It's On Lupron!

Everything looked nice and quiet at this mornings ultrasound, the birth control pills have done their job, and I was cleared to start Lupron! I did my first injection this evening and it was exactly as I had expected, barely worth the stick.

Lupron Kit

This time I'm using a multi-dose vial with no mixing (yay!) so I'll be drawing from the same vial for the next 15 or so days. Like the HGH, the Lupron needs to be stored in the fridge and I'll be injecting with teensy little insulin syringes.

I will be on 10 units of Lupron and birth control pills for the next 5 days and then just Lupron for a couple days after. My period should show up in the couple days after I've stopped the pills, I'll have yet another ultrasound, and then should be allowed to start Estrace with the lower dose of Lupron.

See how tiny? 10 units to start and then down to 5 units.

One step closer to transfer, one step closer to getting this frostie home. I know it's dangerous to get my hopes up but I keep having vivid dreams about this baby being delivered, growing up. I'm already so attached, I don't think I could bare to lose this frostie baby so they had better settle in for the long haul

Medicated FET

I just got the list of things we'll need to get done before our medicated FET can begin. I was hoping we wouldn't need to get to everything on the list before I can even start birth control but no such luck.

First up:

• Get financial clearance, this means calling their financial manager and getting her approval to go ahead with the FET. I'm waiting for a call back from her on Monday. On the subject of money, Reprogenetics never asked us for payment for adding on PGS to our PGD testing, even though I called them and tried to give them my credit card at least 8 times. Maybe they tried to bill my insurance for the PGS as well as the PGD since we had an abnormal embryo? I don't know but I hope it doesn't hold us up. I'm prepared for the clinic's financial person to bring it up just in case and I'm expecting them to send a bill any day.

 Next on the list:

• Get yet another infectious disease panel. I had a huge panel run when we started infertility testing that I had transferred over to the clinic before we started IVF.  Apparently it is now out of date; it needs to be done within a year and since mine is technically from last August, I need a new one. I really don't want to pay a ton out of pocket for it at the clinic so I'm going to see if I can get my OB-GYN to order it. 

Third one isn't so bad:

• Go in person with E to sign consent forms for thaw and transfer. It would have been nice if we could sign and email the forms but to do that we'd need to have them notarized which is just as inconvenient and not going to happen. Instead, I just need to find a time we can both go in to take care of it. 

And finally, progress!

• Order all the meds! They're thinking BCPs, Lupron, Estrace, Progesterone in oil (not sesame!), HCG, baby asprin, Endometrin, Z pack, Medrol, and Naproxen. They also offer Valium but I'm going to pass on that since I'm not a nervous wreck. It's really for patients who can't relax for the procedure but having been through two IUIs (I've been told an IVF transfer feels just like an IUI, basically painless) a HSG and a Hysteroscopy without meds I'm quite sure I don't need it.

My one gripe is I actually had to call and request the list myself, because I need to be super psycho prepared for this stuff in advance, and I kind of wish they would have taken the initiative to send it sooner. If all this needs to be done before I start medication and I was told to "call on the first day of my period", leaving 2-3 days before I'd need to be on medication, I'm not sure how I was supposed to get this done in that time frame. I'm probably starting to PMS a bit since my period is right around the corner but it's rubbing me the wrong way a bit - shouldn't they be more on top of getting me this information? I'm now waiting on a second email from the nurse as well, giving me the details about which tests they want me to ask my OB-GYN to run. It makes me wonder if they think I'll probably get bumped for the holidays so there's no rush :/  

I really hope not, I'm so ready to get this embie back home where they belong! I am going to make this baby to stick through sheer force of will and the sooner I get them back into my body, the better.

FET Protocols

Now that we have two healthy little frosties, E, Dr. D and I are weighing the pros and cons of a medicated transfer vs natural transfer. A natural FET is an option when you have a regular menstrual cycle with regular, trackable ovulation. The transfer is scheduled around your natural cycle, you don't take any medications to alter it and instead monitor yourself for ovulation. Once ovulation is confirmed, they transfer the embryo back 5 days later just as if you'd gotten pregnant naturally. The pros are no artificial hormones, a completely natural environment, no medications to take etc. The cons are that you could have a less than ideal transfer environment since you're not taking anything to beef it up and scheduling/monitoring issues. Since you're relying on natural ovulation, it doesn't always occur at the best time.

A medicated transfer controls the playing field. You take birth control pills and a little lupron to ensure you don't ovulate too early and have to cancel the cycle, and prep your body with estrogen pills or patches that help grow a nice healthy lining. A few days before the transfer, you add in progesterone suppositories and usually progesterone in oil injections which helps prep the lining for implantation. The entire process is scheduled and controlled, the lining is measured carefully to ensure it's ready, ovulation is triggers so there's no question as to when to transfer. Pros are you know exactly how things are going to go and you're doing everything possible to ensure the best environment. Cons are it's more expensive, more injections, more hormones and it's not necessarily a "natural" process.

I'm leaning heavily towards a medicated cycle since I have a short luteal phase and Dr. D agrees. This is somewhat contrary to my usual preference, I run towards the crunchy, do things naturally, follow your instincts line of thinking, but nothing about the IVF/ICSI/PGD/PGS/FET process is crunchy.  I always ovulate around day 16/17, leaving 11 days for the luteal phase, and that doesn't leave very much time for the embryo to implant and get comfy, especially if it's a late implanter. There's no way I would risk a precious, healthy embryo after everything we've been through to get them. 

The question is, if we're going medicated, what protocol? Birth control, estrogen pills and crinone or endometrin yes, all of that should be fine, but what about progesterone in oil? Those injections, usually in sesame oil, are almost guaranteed to give me hives which unfortunately means an immune response. We want my immune system quiet when we transfer so it doesn't try to attack our embryo. Waking it up with a hivey allergic reaction is a bad idea. It's something we're going to have to mull over more so we give our embryos the best chance to stick.

TWO BABIES To Be Thankful For!

We got our results a day early! We have TWO HEALTHY EMBRYOS! TWO!

We followed statistics for my mutation transmission almost exactly. We had a 50/50 shot of the embryos being healthy and we sent in 6 embryos. 3 of the 6 tested were mutation free, but unfortunately one of those 3 had a tiny chromosomal deletion. I asked if there was any way this frostie might still be viable but Dr. D said that with deletions like this, there are usually other segments or things missing as well. This makes me so grateful we decided to add on the PGS, without it we wouldn't have found out that this frostie is sick and would have had a heartbreaking miscarriage or worse, might have had to terminate for defects incompatible with life.

I'm so relieved, I feel like I'm going to cry and possibly be sick at the same time. We still have a long way to go, these babies need to stick! but we're so much closer to actually holding a healthy baby. After seeing so many of these cycles yield nothing to transfer, I'm so, so happy we have healthy babies to transfer.

We are all made of stars

Dr. D needs to confirm it, but it looks like one embryo came from our first batch and one from the second. They're both hatching blasts and although Dr. D told us the genders, we've decided to keep it a surprise. We'd really like at least one thing to be normal about our pregnancy process and since nothing else has been, this is going to be it.

After getting the good news, I asked Dr. D whether he thought we should proceed with our frozen transfer or whether he thought we needed to cycle again and try to get more embryos. They usually say (without PGS) that you need 2-3 embryos per child you'd like to have, and since E and I would love 2-3, but would be happy with any at this point, I knew with only 2/6 that we might need to cycle again. As I've said before, we don't know how quickly my fertility is going downhill but we definitely know it is going. I was ready to hear that we'd need to do this whole process again but Dr. D feels that with my age, if we need IVF again in the near future I should still be young enough to produce some good eggs. I'm not sure if I agree because FXPOI complicates things in ways not reflected by age but I'm going with it.

We have so much to be thankful for this year that I'm overwhelmed thinking about it all. I'm thankful for E and our friendship and marriage, going through this is incredibly difficult and I think it's amazing that we've been able to stay strong and united. I'm thankful for all our friends and family members, who have been incredibly supportive and have helped us stay sane thus far, especially through all the mind numbing waiting. I'm thankful for Dr. D and SCRC for helping us get these two embryos, who with any luck will both be coming home with us as two healthy babies. I'm thankful for IVF and especially for PGD, I'm so grateful that we live in a time where we have the tools and technology to create and screen embryos for so many horrible diseases. And I'm so, so thankful for the two healthy embryos, our two little fighters, who for the first time have given us a real shot at a healthy family.

With a whole lot of hope, wishing, crossed fingers, science and love, we will have a healthy baby in our arms this time next year.

Happy Thanksgiving everyone. I hope you have a wonderful holiday with all of your loved ones.

Waiting, Wondering, Worrying

Well here we are, the day before Thanksgiving, the day before we're supposed to get our results. I thought I'd been dealing with the waiting and what ifs pretty well, I've been staying super busy and for the most part haven't allowed myself to think or dwell on it. I've been intently picking out super cute leggings from various Aussie websites (It's turning into an addiction and I don't even have my first pair yet), hunting for boots to go with said leggings, working on my aquarium which is always soothing and getting everything ready for Thanksgiving. I haven't been counting the hours but it would pop into my head every few days that we were that much closer to results. Somehow they always seemed far off, something that would be happening in the future.

Now, it's the night before and I'm thinking I'm not so okay. After a conversation about socializing with friends turned into a conversation about parents and babies, I suddenly felt quite irrationally emotional, like a cup in the process of overflowing. It's clear that even though I haven't been consciously dwelling on it, my subconscious has been drowning. I tend to internalize things so I can carry on calmly and I now feel like an idiot for genuinely not knowing why my hair seemed to be falling out the other day. It's one of the telltale giveaways that I'm under stress but at the time I couldn't think what it could be. Way to block out the big stuff brain, I'm sure that's super healthy.

On what will likely be the eve of our PGD results reveal unless the clinic closes for Thanksgiving, which is still a possibility, it appears my brain has run out of distractions. It's hit me like a freight train that this is it and I don't know what to do.  I can't stop going over horrible things even though I'm trying to put only positive energy and thoughts out there.

We still haven't paid for our PGS. H never called me back to get our credit card. Does this mean all our embryos were effected so they never did the PGS screening?

What if all our embryos are sick? What if we went through this for nothing?

What if they don't call with our results? How will I get through Thanksgiving with all those people? How will I get through it anyway if it's bad news?

E just got sick and has probably now exposed me. Will that effect our FET if when we get there?

I'm so, so scared our results won't be good. We've been through so much, I've been through so much I need these frozen babies to be healthy.  Now all I can think about is the worst case scenario and I feel like I'm going to choke on the lump it brings to my throat. Please be healthy embryos. Please be healthy.

Christmas Delays?!?!

Originally, I was planning on putting an embryo back straight away after this IVF cycle. I psyched myself all up for a November transfer and told myself I'd have good news for the holidays. I was ready to go, let's get this embryo toasty warm in my uterus!

Then, Dr. D put the kibosh on that. He said I've been injecting waaay too much medication into my body, two months in a row, and that wouldn't make for the most ideal environment for our embryo. Damn. He suggested that we take a wash cycle, wait for the drugs to really leave my system and start fresh with a nice, fresh cycle. Okay, I don't love the idea of waiting yet another month, but I would never do anything to jeopardize the success of my frosties so I got on board. One wash cycle to get everything out and THEN we'd thaw out a frostie and put it back.

With a regular cycle, it's pretty easy to plan when things should be happening. With this period showing up right on time I was pretty much positive that we'd be doing our transfer shortly after Christmas, probably sometime around the 28th if Dr. D really planned on transferring on CD 17. I've heard some people transfer later, closer to CD 20 or 22 but Dr. D said CD 17 so that's what I went with. I psyched myself up again for a Christmas transfer told myself I'd have wonderful news around January 9th. A September baby would be wonderful, right before the holidays really started to pick up.

I was reading through my IVF support group, reminding myself to practice patience when I read about some clinics closing for the holidays and delaying treatments. This should have been obvious, of course they'd want to go on holiday, but my clinic couldn't be closing because I'm transferring right after Christmas, right?  Right??

Nooooooo!!!

I got on the phone to Dr. D's nurse and asked them about their Christmas schedule. Bam, my worst fears were confirmed. They usually close for two weeks spanning the end of December to the beginning of January. Fuck. Right over when I was supposed to be doing my transfer. Double Fuck.

I explained to the nurse that I was supposed to be transferring over that time period and wasn't expecting my period to start until December 12th. She elaborated that the ART center closes completely for those two weeks but there's still a crew on the clinic side. The last day for most things is December 18th and there are only certain days after that where they can perform specific procedures. This is probably for those people who need to stim longer than expected and need their retrieval done over those two weeks, not for people who are looking to transfer a frozen embryo that's perfectly happy waiting on ice.

She told me to call with the first day of my period and we would see how things look then but it looks like we'll be delayed yet another month. I was just getting used to the idea of taking one month off and now we have to take two. I told my acupuncturist S how disappointed I was and she said that success rates are lower around Christmas because people are stressed out so I wouldn't want to transfer then anyway, but I'm pretty sure she was just trying to make me feel better. I don't see out of town family members or deal with a lot of family drama over Christmas so I'm fairly certain that my chances wouldn't be any lower just because it's the holidays.  My frostie certainly doesn't know it's Christmas.

All I want for Christmas is a batch of healthy embryos! One in my belly and the rest on ice.

If we have to wait two months, we won't get to transfer until the end of January, probably around the 25th. This means that I would potentially be getting good (because I refuse to believe otherwise) news on my birthday. It would be a wonderful birthday gift but I'm so anxious to get an embryo back where it belongs. This process takes so long and every month more feels like forever.

News To Be Thankful For?

I still haven't heard back from H, the financial person at Reprogenetics, so I shot an email off to my Reprogenetics genetic counselor D to see if she could give me an update. H is usually really good about getting back to me, she must be on vacation or out of the office because she's never had me wait more than a couple days. I know they won't release my results until they're paid so she's going to have to get back to me eventually to get my credit card.

Lucky for me, D is in the office and she got back to me pretty much right away. I asked her to confirm that she'd received the samples since I had only heard from Dr. D about that, and asking whether testing had begun because we can't wait for some good news.

The message I got back basically said:

I know the waiting is hard. We've started testing,  it will take the full 15 days. You'll know on 11/27.

I know Garfield. I know.

For those who didn't catch that bit at the end, 11/27 is Thanksgiving. When we will have all sorts of people in the house. We will be getting either really good news or really bad news with a house full of people. The waiting is so tough,  I can't wait to find out, but this is not how I wanted to do it.

Plus, I'm sure Dr. D won't be working on Thanksgiving. If he's not in the office, we don't get our results. Reprogenetics is sending them directly to Dr. D not to us, since the sensitive information should be explained by a doctor yadda yadda. I'd honestly rather they just email them so I don't have to talk to anyone if the results are bad but that isn't an option.

E and I wanted time to ourselves to process and deal with the results. We didn't want to share them with the few family members who know, especially if they're not good, until we'd digested them and figured out our next move. Honestly we really wish they didn't know the testing was going on since their questions/expectations/hopes/certainty really make us feel worse and not better. I don't think they realize how difficult the process is, how often people end up with no healthy embryos to transfer. Even with 6 to test, we could very easily have no healthies and their certainty that all our embryos will be healthy and everything will be roses and sunshine feels shallow.

Maybe we'll get lucky and we'll get wonderful news early. I'm still hopeful that our embryos will be healthy, that we'll have 6 frosty babies to be thankful for this Thanksgiving. But it would be really nice if we could get our results without an audience.

AF With A Vengeance

Unsurprisingly, my period showed up exactly on time, 11 days after my trigger. There has to be something said for predictability, at least I know when the witch should be rearing her ugly head. The first couple days I had to top up my Advil every 4 hours instead of every 8+ like I usually would, those cramps break through surprisingly quickly. A couple days in they're not awful, uncomfortable yes, but I'm good with just a couple Advil each day.

I think the toughest part has been waiting with nothing to do. I've taken the supplements, done the injections, done the retrievals, and now all I can do is wait and wait for my test results to come back. There's absolutely nothing I can do to help or speed up the process which is a very unusual position for me to find myself in. I'm not even sure if they've started the testing yet since I haven't heard back from the financial person yet, I'll probably give both her and the lab a call tomorrow to ask for an update.

(And wait....and wait...and wait...)

Once I stop bleeding like a dying person and feel halfway normal again, my plan is to hit the gym hard and try to take off some of this IVF weight. I feel like I've been packing on inches by the handful and I'd really like to get some of it off before I get pregnant. I already know I won't be allowed to gain a ton of weight, not that I really expect to gain a ton anyway, but it would be nice to start at a more normal point for me instead of this far ahead. Of course, starting a diet/exercise plan right before Thanksgiving is probably not the smartest thing I've ever done, but I don't have a lot of time and I need to get rid of this IVF fluid belly so I have room for a baby in there!

Biopsy Samples Off!

This was supposed to post yesterday, I'm not sure why it didn't :/ Weird! 

I wasn't expecting a call this morning since our embryos have already been biopsied, vitrified and tucked safely away, so I was surprised and a little worried when I saw SCRC come up on my caller ID. It turns out Dr. D was just calling to give me an update and let me know that my biopsy samples had been shipped and should be arriving at Reprogenetics today! I wasn't expecting them to ship out so quickly, especially since today is a holiday, but we're officially ready to start testing.

Dr. D said he spoke with Reprogenetics today and they're going to run our tests consecutively - the PGD for Fragile X first, and then the aCGH PGS on any unaffected and premutation carriers. This means that only Fragile X negative embryos will be screened for chromosome issues, which makes sense. What I'd like to know, is if we pay for "up to" 8 embryos and only test 6, can we test 2 more in the future without additional charges? Probably not, but its definitely on my list of things to ask them since I've heard of other people doing this with their labs. I still need to give them my credit card information for the aCGH but I haven't been able to get in touch with their financial person H yet. I left a message with their messaging service on Monday so I'll probably call again tomorrow.

Cilly sneaks into the linen closet for a relaxing nap

Dr. D also hinted that he thought we might get our test results early. He said the 15 day estimate was quite conservative, if the lab was busy, etc. Once the PGD is complete, and this is the portion that takes a bit longer, the aCGH will be performed the next day and then we'll have our results. Everyone at the clinic has their fingers crossed for us and we're all thinking positive and willing these embryos to be healthy.

As for recovery, I'm still really bloated and starting to get occasional cramps in anticipation of my period which should be due at the end of the week. I can wear my regular jeans but the belly is definitely there and it's deflating unevenly. When I woke up this morning my belly button looked off center which is so weird, the right side seems to have gone down a bit faster than the left. I can't wait for my belly to be huge and lopsided because there's a tiny person in there, not just a ton of fluid.

Day 6: SIX EMBRYOS Going For Testing!

Both embryos made it! Holy shit! We now have two more hatching blasts to add to our batch, making 6! I can't believe it, after such a crappy cycle and only retrieving two eggs, I never would have dreamed they'd both be strong enough to make it. Taking them to day 6 was definitely the right decision, the embryologist says they look perfect.  We're going to send these 6 samples out for PGD/PGS and hope/pray/wish/cross everything that they're healthy!!

I was planning on putting one embryo right back once we get our results, an early December transfer, but the doctor says I should take a "wash" cycle. Not everyone needs to take a break but most people only take $1800-$4000 in meds for their cycles and do just one. I've been injecting $9200 in hormones two months in a row and he thinks I should have two periods to wash them all out. The first would be the upcoming one, due at the end of this week if I follow last cycle. Then I'd wait a month, have my next period and start the medication for transfer. He's right and it makes sense, I would never rush anything that could compromise an embie's successful implantation, but it's so hard to be patient!

Right now our biopsy samples are probably being packed in liquid nitrogen and readied for their journey to the east coast. I believe they'll be over nighted to Reprogenetics and then as long as all the samples are good, they'll begin testing. We decided to go ahead and add on the aCGH testing for $2250, it seems crazy to go through all this to test for Fragile X, a developmental disability, and then not check for Down Syndrome or other Trisomy problems. I need to confirm whether they run the tests concurrently or consecutively, hopefully we'll have all healthy embryos and it won't matter, but if somehow they're all affected with Fragile X, they should hold off on the aCGH testing. We won't need to go there though, our embryos are going to be strong and healthy and we'll have a healthy baby before we know it.

Day 5: Mature Morulas

We got a call this morning saying that our embryos were still plugging along, growing well, but weren't quite ready for biopsy. When the embryologist checked on them in the morning they were super mature morulas, right at the end of the morula stage and the beginning of the blastocyst stage.

Ideally, we want the embryos to be nice, expanded blastocysts before they're biopsied so you can get a really clear distinction between what will be baby and what will be placenta so Dr. D and the embryologist have opted to let them grow another day. It occurred to me after the phone call that we also did our retrieval a lot later this time, several hours later than our first one, so these embryos are actually a little younger on day 5. They might have been nice blasts if they were checked in the evening instead of the morning so I'm staying positive and not getting discouraged.

I'm also pretty sure that if they were going to arrest they would have done so already, but I'm not ready to celebrate just yet. They still need to clear this last hurdle though I'm really optimistic now that they can do it. Grow embies, grow!

Day 4: Wishing, Hoping, Itching

Today is day 4 of our embryo's growth and following the traditional protocol, we did not get an update. I'm choosing to take this as a good sign since I'm fairly sure they would have let us know if something happened to our embie babies today. One of the women in my online PGD support group also had two embryos growing at the same time as mine and she lost both of them on day 4. I'm so crushed for her and am now even more worried for our two, this is such a big jump for them to make.

I'm hoping that our next update will be tomorrow, but there's a chance we won't hear from Dr. D until Monday. Last cycle we had 2 embryos biopsied day 5 and 2 biopsied day 6 so these two could be ready on either day. My nerves seriously hope they're healthy and ready for biopsy/freeze tomorrow because I can't take much more of this waiting.

In other news, I haven't been reporting too much on recovery but I'm doing okay. I had so few eggs that I didn't get OHSS this time and only needed some Advil/Tylenol for the first couple days. I've taken an odd one here or there for a hormone headache and some muscle aches as everything returns to normal but overall it's been a pretty uneventful recovery. They didn't even need to give me Fentanyl after the retrieval, just two Tylenol and a hot blanket on my belly. Mostly I'm just exhausted, like can't keep myself awake tired, have to pee all the time and am still crazy bloated. I've been sustaining myself on a diet of Matzo Ball soup (thank you E for repeatedly playing delivery man) and Gatorade/Electrolyte water and feel like I have the flu.

Cillian takes advantage of my exhaustion and bloated pillow belly to get in a good nap

My most obnoxious complaint is probably the bruise on my hand from my IV. The nurse, who was quite experienced and really nice, had to try twice to get my IV in. She tried first on my right hand, which is usually my good one, numbed it up with lidocaine and popped in the IV needle. The needle went in correctly but she was right up against a valve so the catheter couldn't go into the vein. She tried to apply some gentle pressure to open it and then tried to float the catheter in but neither worked. She ended up taking it out and going for my left hand, where she repeated the process and the IV catheter went right in. That site doesn't hurt at all and didn't bruise but my right hand has this nasty, deep bruise that has been surprisingly painful. It was really bad the first day, definitely worse than my sore ovaries, and the bruise is still there and still tender today.

My other big complaint is that somehow, the hivey rash has returned to my stomach. This leads me to believe that I had two separate rashes last time - hives on my belly from the medication, and an allergic rash to E's shaving cream on my bikini line. They were there at the same time so I assumed they were connected but apparently not. The new rash is pretty close to where the old one was on my belly, a little lower, and has to be related to the hormone injections. Just like previous flare up, it itches like a bitch and I have to keep compressing Yin Care, slathering on Cortisone cream and pouring on Benadryl.  Maybe it's related to falling or rising hormone levels or a reaction to the HCG (please don't let this happen when I'm pregnant!) but whatever it is, I really wish it would take a hike.

The Rash Strikes Back!

Just one more day to get through. One more day and then we can move on to testing, find out that all our embryos are magically healthy and perfect and we can start putting them back where they belong. If we're able to do a successful FET in early December we could be bringing home one of these fighter embryos as a baby at the end of August. I hope, I hope, I hope, come on embryos, you can do it. 

Day 3: Quality Over Quantity

Every time I get the morning update I'm floored by how lucky we're getting with our two little embryos. Amazingly, here we are at day 3, and both little fighters look perfect. They are 8 cells each and according to the embryologist, are the highest quality possible. This means that their cells are even and regular, all the same size, and that they have no fragmentation. In short, they look like this:

High Quality Day 3 Embryo

I'm really starting to feel hopeful that these could be our babies. On day 3 last cycle we had 7 embryos - our 4 strong ones that became our frosties, 2 weaker ones that eventually didn't make it and one super slow grower that fizzled out. At this point, those two weaker ones and the tiny one lagging were already noticeably behind the main 4, not so behind as to count them out completely, but not looking fabulous. It gives me hope that our 4 that were growing well continued to grow well, we just need these two to follow suit.

Just twoish more days to go now. Days 4 and 5/6 are the hardest for the embryos, they need to make the big leap from simple cell division to compacting and differentiating. I know this has been a really disheartening and crummy cycle, but these little fighters are strong and I feel like they're going to make it. Come on babies, grow, grow, grow!

Day 2: Cautiously Hopeful

I've been having a really tough time staying positive and hopeful for our two little embies. So much is riding on these little guys making it that it's impossible for me to not be scared of a poor outcome.

Somehow, it appears that our embryos are taking a much more positive outlook on things. The embryologist was feeling quite sorry for us and all our empty follicles, so even though he doesn't usually do a day two check, he decided to look in and see how our embies are growing. The results were really encouraging, both embies appear to be high quality and they're growing strong and even. One was already 5 cells at day 2 and the other was just behind it with 4 cells. At this point last time we had some embryos that were only 2 cells so a 5 and a 4 are really wonderful.

I know I've mentioned before that E and I originally decided to just do two IVF cycles before turning to donor eggs. That plan was based largely on cost, each cycle is $20,000 and two is already an incredible amount of money. But then we had this cycle, and it was so far off that I think E is having to come around a little to the idea that we might need a third.

E has a hard time watching me go through these cycles, even though I think I do pretty darn well with fairly minimal side effects. Watching my stomach bloat up like a balloon and seeing it covered in bruises from all those tiny needles upsets him and he's been pretty set on just two cycles till now. After I woke up in recovery it took a little while for Dr. D to come out and give us our count. I know now it's because he was asking the embryologist to check and double check for more eggs but at the time we were expecting good news. It's hard to remember what happened once he told us we only got two eggs, the anesthesia makes you a bit foggy for a little while, but I know I cursed, turned to E and he told me not to worry, that nothing was off the table at this point and that we'd do whatever needed to be done.

Still, if we do need a third, I don't know where I'm going to find another $20,000.  Before all of this we were saving to buy our first house which is no easy feat in Los Angeles where a tiny two bedroom 900 square foot place runs 600k+. This is another one of those moments where I so, so wish that our insurance would cover IVF, I feel like there would be so much less pressure if we could just focus on the medicine instead of the price tag.

Day 1: Disappearing Eggs

We went into my retrieval yesterday expecting to get at least five mature eggs. Instead, we got two.

Two?

Two :(

Dr. D aspirated and flushed each follicle. They were all still puffy, filled with fluid and drained well. No signs that I could have ovulated early. A mature egg puts out at least 200 units of estrogen and my estrogen was over 1500, an excellent number for all those follicles. So where were they?

Dr. D was so surprised when the lab said two that he asked them to double check the tubes. There's no way I only had two, estrogen doesn't just come out of nowehere, the eggs had to be there. E and I are crushed :( 

I know there are no guarantees with IVF, every step of the process is an exercise in hope, patience and superstition and sometimes things just happen. But where did my eggs go? We know they were there, we have the estrogen has proof of their existence, but they just disappeared. It's like seeing the smoke but you can't find the fire. Dr. D says this happens in less than 1% of cases and he doesn't know what could have caused it. The eggs should have been there.

Our minimum number for proceeding with the PGD testing is six. We need six healthy blasts before it's worth using our PGD coverage and aCGH testing (~$10,000). We really wanted eight but figured just in case, six is still an okay number.

I paced around all morning feeling sick and holding the phone and finally got the call from Dr. D that both of our eggs fertilized. Thank goodness they still have a chance. If both of these little fighters make it, we can proceed with testing. If they don't we're going to need to do another IVF cycle but I have no idea how we're going to pull that off. 

Come on little embies, you can do it. The first step is done, now you just need to grow, grow, grow. 

Our Probe Is READY!

Yesterday morning, I went ahead with my plan to phone Reprogenetics to get an update on our probe. I can never manage to catch someone at their desk so I left a message and waited for a call back. They're usually pretty good about returning calls and it only took a couple of hours for their New Jersey caller ID to pop up on my phone.

My rep for our probe process wasted no time in telling me that our probe is DONE! It's ready! We were originally quoted 6-8 weeks but it ended up being less than 4 weeks from the date they got our samples to the date of completion. I was so surprised, this is wonderful news :) I was anticipating a deadline closer to the 8 weeks and was worrying that we wouldn't get results in time to go right into a FET.

Once we conclude this cycle and the lab has received all our biopsy samples, it takes 15 calendar days to get PGD and aCGH results on our frosties.  Those will be two loooong weeks and I'll probably be going crazy but I know we'll get some good results.

(Source)

This is an example of Fluorescent In-Situ Hybridization, or FISH, a quick result type of PGD that we can't use for Fragile X but that is super cool to look at. This one is for muscular dystrophy. Embryo C is a normal male embryo, I believe the light pink is Y, the dark pink is X and since there's only one X in a boy, a single green dot for a normal chromosome. D and F are both normal female embryos, two green dots each, one for each X, the two dark pink dots. A shows a female carrier embryo, one of her chromosomes is affected but the other is okay, two dark pink dots and a single green dot, and B and E show affected male embryos, no green dots.

Hopefully we will have lots and lots of healthy embryos from both cycles but first we need a nice, big haul from this one. I just started up shots again today, this time 4 Menopur and Omnitrope in the morning and 4 Menopur in the evening. Every time I start up another cycle, I forget how much the Menopur burns!

Day 6: FOUR FROSTIES

We have FOUR frozen embryos!!! FOUR potentially healthy embryos that could grow into four potential babies! The two early blastocysts from yesterday continued to grow beautifully overnight and they were able to biopsy and freeze them this morning.

Original Photo came from here

I am so over the moon! The doctor said I responded so well that you can barely tell I'm a DOR/FXPOI patient :D It took a whoooole lot of meds, but it will be so, so worth it if these embryos are healthy. I need good chromosomes without Fragile X or trisomy problems.

Our breakdown for our first IVF cycle:

• 12 days of BCPs
• 3 days off
• 11.5 days of 600iu Menopur, 0.83mg Omnitrope, 1mg dexamethasone, 5 days of Cetrotide
• Novarel trigger - 10,000 HCG 

 This protocol resulted in:

• 14 follies
• 11 eggs retrieved
• 8 mature eggs fertilized
• 6 embryos
• 4 frozen day 5/6

My mild OHSS symptoms are starting to resolve today as well. I still got up to pee three times last night, but I think the swelling in my abdomen has gone down a little this morning which means the HCG must finally be leaving my system, I didn't test out the trigger since there was no reason but it would have been interesting to see how long it sticks around. Maybe I'll test it out next cycle to see if it really takes 10 days to get rid of it. The horrible acid reflux is also starting to go down, I don't feel like I'm going to throw up stomach acid, which is awesome. I know I got off a lot easier than many people do  so I'm not complaining.

Now, we need to do the whole thing alllll over again. The big question is, do we take a month off or start right back up with this upcoming period? I've been looking into it and research has shown there's a definite synergistic effect in back to back cycles, especially in really low AMH/DOR/Advanced maternal age patients.  The cumulative effect of both cycles ends up being greater than the sum of both cycles - if the med effect from cycle one is 2 and the med effect from cycle two is 2, the cumulative result is 5 instead of 4 in the second cycle. I think that's why Dr. D was leaning that way until I got 4 awesome embryos.

The wild card here would be cysts, last cycle I had the most stubborn follicular cysts on the planet that took two periods and two weeks of birth control to resolve. I don't know if I'll have them again this time since they aspirate the follies during my retrieval, which you'd think would mean no more cysts but who knows. It would definitely make the decision for me though, if I have cysts hanging around on my next CD2 baseline ultrasound, I have to take a cycle off.

Day 5: TWO Frosties!

It's only 11am here but we've already had a crazy, stressful morning. My phone apparently rang at 7am but E and I were both sound asleep and I didn't hear it. Waking up 3 times a night to pee is exhausting -_- Then E's phone rang a minute later, and we woke up just in time to hear the end of the call vibrating on the night stand. Fully awake now, I jumped out of bed and recognized the number as belonging to the ART center currently in possession of our embryos. Our updates come from Dr. D at a different number so it was really unusual to get contacted directly by the lab.

I called them back right away and got a somewhat frantic woman on the phone - apparently they never sent us the correct paperwork to sign for PGD consent! They can't biopsy our embryos without this paperwork, we're holding up the embryos and she was worried we might be on vacation or might not have a scanner or printer and she wouldn't be able to get a hold of us. Ahhhh!

Luckily we do have a printer/scanner and we've been waiting on tenderhooks for embryo updates so there's no way we'd be far from home right now. She emailed me the paperwork straight away and E and I quickly signed and initialed another 20 pages, scanned them in and emailed them back to her. Phew. This was not the start I was hoping for this morning but I'm glad she caught the oversight in time.

Knowing that we now had at least one embryo to biopsy (!!!) I carried my phone around with me all morning until 9:30 rolled around and Dr. D called! He said that out of the 6 embryos at our last update, TWO were now hatching blastocysts that were being biopsied and frozen! YESSS!!! Two more are early blastocysts this morning so baring any problems, they should be ready to biopsy and freeze tomorrow! Ahh!!!  I know we're not supposed to count our embryos before they're hatched, but we have a very real shot of having FOUR embryos on ice to test!

Original Photo came from here

I am so, so excited for these embryos. There's a good chance that our baby could be one of those hatching blasts in the freezer Right Now. Now we need to decide if we should take a month off or start our next IVF cycle straight away with this upcoming period. It should be starting in about a week or so, maybe a little more or less. If there is any benefit at all to doing back to back cycles I am ready to go and I will stick myself with all the needles all over again. Dr. D said my OHSS symptoms, primarily the fluid retention that is causing all the discomfort, should start to go away when the trigger leaves my system which is about 7-10 days after taking it. Today makes 7 days so I should start feeling better in the next 3 days which is awesome. If there's any lingering discomfort, the 12 days of birth control should take care of it and by the time I start stimming again, I should be feeling normal.

I have heard before that there may be some benefit to back to back cycles and Dr. D seems to be leaning in that direction as long as I feel good. If that is the case, we're repeating the same protocol and I'll need to place my next order with IVFMeds.com straight away.

Please send good thoughts to my two little early blasts, they need all the positive vibes/thoughts and prayers they can get to grow up and hatch tomorrow!

Day 4: Acupuncture and Patience

Today, I'm finding it difficult to be patient. We don't get an update on our embryos and I know they're in the most difficult phase of growth where many embryos are often lost. Last we heard, four were doing very well with 7-8 nice, even blastomeres (cells) and two were growing nicely but a little slower with only 6 nice, even blastomeres.

On day 4, we need those embryos to be in the Morula stage, the last phase before they grow into blastocysts, form the blastocoel (fluid filled cavity) and start differentiating cells. Today, and possibly tomorrow if they're slow growers, they should have between 10 and 30 cells.  They might even have begun compacting like the embryo below, which is where the cells start squishing together like the embryo below.

Nice quality Morula

Hopefully they'll make it through the morula stage and grow into nice blastocysts tomorrow. If they're not quite there yet it's still okay as long as they're progressing. They'll be allowed to grow to day 6 when plenty of embryos are frozen and I probably won't sleep until we get the call. As blastocysts, they should be dividing into the inner cell mass (ICM), the Trophectoderm (TE) and the blastocoel (fluid cavity), which gets bigger as the embryo expands.

Nice Blastocyst

We need good cell differentiation to get a clean biopsy of the embryos for PGD. They need to sneak some cells out of the TE on the side there, the cells that will become the placenta, so we can test the fetal DNA for abnormalities.

Since there's nothing I can do to help my embryos grow, my distraction for today was a much needed acupuncture appointment. I haven't been since my retrieval and it's supposed to really help with recovery and the symptoms of OHSS. I laid down on the table, S took one look at my belly and said "Oh boy, you're definitely hyper stimulated". Clearly other people think I look 6 months pregnant too.

I already knew that I probably had OHSS but it's still a bummer to have it confirmed by a nurse. I also woke up sore this morning, my hamstrings and back felt like I'd worked out, and S said it's because of all the fluid I'm retaining. The fluid is responsible for my bloat, my repeated peeing, the heart burn and now the muscle soreness. Oh the joys of IVF.

Dr. D's nurse also called today to ask us about aCGH testing for our embryos and to see how I'm doing. I told her we'd probably base our decision for chromosome testing on the number of embryos we get, our lab doesn't really need an answer until they have all of our biopsy samples but as long as we get a good amount from each cycle I think we'll probably go ahead and add it on. If we only end up with a couple of embryos from each cycle, I'm not sure if it's worth doing, but if we get six lovely frosties each time I'd say it's worth the extra $2500.

As for next cycle and the crazy bloating, she said Dr. D usually takes a "flush" cycle in between IVF cycles to allow all the hormones to flush out of your system. It would also give me a good amount of time to order my meds from IVFMeds.com so I wouldn't be doing things so last minute. She made a note for Dr. D to chat with me about it tomorrow when he calls with our embryo update, so I'll probably be holding my breath until the phone rings tomorrow morning. I so, so hope our six embryos are doing well, I worked so hard for them and I won't be able to relax until they're safely biopsied and frozen.

Day 3: Growth Report

We got our growth report this morning and our embryos are still dividing! We have 4 that look really good with nice, even cell division and 2 that look good but are growing a touch slower. We also have 1 that fertilized but is pretty far behind the others with only 2 cells so we're not sure if that little guy can catch up. E is calling it our runt, Wilbur, but I don't think there's any chance of him catching up.

Original Photo came from here

I talked to Dr. D about our next cycle and he thinks we're on track to start in about 6 weeks. I didn't get to really clarify what that means since I later realized it could mean taking a month off or not taking a month off. If I get my period in about 2 weeks, then go on birth control for about 2 weeks, then stim for about 2 weeks, that's 6 weeks right there. I was asking if we'd take 6 weeks off doing nothing before starting the next cycle but I don't think I got that across. I'll have to bring it up again another time.

I also asked about the crazy bloating which he said is probably from the HCG as well as the estrogen. He said I should expect it to stick around in my system for at least 10 days so I don't see this belly going down anytime soon. I have no illusions about the physical side effects of infertility and the IVF process but it would be nice if I could save some growth for a baby.

As far as recovery goes, I'm feeling a bit crappier today than yesterday. I'm still only mildly sore but I have a weird nauseous/imminent cold feeling that probably wasn't helped by the fact that I woke up every 2 hours to pee and didn't get great sleep. I'm not sure where I could have picked up a cold since I've been taking it pretty easy and not going anywhere but I can definitely feel it hovering at the edges of my throat. Hopefully it's just the hormones because I can not get sick right before our next cycle.