We are praising the Lord for this healthy baby!
Tuesday, August 18, 2009
Tuesday, August 11, 2009
In preparation for the call, I wrote out a ton of questions to pose to Dr. Schoolcraft and prior to the call reviewed them with Berilac:
- We transferred 3 embryos, what was the quality/grade of the remaining 7?
- What was the quality/grading of the remaining 7 on day 5/6?
- What was the overall quality of our eggs/embryos (anything look off/odd/weird)?
- The previous diagnosis you gave us was "egg quality," after completing a cycle with us, is it the same?
- This was my first fresh cycle, and it was successful, are we really a "tough case"?
- Yes we have a child that has made it this far into pregnancy, but some RE's don't consider that a successful cycle, was this a successful stimulation and cycle to you?
- What would you change about our protocol?
- My mom had early menopause at age 36, we don't feel like we should wait to TTC#2, how soon after giving birth can we take CD3 blood work to see where my AMH and FSH are at?
- How soon after birth can we cycle? How do we take breastfeeding weaning into consideration for the timing?
- How soon after a miscarriage can we cycle?
Then the call came, and like I said, I nervously dialed Berilac. I successfully got both men on the line and thanked Schooly for his involvement in our successful cycle, but that, before we forget, we wanted to know how he thought the cycle went down.
So I started with my first question:
- We transferred 3 embryos, what was the quality/grade of the remaining 7?
And I was SHOCKED at the result:
- 1. 8-cell, grade 4 (transferred)
- 2. 8-cell, grade 3 (transferred)
- 3. 6-cell, grade 3+ (transferred)
- 4. 5-cell ... poor fragmentation
- 5. 2-cell
- 6. 4-cell
- 7. 4-cell
- 8. 2-cell
- 9. 4-cell
- 10. 2-cell
I am shocked because the remaining 7 embryos ... were such bad quality, they weren't even graded on quality ... they were developmentally too far behind to get a grading (or he didn't tell us what they were) ... he did mention that the 5-cell had a lot of fragmentation :-( ... with each cell count he told us about I felt the breath go out of my chest. The feeling reminded me of infertility's heart ache and isolation.
At that point, a couple of my other questions went out the window ... did I need to ask what our overall embryo quality was at this point? No. Was this considered a successful cycle? I'd surely say No. So I modified the questions a bit, and below, I'll provide his answers:
2. What was the quality/grading of the remaining 7 on day 5/6?
None of the 7 remaining embryos made it to day 5 or day 6 - they ALL arrested prior to day 5, which is what he would have expected on day 3 ... hence the day 3 transfer. Ouch.
3. What was the overall quality of our eggs? (anything look off/odd/weird)? I didn't ask about the embryo quality b/c I thought that was obvious.
He indicated that look of the egg - graininess or darkness, really doesn't tell much about quality, he's had some weird looking eggs make beautiful embryos and vice versa.
4. The previous diagnosis you gave us was "egg quality issues," after completing a cycle with us, is our diagnosis the same?
Yes, he'd agree that it's the same, but we can't lose sight of the Sperm DNA fragmentation issues. But he believes that the overall problem is with the eggs. He would generically classify us as having an "egg issue."
5. This was my first fresh cycle, and it was successful, are we really a "tough case"?
I reminded him that this was my first real fresh cycle, so were we really "tough" enough to require cycling at CCRM? ... Basically I was asking him if I could cycle locally next time. I truly wondered if I brought out too big of guns by using CCRM and their lab and he said we are a tough case (even in his experience) and we are very fortunate that the cycle was successful.
I think this is where I was really shocked. After 4 miscarriages ... I could (even then) still tell myself that perhaps those 4 miscarriages were flukes ... and perhaps the monkey clinic in Sacramento caused the problems from the first two retrievals and the CGH vitrified oocytes transfer back in January ... but the results of the remaining 7 embryos and Schooly's affirmation that we ARE a tough case really threw me in a tailspin. I guess I was hopeful that somehow we'd been living in a nightmare these past 3 years and that we'd learn today that it was all just a bad dream ... but no, we really DO have fertility problems. I know, I know, many of you are like DUH POLLY ... but I've had ladies who have said to me, they just think I've been unlucky and that really I'm a better case than we think (because we've gotten pregnant so many times on our own) ... but really, this paints a picture of poor fertility - no matter how you dice it. Given that there is a baby in my belly, I really was optimistic that things would look different. This was just so unexpected.
6. Yes we have a child that has made it this far into pregnancy, but some RE's don't consider that a successful cycle, was this a successful stimulation and cycle to you?
I didn't even bother with this question ... for obvious reasons.
7. What would you change about our protocol?
Dr. Schoolcraft said that since I got about 5 eggs from each of my previous retrievals, and was able to generate 14 eggs with CCRM's EPP/Antagonist protocol ... he didn't think there was anything he would change about that.
8. My mom stopped having menses at age 36, we don't feel like we should wait to TTC#2, how soon after giving birth can we take CD3 blood work to see where my AMH and FSH are at?
He indicated that six months after birth is when the mom's hormones get back to normal.
9. How soon after birth can we cycle? How do we take breastfeeding weaning into consideration for the timing?
He indicated that six months would be the earliest time to cycle again and that we'd want to wean from breastfeeding at four months and then take two months off before starting a cycle at the six month point.
10. How soon after a miscarriage can we cycle?
I told him that we'd been considering possibly trying naturally one time before considering treatments again to TTC#2 and I indicated that there is a high likelihood that it will be another miscarriage, I asked him how long we'd have to wait after a miscarriage to cycle again, and the answer is two months.So there you have it. All the details from the call. Where does this leave me? Incredibly grateful for the 'one little engine that could' in my belly. Grateful that I waited until after the first trimester, the genetic screening ultrasound and blood work, and after the 20 week level II ultrasound ... before hearing this news.
You are probably wondering if we're really considering treatments for #2 when we're only 1/2 way pregnant with #1 ... and the answer is yes. We're not getting serious about anything, but we do want to know our options.
I'm glad we had the call. I'm just not happy to hear the results.
Friday, August 7, 2009
Thursday, August 6, 2009
During this successful pregnancy, since many folks in real life have known about our struggles, reasonably, they ask if it was a treatment cycle that worked ... and I'm grateful to be able to tell them that we were fortunate enough to be able to cycle at the best clinic in the country.
There's one more reason CCRM has been on my mind lately ... I remember when we were going back and forth with Schoolie as to whether or not doing a fresh cycle or doing a PBB CGH frozen FET would be our best bet and he said "Sure, we can get you pregnant on a fresh cycle, but I'm pretty sure you'll just miscarry again" ... well, we prayed about it and felt like trying the fresh cycle was the way to go. When Schoolie said those words to me I thought 'man, I hope we can prove you wrong!'
On 3 days past transfer, when we got the call that 'today will be the transfer day' I asked many a question about embryo quality, but my questions went unanswered. I have to think that things weren't going as well as they'd like (hence the day 3 transfer) and so in an effort to keep me optimistic they didn't share the information. Looking back, I'm grateful for that too! You see, I waited to schedule this regroup with Schoolie until AFTER the making it out of the first trimester, until AFTER getting good genetic screening results, until AFTER the big 20 week ultrasound ... so that I could feel confident about this pregnancy and not get discouraged if he were to tell me that my embryo quality was crap ... I think that if he said that, it might make me insecure about the health of the baby growing inside of me. And so we've waited.
So now, here we sit, 5 days away from our regroup call with Dr. Schoolcraft and our opportunity to say 'told you so!' (not really ;-)). Actually, I am hoping to find out what happened with our other 8 embryos, what stage/quality they were at on our day of transfer and how they developed up to day 5 and/or day 6. I'm wondering what he thought of our egg quality and embryo quality. I'm wondering if he'd change our diagnosis after seeing us through an entire cycle. I'm wondering what he would suggest for us in a future cycle ... or would he recommend we not 'fix what ain't broken'. Really, the data is a 'nice to know' but my heart lies in finding out what happened to our little embryos that didn't make it ... even being in the middle of a successful pregnancy, my heart breaks for what we lost.
Two nights ago I guess I couldn't get Schoolie off the brain. I had a nightmare about our call. It just had to do with having him on the line and then my 45 minutes of unsuccessful attempts to conference call Berilac into the conversation. It was less about being unable to correctly dial my husband's number (for 45 minutes ... according to my phone display in my dream) and more about feeling stressed that the doctors are superior and I can't even dial a phone ... I think this concern stems from just wondering if they discarded our embryos because maybe they didn't meet their "standard" ... when I would have frozen everything. Although I know that only 25% of couples make anything to freeze on a given cycle, it was heartbreaking to land in the 75%. And I guess, if the dream tells anything, I feel out of control about that.
I'm hoping and praying that Tuesday's call will bring me some peace about how the cycle actually went down.
On another note, yesterday, for the first time ... I felt the baby kicking my bladder! One second I don't have to go pee, then the next, I was shocked that I did ... then the pressure went away ... it was AWESOME!
Monday, August 3, 2009
We drew another sigh of relief at last Friday's 19 week appointment. We are feeling so incredibly grateful to be able to sit here, nearly half way through our pregnancy, still pregnant, with a healthy baby.
To be honest with you: I didn't know pregnancy could ever result in a healthy live baby for me. I remember after our third miscarriage when I would come in contact with newborns, I would smell them, I would look at them closely - examining their elbows, their eyelashes, their blinking eyes ... and I would gaze in awe. How in the world could God use pregnancy to create a human being that actually survived. With so many losses, to me ... pregnancy = abnormal baby = miscarriage. Many times, I would grab my own arm and think to myself ... if I made it through gestation and birth then surely I can have a baby that can?
Now, there are no promises that our blood work guarantees a healthy baby - but things are looking awfully good.
In other news, at the appointment, I've learned that in 19 weeks I've gained 5 pounds and blood pressure and urine litmus look good.
One week from today ... we are highly anticipating our big 20 week ultrasound!!!