How did we get here??

In these weeks leading up to treatment *really* starting (yes, technically I'm already doing my IVF cycle... just not actually DOING anything), I'm finding myself spending quite a bit of time thinking about what is about to happen.  Tonight I spent some time thinking about what *HAS* happened... how did we get here?

In the spring of 2009, I graduated with my Masters in Educational Leadership.  Jonathan and I had decided not to even think about getting pregnant until I had that degree in my hand.  In May, that mission was accomplished, so we decided that as soon as I started my next cycle, we would start "trying".  At that point, we believed it would be as simple as throwing out the birth control.  Me, being the "Type A" personality that I am, did my reading and research about cycles and ovulation and soon discovered that if I started taking my basal body temperature every morning, I could more accurately track my cycles and pinpoint ovulation and such.  Each month brought new hope and new disappointment... but it was easily dealt with as we had not been trying for long.  My cycles were slightly irregular, but nothing to really worry about, although I wasn't always able to pinpoint ovulation.  As the year wore on, we got more and more frustrated, but knew that it can take some time for some couples, so we didn't really worry.  As summer of 2010 began and we still weren't pregnant, I knew I would have to call my doctor soon.

I ended up calling the doctor in late July, and got in for an appointment relatively quickly.  She needed to run some tests and it just happened to be the right time in my cycle for all of these tests to be run so I went ahead and got them taken care of.  Jonathan also had to have some tests run, and when all of these tests came back, it seemed that everything was fairly normal for me, but that Jonathan was having some motility issues... not severe, but enough that it could keep us from getting pregnant.  At this point, my doctor referred us to the specialists.

I guess it was the middle of August when Jonathan and I had our first appointment with our Reproductive Endocrinologist.  From the minute we walked into their office, we knew that we were in good hands.  Everyone, from the nurses, to the receptionist, to the doctors in the practice, were fantastic.  Our RE, in particular, was awesome.  He explained to us that he saw no reason that we wouldn't get pregnant, but that he tended to treat things rather aggressively, and that he would only do three cycles of any given treatment a try before moving on to something different.  We had tons of bloodwork done that day, and a few other tests, and then we were on our way for me to call when I got my next period, then come in for day three bloodwork and ultrasound.

When day three came, it just happened to be on the first day of school (how nice, huh?)  I quickly learned the drill - the office opens at 7:00 AM - you have to basically be there by 6:50 to get "in line" for your blood to be drawn and to go in for an ultrasound if needed.  I had my bloodwork and everything done, no problem, and was given the name of the specialty pharmacy that I was to pick up my drugs from, and sent on my way.  For the first two cycles, we did a combination of Clomid (to help with ovarian stimulation) followed by Ovidrel (to induce ovulation), with an IUI (Intrauterine Insemination - think "turkey baster").  I remember feeling so hopeful on the first cycle.  The Clomid didn't really bother me much, and aside from a few appointments for blood draws, it was no big deal.  We did these two cycles back to back, and neither (obviously) resulted in a pregnancy.  By the time the second one was over, it was late October and we were already feeling pretty beat up from the failures - we had hoped that the "quick fix" was going to work for us.  We didn't feel like putting ourselves through that again through the holidays so we decided to take a break.  In retrospect, that was a really good decision... we really enjoyed the holidays and didn't have the stress of bloodwork and medications that made me feel like a crazy lady (Clomid was ok for the first cycle, but made me feel NUTSO during the second cycle).

We started our next cycle in late January.  Our RE had originally planned to do three cycles with the Clomid, but said that since we took time off, and since our insurance would cover it, he would be fine with us moving on to injectable medications and IUI.  I took Bravelle for stimulation and the Ovidrel to induce ovulation.  The Bravelle didn't affect me nearly the way the Clomid had mentally, so I was thrilled about that.  The injections were a little tricky to get used to, but I found it interesting to have to mix my own medication and take care of everything each night, so I didn't mind it at all.  Taking these meds meant needing to be monitored more carefully, so I had more frequent morning appointments for bloodwork and ultrasounds.  I responded well to the meds and we did our IUI.  Didn't work.  Unfortunately, the stimulation from the Bravelle led me to have some ovarian cysts.  Because of that, we had to take a month off to try to let the cysts take care of themselves.

When we went back after that month off, the cysts were gone and we started treatment again.  Didn't work. Again. Had cysts (more painful this time) again.  I was heartbroken and knew I needed to do SOMETHING to keep myself going during that month off.  I asked the nurse what else I could do for myself and she suggested both acupuncture and talk therapy.  I jumped on both of these options.  There were some insurance hurdles to clear, but the benefits I have found from each have far outweighed the hassle to get them covered.  After that month off, I went in for my day three bloodwork and ultrasound and found out that my FSH (Follicle Stimulating Hormone) was high.  In fact, we found that out on Mother's Day.  So a day that started out difficult (I had honestly believed I would be a mother by the time that day rolled around) turned even worse with that news.  High FSH is the first indicator that ovarian reserve is low.  Our RE told us that even though the original plan was to go for IVF if this cycle failed, he wanted to make sure we were still in agreement about that.  He said without that test result, he might have let us try IUI for another few cycles if we weren't ready to do IVF, but that now we were basically in a race against the clock so he had to insist on moving forward with IVF.  We did that IUI cycle, but to be honest, despite all the precautions we took (Jonathan wouldn't let me off the couch the day of the procedure!), neither of us was particularly optimistic that it would work.  Even so, it was a crushing blow when our worst fears were confirmed.

We went in for our day three bloodwork and officially started our first IVF cycle.  They had run an extra blood test on me during the previous cycle that confirmed that my ovarian reserve was something to be concerned about.  Because of this, our RE chose a more aggressive IVF protocol than he might have otherwise chosen for a woman my age.  Ironically, my FSH went back down into normal range when they got my test results back that day... but with fertility related matters, you are always labeled with your worst test result, not your best.

That all led us to this past Wednesday, when we had our IVF orientation.  I've been fielding calls from the doctors office to talk about the anesthesia for the day of the retrieval as well as the specialty pharmacy to discuss my insurance coverage.  We're now waiting for the insurance company to approve my meds (they will) before I can go pick them up.  The pharmacy order was a page long, so I am anticipating a large bag of meds (as well as a large co-pay!).  Once we have that, we wait for June 15 for my next bloodwork and then I get to start my Estrace (estrogen) as we await my next period... then things really get going!! Exciting stuff!