Coming to you live from Ian's Family Jewels

I must apologize for the extended time it has taken me to write this blog post.  I feel like I have been going non-stop since Easter.  Work has been consuming my time and fertility has been consuming my mind! 

To start, Ian has been healing great since his procedure (as evidence by the return of his libido, hehe… J) and we finally got the results of the TESE procedure….

HE HAS SPERM!

But, (it seems that there is always a “but”), his numbers are still REALLY low.  Our Embryologist and Fertility Specialist talked with us in length about where we should/could go from this point; citing that we may end up with more eggs than sperm (a phenomenon that they RARELY ever deal with) they recommend that Ian undergo ANOTHER TESE procedure to ensure we will have enough sperm to match the egg count on the day of retrieval.  WHOA… brakes!!!  Ian is supposed to undergo mutilation two times, with no guarantees!  NO WAY (cost and pain attributing)!  So, we decided that all it takes is one sperm and one egg to make a baby and that’s all we need.  Yes; we are done circling the airport people!  Our bags are packed, we’ve paid the fare, and we are in the terminal awaiting take off!! 

At this point, the medications have been increased twice based on my recent ultrasounds and blood work, and believe me when I say, hormones mean business.  Hot flashes, cravings, headaches are a few things that accompany my injections, but, all things considered, I haven’t felt too terrible.  Although, Ian might tell you that asking me to turn off the light could draw tears….

Now that we have been thinking sperm, sperm, sperm, we can transition to thinking eggs, eggs, eggs.  I have an ultrasound scheduled this Tuesday to follow up on the developing eggs.  We should know this week, the dates for egg retrieval and implantation!  I am in Phoenix for the interim, scheduling a date with the pool and the movie theater and whatever else may fit into my schedule ;).  Check back later in the week for a tentative retrieval date or just to leave words of encouragement.  Happy Spring to all!     

Vagal Manuvers

I must start by saying that we know nothing new at this point. We have to wait, patiently (yeah right), for a freeze to thaw test and viability screen to know if the sperm are (1) alive and (2) mature enough for fertilization. Once again, the Jeopordy theme song plays on in my mind...

Although, I can say, we (or should I say Ian) made it through the procedure. I'm not sure yet if "made it" gives us (Ian) enough justice for the Swiss-Cheese-Syndrome he is currently experiencing in his gentelmans area, but I digress. After using local lidocaine (at which point Ian attempted to jump off the table and abort all agreements to mutilate his tenders) they took six core samples of actual testicle, three form each one (top, middle, and bottom). When they were finished, they brought him back to the observation area and came and summoned me from the waiting area. Ian was doing well at this point and was able to tolerate sitting in the wheelchair. He felt good enough to get dressed, so the girls wheeled him to the bathroom and I followed him in (thank God!) to help him. Once he took his boxers off to sit on the toilet he had an indescribable pain (if I were a man I may be able to come close to describing it, but I won't be able to give it justice here) and started to say "I think I'm going to pass out..." at which point he actually did. Now, I am standing in the bathroom with my unconscious husband and thinking "there is no way I am going to be able to pick this guy up off the toilet.." So I call for help and in walks a 5' nothing tech and we are now both thinking the same thing. Luckily, Ian came to and he was able to walk himself to a nearby gurney. They hooked him up to a vital signs machine and his blood pressure and heart rate were really low; he vagaled down because the pain was that intense! I felt to guilty to be standing there pain free at that moment (Ian later cashed in on this moment). Once he was stable, we got him to the car and we made it home with no further mishaps.

Now, he has his Percocet and ice bag within arms reach and is doing pretty good for himself considering he was able to talk his guilty wife into getting him the new iPad and is sole owner of the remote. Monday, I have an ultrasound to make sure no cysts have popped up on my ovaries from the injections, and I'll have a chance to insist I know the results of Ian's procedure (citing my meds for any rude, demanding behavior...). Keep up the prayers and good thoughts until then. I'll be sure to post an update when I hear any new news!

Apothecary

Hello all and thanks for checking in.  I am proud to announce that my Lupron showed up this afternoon!!  FedEx overnight from The Apothecary Shop out of Tempe.  Many of you will not be surprised when I say that I have read through ALL the inserts, much of which is repeat info from the clinic or just nursing in general.  My purpose was to find the common side effects so they could start taking a placebo effect before I even take my first injection :)  I was hoping for something along the lines of "these COMMON and PERSISTENT side effects may occur: radiant skin, healthy/shiny hair, beautiful nails, weight loss without exercise, endless energy, mad cooking/baking skills."  Much to my disappointment, the "COMMON and PERSISTENT side effects are: breast tenderness, constipation, decreased sex drive, nausea, vomiting, pain, swelling..." just to name a few.  Awe well, there is the COMMON phase "No pain, No gain" so BRING IT ON :)

I have a new theme song for the coming weeks.  Its Shots by LMFAO featuring Little John -
Shots shots shots shots shots,
Shots shots shots shots shots,
Shots shots shots shots shots shots.
(you can probably guess how it finishes)
Except I am doing mine at home.... with a needle..... into my fat.  Hahaha!

Only positive thoughts going on over here at the Modrell hoursehold.  Check back for updates from Ian's procedure happening next week!  Hugs to all!

Covalent Bonds

It's been so long since my last post, I had to read the last one to refresh my memory.  I feel like I may have said what I am about to write here on this blog about 640 million times (and NO my lottery numbers didn't win, dang!) but saying it is never as therapeutic as writing in down. 

We had our calendar review!  I was really looking forward to this day and it did not disappoint!  The "calendar" turned out to be a 3 page excel spread sheet detailing each coming day with injection schedules, lab work and ultrasound appointments, when we can and CANNOT have sex (Ian was a little aghast at this point, we couldn't have sex, whaaat?), and when our impending egg retrieval and implantation would occur.  It was AWESOME to say the least - the detail was astounding!  It just lay there in front of me, so white, clean and crisp, eagerly awaiting for me to highlight, draw arrows, take notes and re-transcribe in various other formats for easy identification of key points.  This was the nerd in me un-stifled by any inhibitions or worry about "how I might look" (Ian wanted to leave the room at this point just to escape the embarrassment); I was made for this kind of regimen!

Keep in mind that the ENTIRE excel spreadsheet is contingent on Ian's TESE procedure happening April 20th.  Poor guy, it's like the slap bet countdown on How I Met Your Mother when Marshall set a timer for when he would next slap Barney (please reference your Netflix account and if you're not currently watching, really, your missing out on something great).  He is pretty stoic about the whole thing and I just keep chanting "live sperm, live sperm, live sperm....." over and over in my head; the universe WILL hear me!

So, WHEN they get live sperm from Ian we will be in full fledged IVF mode.  The medications for me start on April 16th (my mother-in-laws birthday, good sign).  It is a shot called Lupron which helps suppress follicles in the early stages.  It is injected into the subcutaneous fat each day (Yay!).  Soon after, I start FSH which recruits multiple eggs and is administered also as a shot.  The Lupron continues at this time, but at a smaller dose to prevent ovulation.  Based on the frequent ultrasounds and lab work results, I will start hMG which is a similar shot that helps to mature the eggs so they will be ready for fertilization!! At this point, I am on a total of 3 shots/day, in case anyone didn't catch that :)  When they see under ultrasound that the ovaries are ready to pop with mature eggs they give me a "trigger shot" and do egg retrieval and fertilization with Ian's sperm within 36 hours!!  Then, 4 days after, they implant the embryo(s) and we wait 11 whole days for a positive pregnancy test.  It looks like implantation will occur sometime around Mother's Day (also, another good sign).

We are both so happy that this day has come, we are more than ready to do whatever it takes!  We are like a covalent bond (recently referenced in 21 Jump Street, also a must see), each needing something that the other has.  Not just in the simple terms of eggs and sperm but also strength, love, encouragement, and bravery, just to name a few. 

We love our friends and family very much. Thanks always for reading!    

Red Light, Green Light

Quick update - Michelle made it to Seattle on Sunday!!  She is seeing her place for the first time today, and while the photos of her studio apartment we generous to the size and condition, she loves it non-the-less :)  She starts work at an Aveda salon branch on the 27th and promises to keep me updated on her settling in progress.  I miss her so much already.

Ian is healing well.  He is still using his crutches and walking boot to get around, but his pain is decreasing each day.  He goes back to work on light duty status starting Wednesday this week, and while it has been great having him at home, we are both ready to get back into a routine.

Speaking for routines, we have been back and forth to Phoenix three times already this month, and the traveling is beginning to show!!  My house goes un-mopped and un-dusted far longer than my usual hygienic standards (which are pretty low anyway), but I guess somethings gotta give.  We had the pleasure of enjoying an educational IVF class taught by a nurse that has been taking care of IVF patients for 28 years; it goes without saying, she answered every ones questions without any of us saying a word.  We learned more than we thought, especially with my compulsive behaviour to research EVERYTHING!

I had an ultrasound the following week to take some measurements of the size and thickness of my uterus.  This gives the doctor a pre-planned map so the embryos can be placed in the precise spot for implantation.  Dr. Behera gave me an "A+" and I silently rejoiced (those that know me understand my continual need for good grades).  Finally, one green light!  And, just to add to the emotional roller coaster, they asked Ian to give one final semen sample for analysis.  We joke that he's going to have calluses by the time this is all done, if you know what I mean ; ) 

The analysis again returned with disappointing results and, even though we said we wouldn't hope for something better, we were still let down. RED LIGHT (again) On the positive side, we already had an appointment scheduled with Ian's Urologist for the 19th to discuss the next step and procedure for sperm aspiration. GREEN LIGHT! 

This brings me to today... Dr. Avila (the Urologist) could not explain why Ian's counts had dramatically decreased over the past year and explained that this left us with ONE LAST option... semen aspiration.  We discussed the procedure (Ian almost passed out for the second time- hehe) and talked about the chances for successful discovery of viable sperm, which ended up being a static number in the end.  At this point, we are scheduled for the aspiration on April 20th (I haven't decided if this is a red light or green light yet), and if they find happy, moving sperm, we are on schedule for IVF!!  This means transfer would happen sometime in the later part of May.

I feel hesitant to be positive at the least or excited at the most.  I feel I have been on a roller coaster that has multiple rises and falls, but with no end in sight.  Anyone with some objective encouragement, please share because I am desperate!         

When it rains, it pours.

While I have silently been thinking of ways to put all of this in words, my life seems to be coming apart at the seams. This may sound dramatic to most, but it really is how I have been feeling the past two weeks. As my close friend says, bad things happen in 3's (you know who you are)...

After our joyous appointment two weeks ago, I felt confident and sure about where my life would be in the coming weeks, months, years even. It felt SO good to share our journey and plans with our family and friends. Now I sit here, feeling the pain in my stomach as if I was punched, gasping for breath as if I were at an altitude of 15,000 feet, standing at the edge of a cliff, waiting to fall or fly...

When I called to schedule a freezing for Ian's sperm last week (with the intention to use as a backup for when we got to the day of egg retrieval in the rare case Ian was shooting blanks that day), the lab tech asked me an interesting question... "Why would we save this?" As panic set in and I explained our plans again, she informed me there was nothing there to save. I couldn't grasp the thought, "wait, what are you telling me?!? My specialist saw this report, the IVF coordinator saw this report; why am I hearing this for the first time from you?" She skirted the questions and said she would have someone call me the next day.

I sat in panic, holding my breath, trying to figure out why this happened, and convinced myself it was a mistake until noon the next day. The IVF coordinator called me and gently told me that my specialist had made a mistake... she had mis-read the report. BUT- there was hope, maybe it was a fluke, maybe it was mishandled in the lab, there were a million reasons running through my mind that had caused Ian's sperm to go from usable to un-usable.

So, we re-grouped and went for another analysis; we were quietly optimistic, thinking for sure that the previous sample was a fluke. Someone doesn't go from having sperm with movement to having none in three months.. When my phone rang later that same day, I knew it wasn't good. Our specialist informed us that, again, Ian's sperm was unusable. Can I just say - DEVASTATION. Why? We were ready - work schedules arranged, emotions arranged, thought processes arranged. How can this be happening??

She discussed with us some other options available and we are clinging to one last hope - sperm aspiration directly from the source. At this point, everything is on hold (again). A Urologist will do the procedure at out fertility clinic and tell us (1) if there is any sperm that is alive, mature, and moving and (2) if it could survive a freezing and actually be implanted into an egg to make an embryo and eventual baby. I still feel like I am holding my breath to say the least.

As the icing on the cake (and to tie in the matter of bad happening in 3's), an axe fell out of the fire truck at about 5 feet and broke a few bones in Ian's foot. The sunny side to this story is that he still has all of his toes (phew) and the fractures are non-surgical. He is off work for a couple weeks and is using crutches with a stabilizing boot until his bones fuse together on their own. So, needless to say, he is keeping me (and my mind) busy.

Lastly, we got the ______ (insert adjective here) news that Michelle got a great job in Seattle and will be moving mid-March. WAAAAA! I mean YAAAA! She is really looking forward to the change and we are all so proud of her bravery. I can't put into words how much we are going to miss her, especially during this time, but this is another post entirely.

Our families and friends have really been our supporting force through all of this emotional turmoil and we acknowledge that we can't do any of this alone. I hope everyone knows how much Ian and I appreciate your support and encouragement and we have faith that our dreams WILL come to fruition.

The Wait

Recipe for Invitro:

• Equal parts man and woman (preferably magnetically attracted and madly in love)


• Two ovaries containing viable eggs


• Two testicles with ambitions sperm


• One magical Petri dish


• One expert Lab Pathologist


• One Fertility Specialist


• One large some of money (preferably cash)


• One ounce of luck for good measure

Insert cash. Preheat female "oven" by injecting multiple hormone medications into the body. After about two weeks, the eggs in the ovaries will mature. Once eggs become mature, place female under light sedation and extract each individual egg from each ovary. Place the newly harvested eggs into Petri dish with newly "submitted" sperm and monitor for fertilization for about 4 days. At the precise moment replace the now Embryos back into uterus, add luck, and wait! another 11 days to take blood sample to check for success! Enjoy!

Prep time: About 4 Weeks Servings: Usually two

To even be able to attempt this recipe, I have to wait for the first day of my cycle. I don't know if I have ever anticipated an upcoming cycle as I have the one that is due any day. Who would of thought a woman could look forward to her period? This cycle is the marker that sets our rough timeline for invitro fertilization (IVF). Until then, Ian and I both have blood work to complete and an IVF class to attend, and the Jeopardy theme song runs through my head continuously...