Tuesday, April 14, 2009

7dp3dt - not feeling the love

I know it's too early to know anything for certain - especially when a blood test is NOT involved, but I will tell you that I'm not feeling it. And if I were pregnant with triplets - I'd be feeling it, I'm sure. It doesn't even seem to me that I'm pregnant with one, let alone three.

I have not POAS today, but I did test out my trigger. I just wanted to make sure the trigger was gone ... to allow the option of testing early, but testing out trigger was so traumatizing that I've decided I'm just going to wait until beta. I will not POAS until just before beta - to prepare myself for the news of the dreaded call.

Days are dragging on.

Work seems unbearable.

Distractions are hard to find.

Emotionally, I'm a wreck.

Pray for me if you think of it - I'm really struggling with feeling loved by God. All I can do is cry out and cling to some good old scripture ...


We are hard pressed on every side, but not crushed; perplexed, but not in despair; persecuted, but not abandoned; struck down, but not destroyed. We always carry around in our body the death of Jesus, so that the life of Jesus may also be revealed in our body. (2 Corinthians 4:8-10)

How do you maintain hope while trying to prepare yourself emotionally for the worst? I want to stay hopeful, but at the same time, I don't want to be winded by the blow to the gut should the results come back negative - how does one keep this in balance?

Please continue to hold my hand while I wait ...
Polly

Wednesday, April 8, 2009

CCRM Cycle #1 - Pregnant until proven otherwise

It was a bit shocking yesterday to learn that we would be doing a day 3 transfer. As a patient that has had 4 miscarriages the thought is that most of my embryos should "look perfect" (or at least be successfully developed!) at day 5 - Dr. Schoolcraft told me in a previous conversation that generally women who have recurrent loss produce many great looking blastocysts - which is misleading - as great looking blastocysts can be normal or abnormal (the thought being that if you are getting pregnant you make blastocysts, but if you are miscarrying those blastocysts are likely chromosomally abnormal - especially in my case) ... but in this cycle, we didn't even make it to blastocyst!

I mean, the fact that I've gotten pregnant so many times, so "easily" indicates that Berilac and I make embryos that make it to day 5 ... so to have only 2 embryos of 7 make it to the 8 cell stage on day 3 is strange. How the heck have we been getting pregnant if 5/7 embryos aren't developing on track? Some might think it's because we must have implanted late in our previous pregnancies but in fact, I've freaked out many a relative when asking them to pray for us when we were "early in our pregnancy" and they would ask "how far along are you?" and I'd respond "3 weeks and 2 days" ... I'm not sure they actually believed me! ;-)

So when the embryologist called yesterday and told me the news, I had one and a half hours to get my stuff together to get down to CCRM for my pre-transfer acupuncture appt. I had to call my husband and my mom. I had to update all you fine ladies. I had to email my support network and ask for prayer. I had to take a rinse-only shower (I guess those embryos don't like my Whole Foods, all natural shampoo as much as I do!) I had to prep my pad for my arrival home - putting important things in reach of the recliner I would soon call home during my 2 day, upcoming, bedrest: remote controls, liquids, numerous pill jars. And when I was done, my dad raced me to the clinic.

We arrived right on time. We took a lovely picture of me in front of the infamous (and likely VERY expensive CCRM lobby waterfall) sporting my must-have IVF occasional t-shirt. I emailed this pic to my husband (surprising him that I even ordered the shirt) and he asked if CCRM created it for us (using our embryos as the pics!!) as a memento or something - too funny! (For anyone who doesn't know - the answer is NO - they barely let you get a glimpse of them before they deliver them to your lady bits - let alone graft a t-shirt for you!)


After taking the umpteenth million blood draw on this trip, we went to the surgery center and waited for someone to call us back. Now, let me tell you, my dad does not look young for his age. I was taking every chance I got to announce that this was MY DAD joining me today (as Berilac had to head back to California on Monday) but I will tell you, I was getting side ways glances from some of the other lobby patients while we waited ... I think the situation was exacerbated because I look like a teenager - it was awesome!

My acupuncturist brought us back and although navigating the gown change out was a bit delicate with my dad in the room, we managed. I relaxed, got stuck like a pin cushion, got a big tasty valium to take the edge off (ok, ok it's purpose was to relax the smooth muscles in my uterus - but I tell you my mind was pretty grateful!). A few nurses popped in and out checking my vitals, taking a peak at how that bladder was filling up - and I am happy to report that I only had to drink 16 ounces of water to make my bladder large enough, I guess my ovaries are still so large that they helped magnify my uterus on ultrasound.

My favorite part was when the embryologist came in and looked at me and said "Polly?" and I said "Yes" (knowing they like to double and triple check that they are putting the right embryos back into the right uteri). He then looked at my dad and said "Berilac?" ... it was TOO funny, dad and I broke out laughing. I told the embryologist that he was my dad and he responded saying - "you'd be surprised, at a place like this we get all kinds!" He confirmed what we had discussed earlier on the phone. He was still reluctant to give us information on the other 7 developing (although not so well) embryos, and this was all the further information that we got:
  • The three embryos transferred did not have any fragmentation removed - there was not enough to warrant it (that's good news).

  • They performed assisted hatching on all three embryos. (They said I was on the cusp in terms of my age and since I had had a failed IVF - they went for it.)

  • Of the 3 that fertilized on day 2, 1 of them had already completely arrested.

  • They will watch the remaining 6 embryos until Friday and evaluate for freeze. (It is my understanding that only 25% of cycles result in embryos that make it to freeze - so sadly, I'm not expecting any.)

Enter Dr. Schoolcraft ... the man, the myth, the legend.

I love building this whole thing up like he's a rockstar or something ... I will say that my dad has a very odd, dry, eccentric sense of humor, so I warned him that Dr. Schoolcraft is not a man you kid around with - thankfully he took my advice and didn't say anything to wig Dr. Schoolcraft out - the last thing I need is an offended doctor threading my cervix and handling my babies! The first thing Dr. Schoolcraft commented on was that we decided not to do the genetic testing and I told him that we opted out of it this time, but if we need to do it in the future - we'd be willing to at his clinic (they have really proven to me that this experience does not have to be as horrible as my last clinic experience - doctors/nurses really ARE competent!) and he broke a little smile at that, knowing I was admitting that I did not trust them earlier when I could have. He asked me if we were ok transferring three embryos and I did NOT delay in saying yes, he then said, "you could have triplets you know" ... pwaaaa haaa haa! (I laugh in the face of triplets!!) I responded asking him the chances and he said less than 5%, I told him I'd be grateful with whatever we get - if we get any babies at all ... (Lord please, please give us children!!!)

Then we started the procedure. The embryologist, Dr. Schoolcraft, and the ultrasound tech all stayed in the room - all concentrating their efforts on my nether regions, while my dad sat by head holding my hand - what a great dad! As the doctor began his descent I reminded him what a horrible transfer experience I had had in January, telling him that my last RE spent 35 minutes trying to just place the catheter and Dr. Schoolcraft's response was "I don't think I could keep my embryologist entertained that long!" ... ha! a joke from the stern faced one himself!! It was great. After that it seemed to go fine. He made mention of understanding why the previous transfer would have been difficult, but I only felt one twinge of pain and after a soft yelp the ultrasound tech said "he just placed the catheter" ... they delivered the little ones and closed up shop.

After it was over Dr. Schoolcraft said it was a great transfer with perfect embryos and he wished me luck.

I of course endured another session of acupuncture and got wheeled out of there. I wore my shirt all around with pride and ALL of the surgery center nurses ooooh'd and ahhh'd over it saying how cute it was and that they'd NEVER seen one like it before! (And the phlebotomist said the SAME thing!!). Now, I've known at least two women who have worn their shirts to CCRM - so there's got to be more ... Brenda, Lisa, how come you didn't sport it in all it's glory? I thought for sure you had??!? ... I'm guessing if any other patients in the lobby saw me in it (which they HAD to have) they likely thought I was just a naive, novice infertile (spreading baby dust!) going in for my first IVF that of course (roll eyes) will work like a charm. I just thought - of all people - those hanging out at the last resort fertility clinic .... are the ones that can appreciate such a shirt!

So there you have it. I'm now lying around incubating a few little babies. Praying that they stick around for the long haul. I've got a uterus full of babies and this was my story of becoming pregnant until proven otherwise.

Tuesday, April 7, 2009

CCRM Cycle #1 - Day 3 Transfer

The embryologist called and he and Dr. Schoolcraft have decided that we will do a transfer today!

On day 3 they like to see embryos that are 8 celled and are graded highly. Here is their grading policy:

Grade 4 means even cell division with no fragmentation
Grade 3 means even cell division with small fragmentation
Grade 2 means uneven cell division with moderate fragmentation
Grade 1 means uneven cell division with excessive fragmentation

We will be transferring 3 embryos today:
8 cell, grade 4
8 cell, grade 3
6 cell, grade 3+

We had hoped for a day 5 transfer, but we are praying that at least one (if not all three) babies will be healthy and stick around.

Please pray for us today, for an uneventful transfer and for the blessing of children.

Monday, April 6, 2009

CCRM Cycle #1 - Day 2 ICSI Report

So it turns out that all 4 of the immature eggs that they retrieved on Saturday matured - I guess the last one matured after I got off the phone with the embryologist.

Well, so they ICSI'ed the 4 eggs and 3 fertilized ... so now we have 10 embryos!

I asked the embryologist if they find that day 2 ICSI'ed eggs are less chromosomally normal than those originallly mature at retrieval and she said they were still collecting data on that, but that they have definitely seen take home babies from day 2 ICSI'ed eggs - that was reassuring.

I asked her how they use the day 2 ICSI'ed embryos ... let's say I was able to make it to day 5 would they transfer any of the day 2 ICSI's as morulas? And she indicated that there are two scenarios for the day 2 ICSI's:

1. If you end up having a day 3 transfer, and you don't have enough embryos, they will transfer some or all of the day 2 ICSI's as well.
2. If you make it to day 5 they will transfer the blastocysts (day 1 or day 2 ICSI'd) and the remaining day 2 ICSI's will be evaluated for freeze.

The short of it is ... we have 10 embryos and we are praying that God will bless us with a normal embryo or two to transfer into my womb for a nice long, warm, comfy, cozy 9 month journey ... please continue to pray with us.

Sunday, April 5, 2009

CCRM Cycle #1 - Fertilization Report

I am pleased to report that on Saturday Dr. Schoolcraft retrieved 14 eggs, telling us that it was a very "standard" retrieval. He got 1 egg for every follicle he flushed. He used a smaller needle, so the recovery has been much better than the past two retrievals (stupid monkey clinic!).

So here's the data in summary:

14 eggs retrieved
10 eggs mature
7 fertilized with ICSI

Of the 4 immature eggs on Saturday, 3 matured by today. Tomorrow the embryologist calls us and lets us know if any of the late bloomers fertilize.

We will get a call on Tuesday morning to find out if we're doing a 3 day transfer or a 5 day transfer.

We are happy with our decision to do a fresh cycle and are hoping and praying for some amazing embryos on Tuesday.

Now, back to my movies and slothfull lying around!

Thursday, April 2, 2009

The smoking gun

Tonight at 10:15 PM MDT we trigger! Our retrieval is set for Saturday morning 9:15AM.

Today we had 10 follicles measuring 1.5cm to 2.3cm (though the estimated number of mature eggs at retrieval is still 6-8) ... and it's official, we are going to go for a fresh transfer.

I will be triggering with HCG and Lupron, in hopes of avoiding empty follicles this time.

I am hopeful, but I am scared too. I know that I am not in control. I know that doing the fresh cycle is the right thing for us to do - but I can't help but think of stories of women who tested their embryos only to learn that the BEST LOOKING embryos turned out to be the abnormal embryos. But I keep going back to the fact that I am not in control of the outcome of this cycle. I am going to pray that we put back two or three normal blastocysts (see how positive I am? I'm hoping we're going to make it to blastocyst stage and that we'll have 3 to transfer!)

My blood labs today showed the following:
E2: 3162
P4: 0.9
LH: 1.8

We take 75iu of Follistim this evening and I go in tomorrow morning for my last bloodwork before retrieval. I picked up my Lupron, Endometrin, and Vivelle patches from Todd's this evening. I am locked and loaded and ready to go! ... ready to pull the trigger!

Wednesday, April 1, 2009

Other things I should be doing ...

I'm fortunate enough to take the week off during my cycle. I'm sitting in this gorgeous 3800 square foot home that resides in a beautiful golf course community; I could be touring the local aquarium or zoo, but instead I'm inside. I could be productive and get my taxes done or clean out my inbox but probably the BEST thing I could be doing right now is kicking back, cuddling up on the couch with the too cute kitty, and napping while I attempt to watch a movie.

But instead, I'm farting around with the follie measurements from today ...


My nurse must have been off today, because I consulted with a different one. I told her we were still going back and forth about the PBB/CGH and told her if we could have a contingency plan it would be a no-brainer. She then told me that she anticipates getting all the eggs! ... like 11-14 or so. I then told her that in my past two ER's I've only gotten 5 and 1 mature egg respectively and on those cycles I had many more follies. She patted my arm and apologized and said we'd likely keep pushing. She then agreed with my nurses' guesstimate of 6 to 8 mature eggs.

We will still monitor tomorrow and Friday, but we also booked a monitoring appointment for Saturday ... just in case. I don't think I'll get instructions to trigger tonight, so ER will likely not happen until Saturday or later. (Sheesh, all this dragging on follicular development is exhausting!)

Ok, back to all the excel fun! I'll update with bloodwork results later.
***
Sat 3/28: ~6-8 follies
E2: 2169
P4: 0.7
LH: 1.0