Thursday, July 31, 2008

IVF#2 - Quick Update


I thought I would send out a quick update:

Embryos in culture – none of them made it past 5 cells and all were discarded on day 6. So no snow-babies for a backup or a future sibling.

Progesterone level – I had my progesterone checked yesterday, they want it >30, mine was >80, so all good there and they want me to continue with the progesterone injections.

As far as how I’m feeling, totally normal. That’s great in the sense that I did not develop OHSS. Now I’m praying for sore boobs and morning sickness. One more very long week to go before I get the results, trying to be patient.

Saturday, July 26, 2008

IVF#2 - Day 3 Transfer

What a day of answered prayers and miracles!!! I'm currently carrying QUADS!!!!

On day 1:
4 fertilized

On day 2 (should be 4-cells):
4 developing slowly at 2-cells
2 hours after leaving me a voice mail, 3 more spontaneously fertilized!!!

On day 3 (should be 8-cells):
6 @ 4-cells
1 @ 8-cells

Now there is a downside to this, 6 of the embryos are multi-nucleated. What this means is that one or more of the cells did not divide correctly and contain more than one nucleus. The nucleus contains the DNA. Basically they are probably chromosomally abnormal. Multi-nucleated embryo transfers are generally avoided unless there are very few normal embryos available. These embryos are at very high risk of arresting or miscarrying. Around day 5 or so, the cells start to differ from each other, some will become the baby, some will become the placenta, etc. Now if the normal cells become the baby, a normal healthy baby can result. So these embies do have a chance of producing a perfectly normal baby.

Good news is that my 8-cell appears to be perfect and has great potential. This little miracle embie went from 2-cells to 8-cells overnight and is a so close to a perfect A that they graded it a B+!!!!! So I'm holding out hopes for my little miracle 8-cell embaby!

Transfer went well. I thoroughly enjoyed my Valium. I transferred what my doctor recommended, which was 4 of the best. Normally they would not have been willing to do more than 3 with me, but considering the above mentioned issue, they want to better my odds. We transferred the 8-cell B+, 4-cell B that jumped to 5-cells right before it was transferred, and 2 more 4-cell Bs.

3 are remaining in culture and they'll watch their development and report back to me. Most likely they won't make it, but you never know about my embies, maybe they'll pull another miracle and we can get some snow-babies out of them.

Here's embabies first photo:

Just three more hurdles to go, to get pregnant, stay pregnant and give birth to a healthy baby. This is the closest I’ve ever been, OMG, I’m a mom right now!!!!

Friday, July 25, 2008

IVF#2 - Day 2 Embryo Update

Here’s the exact message I received:

“I’m calling to leave you an embryo update. I wanted to let you know that unfortunately none of your embryos are growing at the rate that we expect them to, they’re growing, they’re just not growing quite as fast or as well as what we would expect to see today. We would expect to see a 4-cell grade B or better and all 4 of your embryos have a lower # of cells than that. Because of this, we feel it is in your best interest to have a day 3 transfer. We’ve gone ahead and scheduled your transfer for Saturday @ 10am and have cancelled your day 5 transfer on Monday. I will be working this weekend and I’ll come by shortly before your transfer with a picture of your embryos and try and answer any questions you may have. That’s all the info I have for you now, I’ll see you tomorrow morning.”


Thursday, July 24, 2008

IVF#2 - Fertilization Report

Results so far:

19 Retrieved (Wahooo!!!)
12 Mature (Yes Yes Yes!!!)
4 Fertilized (Oh no!!!)

Last Cycle:

10 Retrieved
4 Mature
2 Fertilized
1 Divided slowly, transferred on day 3, didn’t implant

I started the dreaded progesterone injections last night, along with Tetracycline and Medrol. I put drug addicts to shame! They are a 1.5” intra-muscular injection that goes in the boo-tay via hub-bay. I numb up with lidocaine ointment, so it’s really not that bad, but it sure scares the poo out of me, so I have to close my eyes.

Tomorrow I will get a division report telling me how many divided, they should be at 4 cells tomorrow. There must be an egg/sperm quality issue as a 4/12 fertilization rate is very poor. Please pray for my little embies to grow and divide properly. Please pray for strength and peace for me as I wait for that dreaded phone call. I’m trying really hard to not be fearful… but I lost it this morning. I cried so hard I hyper-ventilated and almost threw up. My emotions and fears are compounded by large quantities of hormones, a vasectomy reversal, 2.5 yrs of trying on our own, 2 IVFs, $45,000 and not one pregnancy. I’m doing better now but feel like I’m standing on the edge of a cliff begging for mercy.

My IVF nurse called me to ask how I was feeling. She was trying to get a feel for if I was developing OHSS. So far so good, just cramps and bloating. Then she said my doctor wants to proceed with a fresh transfer this cycle as she doesn’t think my embabies will make it to freeze. Please pray that my uterine lining will accept implantation and that I will finally be blessed with motherhood.

Wednesday, July 23, 2008

IVF#2 - Egg Retrieval

Hello All,

I just got back from egg retrieval and wanted to get an update out before I drift off. Everything went really well! They retrieved 19 eggs, wahoo!!!! Last time they retrieved 10. The embryologist said he thinks about half of them will be mature just from first glance. They will be injecting one sperm into each mature egg today. I’ll get a voicemail tomorrow with how many are mature and how many fertilized. My doctor is leaning towards freezing them all, but hasn’t made up her mind yet. I’m feeling pretty crampy, but nothing unbearable, I’m doped up pretty well right now.

Kerry’s sample was better this time, here’s his results:

Total Count: 40 million
Motility: 3% grade B

Total Count: 60 million
Motility: 6% grade B

When I returned to recovery, there was a “Dear Eggs” letter waiting for me, encouraging them to become great embryos and letting them know they have wonderful parents waiting for them. So cute! It was from a good friend who just went through IVF 2 weeks ahead of me.

So nothing but good news, everyone is very happy with the results, all went perfect and we couldn’t be happier. I’ve been praying like crazy, all I can say is God is good and delivered!

Tuesday, July 22, 2008

IVF#2 - Night before Egg Retrieval

I just got my estradiol level back and it’s now 9029, zoiks Scooby!!!! I’ve been given instructions to stay very well hydrated and eat lots of protein. It won’t prevent OHSS, but will help with the symptoms. But since I’m NOT going to get it, it’s just a precaution. Egg retrieval is tomorrow morning. While I’m having surgery, Kerry has an appt with the Lazy Boy in the collection room. I'll ask again, how fair is that???

I talked to my IVF nurse today and got some more info. I asked her what will determine if they will go forward with a fresh transfer or freeze everything. One consideration is my insane E2 level, the other is she wants to see how many eggs fertilize and what the quality is. If I have a good count and quality, she feels it would be ok to freeze them and I could have a good chance with a frozen transfer later. If I have a low count or poo poo quality and freezing/thawing them would probably result in losing them all, she would rather chance the fresh transfer. So sounds like she wants to keep me safe but at the same time, really wants me to have a good chance at pregnancy. I’m at peace, whatever she decides.

I next asked about the frozen embryo transfer process (FET). If I have to go frozen, the real bummer part is that it will be 3 months from now before I get to transfer them, ugh. Did I mention I’m tired of waiting already? Well I am, let’s get me pregnant already! I would have to wait for this cycle to end, go through a normal cycle on my own, and then start the process the following cycle. The process is unexpectedly more than I realized. It is identical to going through IVF minus the stim injections and egg retrieval. It’s a 6-week process of birth control pills, lupron to shut down your hormone system, estrogen supplements, monitoring visits, transfer and progesterone injections. Basically it’s HRT (hormone replacement therapy). The scary part is that you can’t thaw the embies until you’re ready for transfer, so you have to go through the all the prep work before you even know if your embies are going to survive the thaw. I asked her how many they will unthaw. If they are frozen right after fertilization, they unthaw them all and see what develops. If they are frozen at day 3-5, they will only unthaw how many you want to transfer. They will keep unthawing one at a time until they have that amount or run out. The embryologist will determine when they think is best to freeze. I never thought I’d ever be at the mercy of so many people to get me pregnant. If anyone ever wants some advice on how to NOT get pregnant, I’m your woman! =)

I’m off to go take it easy before delivering all my little follies. =)

Monday, July 21, 2008

IVF#2 - Trigger

I'm officially triggered! I can soooo relate to women who are one week from giving birth right now. I am so bloated and uncomfortable, I cannot wait to give birth to these follies and get them out of me!

I don't know if it's 100+ injections in my stomach over the last 2 IVFs or my high E2, but wow is my skin getting tough to pierce. Thank God I'm done with injections, at least in my stomach!

Now I wait on pins and needles, will they choose fresh or frozen transfer?

IVF#2 - FSH Day 10 Monitoring Visit

I had my fourth and final monitoring visit today. I’ve been feeling pretty uncomfortable in my ovarian area. The ultrasound lady said “I can see why” as soon as she got a glimpse of my ovaries. Here’s my results:

Right: 10, 13.5, 15.5, 16.5, 17, 17, 17.5, 18, 18.5, 2<10.
Left: 10, 10, 11, 11.5, 15, 15.5, 16, 19, 20, 21, 2<10.

So I have a total of 23 follicles!!!!!!!!!!!!!!!! A max of 13 follies will have a chance of being mature at egg retrieval.

My lining is 8.9mm, much lower than last IVF, but still in an acceptable range.

I unfortunately do have some more bad news, despite reducing my meds twice, my E2 has sky-rocketed to 8380!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! It jumped by almost 4000 in just 2 days and it’s going to continue to rise over the next 2 days. Remember the highest they ever want it to get to is 4000. Peak E2 in a normal non-stimulated cycle is about 150-600, so as you can imagine, the body is not used to this extreme level.

They are having me trigger tonight at 9:30p with one and a half Ovidrels. Tue I go for one last E2 blood draw. Then Wed is my egg retrieval at 8:30a.

I talked to my doctor and she’s pretty concerned about me developing Ovarian Hyper-Stimulation Syndrome. I heard this is NOT fun at all. But I’m NOT going to get it, right!!!!! The excessively high E2 could damage the egg quality, boo! She is going forward with egg retrieval, will fertilize the eggs and then decide if she wants to do a fresh or frozen transfer. Based on impaired uterine receptivity to implantation, she feels I’d still be better off with the fresh over frozen. Based on the risk of OHSS, she thinks the frozen transfer would be much safer. The risk of OHSS goes way up if you become pregnant. I checked my clinics success rates for my age group and a fresh transfer has a 45% chance of resulting in a pregnancy and a frozen transfer has a 39% chance.

Prior to IVF#1, I was pre-diagnosed as a poor responder. After IVF#1 I was upgraded to a low responder. Today I was upgraded to a normal responder. So that’s some good news!

For those of you interested, here’s a recap of my E2 levels:

Day 5: 1640
Day 7: 3428
Day 8: 4245
Day 9: Trigger
Day 10: 6867

Day 4: 668
Day 6: 1742
Day 8: 4385
Day 10: 8380 (Trigger tonight)
Day 11: ?

Saturday, July 19, 2008

IVF#2 - FSH Day 8 Monitoring

Today was my third monitoring visit. I have some good and bad news this time. Here's the results:

Right: 10, 13, 13, 14.5, 15, 15.5, 17
Left: 10.5, 11.5, 12, 12, 13.5, 13.5, 15.5, 16.5

So that is the good news, I have 15 measurable follies plus some less than 10 that they didn't bother counting as they won't have time to catch up.

Lining: 7.8mm (down from 8.5mm, that has to be an error!)

Here's the bad news:

E2: 4385!!!! (up from 1742) This is NOT good! This jumped big time and is now higher than IVF#1. This was something that we were all hoping would not happen again. They don't want it to be over 4000 at trigger time and I still have a couple of days to go, so it's going to get much higher. As a side note, trigger is an hcg hormone injection that causes your follies to fully mature and be ready for retrieval. They have no choice but to keep me going as the follies need more time to mature. This puts me at risk of Ovarian Hyperstimulation Syndrome (OHSS), but because I didn't get this last time with an E2 of 6867 at trigger, hopefully I can escape it again. That's not what I'm worried about though, my concern is that excessively high E2 levels are detrimental to implantation. So even if I have perfect embryos transfered, there's a risk that my uterine lining will not be receptive to them implanting. One option is to go forward with egg retrieval, freeze all the fertilized embryos and then do a frozen embryo transfer next cycle when all my hormone levels are back to normal. This is a risk as well as frozen embryos have a lower chance of surviving than fresh. I'm going to talk to my RE Monday and see what she thinks. Our prayer is that we have enough embryos to go forward with this cycle and a few to freeze as a backup. Last time we only had one embryo to work with.

They are lowering my stim dose again by a small amount.
From: 150 Gonal am / 75 Menopur pm
To: 75 Gonal am / 75 Menopur pm

I go back for another monitoring visit Monday morning. Hopefully my follies will be big enough by then for trigger. My ovaries are becoming quite achy and I'm having to slow down. I'm trying to remain positive, hopeful, and trust in God, but honestly I'm scared to death. I just want to be a mom, why does this have to be so hard?

Thursday, July 17, 2008

IVF#2 - FSH Day 6 Monitoring

I'm here to deliver some more good news! Today was my second monitoring visit. Still going good!!! Here's the results:

Right: 10, 11, 11.5, 12.5, 14.5, 3<10
Left: 9, 11.5, 11.5, 13, 5<10
Lining: 8.5mm (up from 6mm, yeah!)
E2: 1742 (up from 668, pretty high, but still lower than last time)

So that gives me 9 measurable follicles and 17 total, wahoo! She said the <10 are around 9mm, so they may catch up. The goal is to get my follicles to 18mm and have them be at the same size so they are all mature at the same time.

They are lowering my stim dose by a small amount.
From: 150 Gonal am / 75 Gonal + 75 Menopur pm
To: 150 Gonal am / 75 Menopur pm
That drops my 5 injections/day to 4, my tummy is happy about that! I think they are trying to slow down my estradiol level.

I go back for another monitoring visit Sat morning.

I'm feeling pretty good. The bloating kicked in big time yesterday, I look so pregnant! I keep looking at myself in the mirror sideways and get so tickled at the thought.

Tuesday, July 15, 2008

IVF#2 - FSH Day 4 Monitoring

Today was my first monitoring visit and I am pleased with the results.

Right: 5<10
Left: 6<10, 2 micro
Lining: 6mm
E2: 668

They don't give measurements for follies less than 10, but they are in the 8-9mm range. Micros are in the 7mm range. So I have about 13 around the same size!!! My lining is a little thin because I just finished my period, but they said I have plenty of time to catch up. My E2 is high again, but they said not as high as last time. Last time my first mon visit was on day 5, so I have nothing to compare. The RE said she is very pleased with the results and said this is right where they would like to see me on day 4 and feel this is going better than last time. Sounds good to me!

They instructed me to stay on the same dosages and to come in Thur for day 6 monitoring.

Happy, Happy, Happy is all I can say!

Sunday, July 13, 2008

IVF#2 - Oops!

Well I wasn’t planning on giving another update so soon, but I think I hit a vein this morning, or maybe even an organ, lol. I injected my lupron as normal and within a minute I had a large marble sized knot that still hasn’t quite gone down. I was sure I had enough padding to protect all from the needle, I guess I was a little too aggressive. Kerry did say that I was much too excited to be injecting myself. I guess I just lost a precious circle inch of much needed tummy real estate.

Saturday, July 12, 2008

IVF#2 - Stimulation Time

Today starts the stim phase, which means I'll be adding FSH (gonal-f) and LH (menopur) in addition to lupron. This also means 5 injections a day until trigger. My poor stomach has already taken a beating after 9 injections over the last 3 days, and I'm just getting started. I'm afraid I'm going to run out of room by time this is over with. But whatever it takes, I'm game. I'm feeling pretty dizzy and very foggy.

Prep time is a little time consuming with all these different meds and I'm having to double check all my doses as my morning and night doses are different. Not easy to keep track of when you feel all doped up.

These are my night time injections (subtract the middle one and that would be my morning injections):

As weird as it may sound, I’m enjoying the process as it helps me feel that one step closer to becoming a mom.

Friday, July 11, 2008

IVF#2 - Loopy on Lupron

Some of you may remember from IVF#1 that the lupron was killing me, felt like I was walking into a beehive. It didn’t matter if I numbed up with lidocaine for 2 hrs and iced, it still stung. Well, great news, this lupron, which is supposed to be the same exact stuff, doesn’t hurt at all, I might as well be injecting water. The only difference is it’s from Freedom Pharmacy instead of Metro Drugs. I called Freedom and they said it’s diluted with saline and all pharmacies should be compounding the lupron identically. I talked to several people who did microdose lupron and I was the only one complaining about it. I wonder if I got a bad batch last time? Who knows, but I’m happy now. I just did my nightly lupron injection with no numbing, I went au naturel… didn't hurt a bit and I'm feeling quite studly.

So anyway, I can definitely feel the effects of the lupron! I’m woosie and very cloudy headed. A co-worker called and was explaining a situation he needed help with and I had to ask him to repeat everything 3 times as I was in lala land and wasn’t hearing a word he said! I had to force myself to focus. I’m pretty dizzy as well. I take this as a good sign as it must be working. I think dh will be taking my car keys.

On another note, I did get AF this time before starting stims, yeah!

Oh, one more side effect… rambling…

Thursday, July 10, 2008

IVF#2 - Injection Time

It's finally here, injection time, wahooo!!! I never I thought this needle phobic girl would be celebrating getting to inject herself.

This is the microdose lupron that I nick-named the “bee sting” from IVF#1. This will keep me from ovulating all of the eggs prior to retrieving them. I went right for it, it was a piece of cake and didn’t hurt a bit. I did numb up with lidocaine for over 2 hrs, so that might have something to do with it. =)))) I’ll be doing 2 lupron injections a day until trigger. That’s it for now.

Tuesday, July 8, 2008

IVF#2 - Suppression Check

Well... I am completely suppressed!!!

Here's the details:

12mm cyst + 1 micro follicle (boo!)
E2: 23
Lining: 5.8

No cysts + 6-7 micro follicles (yeah!)
E2: 18
Lining: 5.8

They want E2 to be below 50. Micro follicles are potential eggs that will develop once the stims start.

I started spotting red today, so maybe I'll actually get AF this time before starting stims. Last IVF I never got AF and ended up having a 50 day cycle.

The ride takes off this Thur when I start injections. Weeee!

Sunday, July 6, 2008

IVF#2 - Last BCP

Wahoooo... Just took my last BCP!!!!!! I didn't think I would ever get done with those darn "I must eat everything in sight pills". I gained about 5 lbs, booooo!

Suppression check should be Tue, I have to schedule it tomorrow. BCPs always have to end on Sunday with my clinic, so I did 5 more days of it than IVF#1. I hope I'm not oversuppressed. People with high FSH get oversuppressed easily and then the stims have a hard time getting things going again.

The ride is about to start and I'm so excited that I can't stand it. Buckling up...