorrow (11/13) Last birth control pill
Next Monday (11/19) First appointment - baseline ultrasound and blood work to check my estrogen and progesterone levels
Next Tuesday (11/20) Reduce lupron dose and start with estrogen patches and baby aspirin

Only 4 more weeks until transfer!

Thursday, November 8, 2012

A Tutorial on Surrogate IVF Meds

Before I start in on this, I would like to remind everyone that I am not a doctor.  This information is from what has been explained to me by my fertility doctors and gathered off the internet.  Also, my only experience is with the surrogate end of the IVF spectrum.  I know nothing about the egg donor portion or someone doing IVF for herself, where in both cases you would be stimulating large numbers of your own eggs for harvesting.  Since I am a gestational surrogate and my genetic material will not be used in creating this baby, the goal is the exact opposite - temporarily shutting my ovaries down so I don't ovulate and accidentally get pregnant with my own child.

As a further note, my meds will not be the same as another surrogate's meds.  Each doctor/clinic has their own protocol that they like to use.  The medications come in the form of injections, tablets to be ingested orally or inserted vaginally, and patches, or any combination of these.  Heck, there may be some system of administration I don't even know about.

Here is a list of the meds I will be taking along with a brief (maybe) description of their purpose:

Birth Control Pills
The point of birth control pills is to hormonally regulate your cycle so they can sync you up with whoever is providing the eggs, which in my case is an egg donor.  Since embryos cannot live indefinitely on their own, it's imperative that my body be ready to receive them within 3-5 days after they are harvested from the donor.  So what they do is have you on active only birth control pills (the first three weeks in the pack) continually until they are ready to prep your body to receive the embryos.  I have been on active only birth control pills since August.  In theory, you should not get your period during this time.  In my case, my period waited two weeks and then came anyway, and I have been spotting ever since.  So I've had a not-quite-period for over 4 weeks now.  Yay me!  Once I am established on the next drug, lupron, I will stop taking the birth control pills.

Lupron is the drug that I will begin taking tomorrow.  Its purpose is to inhibit the hormones that the body normally secretes leading up to ovulation, basically putting the ovaries to sleep for a while.  It is delivered with a subcutaneous injection (like insulin shots for diabetics).  I have to take this shot every day between 6 and 10pm.  Possible side effects include: hot flashes, weight gain, migraines, and extreme moodiness.  Basically, the same as if I were to suddenly become menopausal.  Luckily I will only be on this drug for about 4 weeks.

Once the body is on lupron, it will not ovulate on its own.  Unfortunately, that also means that it will not prepare itself for possible pregnancy by thickening the uterine lining.  So once we have shut down the body's ability to prepare itself naturally, we need to reintroduce estrogen so that the uterus will be nice and thick for embryo implantation.  I will be using Vivelle estrogen patches to accomplish this goal.  In the weeks leading up to the embryo transfer, I will have a couple of ultrasounds to make sure my lining is thickening properly.  If it looks like I need a little boost, I will also be put on Estrace tablets (which are taken either orally or vaginally depending on how much they need to be absorbed) to thicken my lining some more.  I will remain on these throughout the first several weeks of pregnancy until my body wakes up, realizes it's pregnant, and starts producing estrogen on its own.

Baby Aspirin
At the time I start taking estrogen to thicken my lining, I am also supposed to take a daily dose of baby aspirin.  In addition to preventing blood clots (which some of the other drugs can increase the risk of), it also increases blood flow to the uterus and helps make the lining nice and thick.

Progesterone in Oil (PIO)
This is the drug that everyone fears, the ones that come with the big bad needles.  Normally once you ovulate, your body naturally produces progesterone to prepare your uterine lining for implantation (make it nice and sticky, so to speak).  Once a pregnancy is achieved, the body produces increased levels of progesterone to help the embryo hold on and develop the placenta.  If a pregnancy is not achieved, progesterone levels drop, and the lining is shed (resulting in a woman's menstrual period).  Since in my case I won't ovulate, it is VERY VERY important for me to artificially keep my progesterone levels elevated.  If they drop, I will automatically miscarry.

That's where the progesterone in oil comes in.  It is delivered by intramuscular injection, meaning that the needle needs to be big enough to get it all the way through the layers of skin and into the muscle.  It is also suspended in oil, which means it is very thick, hard to administer, and can leave large lumps under the skin where it was injected.  It is most commonly injected into the hip/butt area.  I will also have to remain on this drug for the first several weeks of pregnancy.  Eventually, the placenta begins producing its own progesterone, and I will no longer need to substitute artificially.

I have found that most surrogates have to take daily injections of PIO.  Luckily for me, my doctor's protocol only requires me to have one of these shots every 3 days (which means each cheek will only have to be assaulted every 6 days)!  Why?  Because I will be also taking progesterone in another form...

Progesterone Vaginal Suppositories
I will be using Endometrin vaginal insert tablets twice a day until my body is producing enough progesterone to sustain the pregnancy on its own.  These essentially do the same thing as the PIO shots, which different side effects: discharge and possible irritation.  When the nurse coordinator was going over all of the drugs with me, she told me these are actually what she gets the most complaints about.  Maybe this is because her surros don't have to take shots as often as most?  I don't know.

In addition to these main drugs, I also received in my box of wonders some prenatal vitamins, antibiotics (to prevent any infection that could be caused during the actual embryo transfer), and Valium (which is something I can opt to take to help me relax before the transfer procedure).

Let me know if you have any questions of if I was way off base somewhere!

Wednesday, November 7, 2012

Looks like Santa came early this year!

Phone call from my husband while I'm at work:

DH: Your box of meds just got delivered.
Me:  Yay!
DH:  There are some really big needles in here...

When your husband is a medical professional and feels the need to comment on the large size of the needles, that's when you know you should be scared.

Saturday, November 3, 2012

Calling All Questions!

First of all, I want to say thank you to all the people who follow my blog.  First and foremost, I created this blog as a sort of diary for myself so I can always remember this journey.  But it makes me so happy that there are people following along.  I have several public followers, and I know I have a lot more private followers.  My blog has been viewed over 1000 times in 9 different countries since I created it!

I know a lot of my followers are friends, and a lot are other surrogates.  But I'm hoping that my blog can also serve to educate others who might be interested in pursuing surrogacy, or just curious about the process.  So, here is your time for questions!  If you have anything you've been wondering: about me, my journey, the surrogacy process in general, etc., please feel free to comment with a post.  Too scared to use your real name?  No problem!  You can choose to comment anonymously.

I will answer your questions to the best of my ability in a future blog post!

Friday, November 2, 2012

One More Week...

Until I start my meds!

Wow, all of these months of waiting, and all of a sudden it's right around the corner.  Next Friday, 11/9, I will be giving myself my first Lupron injection!

The meds have been ordered but I haven't received them yet.  I'm hoping that the pharmacy will call me to confirm shipment SOON!  The last thing I want to be doing is stressing that I won't have my meds by the time I need them.