Tuesday, December 23, 2008

Lord, how much longer!!!

I was wanting to write a post about all the nesting instincts I was having recently. I was counting the days in my mind, thinking of all the "clearing up" and "sorting out" I had to do before we leave for Denver, because "When we come back, I'll be in my 2ww, and then I'll be pregnant, and won't be able to do a lot of the stuff I want to do". 

And get this, I even started knitting!!!! If you're someone who knows me, you'll know how UNLIKE me that is! Knitting! I have nothing against it, and have a lot of respect for people who can create beautiful things out of yarn and needles. My mom knits, and I love the stuff she makes for us. But somehow, it's never been something I would pick up on my own to do. Yet, this weekend, I had this huge urge to knit. I went and got yarn, and needles, got on the internet, learnt how to cast stitches, and began to knit. It's not a very ambitious project, it's just a scarf, but hey, for me, that's the most "nestive" I've been!! 

And then today, we got a call from the genetic counselor at CCRM. Apparently they have decided we are going to do a freeze all cycle. So essentially, POOF!! There goes my visions of coming back from Denver during my 2ww, and getting a BFP after that. I need to re-adjust my vision to - come back from Denver after ER, and go back in 6 weeks AGAIN!!!!!!!!!! 

Let me explain what they are planning to do. See, because DH has a balanced translocation, our embryos need to go through PGD. The process of PGD requires a biopsy - where they remove one or more cells from the embryo, and then a FISH analysis, which is the process by which they do the actual testing. 

So far, the local clinic (and most other clinics in the nation) do the biopsy on day 3, get the PGD results back by day 5 for a transfer on day 5 itself. 

Dr Schoolcraft and CCRM's embryologist / geneticists suggested that we try a slightly different approach. They said they would biopsy the embryos on day 5, instead of day 3. This could be helpful in 3 ways:

1) On day 3, the cells are not yet divided into the inner cell mass and the trophoblast. (The inner cell mass is what forms the baby, and the trophoblast forms the placenta and membranes around the baby. The genetic material in all these cells is the same) So when they biopsy, they could be taking out a cell which would potentially have grown to form part of the inner cell mass, which forms the baby. (Note - there is no evidence that this harms the baby, but in the event that it COULD, the RE was wondering if we could avoid the biopsy on Day 3)

By day 5, the inner cell mass and trophoblast are defined, and the biopsy could be done such that cells are removed from the trophoblast only. 

2) Since by day 5, the blastocyst has 60-80 cells, we COULD take more than 1 for biopsy. This way we can reduce any error rates the lab may have. If they have a doubt, they can have a backup cell or two to repeat the tests.

3) By day 5, we will also know much more about the general health of the embryos. 

So they plan to do the biopsy on day 5. At first they told us we would do a day 6 transfer (which could be touch and go, because embryos MAY not survive in the lab culture beyond day 5). Even for a potential Day 6 transfer, we were going to have to really hope and pray and keep our fingers crossed that the results came back within the 24 hours between the biopsy and Day 6. 

Well, CCRM has decided to leave the guessing out of the game. They have decided they will biopsy on Day 5, and vitrify the embryos right then. It could take 24 to 48 hours for the results to come back, but they want us to come back maybe in 6 weeks for a FET. 

Advantages of FET under these circumstances:

1) We aren't going to be left wondering if the embryos will survive in the lab culture beyond Day 5. 

2) My body will have time to get rid of the effects of the stims that I will be on, and will have time to prime up my uterine lining for ET. 

We were worried that since we usually have only 1 or 2 normal embryos after PGD, and since the thawing process kills 30-40% of the embryos, what if the 1 or 2 good ones die? But they tell us that the new process of freezing that they use - flash freezing or vitrification - has ensured that they haven't lost any embryos to thaw related deaths. 

My first reaction when I got off the phone today - complete anger and frustration! How much longer must this whole thing drag out??? In the time that I have been waiting to get started since my ectopic pregnancy in June/July - people have almost their third trimesters of their pregnancies!!! 

CCRM had told me when they gave me the IVF calendar that we COULD freeze all, and that we would decide that after ER, depending on how the embryos are growing, and how things look then. So we could have received this news right at the nth hour. 

Somehow, even though we have advance notice of it, I'm still mad. I'm mad that this whole process is so much out of our control, and that there's nothing we can do to change that fact. I'm mad that I've put my whole life on hold - all of 2008 has gone in just waiting. 

I know I will have to accept this, and that it's probably for the best, and that the doctors are doing what they can to improve our chances, but I'm just feeling so impatient right now! I know I'll be more relaxed about it tomorrow. I know that I will take this too in my stride tomorrow - but right now, I feel like screaming. 


DH said...

Let's go out - MV/SJ/SF and scream our guts out in a bar!

I know honey how it feels - life seems to be a never ending spectrum of waiting!!!

Love u!

Shelby said...

Grrrrr! I feel annoyed for you! Although logically we can all follow exactly how this is best, emotionally it is so frustrating to be thrown right back into the wait again. My gosh, all of us IFers spend way too much of our lives in wait as it is.

As far as your DH's suggestion, I fully support this and if you need some helping in screaming your guts out in a bar somewhere in MV/SJ/SF, let me know!

Anonymous said...

Hang in there.....

margelina said...

Oh, Nikki...(((big hugs))) I'm sorry that this is so frustrating for you right now. I can't even imagine how you must feel. Bbut...all the info you listed sounds like you are being treated by the best of the best, and that they are just removing as much of any potential problems as they can. It is so hard to trust and accept things so out of our control, even when we know its all for the best in the end. Hang in there...you have come so far!!

Chhandita said...

My bags are packed and am ready to move..but had to have a peek before I left... It all sounds so comlicated... (((Hugs)))

Heavy heart said...

I completely agree with Margelina Nikki..they seem professional and focussed on the result..you have come THIS far..just a little distance more..

Lisa said...

AARRRGGGHHH I feely you - just reading your post made me anxious -but how cute that you dh posted and supported you!

Okay, now comes the part where I support you and tell you how okay it is going to be - just words - but hopefully it will all end in a baby.

Thinking of you!

April said...

the thing about ccrm is that they know what they are doing. just remember that they have a 75% success rate. seriously. if you have to wait an extra 6 weeks for the best chance--that's a GOOD thing, right? you are with the best. trust them. ;)

btw: how cute is DH? I don't think that B would ever comment on my blog!!

Earl Gearl said...

Wow. I'm so sorry this process hasn't been what you were hoping for. I know your doctor and the staff at CCRM have your best interests at heart and that they are only trying to help you achieve your goal, but I also know how frustrating the waiting can be. I hope that you will have a wonderful result in about 8 weeks.

Clio said...

sending you some calming thoughts to help you sort through those feelings.
They are taking good care of you. It is frustrating, but since you've waited for so long already, what's a few more weeks. I guess all the reassurance is worth it. After this first wave of frustration is gone, I'm sure you'll be fine. :)

nancy said...

Well, first of all, I totally believe in freeze-all cycles. Both me and I Believe in Miracles got our +'s off of the first FET after freeze all. BUT, what I also know, is how disappointment feels when they spring it on you. I was 2 days from ER when they told me and I was CRUSHED. It's just so hard to get your mind around it. So pleas accept all my offers of ~hugs~ and well wishes. It's like we know it's in our better interest, but damn it, we want to be pregnant! Waiting sucks and I am so freaking very sorry. Damn Damn Damn.

What days are you going to be in denver now?

I Believe in Miracles said...

Nancy and I must be on the exact same wavelength because she wrote almost exactly what I would say - we both got our BFP on an FET cycle. The waiting sucks. I'll give you that. This 'cycle' took 4 months in my opinion. BUT - the silver lining is that you know ahead of time. Mine was a shock the day of after the ER even the whole time prior they prepped me for ET. It sucked.

I'm praying that all goes well.