Wednesday, August 24, 2011

I Crossed the Finish Line

So I realized that I had never posted the conclusion to what happened in my infertility marathon. I crossed the finish line on July 16th and received my two precious prizes Halle and Ben. I made it to 37 weeks on the nose. Ben weighed 6lbs and 13 oz and was 20 inches and Halle weighed 5lbs 13 oz and was 18.5 inches. They spent no time in the nicu, and I had them via csection.

My twin pregnancy went off without a hitch until the very end. Everything was very smooth. I did develop gestational diabetes, but I was able to manage it with diet so it wasn't a big deal. I did develop some itching though at some point during the third trimester, and I mentioned it to my doctors. It really only bothered me at night, but they said if it started bothering me during the day, I would need to get tested for cholestasis. Cholestasis is something that occurs in late term pregnancy that can result in stillborn birth. Anyway I didn't think I needed to get tested for it, but then on July 4th I felt a little itchy during the day. The following day when I was at the hospital for my stress test I asked them to run the lab work for cholestasis. The hospital called my doctor and she approved the blood work. Well then I don't hear anything about the results of this blood work. My itching during the day has subsided and it was only bad at night. My ob and mfm doctor look at my weekly appointments for the results from the hospital, but they can't find them. Anyway my ob goes out of town the week of July 10th and I see a different doctor and ask about my results; he says he will try to find them. On Friday, July 15th (our 11 year anniversary) I get a call at about 4:30 in the afternoon from the doctor saying that I need to go to the hospital the following morning and have a csection because I have cholestasis (the lab results were finally found) and maternal fetal medicine wants the babies out tomorrow. So I get the on call physician the following day who was my old ob. I switched obs because I felt like she was a space cadet and always told me to eat donuts and gain weight to get pregnant which got on my nerves. She's really nice, but just a bit dingy. Anyway, she did the csection. She did a great job. It was very routine and no big deal. However, she had to do one air head thing. She forgets to order my morphine pump before she leaves. So now I'm starting to feel pain and they can't get in touch with her because it's Saturday and something is wrong with her cell phone. Finally, they got in touch with her and I got morphine.

The babies and I were transported to our room. Things were still going great. I was in a bit of pain here and there, but I was walking around by the end of the day. Then the troubles began. Who knew you could develop preclampsia after pregnancy. You can and I did. Who knew you could develop PUPS after pregnancy. You can and I did. Who knew you could become severely anemic after pregnancy. You can and I did. I tried to breastfeed for three days while in the hospital, but it wasn't working and my milk wasn't coming in plus I had a myriad of other problems going on, so I threw in the towel. At the time I felt really bad about it, but it was the smartest thing I ever did for me. Not breastfeeding has really helped with my sanity and being able to give other people some responsibility for the twins and have a little break here and there.

Recovering from the csection took about 10 days before I felt somewhat better. At three weeks I started walking 3 miles and now I am run/walking three miles four mornings a week at 5:30 am. The twins will be six weeks on Saturday. They are good babies, but I never get more than 2-3 hours of uninterrupted sleep because one of them always need something. I call it groundhogs day at our house because every three hours I change, feed, stimulate and put the twins to bed. My husband does the 10 pm feeding by himself so I go to bed at 8:30. He has been awesome with them. If you have twins, you have to have a spouse who is committed and on board to give it 110% or you will be in big trouble.

I'm very active with the twins. Today we went to the outlets and the grocery store. They were great as usual. Right now they are having tummy time to help prevent flat head syndrome. I'm enjoying the twins, and I will be so happy when they both sleep 4 or 5 hours at a time. I'm off work until January so hopefully we will be in a good routine by then.

I'm so glad that I didn't give up and pursued CCRM. There were obstacles and set backs in my infertility marathon. My marathon was much different than many of my friends who easily crossed the finish line, but in the end I crossed the finish line and that's all that matters.

Saturday, July 9, 2011

Less Than Two Weeks Until the Twinkies Arrive

So today I am 36 weeks pregnant. I can't believe it. It really has gone by quickly. The twinkies are scheduled for their csection on July 22nd. Halle is breach and Ben is head down hence the need for the csection. They look great. At my Maternal Fetal Medicine appointment last week. Ben was almost 7lbs and Halle was almost 6 lbs. I'm feeling pretty good considering I am measuring about 46 weeks pregnant and have gained almost 40 lbs. I'm really quite a sight. Nothing on me has really grown except my stomach, so I have this huge stomach with skinny arms and legs. It's kind of funny.

I am really, really ready for them to come out. I feel that they are good to go and if they came today they would spend little to no time in the NICU. I have been incredibly blessed because this pregnancy has been pretty easy. I also have been able to enjoy it. My doctor said something to me that I think is important to keep in mind particularly if you have had to undergo infertility treatments. She said just because it was challenging to get pregnant doesn't mean that your pregnancy is going to be challenging. I have found this to be very true. I know it's hard for so many of us who have struggled to get pregnant because we always think there is something that could go wrong. Try to enjoy your pregnancy and hopefully the challenging part - getting pregnant- is over and the pregnancy itself will be smooth sailing.

Thursday, May 5, 2011

Almost 27 Weeks and Doing Great

I have been MIA for awhile. Nothing bad has happened; I have just been busy with work and life. On Saturday I will be 27 weeks pregnant. I really can't believe it. The twins look great. I go to Maternal Fetal Medicine on Monday and will get to see them again. I count my blessings that I never experienced morning sickness or that I never barfed. Instead I have weird pregnancy aliments like permanent congestion and eczema on my feet. Weird! Anyway, the nursery is pretty much set and ready, and I have a baby shower two weeks from Saturday. I want the twinkies to stay cooking until mid July and then they can make their appearance. I feel very blessed that everything is going so well.

Tuesday, March 22, 2011

A Little Punch in the Stomach

So we saw the twinkies yesterday, and they look great. They were measuring a day ahead and are each 13 oz at a little over 20 weeks. I expressed my concerns about not feeling them move and no one at the doctor's office seemed concerned. They were moving on the ultrasound, but I just don't feel them, until last night.

So running guy and I were grilling out last night and sitting on the patio enjoying a nice Florida evening and I decided to pull up my shirt a little and examine my belly. We were discussing how I still haven't felt them move. I shook my stomach like they do on the ultrasound to make them move and low and behold I got hit. I had my shirt pulled up so running guy saw the movement on my stomach. It was so crazy and it kind of startled both of us. Since then, I haven't felt them move. I don't think I'm going to shake my stomach anymore because if I was sleeping and someone shook me I wouldn't be too happy!

Friday, March 11, 2011

19 Weeks Tomorrow and No I Haven't Felt Them Move

So tomorrow I will be 19 weeks. My husband and I are both over planners and slightly neurotic so we have had the nursery painted, purchased furniture, and started buying clothes. It's really fun. I was starting to get a little nervous this week because I still have not felt definitive movement. I've felt some things, but I am not sure it was them moving. People keep asking if I have felt them move, and I can't honestly say that I have. I know I know it feels like a flutter or gas bubbles, but I'm still not sure. Usually super thin people with twins feel these things early, but I have not. So today I had a few strings pulled and had an impromptu ultrasound done by an ultrasound tech. They are moving and looking great, so now I am fine without the movement. I am sure it will happen soon enough and then I will be complaining that it's uncomfortable.

By the way I am really big now. At 17 weeks I was measuring at 22 weeks. It's kind of funny because from the back I don't look pregnant, but when I turn around there is no missing it. My husband and I get good laughs out of it. I see the twinkies again officially on March 21st and can't wait to see them.

Saturday, February 26, 2011

It's a Boy and Girl

How perfect is that. We are beyond thrilled. We thought for sure we would be having boys, so it was nice to get one of each. It was just what I hoped for. The twinkies look great. Our little boy was measuring 5 days ahead of schedule and weighed 6 oz, and our little girl was measuring one day ahead of schedule and weighed 5 oz. The anatomy scan showed everything to appear normal at this point. Today marks the start of week 17 of my pregnancy. It's crazy to think that probably 20 weeks from now my little twins will be making their debut.

Saturday, February 12, 2011

Doggy Style, In the Shower,Missionary Position?

I have learned that when having twins inevitably the question of how this miraculous event came to be is one of the first questions that people have. Here's the scene:
I say, "I'm having twins."
The other person says, "Do twins run in your family?"
I say, "Not really."
They say, "Are they ivf twins?"
I say, "Yes, they are. (Here's the part I would like to add but don't) "By the way how were your children conceived? I've always wondered if you guys did it doggy style, in the shower, or perhaps the famous missionary position? Since we are talking about the intricate details of how our children were conceived and since you just asked me a personal question, I didn't think you would mind sharing about your conception story."

People are just so clueless, but I think if I followed up with the above statement it would put it into perspective of how they just asked a very personal question. Here is my actual response to do twins run in your family. "Not really, these are medically assisted twins." Usually there are no follow up questions after that. I am not ashamed or embarrassed that we did ivf, but it would be nice if people could just say congratulations and not worry about how the twins got there. If it was a singleton, there would be no questions asked.

I have been so blessed this pregnancy so far. I am now 15 weeks and in a little over a week we will find out the sex of the twinkies. I can't wait!

Sunday, February 6, 2011

SIRM vs. CCRM

I have received several questions lately about my experience at SIRM and CCRM on online fertility boards, so I thought that I would provide my rationale and decision making process for choosing clinics. These are of course my opinions and experiences and you could have a totally different experience going to either one of these clinics. One final note before I begin my rationale, I am extremely fortunate to have insurance that covers ivf procedures - so insurance coverage dictated many of my decisions.

Who Doesn't Like An Easy Button or Why I chose SIRM first?

As most of you know, ivf can be a stressful situation. I have to say SIRM provides an easy button. The phone consult with Dr. Sher seemed thorough, and he easily presented me a clear plan of what he could do for me. A few minutes after the phone consult the ball got rolling with his office manager Sharon and everything started to unfold. I thought wow this process is easy. In my phone consult with CCRM it seemed like things were going to take much longer and would require several trips to Colorado. At SIRM everything was going to be done in one shot. I would spend two weeks in fabulous Las Vegas and hopefully come home pregnant. Dr. Sher ordered a battery of tests for me and discovered that I had Natural Killer Cells and would need intralipids and also that I have a thyroid issue (my TSH was over 5) known as Hashimotos (antithyroid antibodies) which would require using Synthroid. I'm so glad he discovered my thyroid issue, but I'm still not 100% convinced about Natural Killer Cells.

Another huge determining factor for going there was the cost. In total it was going to cost me $1000 plus about $100 for meds to cycle at SIRM because they are in network. CCRM was going to cost anywhere from $7,000-10,000 plus about $100 for meds because they are out of network, and my insurance doesn't cover genetic testing.

So we hit the easy button, and I said lets try Dr. Sher's "different theories." I had been warned my various physicians to steer clear of people who emphasize natural killer cells. There was a girl from my hometown who had success with Dr. Sher after about 8 failed ivfs, so I thought that I would give it a go. Did I find their statistics to be super impressive? No, but the bottom line was it would cost a ton less and we would have fun in Vegas and hopefully end up with a baby.

We did have an absolute blast in Vegas. It was running guy and I's best vacation ever. While we were out there, we both agreed even if it didn't work, we were ok with it because we had so much fun. I also met some awesome girls who were cycling at SIRM, and I still keep in touch with some of them. Friends are such a blessing!

Anyway, back to cycling it wasn't the best experience ever. Dr. Sher was very rushed and it felt like an assembly line of ultrasounds. Buzzing back and forth giving limited information and dropping his famous one liners. Which I was ok with because I don't need petting, and I'm a veteran at ivf by now. The communication was also not the best. The office would call me after 4 for my appointment times for the next day. They never knew when it was going to be until late in the day. The retrieval was my worst experience ever. I have never had bleeding before and I had bleeding for days. Granted it wasn't heavy but still, it had never happened before. I did have the most eggs ever retrieved though and by day 5 I had one awesome blast and one great looking blast to transfer. The transfer process was uncomfortable because of my bladder being full of water. The next day I waited and waited to find out how many embryos were going to be frozen. No one called me. Finally, I received an email at about five PM stating that 6 embryos would be vitrified. Eight is the most that I have ever had made to blast. Out of the 8 two were Grade 1 (the best) and the other six were grade 2 (really good).

Needless, to say despite the intralipids, prednisone, and great retrieval and fertilization report I did not get pregnant from the cycle. It was disappointing, but I knew that I had a plan B lined up.

PLAN B CCRM

I went to CCRM about three weeks after I got home from Vegas. I had already done my phone consult so scheduling my One Day Work Up was easy. I went by myself because running guy had a triathlon that weekend, so we decided that he could go another time to give his sample. CCRM was beyond impressive. Everyone knew what they were doing and it was a well oiled machine. Dr. Surrey was awesome. He explained to me how he wanted to proceed and was so caring and compassionate. I'm so glad he was my doctor. When I left that day, I knew that I had come to the right place. I felt very informed and I was excited to begin the process.

Cycling in Lone Tree was a breeze. I knew when all my appointments would be ahead of time. There wasn't a bunch of waiting to do and I got in and out of my appointments quickly which left a good deal of time for exploring and fun. Communication was excellent. There was only one time when they forgot to call me and tell me the dose of my meds, but I was able to reach someone after hours and get the correct dose.

My retrieval was so smooth. Dr. G did it and I experienced no bleeding whatsoever. They retrieved the most eggs ever and I had a great fertilization report (20). On day six the embryologist called to tell me that I had 7 make it to blasts. I was a bit disappointed because it was one less than SIRM and I had 20 mature fertilized embryos so shouldn't I have 10 make it to blasts? Anyway, I had two AA grades and the rest graded about as ABs or BB. They also thawed my embryos that I transferred from SIRM but two did not make the thaw. So I had a total of 11 being genetically tested.

Two weeks later Dr. Surrey called me with good news. Out of the 11 only one was genetically abnormal. It happened to be on of my AA from CCRM. All of my SIRM embryos were normal (one was no result) and all of my CCRM embryos were normal except one (one was no result). Great news, but it made me wonder why didn't this work at SIRM because based on my results I can pretty much guess that more than likely one or both were genetically normal at SIRM.

My CCRM transfer was such a great process. I did acupuncture before and after and really felt relaxed. Dr. Surrey did an excellent job with the transfer and when I left I felt like we did everything we could to achieve the best results possible.

Six days after my transfer I took a home pregnancy test and saw that I was pregnant. CCRM continued to diligently monitor my estrodial and progesterone levels for about 10 weeks. I am currently 14 weeks pregnant with twins. I never felt like I was in an ivf assembly line at CCRM, but I rather I felt like a valued patient.

SUMMARY: From my experience CCRM made all the difference in the world. Based on my genetic testing results I probably had at least one genetically normal embryo in every ivf cycle I did, but I never got pregnant. What that tells me is CCRM did a better job monitoring me and the lab did an excellent job preparing my embryos from transfer. We will never know why all the other times didn't work and that's ok. I'm just so glad that it worked at CCRM because I feel so incredibly blessed to have these two little babies growing inside of me.

Wednesday, January 19, 2011

Are You Pregnant?

You have no idea how many times in the past three weeks I have been asked that. I am just shy of being 12 weeks pregnant, but I am suddenly one big girl. I have gained 8 pounds. Why am I so large? Here are a few theories:

1. The two months plus of prednisone that I was on.
2. The fact that I was super skinny before, so any fat is noticeable.
3. I have experienced no barfing and am only nauseated when I get hungry

I'm not really sure the reason, but I have not been able to squeeze into my size 0 and 2 pants for quite sometime now. I am in maternity pants.

Needless to say, I have had to tell far more people than I would have liked to that I am pregnant. I work in pharmaceutical sales and I can feel the various doctor's offices that I go into looking at my stomach. Some of them will ask others try to pull it out of me by asking questions. Everyone is always in shock when I tell them how early in my pregnancy I am. Thank goodness I can say, but I am having twins.

All and all I think it is good that I am putting on weight for the babies. Hopefully, that will help them in the long run. It's kind of funny to gain all this weight when I have always been so tiny. Running guy and I get many a laughs at how drastically my body is changing.

Thursday, January 13, 2011

Update on the Twinkies

I've been a little mia, but nothing bad has happened. I have just been busy with life. My little Twinkies are doing great. I saw them on Tuesday, and they were measuring 10 weeks and 3 days which is exactly where they needed to be. Baby A had a heart rate of 176 and Baby B was 164. I have to say that we are already putting little personalities on these precious babies before they have even come out. For instance, Baby A is always so good; always cooperative with the ultrasound. It's always easy to see the heartbeat and at our 8 week ultrasound the yolk sac appeared to be a halo over Baby A's head. Baby B on the other hand is WILD! The first ultrasound Baby B hid in a corner and we couldn't see it's heart rate at first. The second ultrasound it looked like it was playing with a balloon (yolk sac). This third ultrasound Baby B was jumping and moving like crazy. So in summary Baby A is our calm angel and Baby B is our wild free spirit.

I have been completely off progesterone and patches for over a week and so far so good. My next doctor's appointment is at Maternal Fetal Medicine in a week and a half. They are going to work with my ob to help ensure that this is a smooth sailing pregnancy. I am not out of the woods yet, but each week that goes by I feel more confident that my little Twinkies are going to be ok.