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
Saturday, March 16, 2013
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
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
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
Tuesday, February 26, 2013
Nugget's Story - Getting Ready
I felt like I needed to add a post here, because there were a lot of things that had to happen before we could pick our donor.
In March 2012, I called the donor egg coordinator at Shady Grove and said that we were ready to go ahead. They sent back the check list of things that we had to do before we could select our donor.
Part IV - Picking Our Donor.
In March 2012, I called the donor egg coordinator at Shady Grove and said that we were ready to go ahead. They sent back the check list of things that we had to do before we could select our donor.
- repeat mammogram, since I am over 40 and mine was a over year old
- repeat of the HSG test, since I had two D&Cs since my first test
- we both had to be rescreened for STDs and have a concurrent course of antibiotics. This is an annual requirement of the clinic.
- a mock transfer that gave the doctor an idea of how the catheter should be placed for the real deal
- a meeting with the financial counselor to talk about costs, which type of plan we wanted, what was covered and what was not.
- a meeting with the psychologist to make sure that Jim and I were both on the same page and comfortable with having a child that was not biologically related to me.
- a meeting with the nurse to sign pages and pages of consent forms
- injection training, so I could learn how to shoot hormones in my belly and Jim could learn how to shoot them in my butt.
Part IV - Picking Our Donor.
Wednesday, February 13, 2013
Nugget's Story - The Donor Egg Process
Or, How Shady Grove Got All Our Money, Plus Some.
Once we knew this would be our best option for a successful pregnancy, that was the beginning of some serious number crunching to see if it was even possible. Shady Grove has a wonderful program, called the shared risk program. The Shared Risk 100% Refund program entitles the patient to undergo up to 6 cycles of fresh or frozen donor egg treatment as well as any subsequent frozen embryo cycles and receive a 100% money-back guarantee if a baby is not delivered. The pros are that if you need more than one cycle, you are getting a huge discount and you can drop out at any time if it just becomes too much and get a full refund. The con is if you are lucky on your first cycle, you have paid more than what you would have if you'd done a single cycle.
Shady Grove also has the option of a shared donor cycle, where two or three patients share all the eggs from one donor. The pro is that this is a cheaper option, at about 1/2 the cost of a traditional donor egg cycle. The con is that it can take longer for all the recipients to pick a donor and get their cycles coordinated. The third recipient also has a slightly higher risk of being cancelled if there are not enough eggs retrieved.
None of these options are cheap, ranging from $13,3000 for one cycle of shared donor 1:3 up to $39,000+ for a traditional 1:1 Shared Risk program. So we started saving for the least expensive option and hoping for the best. We figured it would take us at least a year to get the money needed for the IVF, plus the costs for the actual baby if we got so lucky. We could have done it right away, but neither of us was comfortable with completely depleting our savings on something that wasn't even a sure thing, plus we were grieving and just not ready physically or emotionally to try again.
Shady Grove occasionally does donor egg seminars at which they donate a free cycle. We actually signed to attend one of these seminars in January of 2012 in Philadelphia. We drove up during a snow storm for a chance at our dream. Because of the weather, only 11 couples made it and we were very hopeful with those odds. At the end of the seminar, which was conducted by our doctor, they drew for the free cycle. We didn't win and I managed to hold it together for all of five minutes before I started to sob while Jim hugged me. Once I got myself together, we went to say goodbye to Dr. Levens and he said that he saw us in the back and was very sorry that we didn't win. He has always been so kind to us and genuinely wished for us to be successful. I cried again. This experience made us even more determined to have one more chance of a child of our own.
We will forever be grateful to a very generous family member who, in early 2012, offered us an interest free loan for half of our estimated costs. This is a gift that we would never, ever have asked for. This let us reach out to Shady Grove months earlier than we would have been able to otherwise. We were finally ready to move ahead.
Part III: Picking a donor
Once we knew this would be our best option for a successful pregnancy, that was the beginning of some serious number crunching to see if it was even possible. Shady Grove has a wonderful program, called the shared risk program. The Shared Risk 100% Refund program entitles the patient to undergo up to 6 cycles of fresh or frozen donor egg treatment as well as any subsequent frozen embryo cycles and receive a 100% money-back guarantee if a baby is not delivered. The pros are that if you need more than one cycle, you are getting a huge discount and you can drop out at any time if it just becomes too much and get a full refund. The con is if you are lucky on your first cycle, you have paid more than what you would have if you'd done a single cycle.
Shady Grove also has the option of a shared donor cycle, where two or three patients share all the eggs from one donor. The pro is that this is a cheaper option, at about 1/2 the cost of a traditional donor egg cycle. The con is that it can take longer for all the recipients to pick a donor and get their cycles coordinated. The third recipient also has a slightly higher risk of being cancelled if there are not enough eggs retrieved.
None of these options are cheap, ranging from $13,3000 for one cycle of shared donor 1:3 up to $39,000+ for a traditional 1:1 Shared Risk program. So we started saving for the least expensive option and hoping for the best. We figured it would take us at least a year to get the money needed for the IVF, plus the costs for the actual baby if we got so lucky. We could have done it right away, but neither of us was comfortable with completely depleting our savings on something that wasn't even a sure thing, plus we were grieving and just not ready physically or emotionally to try again.
Shady Grove occasionally does donor egg seminars at which they donate a free cycle. We actually signed to attend one of these seminars in January of 2012 in Philadelphia. We drove up during a snow storm for a chance at our dream. Because of the weather, only 11 couples made it and we were very hopeful with those odds. At the end of the seminar, which was conducted by our doctor, they drew for the free cycle. We didn't win and I managed to hold it together for all of five minutes before I started to sob while Jim hugged me. Once I got myself together, we went to say goodbye to Dr. Levens and he said that he saw us in the back and was very sorry that we didn't win. He has always been so kind to us and genuinely wished for us to be successful. I cried again. This experience made us even more determined to have one more chance of a child of our own.
We will forever be grateful to a very generous family member who, in early 2012, offered us an interest free loan for half of our estimated costs. This is a gift that we would never, ever have asked for. This let us reach out to Shady Grove months earlier than we would have been able to otherwise. We were finally ready to move ahead.
Part III: Picking a donor
Monday, February 11, 2013
Winter 2013 Restaurant Week
I almost missed Restaurant Week this time around. Honestly, I had given up on it, since it is usually in January. Fortunately, there was a flyer in the elevator at work on Thursday and I was able to find us a last minute reservation for early dinner on Saturday.
I picked Evo Bistro in McLean. The restaurant was not what I would have expected at all judging from the outside. It's in a small strip mall and completely unassuming. I liked this restaurant because they listed their Restaurant Week menu on their website. I need to know that there will be something I will eat among the selections. It was small and busy but with a casual atmosphere that I wasn't expecting from the website. We will have to go back some time when I can try the wine list, which looked very nice.
For appetizers, we ordered the grilled artichokes with jalapeno aioli and the shrimp and grits. Both dishes had some zing, but in completely different ways. The aioli gave a bite and creaminess to the artichokes that they don't have on their own. The chorizo in the shrimp and grits was spicy without being hot.
For dessert, we had the seasonal crumble, which was apple and date and the seasonal creme brulee, which was cranberry.
I picked Evo Bistro in McLean. The restaurant was not what I would have expected at all judging from the outside. It's in a small strip mall and completely unassuming. I liked this restaurant because they listed their Restaurant Week menu on their website. I need to know that there will be something I will eat among the selections. It was small and busy but with a casual atmosphere that I wasn't expecting from the website. We will have to go back some time when I can try the wine list, which looked very nice.
For appetizers, we ordered the grilled artichokes with jalapeno aioli and the shrimp and grits. Both dishes had some zing, but in completely different ways. The aioli gave a bite and creaminess to the artichokes that they don't have on their own. The chorizo in the shrimp and grits was spicy without being hot.
For the entree, Jim chose the sausage wrapped venison with parnips, swiss chard and cranberries. I picked the Chilean sea bass with Swiss chard, caramelized salsify and spicy tomato sauce. The fish was cooked perfectly and the Swiss chard was a nice counterpoint to the mild fish. I had a bite of the venison, which I had not tried before. It was much more tender than I expected it to be.
Sunday, February 10, 2013
Nugget's Story - The Backstory
I decided that I needed to start to write down Nugget's story before I forget all the important stuff that happened along the way. If you are friends with me on any of the many social media sites I frequent, you probably know most of this story. If not, well, here you go.
Jim and I got married in August 2009 and we knew that if we wanted to have a baby, we needed to try right away. We weren't getting any younger. So beginning in October 2009, that is what we did for 7 months until it was time for my annual doctors appointment. At that point, because of my age and the fact that we hadn't been successful yet, she ordered some preliminary testing for both of us and referred us to a reproductive endocrinologist.
We chose Shady Grove Fertility Center. They are a very large clinic with many offices, including one directly up the street from our house. We met with our doctor, Dr. Levens, for the first time in July 2010. I had done a lot of internet research and from my time spent hanging out on The Nest, I was already pretty sure of what information we were going to be given at that first meeting, but I think it was very helpful for Jim. Prior to the meeting, we had completed extensive medical histories (4 pages for Jim and about 8 for me) and returned those. We went over all that history, my charts of my cycle and the test results from my OB/GYN and Dr. Levens laid out a plan for us.
First, there would be about a million more screening tests for both of us. For me, that included a mammogram and an HSG (this is an x-ray type test where they fill your uterus with dye to check the shape and make sure your tubes are open). For Jim, it meant a semen analysis. There was also blood work for both of us to check for STDs, a screening for cystic fibrosis, hormone levels and lord only knows what else. And we both got a dose of antibiotics. Then we would start with several cycles of IUI. We are very lucky and our insurance covers up to six cycles and all the testing. Many people have no coverage for infertility (IF) at all.
We did our first IUI in October 2010 and it didn't work. Our second in November did, but I miscarried and had to have a D&C in January 2011. This was the worst, because we found out about the miscarriage on the same day we were heading home for Christmas to share the good news with my Mom. Instead, we had to give her bad news because it was possible that I'd start to miscarry on my own and we'd spend Christmas at the hospital.
February, March, April and May 2011 all failed. On our 7th try in July 2011, we were lucky again. Again I miscarried and had to have a second D&C in September. At that point, we were done and resigned to living childless, since our only option would be IVF with donor eggs and it would be completely out of pocket.
Part 2: The Donor Egg process.
Jim and I got married in August 2009 and we knew that if we wanted to have a baby, we needed to try right away. We weren't getting any younger. So beginning in October 2009, that is what we did for 7 months until it was time for my annual doctors appointment. At that point, because of my age and the fact that we hadn't been successful yet, she ordered some preliminary testing for both of us and referred us to a reproductive endocrinologist.
We chose Shady Grove Fertility Center. They are a very large clinic with many offices, including one directly up the street from our house. We met with our doctor, Dr. Levens, for the first time in July 2010. I had done a lot of internet research and from my time spent hanging out on The Nest, I was already pretty sure of what information we were going to be given at that first meeting, but I think it was very helpful for Jim. Prior to the meeting, we had completed extensive medical histories (4 pages for Jim and about 8 for me) and returned those. We went over all that history, my charts of my cycle and the test results from my OB/GYN and Dr. Levens laid out a plan for us.
First, there would be about a million more screening tests for both of us. For me, that included a mammogram and an HSG (this is an x-ray type test where they fill your uterus with dye to check the shape and make sure your tubes are open). For Jim, it meant a semen analysis. There was also blood work for both of us to check for STDs, a screening for cystic fibrosis, hormone levels and lord only knows what else. And we both got a dose of antibiotics. Then we would start with several cycles of IUI. We are very lucky and our insurance covers up to six cycles and all the testing. Many people have no coverage for infertility (IF) at all.
We did our first IUI in October 2010 and it didn't work. Our second in November did, but I miscarried and had to have a D&C in January 2011. This was the worst, because we found out about the miscarriage on the same day we were heading home for Christmas to share the good news with my Mom. Instead, we had to give her bad news because it was possible that I'd start to miscarry on my own and we'd spend Christmas at the hospital.
February, March, April and May 2011 all failed. On our 7th try in July 2011, we were lucky again. Again I miscarried and had to have a second D&C in September. At that point, we were done and resigned to living childless, since our only option would be IVF with donor eggs and it would be completely out of pocket.
Part 2: The Donor Egg process.
