IVF #1 D23 : On The Table

We are going to be waiting for results for Our Only One for some time still. In the mean time, everything is still on the table.

We've talked about doing more IVF rounds (either after a failure or after a delivery). Our insurance will pay for 5 more and however many FETs we have (haha). To that end, I've been reading a lot about fertility boosting diets. There is an episode of Creating a Family on this topic, which has a researcher who did a study on 350 infertile women that showed increasing protein in the diet increased IVF success. We're going to start that ASAP. (it takes 2-3 months to show real gains- since it takes that time to mature the egg). Worth a shot, right?

We have also discussed embryo adoption. This is a strange topic, since there really are 2 schools of thought: one is that embryo adoption needs only required blood tests, an agreement between the donating and receiving families (or between both  and the clinic) the other is that embryo adoption is a real adoption: a home study is required, matching fees apply families discuss backgrounds and in many cases really connect. Usually, clinics do the former (but you usually have to be treating with them) and private embryo adoption agencies do the latter, in general. We are open to both methods.

We talked about traditional kid adoption. This has been on our minds for some time and remains something we are seriously thinking about doing.  I worry about any bad feelings that might stem from having a sibling bio-related to us when he/she is not. This is now in addition to my worries about a trans-racial adoption (the most likely outcome) because of our racist neighborhood. This option includes likely moving- not something we can afford at the moment.

We talked about living as a family of 3 and pouring our love and resources into kins (not that we wouldn't anyway). I am terrified that kins would become spoiled beyond measure. And I want another.

But. But I don't want to take away from mothering him hoping for more. I don't want him to hurt from time, money and energy spent trying for another when I have one in front of me.

I look crazy, but he's so cute!

Everything is on the table.  Nothing is decided.

IVF #1 D22- You Are My Only One

I am so very upset.

There was a real mess of a day yesterday. I waited all day for my post-biopsy call and nothing came. I can’t emphasize enough how hard of a day it was. I slept about 3 hours the night before. Throughout the day, I hardly ate and couldn’t concentrate. It was a horrible day and I cried on the way home. All to be still waiting for a call as the clock ticked past 5.

At 5 past 5 I e-mailed the nurse in desperation. She called me back right away and said that the doctor was still likely going to call me, but that she would give me the results anyway. There was one blast biopsied and frozen. Nothing else made it.

One.

We spent $5000, did 14 days of injections, surgery, worrying for One blast. Something that I have created with only femera TWICE in the past 5 months (2 chemicals book-ending my 5 treated cycles), and 3 times in 6 treated cycles. Granted only Liam turned into a baby- but statistically speaking at this point I only have a 32% chance- 65% chance Our Only One is genetically normal (odds for 35 is 35% abnormal, 30 is 30% but I went worst case for the range- given my history I think that’s fair). Odds of success is 50-70% for PGS normal single embryo transfer. Again, I took the worst case.

Best case is 49%. But everything has gone dismally, why would I build myself up? I had the lowest end of expected eggs retrieved (10, range was 10-20). Then only 60% were mature. They said 60-80% should fertilize. We had 66% (4). Then they told me that the 4 growing on day 2 were beautiful, couldn’t be better and that we would likely see most or all make it to blast. And now there is one. So forgive me when I wanted to tell the nurse who told me “I know you might be disappointed, but you shouldn’t be. This is a beautiful, perfect blast. Really, really good. I told 2 women today that they are pregnant from cycles with just one blast”.

I get her thinking, I really do. But forgive me when I (want to) say: Shut Up.

After the reassurances of how early it was when there were so few follicles, the report of “4-8” follicles there were FOUR, the assurance that 4 growing at (end of) day 2 is awesome, that they would make it. And NONE of it being true for me. I just can’t let myself believe that this will work out.

I know that there are some who don’t get a blast, and I know I haven’t received an abnormal result or a negative test (yet?). I get that in a year I could be marveling over a perfect baby and thinking “How could I have been so upset that we made YOU” but the reality is, this cycle is either a total bust- a waste of time, money and hope OR I have lost yet another number in the family I always dreamed of.

In some ways this is the worst case situation. I would rather just cycle again this cycle, so Aug/Sep. Now we have to wait for genetic results {(10 days for results, then the wait for an appointment (another 8 days after they are due in)} If it is abnormal, we can cycle again next month (Sept/Oct). At least then we can continue to hope for some to freeze.

If it is normal, we’ll do the transfer- lose all the $5000 for the testing and have a low chance of success overall. If we transfer and fail the next time we could cycle is November. So far away. We really did this in the hopes of speeding up our time to conception and having some in the freezer for number three. Our RE thought we would be pregnant within 6 more cycles of when we stopped for IVF- that would have been December. If this one turns into a pregnancy and healthy delivery it likely means we will be done TTC. I don’t want to wean early to pursue treatments and this dismal result means I don’t see the worth in TTC at 34. Blue Sunday’s diagnosis (at 28) and the time to conceive after forced me out of the 4 I wanted. Now I’m losing my hope of 3, too. I would love to have results be normal and cycle again before transfer, but that would mean paying out of pocket for IVF. Not happening.

I never sent in the form to sign up for the rapid batching, so if the embryo is abnormal and we choose to PGS again, we have to pay the whole PGS again (less 500$ refund for having so few to test this time).  I can tell you now, I don’t want to test again. We had the money, but I feel like it was thrown away (because it was one embryo) if there were more, I wouldn’t feel so bad. I can’t predict if I’ll respond better in the future, but I won’t be testing next go-round based on this cycle’s numbers.

So as you can tell from the mess that this post is, my thoughts are spinning, my heart is hurting and I don’t see how I’m going to make it to the 18^th before hearing results. I STILL haven’t heard from my MD and that really is upsetting me. I think I am going to e-mail tomorrow morning if I don’t hear from him today and ask to speak with him. At least so I can tell him I want the PGS results when they come in and not 8 days later. 

You are my only one, you are my only one. 

Don't be leaving me now 

Now you're my only one.

James Taylor, Only One

SPOILER:
I feel obligated to annotate this that this one blast I was brokenhearted about is my perfect, gorgeous daughter. 

IVF #1 D17- Day Two Report

I waited all day yesterday for the promised phone call from my Doc. The nurse told me on Wednesday that he would be calling in the morning. As the hours passed, my BP sky-rocketed.

I know they are so busy, I don't begrudge them that, but I just couldn't go through another evening waiting for news.

I called my nurse at 3:59 (calls before 4 are returned same day ;) )and left a message. I think I sounded a little crazy. It was something like "Oh hi, I know yesterday you said Doc would call me today, but I haven't heard. I think you said he'd call today. Anyone, if you could call me back, that would be great, today or tomorrow morning. Really today, I'm sorry I'm just really anxious".

About 30 minutes later she e-mailed me saying the Doc would call. And 15 minutes after that he did! I saw his number come up and was flooded with relief and then immediately dread.  You know that feeling when you REALLY might need an adult diaper. That feeling came. But I managed to sound mostly sane and continent when I answered.

He apologized for keeping me waiting, and assured me he would never forget to call. Then he gave me the (good!) news:

All 4 are still growing! They look "great": 3 really good and 1 good. It is personal, professional opinion that all are likely to make it biopsy and freeze. What a huge relief!

He ended the conversation with he couldn't expect any better and thus far everything has gone as they statistically should. 10 retrieved, 6 were mature (not 8! big difference. and makes much more sense considering my follicle development), 4 fertilized normally, the other 2 had multisperm. 4 still going.

They'll call Monday with the final pre-PGS results.

IVF #1 D15- Fertilization Report

This has been a roller-coaster in the worst way.

The Reaping was yesterday. When the doc came over to discuss pre-op she said to expect to get 5-6. 3-4 would be the low end, with 7 the high end. There was also a possibility that the eggs weren't matured-  my progesterone was 2.1 and they like it 3 or higher. If they weren't ready, she would have just tried one or two and then stopped the procedure.

Fortunately, they were ready and she got TEN! I thought we were good to go and was feeling much better about this cycle than I had been.

All day yesterday I just rested- I am still sore today. May be I'm just a big baby, but I feel icky.

This morning they called me and left a message saying that of the 10 eggs, 8 were mature, but only 4 fertilized. She mentioned that 2 fertilized with two sperm I am hoping she meant of the 4 NOT considered fertilized 2 super-fertilized. Otherwise we only have 2 in the running. She follows up that comment with "so we have 4 available for day 5 biopsy". So I think we're OK on that front.

The doc will call tomorrow with the Day 2 report.

I am feeling so conflicted about what to do. We have 3 options: (assuming at least one makes it to day 5)

1. Just freeze- skip the genetic testing (PGD) and do a Frozen Embryo transfer (FET) next cycle
2. PGD as planned, Since there can't be more than 4, we get a 500$ discount (3100 rather than 3600)
3. PGD with something called Rapid Batching. This means they will test what we send them for 3600 (no discount even thought there will be less than 5) if none are normal, we can cycle again with no lab fee until we get 8 embryos tested. If one is normal this cycle, we forfeit the 500$ discount mentioned above. If we need to cycle again, we pay the PGD all over again (which would be the same as point 2)

Any ideas? opinions? Experience?

As of now, hub and I are sitting on the contract until we talk to the doc tomorrow. The prevailing opinion is that from fertilization (Day 0) to blast (Day 5) you lose about half and that half of day 5 embryos are abnormal. If that holds- we'll have 2 to test and 1 normal. But we all know my odds. Oh, and sometimes they die in the thaw. And we have to freeze them because we didn't prime my body for a transfer. So they would just die in there anyway.

IVF #1 D13: Don't Fear the Reaper #microbloggingMonday

I am really very nervous.

Tomorrow is egg retrieval day- or as I call it The Harvesting.

Not for nothing but the last time I was under was the day of Blue Sunday's termination.  I have some not very good memories from that day's surgery- aside from the loss of my Blue Sunday. I was cold and uncomfortable. The medications made me itch, vomit and be very restless. I am hoping that since this is a lighter anesthesia that I'll feel better. Also, unlike that day, The Harvesting won't the most awful moment of my entire life.

I report at 8am. I triggered at 9pm last night, so I take that I'll be in there an hour or so before prep. Hub will be driving me to and from, I am hoping the let him hang out with me while I wait to go in.

I'll report more tomorrow afternoon!

Come on baby... don't fear the reaper
Blue Oyster Cult, (Don't Fear) The Reaper

IVF #1: D12 Trigger Night

What a weekend. 

I've been up early both mornings to do bloodwork and ultrasounds. Bub is still feeling lousy and coughing up a storm. I was supposed to have  beach day, but I would have been so late, and bloated, and with a sick baby.. so I skipped it. 

So yesterday there were NINE measurable follicles! They ranged from 12-17mm. There were also "5-10" small ones on each ovary. How the heck did that happen in 2 days? (on Thursday, there were 5 total measurable and one small on each ovary). This morning there were still 9, ranging from 12-22. E2 was 2074 (1749 yesterday)

I trigger tonight, and go for the retrieval 8am Tuesday morning. YAY!

IVF#1 D 10: Small Update

I spoke to the nurse yesterday in a very hurried conversation. I was in a meeting (as usual- my work is INSANE. I wish I didn't work at such a tiny place because I want to share some excitement, but it is a small and buzzy company and I would be absolutely outed in my real, professional life. I'll leave it with- we are waiting on word that could literally change the lives of a whole lot of very needy kids.) I left the meeting to take the call but it seemed like neither the nurse or me had time for the conversation.

My doses all stayed the same. I was told to have drug through tonight (Friday) and come back Saturday morning at 7:30 (sob) for what should be a final check and then trigger shot. Estimated retrieval date is Monday 7/20! Estrodiol was 1053 and I had the following eggs:

R: 17, 13 (one less than 11)
L: 14, 15, 16 (one less than 11)

I can't lie, I am really disappointed with only 5 eggs, but at this point it is what it is and  am just going to hope for abnormally good fertilization and growth. I'll keep you updated.

IVF #1 D9: Never the Way I Planned

I had my second scan this morning it was was pretty dismal.

5 follicles, with one of those lagging behind. The largest is 17, the smallest 8.5.

This is all from the woman doing the scan, not the nurse, but I trust the scan people more than the nurse at this point. I was told 4-8 on Monday afternoon (after being told 4 at the scan) 4-8 my ASS.

I feel like this was so much effort for just a few more follicles more than I had my first round of clomid. They assume a 50% decrease in eggs between retrieval and post-biopsy freeze. At this point I am really questing doing the PGD.

4000$ for what will be at best 2-3 embryos seems insane. The vast majority of abnormal embryos won't implant, or won't develop past ~12 weeks. Is potential heartache worth 4000$? Only if I am in the situation of a late termination again.

A craps shoot.

Again.

Hub wants to continue with the PGD plan. I told him I'll talk to the nurse when they call and see what they say.

To be continued.

This was never the way I planned, not my intention
Katy Perry, I Kissed a Girl

IVF #1: D8 Push It Real Good

So less than 15 minutes after  I posted yesterday I got my call from my nurse.

She seemed upbeat about the whole thing. I have 4-8 total follicles with an E2 of 450.4. I did ask if 4-8 would be my baseline from here on out and numbers would decrease from there. She said we were still in the recruitment and growth phase and there was time to get some more. They upped my dose to:

Gonal-f: 375 (from 225)
Menapur: 75 (same)
Ganerlix: One pre-filled injector (new)

I have to call my nurse today because the (other) nurse told me to make sure I had doses through the weekend. I'm not sure if I should plan to dose Monday or not. That would change at least one of the drug amounts I need to order. It's not so very expensive, but I'd rather not blow through money needlessly. And the pharmacy is far enough away from my house that I don't want to make two trips (but not so far it's worth the 15$ delivery fee).

 I had a bad stick last night. I ended up really bruised. I don't know if it was the angle or the ganerlix or something else. Hope it doesn't repeat tonight.

In other news, I am exhausted, bloated and cranky. Boooo.

More bloodwork and ultrasound on Thursday.

Ah, push it

Ah, push it
Baby, baby
Oooh, baby, baby
Baby, baby
Salt N Pepa, Push It 

IVF#1- D7 I'm Totally Freaking Out

I'm Totally Freaking Out

Peg + Cat anyone?

So this morning was my first ultrasound. I have been trying really hard to be calm and cool about this cycle and this morning it all fell apart.

I haven't even gotten my feedback call and I am totally losing my mind. On my To-Dos of the day list is "Don't Cry". So far, so good but only just.

So there were FOUR follicles in there. Two on each side.

Four.

My first Clomid cycle I had three (one of which is Bub).

The u/s lady (who is really good, and I really like) said it was a good scan and it is still early. But I wonder if she's just keeping optimistic?

Anyway, I was trying to keep from posting until I got the update call, but they usually call just after 1- it's now almost 3. I just decided to put this out there.

IVF #1: D5

I guess I have a bit to catch up on.

I went to my patient education class Wednesday, which was injection lessons and medication instructions. That night I started 225 gonal-f and 75 menapur. They can be mixed together, so I only have to shoot myself once a day. Yay. Eventually I will add ganarelix, which can also be mixed in one shot. The first two stimulate egg growth, the last inhibits  ovulation. 

The first night was a little daunting. Hub came to the injection training with me and I had him do both the mixing and the shooting. The next night I mixed and hub shot. The following night I mixed and shot- we had Red Sox tickets, so I had to do it in the bathroom. Yuck. 

Yesterday morning (Saturday- morning of day 4 of stims) I had a blood work appointment. My estrogen level was 141.9, which I was told was perfect and they made no changes to the meds. I go back tomorrow (Monday- morning of day 6) for blood work and ultrasound! 

I am trying really hard to go with the flow and not turn obsessive with this. So far it's going ok. 

IVF #1: Day -2 AKA Why I Get Jealous

Here I am, 2 days from starting injections. I got the enormous box of medications late last week. I have stopped birth control and am waiting for my cycle to start (I was told it should be here today). I have to call my nurse when it starts and probably head over tomorrow morning for an ultrasound.

2 days from now I go to my education class for injections and that night start shooting myself up.

I still can't quite believe we're here.