From twenty-three to ten...

I just got the call from my IVF coordinator, and I’m kind of bummed...actually I'm really bummed.  Of my 23 eggs, only 16 were mature and 10 fertilized with ICSI.  Last time we had 11 that fertilized with 20 mature eggs, so I shouldn’t have been so hopeful.  A normal person would be happy with 10 fertilized, but knowing about my egg quality issue, and what happened with my embryos last time is getting me down.  I'm really hoping all 10 continue to grow into perfect day 5 blastocysts, but I also know that's not likely.  I’ll get another update on Sunday morning from the embryologist on how they’re doing.  Please pray for our little embies.   I’m still wondering why God gave me the eggs of an old lady. Excuse me while I spend the rest of the day mad at the universe.  

Egg Retrieval

I’ll start by saying that yesterday they retrieved 23 eggs! That’s 2 more than last time!! I’ll find out how many fertilized with ICSI sometime today, I’m anxiously awaiting the phone call!  I wanted to give you all an update yesterday, but my retrieval was not nearly as easy as my first one, and I couldn’t bring myself to get on a computer, let alone put thought into a post!

I couldn’t sleep the night before my retrieval, I had so much anxiety that I slept from midnight to 3am, and maybe again from 5 to 6am.  I don’t know why I was so nervous, especially because my first retrieval was so easy.  I think the anxiety was more around what was going to happen during the procedure, rather than how I would feel- what if I ovulated before retrieval and there were no eggs, what if none of the follicles had any eggs in them, etc.  Finally, morning came and we got ready and headed to the clinic.  Once I was prepped, and it was nearing my retrieval time, they led Anthony off to do his sperm collection.  As soon as he left me, I could hear the girl in the surgery room screaming “OWWW” every couple seconds.  This definitely didn’t help my anxiety any. I do not remember anything from my last retrieval, and definitely do not recall it hurting at all.  Once they brought her out, there was only a curtain separating us, and she kept moaning in pain.  When the nurse came to get me and asked me if I was ready, I told her I was until I heard the other girl screaming! She just said that everyone responds differently to the pain meds and anesthesia.  Once we were in the surgery room, she immediately gave me meds that made me not care about anything, and then more medicine that sedated me.  I’m not sure how much time had gone by or how much of the retrieval they’d already done when I could feel EVERYTHING! I kept telling them it hurt so badly, and then I heard, “We have 15 so far”.  They said they were giving me more meds and I remember the excruciating pain for a few more minutes or seconds (who knows) and then finally the next thing I remembered is them telling me they were all finished.  Thank GOD! They brought me to recovery where Anthony was waiting for me.  I was still in pain, but so glad to be done with it.  After a half hour or so, it was time for me to get ready to leave.  Anthony had to help me get dressed because I could barely walk.  One of the nurses wheeled me down to wait as Anthony got the car.  We had planned on going to lunch after, but I told Anthony that I didn’t think I could.  We went to Walgreens to fill a prescription for pain meds and nausea medication and after I took the pain meds, I felt like I could go to lunch and was really hungry since I hadn’t eaten since the night before.  We went to PF Changs, and right after we ordered, I felt the sedation of the pain medicine.  I was SO tired; I thought I was going to fall asleep at the table. I ate my soup and a few bites of food and was already full.  Our server took FOREVER to do everything and all I could think about was getting to the car to go to sleep on the drive home.  Finally we were on our way home.  I started feeling weird, so I took the nausea medicine and not more than 3 minutes later, I was vomiting into a little plastic pan they had given me in case I got sick.  After I filled that, I asked for Anthony to give me his sweatshirt that was in the back seat so I could try and save the car, nope didn’t work.  Poor Anthony was trying to help me, and safely get off the highway to a gas station.  He hit a bump and my vomit pan spilled onto my leg and the car mat.  I think we spent a good 30 minutes at the gas station.  Anthony wins the husband of the year award for cleaning everything, while I changed and tried to wash my hair with shampoo and bottled water! When we finally got on the road again, I wasn’t nauseas at all, I was just so tired.  Every time I would fall asleep, there would be a subtle movement in the car, such as Anthony switching lanes or braking a little and I would wake up startled.  After the three longest hours of me falling asleep and immediately waking up, we were home!  I went to sleep right away, and woke up 2 hours later to eat, then went back to sleep again.  Talk about a long day!  Needless to say, I am praying that was my last egg retrieval!

Today I am feeling better; still extremely sore, but that’s normal and I know it will get better each day.  I am working from the couch today, and I’m thankful to have my little cuddle buddy with me, and a husband who keeps texting me to find out if I’ve heard from the doctor. :)

Ready for Egg Retrieval

I made the three hour drive to Birmingham yesterday morning and had a good monitoring appointment.  The nurse measured the largest 9 follicles and said most of them were mature.  She said she thought that’d I’d be able to trigger, but I’d have to wait to until later that afternoon when my blood work came back to be sure.  I asked how many she thought there were total, and she said she saw at least 10 in my right ovary (yeah!) and not as many in my left.  I’m hoping that this means we’ll get more than 11 eggs, and that they’ll be mature, baby making eggs!  I’m going for quality over quantity this time around, since last time we got 21 eggs (20 mature), and still only ended up with two embryos to transfer and one to freeze.

I received a call on my way home from my IVF coordinator letting me know that my blood work came back and I was ready to do my trigger shot. I made it through stims!! So, last night at 9:15pm, as instructed, I mixed up my HCG and Anthony injected the huge 1.5 inch needed into my upper buttox/hip area.  I was freaking out again since it’s been a few months since I’ve had to use those needles, but it wasn’t too bad.  I better get used to it because daily progesterone injections begin later this week with the same size needle.  Egg retrievals are scheduled 36 hours after the trigger shot, so my retrieval is set for 9:15am tomorrow.  Anthony and I will be heading up to Birmingham in an hour or so to stay the night since we have to be there an hour before the retrieval.  I wish I could enjoy my one night of zero shots, but I have to do an enema instead.  I think I’d rather do an injection!  I’ll update you all tomorrow to let you know how many eggs were retrieved.  Wish me luck; love you all!

Stim Day Eight Update

I hope you all had a great Thanksgiving! We had Anthony’s brother Kevin here, and our Army friends over.  I spent the entire day cooking, and then cleaning it up after we were done eating, but it was so wonderful to spend the day with Kevin and our Army family since we didn’t go home to California.  I didn’t have to go in for another monitoring appointment until yesterday, so we had the entire weekend to have fun with Kev! On Friday we went to lunch and shopping in Panama City Beach, and Saturday we went to the Iron Bowl in Auburn.  The fans are diehard, like nothing I’ve ever seen! They go all out for their teams. I wish I would have taken more pictures around campus so I could show you what I mean. 

Yesterday morning we said goodbye to Kevin, and headed to an early morning appointment in Birmingham (Montgomery is closed on weekends).  Thankfully, we spent the night in Montgomery, so we only had to drive a little over an hour.  The appointment went well; the nurse didn’t count all of the follicles, but she measured the 9 largest ones and from what I saw it looked like there were more than 11-- fingers crossed!  My estradiol and progesterone are still on track, and my endometrium is looking great. She said it’s looking like my retrieval will be on Thursday.  I have to go back for another monitoring appointment tomorrow and unfortunately my main nurse in Montgomery (the good one, not the one I don’t really like) had a family emergency and is going to be out.  This means another trip to Birmingham tomorrow, and for my retrieval later in the week.  Lots of driving, but hopefully it will pay off with positive results!

11/23: Stim Day Four- First Monitoring Appointment

11/23: Stim Day Four- First Monitoring Appointment

Last Wednesday I went in for my first monitoring appointment.  It was only day four of stims, which is a little early, but because of Thanksgiving it worked out best.  I was a little discouraged because the nurse said she saw 6 sizeable follicles in my right ovary, and 5 in my left.  There were others, but she said they were still the size they would be at a baseline check, and most likely wouldn’t grow.  In my first check of my last cycle, I had 18 sizeable follicles so 11 is definitely not what I was hoping for.  I don’t particularly like the nurse that checked me because she never seems sure of herself, so I’m hoping that she was either wrong about the count, or about saying that the others were not going to grow.  After all, it was only day four and my last cycle I got checked for the first time on day six. My estradiol was 189 and my progesterone was .5; they said that’s exactly where it should be on day 4, so at least I have that going for me!  I almost wish I had nothing to compare it to, since many women would probably be happy with 11. 

Here we go again!

I actually wrote this last Tuesday, but things got crazy with Thanksgiving and I never posted it!

11/22:

I’ve been going back and forth about whether or not to blog about this IVF cycle, but I finally decided that I should.  To get you all up to speed, I went in for my baseline appointment on October 12^th.  I had one cyst that they weren’t concerned about and my FSH was 6.2, down from 15.5 from my last cycle! 6.2 is in the normal range, so I’m hoping that the DHEA I’ve been taking has actually improved my egg quality.  Some studies say that you have to go by your all time high FSH, but I’m going to take this as a sign that this cycle is going to have a better outcome! 

Most cycles start off with birth control, but if you remember, my very first cycle was canceled when they saw a cyst at my suppression check.  They attributed it to the combination of Lupron and birth control.  So my first complete IVF cycle, and this cycle, they’ve gone off of my natural cycle.  Because it’s off of my natural cycle, they needed to check my progesterone for ovulation indication during my mid-luteal phase (menstrual cycle day 22) in order to start Lupron.  I went in for my progesterone check on October 31^st; the test results indicated that I had ovulated, and I was able to start Lupron that night.

I continued with daily injections of Lupron from the 31^st through the 16^th when I went in for my suppression check.  I was so nervous about getting canceled because of the cyst they saw in my baseline check, but it went great! No cyst and low estradiol, they said I was good to start stims this past Sunday.

So, tonight will be my third night of taking stimulation medicine! I do two injections a day- one of Lupron (smaller dosage than when I was only taking Lupron), and one of Follistim and Menopur mixed.  I go in tomorrow to see how many follicles I have and how big they are.  I’m not feeling bloated yet, but I don’t think I really felt anything until day six or seven last time. 

Now you’re all caught up!! I had such a good break from the infertility craziness that I almost forgot how involved an IVF cycle was.  Overall, I’m feeling hopeful, but worried about what’s next if this doesn’t work because we can’t afford to do another cycle any time soon (by any time soon I pretty much mean forever).

What's Next?

Sorry, I haven’t updated everyone in a few weeks; I just didn’t have it in me.  The first few days after we learned that I wasn’t pregnant were the worst.  The support from all of you really did help though, and we really cannot thank you enough for that.  I spent the last few weeks preparing for my “What Went Wrong” meeting with my doctor.  I did a lot of research, and came up with a couple pages of questions for him. 

I was nervous driving to my appointment on Monday, not knowing what I was about to hear.  Anthony was in school, so I had to go alone.  It was a difficult meeting, that’s for certain.  My doctor graciously answered every last one of my questions.  I learned that he believes there is an issue with my egg quality.  Although I had a feeling he may tell me this, I must say that I am completely devastated to find out that we are no longer only dealing with male factor infertility, which could easily be resolved with IVF with ICSI.  I have the egg quality of someone much older than 27.  Go figure. Of my 20 mature eggs, only 11 of them looked good, and probably why only 11 initially fertilized.  He said that by day 3, only 4 of the embryos were still looking like they had a chance.  This is usually indicative of an egg quality issue, rather than sperm.  He said that if there is an issue with sperm, you’ll start to see an issue on day 3 or after.  He was surprised to see that the embryos weren’t doing as well as they’d expected, especially because they retrieved so many eggs.  Going into this, I had a high FSH on one of my base line checks.  This indicates low ovarian reserve, or egg quality issues.  My doctor wasn’t too concerned because nothing else about me seemed to indicate an issue.  I had many resting follicles, and I’m still young; usually not characteristics of someone with high FSH.  

Even with the low number of well graded embryos, my doctor still felt hopeful that at least one of the two transferred would have implanted.  One of them was a good grade for day 5 (4BB), and the other was an okay grade (4BC).  He said that although there are better embryos transferred at day 5, he’s definitely seen worse graded embryos bring a baby home at nine months.  As for why they didn’t implant, it’s really hard to say.  Sometimes you just don’t know.  My lining was perfect, and the transfer catheter didn’t indicate any sort of trauma took place during the transfer.  I think that is the hardest fact with IVF to accept.  Sometimes, you just can’t explain why it wasn’t successful.  It’s a $12,000 crapshoot.

My doctor is still very hopeful, and said that if I was his wife, he’d want me to try again.  Even given the egg quality issues, we were still able to produce viable embryos.  He suggested doing another fresh cycle first before doing a frozen transfer, since we only have one frozen embryo.  Even though our frozen embryo is a perfect 5AA, the success rates just are not that great with one frostie, given that not all of them even survive the thaw.  He said that if it comes down to it, he can thaw it and transfer with another embryo from my fresh cycle.  I’m hoping that will not be necessary. 

After providing me with all of this information, my doctor told me that of course the next steps are ultimately our decision.  He said he completely understood if we wanted to seek a second opinion, and that no matter what, his door is always open to us.  I had already considered this before our meeting, but ultimately came to the conclusion that I’m not at a point where I feel we need to see someone else.  I absolutely love all of the staff at my clinic, and think finding another clinic that genuinely cares so much would be really hard to find.  There are many, many people who do not get pregnant on their first cycle of IVF, so I think it’s premature to start all over again with someone else when I still really trust my doctor. 

So where does all of this leave us?  I am going to start taking a supplement called DHEA.  There are mixed studies that show it can improve egg quality after taking it for a few months.  Whether this will end up working for me, who knows, but it’s worth a shot.  It really can’t hurt, so if there is a chance it can improve things, I’m all in.  We’re going to stick with the same stimulation protocol, as everything went really well up until fertilization, and we got a large number of mature eggs.  We’re also going to have Anthony provide a fresh sperm sample on the day of my retrieval, instead of using frozen.  They don’t believe this will have an impact, but we want to do anything we can to change the outcome.  On the day of transfer, I’m going to have someone take me so that I can take a valium.  Some people believe this relaxes the uterus (and the patient).  Whether this will make an impact, again, we don’t know, but why not switch things up from the last failed transfer. 

Planning our second cycle was proving to be difficult with Anthony’s school, and I thought we were going to have to wait and try and again over Christmas break, but the greatest husband in the world said he will do what it takes to be there whenever I want to schedule it.  So, we will start again sometime in October.  This will give the DHEA time to take effect, and my body will have a break from the intense hormones it received last month. 

I will say that I’m really struggling with the question: If there is a God, what is his message?  Are we messing with fate? Why would God make Anthony and me with bodies that are not able to reproduce?  Is this why so many religions are highly opposed to IVF? I have so many questions, and there are so many ways of looking at things.  I just wish I knew why all odds are against us.  I really cannot imagine living life childless, and it scares me to death that I may have to.