Nothing to transfer

I just got the call from my RE that none of our embryos made, they all stopped growing (arrested).   I'm doing okay right now, I had my breakdown last night and pretty much got it out of my system.  I'll post more later.

Day 5

I didn't sleep well and woke up early. I'm not a good waiter.  The nurse usually calls about 9:30a, so once I got to work I tried to concentrate but had a really hard time because I kept glancing at my phone, stomach churning

Right at 9:30a the call came and it was not good news. The embryos have not really changed much since day 3. Today if they were growing properly they should be blastocytes with hundreds of cells and they are still in the cleaved embryos' with only a few cells.  I talked to my doctor and he confirmed what I thought that things are looking pretty grim at this stage.    I asked him if he ever transferred embryos that had not made it to the blastocyst stage and he said yes but they have to be growing.  So right now I am trying so hard to hang on to my very fragile hopes upon at least one of these growing in the next 18 hours.  The doctors said he would call me around 9 or 9:30 in the morning with the news.

 I'm a person who hangs on to hope when all seems lost but this past year as beat me down, I'm feeling very fragile and despondent.

Day 3 Report

So the day 3 report was not as good as we were hoping for but not as bad as we were dreading.

We have:
2 grade 2's one is 6 cell and 1 is 8 cell
1 grade 3 with 3 cells

Grading Key:
Grade 1- No cell fragmentation
Grade 2- Some cell fragmentation
Grade 3- A lot of cell fragmentation

The nurse said there is very little difference in pregnancy rates between grade 1's and 2's.  

Based on this we have decided proceed with Plan B which is to do a fresh transfer on day 5 (Thursday) of the two grade 1 embryos. They will call me on Thursday morning and let me know how the little ones are doing, if they are slow to grow then we could be pushed to a day 6 transfer (Friday).  If we do it on Thursday my transfer time is at 12:30pm. 

I'm feeling slightly overwhelmed at the moment.  

Oh, and I've nicknamed our two grade 2's Will and Hester and our grade 3 is Chester.   The names are from the children's book McBroom's Ghost which I loved as a kid. 

Waiting and recovering

I emailed the nurse today because I'm still having some bleeding and quite a bit of pain.  She told me to rest, hydrate and take over the counter pain meds.  I worked for half a day today and am now sitting in the recliner with the heating pad.  Tomorrow morning we should get our day 3 status report, to say I'm anxious for the results would be a bit of an understatement.

Fertilization Report

I got the call from the clinic this morning while I was in the shower, I figured that is what would happen so I'd taken my phone in with me. So I jump out and take the call dripping and naked.

Of the 9 eggs they retrieved 7 were mature and 4 fertilized, one is still questionable and may still fertilize.   There was more details about the 4 that fertilized but they went over my head. I've emailed my nurse to ask if they used the fresh sperm or the frozen vials because I forgot to ask on the phone and asked for the details of the fertilization report too.

I'm still incredibly sore this morning, I have to move slowly but the pain is not as bad as yesterday. I'm still bleeding a little but less than yesterday. The nurse said I could take ibuprofen.

Update:
Found out that they were able to use sperm from the fresh samples, that is HUGE news for us!  18 months ago hubby was diagnosed as azoospermic (zero sperm) so to be able to use fresh sperm for IVF was something we didn't think could happen.

Here is the actual fertilization report from the clinic. m2 indicates a mature egg, "gv" or germinal vesicle indicates immature egg, "2pn" is 2 polar nuclei and indicates normal fertilization, "nef" is non efficient fertilization.

Also it appears from reading the report that we have 2 that are on the fence, not one. So let's hope those little buggers decide to get with the game!  Maybe I should name them to encourage them?

Update and PIO Shots

Just wanted to post an update; I've spent the day in bed, that's really all I've felt like doing. I took some advice from other ladies and started using the heating pad after lunch and that helped a lot.  I've played around online, watched some tv, read, slept. The pain has lessened a lot as has the bleeding.   Bending and jarring still hurt so I haven't moved much other than to go to the bathroom and walk to the kitchen. Probably won't do much tomorrow either.

I enjoyed one day without a shot, tonight we start the Progesterone in Oil (PIO shots). Now we're in a little bit of a unique situation because we still have not yet decided if we are doing a staggered or fresh cycle. We are going to wait until our day 3 report (Tuesday) to decide based on our embryos.  So in case we decide to do a fresh cycle (transfer embryos next week) we have to take the medicines. Progesterone supports the utereus and fetal development so I will take 50mg per day in an intramuscular injection until either we decide to do the staggered cycle or until 12 weeks of pregnancy.   This is a shot that goes in my butt so hubby does this one.  He's been doing the E2V shots so he's not as freaked out as he was when he first did a shot for me.   

I'm trying not to think too much about the fertilization report but I do hope the call comes early in the day. 

Egg Retrieval Day

I woke up at 5:30, more than an hour before I needed to, so I laid in bed for awhile before my buzzing brain made me get up. Long shower and still had time to kill before we could leave so I painted my toenails

Finally time to go, we got there and were taken straight back, we were the first ones of the day.  I was told to undress completely and put on a gown. I did that then they took hubby  away for him to do his business for his sample.  A nurse came in to put in my IV and I was so surprised when shot got it in on the first try! 

Next they gave me a Valium, which means I got a drink of water, that made me happy, I was thirsty already! She gave me my medicine instructions for the next few days and my discharge instructions.     My doctor came in and talked with me, I shared my concerns with him and he put them to rest, he's a great doctor and a good person, I even got a hug!

Hubby came back and we waited a few minutes then they took me to the bathroom then back to the surgery room.

I sat down on the table and draped my legs across these huge stirrup thing, different than the regular stirrup beds these go from your knees down.  The anesthesiologist then started putting something in my IV and I started getting fuzzy.  However, while I stayed fuzzy I was not under well enough and I started feeling pain when they were working on me. I remember them asking me if I hurt a few times and I must have said yes because I don't recall anything after that.  As a side note,  this is not the first time this has happened to me, when I had a gastroendoscopy some years ago I also woke up during it, must be something about the light anesthesia for me.   I woke up back in the recovery room with hubby  and the nurse telling me to breathe because the monitors were going nuts because my oxygen level dropped.  Again, not unusual for me, this happens every time I have surgery.  I was still very woozy and dizzy and only vaguely recall them coming in the say that they had found sperm in hubby sample (yay) and they wanted him to do another one. 

They also came in and told me the got 9 eggs which I was happy with, it was the number I had in mind for a few days now for some reason. 

Not sure how long I stayed in recovery but they came in and told me I could get dressed.  I managed that but needed help walking out.

We came home and hubby made me a breakfast sandwich and some coffee which I ate and then promptly feel asleep while he went to pickup my refill of dexamethasone 

I slept very soundly for a couple hours and woke up with pretty bad cramps/pain.  My discharge instructions didn't say anything about pain meds so I called the nurse line and she told me to take extra strength Tylenol.

So here I am now, laying in bed, eating a few potato chips and drinking some powerade.   Tomorrow they will call with fertilization report. 

Oh, and here is a photo my my ovaries ultrasound they gave me, not sure why. 

Egg Retrieval Eve

I've been a big ball of crazy all day.  I woke up at 5am thinking about my left ovary.  My left ovary hides behind my uterus and the doctor who does my ultrasound monitoring throughout the cycle always has to hunt around to find it, but she is good at doing so. She is not the doctor that will be doing my egg retrieval though,  I like my doctor and trust my doctor but this is where my anxiety has focused. I worry that he won't be able to see the left ovary well enough to get the eggs out and that is half of the follicles we have for this cycle in there! I made sure that I'll be able to talk to him before I go under tomorrow and will express my concerns to him.  One of the reasons I like him so much is that he does not discount my concerns or fears, he talks me through them and reassures me with facts.  

Other worries include but are not limited to:  fertilization rate using our frozen vials,egg maturity, premature ovulation from the HCG, attrition rate, genetic issues, freezing issues, thawing issues... the list goes on, I won't bore you. Just suffice it to say that my name is obsession and my internet history is filled with too many searches to count on most of these subjects.

I'm hydrating now since I can't have anything to eat or drink after midnight until after the surgery.    My husband will be giving a fresh sample tomorrow too in in hopes that the changes he's made to meds and diet over the past 3 months will have made a difference in his count.

I had a nap when I got home but I'm still sleepy. As soon as my favorite stretchy pants I want to wear tomorrow come out of the dryer I'm going to bed.

Trigger day!

Today is trigger day!  I got the call from the clinic this afternoon to do my trigger shot at 9pm tonight and come in at 7:45 on Saturday morning for an 8:30 am retrieval.

Update: HCG Trigger shot hurts! Not the shot itself but almost immediately afterwards I feel like I've been punched in the shoulder! No one told me this, I was not prepared!

A lot of people not familiar with IVF have asked me, "so what's next"? So here is it is

Today (2/20): 

• Trigger with HCG shot at 9pm exactly
•  HCG is the hormone produced when you are pregnant, in this case you get 10,000 units in one shot in the arm to cue the eggs to finish maturing and to prepare for retrieval. This trigger shot is done approximately 35-36 hours before egg retrieval
• Start antibiotic (Clyndomicin) vaginal suppository as a secondary prophylactic measure to prevent infection (already on z-pack)

Friday (2/21):

• No meds except antibiotics, folic acid and dexamethsone.  This will be my first day without an injections since January 22nd. 
• No food or drink after midnight

Saturday (2/22):

• Egg retrieval
• Be at the clinic at 7:45
• Meet with anesthesiologist
• Get put under
• Doctor uses ultrasound and inserts a needle through my vaginal wall into my ovaries to remove the fluid and egg from each follicle (so a dozen times or more)
• I wake up
• Husband gives fresh sperm sample but expect to be using frozen vials, Embryologist will examine and make this call
• Embryologist examines eggs and determines how many eggs were retrieved (not all follicles have eggs) are mature (not all eggs retrieved are mature)
• Embryologist fertilizes each mature egg using a procedure called Intra-cytoplasmic sperm injection (ICSI).  Pronounced Ick-see and its where one sperm is injected directly into each egg

Sunday (2/23);

• Fertilization report from clinic 

Monday (2/24): 

• Nothing

Tuesday (2/25):

• Day 3 growth report 
• How many are continuing to grow
• What are their grades, cell sizes, etc

Wednesday (2/26):

• Nothing

Thursday (2/27):

• Day 5 growth report
• Biopsy for PGD (Pre-Implantation Genetic Diagnosis)
• This could also be moved to day 6 depending on growth
• If we have only a couple of embryos/blastocytes at this point we may decide to forgo genetic testing and go straight to implantation but the plan is to do the PGD
• Biopsies are sent to genetics lab to make sure they are chromosomal normal
• Embryos are frozen

Depending on how long it takes to get the results of the genetic tests and how long it takes my normal cycle to return we will do what is called a Frozen Embryo Transfer (FET) in either March or April, more on that later but it involves much less drugs!

Follicle Update

14 measurable follicles as of this morning. The doctor said they are growing just as they are supposed to! So happy to be normal for once! I don't have my E2 number back yet, I'll update when I get it. My lining was at 12.7

	2/17/2014			2/19/2014
	Right	Left		Right	Left
>23
22
21
20
19					1
18					1
17				1
16				3	2
15		1
14	1	1		1
13	2	2		2
12	1	1
11	3				3
10
<9				3

So the plan, regular meds tonight and in the morning then I'll do my HCG trigger shot tomorrow night. That is the shot that tells the ovaries they can start letting go of the eggs in preparation for retrieval on Saturday.  I will get a call tomorrow to let me know what time to do the trigger shot and what time my egg retrieval will be on Saturday. The trigger shot is done 35 hours before retrieval.  

I'm excited but still nervous about all the possible outcomes.

Update: E2 is at 1,293 today. I expressed concern that it was down from Monday but the nurse said when you are doing estrogen priming that it can be all over the place and is not a good indicator of follicles.  I'll be doing my last estrogen shot tonight. 

Follicles!

Went in for ultrasound and blood work yet, I don't know my E2 number but will update when I hear back on that. Follicle count was much better this time than it was last cycle at this time.   I had a total of 12, the sizes are shown below.  The doctor was pleased and said she thinks we'll be able to do retrieval on Friday or Saturday. My left ovary was again hard to see and I asked her if this would be a problem for retrieval, she said not really as they are able to do more when I'm asleep than they can when I'm awake!

	2/17/2014
	Right	Left
>23
22
21
20
19
18
17
16
15		1
14	1	1
13	2	2
12	1	1
11	3
10
<9

Update: My E2 is 1401! Nurse said that is right on track. My lining was at 12.5.

And here is a current side effect listing, in no particular order

• Headache
• Nausea
• Exhaustion
• Leg Cramps
• Sleep Disturbances
• Bloating
• Discharge
• Sore Breasts
• Forgetfulness
• Irritability 
• Emotional

Shooting up in the bathroom

Sometimes you have to do your meds in the bathroom of a church reception hall while shooting a sweet 16 party.  The follistim case is the perfect size for a small ice pack.

Bruising

The left side of my lower abdomen looks like I've been beaten. I'd post a picture but no one wants to see my fat belly. I'm bruising MUCH more this time that I did last time but ONLY one my left side. I barely have one mark on my right side even though I rotate sides daily for all shots. The left side bleeds more too.  Last night after I did my Menopur injection I had a large knot under the skin, I rubbed it for awhile and it went away but it is so sore today!

Update

I went to see my RE this morning for an ultrasound and he is very please with how I am coming along for being 4 days into my stims (today is day 5).  He said he saw at least 5 or 6 follicles mostly on my right side as my left ovary  likes to be sleepy and hide. He said he was very encouraged.

Last night I went out with friends and did my shots away from home the first time. I just put in ice pack in my Follistim case and put my Follistim vial and my Menopur that was ready in a syringe in it, then when it was time I just went in the bathroom at the restaurant and did the shots. Didn't try to do it in a stall since there is no where to set things down, I just did it at the counter. I figured if anyone walked in I would explain, but they didn't so it was no issue.

Tomorrow night I have a photography job so my nurse said it was okay to do my EV2 shot earlier in the evening than I usually do.

The nurse at the clinic had to call Walgreens to get me some more needles. Since I got some meds from other ladies who had been through IVF I didn't get enough meds in my shipment from Walgreens to begin with. I got those and should be good for the rest of the cycle unless I need more meds

Today is Valentine's day, we are going out to dinner tonight, yay!

Stims started and lessons learned

I started Follistim tonight so its now officially stim time again!

Last night I started the second part of the estrogen. This one is a vaginal suppository, what fun!  You get an applicator to insert it but since they have to be kept refrigerated it still feels odd. And as I found out the hard way they make you leaky! Which leads me to some lessons learned so far.

1. Panty liners- just go ahead and wear them as soon as you start to cycle. All the meds affect bodily fluids.

2.Reminders- some/all of these meds destroy short term memory. I have turned into a goldfish.  alarm clock+on my phone is my new favorite app. I have separate alarms for each med that won't stop going off until I dismiss it. I have notes EVERYWHERE! 

3. Falling pills- you are probably going to do your meds in the bathroom and chances are something is going to fall in the sink. Place a paper towel or clean hand towel in the sink before doing meds.
4.Organization-  see previous post for more on how I do this but with the memory issues keeping track of up to 7 meds a day can be a challenge. 

5.  Aim- clean a bigger area with alcohol than you think you need.  I have big boobs and can't see my belly. Its hard to aim in the mirror so give yourself a bigger area to work with.

6. Cold- cold meds burn more. Cold oil based meds burn a lot more. Even a couple minutes out of the fridge makes a difference.

That's all I remember for now. I'll try to add to this.

Freak out!

I totally freaked out tonight! I forgot to do my Ganirelex shot this morning. I didn't remember until 6pm!!!  I quickly called the on call nurse and she said to go ahead and take the shot now and again in the morning. She said this was the best possible timing for forgetting one. The Ganirelex keeps me from ovulating and since I'm still on my period and didn't miss the shot all together it will be fine.  I have now setup multiple alarms on my phone and my husband is putting up a big sign in the kitchen that says "DID YOU DO YOUR SHOT?" Ugh, my heart is still beating fast!

So he did a really good job with the E2V shot on Sunday night.  He said it felt too easy so he was afraid he didn't get it in the muscle, the sore spot I had the next day proved that he had!  Speaking of sore spots I seem to be bruising a bit more this time around, I already have several small spots on my belly and still have about 3 weeks of shots left.

Estrogen

I went Saturday morning to have my Esterogen level re-checked, it went from 162 on Thursday to 26 on Saturday!  But since I hadn't gotten my period yet they wanted me to wait on starting the E2V shots.  Well now I got my period so tonight will be my first intramuscular injection. My husband has watched the video on how to do it several times and says he is ready but still nervous.

As a side note, the clinic has been great, I was on phone and email with them off and on all day yesterday (Saturday) and they were super responsive and very nice.