As we move into our 2nd phase of our fertility treatment, I come home to a pharmacy shipment sitting on my doorstep that contains one of my worst nightmares.
I guess this is one way to face my fear of needles!! 
May 5, 2010
February 1, 2010
Eventually, I will start catching up on the fun things Rob & I have been doing – PROMISE! Until then (and even during then), I would encourage you to check out two of the blogs listed under my “Links” section. This section is on the right-hand side of my blog page.
The first is a blog called “Cooking Lessons by Chuck”. Chuck is a truly awesome guy who I met through Johnny & Vicky at LCYC. He and his wife Nancy are two of the most fun people I have ever met. Aside from telling very entertaining stories, Chuck also posts some of his recipes on his blog. Chuck is an excellent cook. EXCELLENT! And yes, I am hoping to try some of his recipes soon and may eventually have to buy a cookbook or two of his. Feel free to check his blog out!
The other blog that I would recommend involves a lot less reading, although you could read the comments for each post if you would like. This blog is called “League of 1000 Words” and can also be found under my Links section. This blog is a collaboration of photography from several people, one of which is my friend Jen whom you might remember from our wedding. The photographers try to accomplish certain challenges each week and post pictures relating to their agreed upon challenge. (You can read more details on this on the site.) They are all fantastic pictures and I’ve found it interesting to not only look at the pictures, but also read the comments to see what others get from the pictures.
Just wanted to pass those two along as I’ve found them both enjoyable! 
February 1, 2010
I received the phone call this afternoon that our pregnancy test for Round 2 came back negative. All I could think was “Really?? Negative??” I mean, after a year of nothing but positives, whenever we were sure to try at the right times, it seemed weird to have a negative. I felt like a straight-A student who received their first F.
However, after thinking a little more on the whole “negative” thing, I figure maybe it’s not quite a bad thing. I mean, most NORMAL people do not get pregnant every single time they try. Maybe I am finally having a NORMAL experience. (Yeah, I’m trying not to laugh too hard as well.) Okay, let’s just say that maybe I’m headed back on the right track and now maybe it won’t happen until it’s ready to happen and until it’s “right”. Hey, a girl can dream, right? 
On another note, I found out something interesting about the Prometrium that they have me taking. In case I didn’t mention before, I start taking Prometrium twice a day starting 4 days after my Ovidrel shot. The Prometrium is basically extra progesterone hormone. Progesterone levels rise every month after ovulation, preparing the lining of the uterus for pregnancy. In a non-pregnant menstrual cycle, progesterone levels rise after ovulation and fall just before a woman gets her menstrual period. When pregnancy occurs, the progesterone level should remain elevated. The ovaries produce the majority of progesterone through most of the first trimester, but eventually the placenta takes over production of the hormone by about the tenth week of pregnancy. Because progesterone plays a role in maintaining the uterine lining, some researchers have theorized that having low progesterone before a miscarriage might actually play a role in causing the miscarriage. So, they have put me on Prometrium to ensure my progesterone levels remain high enough that they don’t potentially allow for a miscarriage to happen should my body not be able to maintain a high enough progesterone level.
Now, the Prometrium that I take comes in a nice little yellow capsule form – very similar looking to Butter Popcorn flavored Jelly Bellies. However, I do not take these capsules orally. Oh, no. I have to take them as a vaginal suppository. Twice a day. Yup, TWICE a day. Because I am one who tries to find humor in things in order to help myself get through it all, I was surprisingly able to find humor in this little lovely experience as well. Over Christmas, I was re-introduced to PEZ dispensers. I watched kids fill their PEZ dispensers. They loaded up the dispenser with candy from the bottom and then pulled back the head of the dispenser to release the candy. After watching this, I had to try not to laugh. I mean, after all, what have I been doing? Feeding small pills resembling candy into myself! I told Rob that I felt like a Butter Popcorn Jelly Belly PEZ dispenser and that if he pulled on my ponytail, a Prometrium capsule might pop out my mouth. Cause seriously now, they’re all lined up in there, they’ve got to start popping out at some point, right? And yes, Rob did pull my ponytail just to see if one would pop out my mouth. It didn’t. Apparently there aren’t quite enough lined up yet. This is the story behind the Human PEZ Dispenser that I mentioned in a previous post.
Okay, so what did I find out about the Prometrium during this phone call? The Prometrium is what I have to thank for giving me side effects that are the EXACT SAME as being pregnant. So, regardless of whether or not I’m indeed pregnant, I get to feel just like I am for about a week and a half each month. That’s fun, right?? Right?? RIGHT?!!?! Yeah, I don’t think so either.
So, enough of the sarcasm. Even though it has now officially been 1 year since we began trying to start a family, we only just finished our 2nd round with the fertility clinic. Our SECOND round. I try to remind myself that it is still pretty early and I’m pretty sure they’ve still got plenty of tricks up their sleeves. So, chin up! And as a very dear friend always says, “Eye on the prize! You’ll know when you’ve had enough and can’t keep going. Until then, eye on the prize!” For now, I’m still hangin’ tough. And no, I don’t mean like the New Kids On The Block song.
January 16, 2010
I received a phone call from Crystal informing me that my MTHFR test results were in and they are NEGATIVE!
We went in for our appointment on Monday, 1/11. I had some blood drawn and then had an ultrasound performed. During the ultrasound, they took measurements of the lining of my uterus and any follicles on my ovary that were maturing. This time, I had two follicles – one on my left ovary and one on my right. They measured 12.9 and 14.2 respectively. Neither one fell within the ideal range of 18 – 24mm so we didn’t think we would have to trigger that evening. Sure enough, I received a phone call that afternoon saying that not only were my follicles not large enough, but my luteinizing hormone levels were not high enough either. The level was only 4.7 and needed to be at least 15.
So, we went back to SGFC again on Thursday morning (1/14) for more blood work and another ultrasound. This time, the follicle on my right ovary had decreased in size from 14.2 to 12.7. But, the follicle on my left ovary had increased from 12.9 to 21! With this new measurement, we were pretty certain that we would receive a phone call that afternoon saying that we should trigger that evening. Sure enough, we did!
During the first visit on Monday, I got excited with the thought that since I had two maturing follicles, maybe I would have the possibility of twins! I learned later that it is rare for 2 maturing follicles to yield twins. Most of the time, one of the follicles will take over as the dominant follicle and the other one will decrease back to it’s original size without releasing the egg. After the appointment on Thursday, it appeared that was exactly what was happening.
We go for our pregnancy test on Monday, 2/1. Here’s to hoping that it comes back positive and is a healthy pregnancy!
January 8, 2010
Well, Labcorp still sucks. My test results for MTHFR were supposed to be in the computer system today. Crystal (my SGFC nurse) called me this afternoon to let me know that she checked both this morning and late this afternoon and nothing had been posted on the Labcorp site. Part of me isn’t surprised.
So, in the meantime, let me fill you in on what I should have posted a while ago. You are probably wondering why I am taking the Ovidrel shot and how exactly it is supposed to help me. Dr. Mottla thinks that the reason why we have not been successful with maintaining a pregnancy is because my egg is not releasing from the follicle at the right time. Basically, the egg hangs on longer than it should so by the time it is actually released from the follicle, it is starting to die off. (He likes to say it is getting old and tired.) It is alive enough to be fertilized, but because it is not fully alive the fertilized egg will only be able to grow/split/divide so far before it gets to a point where the next “piece” that it needs to continue to grow is no longer there so it stops growing and dies off.
By doing OI (ovulation induction) with Timed Intercourse, Dr. Mottla is able to force the mature egg from the follice at the appropriate time thus guaranteeing us as long of an egg “life” as possible. So, using this method, here is how this month will go. On Monday (1/11), Day 12 of my cycle, I will go into SGFC for an ultrasound and blood work. The blood work will measure my hormone levels and the ultrasound will allow them to look at two things. First, it will allow them to check the lining of my uterus to make sure that it is thick enough for implantation. Second, it will check for the follicle that is going to release an egg during this cycle. This is much more obvious than I would have thought because this specific follicle appears to be at least 3 times the size of the other follicles on my ovaries. The ultrasound technician takes a measurement of my follicle and if it is between 18 and 24mm (and my blood work is acceptable), I will receive a call that afternoon telling me that I should administer the shot and have sex that night and again 36 hours later. If the follicle is not yet the correct size, I will return for another ultrasound the following day and they will continue to check until it is ready. That’s it. All in all, it’s pretty simple.
It is important to note, this does not guarantee that we will be successful right away. It only guarantees that my egg will have as much of a lifespan as a “normal” person and provide it with a greater opportunity than we have had in the past for being fertilized while it is still fully alive. We still have to try our luck like any “normal” couple with regards to facing the odds of a sucessful fertilization & conception. Also, this process does not guarantee that we will not miscarry again. What it does for us is bring us back down to the same odds that every other “normal” couple has with regards to miscarriage.
Hopefully this helps to explain a little more and answers some questions for everyone. I’m hoping that Labcorp is just a little slow with the results and that they did not run the wrong test (like last time). I’ll post again on Monday to say what the follicle measurements were and also to give an update on the MTHFR status.
January 5, 2010
So, I had to have my Karyotype test redone because LabCorp sucks.
They had the wrong test performed on that tube of blood. Fortunately, the new set of results came back in time to still go forward with the original plan.
On Sunday, December 6th, we went into SGFC for an ultrasound and blood work. The ultrasound revealed that my left ovary had a follicle measuring 18.8mm. The technician said the nurse would probably call me that afternoon and tell me that I should take the injection that evening. They normally like to trigger the egg release when the follicle measures between 18 – 24mm. Sure enough, I received the phone call that night.
I pulled the syringe out of the fridge to let it warm up before I used it. Rob ended up having to give me the shot. First off, it’s a little hard to give yourself a shot in the stomach right by your bellybutton when you have 2 boobs blocking your view as you look down. Secondly, I am okay with needles as long as I don’t have to watch them go into skin. This poses a problem when you have to give yourself a shot… with a needle. Yes, I would have made for a horrible drug addict. Anyway, Rob used to give his parrot injections so he figured since my syringe had a subcutaneous needle, it would pretty much be the same thing.
The injection is called Ovidrel. It is basically hCG which is the hormone that stimulates ovulation and no, it does not have a risk for multiple births so there is absolutely no extra chance of twins with this. The fertility process we are going through is called OI with Timed Intercourse. It is very simple and involves taking the shot at the appropriate time (when the follicle is within the correct size range) and then being “on duty” (as Dr. Mottla puts it) to have sex the night of the shot and then 36 hours later (basically the morning of the 2nd day after the shot). That’s it! Simple enough, right?
On 12/22, we went up to Annapolis for our first pregnancy test (blood test). We got the call back that my number was 36.8 and that it was positive, but lower than they would like to see so we should be “cautiously optimistic”. So, we were cautiously optimistic and went in again 2 days later for another test. SGFC likes to do LOTS of blood work. They take as much data as possible to better understand things and also to better be able to let us know what’s going on. So, on 12/24 (yes, Christmas Eve), we went up again for our second test. We got the call back that my number had increased to 88!! How wonderful! It had doubled, which is fantastic, although they still warned us that they would like to see it higher. On Monday, 12/28, we went back again for another test. This time they called and said my number had dropped down to 50.8. It was deemed a chemical pregnancy. This is basically where the egg is fertilized but it never fully implants into the uterus. Although it was disappointing, it was not physically painful like a miscarriage and was pretty much the same as a very heavy period. Also, the good news is that we do not have a waiting period afterwards and can try again on the next cycle.
During this time, I got a very nice letter from my cousin. She filled me in on her experiences with pregnancy and miscarriage. In the letter, she let me know that she had tested positive for MTHFR. It is hereditary and is basically a genetic blood clotting disorder that causes miscarriage in women trying to get pregnant. I contacted SGFC and they let me know that although they did test for clotting disorders, they did not test specifically for MTHFR and they wanted me to have this testing done since they now knew that it does run in my family. I go tomorrow to have blood drawn to test for this disease and my nurse said she expects my results to be in by Friday, 01/06.
Right now we are slated to go back to Annapolis for an appointment to determine if the follicle is the right size for a trigger injection on Monday, 01/11. Once the results come back from the MTHFR test, I’ll post those and also provide an update on whether or not we’ll be going forward with the trigger injection this month or not.
So for now, keep crossing your fingers and toes for us and keep praying as well. Even with all the frustration and disappointment, it is reassuring to know we are on the right path to finding a solution. I am so grateful for everyone’s support through all of this. It is nice to know that we have people who care about us and who are right there with us through all the tears and who can also appreciate my crazy sense of humor when I say I feel like the human PEZ dispenser. (Yes, I’ll post that story later.) Here’s to hoping that 2010 is a much happier year for us all!
November 4, 2009
When I got out of work today, I had a voicemail waiting for me on my cellphone. It was Crystal, my nurse from SGFC. She called to let me know that all of our bloodwork results, with the exception of one, came back normal. They are still waiting on my karyotype test result to come in. Hopefully they will have the results in the next few days and then we will be cleared to go forth with Dr. Mottla’s original plan. Even though we (and Dr. Mottla) expected everything to come back normal, it is still a huge relief to know that nothing is wrong. Keep your fingers crossed that we get good news on the last test and I’ll keep everyone posted!
November 1, 2009
On Tuesday, Rob & I went up to Annapolis for my HSG appointment. I was hoping that they would allow him to come back with me for the procedure, but he was not allowed in the room because of the xray pictures they take. The procedure was a lot faster than I expected and I only had one brief moment of a sharp cramping. I am very thankful that everything turned out like it did. It was definitely very uncomfortable, but luckily was not nearly as painful as what other people have experienced.
The radiologist said that everything looked great. The dye spilled right out (I saw this on the monitor) and there did not appear to be anything in my uterus such as a septum, tumor, etc that could be causing a problem. Now, we breathe a big sigh of relief and wait about 2 weeks to call SGFC and make sure that all results have come back normal so we can finalize our plan for a path forward.
October 24, 2009
Rob & I went up to Annapolis yesterday for our Day 3 testing. It is called Day 3 testing because it falls on the 3rd day of my cycle. Our first stop was Shady Grove Fertility Center. (From now on, I’ll refer to it as SGFC so I don’t have to type it all out.) I had a tube of blood drawn for hormone level testing and then had a baseline ultrasound performed. Rob came in for the ultrasound and got to see the gray fuzzy circular shaped thing on the screen that Hope, the technician, was pointing out as my ovary. She verified that I indeed do have an uterus and 2 ovaries. Woohoo! As if I had a doubt. lol (For those of you who aren’t familiar with the lingo, LOL = laugh out loud) Hope also checked for follicles on my ovaries and quickly pointed out 8 very dark gray spots on the screen that appeared to be on top of what she previously pointed out as being my ovary. She told us that everything looked great and that she expected Dr. Mottla to be very pleased with the results.
Upon leaving SGFC, I confirmed that the remaining blood work that needed to be performed at LabCorp did not require either or us to fast. We were told we were in the clear for the remaining blood work so we grabbed a quick breakfast at Denny’s before heading off to LabCorp to have the remaining tests performed. We had to have the work performed at a LabCorp facility because some of the samples needed to be frozen and apparently not all places have the ability to store frozen samples. Anyway, here we had blood drawn to test for STD’s and things such as genetic fragmenting of our X and Y (in his case) chromosomes. In addition to that, I also had blood drawn for other tests such as clotting disorders, auto-immune disorders that would cause my body to overeact thus killing off a fetus, as well as a whole bunch of other things that led our blood drawing score to be Amy – 12 tubes and Rob – 2 tubes. However, as Rob pointed out, if you count the 1 tube I had drawn at SGFC, I actually had 13 tubes drawn from me that morning. I was amused that 1) the number of tubes was actually 13, and 2) I was still able to stand up and feel half-way normal!
On a side note, one of the technicians, Sam, told us that she used to work as a Labor & Delivery nurse at GW Hospital and used to assist Dr. Mottla. She then proceeded to rave about how wonderful he is and how the entire group at SGFC is just absolutely fantastic. This made me laugh because I have heard this same exact comment from everyone I have come into contact with who has either been there themselves or knows someone who has been there. I have to admit, it doesn’t get old as it’s great to always feel reassured that we are working with such a great group.
Later that afternoon, Crystal (my nurse at SGFC) called to let me know that my hormone levels fall within the ranges they are supposed to be at and that they were very pleased to see all the little follicles on my ovaries (indicating that I still have lots of eggs).
My HSG (hysterosalpingogram) is scheduled for 2pm on Tuesday, 10/27. This is the test I am most anxious about as it is supposed to be the most painful. If you want to know the details, click on “HSG” at the beginning of this paragraph and you will see a sheet very similar to what I received in the mail. A lot of times this test is used to detect if fallopian tubes are blocked. In my case, we are pretty sure that my fallopian tubes are open. Dr. Mottla is using this test to look at the inside of my uterus to see if there are any fibroids, scarring from my D&C, or the presence of a septum that could be causing my miscarriages. I’m hoping that Rob can come in with me for the procedure. Also, I’m hoping that I won’t be in too much pain and will actually be able to see what’s happening on the monitor. I’ll post the results from this afterwards.
October 8, 2009
Unfortunately, 2009 has not led to the start of a family like Rob & I had hoped. Fortunately, we have friends and family who have been very supportive throughout the journey thus far. Now that it looks like things aren’t going to be as simple as we had initially hoped, we are going to use this blog to keep those who are interested up-to-date. A lot is going to be happening and we know there are quite a few people who are going to be there with us as much as possible even if it is just through crossed fingers and lots of prayers.
After 2 failed pregnancies (the first ending with a D&C on May 15th and the second a natural miscarriage on September 17th), Dr. Strider (my OB/GYN) told Rob & I that he wanted to refer us to Dr. Mottla. Dr. Mottla is a fertility specialist, otherwise known as a Reproductive Endocrinologist. Dr. Strider felt that Dr. Mottla would be able to complete any necessary testing to rule out potential problems that could be causing recurrent miscarriage. I was glad Dr. Strider made this suggestion as I really did not want to go through this again if there was a way to determine a contributing factor and therefore significantly reduce the likelihood of a miscarriage occurring in the future. So, I called Shady Grove Fertility Center in Annapolis, MD and scheduled an appointment with Dr. Mottla.
On Wednesday (10/6), Rob & I met with Dr. Mottla. We reviewed the in-depth questionnaires and I reviewed the 2 miscarriages I had already been through. Dr. Mottla told us we were already way ahead of the curve as we seem to have no trouble getting pregnant. He presented the various tests that he felt were relevant to the detection of an issue that could be preventing me from maintaining a full pregnancy. After reviewing these and reassuring us that all of them could be overcome (most by simply taking a pill), he proceeded to tell us that his best guess is that all tests will come back with perfectly normal results.
At this point, I wanted to cry. I had already spent a couple weeks going back and forth between wanting everything to be okay and wanting something to be wrong (that was easily fixable). If nothing is wrong, then it’s a relief because, well, nothing is wrong! If something is wrong, then that would almost be a relief because it would be an answer as to WHY it had happened and the problem could be addressed which would reassure me that the likelihood of a 3rd miscarriage would be significantly lower. I shared this frustration with Dr. Mottla and he reassured me that it was completely normal to feel that way.
Dr. Mottla then proceeded to fill us in on why he thought I was most likely having the miscarriages. (I’ll address this in more detail in a later post.) During this discussion we learned a lot about the reproductive process and about the plan that Dr. Mottla has for us if nothing turns up in the testing. It was reassuring to hear his confidence in how everything was going to work out just fine, yet at the same time was very odd to be sitting there feeling so frustrated and listen to someone who made everything sound like it was going to be a piece of cake.
We feel like we are in very good hands. Dr. Mottla is the head of the Shady Grove Fertility Center and when he reviewed the way his clinic operates, we learned that we have one doctor (Dr. Mottla) and one nurse (Crystal). We do not get passed from doctor to doctor or nurse to nurse. I was very impressed with this and felt like we would definitely be getting very personalized care & a lot of attention with having one specific doctor and nurse assigned to us.
So now we begin the part of our journey where I become a guinea pig who is at the beck and call of her reproductive system in order to complete all the testing. This is going to be completely foreign to me. All my appointments are going to be scheduled in correlation with specific days of my cycle. The day my period starts, I am supposed to call the clinic and tell them that I am at Day 1. Dr. Mottla said I don’t need to explain what Day 1 is because everyone knows what Day 1 means. This made me laugh. So, I call on Day 1 and set up an appointment for Day 3 (regardless of the day of the week, yes, you know I had to ask, “Even if it’s a Sunday?!”). On Day 3, I go in for an ultrasound and have A LOT of blood work done. The blood work will test for a range of stuff that I’ll detail in a later post. Then somewhere in Days 5 – 12, I will have an HSG (hysterosalpingogram) performed. This is a procedure that uses x-rays and a special dye to obtain better views of my fallopian tubes and uterus. In my case, they are using it to verify that there is nothing wrong with my uterus that would be causing miscarriages – fibroids, polyps, a septum, etc. Once all of these test results come back, we will be able to establish a definite path forward.
This whole ordeal has been very difficult & frustrating for me, but I’m finally starting to feel a little relieved now that we have a plan and are going to hopefully get some answers. I will try to do a better job updating this site after each appointment so everyone can stay updated. Please feel free to leave comments if you want to or shoot us an e-mail with questions or supporting words. You can leave comments here by clicking on “Leave a comment” at the top of this entry.
We’ll keep you posted!
