IVF vs. FET: Our Experience

As most of you know, we recently did a Frozen Embryo Transfer in an attempt to get pregnant again. Unfortunately, it didn't work, but I wanted to talk a little bit about the experience now since I didn't blog during.

I mainly wanted to talk about the differences because it was very similar to IVF in most ways.
The overall difference between the two procedures is that IVF starts from the very beginning. Meds are give to stimulate the ovarian follicles in order to be able to retrieve eggs. The eggs are then fertilized and different meds are given to prepare the body for pregnancy. With an FET, the embryos are already created, so there is no need for stimulation of the ovaries, it is all with the goal of preparing the body for pregnancy.

Meds:
Many of my meds were the same as during IVF (here too), but there were a few differences. This time I gave myself Lupron injections, estrogen (e2v) injections (instead of suppositories, my mom gave me these, because they're best in the tush), dexamethasone, an antibiotic, and progesterone suppositories.

The Lupron was an every day injection to prevent ovulation (I think). This was the same as IVF. The e2v is to thicken the lining of the uterus. Last time I had suppositories instead, and I think I started them later in the cycle. I got one injection in my butt twice a week.

You start out with this big scary needle to draw up the medicine. It's a thick liquid, so alarge needle is needed.

Then you switch to a smaller, yet still terrifying, needle, haha.

The dexamethasone was the same as last time. It's a low dose steroid that acts as an immune system suppresant, to keep my body from attacking the baby as a foreign body. The antibiotic and the progesterone were also the same.

For the most part, the side effects weren't as pronounced this time. I had some mild nausea off and on from the progesterone and estrogen I think. The main side effect I noticed was from the dexamethasone. It made me hungry and made me feel like my blood sugar dropped shortly after eating.

Weight

I worked really hard to lose weight before starting my FET and actually started at about a pound or two less than when we started the IVF. I lost thirteen pounds total. Unfortunately, between stress, the dexamethasone, and being on vacation with food everywhere, I gained back ALL THIRTEEN POUNDS during the two week weight. More on this in another post, because it's a major struggle right now. During IVF I only gained five pounds and most of it was bloating.

Emotions

It was bizarre emotionally this time. I felt less connected to the whole process. Maybe partly because I wasn't blogging about it, but mainly because I was so focused on Cai and generally less desperate. Not that I didn't want another baby as much, because I certainly did, but it didn't feel like life or death like it did with our first round because we already have Cai. With Cai I prayed CONSTANTLY and talked to the embryos constantly. This time I didn't have as much alone or quiet time, so it was a little different. I also spent more time getting massages and chiropractic adjustments last time. This time I didn't have the money to do that, so it wasn't really an option. I also struggled with feeling like I was being over confident this time because it worked the first time for us. 

Cost

According to Steve, the overall cost of IVF, start to finish, including testing, meds, and embryo storage fees, was about $20,000. The total cost of the FET this time was about $6000. 

The starting cost for an FET at our office was $4500 (I think the prices had just gone up, but I'm not sure). Meds were MUCH cheaper this time because there were fewer and because our insurance covered more of them. That was a huge blessing for us. Most of the additional costs were tests that I had done before starting, both through our fertility doctor and my PCP. I was concerned about possible thyroid issues and wanted to get that taken care of before starting. I was also taking some natural supplements to help prevent the preeclampsia and cholestasis I experienced while pregnant with Cai. In addition, there are a few procedures before the actual FET process starts that are not covered in the $4,500 total and were not covered by insurance. Also, the cost of storing our remaining embryos went up significantly. Before we do another FET I will have to undergo some testing in order to be sure that my body didn't do something to prevent implantation. I'm not sure what that entails, but I'm pretty sure insurance won't think it's necessary. 

For our IVF we pulled money our of Steve's 401k to pay the majority. We were also, as a couple, making about three or four times what we are now, haha, so we had more money available in general. For our FET we relied on gifts from friends and family (THANK YOU!), selling some things, and credit. I think that made it even harder when it failed.

If you'd like to help us with that cost and the cost of our next two transfers with our remaining embryos, Steve has started a Go Fund Me page for us so that you can do that.

To be honest, I have mixed feelings about doing another round. First of all, I want to lose weight again. More this time, if I can. Part of me can't wait to jump right in again, but another part of me is dreading going through all of the meds and appointments and uncertainty again. I so want more children though. We want Cai to have siblings. I pray daily for our last two little frozen embryos (as I did when there were four of them), and I can't wait to (this probably sounds weird out of context) have them inside me where my body can keep them safe, but I'm also afraid of what might happen again. 

Prayers would be greatly appreciated. Also, if you're going through this or thinking about going through this process, please feel free to reach out to me with questions or just to talk. Also, I'm in an awesome support group on Facebook called Baby Fever which I highly recommend, and its sister group Fertility Friends which is for women who have already conceived but have or are still struggling with infertility. Please let me know if you'd like an invitation!

IVF and Side Effects

First of all, let me say that if you are not doing IVF, thinking of doing IVF, etc., there is little point in reading this post. Some of it will be TMI, and some of it will be boring. Just a little disclaimer. I'm only sharing because these are the kinds of posts I'm finding really helpful on other people's blogs.

Side effects I'm dealing with during IVF

Hot Flashes- This one I expected because I had similar issues on Clomid. They actually aren't even as bad as they were on the clomid.

Headaches- I've had a headache almost consistently for the past three or four days. Some moments were really bad, most were tolerable. This is a common side effect during IVF. However, tension headaches are pretty normal for me and the weather has been pretty up and down lately, so they could be totally unrelated to my meds.

Thirst- I am so thirsty all the time. Constantly. To the point that while out with my family Friday night, my mom said, "Boy, you really are thirsty all the time." I guess this isn't really a bad side effect to be dealing with except that teaching isn't really conducive to all of the peeing that comes with all of this drinking.

Weight gain- I've gained four pounds since starting the stimulating meds. Some of this is due to the meds and what they do, but I'm sure some is because I've been eating a ton because I'm also dealing with...

Hunger- Because of the steroid I'm also on, I'm hungry. Like, I'm constantly thinking of the next thing I could be eating. Food literally calls to me. I've been trying to be careful with the quality of what I'm eating. For example, last night I was craving dessert, so I made cinnamon rolls with whole wheat flour and sucanat, in an attempt to lower their glycemic index. Sometimes I'm not very good at all, as in eating cupcakes that I keep finding in the teacher's lounge (apparently we're in a big birthday flood right now). I'm still trying to cut out gluten when I can and use as many quality and organic ingredients, but I'm not always succeeding.

Bloating- This isn't severe, at least not sever enough for me to be afraid of hyper stimulation, but it's uncomfortable. Anything I eat makes me feel bloated. For example, Saturday I ate a whole wheat English muffin and a banana for breakfast, and I was bloated as if I had eaten an enormous meal for about four hours afterward. I did use this as an excuse to buy myself two skirts, a gray jersey maxi skirt from Walmart this striped jersey skirt from Target. It's comes a little bit below my knees and is cut kind of like a pencil skirt. The nice thing is, both skirts could easily be used into pregnancy because they're super stretchy and comfy.

Tenderness- This one is probably way too much information, but I have some pretty significant breast tenderness. My belly is also slightly tender from the injections.

Bruising- This one is pretty obvious, but some of the injections leaver bruises on my belly. I've only for a couple, and none of them are major, but  between that and some of the little puncture marks from the needles, my belly looks like like a connect the dots.

Mood Swings- It's very difficult for me to tell you if I've been experiencing these. Earlier this week I was pretty weepy, but I was also super stressed out because of circumstances. Now that things are normal, I'm not feeling any out of the ordinary emotions. If I am experiencing mood swings, they are very mild.

Today I'm Feeling...

Today I'm feeling...

Tired. The past couple of days have been super stressful between financial drama regarding the IVF and the snow causing me to be late for doctor's appointments, and battling a severe headache today. Is it spring yet?

Relieved. All of the financial issues were worked out thanks to an amazing husband who jumped to the rescue to the point of leaving work early and driving two and a half hours to pick me up and work things out at the bank, and thanks to God's perfect timing with our income tax return.

Thankful. For my Lord's perfect timing. Between all of the money falling into place at literally the eleventh hour and some other little things that He's done, I'm feeling so thankful. I mean, even, in a weird way, the fact that my sister has been sick and home from work for a few weeks now has been a blessing. Having someone here with me when Steve is stuck at work because of the snow has made this stressful time (and dark winter) bearable. I'm not glad that she's sick, but the timing has been a blessing to me and I'm so thankful for her and how she's helped me. (Pray for her if you think of it. Although she's not really in any real danger, the time until full recovery is indefinite right now.)

Excited. It's all really starting to feel real now. I will most likely be pregnant soon (I'm not going to share the exact timing, partly because I don't know it yet, and partly because I want to be able to keep it to ourselves for at least a day or so after we find out, haha).

Hopefully Expectant. I feel like I have turned a corner with hope and am feeling more expectant than intrepid right now. I feel like I had to take a faith jump this week to prove that. It's a silly thing, but I have to order my bridesmaid dress for my sister-in-law's wedding which is in July. The dress is being discontinued, so I have to order it before I find out that I'm definitely pregnant, but I'm still going to order as if I will be pregnant. Actually, per the David's Bridal consultant suggestion, I will order three sizes bigger instead of the normally suggested two sizes because as she put it, "you're more likely to have twins, so I would go up three sizes." Apparently she is moderately familiar with IVF, haha.

Puffy. I started the FSH stimulating meds this week and my ovaries started to feel puffy and bloated very quickly, like after the second day of these. Because of my PCOS, I'm at risk for hyperstimulation, so this concerned me, but I went in for my bloodwork today to check my estradiol level and the doctor decided to cut the rest of my Follistim doses in half just to be safe. This makes me feel better and safer. Ovarian Hyper Stimulation Syndrome is not super common (I think like 5% of women get it or something), but another blogger I follow, who also has PCOS, just went through it, and I'd like to avoid it at all costs.
Because of the puffiness in my abdomen, I've been leaning toward looser clothing like yoga pants, and stretchy skirts and dresses. Unfortunately I can't wear yoga pants to work and have a limited number of dresses and skirts that I can wear (especially with boots which I'm leaning toward because I'm still having to park at the end of my very long driveway and walk down through the snow every morning), so I'm finding myself making a wish list of dresses like this one from Like Twice or this one from Target.

Sore. I'm not a huge fan of the Follistim pen and the menopur injections. They sting for a while afterward even after I ice the injection spot. Keeping busy and distracted after giving them helps. So does putting ice on them afterward, but I'm still not loving it. Giving myself the lupron injections made me feel empowered. These new ones are not my friends though. I did read some tips on handling these from this blog and this one.

Surrounded. By the prayers and encouragement of so many people. It makes me really glad that I'm being open about this process. Although I'm sure others think I'm nuts because I'm being so open, it has made me feel loved and helps to know that so many people are praying. My coworkers and bosses have been particularly amazing and accommodating. My family has also been absolutely amazing.

Well Taken Care Of. I'm so happy with our choice of doctors. We decided to go with Sher Fertility Institue of New Jersey and everyone from the receptionists, to the nurses, to the office manager, and Dr. Peters have all been incredibly helpful and understanding and kind and just generally wonderful. I think it's such a big deal, and unfortunately not common in many doctor's offices, to have kind and helpful office staff. I'm so thankful for it.

Ready.  For spring mainly. I'm ready to not spend an hour plus trying to get my car out of the driveway on the morning of an appointment and work (like this morning). I'm ready to be able to say yes to people who want to come view our still-for-sale house instead of no because of the driveway being a mess (the plow we hired never showed and now it's kind of even too messy for a plow). I'm ready for green and buds and warmer weather (the forty degree days we've had this week have been INCREDIBLE) and all the hope that comes with it.

Overall, I'm keeping scripture like the one above (a verse my mom had me memorize when I was plagued by nightmares as a child) are keeping me focused. I'm so very thankful for this opportunity and so very hopeful that it will end (or rather begin) in parenthood for us.

Thanks for your prayers!

Not So Smoothie Saturday

I intended to share another smoothie with you today, but because of the stomach bug I've had for the past three days, a smoothie is one of the last things I felt like making this morning. Instead, I'm just sharing an IVF update.

The only nice thing (if we're looking for a nice thing) about having this stomach thing and not being able to eat much is that it knocked my weight down a few pounds which is nice considering the meds I'm on/will be on soon will most likely make me gain a few pounds. Considering I'm already overweight, that's something I'm trying really hard to avoid, at least until it's the weight of a baby. :0)

I had some tests done this week; blood work and ultrasounds and such. I learned that I have a nice, clean uterus and ovaries. I currently have no cysts or fibroids or other issues. That particular ultrasound wasn't super fun. It was internal and included two different catheters. One of the catheters was a mock embryo transfer, so although it wasn't exactly comfortable, it was nice to know exactly what that will feel like and that it wasn't terrible.  It all went really quickly; in fact, when I went back out to the waiting room to call Steve in, he thought I had just been taking awhile to give a urine sample and had no idea that I was done with the ultrasound already. Overall, that was all good news.

After the ultrasound we spent some time with nurse learning all about how to do the injections I will need. I will be on four different injectable meds and each one is slightly different. The first of those injectable meds arrives this week (we didn't order them all at once because insurance isn't covering any of them and the nurse recommends applying for discounts for some of the others before ordering...I don't start those meds until later in the month anyway). My med protocol includes the following:

Dexamethasone (oral)- a low-steroid to keep my body from attacking the embryo once it is transferred to my body. I'll take this throughout almost the entire process.
Birth control- to prevent cysts on the ovaries. I'll take this for almost two weeks.
Lupron (injection)- lowers estrogen levels, shrinks uterine lining, prevents ovulation. I'll be on this for over two weeks.
Menopur (injection)- a stimulation med to help follicle growth. This one comes with two vials that need to be mixed. According to my current calender, I'll only be on that for six days, every other day. I say "current calender" because I will receive further instructions at the end of the month depending on how things go and when my egg retrieval is.
Gonal F (or follistim depending on whether we can get a discount or not) (injection)- another stimulation med. This one is nice because it's in the form of a pen. I just need to dial the right dose, just like you would with an insulin pen. I'll be on this for about a week.
HCG Trigger shot (injection)- this one needs to be mixed too. I only take this one once (thank goodness because it's an intramuscular shot) 34 hours before the egg retrieval.
Progesterone- I'll start on this after the transfer. My doctor's office uses progesterone suppositories instead of injections. Apparently studies now show that the suppositories work just as well as the injections, but they are a lot less painful. I'll be on that at least until they confirm the baby's heartbeat, if not longer.

I also found out that my blood work showed that I have slightly elevated levels of antithyroid antibodies. I still need to call the doctor's office for more information, but I know a little bit. The doctor didn't seem to be super concerned and even suggested that further testing was up to us and not absolutely necessary, but it could potentially mean we have a higher risk for miscarriage. That makes me nervous, but I'm choosing not to worry about it. I will find out more from the doctor on Monday, and like I said, he didn't seem to think it was something to be concerned about "in my case."

Overall, I'm feeling a little overwhelmed right now. Last week I was feeling in control and on top of things. I was eating better, going for walks, ending my night with a nice yoga routine. It felt pretty good. But this week, the combination of the blood work results, the stress of the cost of it all, and this stupid stomach bug knocking me down, I don't feel like I have any control over how this all works out. And really I don't. And that's a good thing, because the Lord is much more qualified than me. I know that it's important for me to remember to rely on the Lord through this, over and over again. It's not super easy though.

This whole time, without even realizing it, I've just been assuming that all of this will work, and we'll have a baby, or two, this time next year. Perhaps that has been faith that this is God's timing for us, or perhaps that has just been wishful thinking. Suddenly though, it has occurred to me that in a little over a month, we could be going through another devastating experience. Or we could get pregnant only to lose the baby. I have to consciously be reminding myself that no matter what the outcome, no baby or three, we have a God who loves us and will help us through it. Moment by moment.