Sunday, March 24, 2013

Chubby Hubby Bars

Nearly every Sunday, we go to dinner at my sister-in-law's house and I am in charge of dessert.  This time, I think I might have made the most unhealthy delicious dessert on the planet.  I found this recipe on Pinterest and it led me to the blog Cookies and Cups.  You really need to make these; they are divine.

This bar cookie is like the Ben & Jerry's ice cream flavor of the same name.  The base is a pretty standard chocolate chip cookie dough, but with chocolate covered peanut butter cups and pretzels instead of chips.

After that is baked and cooled, you add a layer of caramel.

Once that sets, you add a layer of melted chocolate.

So, so bad for you, but oh so good.

Tuesday, March 19, 2013

Nugget's Story - Egg Transfer

On September 4, 2012, we went to the main office for Shady Grove in Rockville.  The fourth floor of their office there is the embryology lab and the surgery center and that is where they do all the egg retrievals and transfers.  I have been to the fourth floor before three times, but this was the first time I had been there for something good.

After waiting around for what felt like forever with a full bladder, we were called back for transfer.  We both got booties for our feet and I got undressed from the waist down.  I did wear a pair of lucky socks that a Nestie sent me for a secret pal gift.

Our doctor came in and talked to us about how many embryos to transfer back.  He recommended transferring two, and even though we were afraid of the possibility of twins, we went with his recommendation.  He then went to the lab to see if our babies were ready to go.

The room where the transfer was done had a monitor so we could see our two embryos on the screen before they were transferred to a catheter, which the embryologist brought to our doctor.  Then we could watch as the catheter was introduced and the embryos were transferred.  On the monitor, it looked like a little fireworks explosion as they came out of the catheter.

Our doctor told us that I should lay there for ten minutes or as long as my bladder would hold out and then we could go home, where I would spend 24 hours on couch rest.  That was it.  We were done and all we could do now was wait. 

Nugget's First Picture

Saturday, March 16, 2013

Nugget's Story - Egg Retrieval and Fertilization

I have to start by saying how wonderful our nurse at Shady Grove was during this whole process.  Actually, all of the nurses we'd had over the three years we worked with the RE were great.  They do a fantastic job of keeping their patients informed about how their cycle is going and test results and were always available to answer whatever deranged questions I would come up with.

Once our donor began her stimulation medication on August 19, I talked to our nurse pretty much every day.  Each time the donor would go in for a check on how her ovaries were responding, Pam would call me in the afternoon with an update on the number of follicles they saw and the sizes of the ones they measured.

After eight days of stimulation medication we got the call that our donor was ready for egg retrieval on August 30.  We'd made an appointment the same day for Jim to drop off his sample so that it would be there and ready to go for fertilization.

Let's stop for a minute and talk about fertilization.  There are two ways that the embryology lab can do fertilization.  The first is a natural unassisted process.  They put the sperm and the eggs together and let the sperm fertilize the eggs the same way they would inside the body.  The other way, which is automatic with my clinic for donor egg cycles, is intracytoplasmic sperm injection.  In this method, an embryologist selects a healthy-looking, single sperm from the male's semen and injects it directly into the egg with a microscopic needle.  Shady Grove chooses to do ICSI because they want to ensure that as many eggs as possible have a chance to become embryos.  This was especially important to us, since we were sharing eggs with another couple and this would be our only chance at this.

Late in the day on August 30, Pam called to say that we had 11 eggs retrieved.  Of those 11, seven were mature eggs.  Of the seven, four fertilized with ICSI.  Now we just waited and watch the eggs develop.  Pam would call every day with an update on how many cells each egg had divided into and we planned for a three-day transfer on September 2.  At this point, the worry changed from will we have any eggs and will they fertilize, to will any of them keep growing to make it to transfer.

On September1, the on call nurse let us know that they were going to push the transfer to day 5.  The embryology lab wanted to give them two more days to see if they would differentiate more.  On a three day transfer, all the embryos look pretty much the same.  By day five, you can usually tell if some are better than others. 

Part VII - Egg Transfer

Monday, March 11, 2013

Nugget's Story - Shots, Shots and More Shots

On July 11, we were notified that we did not get a third couple for our cycle and we were set to go ahead with just the one other couple.  The next day, our nurse sent me my medication protocol and called in all my meds.  I feel pretty positive that I took a picture of the giant pile of medicine I picked up from the specialty pharmacy, but now I can't find it.  Trust me that it was a ton and you never want to be handed that many syringes and sharps containers at once.

At this point I've been on birth control pills for months.  When you are doing a donor egg IVF cycle, you do not want your body doing anything on it's own and as a part of a shared cycle the donor and the recipients have to have their cycles in sync.  So, one more month of birth control for me, so that all three of us can get on the same cycle.

My Protocol:

7/3 -8/6  stay on birth control pills for 35 days, all active pills

8/4 - begin Lupron shots daily, 20 units each morning.  This is a subcutaneous shot that goes in your belly fat.  Lupron is used to treat prostate cancer, endometriosis and premature puberty in children.  Therefore, my insurance covered it and I only paid $75 for a 14-day kit, rather than $216.

8/6 - stop birth control pills, but keep doing the Lupron shots.

8/10 - this day I had to go in for an ultrasound and blood work in order to make sure that my ovaries weren't doing anything.  After a call back that afternoon, I stopped the Lupron shots and started Del Estrogen shots.

8/10 - begin .20cc Del Estrogen shots every three days.  These shots are intramuscular shots to the butt.  I can't reach my own hip and see what I am doing, so Jim had to do these shots (and all the IM shots) for me.  Del Estrogen is used to treat the symptoms of menopause and is not covered by insurance.  It was $86.59.

On 8/19, the donor started her medication to stimulate egg production.  On 8/23, I had an appointment for blood work and ultrasound to check the lining of my uterus.

On 8/29 - begin progesterone in oil shots daily.  This is also an IM shot and is by far the worst of the medicines.  The oil is thick and it has to go in slowly.  It makes a knot and if you are extra lucky like me, after awhile, it make you itch.  It is also not covered by insurance (but some progesterone is) and cost $114 for three vials.  If the IVF works, I'll be getting these shots until I am 8 weeks pregnant, so I will need a refill of this script.  Then they will be replaced with a progesterone suppository for 2 or 3 more weeks.

8/30 - Egg retrieval day!  This is also the day that Jim has to drop off his sample for wash and fertilization.

Part VI:  Egg Retrieval, Fertilization and Transfer

Saturday, March 9, 2013

Nugget's Story - Picking Our Donor

We were finally ready to go on what my sister called the most important shopping trip of our lives.  I mean, really, how do you go about selecting the person that will provide half of the genetic material for your child.  What if our IVF didn't work; would I always blame myself for picking the wrong donor?

Once we had completed all of the pre-IVF testing and screening, we were finally given our password to access the donor database.  The database is a very dynamic thing - new donors are being added all the time as they finish their screening and donors are taken out as they are selected.  You don't get to see the entire list, only donors who are eligible for the program you selected.  The database coordinator said that the list was a little on the low side when we first got access, but not to worry, that they had a bunch of donors who were almost ready to be entered.

In the actual database you can sort and select by an almost infinite number of criteria.  I wanted someone who looked most like me, but because their were so few to choose from, I started by just selecting Caucasians.  From that list, there were a couple who might have worked.  I wanted someone with brown hair, green eyes and my same blood type.  If you want to see more about a donor, you click for the full profile, which includes physical characteristic, personal characteristic about religion, education, work history, need for glasses or braces, athletic ability, past pregnancies, drinking/smoking/drug use and more, brief physical descriptions of the donor's parents, grandparents and siblings, an extensive medical history for the donor's relatives, a personal narrative, and finally, childhood pictures of the donor.  All together, the donor profile is 10 pages long.

We actually missed out on the first donor that I selected.  I was browsing the database and found someone that I thought would be a good choice, so I sent the profile to Jim for his input.  By the time he got back to me, just an hour or so later, she was already out of the database.  Back to the drawing board.  It took another couple of days before another good candidate was added to the database and this time we jumped and were the first couple to select this donor.

Our donor is 5' 3", 27, a college graduate and back in school for nursing, she likes jazz and dance and played softball and oboe, she wants to use her nursing degree to volunteer with the Peace Corp or Doctors without Borders.

We locked in our donor on June 4, 2012 and now had 48 hours to pay our deposit of $7,000 to hold our selection.  It also began our next waiting period, because we were the first couple, but we needed two more to start the process.  It took about a week before a second couple chose the same donor.  This started a 30 day countdown for a third couple.  If after thirty days, there was no third couple, the IVF cycle would go forward with just the two couples and Shady Grove would take the third spot.

Part V - Shots, Shots and More Shots