Tuesday, December 30, 2008

What's Next - Part 1

What's next? A 3 month break to heal physically/emotionally and counseling with someone who specializes in infertility.

Over the last 3 years, my husband has always commented on how strong I am and how easily I bounce back from incredibly disappointing circumstances, but this last failure has taken a toll on me. I'm struggling with anger and frustration. I have so many questions that have no answers.

Despite my circumstances, I have been very blessed in the area of infertility over the last 3 years. How? Blessed that I am genuinely happy for those who conceived effortlessly and free, thank God they didn't have to endure the trials of infertility. Blessed that I have overwhelming joy when someone announces their pregnancy miracle. Blessed that I love to hear a friend's birth story. Blessed that I am able to serve in the nursery at church. Blessed that I can attend baby showers and children's birthday parties. Blessed that I can stroll through the baby department full of hope and expectation. Blessed at how much I enjoy receiving photos of babies and belly shots. Blessed that I can so easily ignore ignorant comments/advice.

I feel I'm losing a grip in a few of these areas as my fight with infertility continues. It's relentless and I know how fast it can take you down if you let it. I peed on one little evil stick and now all this...

I'm currently unable to attend baby centered gatherings. I don't hold any ill feelings towards the people living my dream, but being in this environment surrounded by the very thing that I can't seem to reach for the life of me hurts too much right now.

I had to temporarily step down from serving in the nursery. I felt it would be best for the parent to not witness my tears while holding their adorable baby.

I can no longer walk through the baby section without tearing up. Will I ever be able to walk through there and actually buy something besides a baby shower gift?

I suddenly struggle with unsolicited comments/advice. My husband keeps telling me to take the good, the encouraging and ignore the rest. I realize that those that have never dealt with infertility truly cannot comprehend but some people say the most hurtful stuff.

Speaking of unsolicited advice, just the other day a lady approached me and said she wanted to talk to me. She went on and on about what an amazing person I am and what an amazing loving person my husband is and how incredibly blessed our marriage is... I was wondering if she was confusing me with someone else, I'm just your average gal. I was just standing there smiling at her, having no clue what she was getting at... Then one sentenance later, the smile had faded. She told me that I should give up on having children because I'm blessed with a great marriage and how she has a really bad marriage and how I should just be thankful for my marriage. She then hugged me and said she just wanted to encourage me. I stood there dumbfounded. Maybe I should have told her that she should give up on her marriage because she's blessed with 2 handsome sons and 5 beautiful grandchildren. I don't know why I let it get to me, I guess because when you're already down, things affect you on a deeper level. She left me questioning myself, am I ungrateful because I want more than a great marriage, that I want a child with this person that I love? Sorry, rabbit trail, moving on...

It truly is a gift to be able to be genuinely happy for those who so easily obtain the very thing that you have been denied, your heart's desire, the thing that consumes your every thought, the thing you would give anything for. I don't want to lose this gift. Without this gift, there's jealousy, hurt, bitterness, anger, loneliness, depression, self destruction and separation. I can't go there, I will not go there, I cannot give this seed a chance to grow. So yes, I'm seeking help. Hi, my name is Jill and I'm a messed up mama-wannabe-aholic.

Tuesday, December 23, 2008

IVF#3 - Post IVF Consult

What happened and what's next? These are the 2 most frequent questions I've received and I'll address the what happened.

My beta was due on a Sun when the labs are closed, so I scheduled it for a Mon. The plan was to not test before the beta. Due to the torture of not knowing and some timing issues, we decided to do a home test after church on Sun. We thought for sure I was pg. We even went to Walmart and bought the digital test.

We each had our own cup of pee (both were my pee) and we each had our own pg test. I had the one with 2 lines and Kerry had the digital. We had the camcorder rolling. We dipped at the same time and just waited for what seemed like an eternity. I knew I would know before Kerry because his had a 3 min hourglass before showing the results. I was watching mine intently, waiting for that elusive 2nd line to appear... waiting... waiting... waiting... sweating... heart racing... you've got to be kidding me, where's the 2nd line???? Kerry's still oblivious watching his hourglass. I dropped mine and leaned over to watch his... tick tock tick tock... "Not Pregnant". Evil pee stick! I think I even heard it laugh at me. We sat there stunned. For the first 10 mins I was really impressed with how well I was handling it. Then a few tears... Then complete hysteria. I don't think I've ever cried that hard in my entire life. I can't believe it, I failed at the #1 clinic, what a blow.

The next day I had to go do my beta. We all know how that turned out. I faxed the results to CCRM. My backup nurse called to give me the results and then asked if I had any questions. I said, is this it? Do I get to talk to the doctor? She said of course and she took my file over to Dr. Schoolcraft.

Schoolcraft called me back within 20 mins, I was very impressed. He said he was sure sorry and that he thought for sure that one of the 3 transferred would take as they were great quality. He said that although it was a funky cycle, he felt it went much better than my previous cycles. He thinks there's an egg/embryo quality issue. I asked him would he do anything differently looking back. He said he would want to do CGH genetic testing on the embryos. He said that when I first came to him he wasn't sure that I would make very many eggs and that's why he didn't recommend it at the time. He feels we need to get the final question answered, are any of the embryos genetically normal. If there are normals, then it's just a matter of getting the recipe right. If there aren't, then it's time for donor eggs/embryos. I asked him if he would lower my stims any to keep my e2 from going so high and he said not initially as I start out fine, but then towards the end it goes crazy, so he would cut the dose down earlier after 4 or 5 days. I asked him if he would keep me on long lupron and he said yes, the only reason to not use it is if you can't get any eggs on it. I addressed my concern of an implantation issue, is it that my uterine environment is unhappy when jacked up on stims, or do I have an implantation issue? He said we would get to test the theory as my snowbaby or a CGH cycle would both be a FET cycle. He said all the standard tests don't point to an implantation issue as my tubes aren't blocked, the hysteroscopy and uterine bloodflow were fine and then all the ultrasounds showed my lining get to the right thickness with a triple pattern. He said the bigger arrow is pointing at egg quality issues as the embyos have struggled on all 3 cycles. He said if I wanted to unturn all stones, I could do the endometrial biopsy checking for the beta 3 integrin protein that assists implantation. The majority of patients missing this protein have blocked tubes or endometriosis. I've never been tested for endo, but I don't think I have it. We discussed natural vs medicated FET cycles and he said with me being in TN, it would be much better to do medicated as we would know the transfer date a month in advance vs 4 days. I asked if you take the planning aspect out of it, is one better than the other? He said they are about the same, but still recommended medicated and said it would be better to not chance that the cycle you go to do the FET your cycle hiccups and your hormones are out of pattern. He then said the other thing I could consider would be to do the CGH cycle first and then combine the embryos and have a better chance as we would have more to transfer. I asked if he felt confident that I would be able to get some blasts for genetic testing and he said yes, that if they would have cultured my 4 best embyros instead of just 1 (we transferred 3), he feels we would have had 2 or 3 blasts. I asked if he would test the embryo I already have frozen and he said no because he wouldn't want to put it through another thaw and refreeze.

For you CGH gals that are getting no results back, I did ask him what's that all about and he said they only remove 1 or 2 cells from the embryo and they have to amplify/copy the DNA about a million times to have enough DNA to analyze and if the reaction doesn't produce enough, the signal isn't clear. So the lab states that the signal wasn't clear and there just wasn't enough DNA and they don't feel comfortable saying if the embryo is normal/abnormal. He said he gives the patient the option if they want to transfer the no-result embryo.

I'll address what's next in my next post.

Sunday, December 21, 2008

I Want To See Miracles

Today was a challenge at church. It was the last week of the series on miracles. I followed the series intently as that's what it's going to take for me to become a mom, a miracle. During worship, we sang a powerful song that goes "I want to see miracles, I want to see the hand of God...". I stood there chanting to myself "don't cry, don't cry, keep it together". Well you know how that goes, the harder you try not to, the worse it gets. Eventally I lost and the floodgates burst. We were in the 2nd row, so there was no hiding. The tears rolled practically the entire service. The ending message was about not giving up and not being denied your miracle. So I left with 2 choices, defeat or to not be denied. I won't be denied!

Monday, December 15, 2008

IVF#3 - Beta

Negative, Not Pregnant!

Sunday, December 14, 2008

IVF#3 - Results

Emotionally, mentally, financially broken....

Saturday, December 13, 2008

IVF#3 - More 2ww Torture

Yesterday was horrible, I cried way too many times and was just convinced it was over for me. I told Kerry (who is out of town) that I was going to test in the morning and get the grieving over with. He begged me not to test while he's gone, but I was determined, I couldn't take it anymore. I woke up at 4am and peed in a cup and then went back to bed. I woke up again at 6:30a, temped and put in my next suppository. As soon as I saw my temp go back up and the fact that I have made it without any spotting/bleeding past the days I had started in my previous IVFs, I found new hope. I decided to not test.

Being on vaginal suppositories 3x/day, I have lots of leakage. I had to close all my blinds around the house because every time I felt any leakage, I stopped right there, dropped the drawers and took a peek to make sure it was white and not pink/red.

Kerry just texted me to see how I was doing today and said he got all choked up when he was telling some female co-workers how this just has to work and can't bare me going through another failure. Then he asked me to please not test without him. Gosh, I'm so blessed to have him. I just can't test without him. I'll see if I can talk him into testing together Sunday AFTER I work the nursery.

This will be our child:

Friday, December 12, 2008

IVF#3 - 2ww Blues

I'm feeling down today. My chart isn't looking so amazing and I just don't feel pg. I am so freakin scared. No, I haven't tested at all. Too scared. I think I would have caved if I had ever got that overwhelming feeling that I was pg. I thought about testing this morning, but can't because I have my annual review today, didn't think it would go over too well to be sobbing during that. I have a Christmas party to attend Sat and it's my turn to work the nursery Sun at church. So I just can't face a negative and be able to hold it together for any of these events. Maybe I'll test after church Sun, no one to face then.

Going by my last 2 IVFs, I would have started bleeding by today... so I'll be toilet paper watching all day. I think I'll lose it if I see red again.

Thursday, December 11, 2008

IVF#3 - No Symptoms

I'm feeling NOTHING! I have no clue which way this will go. I still have high hopes, but I know how devastating it's going to be if this fails a 3rd time, so I'm really dreading the beta.

Monday, December 8, 2008

IVF#3 - Snow Baby

I can't believe I have a whole week to go till beta, torture I tell ya!!!! I've been frustrated because I've been feeling great, but within the last hour I've been feeling mildly crampy, wahoo!

I just called the lab regarding my remaining embryos and I had one PERFECT day 6 embryo frozen!!!!!!!!!!!!!! I now have a backup or a future sibling!!!

For those that like the details...

This embryo came from the first batch, nothing made it from the second batch. Here's the stats on this embryo:
Day 2: 3-cell grade 4-
Day 3: 6-cell grade 4-
Day 5: early blast
Day 6: 4AA blast

The 4 is the development stage of the blast, which in this case is the stage right before it hatches out of its shell. The first A is the grade of the inner cells that will become the fetus. The second A is the grade of the outer cells that will become the placenta.

OMG, I am so excited I don't quite know what to do with myself!!!! I finally got a blast!!!!!!! This gives me even more hope for the embryos that are inside me since they were the best of the bunch!

They also used the new vitrification process instead of cryopreservation which has a near 100% thaw success rate.

I did have one other blast but they discarded it because it was 4BC. =(

AHHHHHHHHHH, someone just knock me out already, I'm too happy!!!

Thursday, December 4, 2008

IVF#3 - Photos

The triplets and I are doing well, but we're getting pretty bored stuck here on bedrest. We though we would share a few more photos from our trip here.

Feeding the squirrels at The Broadmoor, Colorado Springs:

Pike's Peak, Colorado Springs:

Garden of the Gods, Colorado Springs:

Kerry made me a snow belly:

Wednesday, December 3, 2008

IVF#3 - Day 3 Transfer

Sorry for the late update, we had to scramble to find some flights back home for this Fri.

I had my day 3 transfer today and all went well! I'm currently carrying TRIPLETS!!!!

Here's the details if anyone is interested...

I had b/w an hour prior to the transfer. They want your E2 to be > 1000, mine was 1670, so all good there.

I was admitted to the transfer room where I put on a gown and was given a Valium (oh la la!). The sonogragher came in and did an u/s on my belly to make sure my bladder was full. It was very full so they gave me a cup and told me how much I could let out. That was a relief. I went back to my room and layed down, felt a little dizzy and fell sound asleep. The sonogragher came in and checked my bladder again and said all was ready to go.

Dr. Schoolcraft came in to do the transfer. We were expecting the embryologist first to give us our embryo report. So at this point we still had no clue what we even had left. He said we had 3 great embryos he'd like to transfer but he needed to know that we were ok with the risk of triplets or twins. He also gave us the option of transferring just 2 or changing our transfer to a day 5 to see which embryos were the best, but that carried a risk of nothing making it. As much as I wanted a day 5 transfer, I just couldn't take that risk that nothing would be left and then I would have no chance. Our heads were spinning and he pretty much wanted an answer on the spot. Since we transferred 4 last time and ended up with nothing, we decided to just go for it and transfer the 3. Multiples may be scary, but not as scary as going home with nothing. He said there was a less than 10% chance of triplets and 20% chance of twins. Just the fact that we have a risk of multiples made us excited because that must mean we have a good chance of having one.

The embryologist came in wheeling in this huge incubator. There was a monitor on top showing our 3 embabies. Kerry took a picture of them but with the screen being out of focus and then not being able to use a flash, the photo isn't very clear, but at least we have a photo of them.

The embryologist loaded up the embryos, the sonogragher had my uterus on the screen and Schoolcraft threaded the catheter through my cervix. Within a min, it was done. I had to lay there for an hour and now I'm back at the hotel on 48 hrs of bedrest. Kerry has been taking great care of me, he's such an awesome husband!

Here are the embryo details:

CCRM grades their embryos on a scale of 1- to 4 with 4 being perfect. 4- would be less than 10% fragmentation.
Batch 1 (3 day old embryos, should be 4-8 cells):
Embryo 01: 9 Cells, Grade 4-, Transferred
Embryo 02: 8 Cells, Grade 4-, Transferred
Embryo 03: 6 Cells, Grade 4-, Transferred
Embryo 04: 6 Cells, Grade 4-
Embryo 05: 6 Cells, Grade 4-
Embryo 06: 4 Cells, Grade 4-
Embryo 07: 4 Cells, Grade 3 uneven
Embryo 08: 3 Cells, Grade 3

Batch 2 (2 day old late bloomers, should be 2-4 cells):
Embryo 09: 6 Cells, Grade 4 uneven
Embryo 10: 4 Cells, Grade 4-
Embryo 11: 2 Cells, Grade 4-
Embryo 12: 2 Cells, Grade 4-

OMG, I can't believe I had 12 still going in culture. I'm praying for a couple of snow babies as a backup or for a future sibling. Schoolcraft said not to hold my breath, but that it's not impossible. We will get a call Sun/Mon letting us know if any made it to freeze.

Gosh, I just really feel like this is going to work this time!!!

Here's my trips (they don't appear perfect to me, but CCRM said they were, so I'll trust them)

Tuesday, December 2, 2008

IVF#3 - Day 2 Embryo Report

I'm still bloated but getting better each day. I've eaten half of the salt provided in our room. This is pretty much how you can picture me in my room every day.

Ok, now onto the news you really want, day 2 embryo report!!!

As a recap, we had 13 mature on day 0 and 3 more that matured on day 1. I got better news, when they went to icsi the 3 late bloomers at noon, they found that 3 more had matured for a total of 6!!! 4 of the 6 fertilized normally!!! This also means that Kerry's boys survived in culture overnight! So that bumps our total mature up to 19 out of 23 and our fertilized from 7 to 11!!! Thank you God and the CCRM lab!!!

Then the embryologist asked if I'd like to hear the progress on my original 7 that fertilized. I lucked out as they don't normally give day 2 results. She said that they expect embryos to be between 2 and 4 cells today and that all 7 are progressing normally. I about fell over. Here are the details:

1 @ 4-cells, 2 @ 3-cells, 4 @ 2-cells

So definitely not perfect as they much prefer them to be at 4 cells by now, but there is still time to catch up and they could divide into 4 at any moment. I've never had anything over 2-cells on day 2, so I'm thrilled. We have already declared the 4-cell as our take home souvenir.

As far as quality, they don't grade them at this point, but she did say that all have less than 10% fragmentation, no vacuoles and no multinucleation. Yeah!!!

I have b/w tomorrow at noon to make sure my e2 is at the right level for transfer. My day 3 transfer is scheduled at 1p. I won't hear another update until then unless they find that my embryos are doing really well and decide to push me to day 5. I'm still holding out hope for a day 5 transfer.

Monday, December 1, 2008

IVF#3 - Fertilization Report

Some quick terminology for the family:
OHSS - ovarian hyper-stimulation syndrome
ICSI - Intra cytoplasmic sperm injection
SA - semen analysis
U/S - ultrasound
B/W - blood work
Multinucleated - each embryo cell should have 2 nuclei, one from each parent, multinucleated means there is more than one pair which is abnormal.

Last night was a little nerve racking as I bloated up to the appearance of 6 months pg and was having lots of sharp pains. I literally had to waddle. I showed Kerry my belly and he said "Good God! Are you going to be ok?". I listened to the nurses and ate tons of salt and protein and drank tons of electrolyte enhanced water. A normal blood pressure is 120/80, but I have a very low bp of 100/60, that's just what's normal for me. With all of this salt intake, I told Kerry maybe I'll get up to a normal bp.

I woke up feeling much better and about 80% of the bloating went down, the salt worked!!! I told the nurse that I thought salt caused you to retain water, but she said it works in the opposite manner with it comes to OHSS. OHSS causes all the fluid in your organs to seep out into your abdominal cavity causing the organs to be dehydrated, I guess the salt causes your organs to retain their fluid.

I had my u/s this morning to check for fluid. They did find some fluid around my uterus, but not enough to compromise my cycle. Thankfully all other organs like the lungs and liver were free of fluid build up. Yeah!!! I have to keep up the salt/water intake to keep OHSS at bay.

The embryologist called with my report. Here's the results including my previous cycles:

Retrieved: 10
Mature: 4
Fertilized: 2

Retrieved: 19
Mature: 12
Fertilized: 4 + 4 late (7 are multinucleated, so only 1 is normal)

Retrieved: 23
Mature: 13 + 3 more today (will rescue-isci today at noon)
Fertilized: 7 (waiting to see if the 3 above will fertilize)

So as of right now we've dropped from 23 to 7, so it's a little sad, but it's still the best we've ever had, so it's also exciting. I can't tell you how nice it was to be able to get off that fert call and not be in tears!

Kerry's SA results:
Volume: 1.8ml
Count: 23mil/ml, 41.4 mil total
Motility: 5%
Motility Rate: 3 (1 being twitching to 3+ being fast)
Total Motile: 2.07 mil
OMG!!!! We have NEVER had progressive motility out of the 12 SAs he's had done!!! They said they were moving really fast, this is a total answered prayer!

Now we sit and do some more waiting. Tomorrow we find out if the 3 that matured late fertilize. We won't get a division report until day 3, but I'm hoping I can get some info out of them when they call in the morning. Division is where we have lost practically all of our embies, so say an extra prayer for us for our day 3 report.