Small Miracles

Oh, today was a good, good day.  That is the understatement of the century...it was a life changing day! While getting ready for our once every 15 years family reunion , I got the call from the embryologist.  He didn't keep me waiting long...he was so excited to tell us that the results indicated 3 out of the 4 embryo samples he sent to the lab came back NORMAL!!! That means 75%!!!  Unheard of!!

Of course, I probably blew out our embryologist's ear drum...but it was worth it.  We are absolutely floored by the news and cannot believe our results were so great.  I am speechless and thank God every single day for this opportunity. Next steps are go to through a FET cycle, which I understand is like an IVF cycle- Month 1 is BCP and Lupron, Month 2 is Estrogen & Progesterone prior to transfer. We still have to speak to the doctor to see how many he wants us to transfer, but we are up for anything.  I feel like we just bought a huge insurance policy and I feel so good having some "in the bank".  We have renewed hope and have rekindled our spirits today.  This was the news that we needed to push forward and feel like there is finally a light at the end of the tunnel.

Oh, and all 3 little blastocysts are boys.

Still in the game

Hope is back.  At least, temporarily.

I did not get my normal 7:30am update call from the embryologist, which led me to believe either (1) the embryos were still not progressing and they were giving them until the last possible second to assess them, or (2) there were some good blastocysts and they were busy biopsying and freezing them before they called me.  Turns out, it was #2.  As of today, I had 9 blastocysts out of 13 total embryos.  Apparently 5 of them were not good quality and would not have survived the freeze and thaw, and 4 of them looked very good.  Those 4 were biopsied today and results should be in by Saturday or Sunday of this weekend.

Of the 4 biopsied, on Day 3 they were graded 1 B, 1 C, and 2 As.  Day 5 grading has them at 2 Bs, 1 C, and 1 C+ for structure of the blastocyst.  I really don't know what to say.  I don't know how my stats will shake out, but I really don't see us getting any normals out of the bunch.  Getting 1 would be a downright miracle, much less having two like we did last time.  I am FULLY aware that there is a high chance that there will be zero normals in the batch.

Lord, please let us catch a break.  I.am.so.tired.

The fat lady hasn't sung ...YET...

...but I know it is over.  I feel it like I felt it last time, and that's why I just had my second vodka tonic of the evening.  That and because the IVF nurse told me to stop my progesterone and medrol pills and to call with my next cycle.

Day 3 was really lovely-  I got a call on Monday that 13 were graded A and B and 8 were C or D.  Then I read a statistic on an IVF clinic website that patients will lose 46-85% of their embryos from Day 3 to Day 5 because of the extended culture time and the fact that most will not be normal (abnormal number of chromosomes).  That pretty much is in line with last cycle; we had 15 on Day 3 and by Day 5 we had only 3 that made it to blastocyst.  Again, following the same pattern, this morning we got our Day 5 status update, and unfortunately 8 had arrested, and 13 remained but were all in morula or early blastocyst stage.  None are at full blastocyst as of 730am on Day 5, which is where they were supposed to be.  So, the lab cannot biopsy any of them for a transfer on Day 6, meaning my hope for a fresh transfer tomorrow is now gone.  The best we can hope for at this point is a call tomorrow morning that at least one or two made it to blastocyst stage and are able to be biopsied and immediately frozen.  But I just don't see how the chances that those biopsied will even be normal, given that one of our strongest embryos from last time had THREE COPIES of every chromosome.  I am not seeing the positive side right now, and the fact that I will never know how many of the 21 were actually normal kills me.  I suppose I should wait for tomorrow to come and go before I have the pity party, but I don't see the point in putting off the inevitable.

Assuming that I have no normal embryos and no transfer or frozen transfer from this cycle, that leaves me with a lot of questions about what it is we are doing and what we are trying to accomplish here.  Part of me feels like this IVF thing is actually doing more harm than good to my body and eggs.  Sure, I have a huge quantity of eggs, but it appears it is at the expense of quality.  I don't really give a sh*t if I produce 21 mature eggs and only 1 out of the batch could potentially be normal; I would rather produce 5 eggs and have 2 normal.  I am also asking a lot of the bigger questions like "why me?"  and "am I being punished?"  but I will attribute that to my Catholic upbringing and the teaching that God is punishing.  My dear friend (we'll call her her Ms. Awesome Therapist) assures me that God does not cause us pain to teach us lessons, but only to help us out with something later in life.  I like her thinking.

Consequently, I bought another book on Amazon as recommended to me by another girlfriend, called "The Power of Now" by Eckhart Tolle.  Her mother passed away a couple of years ago and I know she has suffered more tragedy in her life than I personally have, so her recommendations hold a lot of weight.

I think the bottom line right now is that I am so tired, my body is so messed up, we have no money left, and we are mentally exhausted.  However, the flip side is that if I'm not doing SOMETHING to help my quest to have a baby, then I feel even worse.  It's like, I can't even take a break because the whole time I'll think that I'm wasting time and not doing anything.  I am really hopeful that our doc will give us an even steeper discount for IVF #3 so we can move forward, or else we really really for real this time are going to have to give it a rest.

We have cleavage! 21 of 25 are fertilized!

Yesterday morning we got great news, of the 25 retrieved, 23 were mature and 21 fertilized!! Yesterday, on Day1, this is what the 21 looked like:

As early as 12 hours after ICSI, the fertilized egg begins to display two pronuclei in the center; one pronucleus from the male, and the other one from the female. The genetic material is also visible in both pronuclei.

This morning, another promising phone call.  All 21 reached "cleavage" stage, and  this morning, this is what our 21 little embryos look like:

Later today, this is what they are supposed to look like as they undergo another set of cleavage.  They  must get it from their mother.

Tomorrow morning we will get another report on Day 3 with grading.  Then we won't get another call until Day 5, where they should have all passed the morula stage (Day 4) and be entering blastocyst stage.  Right now, judging by the stats from last time, I am hopeful that 10 out of 21 will make it to Day 5 blastocyst stage and will be able to be biopsied on Wednesday for transfer on Thursday.  The doc said there would be a possibility that they all don't make it to Day 5 in time, in which case they would biopsy Day 6, freeze all of them that made it to blastocyst (that's the only time they will freeze them) and then we would have to wait another cycle and do a FET (frozen embryo transfer).  I really really really do not want to do that and risk losing them in the freeze/thaw cycle but I keep telling myself I will follow doctor's orders and they know best.  But it is SO HARD not to be in control.  I just want to run up there and say  "put all 21 in and may only the fittest survive" but I know that's not the answer.  I just really really want a transfer this cycle.  But it doesn't really matter what I want, I'm trying to do a better job of letting go and letting God take over, giving it to Him.  Easier said than done.

Retrieval Day- 25 Eggs!!

I really shouldn't be allowed to be put under general anesthesia.

So this morning went really well, we were in the doc's office getting prepped around 6:45am.  M was whisked away to do his business and I was set up with my gown, IV, blood pressure and heart rate monitoring, etc.  So my anesthesiologist was super cute.  I thought it when I saw him but obviously would have never said anything.  They wheeled me in the retrieval room around 745am and the last thing I remember is just some coldness in my veins then I was out.  Nothing like last time- didn't have that panicked feeling that I was awake, or the burning feeling in my hand.  That was a relief because that was what I was most dreading.  Anyway, upon waking up apparently I said to my anesthesiologist, "Have I told you that you are cute?  Well, you are."  He responded by saying "I have a face for radio".  Meanwhile, my nurse was like "Yeah, like he hasn't heard that before."  Other than my lack of inner monologue, I would stay retrieval day went very well!  All in all we have 25 eggs that will be ICSI'd today and we'll have a report tomorrow AM with how many fertilzed.

There was one thing that kind of threw us for a loop today-  about 20 minutes before surgery our embryologist came in to talk about the procedures they would be taking for PGD this cycle.  Now, the clinic is fronting my PGD bill this round.  Last time, they biopsied 8 embryos on Day 3 and only 1 made it to Day 5 blast so that one was also biopsied.  Out of the 9, only 2 were normal, the remaining 6 were not able to be biopsied because they did not make it to Blastocyst stage.  So this time around, they said they were only going to do Day 5 biopsy on Blastocyst embryos, they would not consider doing Day 3 because the field was "moving away from Day 3 unless absolutely necessary".  Now, the thought crossed my mind that they were perhaps doing this to SAVE MONEY on me since they were fronting the bill.  Actually, the thought crossed M's mind and passed it along to me.  I personally can't believe that ethically that would be the reason, and as of right now I refuse to believe it.  I still have some research to do on Day 3 vs. Day 5 biopsy and what the industry standard is, but if they are trying to save money by biopsying only the Day 5 embryos, I don't even know what to say about that.  The "First, Do no Harm" part of the Hippocratic oath would surely be out the window.

I guess for right now we are going to go with what the experts say! You know what happens when we try to buck the system...

Monitoring appointment #4 and Trigger!

This morning was my fourth and final monitoring appointment! Stats are as follows:

Lining: 8.6mm
Right ovary: 12 follicles ranging from 9.5mm to 21mm, with the average being 17mm
Left ovary: 11 follicles ranging from 11mm to 17.5mm, with the average being 16mm

Took the trigger shot tonight at 6:15pm on the nose, along with my last dose of Lupron and 2 vials of Menopur.  Retrieval is scheduled bright and early at 6:45am on Friday!  Hallelujah!!   I have to mention that I am not nearly as uncomfortable in the belly area as much as I was last time. I really think I had undiagnosed OHSS last time, but who knows.  I am definitely less swollen (I'm probably speaking too soon) and I have been able to wear pants.  Not really sure why this one is different, maybe my body is used to the medication?

I am so excited, Friday can't come soon enough! I can't believe it's here again- it's like Christmas! I have a good feeling about this one!!

Monitoring appointment #3

This morning was my third, but not yet final, monitoring appointment for this cycle.  Next appointment is 8am Wednesday morning (cycle day 11).

Lining: 6.2mm
Right ovary: 9 follicles ranging from 9mm to 15mm, with the average being 12.5mm
Left ovary: 6 follicles ranging from 8.5mm to 13.5mm, with the average being 11mm
Medication: 5 units Lupron, 4 Bravelle + 2 Menopur nightly
Side effects: Bloating, mood swings, vivid dreams and lots of trips to the bathroom in the middle of the night

Today in the waiting room of the doctor's office, someone actually talked to me. In all of the times I've been there, we ladies don't say one word to each other, as if sharing our stories (or even making friendly small talk) is a no-no.  We sit there silently with our blackberries, iphones, or books and pretend that this waiting room is no different than any other.  But today, one of the women complemented me on my purse and followed up with "It's the little things, you know? Especially with everything going on here...retail therapy."  I agreed with her and made some small talk.  I still feel like I should have said more to her.  People really just want to vent with people who are going through the same thing that they are, they just want to be heard.  I think we have a tendency to keep everything in because that has been our habit; we keep our miscarriages secret, then we keep our infertility, IVF, etc a secret until finally we can't hold it in any more.  Consequently, that makes us feel withdrawn from the people whom we should feel the closest to and be able to confide in.  Right now, I don't really feel close to anyone.  I feel alone and misunderstood, and most of all unable to control my emotions.  I want to be a calm, rational person; I don't want to be bitchy or nag or be in a bad mood all of the time.  I have to consciously wake up every day and make the choice to keep it together, to take a deep breath and just roll with what life is throwing at me.  But I have these days where I just want to punch everyone in the face and go to bed.  I know we all have these days (please tell me you do) but mine are more frequent lately.  I would like to blame the medications but mostly I think it is just me.  I feel so alienated and like no one understands me...and as soon as those thoughts cross my mind its like a downward spiral.  Once I'm in the hole it's really hard to get out but I find that just going to bed for the night and waking up fresh helps. 

On that note, I'm off to bed.

Monitoring appointment #2

The fluttering and tingling in my belly area is back! That means my little follicles are moving and growing and maturing and I am so freakin excited!! 

Today is cycle day 4, and this morning went for a lining check, follicle count, and bloodwork.  All looks good, and they are counting about 8 on the left ovary, ranging from 4mm to 8mm, and 7 on the right ovary, measuring 4mm to 7mm.  There are a bunch of smaller ones she didn't count, but overall looks like we are on exactly the same track as last time.  No change in my meds from yesterday- doing the 4 Bravelle/2 Menopur combo, keeping Lupron and antibiotics at night.  We will continue on with the same protocol and my next appointment is Monday at 7:45am.  I really need to dump my needles at the doctor's office- they are overflowing in my kitchen and bathroom!  Ahh one of the many perks of going through IVF...

Monitoring appointment #1

Went in for my monitoring after 6 days on the Lupron and I am fully suppressed!  Plan of attack is as follows:
- Start 6 Bravelle this Sunday through Wednesday
- Switch to 4 Bravelle and 2 Menopur next Thursday (monitoring appointment #2)
- Continue with anticipated HcG trigger shot 7/19
- Tentative retrieval scheduled 7/21

So far, I haven't experienced any new side effects of the Lupron, except maybe the crazy/vivid dreams and slight insomnia.  Ok, and a couple of mood swings too (poor M).

Even though this cycle is taking longer, it feels like it came quicker.  I think not having to go up to the doc's for injection teaching, IVF orientation, etc is helpful to move it along. I feel like there is less anticipation this time around also- I feel more relaxed and less stressed out about what is to come, because I've done it before.  Hopefully that will bode well for me and this time we can get the job done!  Honestly, it is kind of sad...I'm not expecting much this cycle for some reason.  I'm not trying to set myself up to fail, I guess I'm just feeling like if it didn't work I wouldn't be as devastated as last time.  I feel like I'm totally floating through life at this point, partially telling myself "this will happen this will happen" and the other part of me thinking "well, if it doesn't happen, maybe we can just go the donor egg route and be done with it".  Don't get me wrong, donor eggs are plan B followed by adoption as plan C, but maybe I've just talked myself into the fact that both of those options may very well be on the table after another couple tries at IVF?  I don't know, I try not to dissect my feelings anymore.  I am just so tired, and I haven't even been at this for six months yet!  Some of the ladies I read about have been at it for YEARS. 

Regardless, this experience has definitely taken some years off of my life and contributed to my increased gray hairs.

Happy Fourth of July!

I can't believe it is the middle of summer already...time is flying.  Good thing, because I am SO EXCITED about this next IVF cycle! I started my Lupron last Tuesday and just took my last BCP this evening. I hate these BCPs...there is something different about the one my doc prescribed me this time...my boobs are killing me and this has never happened to me before on my previous pills.  I just can't wait for it to be over...if I'm going to have sore boobs it better be because I am pregnant! That is the only acceptable time! I think the Lupron is making me a bit moody, but other than that, no real change in my symptoms from last time.

I have been doing everything in my power to distract myself from the cycle to make time go by faster, including baking everything under the sun.  M recently had to purchase a treadmill because he has gained so much weight due to (among other things) my baking frenzy.  This weekend, I made these:

http://annies-eats.net/2010/06/02/cookies-and-cream-cupcakes/

Oh. my. goodness. They are as amazing to look at as they are to eat.  And they help my sore boobs just a little :-)

This Friday, July 8, is my first suppression monitoring appointment, and I assume I'll be starting Bravelle that evening or on Saturday.  I will continue to listen to my circle + bloom IVF cycle mind/body program as I did last cycle and am going to try to stay as positive and relaxed as possible!  There is definitely much less anxiety with this cycle simply because I know exactly what is going to (i.e. supposed to) happen.  Oh man, I hope I didn't just jinx myself...we keep praying for the same meds response as last time, the potential for 15 more embryos and God willing another one or two "normals" to implant.

I went back on Facebook recently and was surprised at everything I have missed in the past couple of months since I haven't really been on (as per my FB ban post).  I am amazed at people that I saw making wedding announcements earlier this year before my first IVF cycle noting that they are now expecting later this year or early next year.  I think I will go back to my self imposed ban...and while I'm at it, I should also probably stop going to the beach until maybe after this cycle is over.  I was at the beach the past couple of weekends and am simply astounded at the number of unfit parents.  Obviously, I am judging by surface appearances/behaviors only, but when I see a 300 lb mother in a string bikini dragging her small child down the boardwalk, screaming "hurry up" with a cigarette hanging out of her mouth and a huge bucket of boardwalk fries...I can't help but judge. If you say you haven't judged those people you are either (1) not human or are (2) lying.

Alright, I digress.  Here's to moving forward with blinders on- trying every day to be a better person and not to judge.