you take the good, you take the bad, you take them both and there you have...

i am on a bit of an information overload right now but feel it is best to try to get all of these facts down while they are still lurking around in my brain. we were at rrc for 4 hours today meeting with the the nurse, doctor, scientific director, financial counselor followed by having 4 viles of blood drawn and an exam that i will not be able to talk about without mucho vino. i know i said i was going to put it all out there but you have to draw the line somewhere and the pelvic ultrasound is the line. no doubt. in a nutshell, what we have is an abundance of information and now we have to try to dissect it and decide where to go from here. we can start the process whenever we like, it is not as i originally thought based on my cycle. when we decide it is go-time they will first have me begin to take birth control pills. i know, didn't sound right to me either. i spent the last, well the number is not important, so many years trying not to get pregnant and now you want me to start taking birth control to try to conceive? apparently the birth control pills is a way to tell your body to stop ovulating and allows the doctors to come in with hormone injections and various medications and take over. so, i am going to try to describe the process to the best of my ability.

here goes. for argument's sake, let's say we are going to start this process tomorrow. i would begin taking birth control pills and lupron for the first half of the in vitro cycle to suppress my body's production of hormones that cause stimulation and ovulation. i should probably point out that an in vitro cycle lasts approximately 2 months. once suppression is confirmed by ultrasound and blood tests, i will begin gonadotropin injections which should stimulate the ovaries to produce eggs. these injections will be administered by josh once or twice daily and last about 8-10 days. the nurse actually said after informing us of this "man he looks like he wants to bend you over and throw it at you like a dart." i am assuming you can picture "the look" josh got after that. from here, i will have 2-3 ultrasounds and blood draws to monitor the follicle development. when the doctor has determined that the eggs are ready to be retrieved, josh will administer a "trigger shot" aka "the big one" to mature eggs for retrieval.

the eggs are retrieved approximately 36 hours after taking the trigger shot. i will check in at overland park regional center where an anesthesiologist will sedate me and proceed to suction the fluid from the ovarian follicles with a needle. the eggs come out with the fluid. this was the part that i apparently skipped in all of my research. it is apparently more painful than i had imagined and i will be on bed rest (only able to get up to go to the bathroom) for the two days following. if there is a silver lining it is that i will get some good pain meds:)

the follicular fluid will immediately be examined in the ivf lab, and the eggs will be counted and placed into culture dishes. they will tell us at this time the number of eggs retrieved. the embryologists will attempt to fertilize all mature eggs. they will call us each day with an embryo count. they like to retrieve 12 eggs on average with at least 70% of them continuing to mature.

assuming at least one, and hopefully two (i will have more on this later) mature, they will be transferred to the uterus through a long flexible tube. josh will be there with me and we will be able to see our embryo(s) on the monitor prior to the transfer. the transfer is a simple (their words, not mine), relatively painless procedure that takes only a few minutes. they said "relatively painless" and "comparable to a contraction" in the same sentence. i was fortunate enough to be in the room for the birth of my niece and nephew and witnessed first hand my sister's head spin around in one of those "relatively painless contractions" but i guess i will take their word on it. from here, i remain resting for 15 minutes after the procedure followed by another 2 days of bed rest. they stated, and i have it in writing, "no cooking, cleaning, chores, projects, or errands, for 48 hours." just thought i better put that out there as it is a pretty valuable piece of information. i will return to rrc 8 days later where they will draw blood to determine if i am pregnant and they will call us that afternoon to let us know. if positive, they will repeat the blood test a couple of times over the course of 3 weeks followed by 1-2 ultrasounds to confirm the heartbeat or heartbeats and make sure it is not ectopic and then my regular ob takes over from there.

whoo, if you think you are exhausted imagine having it regurgitated to you over four hours and then asked to write a nearly $700 check and be on your way. so, those are the basics, although there seems to be nothing basic about it. now, i don't want to cover it but feel it needs to be...where things can go wrong. during my pelvic ultrasound they found that one of my ovaries is much smaller than the other. while it is not something to be extremely alarmed about at this point it is certainly nothing to jump for joy about. apparently the bigger the ovaries the more the eggs and obviously the more the eggs...you get it. plenty of woman have had babies with only one ovary so at this point we have no reason to believe this will be a major obstacle. it is imperative that we have embryo's left over that can be frozen for future use for two reasons. one, if it doesn't work the first time (which it doesn't for 60% of women in my age group) then to try again we just have to thaw one or two out and implant it and can skip over a lot of the invasive stuff it took to create the embryos. two, it would cost a lot less to to do it that way, if we have to start over again we will have to pay full price, which is nearly $15,000 per try. obviously, there are a number of things out of our control that are no different than pregnancies created in the bedroom so there is no reason to worry about that.

so, in a nutshell, we have no idea where we are going from here. we could start tomorrow if we wanted but we have to have $11,000 up front 4 weeks after we start and that doesn't even cover the whole process. so unless we or one of our super generous friends or family hits the powerball tonight we have a lot of figuring out to do. we are both remaining positive, we just need some time to let it all soak in. i will update tomorrow when the doctor calls with the results of our blood tests. oh yeah, the blood tests, i don't believe i explained what that is all about...i promise to do so tomorrow.