The Making of a $25,000 Baby

Heartbeat(s)

2012-03-04T07:04:00.001-08:00

Wow. Just wow.

Earlier this week Jill and I went for our first sonogram since we found out she was pregnant. Going in, this seemed like a much bigger deal than the original pregnancy test. That was just a blood test and a phone call later in the day. Very cool, but still – it seemed like it was just another step in the process.

I figured this would be neat – there is a visual component to sonograms that is really interesting. Obviously the images aren’t exactly crystal clear, but its still cool to put a picture to what we’ve talked about.

As soon as we started seeing things I was blown away – within 5 seconds we were looking at a picture of our baby on the screen. We knew it had worked so we knew we would be seeing this, but it was still overwhelming. There (s)he was. Hanging out. What I wasn’t prepared for was being able to see the heartbeat. I didn’t know that was possible at this point. The pregnancy calendar is a bit skewed because of IVF, but basically Jill was at 7 weeks and 1 day. And on this day our baby had a heartbeat. I am – technically – a dad. BIG stuff. Awesome stuff.

As Jill has mentioned, everything (except for the cramping and nausea) has gone really well so far. Since they transferred two embryos, there was a good chance she could have two babies – and possibly more if they divided. So after gawking at baby #1 for a couple minutes the doctor moved on to see if there were more.

Not 3 seconds later we were staring at baby #2. Again – seeing the heartbeat – knowing that my baby – BOTH my babies! – were in there and doing well was just, well, life altering!

This was a best case scenario for us. Jill and I have talked about wanting two kids forever – if they come at the same time so be it! Just an FYI – these two babies will be as different genetically and physiologically as siblings born years apart – they are fraternal, not identical.

We don’t know if they will be boys or girls yet – that info comes in a couple months. Baby #1 – who the doctor labeled ‘A’ in the photo – is lower in the uterus and is likely to be born first. I’m calling him(her) Alpha. Baby #2 – labeled ‘B’ in the photo – is a bit higher in the uterus. I’m calling this one Beta.

Just to be sure the doctor checked to make sure there weren’t any more babies hiding in there. Thankfully there weren’t. We’re really excited to be having two, but are fully content with that. Last thing we need is an army of babies and the TLC reality show that would inevitably follow. Because I think we all know that doesn’t always end well. And Jill would have to get an awful hairstyle…

One thing I want to reiterate – seeing BOTH of these heartbeats was probably the most amazing experience of my entire life. The more I think about it, the more significant it becomes. Its generated a 1000 different thoughts for me – some of which I’ll share on the blog and some of which will be kept (and rightfully so) in the corners of my brain.

Did I mention I’m a dad? Again, wow.

Call me “Patches”

2012-03-04T07:02:00.003-08:00

Now that we know we’re pregnant, the “fun” hasn’t all finished for me. Right now, I still have to do a shot of progesterone each night (more bruises). Joe has to administer those since they need to go above my rump (thus the black circles so he knows where to inject) And I’m wearing three patches of Estradiol. Both are needed because my body isn’t naturally producing all of the necessary hormones yet. Some trickery is still needed to make sure the pregnancy is safe.

The shot I can deal with; it’s almost old hat by now. But these patches are the pits!! They’re itchy and sticky; they dry out my skin too. Plus, I’m pretty sure they are causing some pretty bad cramping that, as luck would have it, all hit in the middle of the night (did I mention that I’m already exhausted at the end of each day?). Fortunately, the patches are only needed for a few weeks, and then I will wean off them. But the wait for that seems interminable right now. I look like I’m trying to really, really quit smoking!

I guess this was just another one of the pieces that was included in the box o’ drugs that I was unprepared for, and am definitely not enjoying.

Surreal news

2012-03-04T07:01:00.002-08:00

We got the call from our clinic. And it worked – we’re pregnant! It’s a phone call that changes your life and yet there isn’t much to react to. Don’t get me wrong, I can’t begin to describe how excited I am that we have had success with this whole process. But now it feels like we have lots of waiting to do – waiting to find out how many babies there are, waiting to make sure we get past the first 12-14 weeks, waiting to tell our family and friends. And you can’t really start planning for anything either. So we just keep the news and excitement inside until we get a few weeks down the road.

It occurs to me how lucky we have been through the process (not lucky to have needed to go through it in the first place). We had wonderful results with the egg retrieval (17), we had great results with fertilization (14), and we had great results with viable embryos (2 transferred and 8 frozen). I don’t think we could have hoped for each step to have gone better. For me, it’s especially such a relief to know we have the frozen embryos because this means we will never have to start from scratch with a fresh cycle. This means less needle sticks, fewer appointments and an easier process all around. So that is an extra relief for me personally.

Of course, we might not ever go through another cycle if we end up with multiples. But that’s news we have to wait for over the next few weeks.

Administrative Note

2012-03-04T07:00:00.000-08:00

February was nuts for us. I was traveling for work and working funky hours and Jill was dealing with some pretty serious physical discomfort, so we didn't post events as they happened. We've written about the events that happened during that time, though, and I'll post them in basically the same chronological order in which they occurred.

At some point we'll post a calendar of events to clarify the different steps in the process.

We will now return you to your regularly scheduled blogging...

Getting an A in Fertility

2012-02-03T09:53:00.000-08:00

If grades were given for fertility, well at least science-aided fertility, I’m pretty sure we would get an A.

Yesterday was the transfer. The day when they take the embryos and transfer them to my uterus. Pretty easy procedure, at least from my end. Only took about 10 minutes and we got to watch the entire thing on a big TV screen. The impact of that, watching our doctor transfer what will hopefully be our baby(ies), really made everything very real.

They transferred 2 embryos (and we got a picture of them!! Who gets to have a picture of their embryos - so lucky!), so now we just wait. Nine days, to be exact, until the pregnancy test next Wednesday.

I actually think the best news was the fact that besides the two embryos that got transferred, we have 8 more that are viable to freeze. Thus, the A in fertility. The nurses basically told us this was fairly unprecedented. What it means to me is that, if this cycle doesn’t work out, we do not need to start from scratch – we can do a frozen cycle (more on that in another post). This means skipping the weeks of multiple injections every night and the week of driving to an appointment over an hour away every other day.

Based on the doctor and nurses reactions, I really don’t think things could go any better. And so we wait, cautiously optimistic…

C-day according to Jill

2012-01-31T15:58:00.000-08:00

By the time we got to the retrieval, I was feeling terrible. The last ten days had become pretty disruptive of my everyday life. I had missed several days of work from not feeling well. In the early part of the week of the retrieval, I was barely able to stand up straight because I had such pain and cramping due to the hormones. At one point, I really thought that I was having appendicitis!! Apparently, I found out at one of the many ultrasounds, my right ovary is actually a bit higher than my left. So with all of the follicles growing, the pain on my right side was still coming from the ovary.

I was feeling relatively calm the day of the procedure. By then, my curiosity was really starting to get the best of me – I wanted to know how many eggs had been cooking in there!! And the only thing I was a little apprehensive about was the anesthesia. I had only had to go under once before, and that was just for my wisdom teeth when I was 16. So I wasn’t sure what to expect, but the anesthesiologist was awesome and made it all super easy. One minute I remember talking about manicures and the next minute, only about 20 minutes later, I was being rolled into the recovery room. Thinking about it now, it’s pretty laughable that I was laying there, legs up in the air in stirrups, and I don’t even remember the doctor walking into the room.

When the doctor came in, he gave us great news. 17 eggs!! I had really been hoping for double digits, but this was more than even I thought I could hope for. No wonder I had been feeling so terrible; the doctor said that both of my ovaries had probably grown to the size of grapefruits over the last week. But he was really optimistic about how things had gone and the likelihood that we would probably end up with extra embryos that we could freeze in case things didn’t work out in this first cycle.

He also told us that they consider retrieval day as conception day, which I suppose makes sense since it’s the day when the sperm and egg come together, but it was kinda neat to think about that. Although, once we got home, I said to Joe that certainly wasn’t as enjoyable as I thought our conception day would be. I had to ask him, “Was it good for you?”

Now that the retrieval was done, we just had to wait for the transfer day and I had to start the progesterone shots. But it was only one shot (which at this point was amateur’s work) and since it had to be given in my backside, Joe has to do that for me. I just have to lie around; they haven’t been painful at all. Which is a very welcome relief from the weeks of multiple needle sticks.

C-day

2012-01-31T15:57:00.000-08:00

The technical term for this is retrieval – the day they go in to get the many eggs that Jill had been growing as a result of the drugs she was on. I called it “C-Day” because the doctor said this was basically the day of Conception – after retrieving Jill’s eggs, they would be introduced to my sperm, some smooth jazz would be played (or at least I hope there was), and hopefully fertilization would occur.

It was kind of weird knowing that a 3^rd party (a scientist in a lab) would be ‘intimately’ involved in the process. At this point I’m obviously aware that this is part of the process, but driving home – thinking about what was going on – it was a bit odd.

Right now is a pretty hectic time for Jill and I – there are some other “life” things in process that have served as distractions – and I wonder if I’ll look back on this day and ask why I wasn’t more emotional/shocked/expressive. This whole thing has been a process – a rather scientific process at that – and I’ve consistently focused my attention on that. Maybe as a defense mechanism – because in isolation I think this could be completely overwhelming.

Let’s do shots – the “receiver’s” point of view

2012-01-29T12:43:00.000-08:00

It wasn’t really the shots that ever made me react emotionally; it was really the quantity of what we were having to deal with. Three shots every night for several days – that’s a lot!! And the few times when we had to add a different type of needle into the process also made me nervous because I didn’t know if this new needle was actually going to hurt when the others hadn’t so far. So the days of adding new injections were the hardest, but each one turned out just fine. None of the injections ever really hurt. I’m just glad I don’t have any real problems with needles.

Here’s the schedule of what I like to call the “pin cushion days”:
1. Ten days of Lupron injections. This was to get everything to shut down so that I didn’t have a normal cycle. Pretty easy stuff – small doses, small needle, really quick. Maybe only a small bruise or two. No problem.

2. Ten days of the serious stuff. This was a combination of Lupron (to make sure the other hormones didn’t make my ovaries go out of control), a dose of low dose hormones and a dose of Gonal-F (another hormone). The purpose of the second two hormones was to get the follicles in my ovaries to start growing, and to get more than one follicle growing at a time. Each follicle has the potential to be home to one egg, and we were hoping to get as many eggs as possible.

Now we were up to three shots every night, so a little strategy was involved. I had to take turns in which thigh I would give two injections and the third always went in my belly. Again, the needles were pretty small and the doses were completely manageable. But every once in a while the angle of the injection (which I was giving myself) would be a little off and I’d end up with a pretty gnarly bruise (as shown in the picture of my thigh). Really nothing that hurt, but seeing that blood was sometimes just overwhelming and dropped a bomb of reality in my lap of everything I was having to do in this process, and it was hard to deal with. Most of the time it was pretty straightforward to handle, but there were a few days when I just wanted it all to be over.

3. Finally, there was one injection – the trigger shot – required about 36 hours before the retrieval. It was just one injection (which was a welcome break), but it was a very large dose. I was already feeling pretty icky with everything that was going on inside, so I was a little nervous that this was just going to make me feel worse. Another easy injection, and then it was just wait and see what happened at the retrieval.

One thing throughout all of these shots that has been so amazing is having Joe there to help. As he’s mentioned, he’s had a ton of experience around needles and labs, so he was easily able to help put together every dose of every injection I had to take. Not having to worry about making sure I was preparing the needles correctly, with the right amount of stuff, every night was a huge relief. It allowed me to focus on just getting through the injections. It really meant a lot to be able to rely on him for that part of the process.

Let’s do shots!

2012-01-29T12:41:00.000-08:00

I’ll start this with just a bit of exposition. Women normally release one mature egg/month. It’s part of their monthly cycle. “Normal” people get pregnant when one of the millions of sperm cells that are a part of every “normal” sexual experience meet that egg and they, well, get funky. So the cramping and so forth that happens is the result of 1 (one) egg maturing. In IVF, they supercharge the hormones – that’s what all the shots are for – in order to get a woman to produce several mature eggs at one time – at least 4-5 and hopefully double digits. So imagine for a second the discomfort that comes along with a “normal” period that gets you one mature egg – multiply that by 10 eggs and you can imagine the discomfort that comes along with it.

Now. Enough exposition. Let’s do some narrative… As I’ve said – I’m comfortable with needles. I don’t love them per se, but they don’t bother me. I’m also comfortable drawing up doses, double checking and delivering the drug. For me the couple weeks of getting Jill primed and ready to produce a whole bunch of eggs at once was more about helping her – being a part of the routine, and trying to be supportive.

I know it was a lot tougher for her. Obviously. She is not, and has never been, a scientist. She has not dosed hundreds of subjects. Spending as much time as I have in healthcare, treatment regimens like this are more familiar to me. I imagine it was all incredibly invasive for her. As an observer, it seemed like it was the anxiety before the shots that was the most difficult for her to deal with. She was always wondering if she was “doing it right.” Every once in a while she would bruise or there might be a bit of blood – things that were totally normal over the course of 2-3X/day needle sticks. When it comes down to it though, none of this stuff was normal for her and I was definitely impressed with how she steadily plowed through it all.

Jill covers this subject (much better than I do) as well so I'll put her post up shortly.

As a note -- all of her posts will be in Blue font and mine will be in Black. Unless, of course, we find a better system...

Box of drugs – the female version

2012-01-28T12:54:00.000-08:00

“Holy man!” That’s what I thought when I saw the size of the box that the drugs were delivered in. I thought we were only talking about three different vials of hormones with a few needles provided. But this box could’ve held about 6 pairs of shoes.

And when we actually opened the box, it contained more than I was aware of or had ever been told about. I think that’s where most of my anxiety came from in considering this box. I was prepared for the shots, but I had no idea what this other stuff was for, and I really wanted to make sure that we did everything right so that we got good results. What if I missed something that the nurses told me? I mean this box had three different types of injectible hormones, hormone “patches”, three bottles of pills, and four (yes, four) different types of needles. It even came with a hazardous waste container. And, we were still waiting for another injected hormone to arrive from another pharmacy company.

I was definitely excited about the process. We’ve known that IVF was in our future for well over a year, and knowing that (as the person who would be on the receiving end of everything IVF included) had caused a bit of anxiety ever since. Most of the time, it wasn’t something I thought about. But, now, here we were, ready to start this whole journey. No turning back!

This has been two years in the waiting, and I felt mentally prepared for the fact that this was going to be challenging both physically and emotionally. It was just that the box took me off guard and took a while to get used to. The thing that really helped make everything more manageable was the fact that these shots were only really going to last about 3 weeks, and I could certainly live with that. And, of course, the results at the end could be what we’ve wanted so desperately for so long now.

Big 'Ole Box of Drugs

2012-01-27T15:36:00.000-08:00

Having been raised in the US and being a fan of pop culture, I’ve seen my share of drug movies. Thanks to Scarface, I’ve seen what a big ole pile of drugs looks like. In addition, I’ve worked in the Pharma industry for nearly 10 years. I’ve marketed drugs, measured drug levels in patients, studied how different people metabolize drugs, and I’ve even been in a couple clinical studies myself.

With this background you would think I wouldn’t bat an eye at the box ‘o dope the fertility folks sent us a couple weeks ago (following us forking over nearly $3200) but I did. It was impressive. Looking at my wife and thinking that most or all of this was going to be given to her – the majority via needle injection – was pretty daunting.

I think the shock was worse for Jill – I’ve opened boxes full of needles before. I did some animal testing in the past and I’ve dosed more than my share of lab rats with god-only-knows-what via injection. For her, though, it had to be intimidating – all those needles, various solutions – I forget sometimes how foreign and, for the lack of a better word, scary it can be.

Mostly though, this box of drugs represented all that thought and all that planning becoming reality. We were starting IVF. This involved handing over the money we had worked for. This involved starting the meds and the shots every night. This involved the potential for a baby 9-10 months down the road. At the time, we were more focused on the procedure of it all – making sure we got the right amounts at the right time – that kind of stuff. Now – only two weeks later the big picture has started to set it a bit more.

From my current understanding, the differences between IVF and a traditional pregnancy start about 3 weeks before her egg and my sperm “do their thing” in a petri dish somewhere and continue until about 2 months after “conception.” This initial round of drugs is used to generate a whole bunch of eggs (which I’ll get into more in my next post) which are collected and removed. Obviously, in traditional pregnancies, fertilization happens internally (which is called in utero fertilization or just ‘plain ‘ole gettin’ knocked up’). Then the petri dish dance party happens and they transfer the fertilized egg back into Jill. Since this happens outside the body it’s called In Vitro, which in Latin means Within Glass. Then the next round of drugs is used to get all the “you’re growing a baby” stuff happening – which is needed because since fertilization didn’t happen internally, Jill’s body wouldn’t know that it needed to get going. After a couple months of jumpstarting, her body catches on and she goes off the meds and we basically transition over to a normal OB/GYN and it’s a “normal” pregnancy from that point on.

Please note I said normal pregnancy – NOT normal baby. No child of mine will ever be called normal. I simply won’t have it!

Hello World

2012-01-26T14:26:00.000-08:00

So. Hi. Thanks for stopping. A bit of introduction is probably necessary. I'm Joe -- my wife is Jill. I tend to think of this as "our" blog and hopefully you'll see posts from both of us at various points. Anyways -- We're in our mid-30s and we own a home. When I was younger I had what I called the trifecta -- it was the measuring stick by which I judged how "grown-up" a person was. It, logically, consisted of three parts -- marriage, owning a home, and having kids. So we have the first two taken care of, but the third -- that one wasn't quite so easy...

I don't want to ruin all the good stories right off the bat, so I'll save the specifics of why we're going through IVF for a later time. Clearly, though, we can't have kids the 'old-fashioned way.' We tried -- and it was fun -- but after about six months or so it become clear that it just wasn't going to happen, so before we relocated from Chicago to Milwaukee we were both scoped, poked, and prodded to find out what was up. Not too long after moving to Milwaukee we started the process by visiting with a few different IVF docs. Now -- about a year after moving here -- we're actually getting the process started. And its a lot. Which is why we decided to start a blog.

The way I see it, there are roughly three main goals we would to accomplish with the blog:

1) Educate. Probably for the most part this will be friends and family, but it would be neat to help people we don't find out more about the process.

2) Update. See, the thing about IVF is that -- we think about it all the time. It's all-consuming. So when we're not talking about it, or - amazingly - not thinking about it -- we don't really want to talk or think about it. But we also fully recognize that people are interested -- as they should be. This is our way of saying -- hey -- this is whats going on, without having to answer the question "How is IVF going?" Because the honest answer really goes one of two ways -- its either 'it kinda sucks and it costs a lot of money' OR 'I'll tell you in 9 months.' Both are pretty accurate.

3) Record. Maybe this is narcissism - I don't know. I just think it'll be interesting to come back and look at this in the future -- regardless of how things work out.

Lastly, just a heads-up as to subjects coming at some point in the future -- I'll break down that $25,000 number in the blog's title, give more about the biology and what is happening, and we'll definitely spend a lot of time talking about what the experience is like. Because it's crazy, it's weird, and hopefully -- it'll be successful.