so this week is a little bit different we're gonna kind of just do a little vlog um about
our infertility and ivf process yeah um you guys have maybe followed along for the
last two years as we went through our first journey through pregnancy natural conception
yeah i went week by week through that and shared some parenting medical advice things like that
and of course if you missed it kind of now as we're trying for baby two we've discovered
we've got some secondary infertility and so i thought we might as well share this along the way
and uh give you guys inside look into what it looks like for a ivf physician
and a reproductive endocrinologist uh to go through ivf with your pediatrician husband so
just in case you haven't met us before i'm Kurt i'm a board-certified pediatrician i'm sarah i am
a board-certified ob gyn and also a fertility specialist and we are the doctors bjorkman
so we thought this week we would just kind of share what we've been feeling and doing
um with this trying to get pregnant again and then starting this ivf journey too so yeah so we
this has been very unexpected as it is for most people you know um but especially we got very
lucky the first time around and got pregnant very easily with cease um it was like three or four
months of trying and then hey we've got a baby everything's kind of well within normal yeah and
then even thought like hey we want to have kiddos close and age to each other and so six months had
passed and we were like hey let's try for number two yup let's keep this party going and just
didn't get pregnant and wasn't pregnant and wasn't pregnant and wasn't pregnant and you
it the two-week wait certainly sucks time and time again and i think going into it early like we knew
like hey sarah was still breastfeeding we thought like kind of there may be some hormonal things
with that and other things that like may make it harder to get pregnant at first yeah um and so we
tried a couple times then started to investigate like hey why aren't we getting pregnant right um
it doesn't have anything to do with hormones or breastfeeding is it anything else i'd play in
real life because we're checking things off our list like oh it's not this it's not this it's
not this it's not this yep and i said maybe in fact this is good old secondary infertility and
um you know we tried a couple months of ovulation induction with letrozole and that didn't work and
you know we were kind of at this crossroads of hey what do we want to do next do we want to do more
letrozole and IUIs are we ready to move to ivf what do we want to do next um in our investigation
kind of the only thing we found was some mild male factors mild abnormalities in
kurt's sperm and we don't know if that's always been there because we didn't have a
test before or like at head covenant is that you know there's this studies are showing that um
inspection may amount and mobility motility utility yes so after trying for almost a year
and i'm kind of failing some medical augmentation ovulation induction with
letrozole we did a few cycles of that and no dice i've burned through a lot of pregnancy tests
and ovulation tracking and all of the things that we talked about that shouldn't all of the things
help us get pregnant quickly and we what did we do we've got i got a mirror to try that to help
tracking which was really nice and healthy yeah that was cool we should talk we can like i can
show you how we used that um the regular old ovulation predictor strips the ones with the
smiley faces um tried all the things we tried all the things and also did you know the letrozole um
no dice no success and so now we're gonna start ivf we're gonna hopefully be able to have some
embryos so if we wanna have more than two children we can have some in the freezer three four
yeah number eight you know no thank you um but i mean we are in our mid-30s as kurt said and so
having babies does not get easier as you get older and so um we said hey if we want more than one kid
it might not be a terrible idea if we ended up with some embryos in the freezer well we'll hope
um you know time will tell here in the next couple weeks how that goes um but it has certainly been
a learning process so far do you want to share maybe some of the feelings that you've had kind
of going into this yeah sure um i've had a lot of feelings about doing ivf i guess and infertility
and one of those is like i kind like this is i we have been so open and it was very easy to share
everything else with our pregnancy and getting pregnant with csun um that was very easy and
felt very natural this has been harder i think i don't know if it's like some embarrassment i
i don't know um that we just like haven't been able to get pregnant and this like
i don't know um i'm a reproductive endocrinologist and infertility specialist i should like i know
how i get people pregnant for my living it's my job um and you know despite doing everything
right um infertility still um exists yeah and it's funny how like even as we were going through our
infertility workup you know like there was almost like as like things were coming back like oh it's
not this it's not this you know you like kind of it adds to like oh it should be this causing the
infertility and then it's not yeah and then like you know when we did my uh semen analysis and like
there was kind of low count and low motility um borderline numbers for that like it was funny that
almost like it was relief for sarah and now like it wasn't hurt it isn't me i thought it was me the
whole i thought it was me the whole time um and it wasn't which then like you know is a different
feeling for for me in terms of like oh gosh like we've been working and doing all these things and
the whole time it was my semen or like was that knotted at all and it was like that was something
new that came on in the process secondary to covet infection so yeah i also as an infertility doctor
i take care of patients all day who are trying to have their first baby so i have this guilt
i have a beautiful daughter i we love her so much we're obsessed with her and here i am like
that's not enough i want another baby i'm gonna do this treatment for more babies and so there's
like a little bit of guilt and i think that is a common thing with secondary infertility
that um couples uh in general like don't feel as much support um and it is overlooked a little bit
because again you already have a child um and so it's just it's just looked at a little differently
i also am like very very aware of the privilege we have in doing this um i am an ivf doctor i have
so much access to care i knew when we weren't getting pregnant to go seek care to start a
work up to do these things we had access to do that we had insurance coverage to do that i
just have so much um i have so many resources as a physician that many women and people who struggle
with infertility don't have um and so i'm just very aware of that privilege um and and thankful
grateful for like where we are that we could do this and even like our infertility work up
was probably expedited because you're able to kind of sit down and say like oh we need to do
this this and this yeah so a lot of that maybe happens without kind of waiting for that first
visit and then waiting for follow-up visits of labs and right things like that have been very
fortunate for us but we'll go through and share a lot of that experience with you guys too yeah
um ultimately through all of it i have been so grateful i think we like the nurses i work with
the pharmacists our embryologists the docs around us are so great and i think the other
emotion we have is just so much hope um because we have this great team that's taking care of us
and we have a great um embryology lab and so i just like have so much faith in them and
you know from the pharmacist who's amazing and sat down with me and went through how
to do these meds and how to do different things and our nurses who are just like
loving on me so hard even though i've been you know their doc for so long and it's just
it is there so much gratitude so much hope um at this point despite months and months of not
being able to get pregnant i'm hopeful um so we wanted to share that with you we are really truly
just starting this process so you can live it with us i have officially finished my one month
you know three weeks of birth control pills which is very counterintuitive but often that is how you
start to get ready for an ivf cycle not just to time the cycle that's the purpose of that
it a helps with timing and b like helps synchronize the cohort of follicles in your ovary
so that all the eggs are on the same time cycle yes that's the goal so we're gonna do our first
injection and we will do we'll do more videos on like how to do ivf meds and things like
that um because as i said when we're going through this if i'm looking it up and learning
about it probably some of you out there are as well and so we want to share and make things
easy and understandable as always um and so tonight injection one is follistim so shall we
yeah all right so i'm opening these things for the first time i will you open that real quick i had a
lesson with the pharmacists on um last week just so everything's ready to go so follow stim is um
a medication that helps the follicles to grow you all of these medications and follicles again are
precursors for eggs or whatever yes the eggs grow in the follicles okay so hang on to that so you
basically are going to want to refrigerate fall stem has these cartridges that you put in a pen
you want to keep that um solid stem in the refrigerator until you are ready to put it
in your pen because it's good in the fridge basically until the expiration date on the
box which like this is 2023 november of 23. so a year and a half yep but once you put it in the pen
it is good for 28 days so at room temperature like once it's in the pen it's good for 28 days and
you can have it out at room temp so in the fall stem box there is this little cartridge this is
the million dollar medication not literally not literally but it's very very expensive um
very very expensive um so the pen comes apart you put the metal i think on here
like something like this no like this there is a little it fits
in here and then you screw the pen on i hope yep there we go there's a little resistance
so we haven't practiced we haven't practiced this this is really first time so you then dial up your
dose on the pen until you get to the number that you need now our pharmacist told me never ever
put the needle on until you have the dough styled and you're ready to go okay um so these
needles come all pre-packaged it's very sweet and these plastic little things pen is dialed take
the pen off you then you're supposed to yeah yeah can you open the alcohol swab sure you wipe this
tip of the pen we'll wipe once there open that bad boy you open your needle
and then you yeah isn't this nice you put it into the pen and screw it and screw it on sweet
now you pull the needle out and there's still a little needle protector okay
so the pen is ready to go i'm going to clean about a two inch area here
on my belly and where does the shot need to go sub cube okay what does that mean so in
the subcutaneous tissue aka the fat around your belly button in this smiley face so then you pinch
carry on captain i want you to uncap this and there's a needle
am i really doing this maybe you should do this totally up to you we're at 225
okay i think i can do this can i do this yeah i'm afraid
so 45 degree angle and then we okay i think so okay we're gonna go
in oh not that bad so we're in we inject the medication it clicks clicks clicks you
go till it's done clicking you hold one two three and then you pull out
okay okay that was not as bad as i expected that was fine what do you have to do with
the needle now put it back in this okay yep without uh poking yourself or your partner so
carefully back in this plastic thing then you unscrew because we're gonna dispose of this in
a sharps container that was our first injection first one it was mostly fine what time is it
it is eight o'clock so you to take your injections at the same time every night
like plus minus 30 minutes um so 8 o'clock is our time yep every night um for the next
to 12 days here we go um we'll see you soon bye guys bye okay we did it we did it
we're doctors but not your doctors anything we've
said in this video is for education or entertainment purposes only it is not
medical advice any specific medical questions you have should be directed to your provider