"Almost Perfect"

Here's the update on my appointment with Dr. Hopeful today.

Dr. Hopeful had Julie, the u/s technician do a vaginal u/s first.  I was told the u/s would be pretty clear so if it looked 100% perfect, then we would not need to do the SIS.  The thickness of the uterus lining was good, though I  did not ask what the measurement was (I thought maybe 6 mm? Not sure).  I have 17 follicles on the left ovary and 11, possibly more on the right.  This means I a good number of follicles that could potentially produce a good number of eggs for retrieval.  An excellent number of follicles overall. This whole time, I was looking at the u/s monitor, but could not make out anything other than my lining.  I wish they would take some time to show me exactly what they were seeing on the screen, but I know it's not standard practice.  I'm just a very curious person and like to know what I was looking at.

It turned out from the u/s view, my uterus was not 100% perfect, so Dr. Hopeful wanted to go ahead and do the SIS, just to be sure.  I was starting to get worried but she assured me no need to get all worked up yet until we can be 100% sure.  The u/s wand was removed, the speculum inserted (my least favorite part!), the cervix was cleaned out and the catheter was inserted.  She then injected the saline solution through the catheter.  I experienced some cramping, but not bad though.

Julie reinserted the u/s wand and the image of my uterus showed up on the u/s monitor again.  This time I could see an almond-like shaped cavity on the screen similar to the one below.  The image on the left is before, and the one on the right is after the injection of the saline solution into the uterine cavity.  The images below are not of my actual sonogram, just something I found off the internet.  I wish I had asked for a copy of the image, but didn't.

According to Dr. Hopeful, the uterus looked good.  Though not 100%, I am about "99.5% perfect" as there were some "fluff" in my uterus.  I guess it is normal when you are on birth control pills, which can cause that.  

I guess I also have an "easy cervix".  Sounds kinda naughty don't you think?  Having an easy cervix is good, makes it easy for the embryo transfer.

Somewhere in all the action, the trial transfer took place.  Not sure where, but I guess it was all rolled into one.  I had to wear a pad before I left the clinic as I leaked a little after.  I'm still a little cramped here and there, but not bad.  Felt a lot like when I did my IUIs.

So I'm all set for IVF.  "Almost Perfect" is good enough for me.

Next steps:  Shots class and nurses consult next Tuesday, a week from now.

**Note to self:  I should bring my camera with me to future appointments, just in case.  As I was getting dressed after the procedure, I stared at the u/s monitor and wished I had my camera with me so I could have taken a picture of the images from the SIS that will still displayed on the monitor.  

Appointment Tomorrow

I have an appointment with Dr. Hopeful tomorrow.  She will be doing a SIS (saline infused sonogram) to check out my uterus, to make sure there are no polyps or other irregularities before we start IVF in the next few weeks.  The last time I had it checked in August, the doctor said it was "perfect".  I  have undergone 3 hysteroscopies in 2005 and 2008 to remove polyps which can and sometimes do return.  If you are the praying kind, please pray that this sonogram will go well, and that Dr. Hopeful will not find anything unwanted there.  If they do, I may need to have surgery again to remove any polyps before we can proceed with IVF.

We will also be doing a trial transfer at this appointment tomorrow.  According to Dr. Goo.gle, this procedure consists of a pelvic exam and placement of a tiny catheter inside the uterus to determine the direction and length of the uterine cavity.  It's supposed to minimize trauma to the uterine lining during the embryo transfer.  I will do a post after the appointment tomorrow.  Today also marks my 1 week of taking BCPs.

Last night, my Babe and I went over to my MIL and FIL's to watch the Super Bowl, and to take advantage of their Tur.bo Tax software. We found out that my Babe had forgotten to update his deductions on his paycheck after I stopped working last year.  He had paid too much taxes, so now we will be getting some money back from both state and federal.  I'm happy as the money will go directly into paying for part of the IVF cycle!

I have decided that I will not tell my Mom about our upcoming IVF cycle.  After our last incident with trust issues about telling others, it is best not to tell her until it is a success.  My sister agrees that Mom does not need to know or worry, and it will give me more peace about it too.

One last thing, if you have not already signed up for my first giveaway, make sure you do.  The last day to sign up is Wednesday!

Confession and RE Update

Confession
First of all I have a HUGE confession to make.  For those of you that have been following or reading my blog I hope you understand why this is something I did not make known previously in my blog.  I will explain later.  So here goes.


This will not be my first IVF.  A year ago, we through one round of IVF overseas.  Unfortunately it was not successful.


I grew up in Asia and was home visiting family for a couple of months and decided while we were there, we'd try a round of IVF.  It was a lot cheaper to do it there compared to the US.  Only my family and a few of my close friends know we did this.  It's not something we like to share because some people frown on the idea of going overseas for treatment.  Plus we weren't sure if it was something we would share with our RE and if it would disqualify us from the IVF shared risk program.  Last night, DH and I discussed whether we should tell our RE about this.  Giving her this additional information may come in handy in her decisions on our protocol and procedures.   We decided it would be the best to be honest, even if it meant jeopardizing our chance at the shared risk program.


Overall we had a good experience doing IVF in this Asian country (due to the anonymous nature of this blog, I will not be disclosing the country).  I will write about it in more detail in a later post.


Now that you know the truth about our IVF experience, I will be updating my TTC history in this blog.


RE Update
Now, on to the part that you have been waiting for, the update on our appointment with the RE.

Last night, I again had a hard time falling asleep.  I think I got 4 hours of sleep, max.  I was tired, but felt pretty good at the appointment.  Since our last visit, the RE clinic had moved to a newly built and much nicer building.  There must be a huge market for the fertility business because the clinic was much bigger, fancier, and covered 2 floors.  The waiting room was twice the size of the old one and it was pretty busy, even in this sucky economy.  We found out later from our RE that the new facility included a new world-class IVF suite, with its own procedure rooms, andrology lab, embryo lab, incubators, recovery room, etc.  "The best that we could find", as she put it.

Our meeting with the RE, whom we shall call Dr. Hopeful, went really well.  She noticed it's been 2 years since our last visit so she asked us what we've been up to.  Right away, we were upfront about our previous IVF overseas.  I was worried about how she would react to it, but she seemed OK with it.  She was quite pleased with how I responded during that cycle, other than the fact it didn't work.  Our meeting lasted almost an hour and she gave me lots of information.   I was given the following handouts.

• IVF handbook
• Estimate of charges broken down into details by monitoring, IVF procedures, medication and additional charges.
• Statistics of IVF results for the clinic
• List of acupuncturists in our area.  Dr. Hopeful could not recommend acupunture medically (inconclusive research), but her thought is if it makes you feel good and help you relax, then do it.
• Comparison sheet for the cost of IVF by fee for service (pay by cycle) vs. share risk program.
• Classes for Mind/Body program, which she highly recommended.

In addition I found out the following:

1. Dr. Hopeful does not think a previous failed IVF necessarily means we don't qualify for the shared risk program, and recommends applying for it.  More details about the cost and payment of IVF will be discussed with Melissa, the financial coordinator.  In the mean time, we still have not decided if we will do the shared risk program.
2. Only 2 embryos will be transfered
3. Based on our fertilization success during our last IVF, we will not need to do ICSI.
4. There is an 18% change of miscarriage with IVF.  
5. I will be on Lupron, Menopur and Follistim.  I have had experience with Follistim, but will need to pay attention to researching side effects of Lupron and Menopur.
6. I will NOT need to do PIO (progesterone in oil) shots!!  The is the BEST news yet!!  I guess I will be on a suppository called End.ometrin.  I am so happy about this!
7. We will probably go in for a shots class so DH can figure out how to stick a very long needle in my butt.
8. I will need to do one IM (intramuscular) shot for the HCG trigger shot, most probably be done by DH.  I can handle doing one IM, but so relieved I don't have to do daily IM PIO shots.
9. The doctors at the RE office rotate through the procedures weekly.  This means Dr. Hopeful or one of the other doctors may actually perform the procedures.
10. We will need to do the following tests: 

• Ovarian Assessment Report -  to test the quality of my remaining eggs
• SIS (Saline Infused Sonogram) - check the uterus
• Trial transfer - measure the uterus prior to embryo transfer
• STD screening

It sounds like after my next AF arrives, I will start BCP on day 2 or 3 for 21 days, then start stims.  Today I am on CD11.  If AF is on schedule (which she probably won't be), I should start BCP on Feb 1st, and then we go from there.

In the mean time, I am waiting for a nurse to call to schedule a consultation and also for Melissa the financial coordinator to call to discuss costs and payments.  Actually someone from the clinic called this afternoon to discuss starting my IVF cycle but I was napping, thanks to only 4 hours of sleep the night before.  Tomorrow I will call the clinic and find out our next steps.

I'm getting excited about finally starting this, but at the same time I'm torn about the huge amount of money we are about to spend of IVF.