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.  

I Guess It's Still Not Our Time

On Monday and Tuesday this week, I succumbed to temptation and took a pregnancy test, both of which so bluntly said “Not Pregnant”.  You think that would have prepared me for the call I received today confirming that I was not pregnant, but it did not.  I knew those two tests were right, but I held on to a sliver of hope that the blood test today would be different.  It wasn’t and I felt like the wind got knocked out of me when I heard my nurse on the other end of the phone telling me she was sorry.  I guess the finality of it just slapped me in the face.  I couldn’t even keep it together for the minute I was on the phone with her.  I wish Anthony was home because he somehow finds a way to make things better.  I cannot put into words the pain I feel in my heart today; it is an unexplainable sadness.  I want a baby more than I have ever wanted anything, and I tried so hard.  Why did my body let me down? Why didn’t those two embies make a home?  I will find the strength to try again, but right now it just hurts so badly.  

The Longest Wait

When I said that 9 days was going to be an eternity, I wasn’t kidding.  It’s only Wednesday, and I’m slowly (or maybe quickly) going insane.  It all started yesterday when I got the call that they were able to freeze one embryo.  ONE?! What happened to the other six that were doing well on Saturday?  I went from not expecting for any to make it to freeze, to feeling like crap when I got the news that ONE of them did.  I know that many people don’t have any frosties, but I can’t help but question why the others didn’t make it.  Does this have any reflection of the two inside me?  The logical answer is probably that they only freeze the really good embryos.  The ones that make it to day six and the ones that they feel can survive a thaw, and make a viable pregnancy.  The logic makes sense, but it doesn’t help the insane person I’m becoming one bit.

So the next reason I am negative Nancy is because I haven’t been spotting.  Most women would probably be happy they weren’t spotting, but I’m worried because I’m not.  I’m hoping to see it, so that I can hope its implantation bleeding.  The logical explanation here is that only 1/3 of women actually experience implantation bleeding, but again the insane person inside me isn’t allowing me to be logical. 

I’m sure the progesterone shots in my butt every night, are not making my emotional state any better.  They’re probably doing the exact opposite; making me crazy and irritable.  Great combo!  Poor Anthony, he’s taking it so well; he is so supportive, and trying to keep me positive.  His countless sweet words bring me to tears often.

If any of you have ideas to keep positive (and/or sane) over the next week, please let me know!

Here are photos of the embryos we implanted, and the ultrasound of the transfer.  You can barely see a little tiny white dot in my uterus (which isnt even visible in this small size photo)! What you can see, is a glimpse of my follicles, at the top right, which are still large and making me so, so bloated!! I appear that I’m already four months pregnant! Lovely! J