Transfer

Yesterday was our 3-day transfer. The clinic was running right on time, so I was happy not to have an extra-long wait like I did last time. I did a 30-minute acupuncture session and right after they checked me in and took me back. Transfer is a lot easier than retrieval and much less involved. No IV, no fasting, and John got to be in the room too (though he did get to wear a sweet surgical outfit, hair net and all).

The doctor on duty talked to me about our embryos and told me we still had both and they were both 8 cells, which was great (most embryos are between 4-10 cells on day 3 with 6+ being more ideal). The embryos are also rated based on fragmentation. Just because an embryo has some fragmentation doesn't mean it won't grow into a normal and healthy baby. We had one fragmented embryo and one embryo with no significant fragmentation (which they said had a "high likelihood of implantation). We decided to transfer both because the risk of multiples is still pretty low, although not impossible. It felt like the right decision for us and we knew the likelihood of the second making it to freeze on day 5 was very low, so we wanted to give it a chance in hopes that it would grow better in its "natural environment." I don't know if that's really true, but it makes me feel better anyway.

My clinic doesn't require any strict bed rest, but I have been mostly on bed rest the last 2 days. I did another 30-minute acupuncture session right after the transfer and then we came home and I have been on the couch or in bed pretty much since. Tomorrow I will probably be up and about more, but I still can't lift anything heavy or do any strenuous activity. I am trying to focus all my positive energy on one or both of our embryos snuggling in cozy for the next 9 months. The next couple of weeks will be nerve wracking yet again, but I am going to try and stay busy, distracted, and positive.

ER/Fertilization report

Yesterday was egg retrieval and we got 6 eggs. That was consistent with the ultrasounds I had been having. Overall it went fine, except when they could get my IV in on the first try. Yay. I woke up in the same amount of pain as usual, but this time I didn't have them give me any IV pain meds. Last time I ended up super nauseous from that, so this time I just took extra-strength Tylenol and I was ok. I would rather be in a little more pain than have the nausea. It was funny because I was telling one of the nurses when I first woke up that the pain after ER is the worst part of IVF. Then I corrected myself and told him that dealing with my insurance, specifically Aetna Specialty Pharmacy, was the worst part of IVF. I kind of went off for a minute and a few minutes later when I was more with it, I had a good giggle about it.

Anyway, today I got the call that only 2 of the 6 fertilized. Not the best report and not nearly as good as last time, but 2 is better than none. We will definitely be doing a 3 day transfer on Monday (my clinic requires at least 4 embryos to push forward to a 5 day transfer) and we will transfer both if we still have both. I am trying to focus all my positive energy into our two embryos growing and staying strong over the next few days if you want to join me in my positive thinking. :-) But nobody should call me because if my phone rings, I will get nervous it is the lab calling to say they didn't make it. Maybe this is the worst part of IVF, worrying about my little embryos and hoping we make it to transfer.

IVF #3

Well I have been a huge blog slacker. Sorry to anyone who has been waiting for an update. I really do want to journal this process, for my own records and so I can easily share our journey with friends and family. I was in a pretty long funk though for awhile leading up to this cycle. I found it hard to get excited about doing it all again. I am so thankful to have another shot at this and to even have the opportunity to do IVF. The whole process is very draining though. I was excited that try #2 went so much better than try #1, so I thought I would be more hopeful going in to this cycle.

Anyway, I started stimming on 9/7. After 4 days of stims I already had a lead follicle at 14mm and then a 12mm and a 10mm so they started me on Ganirelix on stim day 5, which seemed pretty early to me. That meant ordering more Ganirelix and paying out of pocket because my insurance will only cover 4 vials in a 30 day period. I used 3 before the cycle even started as part of my suppression with estrogen priming. Luckily my nurse was also able to give me a couple of samples, so it wasn't too outrageous. Oh, and if I haven't mentioned here before, I absolutely hate Aetna and especially Aetna specialty pharmacy. I won't go it to the whole long story, but know that if I had any other choice, I would not use them. They have caused me a lot of added stress this cycle with messing up my medication order.

With having a lead follicle so early, there was talk I might trigger as early as stim day 9, which seemed too early for me. Luckily things slowed down a bit after starting the Ganirelix. My sister Rachel came for a long weekend visit and I would have been super sad to miss out on some time with her if I would have had to have my retrieval while she was here. It all worked out though and we had a fun weekend enjoying Boston, Plymouth, and Martha's Vineyard. I had a couple of monitoring appointments while she was here, but those were early enough that she was still sleeping when I got back.

So I ended up stimming for 11 days and triggered last night. I have 6 follicles between 14-23mm so hopefully we will end up with 6 eggs. There were a couple of small ones too (less than 12mm) so it's possible one or more could catch up. It's also possible that one or more of my follicles are cysts and don't have an egg at all. My estradiol level was low and slow to rise again, but it finally started doubling every 24 hours, so hopefully all is good there. I've really been trying not to stress or obsess about the numbers, but of course that is hard.

Egg retrieval is tomorrow morning. This is the first time it will be on a weekday morning, so we are scheduled early and will arrive at 7:00 for a 8:00am ER. Traffic is crazy headed north on weekday mornings, but we will leave at 6:00 and hope for the best. I will take it easy all weekend and we will either have the transfer Monday or Wednesday, but we are hoping for a 5-day transfer again.

I can't say that I am as excited as I should be, but I am feeling better than I was a couple of weeks ago. Having Rachel here was a much needed distraction and has helped lift my spirits. Maybe I will be more excited when we get lots of eggs tomorrow and hear a great fertilization report on Saturday. Each step of this process is stressful though, so please send all your positive thoughts and vibes our way that the next few days will bring lots of good news.

Rachel and me dipping our toes in the ocean at Martha's Vineyard at sunset

Me and Rachel in Boston at the Harbor

Cycle results/update

Sorry to anyone who has been waiting on an update for this cycle who isn't my immediate family that already heard the news that our cycle did not work. I had to check-out for a couple of days and tried not to spend much time online, then things were busy buying our new car, and then we went out of town.

So sorry to keep you hanging, but I found out on the 10th that our cycle was a bust when I started my period before I even went in for my blood pregnancy test (beta). My clinic has a policy that you still have to come in for your beta to make things official, since some women can have bleeding in early pregnancy. I had been testing at home for a couple of days and had negative tests, so I knew that the beta would be negative, and it was. Even though it was expected, it was still hard to go to the clinic that morning to be poked yet again for nothing. I took a couple of days to be sad and then I decided to move forward and not dwell on the failure.

Even though the cycle wasn't successful in that it resulted in pregnancy, we still had a lot of successes. We got 8 eggs. 7 were mature. 5 fertilized and made it to day 5. We also found out that we had 2 that were still growing on day 6 that were frozen (the other 2 had stopped growing). So all in all, things went so much better than our first IVF cycle and we made a lot of progress. I actually have hope again that this could work for us. Unfortunately, it is going to take trying again (hopefully just one more time) and moving forward. The other option is to give up, which just isn't really an option right now. This journey has been long and we have had so many bumps along the way, but I know it will be worth it when we have our baby.

I had a follow up appointment with my doctor last Wednesday and we decided to go ahead with another fresh cycle. We are going to keep our 2 blasts frozen for now and will hopefully add a couple of more to be frozen for more cycles in the future. My doctor still thinks our best chance for success is with a fresh cycle, so we will start over again. I will do the same protocol as last time with hopes of at least the same, if not even better, results. I will start my Estrogen Priming around Sept 2, assuming my body cooperates and I ovulate on "schedule" this month, since the timing of the next cycle isn't really solidified until ovulation is confirmed for this cycle. Hopefully I will start stimming around Sept 8-9th and ER will be around Sept 20th or so. We are planning a single embryo transfer (SET) again if we make it to day 5 again. We still feel very strongly that the risks of twins or high order multiples isn't worth transferring more than 1 for now and my doctor is on board.

So in the meantime, John and I are trying to have some fun and relax and enjoy the break from meds and shots and doctor appointments. We got our new car and took it on its first adventure this weekend and headed to Acadia National Park in Maine. We had a great time and we love our new car (Toyota RAV4). My back is mostly healed from the accident and all of that stress is nearly behind me. The weather had been beautiful in New England and super mild and we are loving it. So things are pretty good and that is what we are focusing on for now.

Acadia National Park-Maine

Day 18/Transfer Day

We just got back from the clinic (yay for traffic) and everything went great at transfer. They were running an hour behind, so the waiting wasn't fun, but not so bad. We transferred one early blastocyst and the other four were all still growing as of today and will be frozen tomorrow if they are still good quality, so we are still hopeful to have one or more make it to freeze to transfer in the future. They will send out a letter tomorrow so we probably won't know until early next week.

The next 10 days are probably going to draaaag by for me, but hopefully I can stay busy. Thanks again for all the love and support.

Here is our baby's first photo:

5 days old :-)

Day 16-17

Talk about the longest 5 days of my life. Waiting this week has been tough. I am trying to stay busy and distracted, but it's hard. I feel like my mother instincts have already kicked in and I am constantly thinking and worrying about my little embabies growing in the lab. Wondering if they are ok, if they are growing, if they are safe and being well taken care of. The nurse told me that no news is good news. Well no news is still nerve-wracking. But my goal through this whole cycle is to focus on the positive and to be as peaceful about all if it as possible. Not worrying about the what ifs and what could go wrong, but focusing on how it could all go right. I want it to finally be our turn and I want to move forward with this next stage of our life.

My embryo transfer is scheduled for 3:00 tomorrow afternoon. I will go in for a 30 min acupuncture session prior, then will check in at 2:30. Hopefully the OR is running on time so I can have another 30 min acupuncture session post-transfer (but the lady leaves at 4:00, so if the OR is behind and I'm not done before 3:30, I will go back Sat morning for acu). There are some studies that say pre- and post-transfer acu sessions increase implantation rates. I want all the help I can get.

To get an idea of what is happening to our embryos, click on the link below and watch this video from Boston IVF (our clinic). They use a special Embryoscope Incubator that allows them to watch and evaluate the growth of the embryo while it is incubating. This cuts down on the handling of the embryos and can help preserve their quality. In conventional techniques, the embryo is removed from incubation and placed under a microscope and then put back. This takes that step out. Pretty cool, right? This particular embryo was from conventional IVF, where the sperm fertilizes the egg naturally. We did a procedure called ICSI, where they actually inject one sperm into the egg, as this increases fertilization rates. But the development to blastocyst is the same. Our embryo/blastocyst will be about 125 hours old when it is transferred, so it could be anywhere from 60-120+ cells by that time (which is why in the video it becomes impossible to distinguish the individual cells). There will be an inner cluster of cells that is the baby and the other cells will become the placenta. So there's your biology lesson for the day. :-) We will transfer the highest quality embryo/blast and then freeze any remaining that are high enough quality (sometimes they let them grow one more day before freezing).

Anyway, thanks again for all the support and well wishes. It means so much to us to have so many people rooting for us. If you can send a little extra love/prayers/positive vibes or energy to the universe or whatever it is you feel comfortable with around 3:00pm tomorrow, I would really appreciate it.

https://www.facebook.com/photo.php?v=10151602873713654

Day 15

Got the call this morning that all 5 of our embryos are still growing and doing well (the nurse even said they were above average) and we are going to do a 5 day transfer on Friday. Yay! I did not get much sleep last night. I did a lot of reading yesterday about the risks vs. benefits of transferring 1 or 2 embryos on day 3 and was feeling some stress about making the best decision. Now I don't have to worry about that at all, since we have known all along we would just transfer 1 if we made it to day 5. As much as having 2 babies at once would be great (you know, 2 for the price of 1) and I have no doubts about my ability to mother twins, a high-risk pregnancy really scares me. I am at an increased risk for preeclampsia as well as gestational diabetes, so a twin pregnancy would be extra risky. Not to mention the very small chance that one or more embryo could split and I could have 3-4. Yikes. So we are doing a single embryo transfer (SET) to give us the lowest risk of multiples. Best case scenario is we will transfer 1 and still have 1 or more to freeze for the future.

The next few days are going to drag so I am going to try and keep busy, not obsess over statistics, and keep hoping for the best. All of your support and positive vibes are so encouraging, so thank you so much.