The Phone Consult

Our doctor called us this past Monday to discuss our past and, potentially, future treatment.  Of course, she called 45 minutes late, meaning we were at school until 5:30.

First question was "how are you holding up?" And the answer was "I'm a wreck."  I feel better now, however, now that we have a plan.

Dr. Johnstone said that there are a lot of reasons why my body isn't responding to the medication the way we want it to.  She said part of it is having my diabetes under control.  I guess I kind of thought it was?  My A1c was under 6 the last time I had it checked, and for diabetes patients, under 7 is considered normal.  I think for non-diabetics, normal is 4 or under?  Don't quote me on that. 

Another part is being a hippo.  She said that losing weight would help my body respond better to the medication.  So...that's what's next on my agenda.  I'm not quite sure if that will mean a membership at Anytime Fitness or the city Rec Center.  Ryan and I will have to discuss that.

Dr. Johnstone told us that she has discussed my case with the other physicians at the U, and they will continue to discuss my case if we try this again.  The game plan if we do this again is to try to OVER stimulate me.  I will need to be monitored more regularly than I do right now.  MUCH more regularly.  I think that I will need to stay in Salt Lake over the course of the two weeks of stimming meds.

I guess what I'm trying to tell you is that we're going to try again.  In June, right after school is out.  I'm thinking about taking the tent down to Salt Lake and just living at a KOA for those two weeks.  I hate driving back and forth. 

Until then, I have several things going on.  I will be on birth control pills from now until then to regulate my cycle.  During our spring break I need to go to Salt Lake for a test called a sonohysterogram that will take a look inside my uterus to make sure all is well for a pregnancy.  I've had an HSG before to check to see if my tubes and the uterine cavity were good to go.  They were, but by the time April rolls around, it will have been a year and a half, and since we know my tubes are clear, and since we're doing IVF anyway, we need a more detailed test for the uterine cavity.  We're going to be working diligently on the losing weight thingy, and saving money.

Speaking of saving money, the doctor also said that they will be ordering meds through the University of Utah pharmacy from now on, because they can get them for the same or LOWER price than the specialty mail order pharmacy.  This is nice because hopefully we'll be saving money, obviously, but also I can get smaller doses of the really, really expensive meds without having to worry if they're going to get here on time, or having to worry about switching drugs with the clinic.

So that's where we are.  I'll be scheduling the saline sonohystogram within the next week for April, or at least calling to see what I need to do for that.  I go to the diabetes doctor on October 18th, so we'll see what she has to say.

I'm sure I'll be updating between now and then...

Attempt Number Two...

Didn't work, either.

Because apparently I'm a freak of nature.  And apparently my doctor has a hard time telling me the honest truth.  And that irks me off.

I went for my first stimming ultrasound on September 19th.  And my doctor told me everything looked textbook, and that I had a hole lot of maturing follicles.  She also told me that this initial ultrasound looked much better than my first one during the cycle in June.

She said I wasn't ready for retrieval yet, and had me come back on Wednesday, September 21st.  This ultrasound wasn't as good.  She said there hadn't been much change since Monday.  She wanted me to come back the next day for another ultrasound, hoping for some measurable growth.  Sick of driving back and forth, I made a hotel reservation for the following night, and lesson plans for Thursday and Friday, because I was expecting to have to go to another ultrasound that day for a retrieval on Sunday, according to my doctor.

Unfortunately, after Wednesday, I was feeling pretty hopeless.  I was bawling as I called Ry after the appointment, because this is exactly what had happened in June. 

I drove back home Wednesday evening, making the latest appointment I could so I wouldn't have to leave at 4:30 in the morning, I could leave at 6 instead, which is much more manageable.  I felt better on Thursday than I had in two weeks.  So I knew things weren't good.

I got to Salt Lake on Thursday morning expecting the worse, and that's what I got.  There was no measurable growth again, so my doctor decided to check my estrogen level, hoping that it was close to 1000 and we were about ready to make some sort of hormonal breakthrough.  While in the ultrasound, I asked the doctor if there was any point in trying another round of IVF.  She said there probably no point as I was on a pretty dramatic dose of stimulating meds and there wasn't much of a change in my ultrasounds, but she wanted to do some blood work to check.

After leaving the clinic, I called Ryan again, crying even harder, because even without the blood results, I knew it was over.  I don't know if I'm upset that we spend this horrendous amount of money on something that didn't work AGAIN, or if I'm upset that I'm not going to be pregnant right now...or ever.  I went to downtown Salt Lake to Barnes and Noble and spent a few hours there waiting for the phone call about my blood work.  I drove up to Park City to wander around the outlet mall for a little bit.  While there, I got the phone call saying that my estrogen level was at 197.  While that was 20 times (literally) better than my estrogen level at the same time in June, it was still 800 points lower than it need to be.  It was official, it was over.  I was told I could come back for an ultrasound on Friday just to check, but I refused.  There was no reason to continue torturing myself.

So I drove the remaining two hours home, crying all the way, mourning the loss of an opportunity to become a parent.

Now the question is "where do we go from here?"

And the answer is that we really don't know.  We have a post-cycle phone conference with my doctor on Monday after school.  And honestly, she's going to hear it.  I want the WHOLE truth.  I want to know if there's any way to remedy this low estrogen level.  We want to know if there's alternate medications we can try, etc.  If we're not satisfied with the answers, I think we're going to move our money somewhere else.  Hopefully she'll be able to give us some other solutions to the issues we've face through both of our IVF cycles, and we'll try it again.  I don't want to miss any more school, so I'm hoping that the busy weeks can be over my Christmas vacation.  If it can't we're going to have to wait until next summer again.  My students deserve to have me, not a substitute.

So that's where we are.  Ryan wants to continue with infertility treatments, and to tell you the truth, I'm not a huge fan.  I don't want him to resent me for not trying all the times we could have, though, so I'll continue.

Please pray for us as we struggle through the decision-making process.

Tomorrow is the day...

I begin my stimulating meds for our second try at IVF.

I'll be taking almost twice the amount of stimulation meds I did for our first attempt.  I have bloodwork at the butt crack of dawn on Thursday that will be completed stat so my doctor in Salt Lake can decide whether or not I need to take more meds, less, or stay where we are.  I have my first ultrasound during the stimulation on Monday, September 19th, and expect an ultrasound every other day until its time to take the trigger shot.  Thirty-six hours after the trigger, we have an egg retrieval, and then 5 days after that, we'll have our embryo transfer and hope for a positive pregnancy test.

We've been going back and forth on how many embryos to transfer.  Transferring one would probably be best health-wise, but transferring two really increases our chances of a baby.  I think we'll do this:  transfer one REALLY good embryo, and maybe one NOT so great embryo.  We know that God is the only One who can breathe life into our little ones, regardless of the "grade" of embryo they are.

So...please pray for us, and our future little ones as we go through this process.  Please pray for some emotional stability, and healthy stimming and hopefully a healthy pregnancy...

Round 2

After our first IVF cycle got cancelled in June, I was prescribed a medication that was supposed to help "calm" my ovaries and bring on the beginning of another cycle (chicky time).  That med was supposed to work within about two weeks.  Alas, it did not, so I contacted UCRM (Utah Center for Reproductive Medicine) at the beginning of last week and asked why.

Of course, they asked if I could be pregnant.  I kind of wanted to take them into a room and tell them how that stuff works, and how it's not possible, but I took a pee test and of course, it came back negative.  They ordered a beta HCG pregnancy test (what a waste of money), along with some other type of hormonal tests.  I got my results on Monday, and the nurse from UCRM told me that I had apparently ovulated on my own and I should expect chicky time within a week or two.

So...chicky time showed up on Wednesday, and I contacted UCRM to let them know.  I was instructed to start taking my birth control pills on Saturday, and they would order my meds for me.  I start taking my first injectable medication on August 28th, and we are hoping for a retrieval between September 25th-29th, and a transfer shortly after that.

I'm having a hard time with this.  I had a meltdown a couple of nights ago that I will blame on unplanned PMS.  The hormones make me miserable sometimes, and I've probably cried more in the past three months than I have in the past three years.  I struggle with actually wanting to be pregnant.  It's not that I don't want a baby, because I do.

So we're going to try this another time.  I know God doesn't give us more than we can handle.  Here we go.  Keep us in your prayers.

Second Ultrasound--Success! Third Ultrasound--Not So Much

I'll just say this:  We're done.  There is no egg retrieval, no baby this time around.  If that's what you wanted to know about, and that's it, you can move along.

The second ultrasound I had was to check to see if follicles were growing and my body was responding.  We were all good!

My last ultrasound wasn't anything like the first.  Actually, I take that back.  It was EXACTLY like the first.  And that was the problem.  I only had about 5 follicles that were above 10 mm, and they hadn't grown as well as we'd hoped.  In fact, they hadn't grown at all.  My body wasn't responding to the medication.  My doctor tested my estrogen level to see if it was in transition, but it was still REALLY low.

Because of all of that, my doctor said we could continue with the medication, but that it would probably be pointless, and expensive, to continue.  The estrogen-level check confirmed that.

Needless to say I was really upset.  I was told that there was an open consult room I could use to get myself together.  I felt like I was inconveniencing them.  I feel like they don't like that I don't know what's going on.  Like I was stupid because I didn't know that I would have THREE different doctors.  I feel like they think I'm stupid because I called bawling because them and my insurance company couldn't get their poop in a group to get preauthorization for our meds...which would be denied, making me eligible for some significant discounts for said medications.  We could have gotten a $500 discount on the "liquid gold" medication.  $500 might not be that big of a deal to some people, but its a huge deal to us.  Its an even huger deal considering we have to do this AGAIN.

I don't know how long I can continue this.  The past week since I went off my stimming meds has been pure hell on earth.  Bleeding, headaches, tummy issues. I know that some women do this multiple times.  I just don't know that our finances and my body can handle it.  When I'm doing all of the stimulation meds, I'm doing 8 shots a day...it sucks.  Even now, a week later, I can barely find a spot to give my insulin that doesn't hurt me...

So that's where we are.  I'm taking another medication to help calm my ovaries down and induce chicky time.  After that, I get to start this all over again.

I just want a baby...  I'm angry with God and just generally discouraged.  I know I said it would all be okay, and it will be.  I think I understand God's gift of time...

First Ultrasound--Success!

I drove to Salt Lake today by myself for my first screening ultrasound.  I met with the doctor who was on call.  His name is Dr. Peterson, and he is the director of the Utah Center for Reproductive Medicine.  I talked to him previously regarding our consent forms and in regards to our moral issues regarding what we're doing.  He is kind, compassionate, and caring.  I was really impressed with him, and I'm sad that he's not going to be the main doctor on our team.

At any rate, my ultrasound took less than five minutes.  He measured the size of my ovaries and the thickness of my uterine lining.  He said that both ovaries had several immature follicles, which seemed like a good thing.  I took it that the medications I will be taking starting next week to stimulate my ovaries will be used to mature the follicles that are already there.  I think I had around 20 if I remember correctly, which is a good number.

After my ultrasound I met with nurse Janine.  She reviewed how to use the pen for my Follistim medication and how to mix the Repronex and inject it.  These are the most expensive medications I'll take.  I expect that they'll probably be at least $1000, BUT, after reviewing my ultrasound today, my primary doctor at UCRM, who is in charge of my cycle, cut down the amount of Follistim I will be injecting, so we don't have to order as much.  Yay!

So I start all of this stuff on the 20th.  This is the big push.  I have my next screening ultrasound on the 27th.  Depending on how things are going, I may or may not have to stay in Salt Lake for a few days.  Its cheaper just to stay than to drive back and forth...We're getting closer.  And that's a good thing.

News from the Infertile Front

I started my Lupron injections on Sunday evening.  It's been fairly anti-climactic.  The needles are bigger than my insulin needles, and I think I might be allergic to the metal in the needle.  I get scratchies at my injection sites that look like mosquito bites.  I wonder if I can just use my insulin needles to give injections.  I'll have to ask at my screening.

My screening appointment is this coming Tuesday morning in Salt Lake.  We will be signing consent forms before we go, and they will be amended.  We will be retrieving all the eggs we can at the end of the month, and we will choose the best eggs and the best sperm to put together, creating between 4-6 embryos.  We will be transferring two embryos and freezing the others for the future.  That is NOT how the consent form is written, so we were told to write it up, have Ryan initial it and sign it, and I sign it in the presence of a witness.

My screening appointment isn't anything huge.  We review my meds schedule, and have an ultrasound to be sure that my ovaries are, in essence, dormant.  Because, at the end of NEXT week, I start "stimming."  I take the injections to entice my ovaries into making multiple follicles.  Two weeks after I start stimming, I will probably have to spend a few days in Salt Lake for daily ultrasounds until it is time for my retrieval.  Three to five days after that, we place the embryos back into my uterus, and then in 12-14 days I do a pregnancy test (blood).

We also got some REALLY good news from Ryan's hamster egg penetration assay we had done three weeks ago.  He scored "100%."  I didn't know if that was a good thing or not, so I had one of the nurses call me back.  I think what they do is take a certain number of hamster eggs and see how many Ryan's sperm are able to penetrate.  So, in that respect, 100% is AWESOME.  It means that we do NOT have to do the ICSI procedure, and they just put my eggs and his sperm together and let Ryan's sperm do the work its supposed to.

I'm getting excited.  It's so weird to think that in a month I could be getting a positive pregnancy test.  Or I couldn't.  I'm going to cross that bridge when I get there.  I know that God is in control, and if He wants us to be parents, even though we're having these medical procedures, He is STILL the one who has to knit our babies together and tuck them in my womb for their growth.  He is the great physician.  Praise Him!

The Follow-Up

Our appointment didn't necessarily go as planned.  I'm frustrated.

We got to UCRM barely in time for Ryan's appointment at 2:30.  We were supposed to get there at 2 for our injection training, but unfortunately my sub showed up late, so we started our injection training, Ry had to go, and then we had to pick it back up again.  Like I said in the previous post, many of my medications that I have to take are given much like the insulin I already take.  The only exceptions are the single HCG shot Ryan has to give me to mature the eggs, and the progesterone in oil injections he will have to give me until we either get a negative pregnancy test or until the placenta can make enough progesterone by itself to sustain our baby (or babies!).  One of the follicle-stimulating medications I take will be given by pen, and some of the sub-cutaneous injections have to be mixed before I can give them, BUT...I think I can handle it.  I hope so, anyway.

Anyway, the discouraging news we got probably isn't that big of a deal to most people, but it is to me.  Our intake doctor told us that were able to freeze eggs.  He said it was semi-experimental still, but that it was doable.  I was really excited about that.  During this appointment, however, the nurse had us pull out the consent form.  I told her that none of the options on the consent were what we wanted to do, that we wanted to freeze eggs.  She went to talk to the director of UCRM, and he called me later in the week.  He told me that we could freeze eggs, but after thawing, there was approximately a 4% chance of actually having a viable embryo.  And, on top of that, freezing eggs costs an extra $2,000.

The director, Dr. Peterson, talked to us about some other statistics.  He said that out of all embryos, only 1/2 survive.  So if we were to create 15 embryos, if we were liberal, only about 8 would survive.  If we transferred two, which I'm planning, we would have six left over.  After freezing and thawing for more use, only 2/3 of those would survive, so we would only have 4 viable embryos left. 

I struggle with this, still.  I believe God is in control of EVERYTHING.  So who's to say we wouldn't have 15 viable embryos at the end of all this?  Certainly not I, nor any doctor I know of.  I'm sure that many babies go home to Jesus before their mamas even know they're there.  I don't mind freezing our babies as long as they are given a chance to grow inside me, and God decides whether or not they get to live their lives.  Does that make sense?

I know many people don't agree with me, and that's fine.  They don't have to.  My own husband doesn't doesn't agree with me, but he respects how I feel.  Thank God.  Because people who are supposedly close to me DON'T respect that, and are so self-righteous it makes me nauseated, which is something I'd hoped to avoid until I was pregnant.

So we're waiting for the results of Ry's test, which are supposed to be in the mail this week.  I'm not sure why it takes so long.  Shouldn't you know right away whether or not a sperm can penetrate an egg?  I guess there's a reason why I'm just a teacher.  I think we're going to be freezing some embryos.  I think I'll ask that they take the 10 best eggs that are retrieved and fertilize them, transfer the best two, and freeze the rest of our babies that survive, so we can give them a chance later...I hope that will honor God.  Although I don't know that I can say for sure.

I start my second med next Sunday, June 5th.  It's my first injectible medication, and something I've taken before.  It's called Lupron, and my doctor here in town gave me a mega-dose of it to put me into virtual menopause for three months to see if I had endometriosis.  No mega-doses this time.  Just small amounts to "quiet" my ovaries.  I have my first ultrasound for this cycle on the 16th or something like that.  The nurse gave me my detailed calendar.  I should scan it so you can see how involved it is...

Anyway, when we get Ry's results, I'll try to say something about that, too...

Another Step

Ryan and I go to Salt Lake City again tomorrow for another appointment.  We're not actually going to see a doctor (I don't think, anyway).  We're hoping to get there a half an hour before our appointment so that we can do injection training.  I have some medications that are given intramuscularly (is that even a word?), and Ryan needs to learn how to give them to me.  I know that my school nurse said that she will give me my injections, but I can't imagine having to drive over to Green River every day for the next few months.

Anyway, tomorrow when we go, we're doing our injection training.  Many of the meds I have to take are just subcutaneous injections, much like my insulin injections that I already take.

Ryan also has an appointment with the andrology department.  He has to provide a "sample" for dual purposes.  First, we will be "freezing and storing" for our upcoming IVF cycle.  This is done in case, on the day of my egg retrieval, when Ryan has to do this again, the sample isn't usable to fertilize said eggs.  The second reason why Ry has to do this is a hamster egg penetration assay.  This is a test that is done to determine whether Ryan's sperm is able to penetrate an egg.  A hamster egg is very similar to a human egg, so that is what they use for this test.  It's kind of gross, but if it does the job...

Depending on the results of the hamster egg penetration assay, we will know whether or not we will have to do ICSI during our IVF cycle.  ICSI stands for inta-cytoplasmic sperm injection.  If Ryan's sperm successfully penetrates the hamster egg, we can assume that his egg, when placed into a petri dish with my egg, will penetrate it.  If Ryan's sperm does NOT penetrate the hamster egg, an embryologist will take a single, healthy sperm and inject it directly into an egg and see if it will develop into a healthy embryo.  We are hoping for no ICSI, mainly just for cost reasons. 

You may be wondering how much all of this costs, and how we're paying for this.  Many of the clinics who do IVF in the northern Utah area are comparable in price.  I like the University of Utah the best because they allow us to freeze eggs and sperm separately, instead of in embryo form.  The University of Utah also bundles everything into a nice package for us, and really, ends up being cheaper than the other centers.  I think this cycle will cost us between $10,000 and $15,000.  I know that insurance doesn't cover the actual retrieval and embryo transfer, but I'm not sure about the medications.  I need to check that.  That cost includes my medications, all the ultrasounds I need to have, the semi-surgical egg retrieval, the preparation of the embryos, and the transfer of the embryos into my uterus.  If we have to do the ICSI, it costs an extra $1000.  We are paying for this with one $5000 credit card, that we hope to pay off in about six months.  Thankfully Ryan just had open enrollment in benefits for his work, and we chose to max out his health savings account with $5000.  I have another credit card I applied for worth $1700, and we also have a line of credit through our bank.

If this first IVF cycle isn't successful, and we have eggs and sperm banked, the subsequent cycles are MUCH more inexpensive, and much easier on my body.  I won't have to have egg retrieval, where they place me under conscious sedation and, with a needle guided by ultrasound, harvest mature eggs, and I won't have to take the horrible medications that help produce all of those eggs.  I will only have to take medications to help build the lining of my uterus.  I think the subsequent IVF cycles are under $5000, and we can save that in just a few months time in order to pay for another one.

It's scary, and it's kind of stepping off a cliff hoping there's an unseen net below that will catch us.  We are praying, and having faith that God knows the desperate desire within our hearts to be parents.  He might choose to say "no" right now...and that will be hard, no doubt, but...He is in control of all of this. 

Praise Him!

Here We Go...

Ryan and I just returned home from our 2nd trip to Salt Lake City in 3 days. 

This past weekend's trip was for fun.  We went to see Larry the Cable Guy, Bill Engvall, and Jeff Foxworthy.  Surprisingly, I think Bill Engvall was the best, and I was actually a little disappointed with Larry.  Whatever.  It was still nice to spend some time with my darling husband.  We have so much fun together.

Today's trip was all business.  Ryan and I left here around noon so we could get to our appointment at the Utah Center for Reproductive Medicine.  This is where we went back in the fall for our consults.

It's still true.  I love our doctor.  He takes the time to sit down and listen to our concerns and answer our questions.

So we got there early, and we had no sooner sat down than we were called back into the examination room.  We had to sit there and wait for a little while, but soon Dr. Keye came in and began our in vitro consult.  He reviewed some of our history, and walked us through the process that we will go through.

A few weeks before I start the medications prior to egg retrieval, I start a regimen of birth control pills.  I will only take the active ones.  Then I begin injections, and have several ultrasounds to be sure that my ovaries are producing the amount of eggs we want them to.

During this time, both Ryan and I have to take antibiotics.  When the ultrasound and bloodwork both show that there are enough follicles for harvesting, I take an injection of HCG, and 36 hours later is my egg retrieval.  During the egg retrieval, I am given conscious sedation, and a needle is passed through my vaginal wall using transvaginal ultrasound, and each egg is placed into a test tube.  While I'm in the midst of my procedure, poor Ry has to do his part into a cup.  Prior to this, he will provide another sample that will be tested to see what kind of procedure we need to do to fertilize my eggs.  Its kinda gross, and I'm not going to go into it here.  lol :)

So, when all of that is said and done, the embryologist takes both of our contributions to the lab to begin fertilization.  Depending on that test of Ryan's, s/he will either just throw his sperm and my eggs into a petri dish and let them do things naturally, or do ICSI, where a sperm is injected directly into the egg.  After 3 to 5 days of dividing, the embryos will then be placed into my uterus, and 17 days after the egg retrieval, I go for a blood test to see if we're pregnant or not.

It's expensive.  But its doable for us.  I felt a lot better after this appointment.  I think the University of Utah is moving ahead with egg freezing.  It's still experimental, but Dr. Keye said there are now hundreds of children who have been born from frozen eggs.  This news made me SO happy.  I was so struggling with the morality of creating embryos and perhaps not using them, and having to "dispose" of them, or donate them to research.  I didn't like any of those options.  I'd much rather freeze my eggs.  I would feel comfortable standing in front of God on my dying day saying that I didn't kill any of the children He Himself allowed to be created.

Dr. Keye also did my yearly exam.  I have my prescription for those birth control pills to be started before school is out, and I want to start my injections on June 12.  That puts our retrieval and embryo transfer around the 4th of July.  Which is perfect.  My dad died on Independence day, and it would be wonderful to begin new life around that time.

We decided to only fertilize two eggs (and hopefully they'll take and be good quality embryos), and only transfer two embryos so we don't end up octoparents.  We can always go back and use my frozen eggs if this doesn't work, without having to go through another retrieval, which is the worst part of the entire thing.

During my ultrasound and exam today we did a mock embryo transfer.  It was much like an IUI, and, in fact, is just the same procedure, but instead of just putting sperm in my uterus, we already have embryos.

Okay, I feel like I'm babbling, and I probably am.  I'm excited though.  I'm excited that at this time next year, I could be a mom, if this first cycle works.  Exactly.  One year from tomorrow would be my due date if my conception date was July 7th.  While the prospect of pregnancy, or even the prospect of carrying twins scares me to death, it's only a short part of a lifetime of blessings.  I'm so thankful that God has allowed us to live in this time of technology, otherwise we might never have biological children.

I'll keep you posted.  I have some bloodwork that needs to be done, and we have Ryan's test, too.  Please keep us in your prayers as we move forward with IVF.

Another Step in the Process

My perinatologist called me about an hour ago...at 6:30 at night.  Which is awesome.  Something completely unexpected.  I'm a fan.

Anyway, he has put me on insulin.  Both types.  I have to take the long acting insulin twice a day, and the short acting with every meal.  I have to wake myself up in the middle of the night to give myself an injection of the long-acting stuff.  Awesome. 

I'm nervous about it.  I got all of my stuff, but I'm going to have my wondrous school nurse talk me through it tomorrow.  I'm just not ready.  I can't just have the pharmacist show me.  I need a little more support than that. 

So tomorrow's the day.  I'll let you know how it goes.  :)

First Baby-Related Appointment of the Year

So I got up really early this morning...like 3:30 AM.  Ryan's car is in the shop again, and I had to take him to work.  I came back home, went to sleep for an hour and a half, and then got up to get ready to head to Salt Lake.

Have I told you how much I like winter mountain driving?  I haven't?  Well...the thing is, I don't.  I hate it.  I have rescheduled this appointment 3 times since Thanksgiving because of bad roads.  I wasn't going to let a little snow shower get in my way this time.  I wish it would have snowed in Wyoming, however, the only real snow I hit was going down the mountain pass into the Salt Lake valley.  I hate it.  LOL

Anyway, today's appointment was at the University of Utah hospital with a maternal/fetal medicine doctor.  My reproductive endocrinologist wanted me to meet with him so we could go over the risks pregnancy would have for me with all of my other health issues.

I *really* liked this doctor.  He was kind of asinine, but he was realistic and down to earth, and he had a little sense of humor, which is a must for one of my providers.

After getting lost for several minutes and checking in, I was promptly led to a conference room.  I was weighed and had my blood pressure checked.  My blood pressure was actually good, today, which is surprising considering the drive I had.  And my weight...well...I'm still fat.  Shocking, I know.

So I sat down with Dr. Branch for an hour.  We went over my medical history as well as Ryan's.  Neither of us have any known genetic abnormalities in our histories, like cleft palate or mental retardation (I joked that he hadn't met my husband...lol!).  We discussed my risk of preeclampsia, which he said would be about 25%, which is fairly significant.

We also talked about the risk of multiples that comes along with IVF.  He brought up the topic of "fetal reduction."  I have a huge problem with that, so instead of Dr. Keye, our reproductive endocrinologist (who will do our IVF), transferring a bunch of embryos, we'll only have him transfer 2 or 3, if that. 

We spent most of our hour talking about my blood sugar.  It needs to be reduced, obviously, as the last time I had it checked it was at 7.1%, which is high.  Dr. Keye wants it below 7% before we go ahead with IVF.  Dr. Branch wants my daily blood sugars consistently under control before we move ahead.  So...I had my last dish of ice cream for a while tonight, because tomorrow I'm keeping track of everything.

Dr. Branch said that the most important thing is consistency.  I need to get good sleep EVERY night of the week, and get up and go to bed at the same time.  I need to try to eat the same amount of carbs at each meal, and eat each meal at the same EVERY day, weekends or not.  Getting up at 5:30 on the weekends is kind of going to suck, but if it gets us closer to our goal of a baby Gargano, we'll do it.

We discussed exercise, too.  He suggested an hour a day, but to start slow.  I've been doing EA Active, but he says that's probably not enough.  If I start out slow, I'll be okay.  He said I can break up my workouts, too, so maybe I'll walk a little after school and do EA Active or Wii Fit later on in the day. 

Lastly, we discussed insulin.  He said after I get the diet and exercise things going again, we'll probably have to try a small dose of insulin to get my blood sugars completely under control.  He also said we'd change my blood pressure medication after I actually got pregnant.  Dr. Branch said I would be considered a "high-risk pregnancy" right off the bat, but it's relative, and my issues aren't HORRIBLE, and that he's seen way worse, praise the Lord.  LOL. 

So, we're moving forward.  After I make supper, I'm going to make my little spreadsheet thing to keep track of stuff.  We're going to talk next week via phone to see if my sugars lower and stabilize and to see how the exercise stuff is going.

So, my guess is that it will be a few months before we do our first cycle of IVF.  That's okay with me.  I am thinking forward to when I would actually have a baby.  November is a good month for a baby, with Thanksgiving and Christmas breaks...:)