At Last

We have been planning to start a family since 2008, and at last we met our little rainbow princess!

Our daughter was born at 2:07 am on November 22, weighing in at 8lbs 1oz and 21 inches long.

She was quite content not making her arrival, so at 41 weeks, I was induced. It took 16 hours from start to finish, with contractions every 2 minutes the whole way through. I hardly needed any Pitocin to get my labor to start progressing and was on 1ml/hr for 80% of the time, only ever getting up to 4ml's/hr.

I requested an epidural about 5 hours in so I could rest a little because the contractions were pretty intense, without a lot of breaks between contractions. I had some relief for a few hours, but the epidural ended up failing. I didn't have a specific birth plan, so I was open to both natural delivery and an epidural. I believe being open to both options going into the process, made it easier for me to accept, and move forward with the natural delivery.

I spent 2 hours in transition phase, and 2.5 hours pushing. She nursed within 30 minutes after her birth and has been a champ ever since, with a little help from a lactation consultant. The biggest complication was that I came down with an infection, and fever during the delivery, so we both needed antibiotics.

Our daughter handled the delivery so wonderfully, holding a steady heart rate the entire time. She has been such a calm, content baby so far, we are so in love, and have never been happier!

Sooner or Later...

On Friday I had my weekly Dr's appointment. Everything was looking great, but because of my paranoia, I asked if they were planning to check the fluid levels again. The Dr. agreed it would be a good idea to check just to make sure things are remaining at the same level or getting better. If they were getting worse we would have to discuss our options.

The AFI measured at 9.0, which is better than what was seen the previous week. Baby looked content and like he/she had gained a bit of weight. His/her face had a bit more "chunk" to it than we saw in earlier ultrasounds.

I have definitely felt much better this week after the follow up ultrasound, but now I'm just left very anxious for our little one to arrive. I also have noticed I am much more emotional this week, crying very very easily. I'm sure this is just a glimpse of what is to come after the baby arrives! My poor husband!

There are only 6 days left until our due date and I am finding it difficult to think of anything else! Here is to hoping baby comes sooner rather than later because we are so very anxious to meet this rainbow baby.

Worry

Here I am again, neglecting this blog. I don't really have any good excuses, I'll go with pregnancy brain.

I am 38 w 1d and counting down the days until babies arrival. We are so close to meeting this baby, but I really have been having a difficult time relaxing in these last few weeks. Daily I have been struggling with irrational fears that something is wrong or could go wrong. I find myself over analyzing everything, and waking up in the middle of night performing kick counts just to check in on baby. This is such unfamiliar territory, so I don't know what is "normal" during the last weeks of pregnancy.

I went in to L&D last week for monitoring because I felt a small gush, but after a few tests it turned out it was not amniotic fluid. They did an ultrasound to confirm fluid levels and the doctor measured and AFI of 7.9 which is on the low end of normal. The doctors were not concerned with the AFI level and sent me home. Because of my experience of low fluid with Faith, I am sure that the AFI level is triggering the increase in my paranoia. This baby always has perfect timing letting me know he/she is doing just fine with his/her big stretches or hiccups.

Despite the increase in paranoia, I really am enjoying this pregnancy. I am just very anxious to have this baby in my arms. I will then have so many other things to worry about!

Time goes by...

Time seems to move by so quickly! I can't believe it has been well over a month since my last post. Since then I've had several doctors appointments, 2 baby showers, and a maternity photo session.

All the doctors appointments are going well. I have gone in a few times because of fear that something is wrong, but in the end, the practice I see is fantastic at reassuring me that everything is going perfectly smoothly, and the little baby is healthy and doing well. I was concerned with the changes in babies movements, so to ease my mind and to confirm that everything was okay with baby they ordered a non-stress test. A non-stress test included me being monitored on a fetal monitor for a minimum of 20 minutes. They were watching me for contractions, and the baby for elevations in heart rate of about 10bpm when I indicated there

was movement. In order to pass they need to see 3 elevations in 20 minutes.

Within the first 5 minutes, our little baby had already passed the test! So I was able to sit and relax for the remainder of the test. The elevations in heart rate after the baby moves indicates that everything is functioning properly with the babies cardiovascular system and placenta.

The baby has been head down since about 28 weeks every check up since he/she has been bottom up! We have our next growth ultrasound on the 18th at 36 weeks! I'm definitely excited to see how big the baby is, and if we are having any progression!

Both of my baby showers were wonderful. We are very fortunate to have had 2 thrown for us, and that we have received so many generous gifts! Because of every one's thoughtfulness, we really did not have to buy very much for the baby, for this I am very thankful!

Last weekend we spend a portion of our Saturday in Northern Wisconsin for our Maternity session. I have only seen a sneak peak at some of the photos, and I love how she capture this moment for us. Thanks very much to Ruby Photography for taking time to capture this pregnancy! Below are a few of her photos from the session.

All photos by: Ruby Photography

Sneak Peak and Preparations

I am currently 29.5 weeks pregnant with our rainbow baby, due November 15th. This baby is so very active, and I love every moment watching him/her move around. I am already so in love!

We have decided to cloth diaper this baby, so the past month I've been doing extensive research to attempt to figure out the best options for us. I've placed several orders, and we are all set for the newborn stage (pre-folds and covers), and we have many different types to try when baby gets bigger (pockets, AIO, AI2's, and pre-folds). Once we figure out what works best for our baby, and us, then we'll finish the stash.

The nursery is almost complete. All of the furniture for this room was under $300. We got the crib, changing table/dresser and glider on Craigslist. These were such a steal because we don't have to re-touch a thing!

This week we had a growth ultrasound, and baby is estimating to weigh in at 3 lbs 4oz! And to make the visit even more special we got a sneak peak at baby's face with a 3d ultrasound!

In Memory

The one year anniversary of Faith's birth, came and went. I woke up that morning to a loud thunderstorm, and I remembered my grandmother always told me that the sound of thunder came from angels bowling. As silly as it seems, I imagined the angels bowling to celebrate Faith's birthday!

Christopher and I celebrated her birth by donating blankets, hats, and stuffed animals to the hospital where she was born. Her blanket and hat are my favorite keepsakes of hers. They were so very unexpected the day she was born, but we were so very thankful for them, so we wanted to be sure to give this same special gift to other families.

We reflected on Faith's memory, by looking through all of our photo albums, and her memory box. We ended her birthday enjoying an ice cream cake, which I'm sure she would have loved. It was beautiful day for just the two of us to remember her, celebrate her, and honor her.

Approaching An Angel-versary

Today, I gave in to my grief and didn't go to work. I couldn't seem to get myself together inside and out this morning. Being at home near her is what I needed at this moment, so I gave in. I just don't have it in me to mask my feelings of missing my baby girl.

I know I have come such a long way this past year, because I can think about Faith without crying, and I don't feel guilty if I leave her necklace at home, but that is not the case this week. As Faith's 1 year "angel-versary" approaches, I've been spending a lot of time breaking down what was happening to us, day by day last year.

Today I am 22w5d pregnant. It was this day in my pregnancy, last July 21st, when we drove to the hospital knowing those were our final moments with her, and we would soon be saying goodbye. I remember I continued to pray for a miracle up until the moment we arrived to the hospital, and I'd rub my belly over and over on the drive trying desperately to hang on to those moments with her. I find it incredible how even 1 year later, I clearly remember exactly how I was feeling, and what I was thinking during our last days together.

I really wanted July 22nd to be a celebration of the day she became an angel instead of another grief milestone, but this morning I came to the realization that I cannot be joyous in her being an angel without missing my little girl, and wishing things could be different. She is always with us in our hearts and watching from above, but I'd still rather she be in my arms!

First Flutters and Flips

Over the past few weeks I have been feeling little flutters every now and again. This past week, they have been pretty regular and definitely getting stronger. This baby is most active when I'm sitting still and right before bedtime!

These little flutters are such great reminders that baby is doing well and is getting stronger every day! I never felt movement with Faith, so this is a first which I am so very thankful for, it is such a wonderful gift.

Whenever baby is most active, I place daddy's hand over my belly and sure enough, the baby stops in his or her tracks! My thoughts are it will only be a matter of a week or so until Christopher is able to feel the baby from the outside.

We had our 20 week scan last week and baby got an A+. It appears we have a healthy little baby on the way! One of the U/S scans showed baby laying like daddy, resting his/her hand on top of their head! We are so thankful for every moment we get to spend with this little one!

Sixteen Weeks and Change

We had our early Level II yesterday, and everything is looking good with Baby Botkin. All the measurements were right on track, the organs appeared healthy, and the fluid levels looked right were they should be. Baby seemed to be taking advantage of all of the space. We saw baby jumping and flipping around several times throughout the ultrasound. We got a bit lucky because our ultrasound tech had a student observing, and once the tech was finished with the scan, the student continued to scan for awhile. So we had about 45 minutes of quality baby viewing time!

Baby is still pretty small at about 4.5 inches, but we still got to see quite a bit. I have my guess as to what the gender is, anyone else want to share their guess?

The first picture one shows Baby Botkin's bicep and thumb sucking abilities! The picture below shows baby's spine to be in good shape!

It was confirmed that I again have an Anterior placenta, so it may be awhile until I really feel the baby moving!

Our final Level II ultrasound will be June 29th at 20 weeks. Baby should be much bigger because of the expected upcoming growth spurt. I can't wait!

Physically and Emotionally

I am just about out of the first trimester at 13 weeks 5 days today! YAY!

We met with our Maternal Fetal Medicine group about 2 weeks ago. This is the same group that delivered Faith, so we feel we are in great hands and are hopeful we get to to deliver at the same hospital and bring home a baby this time. Baby is doing well with a heartbeat of 160bpm. It was difficult but healing being around the people and at the same location where we learned the fate of our pregnancy with Faith. We saw the genetic counselor who diagnosed Faith with SLOS and she was so excited to see we were expecting again, and very kind in asking how we were doing physically and emotionally!

Physically I am feeling really good. My morning sickness is scarce, and my energy has returned! As I'm exiting my first trimester I am always hungry and I've been having the most vivid dreams. I get up quite often in the middle of the night, am always warm, and have lots of experiences of pregnancy brain! I haven't been able to button up my pants for a little over a week and my tops are tight on my lower belly. Today I dug out my old maternity clothes, because I think I'll be needing them in a couple of weeks.

Emotionally I have been having my ups and downs. This pregnancy is following the exact same timing as my pregnancy with Faith. She was due November 16, 2010 and this little one's estimated due date is November 15, 2011. I've been thinking a lot about my time with her last year, while looking forward to better things to come this year. Mostly it is difficult just being in the exact same place as we were a year ago.

Our next appointment is June 3rd when I'll be 16 weeks. The Dr's are going to perform an early level II ultrasound to make sure all is well with baby and that my fluid is looking good. I'm really looking forward to seeing baby again! Early July we'll have one more level II, to make sure everything is right where it is supposed to be. Until then I'm remaining hopeful that all is well, and that the baby is growing and happily bouncing away in lots of amniotic fluid.

The Next Chapter

I can't believe it has almost been a month since my last post! As of our last appointment on the 12th, everything is moving right along . Baby was right on target for growth, and the heart rate was speeding away at 160 bpm. We also saw baby's little arm buds waving away, it was so cute and unexpected!

We are now finished with our IVF Dr. and have our consultation on the 21st with the maternal fetal medicine group we are going to for the rest of the pregnancy.

I am off of the Estrogen patches, have 5 shots of Progesterone left and get to stop Metformin on the 26th! I cannot wait to be off of all medicine and into the next chapter of this pregnancy!

Second Month, First Appointment

I am only in my second month of pregnancy, 6 weeks 5 days to be exact! We had our first pregnancy appointment with our IVF Doctor on Friday. Everything is looking great so far. We have 1 baby which is looking to be developing right on track so far! We were able to see and hear the heartbeat, which reduces our chances of miscarriage down to 10%.

Of course seeing and hearing the heart was wonderful, and even though our chances of miscarriage are reduced, it has happened before so I'll remain on edge for the remainder of the first trimester!

So far I have been feeling pretty great! Which is different than my other pregnancies. I am tired all of the time, hungry a lot, get dizzy spells throughout the day, and heartburn in the evenings. So far so good, because the morning sickness this time is much more bearable than I've had before and I'll take it while it lasts!

As requested, below are a few early pictures of the baby.

The first one is from our embryo transfer procedure. If you look closely you can see an arrow on it where it is pointing to where they were placed, look for a brighter white dot. The top of the picture (black space) is my FULL bladder, which was the worst part of the procedure. It had to be full during the transfer and I had to lay with it full for 30 minutes after the procedure was over.

The next picture shows the yolk sak (circle) and itty bitty baby at 6 weeks 3 days! YAY!

I'd like to thank everyone for their continued support, kind thoughts and prayers during our journey! We are so greatful and remain hopeful that this pregnancy will be an uneventful one!

A Positive Result

I am beyond excited to announce that our IVF cycle was successful and I am pregnant. We found out on March 10th, which is one year and 3 days after we found out we were pregnant with Faith (3/7/10). I am both excited and nervous about this journey, and already feeling very very tired!

For now I am keeping all fingers and toes crossed that baby is healthy and keeps on growing, growing, growing!!

Shooting Star

Wow, what an amazing week last week was!

Tuesday the 22nd I had the egg retreival. From my 30 developing follicles 10 mature eggs were removed.

Wednesday I returned to work, and we were told that 6 of the eggs fertilized. The egg removal left me feeling like I was kicked right in the gut. I spent the day walking very slowly and sitting as much as possible. I should have taken the day off, but never could have predicted how uncomfortable i'd be.

Thursday I started Progesterone in Oil Intra-Muscular injections. I had been torturing myself by watching videos of people getting the injection and some of women giving it to themselves. I was so anxious from all of my self inflicted torture I passed out right after the injection was over. I woke up on the kitchen floor with Christopher holding up my legs and grabbing a cold compress for my head. It was a little scary at first, but i've had a few laughs and a handful trouble free injections since. A little tip is remember to BREATHE!!! To make this easier for me, we now do the injections lying down. This way I can focus on deep breathing without having to worry about anything else.

Sunday we learned that 5 of the embryos made it to early day 5 transfer which were evaluated with PGD.
Embryo's 1 and 2: not recommended for transfer. They arrested/stopped developing before we arrived and genetics predicted them to have an issue with chromosome 11.
Embryo 3: recommended for transfer, is not a carrier of SLOS
Embryo 4: recommended for transfer, is a carrier of SLOS, specifically my mutation c.964
Embryo 5: not recommended for transfer, affected with SLOS

We decided to transfer the 2 embryo's which were recommended for transfer, leaving no embryo's left to freeze. Embryo 3 was considered to be a compacted morula, a little behind in development for a day 5 transfer and embryo 4 was considered to be an early blastocyst. A full blastocyst is expected on a Day 5 transfer, but morula's and early blastocysts are also common. While our embryos were a little behind in growth, the Dr. assured us we transferred early in the day on day 5, so they haven't had the full day to develop. From what i've read even though they are developing a little slower it is likely that they are perfectly healthy! Our odds of pregnancy are a little less than with a full blastocyst, but still good.

The transfer process was absolutly beautiful. The medium the embryo's were in showed up bright white on the ultrasound, so when they were placed in my uterus it looked like a shooting star. We have a picture of them being placed, which I remain hopful is the first picture of our rainbow baby or babies...

I have been thinking alot about embryo 5. I feel sad and a slight sense of guilt for not even giving this beautiful embryo a chance. With this technology comes many sacrifices of which I will be forever greatful.

A Midnight Trigger

I had two monitoring appointments this past weekend. On my Saturday appointment, my follicles weren't quite big enough for triggering and my Estradiol level was not quite high enough, so the Doctor had me re-add Follistim in the evening and come back in on Sunday morning for another peak.

On Sunday everything was looking great. In addition to my evening does of Menopur and Follistim, we triggered ovulation with Ovidrel at 12:30 this morning. I also started an antibiotic with dinner in preparation for the egg retrieval procedure which is scheduled for 12:30 on Tuesday the 22nd.

For this IVF cycle, I am all finished with the abdominal sub-cutaneous injections (YEAH)! The next set of injections I are intra-muscular injections of Progesterone in oil. Progesterone is critical in preparing my body for and hanging onto a pregnancy, so I'll start them right after the egg retrieval.

My past few appointments showed we have about 30 follicles, of which about 15 are looking to be a good size for fertilization! I'm so excited and anxious, but keeping my fingers and toes crossed that we have some healthy embryos to transfer back into me on Sunday!!

27 Follicles

Today's appointment identified that I have 27 follicles of varying sizes, of which about half are looking like they'll be in good shape for fertilization in the upcoming days. Holy smokes, no wonder why my ovaries feel like they are being pulled on all day! While I'm sure it is only going to get worse in the next few days the feeling is a great reminder that everything is progressing along nicely!

My Estradiol levels are tracking very nicely now, so I will remain on just Lupron and Menopur for the next couple days, then head back Saturday for another peak. From now until a pregnancy test, I am to take it easy and absolutely no exercise.

Everything has gone by so very quickly during this cycle and the nurse hinted things are tracking towards a Saturday or Sunday ovulation trigger shot. This means an egg retrieval will happen on Monday or Tuesday! Keep your fingers and toes crossed!

Our Memory Book

A couple weeks back Christopher and I put together a great album of our time with Faith, an idea I got from a new friend of mine.

I love how it turned out, and can't wait to get it.

Click here to view this photo book larger

A Little High

The monitoring appointment on Tuesday confirmed my suspicions that my follicles were growing! I have been feeling achy growing pains in my ovaries throughout the weekend! This is great of course and means I'm responding to the injections.

The IVF coordinator, called Tuesday afternoon with my lab results and confirmed I am indeed responding, but a bit to well . My Estradiol was a bit higher than they'd like to see on that particular cycle day, so the Dr. reduced my injections to just Lupron and Menopur for 2 days until my appointment on Thursday.

Responding too well to the injections can be an issue much like not responding at all. However, with PCOS quick response is very common! If my follicles increase to quickly my uterine lining will not be ready and the egg quality will not be as ideal. Lets keep our fingers crossed that everything slows down a bit so we can slowly and steadily keep on progressing to our egg removal next week!

The Middle

On Friday the 11th I had my first IVF monitoring appointment. The ultrasound revealed I have about 10 follicles (can't remember the medical term of what they called them at this point in my cycle) in each ovary, which gives us great odds for plenty of eggs!

I am now taking 3 Metformin, and 3 injections daily, which puts us right in the middle of our first cycle. YEAH!! All of the injections I'm getting now are given subcutaneously (through the skin) in my abdomen, by the gentle hand of my husband Christopher!

The first injection is Lupron, which I've been taking since the 31st of January. I started at 20 units, but was reduced to 5 units. The specific IVF protocol I'm on is sometimes called Lupron Down and I'm now on the 'down' portion. As a part of the 'down' portion, I also getting injections of Menopur and Follistim, all of which are given at the same time of day. Menopur and Follistim are the drugs which will force my body into producing multiple eggs ready for fertilization.

As of today, Menopur is my least favorite but also happens to be the largest volume. Don't get me wrong I'm so excited to be on this journey, but I am finding it difficult emotionally, and get very anxious around injection time. I remind myself every night before the injections about all the good things these drugs are doing. Because of them we are so much closer to the dream of having a family, and I am very grateful.

My next appointment is Tuesday. They'll draw more blood and let me know if we need to adjust our injection doses, so stay tuned!

Disposition

In order to enter an IVF cycle, we had to complete many consent forms. These forms are required prior to receiving all the medicine needed for the cycle.

The last form needed in our file was titled: Consent to Cryopreserve Embryos and Decisions as to Future Disposition. This form decides the fate of any of our left over normal embryo's not transferred.

Question 1: How long should they be cryopreserved: 1, 2, 3, 4 or 5 years?

That's an easy one. As long as we can, so we chose 5 years. We have always wanted a large family, and if we are lucky to have extra embryo's then we want to make sure we have them long enough to use them.

Question 2: After such time elapses I/We request to:
a. Donate the excess embryos to appropriate recipient
b. Discard the embryos

I had my answer to this question, but this form requires both spouses to respond and of course agree. Christopher and I did not agree. Actually, we didn't immediately agree to majority of the remaining questions. Including in the event of death, and in the event of divorce.

This form weighed so very heavily on my heart. These check boxes are not what I had pictured for our family when we were married 4 years ago. I want all of our babies. I want to care for them all, give all of them a chance to grow and be loved. Unfortunately this is just wishful thinking and is not a choice we can make.

Ultimately we came to full agreement, but even today my heart is still heavy. Through all of this I am left to wonder what it must feel like to innocently enter into the joys of motherhood.

Makeover

If you haven't noticed, my blog got a fabulous make over, thanks to Franchesca from Small Bird Studio. It turned out so beautifully and I am very grateful.

It's a new year, so here's to a new look!

My Dear Mother - A Poem

Today on my daily lunch break Baby Center perusing, I found the following poem and wanted to share. I'm not sure who it is by, so unfortunately cannot give them credit.

My Dear Mother:

I did not die young.
I lived my span of life
Within your body
And within your love.
There are many
Who have lived long lives
And have not been loved as me.
If you would honour me
Then speak my name
And number me among your family.
If you would honour me
Then strive to live in love
For, in this love, I live.
Never ever doubt
That we will meet again.
Until that happy day
I will grow with God
And wait for you.

Some FAQ's and Our Protocol Details

I've been getting a few questions here and there from family and friends, so I've decided to post a few FAQ's:

1. What is a PGD (pre-implantation genetic diagnosis) system, how is it created, and why is it needed?

A PGD system is unique genetic marker system created for each family who needs to undergo PGD.

To set up our PGD system, Christopher and I had blood drawn so they could use our DNA along with Faiths to develop our system. They compare our DNA with Faith's and look for shared markers which are present in our DNA and Faith's. The shared markers they are looking for specifically for this PGD system will always be present in a child of ours affected with Smith-Lemli-Opitz (SLO).

Even though they know which SLO mutation Christopher and I carry, this is not sufficient in accurately and quickly identifying which fertilized embryos are affected by SLO with a very small fraction of DNA (5 days after fertilization).

2. How does the IVF process work?

An IVF cycle follows a normal menstrual cycle. On the first day of a menstrual cycle, the beginning of the IVF process officially starts. They use what is called protocols, and there are different protocols which all just vary timing and type of medication used. The protocol which has been selected for me is called the Long Lupron, or down protocol.

Below is a description of the protocol I've been selected for:

*Standard Down Lupron-On day 3-5 of menstrual cycle go for labs and us Estradiol, FSH, LH if all in range start birth control pills on day 3-5-Birthcontrol pills for 14 or 21 days.

-Overlap at a certain point birth control pills with Lupron injection for 5-7 days and call with next cycle never stop Lupron.

-Come in for ultrasound and lab continue on Lupron and start stimulation medications =Follistim and Menopur

-Do this for about 10-11 days (during this time you will need to continue being monitored by ultrasound and blood work at least 3-5 visits.) and when follicles are ready for trigger injection-Ovidrel you will have egg retrieval 35 - 36 hours later.

-After egg retrieval you start on another injection progesterone in oil and add delestrogen later-Embryo transfer happens 5 days after egg retrieval.

-Pregnancy test is 10 days after embryo transfer. and you continue on progesterone and delestrogen until you are about 9-11 weeks pregnant.

3. What's next?

We have been told that our PGD system will be complete this week or next, so we should be all set to follow the Down regulated Lupron protocol this month, as the first portion of the protocol is only birth control pills.

This is one of the longest IVF protocols, but from what I've read is best for patients with PCOS. My next step is to wait until the start of my next cycle and then give them a call for specific instructions.

Keep your fingers and toes crossed for us! This is going to be a busy beginning of the year!