Shelton & Brandi

Hello! We're Brandi & Shelton Koskie. Since 2006 we’ve been one of the many couples on the In Vitro Fertilization journey. We were the first IVF fundraiser blog, and thanks to the generous help of many, in we had our first successful IVF attempt. Nine months later, we had a beautiful girl, Paisley. You’re invited to follow along on our journey from infertility to parenthood.  Learn more

Sonohystogram

Today I had my sonohystogram. It was the first I’ve seen Dr. T since our IVF consultation last November, and it was definitely a welcome visit. It’s always a welcome visit. I adore Dr. T. In fact, I wish there were some way to make him my all-the-time-everything doctor because I so would. He has a bedside manner unlike any doctor I’ve ever been around. He isn’t patronizing and he doesn’t dumb down information, but he definitely makes it digestible. He makes you feel like you’re the only other patient in the entire building, and while we both know that I’m not, I appreciate having his undivided attention the entire time I’m with him. He calls me kiddo, which I think is sweet. He’s thorough, and honest, kind, and I’ll even go so far as to say pretty good looking, too!

I went in roughly knowing what was happening with this procedure, but not one hundred percent. I’d done my Google homework last night, but the results only yielded information for a hysterosalpingogram, in which they inject dye to investigate the fallopian tubes, uterus and the rest of the hoo-hah business. So while I knew it wasn’t going to be as invasive as that, I wasn’t quite sure what we were doing. He walked in and asked if I had any questions, so I told him I just wanted to be clear about the procedure. Using one of those super cute plastic vagina models (that would make a great paper weight) he explained that they’d run a very thin catheter into my uterus, fill with saline to expand the uterus, and then use a vaginal ultrasound to take a thorough look at my uterus. This is to ensure there are no detrimental surprises the day we do the embryo transfer.

I was told I would be uncomfortable and feel some cramping due to the catheter. It wasn’t until he told me the catheter was in that I realized he’d done it. So that was good. The speculum was one of the most uncomfortable parts, as was the ultrasound probe.

On the screen I could see a teardrop shape and he explained that it was my uterus. The conversation was very reminiscent of the one in which Dr. T told me what beautiful, healthy ovaries I have. He said that I have a “textbook, beautiful uterus.” (I hope he’s never tried to use that as a pick-up line!) So that was great news. The other good news was that typically when Dr. T and I do these little ultrasounds the screen is littered with giant ovarian cysts. I’ve had two surgeries because of these things and a number of years in quite a bit of pain and discomfort. Fortunately, they seem to have disappeared recently and there were no signs of them today. Ovaries looked good, too.

I got the good to go from Dr. T!

We had a discussion about the number of embryos that we’ll transfer. I assured him that we were solid on our decision to only transfer a single embryo. This pleased him, and reassured me that it was the right choice for us for several reasons, primarily being that we’re healthy, we’ll get plenty of good embryos, and we can come back for more.

The rest of the day I had just minor spotting and some slight cramping, but otherwise, this procedure was completely manageable.

Finally, Shelton and I made a brief visit to the lab to have blood drawn. We both had to be screened for Hepatitis B and C and HIV I/II. I had to have ABO and Rh blood typing done as well.

Today’s total was $425 for the sono and $385 for the labs. Plus, I started my second pack of birth control pills today ($26). See our progress and IVF expenses here.

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Written by Brandi and posted under IVF Journey

Man Surgery Explained

Shelton and I received our packet in the mail from his surgeon, the urologist, Dr. G., tonight. Inside was a stack of paperwork with instructions for the weeks and day leading up to his surgery. He can’t take anything that relieves pain, basically. No eating the night before. Abstinence for about five days prior. Pretty standard stuff. He and I both have required labs for HIV and Hepatitis that we’re taking care of on Monday.

I was kind of shocked to read that the surgery could take four hours. And the following conversation took place over dinner:

Me: Four hours is a long time. None of my surgeries ever took four hours.

Him: Take a lap top, you’ll be there for a while. This is going to suck balls.

Me: Ha… Ha…. you said suck balls. And your surgery will literally be…

Him: Nice one!

If you can’t have an immature puntastic laugh once in a while and share it with the Internet, what fun is this anyway?!

Here is my VERY layman’s attempt to explain the surgery. The purpose is to obtain the sperm, since they don’t have any other way out. (Basically has a natural vasectomy.) They’ll make a small incision in the aforementioned body part, insert a small “vacuum,” and draw out the sperm. A rep from the fertility clinic will be on hand to assess the quality of the sperm, and Shelton will remain “open” the entire time. They will not “close” until they are certain they have everything they need.

This will also be the first time we’ve ever seen his sperm sample, so fingers crossed we’ve got a few Michael Phelps swimmers in there!

Surgery takes place July 14; also that morning I take my very first shot of Lupron. What a really fun day that’s going to be!! Maybe we’ll go to Home Depot and Bed Bath and Beyond too if we have time!

In our original estimates, this surgery was supposed to cost us about $7,000 (out of pocket). The bill we received today (as everything has to be paid in advance) totals $4,467 (out of pocket). More unexpected savings making our total investment $3,000 less than originally expected.

See here for a running total of our IVF expenses.

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Written by Brandi and posted under Pregnancy

Teen Pregnancy Pact

I don’t think the “what the hell” spinning of my head has quite stopped yet. I found a news story this morning that said a group of 17 girls, none over age 16, in a Massachusetts high school made a pact to get pregnant. The girls wanted to be pregnant together and raise their babies together. This is so concerning on so many levels. I can’t imagine the impact this will have on their lives, their children’s lives and for those around them. I of course do not know them or their families, nor do I know anything outside of what the Yahoo news shared. So far be it from me to make ill informed assumptions and point fingers and call out everything that’s wrong about this. My first hope is for the safety and health of both the mothers and babies. You can’t help but wonder what kind of environment bred thinking that deems this appropriate. Media, family, school, etc. all play equally guilty roles. My second hope is that this story is told and it is shared to prevent another ludicrous pact like this being made.

This is one of those instances where I stand by my support of sex education. I was unbelievably fortunate to have parents who were very open and honest about educating me about sex, its consequences and my choices. I know that not all children and teens have this luxury. This is an example of where talking to your kids and presenting multi-dimensional perspectives can really help them make the best choices possible.

Written by Brandi and posted under IVF and Infertility News

Big Box of IVF Needles and Fertility Drugs

Earlier this week I received a phone call from the pharmacy filling our fertility drug order. I confirmed all of the pertinent details and then reviewed the order. They had the Doxycycline, Ovidrel, Progesterone in oil and Gonal-F, plus needles. I referenced the list we’d received in IVF class, and everything checked out. I had to call back with some insurance information, knowing it was really a waste of time because they weren’t going to cover any of this. Once I confirmed that I was told they would process my order through insurance and call the next day with a final total.

Yesterday, I received that call. I told the rep that if she hears a loud thump it was me falling out my chair. I think she was too busy to have a sense of humor and with a very concerned tone asked if I was OK. I laughed and told her I was just dreading the total. So drum roll please…. she ran the card and announced that we would be charged $1781.21. I didn’t fall out of my chair. In fact, I was rather relieved by that number. Don’t ask me why spending $1800 on prescriptions is relieving, but I expected an amount far surpassing that. Plus, we got our needles complimentary so that made the entire thing sound like a bargain!

I was told that FedEx would deliver the package tomorrow morning (today) between 8 and 3 and that someone had to be here so that the Gonal and Ovidrel could be refrigerated. At 8:15 the doorbell rang and our package had arrived. I signed. Walked back inside. Placed the box on the floor. And started bawling. I just kept saying “it’s here, I can’t believe we’re doing this, we’re actually doing this.” I think a part of me had just believed we were going to let time get away from us and one day it would be ten years later and there still wouldn’t be a baby. But that’s not the case. We are doing this. We are actually doing this.

So I had a good hearty cry this morning and then followed instructions and took inventory of the package. Two things were wrong:
1. My sharps container was missing. The container for the used needles. Don’t ask me why but I am so excited about that sharps container. It feels so official. I mean, how many people do you know what a needle box in their house? (If you can answer that… maybe you shouldn’t!)

2. My receipt was small. As in, a lot less than I was quoted less than 24 hours previously. $1142.66.

I called the pharmacy and I was told they would get my sharps container in the mail (damn right!), and then asked about the total. Don’t get me wrong, I’m jumping for joy over here. I saved $600 without even trying. I just wanted to confirm that a mistake hadn’t been made and which of the two charges we were actually incurring. Lucky us, it was the lower amount.

I promptly moved my drugs to the lower shelf of the fridge (behind the negro modelo) and then moved on.

I think when we have kids and we’re inevitably faced with the dreaded “how are babies made” question, I’ve got an easy answer. They come in a box. It’s like a model airplane kit. Except more expensive and more painful. The stork sends a box full of supplies and then you just make a baby. And a man, not your father, puts on the finishing touches, and wah-lah, you have a baby.

It should also be noted that two of my drugs are missing from the above list – Lupron and Menopur. We found out this week that our entire doses for both are being donated. I can’t even tell you how excited we were to learn this news. I’m not sharing specifics because I honestly don’t know what the disclosure parameters are with this and I don’t want to disrespect or cross a line I shouldn’t. But the parties responsible are likely reading this and we just want you to know that we are incredibly grateful. I’m not sure how those two items would have impacted our total Rx bill, but I am so very thankful that they didn’t. Hopefully we’ll have a fast cycle and we’ll be able to return the favor!!

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Written by Brandi and posted under IVF Journey

IVF Class and Our Big Bag of Needles

Well, folks, we’ve decided to get a goldfish. They’re like 35 cents, don’t come with any needles, or severe hormone shifts.

It wasn’t ALL that bad, but definitely overwhelming and quite sobering. After spending the past five years talking about it (and talking and talking), the whole thing slapped us in the face today. My stomach rolled over the moment we walked through the doors. During one portion while our coordinator “M” (she’s reading this… hello!) was giving her presentation, I thought I was going to have to leave. Tears started welling in my eyes and I was shaking my leg so hard I thought my sandal was going to fall off. Because rapidly shaking your leg is the cure for public crying.

We took our seat at the tables and there was a pink bag at our place. Shelton got really excited and thought it was a goody bag – full of drug-branded sticky notes, clicky pens and even candy. There was no candy in that bag. It might as well have been a goody bag from a Halloween party at Hansel’s and Gretel’s witch’s house. It was full of NEEDLES!!! Giant needles. Probably the same ones used to give elephants and humpback whales tranquilizers. There it is, my needle phobia (trypanophobia).

I literally shuddered. And used all self-restraint not to ask “M” if we could just get a topical cream or some sort of flavored Dimetapp-style liquid. Give me a pill the size of an Oreo cookie if you must. But needles? Most are tiny, I admit. The ones for Lupron, Gonal F, Menopur all seem to be relatively approachable. I’ll probably cry and throw a fit the first couple of times and then I’ll get over it. That progesterone needle? It’s the one that’s seven and a half feet long. It’s the one I’ll do daily injections with for SIX WEEKS! In my butt. Which will apparently bruise and be sore.

We also learned that despite my constant theory that we’d get ONE DRUG throughout our entire fertility preparedness project, that there will be multiple drugs. Administered BY NEEDLE multiple times a day. The Lupron, Gonal and Menopur will last up to 12 days. The progesterone starts at egg retrieval (Day Zero) and continues through what will hopefully be my sixth week of pregnancy.

The entire three hours did not consist of the needle parade. “M” thoroughly walked us through the ins and outs of this upcoming cycle. There were points where she’d make a little joke and the room would laugh and I would be so thankful. We’re in there with 18 other infertile couples and it felt like the most awkward first day of school. No one looking to their sides, straight ahead. I could feel the class-clown tension between Shelton and I; each of us constantly wanting to make some uninvited wise ass comment. Because we decided to wear our mature adult clothes today, we kept quiet.

She explained that due to the drugs our estrogen level on the day of egg retrieval would be close to 4000. Any other time of ovulation it would be about 300. That is ludicrous. She gently suggested to the husbands that they remember this estrogen spike and act accordingly.

We also heard from one of the clinic’s doctors. She explained some of the risks associated with the drugs, and risks and statistics for multiples. I still REALLY want twins, as in, does Shelton’s opinion count since he doesn’t?? However, since I was wearing my mature adult clothes, the ones that say you can trust me with a newborn baby and that I pay my taxes on time, I decided to hear out the doctor. Because of all the drugs we’re on, the likelihood of multiples skyrockets. I asked if family history of twins plays any role and she said that what we’re doing overrides genetics. Fair enough. So if we implant two embryos, there is a 50% chance we’ll have twins (or more!). If we implant a single embryo, there is a 5% chance will have twins. I felt like Jim Carrey in Dumb & Dumber – “so you’re saying there’s a chance!” It would be the responsible and safe choice to opt for the singleton. After all, I’ve decided we’ll have more than enough embryos to freeze and come back later.

Then we heard from the embryologist, described as our first babysitter. She takes the eggs, and the sperm, and waves her magic wand, or rather pipette, over the petri dishes and builds our little babies. The only concern I had with her was, how do we know my egg didn’t get matched with guy B’s sperm? Before I could ask she more than reassured me that that isn’t going to happen.

Finally, we signed so many forms that I honestly thought someone was going to hand me the keys to a new house. We consented to the IVF, embryo transfer, ICSI, embryo freezing and more. We signed off that the living spouse gets custody of the frozen embryos if one of us should die (I had to promise Shelton I wouldn’t make his “ghost” babies). If we both die then we selected to have our remaining embryos donated to research.

I have to call “M” tomorrow to get my birth control and prenatal vitamin prescriptions filled. I hadn’t even thought about the vitamins. I’m no good, NO GOOD AT ALL, with daily pills. So keep your fingers crossed for me. In college I used to tape my birth control to the bathroom mirror so I wouldn’t forget… maybe I’ll try that again.

Afterward, I made Shelton take me for ice cream. Not because the doctor hurt me, which was always my mom’s rule growing up, but because of the impending promise of pain.image

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Written by Brandi and posted under IVF Journey

IVF Handbook and a Scheduling Conflict

I told you about receiving our IVF handbook/packet, which turned out to be an oddly emotional moment for me. I didn’t want to waste any time and so I asked Shelton to read through the entire thing with me – giving us a chance to discuss things, question things, maybe even laugh at a few things. He suggested we each read it separately, and then regroup to discuss. I suggested more strongly that we do it the way I had originally suggested.

In the end, we read through it together. All 50 some pages in one evening. We scribbled notes in the margins to ask at our June 3 IVF class. We read really big scientific words and referenced the glossary often. We were forced to discuss some of those uncomfortable ethical situations that those “easy breeder” couples don’t seem to ever face. You know – like who gets the embryos if we divorce, do you dispose/donate/freeze additional embryos, if you have multiples do you do selective reduction, etc. All things we’ve discussed ad nauseum previously, but forced to face a little more head on this time.

At the end of each page or section I would summarize by saying, “Bottom line, Brandi might die.” I’d giggle. Shelton wouldn’t. I guess the side effects with the fertility drugs, surgery, the actual carrying of the baby in my womb come with a lot of risks but the statistics seem to be on our side. We hope. Ovarian Hyperstimulation Syndrome (OHSS) seems to be the strongest risk, and this was expressed by Dr. T some months ago. I’m reassured by the daily or every-other-day visits we’ll be having once I start my meds. Surely if there are red flags that will allow us to catch them early and begin treatment.

I am so very hopeful that OHSS or any other side effects or circumstances force us to cancel our cycle mid-way, or not even start. They make it very clear that there are serious demands not only on your body and mind, but also on your schedule. It is imperative that you be available to make all of the labs, ultrasounds, check-ups, etc. It seems we’re already running into a bit of a scheduling conflict. Next month, one month before our cycle begins, I’m supposed to go in for “third day labs.” Blood is drawn on the third day of my period (and I could very well be completely botching this explanation) and they test for FSH (follicle stimulating hormone) levels. This helps them determine the dosage of my fertility drugs in July. Well, I have a business trip planned during that week (as always, my quarterly trip to NYC for work never fails to conveniently fall right at that time). Our IVF coordinator, “M”, is checking with Dr. T to find out how we should handle this. Regardless, I’ll still begin my birth control cycle next month.

That seems to be the low-down on where we stand right now. I really can’t believe we’re getting so close. Just one more week to the IVF class!

Written by Brandi and posted under IVF Journey