Thursday, September 25, 2008

IVF#3 - CCRM One Day Workup

Hello Everyone!

We just got back from Denver and what a whirlwind it was!!! Sorry for the late update, but I have been completely wiped out. I don’t know if it was the elevation change (4500 ft higher than home) or a 6 hour non-stop workup with no food/water, but both of us were pooped our entire trip.

My cd3 frozen blood serum made it through security and into the hands of CCRM, hooray! Can you tell I’m proud?

Our workup was Tue @ 8am. This is pulling up to CCRM, Kerry was getting a kick out of how giddy I was.

I guess when you’ve done the amount of research I’ve done on this place, it becomes pretty cool to finally see it in real life. This entire building (3 levels) is all CCRM, no IVF clinic has this size of a building without the success rates to back it up. It was beautiful inside. Here’s me standing by their waterfall.

We started off with the IVF nurse consult. As soon as they called us back, I proudly handed her my serum, mission accomplished! They assign a nurse and want you to build a relationship with them as you will be working with them throughout the entire process. I was hoping and praying to get a nurse that gives details. When my results come in, I don’t want an “everything looks fine”, I want to know my exact numbers etc. I’m anal and analytical and Kerry knows that about me, so he proceeds to tell our nurse Kathy our situation and how stressed out I get if I don’t get details and to please give his wife the details so that he can be spared. She then tells us that we are a perfect match because she’s very detailed and loves to explain everything thoroughly. I love her! We spent so much time gabbing that we got behind and she had to ship us off to our next appt with the business office. Here we basically signed over our entire 2009 income in 5 minutes.

Next they sent Kerry off for a semen analysis and an antisperm antibody test and me off to complete some procedures. I started off with an intra-vaginal ultrasound where she thoroughly looked at my uterus and ovaries. Other than a small cyst on the top of my uterus that wouldn’t affect anything, she said everything looked great. My left ovary was showing a 15mm dominant follicle that will ovulate soon. My antral follicle count was 10-12 total and she said that was really good considering my situation. She then continued with the Doppler blood flow test, still using the intra-vaginal u/s, she finds the uterine arteries and watches the blood flow to my uterus. All I can hear is this loud swooshing sound which was my heart beat. She kept coming up with different readings so she hung out in there for at least 10-15 minutes, I was about to charge admission. It was becoming quite uncomfortable as she moved the wand at different angles, not to mention all the pressure it was creating. I swore if she didn’t get out of there soon, she was going to get a little surprise. They want the readings to be less than 3. My left artery was 2.63 and my right was 3.43. She said it was borderline, I was happy with that. Next was my hysteroscopy with Dr. Schoolcraft. This would be my first time meeting the guy that I have done so much reading about. He was really nice, quiet and humble. The hysteroscopy was by far the worst part of the day, but very quick. He inserted a speculum, cleaned my cervix with iodine, injected some lidocaine, dilated my cervix, injected CO2 gas, inserted the scope, viewed my uterus and did a trial embryo transfer all in no more than 2 mins. I would have loved to seen the look on my face when he said he was all done, $625… 2 mins!!! The pain was a little intense but it was so quick that it wasn’t too bad. He said everything looked great. So which one of us, me or hubby, would you say got the crap end of the deal? You be the judge.

We then went to our regroup with Schoolcraft. It was nice to finally get to talk to him “face to face”. He had no test results at this time other than a great looking uterus, so we unfortunately did not receive the details I wanted like what protocol he would put me on. He did make the observation that I’m a bizarre case, not his words, but he said things didn’t add up with me. My husband could have told him that for free. He said with my high FSH and low ovarian reserve, he’s really surprised by the quantity of eggs that I produce and really surprised by my outrageous estradiol level. I basically have the diagnosis of a poor responder but respond very well. He reiterated a lot of what we discussed in our phone consult so there wasn’t much new stuff said. He did suggest some additional testing back home that I’ll need to complete before I cycle, oh yippee, more tests! He’ll have more answers after he sees all my test results.

We returned to nurse Kathy for our consult part 2. We spent the entire time going through paperwork and signing consent forms. It was a tornado of information and even I was overwhelmed. I cannot even imagine receiving all of this if I’d had not been through this 2 other times. Total info overload, but incredibly thorough.

Our last appt was with the lab to draw blood. They will be testing both of us for Hep B, Hep B Core, Hep C, HIV I&II, RPR (Syphilis) and female antisperm antibodies. We have already passed all this testing from our first IVF, but required to do it again.

Here are the additional tests I need to complete back home:

Blood work: Thyroid, Varicella Zoster (chicken pox), CBC (complete blood count), Fragile X (mental retardation) and a Chromosome Analysis to see if I can produce normal eggs.

Procedures: HSG (inject dye into tubes to make sure open), Mammogram and 8 sessions of electro-acupuncture to improve my uterine blood blow.

I suddenly feel overly compassionate towards lab rats.

Wed we treated ourselves to a vacation day. We went hiking in Red Rocks Park. It was beautiful. They have a natural amphitheater there that was really cool. The increase in elevation totally came into play here. We were so out of breath at the slightest incline, we felt fat and out of shape, great for the ego.

We had to return to CCRM today so that Kerry could give a semen sample for a frozen backup just in case anything would happen like missing his flight during egg retrieval. We then had to scramble to the airport. Kerry went on to Las Vegas for training and I came back home to Nashville. Ahhh, oxygen, I can breathe again!

CCRM called after I returned home and gave me a few of our test results:

Semen Analysis, reference range is in ( )’s:
Volume 3.3 ml
Concentration: 25 mil/ml (>20)
Total Count: 82.5 mil
Motility: 22% (>40%)
Motility Rate: twitch to 1+ (2-3)… this is the biggest problem
Morphology: 2% normal (>4%)

Antisperm Antibodies:
IgG: 44% head, 0% entire, 3% tail, 0% mid
IgA: 7% head, 0% entire, 1% tail, 0% mid
I don’t really know the difference between the G and A antibody, but head is the worst place to have antibodies. They said it was a very good thing that the entire sperm wasn’t covered in antibodies. I guess this adds up to 55% antibodies and they want it below 20%. His last ASA in Sept 2006 showed 64% antibodies, so I guess this is slightly better news. Fortunately IVF bypasses this issue.

CD3 Blood Work:

FSH: 12.1 (less than 10)… this is elevated, but I’m quite happy with it as it was 12.48 8-months ago, so very thrilled it hasn’t gone up!
E2: 26 (less than 50)
AMH: 2.0 (greater than 1.5)… this was a new test for me, it stands for anti-mullerian hormone, it’s a test for ovarian function. The nurse said 2.0 was great and means I will respond well to meds and therefore they can give me gentler dosages… yeah!!!! Guess this explains why I respond so well despite the high FSH. If only my local clinic would have tested me for this, they wouldn’t have put me on a bazooka of a protocol on max stims.

I’ll send out updates as I get in more results. If you’re still reading, I commend you for hanging in.

Wednesday, September 17, 2008


After a much needed break, I’m back! I apologize ahead of time at how long this is.

After extensive research, I’ve made my decision to go with CCRM (Colorado Center for Reproductive Medicine) for IVF#3. This is the #1 rated IVF clinic and lab in the US and has the highest success rates. They say if anyone can get you pregnant, CCRM can. I’m putting them to the challenge. Some of you may think we are crazy for going to this length to conceive, but if you could step into our shoes for just one day and feel the heartache we experience, you would understand.

I had my phone consult with Dr. Schoolcraft on Sep 10. $250 for 26 minutes, yikes!!!! Schoolcraft is known to be a straight shooter, he tells it like it is and doesn’t sugar coat anything. Many girls get the donor egg speech, so I was prepared for that. I think it went really well. He specifically said that he did not believe it was time for donor egg and felt I still had a good chance with my own eggs. *** Asked him to hold so I could do a cartwheel! *** He thinks the reason for my past 2 failures was too aggressive of a protocol and lower lab quality. Their lab really is top notch, I have read so many posts where the girl had multiple failed cycles locally and never had any embryos make it past day 3 (like me) and then went on to have multiple blasts (day 5 embryos) and sometimes even enough to freeze. So it will be interesting to see if they are able to get any blasts out of me. I asked him about my slow dividing and multi-nucleated embryos and he said that while it is possible that I just have poopy eggs, he feels it is probably more to do with the protocol and lab, some labs use too harsh of a culture medium. He couldn’t give me my chance of success until he runs some tests on me, but he thinks I have a good shot.

My next step, which is required for every CCRM patient, is what they call a one-day workup. It’s an entire day of testing for both husband and wife. They are very thorough and are adamant that their lab runs all of the tests. We have already done most of this testing, but have no choice but to repeat it. Our workup is scheduled for Tue, Sept 23rd. We leave the 22nd and come back on the 25th. This will be cycle day 13 for me and since FSH, LH and E2 hormone levels have to be tested on cycle day 3, they have you get that drawn locally after the workup and mail it to them. I decided to be proactive and get it done ahead of time so that it won’t delay me later and I can get my results along with all my other testing. Problem, cd3 fell on a Sat. Talk about jumping through fire burning hoops to get cd3 b/w on a Sat without a script and have the lab let me take the blood without running tests on it!!! But I prevailed! My ob/gyn was willing to do this for me, but they were closed on Sat. I found a paramed company that was willing to come in on a Sat and do it for me, but they didn’t have the right lab supplies. No one else would draw without a script or let me take the blood home. So on that Fri at last minute, my ob/gyn called and offered me the lab supplies if I could get there in 20 mins (it’s a 30 min drive). I hung up and drove like a maniac, praying that I wouldn’t be killed over cd3 b/w! I made it in 19 mins and got the lab supplies, I felt like I had won the lottery. The next day we drove to the lab that so generously did this for us for free. They were to draw 2 vials of blood (my ob/gyn gave us 4 vials just in case) and they drew 4. Thank God we didn’t give them more than 4 vials. We then waited for it to clot, centrifuged it, poured the serum into transfer tubes, put it in a cup of ice and rushed it to our freezer. 3 of the 4 tubes of serum froze within 2 hrs, the 4th very strangely took 24 hrs to freeze. I joked to my husband that they could freeze me and I would live, he said; no, only a fourth of you would live, he’s so funny. So now I just need to get that serum on the plane and kept frozen. I pity the poor TSA officer that gets in my way, that serum is going with me!