IVF after Gastric Bypass Surgery

BFP!!!

2009-05-25T12:45:00.000-07:00

I had my beta done this morning and my RE herself called me back. Normally, a nurse calls you back with lab results. I was wonderful to hear her say "you are pregnant". My beta was 267 at 12dp5dt. I am flying to Seattle tomorrow for work and will have to figure out where I can have my repeats HCG (beta) levels out there this week. My sonogram will be next Tuesday.

Correction on HPT

2009-05-22T18:26:00.000-07:00

I wrote earlier that I first tested on 5dp5dt....I actually did but received a negative that day. I tested every morning since. The first faint positive that got was 6dp5dt.

Still feeling good but tired. I can't wait for my beta.

Forgot something....

2009-05-21T20:04:00.000-07:00

They put two blasts in on 5/13/09 and I actually had two blasts that made it freezing. I am a happy that I have a back up for another try if this doesn't work out (which hurts to even mention that) but on the flip side....I feel guilty wondering what am I going to do with them if this pregnancy is successful. I don't believe in destroying them, and I don't want to pay money out for the rest of my life on keeping them frozen and I don't think that I could handle giving them away.

HPT results

2009-05-21T20:00:00.000-07:00

I took my first hpt 5dp5dt and got a very faint positive. I have continued to take one hpt every morning and the positive line has continued to get darker. So, it appears that I might actually be pregnant! I am cautiosly optomistic and too afraid to be happy. After two failed cycles and one ruptured ectopic....I need to see the heart beat before I start to let myself relax. My beta is scheduled for Monday (Memorial Day).

Fertilization Report

2009-05-09T21:13:00.000-07:00

Out of my 9 eggs retrieved...8 were mature and 7 fertilized using ICSI. They were all at two cells today. I hope that they are thriving and I can't wait to here tomorrow how they are doing and when they go back in.

I am concerned about my lining. It went from 8.2 to 6.8 at the end of stimulation. I am not doing progesteron shots this time. They have me on estrace pills and I start the endometrium suppositories the day after retrieval. My RE's office told me not to worry because my estrogen level was at 2600 and the estrace would help my lining be ready for the transfer. Trust is difficult in this process! Specially for a control freak like me!

If I do a 3 day transfer, three embryos go back in. If it makes it to a 5 day, 2 will go back in.

The eggs are out!

2009-05-08T12:23:00.000-07:00

Well the cycle has progressed with ups and down. It started out with such slow growing of the follicles and a huge 42mm cyst that it was almost cancelled. Then the cyst decreased to half of its size (thanks to a lot of praying) and the follicles started to grow a little better.

I haven't been a huge egg producer so the 7 that they were looking at was expected...although still disapointing to me. Today the eggs came out and they actually got 9. I was pleasantly surprised. My husband said a prayer before I went in for the retrieval so I have to give the credit to God again. I won't find out until tomorrow how many were mature and how many turned out fertilizing. I am hoping for 5 to 6. More prayers!

IVF #3

2009-04-28T17:29:00.000-07:00

We are starting off to a tricky start. Today was my first monitoring day which is stimulation day 4 for me. My estrogen level was 468 and I have a cyst that measures 42 mm on the left ovary. There were 10 eggs visible but it is still early.

I was hoping for more eggs being that I am on the lupron flare protocol (micrdose lupron protocol) and I am concerned that the cyst will interfere with the progress of my cycle. My medication doses were lowered from 150 menapur to 75 and the Gonal F will remain at 300, no change with the twice a day 20 units of lupron. I return tomorrow for more bloodwork and another sonogram.

IVF #3

2009-03-30T15:35:00.000-07:00

Well, I am back after a long break. I had an HSG done and learned that my remaining tube after my ectopic was blocked. My insurance finally approved IVF, so here we go again. Today is CD1 and I start BCP Wednesday. They are estimating my egg retrieval to be on 5/6. We are really hoping this one will work.

I had to start synthroid and repliva because my thyroid levels were off and the anemia creeped back. We wanted to make sure that all of my lab levels are normal for this time. Gastric bypass has made that challenging at times.

Update

2008-07-30T19:24:00.000-07:00

I have pretty much healed completely. I am hoping that I can still have a successful pregnancy with the one tube that I have left. I am supposed to schedule an HSG at the beginning of my next period. If the one tube that I have left is blocked....then my doctor said that we can submit a request for my insurance to cover the cost of IVF. This of coarse is...after having a current loan for almost $25,000 for all of the infertility stuff we have already done. It think that the loss feels so much more heavier when you are empty handed and in debt!

I am not sure if I prefer for my tube to be open and get stuck with having to try naturally with such a small chance that I will conceive or if I am hoping that it is blocked in the hope that maybe our insurance will actually pay for IVF. I hate how having a baby for me really just boils down to money.

I suppose all that I can do is pray....it really is out of my hands.

Ruptured Ectopic

2008-06-23T18:10:00.000-07:00

Well, I never made it to my doctor appointment today. I ruptured my ectopic pregnancy while working in the ER this weekend. I was in the middle of assisting a doctor with popping a dislocated shoulder back into into place. All of the sudden I got completely soaked in sweat and felt like I was a second away from passing out. I began having pressure and a dull ache through out my pelvic area. I also felt pressure over my bowels. I stepped away to compose myself. I sat down, began fanning myself. After a few minutes it got a little better but the pressure in my pelvis was building. So, I talked with one of the doctors and he asked me check in right away. I gave my patients to another nurse and checked in.

My repeat HCG level showed a drop from 1700 to 1400. The repeat sonogram showed no sac in the uterus and a mass was visible on one of the tubes. The bloodwork also showed a drop in my H and H (which means that I was losing blood)...so, within an hour I was off to the OR. They removed my left tube....which had infact ruptured. There was blood in my belly.

They had been suspecting that my ectopic was on my right side but it turned out to be on the left. I was glad for that. My shorter tube with some scar tissue was the left tube. My right tube is my longer one with no known scarring.

The doctor that did the surgery recommended not TTC for 3 months and having an HSG to check and see if my remainding tube is patent before TTC again.

Physically I am sore. I was discharged this evening. Emotionally I am not as good. I am really feeling the loss of my baby. I also feel anger that I can't just get pregnant and have a healthy baby. I feel scared that I will never have one and that this might happen again.

It makes me really sad to think that I was pregnant yesterday and now I am not...just like that...it's over.

Ruptured Ectopic

2008-06-23T17:54:00.001-07:00

Well, I never made it to my appointment today. I ectopic pregnancy ruptured while I was working in the ER. I was in the middle of assisting with popping a dislocated shoulder back into place when I suddenly got soaked with sweat and felt like I was going to pass out. I kept hoping the shoulder would pop back in because I didn't think I would be able to stand up for much longer. I left the room, went to sit down, began fanning myself and started to feel pressure in my entire pelvic area. I also felt a lot of pressure over my bowels. After a few minutes it passed but I began having a dull ache with increasing pressure in my pelvic region.

I talked to a doctor in the ER and he asked me to check in right away. I gave my patients to another nurse and checked in. They did repeat HCG levels that showed my level dropped from 1700 to 1400 and the repeat sonogram showed no sac in the uterus but a visible mass on my tube. So, within an hour I was in the OR. My left tube was removed and I had infact ruptured the tube with my ectopic pregnancy.

My left tube is my shorter tube that measured 3.5 cm and had some mild scar tissue. My right tube is 4 cm and had no visible scar tissue...this is after my tubal ligation reversal. So, I am glad that my better tube is still intact. The doctor that did the surgery recommended not TTC for 3 months and having an HSG prior to TTC again.

I was discharged from the hospital this evening. I am pretty sore...the surgery was done laporscopically (that might be spelled wrong). Emotionally I feel pretty down. I am really feeling the loss of my baby. The nurse assigned to me was pregnant and looked like she was due to deliver any day now. That upset me. I kept seeing commercials for the Clear Blue digital pregnancy tests! It's heart breaking to be pregnant one moment and then not be pregnant the next.....just like that. At time I feel angry that others can have healthy pregnancies and I can't...then I feel overwhelmed with sadness that I lost my baby and fear hits me that I won't get pregnant again. I am terrified of going through this again. This was horrible!

Ectopic???

2008-06-20T11:11:00.001-07:00

My doctor called today with the lab results from the visit that I had in his office yesterday. My HCG level went from 504 to 1700. I wanted to be happy...However, it means that when he did a sonogram in his office yesterday and saw no sac....there should have been a sac. He wanted me to come in to his office today and do the methotrexate shot to terminate this pregnancy which is being diagnosed as ectopic.

I really couldn't bring myself to do that. I agreed to come to the office on Monday morning for one last sonogram. If there is no sac in the uterus at that time....I will do the shot. That will be the hardest thing that I have ever done.

I have read so much information and there is some out there that says...sometimes you can't see a sac until your HCG is at 2000. I am going to hope and pray that is the case this time. By Monday my HCG level should be at about 3500. My doctor feels concerned that I will rupture my tube this weekend. I had to remind him that I am an ER nurse and I will actually be working in the ER Sunday....if anything goes wrong, I know what to be aware of and I will be treated right away. He has already discussed my case with the on call doctor for this weekend...she has my name and number.

So, tonight I will go out to the dinner cruise that my husband and I booked when we found out that I was pregnant and I will feel blessed that I am pregnant for the moment.

Doulbing Numbers!

2008-06-17T14:36:00.000-07:00

My doctor called today with his update...my HCG level from yesterday's blood draw came back at 504! I am nervously excited!!!! My progesterone was 12...low but within normal. My doctor will see me again on Thursday for a repeat sonogram and blood work. He mentioned that if it turns out to be ectopic, he doesn't want to do the metho shot...he would rather just take the tube. He feels that if I have an ectopic, it means that the tubal reversal didn't work on that side. I sent a message to the doctor that did my surgery for another opinion. I am really nervous about everything but I am still praying!

ER Visit

2008-06-15T20:45:00.000-07:00

By the time I got to the ER there was no sign of bleeding at all. I still had some mild cramping. The sonogram showed a tiny sac in my uterus that still couldn't be measured because I am just under 5 weeks. The possibility that it is a pseudo sac still exists. A pseudo sac is a collection of blood that appears to be a sac. My HCG last night in the ER was 241. I was shocked to hear that is ALMOST doubled in the last two days. I felt my heart skip a beat with excitement. However, my head quickly began doing calculations:
1st HCG - Monday June 9 was 95, the following day was 130, two days after that on Thursday June 12th is was only 139. That was when it appeared to be headed to a miscarriage. Then last night in the ER is was 241. Ideally...they should be at about 600 right now...and that would be on the low side. I felt my heart sink again after those facts went through my head.

We see my doctor tomorrow for another HCG and sonogram. I so very much want to have hope but I want to be realistic.

Bleeding

2008-06-14T14:42:00.000-07:00

I finally started very light spotting. I feel so much relief. I have very light cramping. I really just want this to be over so that we can focus on trying again and not the loss. My OB recommended that I go to the ER just for HCG numbers. He said it was too early to know if it was ectopic.

No rise in HCG

2008-06-13T09:11:00.000-07:00

Well...I received a call from my OB this moring. My HCG is 139 which is pretty much the same it was 3 days ago. This means that I will either miscarry or that it is ectopic. I am having no symptoms but it really sucks to just sit here and wonder how the end will be.

I wish that I would have taken my husband's advice and not shared it with the family this past weekend. It was just hard to hold news that I was so excited about in. I really wanted to share my joy.....however, I really don't want to share my pain now.

I guess the good thing is that I know the tubal reversal was successful because I can infact get pregnant. I just wish that the risks for ectopic and miscarriages weren't so hi.

First HCG level

2008-06-10T19:43:00.000-07:00

My first HCG level done yesterday was 95. I am only 4 weeks, so that is within the normal range. I can't help but want it to be higher. It's supposed to double every two days. However, I am unable to have another one done tomorrow. I am scheduled to have on done again Thursday instead. BUT....being a nurse can sometimes have its benefits (and downfalls). I had one done today at work and my level came back as 130. So, it is working it's way to being double!

Definite BFP

2008-06-07T19:28:00.000-07:00

I went out and bought more pregnancy tests! I took a digital Clear Blue HPT this afternoon and the result read "pregnant". So, I definitely am. These next two weeks will be tough emotionally. I won't know that I am in the clear for a ectopic pregnancy until I have a sonogram showing a pregnancy in the uterus. It can't be done until HCG levels reach 1500. I am scared, nervous and happy.

Maybe a BFP???

2008-06-07T08:56:00.000-07:00

Just wanted to post an update. I took a HPT last night and again this morning and got a very faint positive both times. My AF is actually not due until tomorrow. I'm not too excited just yet because of the high risk that it could be ectopic or a miscarriage due to the tubal reversal surgery that I had. Also, today when I was peeing (sorry about the TMI), it ended with a tiny drop of blood. It wasn't dark like implantation bleeding (which I have never had anyway). I kept wiping and wiping after that....being paranoid....but it was clean. Hmmmm.

Waiting Again

2008-05-06T18:57:00.001-07:00

My DH and I have been TTC since my TR in January. My AF is due next week and again, I am hoping that it won't come. I am wondering if I have done the right thing. I belong to a blog for the doctor's ofc that did my TR.....and I am noticing a significant number of women that are having ectopic pregnancies or miscarriages. They seem to out weigh the normal pregnancies.

However, I do like being able to try every month without paying several thousands of dollars.

Waiting to TEST

2008-03-10T16:22:00.000-07:00

I got a positive on my ovulation test around cycle day 12 and TTC. I am 7 dpo and waiting to test. My AF is due on 3-19. I am hoping that we conceived but not hopeful that we did...if that makes sense.

However, I am completely healed from my tubal reversal and feeling great.

Ready To Try

2008-02-21T18:57:00.001-08:00

My AF showed up today. So, it is CD1 for me. I am going to use an ovulation kit this month and give it a try. I am kind of afraid....I haven't gotten over how painful it was to see a big fat negative on the tons of pregnancy tests that I took while going through IVF. Each and everyone broke my heart.

I told myself that I wouldn't take any until the day that my period is due. After two rounds with IVF...I am not feeling so positive about getting pregnant.

Recovering from Tubal Reveral

2008-02-04T18:56:00.000-08:00

I returned from Chapel Hill, NC two days ago. I had my tubal ligation reversal on Jan. 31st as scheduled. It wasn't too bad immediately afterwards. Dr. B totally numbed my abd so I felt groggy and that was about it. I took vicodin for 2 days and had to get off that stuff because it was making me feel really sick! I felt dizzy and that nauseated me. So, these last 2 days that I have been off the narcs...I haven't felt nauseated but I have felt sore when I move around and I occasionally get chills and weakness. I have been pretty careful at monitoring my temperature which has remained normal.

I had concern before the surgery as to how my incision would heal because of excess skin from my gastric bypass. That has indeed turned out to be an issue. My incision is right at the bottom of my belly (bikini line)....which is right where I have excess skin (sorry about the TMI). It has been a chore to take care of that!

On another note...it feels so strange to be able to get pregnant! I haven't worried about that in 10 years! According to my cycle days, I ovulate this weekend. I hope that I am feeling better!

Tubal Reversal Scheduled

2008-01-13T13:42:00.000-08:00

My tubal reversal is scheduled for January 31st in Chapel Hill, NC. I was able to get the time off work. I am really nervous about this. I just had major surgery less than two years ago with the gastric bypass and don't really look forward to my belly being cut again. I still also would like a tummy tuck in the future and that would be another time that my belly gets cut!

I am also terrified of an ectopic pregnancy. I hope that all goes well. I am due back at work less than a week after my surgery!

The Beginning Journey of Tubal Reversal

2008-01-02T15:27:00.000-08:00

I guess that I should re-name this blog to infertility since I am no longer on the IVF path. I called the insurance company today to verify my benifits for a tubal reversal. I was told that they would cover 100% with an "in-network" provider and 80% with an "out of network" provider. I was also told that I do not need pre-authorization. Of coarse, I requested that they send me this in writing.

I am still waiting to hear back from Shady Grover Fertility regarding who does the tubal reversals through their clinic. They did my IVF and have all of my records. I was told that their process is....the doctor that did my IVF will review all of my information and contact the doctor in the practice that does tubal reverals and review all of my history with them. Then, they will contact me with his information so that I can set up a consultation. My doctor has been out of town for the holidays. She was due back today.

I would really like to just find out if their doctor does the "microsurgery" type of tubal reversals and how many a week does he do, how many has he done. I only want to have this done by a surgeon that is completely specialized in this, has done over 5,000 of them and does it via microsurgery.

There is a place in North Carolina that meets all of these requirements (of mine :-) ). However, they would be out of network...so, I would be responsible for 20% and I would have to pay it up front and then get reimbursed by my insurance company.

I sent the doctor in North Carolina the information from my pathology report of the tubal ligation. It states how much of my tube was removed and by which method. He is supposed to review this with my history and let me know if it is even worth doing. However, I can't imagine too many doctors saying "no" to money. Sad but true.