Tuesday, March 31, 2009

And the count came down again today ...

I was a little disappointed with today's appointment ... though I'm trying to take each day in stride, remembering what a very dear friend's recently passed father-in -law said on his death bed, regarding his unexpected and quick fight with lung cancer ... I'm just riding on the back of the bike. (Meaning: God is in control and I'm just along for the ride, I can't control this!)

This morning my scan showed very little progress with the follies. Well, actually, I think it was good progress ... the largest follie only increased .03 cm yet the smallest increased .12cm and the medium sized ones all increased nearly as much. So it seems as if the progress yesterday allowed the follicles to be more uniform.

I asked the nurse how many eggs she thinks we'll get at retrieval and her guess was 6-8. So again, just more encouragement to do the fresh cycle. She also said that she thinks retrieval will be on Friday or likely Saturday. This evening is the first night that they've adjusted my meds, I'll go from taking 150iu Follistim (as I have each night since stims started) to this evening taking 225iu. I go back in the morning for another monitoring appointment.

I said good bye to my mom this afternoon and sent her on a plane home - she wanted to fly out in sunny weather and she wanted to make sure to be home by Saturday for my aunt's funeral ... so today it was. I get to pick Berilac up at the airport late this evening. I miss him so much, I can't wait to see him!

Although I don't know how this cycle will end, I do know that I really appreciate the hardwork of my nurse, the professionalism of this clinic, and overall the experience of working with the "experts" rather than the monkeys (from the monkey shop clinic ;-).

Stay tuned for more exciting cycle updates ... until then, I'm just holding onto the back of the bike, enjoying the wind in my face.


Providing Estrogen levels and the like (for anniep and others interested):

Sat 3/28: ~13 follies
E2: 431
P4: 0.2
LH: 0.8

Sun 3/29: No appointment

Mon 3/30: ~11 follies
E2: 865
P4: 0.2
LH: 0.5

Tues 3/31: ~8 follies
E2: 1192
P4: 0.2
LH: 0.9

Monday, March 30, 2009

Steady progress

Things are coming along.

So before I headed out to Colorado I was being monitored locally, they measured 15 follicles. Then on Saturday at my first CCRM appt the count was 13. Today the tech didn't want to get my hopes up - and they measured 11 follies from ~1.0 to 1.8.

My original schedule showed a Friday retrieval, but since they started my antagonist 2 days early, we thought maybe my retrieval would be 2 days early. Well, I didn't get instructed to trigger tonight so it's at least Thursday or later ...

I'm not sure how many to expect, but if quantity isn't going to happen, I will surely be praying for quality!

Berilac and I are nudging our way closer and closer to deciding to do a fresh cycle. Please continue praying for us - for peace and of course for the blessing of children.

Saturday, March 28, 2009

Safe in Denver

On Thursday, Denver encounter a blizzard - the largest it's seen since 2007. There were many incoming and outgoing flights cancelled and the roadways were horrendous. My mom and I were supposed to fly in yesterday morning on a 6:30A flight, but it got cancelled and the airline could only reschedule us for a late night Saturday flight ... which wouldn't cut it since my first appointment at CCRM was Saturday morning! So we switched airlines and they got us on the 2P flight yesterday. We landed into a very serene Denver International Airport - after hearing how bad the conditions were on Thursday, we were both relieved at the landing conditions!

And, the house we are staying at ... IS AWESOME!! We are blessed to be able to stay with Daisy's parents! We have 1800 square feet to ourselves ... and yes, that's larger than my California rental. And gorgeous to boot ... wowza!

So how is the cycle going thus far?
Local monitoring Thurs 3/26:
Lining: 5.5mm;
5 follies near 10mm, 5 follies near 6mm, 5 smaller follies

CCRM monitoring Sat 3/28:
Lining: 9.0mm;
6 follies near 12mm, 7 smaller follies.

The nurse suggested I would likely start Ganirelix tonight. And I should learn my new dosing this afternoon. I have my next appointment early tomorrow morning.

I asked the nurse when she thought we'd get more information on how many eggs they anticipate at retrieval and she said Monday or Tuesday. If there are fewer eggs I'm really tempted to do a fresh cycle. With these results - it seems to me as if we'll get 6+.

I am praying for some good quality eggs this time around.

There are other things going on in my life these days as well. DH's company just had two back to back furlough situations, totaling 16 weeks forced unpaid leave for 20% of the company (luckily Berilac was not chosen to go on furlough) however the remaining 80% of the staff will take a 10% pay cut. So we will soon be getting 10% less each month AND the company has stopped paying for his master's degree program. In more disturbing and painful news - my aunt committed suicide this past week. Her funeral will be next Saturday 4/4, but I'm not slated to leave Colorado until 4/5 or even 4/12 if we do the fresh cycle. My mom and I are here in Colorado and we are trying to learn the details of her death while catching up with long lost relatives and grieving the loss. My mom is very sad to have lost her sister, especially in this way. And I wasn't too close to my aunt, but still I have a lot of emotions to process.

As if cycling at an out of state clinic isn't enough to have on your plate. It's going to be an interesting week.

Friday, March 20, 2009

ER day: Option to convert to fresh? ... DENIED

I just had a consult with Schooly where I asked him what he thought of us converting to fresh if we only get a handful of mature eggs at retrieval ... he said he thinks he could do a fresh cycle and we would get pregnant ... but he thinks we'd likely miscarry.

I explained to him that I'm concerned that the technology might ruin the eggs (and thus cause the demise of our embies) like it did in our last failure of a cycle and he said that he didn't think it would. He said that if we had just 1 embryo, he'd suggest we move forward with the PBB/CGH genetic testing.

I suggested to him that it seemed that he had better results on fresh cycles than they do on the PBB/CGH cycles so why would anyone opt to do PBB/CGH when they could do fresh? ...

FRESH CYCLES : 2007 SART reports indicate that 40 year olds cycling at CCRM have a 50% chance at clinical pregnancy.

CGH/PBB CYCLES: this group is on average 40 years old and CCRM is reporting a 22% clinical pregnancy rate.


Edited to add: 22% success is for PBB/CGH not blastocyst CGH (which has an 84% success rate). These stats are of clinical pregnancy rate and not live birth rate b/c they do not have live birth numbers for this new PBB/CGH technology.

Schooly indicated that you can't compare these two groups. 40 year olds who do PBB/CGH are women who probably should be using donor eggs where as the women who do the fresh cycles aren't at the stage where they need donor eggs yet.

I asked him what his success rate was for pregnancies from frozen oocytes (as this is likely the MOST delicate procedure that could harm the eggs) and he said that their pregnancy rate is the same from vitrified oocytes as it is with fresh oocytes ... the same.

Lastly, he said he wasn't even sure why we were asking this question. He really doesn't anticipate that we will yield a low mature oocyte count. Dr. Schoolcraft said he was confident we would get a lot of eggs - I told him that I'd rather operate in the realities of my life ... get that? Me, I was the one being all stern with bad bedside manners and HE was the one all emotional and optimistic! (This is funny for anyone who's spoken with or met Dr. Schoolcraft ... he's not exactly warm and fuzzy.)

So Berilac and I have until trigger day to decide which technology we will use ... straight fresh IVF or PBB/CGH while vitrifying oocytes.

Tuesday, March 17, 2009

CCRM Cycle #1 - Starting shots

Today is a big day. And comically enough, I almost accidentally made yesterday the big day. There I was in my dining room, tummy swabbed, Ganirelix pre-filled syringe all cocked and ready to plunge when I thought ... now how much of this am I supposed to take? Turns out I'm supposed to take the whole thing ... but not until TONIGHT!! Dur!!

Happy St. Paddy's day folks! Too bad I'm not Irish (Polly McGamwich :-) and can claim the luck O'the Irish!!!

So, I finished my antibiotics. At CCRM I am doing the EPP/Antagonist protocol (the Antagonist protocol with estrogen priming during the previous luteal phase). I started estrodiol pills 2x daily yesterday and I will take those until AF. I have been taking prometrium 2x daily since ovulation to keep AF at bay. Last night was my last dose, so AF should arrive on Friday. Once AF arrives on Friday, I go in for my local monitoring (baseline ultrasound) on Saturday. Tonight I start 1 of 3 nightly Ganirelix shots. When AF arrives - that sets the cycle dates and I can buy our plane tickets. If all goes according to schedule, I start stims on Sunday morning.

Unfortunately, Berilac can't join me in Denver the whole time from 3/26 to 4/5. So I've asked one of my parents to come. My mom will be joining me from 3/26 to 3/31. And Berilac will fly in the night before ER (likely 4/1). I am SOOOO incredibly grateful to Daisy's parents who are graciously and generously putting the three of us up from 3/26 to 4/3ish. Then we will spend the weekend of 4/4-4/5 with Berilac's aunt!

As I mentioned in my last post - the plan for this cycle is to do the stimulation and retrieval and wait 6-8 weeks for genetic test results on the eggs. However, I have asked CCRM that if we only get 6 or fewer mature eggs at ER, can we convert to a fresh cycle? My thinking was that if we get 6 or fewer "testable" eggs then the numbers are so small it's not worth going to genetic testing. We would be lucky if 6 mature eggs yielded a 75-80% fertilization rate (4-5 embryos) and we would be lucky to expect a 50% blastocyst growth rate - so only 2-3 would make it to day 5. I am comfortable transferring 2-3 blasts (and I think it would be highly unlikely to GET 2-3 blasts from 6 eggs) ... but I know for certain I would feel regretful (as I did with the monkey clinic) ... if we could assume at least 1 egg was normal from a handful of eggs retrieved and rather than fertilizing the few we have, to lose all of them because of a sensitive testing and freezing process ... would again be so devastating. If I had more eggs to work with, it wouldn't be so scary.

So if CCRM is in agreement, there is a chance this could turn into a fresh cycle. And if that is the case, I would pray for a 5 day transfer and return home around 4/9 ish rather than 4/5. So really, if CCRM is ok with this plan, then I'm in a win-win situation! Here's hoping they can accommodate me.

I feel so informative in these last couple of posts, so lack luster. Honestly, I am excited to be going to CCRM now, getting my monetary savings, getting CCRM behind me sooner rather than later. I know that CCRM is an amazing clinic - and likely one of the very best, but I'm not thinking that this is our meal ticket. I'm just going through the motions, glad to be moving forward. I'm a little indifferent about the outcome, I'm just grateful that I have this opportunity. I guess a good phrase for my current situation is comfortably numb. I'm not doomsday and dark about the experience, I'm not scared. I'm just doing the next right thing. I am hopeful that we can do a fresh cycle, so we can go to transfer and leave Colorado ... not having to come back. I want CCRM behind me. Is that strange?

There were SO MANY expectations on my transfer in January. I guess that's what you get when you look forward to something and build it up for a year. In retrospect, I wouldn't have set myself up like that! (Heck, maybe that's why I'm numb going into this?) I would have had lower expectations. It's a safety mechanism I guess.

All said, I've got a lot of peace right now. I have been avoiding blogging and obsessive message board activity because life has been more interesting. I have spent the last couple of months enjoying my work, getting into a couple of good TV series on DVD, and just enjoying life. Friends have even mentioned a change in my demeanor. So I guess all the wound licking and catching my breath has served me well. I am grateful to God for this respite and I look forward to seeing what He does in the upcoming ... weeks, months, and years.

As for now ... let's get this party started!!

Monday, March 9, 2009

All systems go ...

I'm sorry I've been so quiet lately. As many of you know, when you get kicked in the gut, you usually stay down for a bit to recover your breath ... looks like it's taken me 6 weeks to catch it.


Well, if all goes according to plan, I will be cycling in Colorado in less than 3 weeks.

I have hesitated to post any updates as things have been so fluid, not knowing if we were going to head to Colorado this month, next month, or if we'd have to wait until May. If AF stays at bay until 3/20 (I'm on Prog supps, 400mg/day) then all should go smoothly.

I head out to Colorado on 3/26, with an estimated retrieval date of 4/2. I will stay through until 4/5. This cycle will be similar to the last cycle: we will retrieve eggs, biopsy them, vitrify them, send the biopsied portion off to another lab for genetic testing, then in 6-8 weeks when we get the results we will only fertilize the eggs that prove "normal" in genetic competency. It looks like our next attempt at pregnancy will be end of May/beginning of June. You ask why would I attempt again what just resulted in a huge embarrassing failure back in January? Read more to find out ...

Ok, it's been awhile ... let me catch you up:

1. Planned a February injects cycle at local University clinic: The second I found out about our negative beta, I called the local University Clinic and asked them if I could cycle there (if you remember they consulted for me back in October). I knew that CCRM would make me wait until an LH surge, but I knew the University clinic (NOT the monkey clinic) would allow me to do an injects cycle at AF. I could not stand the idea of waiting one more month (when we'd waited nearly 12) to execute our last attempt at pregnancy (we waited from Feb 2008 to Jan 2009 to do an embryo transfer ... the patience that took was outstanding). I even set up a new cycle at the University clinic before doing a cycle post mortem with the monkey clinic or a consult with Dr. Schoolcraft to see what he thought of the whole January fiasco.

2. Had a consult with Dr. Schoolcraft: I scheduled a consult with Dr. Schoolcraft - a cycle review if you will (of a cycle at another clinic! How ballsy was that?) to review what happened during the January cycle. If you remember, we had our three best eggs fertilized with our 3 best sperm and we had two embryos that arrested at 24 hours and the third that was getting a failing grade by day 3. Dr. Schoolcraft basically said - he thinks the January failure was caused by a lab error. He said it did not make sense that a girl who has gotten pregnant four times (note: embryos have gotten to the blast stage in all four natural attempts at pregnancy) should have her best embryos arrest at day 1. Makey-no-sensy. He said that there are many points of breakdown and considering how consistent the results were - he believes that something broke. I asked the big scary question: "will you still cycle me?" he said "absolutely, the January cycle does not detour him in any way, and I shouldn't let it discourage me" ... that's what he said verbatim. It was at that time that I cancelled the aforementioned local University clinic injects cycle and decided to wait until LH surge for a CCRM cycle.

3. Failed cycle "post-mortem" with monkey clinic: So what do you think they blamed the failure of the cycle on? If you said "Polly," you're correct. The bastard blamed it on me. Can you believe this? The afternoon of the first negative pregnancy test I asked how to wean off of the Dexamethazone (as my WBC on my CBC were going up and Dex can cover over an infection). They told me that I couldn't wean and I needed to continue the meds until the second [NEGATIVE] pregnancy test - as it could turn into a positive test ... um, yeah, I'm smarter than that. So I told them that I skipped a dose of Dex between the first and second negative pregnancy tests and they said that we'll never know if that caused the lack of pregnancy. (Meanwhile: they've told me MANY times that they give enough drugs that if a girl accidentally forgets to take 1 of them 1 day - that it won't adversely affect the cycle ... but I guess not in this case). Liars. They had us retake our AMH, as I didn't share with them my CCRM values (they think it's been 3/08: 1.0, 11/08: 4.2). They think that we should do the ridiculous poor responder protocol, which we've failed at twice over now ... unless my AMH stays elevated. Then, in that case, they will reconsider a new plan. Whatev, I'm moving on.

4. Waiting for my LH surge to schedule CCRM trip: So considering that the cycle following a failed FET should be similar to a "normal" cycle, I should have surged on 2/12 and was planning on going to Denver around 3/2. Well, come 3/2, I still hadn't even LH surged (ovulated) ... so I finally did (but that lined up with a schedule in Denver that I couldn't make) so eventually, I asked to be put on Prog supps, which extends out luteal phase - which in turn allowed me to get a CCRM schedule that works for me.

So we're all systems go ... unless we hear from AF.

In my next posts perhaps I'll bring you up to date on the emotional and spiritual aspects of these last 6 weeks ... I'm still catching my breath.