Max Rides CalTrain for the first time

Because Max is in a train phase right now, we went to ride CalTrain. Here are some pics of the adventure.

Catch up and Max "face plant"

It's been many moons since I blogged here. Max is now 20 months... today! Lots has happened since the last time I posted. I've been telling myself, I would catch up with all of the events that have happened. With babies and toddlers, it all happens so fast... I know that now. He has gone through so much already - learning to walk, first tooth, many teeth, new words, new interests, growing tall, eating new and different foods... just so much. Every day there's something new. I really do want to go back eventually and try to remember some of his firsts and on what days they happened.

For now, I'll blog about today. Over the weekend, Max and I took CalTrain for the first time. Max is addicted to trains. We went from Lawrence station to Palo Alto station and spent some time at the Stanford Shopping Center.

On Sunday, we drove to Concord to pick up the Thomas the Tank Engine, Little Tikes bed we found on craigslist. I spent Sunday night through early morning cleaning up his room, disassembling his crib and getting the house cleaned up.

This morning, Monday Ei's Dad came over at 8 AM to watch Max. Ei was stuck in Ohio due to delays. After I came home from work, Ei's Dad toook off for the gym and Mildred and Jimmy came over because they're going to stay for a few days. Mil had dinner with work folks at Piatti's in the Rivermark. After dinner, Max wanted to go for a walk so Jimmy, Max and I walked over there.

While at ColdStone, Max wanted to run around on the sidewalk. He's been running around really fast lately. But as a toddler of 20 months, he can be unpredictable.

As he was running to Jimmy he tripped on his own feet I think. He fell forward and for some reason didn't get his hands out to support himself and fell on his face - aka face plant. He started crying with the cry where nothing comes out for the first few seconds. He wiped at his face frustratingly as if to say make the pain go away. Then I noticed the blood. And I saw the piece of skin hanging from his lip. I immediately searched for a napkin and started wiping the blood off. I felt horrible, but did my best to comfort him.

After a few minutes went by, he wanted to run around again. But he was noticeably quiet. He kept sucking on his upper lip and it was swollen fat. When we got back home, he cuddled up in my arms with his blanket and fell asleep after a few minutes. Then i tucked him away in his big boy bed. If they sold a magical spell to protect kids from spills, cuts, scrapes, bruises, etc. I would buy it in a heartbeat.

Hello

Maximilian is trying to say Hello... except it comes out Hehdo. Which makes me laugh. He was holding the phone last night, talking to Mommy on speakerphone. Mommy is on a lay over in Tulsa, Oklahoma. I was telling him to say hello to mommy and out of the blue, he says... Hehdo.

Ultrasound July 7, 2006

New Doctor

Today Eileen met with our new OB/GYN. His name is Dr. L. Eileen decided to go with him because he delivered both of her sister's babies and the babies of two other friends.

Eileen went by herself because I had to work. She waited in the waiting room for about an hour and a half. Dr. L. was delivering a baby girl. Finally, when she got to see him he was very nice and very friendly. He loved to show off his new ultrasound machine he just got in last year. It was able to do a 4D picture. And here it is. Isn't he/she cute already? You can already see the Guevarra cheeks. Eileen says he/she already has my big arms.

The bottom picture shows the heart beat. The picture says 182 BPM, but I think that is rather fast so I'm not sure if that is the heart beat.

Click on the picture if you want a larger view:

Due Date

According to this online due date calculator, the baby is due October 16, 2006.

http://www.intmed.mcw.edu/clincalc/pregnancy.html

2nd Ultrasound

Ei went in today for the second ultrasound. It will also be the last ultrasound with our IVF team. After this, we go on to our OB/GYN. I didn't go this time but here is the picture. Ei said you can see arm buds and legs. The doctor said the baby has a spinal cord. He pumped his fist in the air and said "Yeah one baby!"

I was worried over the weekend because Eileen had some abdominal pains. They turned out to be gas. She called the on call doctor and she recommended Gas-X and adding more fiber to her diet. I think it could also be some stretching as the baby grows.

Ultrasound Day

So just like us you've probably been wondering... they transferred three embryos in... how many implanted and are growing? Today we did the ultrasound with Dr. A. and we have... drum roll please... one healthy growing baby! I have to admit I was a bit sad because I was hoping for multiples. At same time it's good to know the pregancy will be easier and the baby looks great. The doctor said the baby is the right size for this stage (about the size of a peanut at 6.5 weeks) and the heartbeat at 133 beats per minute is just right. The ultrasound machine they used was not the type that is able to record the sound, but just to see the heartbeat on the monitor is amazing. We are so happy this was successful and very thankful as well. We appreciate all the well wishes from all of you. We'll continue to keep you posted.

Third Beta

HCG beta level is now at 2,030. We estimated that it would be at about 1,000 at this point. So, there might be a couple or a few buggers in there pumping out the HCG.

Eileen hopes that all three took. She's become attached to them. When we have the ultrasound on Feb. 23, I wonder what we will see?

Life's Greatest Miracle

We watched these videos from Nova. Fascinating pictures.

http://www.pbs.org/wgbh/nova/miracle/program.html

Second Beta Test

Eileen went in this morning for the second beta test and got the results back. HCG level is now at 235. On Monday it was 58. In a normal pregnancy, the HCG doubles approximately every 2 days during the first 4-6 weeks. (See this link http://www.mommyguide.com/print.php?sid=67). It's been about 4.5 weeks since Eileen's last period (Jan. 9)



HCG levels can also give an indication of multiples (twins, triplets, etc.). It's still hard to tell right now how many embryos have implanted. Since 3 were transferred, obviously there is a chance that 3 can take. But as mentioned in a previous post, the Doctor told us there is a 1-3% chance of that happening. Bottom line I guess is we still don't know at this point.

Eileen will go back on the 13th for another beta test. And the first ultrasound scan is scheduled for the 23rd. The ultrasound will definitely tell us for sure how many embryos implanted.

At this point I'm guessing the embryo(s) are in Stage 5:

BFP!

Got the call today at 12:25 PM. HCG level is 58. I just called Eileen and she was so happy. I am very excited too.

It all started this morning at 830 AM when Eileen went to the hospital for the 9 AM beta test. I left the house to go to work shortly after. Eileen wanted the hospital to call me on my cell phone because she was too worried about the news they would give us. While at work I noticed I left my cell phone in my car, which Eileen drove this morning (I drove the truck). I called and had her bring my phone to me at work. Shortly after that I got the call. It was Nurse L. She didn't sound excited or sad or anything so I was worried. But then she said "I have good news, Eileen is pregnant". A rush of joy came over me. I was so happy.

Eileen has been peeing on a stick for the past few days and all came up BFN. The 2WW has been a rollercoaster. Does she have symptoms? Does she not have symptoms? Then the negative HPTs. But I guess a day or hours can make a difference. It's possible her HCG was not high enough yesterday to show up on the HPT. She needs to go back on Wed. to do another beta. Then in 2 weeks will be the first ultrasound.



It's a Bee F P (Big Fat Positive)...

IVF Calendar

Here's what we have so far (click on the calendar for larger view):

The 2WW continues...

4 more days until the pregnancy test. I came back from my business trip to Tulsa. Eileen told me the other day she tried a home pregnancy kit and it came up negative. Later that day she started getting large amounts of white discharge that she normally does not get. Some web sites tell us this is a sign of ovulation, or the cervix closing, or could be a sign of pregnancy. The only thing that will tell us for sure is the pregnancy test on Feb. 6th. I think we will be very excited if we get a . But if we don't, we'll try again on the next cycle.

Waiting... waiting... and more waiting...

We're about 6 days into the dreaded 2WW (Two Week Wait). Everyday we wonder if any of the fertilized eggs have implanted. We're very hopeful. We've come this far and everything has went as well as it could. The implantation is supposed to have begun 5-6 days after retrieval. So that would be this past Saturday or Sunday. http://www.visembryo.com/baby/stage4.html Fingers are crossed.

The nightly progesterone in oil shots have become easier to bear for Eileen. I just wonder how she will do this week when I am away on business in Tulsa. She will have to inject herself in the thigh and I know that will be painful. Only about a week to go before the beta test on Feb. 6th.

Our New Family Picture

Here is the picture of the three embryos transferred today. This is the picture given to us by our embryologist. Can you tell which two are the 8 cell embryos and which one is the 9 cell? The embryologist told us all three look beautiful because there is no fragmentation and the developing cells within the embryos are all about the same size.

Transfer Day

Today the embryos were transferred into Eileen's uterus. It was an easy and painless procedure.

We arrived at the hospital at 9:45 AM. First we made a payment for the ICSI and embryo freezing since it is not covered by my insurance. Then we went down to day surgery for the transfer. We met with David, one of our embryologists. I remembered that he showed me into the room for the sperm collection earlier this week. I didn't realize back then that he was an embryologist working in the lab.

David gave Eileen her gown and me some scrubs. We were a bit late and they were already doing one other transfer today. Once we were dressed, they took us into the room. We met another embryologist, but I do not recall her name. Eileen and I agreed that at some point in time we should send our team a nice card and a little gift for helping us through all of this.

Almost everyone we met (the embryologists, the RE) raved about how beautiful our embies are. The embryologist gave us a picture of the three embryos they planned to transfer. One is a 9 cell, the other two are 8's. They are all Grade A. Now we have a new family photo!

Dr. S performed the transfer procedure. She explained everything as she was doing it. It was very exciting. All three embryos were transferred through a catheter while using ultrasound. She let us snap a picture of the embies after they were transferred to their new home.

After the procedure, we sat for a while. Earlier in the morning, Ei was instructed to drink 3 bottles of water to enlarge her bladder assisting with the transfer. So by the time the transfer was over, she had to go pee really bad. The nurse gave us a bed pan, but we did not know what direction to place it! Whatever we did, Ei did her thing and that was that.

A bit later we were released and we went home. They prescribed 24 hours of bed rest for Eileen. After that she could return to normal activities but nothing strenuous. We're scheduled to return to the hospital to see if we're pregnant on Feb. 6, although they said we could do a home pregnancy test after day 10 if we wanted to.

Now it's the waiting game. With 3 embies transferred, we were wondering about what if all three take? Dr. S told us because of Ei's high FSH, there is a 1-3% chance of triplets. But if it does happen, she assured us that twins and triplets have very good chances of arriving safely with the advancements in neonatal intensive care and such. The only thing they are cautious of is Ei's short stature which makes it difficult to carry multiples. Eileen is about 5'2". We'd love to have twins or triplets, but overall we just want a successful cycle and if so, for our baby or babies to be healthy and safe.

A funny thing happend before we left the hospital. Dr. S popped in to say that they were now freezing 7 left over embies instead of 6 because one just divided! I forgot to ask her about this. If it divided, that would mean those babies are identical! I wanted to know if they had some way of seperating the embies so if we were to come back for another cylcle that they could put them together. I guess we'll have to call her back.

Good News

This morning Dr. S called us to give us some good news. She sounded very happy on the phone. She told us that nearly all of the fertilized embryos look beautiful. She went down the list and gave us the ratings for all of them and the majority were Grade A with 3, 4, 5 and 6 cells. A couple of them were B and B+.

The doctor said it's not often they see a group of embryos where almost every single one of them look this good. The transfer is scheduled for tomorrow at 10 AM. They will transfer 3.

All I could think of on my drive to work this morning was where in the world am I going to put 3 kids in my two-door sports coupe? Obviously we'd have to get a family car. But I would gladly do that if our IVF cycle is successful.

How we got here and what's next?

A recap of what's happened so far and next steps.

1. About a week and a half ago, we started with the "Super Ovulation" process. It started with Eileen injecting Lupron and Follistim. These injections are intended to stimulate the ovaries to ovulate as many as 20 eggs at once. As you know, a woman typically only ovulates one egg per month (although some can ovulate more but not 20 at time).

2. After a week and a half of injections, the ultrasound showed 19 follicles forming in the ovaries (about 9 or 10 in each ovary). The follicles are filled with fluid and contain the oocytes (eggs).

3. Yesterday, the Doctor retrieved 14 eggs along with the follicular fluid. This involved putting Ei under sedation and the doctor poking a large needle through the vaginal wall 19 times. Very painful.

4. My sperm was collected at the same time of the retrieval. (I had to do my own retrieval ;-)

5. The Embryologists in the lab performed ICSI which involves taking one single sperm per egg and injecting it directly into the egg. Of the 14 eggs retrieved, 11 have now fertilized.

6. During the fertilization, the eggs are incubated in their petri dishes in a storage that keeps them at body temperature. During this time, the cells divide. In the next couple of days some will have divided into 4, 6 or 8 cells. Some more. If kept for 5 days they could reach the Blastocyst stage where the cells have divided to a hundred or more.

7. Assisted Hatching will also be performed on the eggs that will be trasferrred. At one point the cells within the eggs are supposed to break from the zona pellucida which is like a shell. AH is where they put a small break in the zona by wearing it down with acid or a laser. Basically, it's supposed to help the egg implant when transferred into the uterus.

8. Wednesday or Thursday this week, Eileen and I will go back for the transfer. At the clinic we hope to see pictures of the eggs. We read in a book that the eggs are going to be ranked according to quality, how many cells they've divided into and other factors. I believe that they will also discuss with us at that time, which ones they will transfer back into Ei's uterus and how many.

9. The transfer involves inserting the eggs through a catheter into the uterus. I think the doctor also uses some type of camera to guide them to an "optimal" place in the uterus. It doesn't involve pain like with the retrieval and I will be able to be there with Ei.

10. Once the egss are trasferred back in, that is where nature should take over. The eggs should implant into the uterine lining as in a normal pregnancy.

11. Then after two weeks of waiting, Ei takes a pregancy test and then it's the moment of truth.

Note: They might transfer two or more eggs so there is chance of multiple pregnancy. We would be delighted to have twins if it comes to that. But for right now we just hope for any kind of success with this.

Retrieval Day

This morning, Ei was up bright and shiny at 6 AM. I was up not so bright and not at all shiny at 6:30 AM. We were late for our 6:45 check in. No problem, we checked in at 7 AM and we had to sit and wait anyway.

Finally we were taken into the Day Surgery prep area. Ei got into her gown, signed some paperwork and was given the anethstesia for conscious sedation. Dr. S was going to perform the procedure. Then they wheeled her off for the oocyte retrieval.

Meanwhile, I went upstairs to do my part. I already had the experience of donating sperm samples for the testing so I was not intimidated anymore by what could be to some guys a potentially demoralizing experience. If you've seen the movie Forget Paris, and the funny scenes where Billy Crystal has to deal with this, you'll know what I'm talking about.

For the uninitiated, here's how the sperm collection goes. The clinic has a room or rooms where they try to make you as comfortable as possible. It's complete with a leather couch. There is a machine that can make ocean sounds or noises of the forest to get you in the mood. And of course there is a collection of adult magazines and videos. Then you do your thing in a cup and put it in a small door and press a button. That's it.


After my part, I went back down to the waiting area for day surgery. Then they called me on my cell phone to go back and see Ei. She was sitting up, but obviously in pain. She told me they retrieved 19 oocytes. Nurse C told us that we should be hearing back from the clinic on how many oocytes fertilize and how many will be good for transfer. We should be back for transfer 3 or 5 days from now.

We sat and waited for a while as the percocet set in and eventually she felt good enough to get up and walk. On the drive home, she got a little car sick. Once at home, it's been bed rest since then. I've been brining her food and drink and doing my best to make her feel comfortable.

Tomorrow we'll hear the news about the eggs and start with some new Progesterone in oil shots and Ei's estrogen patch.

A Busy Weekend

To say the least... This was the weekend, our Goddaughter had her 18th Birthday Cotillion. Or debutante ball... party. If you've ever seen the movie The Debut you get the idea. Anyway, I agreed to not only sing at the party but to also create a video montage.

I practiced singing throughout the week and on Friday night, as last minute as one can get, I threw the video together finishing at 6 AM. Our appointment with the fertility clinic was at 9 AM Saturday. 2 hours of sleep.

I was awakened by Eileen's typical wake up call by announcing from across the room that we have to leave or we'll be late. We were late. I was groggy and it was quiet driving all the way to the clinic which is not the usual.

Since we were leaving from the airport for the birthday party after our appointment, we packed our bags and put Machi Cor the wonder pug in the laundry room. If this is all too confusing, welcome to our world.


Dr. A was not in, so Dr. S did the ultrasound. I didn't get to see the ultrasound when they first identified the follicles, so this was a new experience for me. Eileen had fun posing with the condom sheathed ultrasound device. I read another blog where the blogger referred to it as the dildo cam. Did I ever tell you IVF is lots of fun?

I watched from the sidelines as Dr. S measured each follicle using a trackball and pointer on the screen. I kept thinking of Atari's Missle Command (click Guest). It was like classic arcade gaming in the ovaries.


The follicles did not look the way I expected. They seemed larger than I imagined and very close together. I pictured follicles to be smaller and farther apart. The nurse did say that Dr. S liked to use a higher magnification though. In all, about 22 oocytes were measured.

The lights came up and Dr. S told us that Eileen would have to start later that evening with that shot I have to give her in the butt (Eileen says it's not the butt and it's called Norvel - HCG). We drove off to the airport and talked some more about baby names. I always make it a point to say "IF we get pregnant, we'll name the baby (fill in the blank)". But I caught myself not saying the IF. I'm still wary of not getting our hopes up too high.

The fun was just beginning. We boarded our plane. A quick and easy ride and we were landing in San Jose. We picked up the rental car, then picked up Ei's mom, passed by Radio Shack for some connectors, and stopped off at the condo to get ready. The video montage DVD didn't burn quite right so I had to redo it. It took 1.5 hours to render. So by the time we left the condo for the party, it was just about done. Phew.

We drove 45 minutes to the party in Concord. First thing to do was to set up the screen for the video show. Shortly after people started coming into the banquet room (over 300 guests expected). After some intros by the Ei's sister and cousin acting as the emcees, I was asked to do the prayer speech to kick off dinner (check that off of my list of things I didn't say no to).

It was about this time that Dr. S instructed us to do the shot. Where of all places at the Holiday Inn would we do this? Luckily, a cousin loaned us a key to their guest room and up we went. It wasn't bad at all considering I forgot to pinch the skin. I found it's tougher if you don't. But Ei wasn't in much pain at all and was prepared with a heating pad. Not bad.

I went back downstairs and started the video montage. Then there were some performances and speeches, and then on to the singing. I started off well but horror of horrors, my voice cracked in the middle some where. Oh well, I guess it couldn't all be perfect when you are trying to shove 10 million things to do in one night. After leaving the party we went home and finally got into bed after 2 AM.

I was then awakend Sunday morning, as if it was all some kind of weird dream to the sounds of "The Broncos game is on!" or something like that. AFC championship game between the Denver Broncos and the Pittsburgh Steelers. We lost. Well, at least the night before "Pac-Man" Pacquiao knocked out Erik Morales. At least that was something good. And it was Eileen's day off from taking shots.

After the game, it was off the airport again and back to Denver. It was cold. On the way from the airport we stopped off for the requisite two cheeseburger meal and arrived at home to go to bed to be ready for the 7 AM retreival.

Starting Out

This is our adventure of trying to have a baby through IVF (In Vitro Fertilzation). IVF is not new and if you happen to stumble upon this blog, you probably know much already. But for the uninitiated, IVF is a reproductive technique used to help couples to become pregnant who would otherwise have difficulty becoming pregnant naturally. It involves retrieving eggs from the female and sperm from the male and putting them together in a lab dish. Once fertilized, one or more eggs are placed back into the female and if successful pregnancy results.

The first successful IVF baby was born some time in 1978. The news of this breakthrough was controversial because of religious and ethical reasons. But since then tens of thousands of babies have been born through IVF. IVF continues to increase in popularity as more and more couples go through it each year.

So our journey begins. I'm Marvin. Eileen and I have been married over 5 years. After getting married, we put off having children for a while. We told ourselves, we'll try in 2 years. Two years went by then we told ourselves again, we'll try in another 2 years. In all this time we had unprotected intercourse and had not become pregnant naturally. I think we both had the mindset through those years of "if it happens it happens."

Fast forward to the present. We decided we're both ready to have a child, but it doesn't appear we could be successful at having one through normal intercourse. Eileen has always had irregular periods since her teens. Along the way she found out she has something called PCOS (Poly Cystic Ovarian Syndrome) which involves hormonal imbalances and cysts on the ovaries. It may be related to her family history of diabetes and issues with insulin. We knew through reading more about PCOS that this would complicate trying to get pregnant.

I started working for a new company recently and as my company's benefits enrollment period came about we discovered we had the option of coverage for infertility and IVF. Being covered financially we decided to take the next step and visit a fertility specialist.

Through several visits with our doctor and fertility specialist Dr. A, we took lots of tests and were told about our options. To make a long story short, IVF seemed the best way to go. There are other advanced reproductive techniques used as a first line before resorting to IVF such as Clomid (an ovulation inducer) . We found out through the tests that I also have a low sperm count. Because of this our chances of getting pregnant using just Clomid were slim.

Another first line technique is AI or artificial insemination. It involves a "sperm wash" where they sort the sperm, find the best swimmers and inject them directly into the uterus. The technique is called Intra Uterine Insemination. The chances of success for that were low as well. So we both decided to go straight to IVF as the doctor's recommended.

Here's and overview of the IVF procedure:

1. Administration of fertility drugs and monitoring the cycle
2. Collection or retrieval of eggs
3. Mixing eggs and sperm together outside the woman's body in a culture dish or test-tube
4. Any remaining embryos of good quality may then be frozen for future use.
5. A procedure called ICSI can be used to inject a sperm directly into the egg
6. Assisted Hatching technique can also be used to assist the blastocyst to escape the pellucida
7. The best 2-3 embryos are then transferred into the woman's womb
8. Wait, let mother nature take its course and hope for the best

Today we started towards step 1. We met with Dr. A. and Eileen had an ultrasound to see if things are happy in the uterus. She had her blood pressure, weight and other data recorded. Then we met with Nurse L to have her show us the schedule of injections and how they are performed. Also, blood was drawn for the baseline estrodial reading which we received the results later that evening. All is well.

About the injections, there are A LOT of them. Some small needles, some LONG. Eileen can do some herself. Some I have to do. All in all, it seems pretty easy, but we know there will be pain involved and we'll have some challenges with schedule since they are very time dependent. We'll have to wait and see how we manage.

As far as schedule, I guess it will be shots, and monitoring for the next couple of weeks and hopefully we can then move to Step 2, the egg retrieval. So not to get too far ahead, I'll stop here for now.

I invited Eileen to this blog and she will post experiences in her own words. Until then, I just have to say, on the emotional and psychological side as a wannabe father I am excited but at the same time wary of the potential for letdown. No one likes to get their hopes up high only to be faced with bad news (I'm thinking of the families of the miners in West Virgina). But on the other hand what a joy it would be to awaiting the arrival of a baby (or two!) This predicament is typical of life isn't it? Onward with our journey.