What would you do?

We're back from our trip to the San Diego area, and I must say, I am SO glad we went. We really needed to de-stress, and the last 3 days have been awesome. We went with another family, and I think that was a good idea too, because we were forced to get out and be normal and not talk about our IF and IVF all the time. In fact, we didn't even talk about it once! 

We're back, and both DH and I are feeling "re-charged" and sufficiently calm to get started with FET preparations.

I started Lupron on Tuesday, and yesterday, I had to do my shot while we were driving back to the bay area. We stopped at a gas station, DH prepared the syringe, our friend was checking the air in the tires and I pulled up my t-shirt and did my shot right there in the parking lot! I was laughing with DH later at night that it's almost comical how we've come to a point where we're practically immodest about and because of our IF. I don't even blink or hesitate if I'm talking about IF - I'm not embarrassed talking about sperm, eggs, uterus or anything IF/TTC related!  

I'm still on my BCP - I take my last pill this weekend. AF should come next week, and then I start the patches. So far so good. 

We head out to Denver on 2/24, for our FET on 2/25. The date 2/24 has a huge significance in my life. My last pregnancy (the ectopic) had a due date of 2/24. It's sad that SO much time has gone past since my last pregnancy. At the same time, it feels significant that my FET is scheduled 1 day after my due date. Almost like I needed to wait till the due date to be cleansed of all the negative and hurtful emotions that I felt over the last year. 

I need to think about this upcoming FET, to think about how many blasts we're going to transfer. Here's where I need your suggestions.

These are the blasts we have (in terms of grading):

4AA

4AA

4BB

3BA

I feel we should transfer 2 blasts this time. I also think we should transfer 1 of the 4AA grade blasts, and one of the remaining 2. We thought about transferring both the 4AA grade blasts, to maximize our chances for this cycle, but we both agree that it will be better for us mentally to know we have a good quality blast as backup, in case this cycle doesn't work, or something goes wrong during the pregnancy. 

If all goes well, and we do come home with a healthy baby in say Oct/Nov, then the 2 blasts can stay frozen till we are ready for a sibling. 

What do you think? What would you do? 

(I may be thinking ahead of myself here totally - I have no idea if CCRM lets the patient have any say in how many blasts are transferred or which ones are transferred, but I want to be prepared with our decision nevertheless.)

Vacation Time

After all the highs and lows and the drama of the last couple of weeks, both DH and I needed to get away for a bit. We decided to take a little vacation in San Diego. We booked our timeshare last week and thought that we'd either use it as a WTF break, if the PGD news was bad, or as a celebratory trip, if the news was good.

Here we are in San Diego on our celebratory vacation! We drove down yesterday with a couple of friends. This is just a quick post, lest you guys wonder where I disappeared to!

We will be back on Wednesday, and I will post an update on Thursday. I have some questions for you ladies, so watch out for my post.

Have a good week, everyone!

PGD results are in

We got 4. Yes, that's right. 4!

I'm happy, relieved, excited and so thankful to God. Thanks also to all of you for your prayers and good wishes. You may never know how much your support and comments have helped me. I was losing my mind, and each one of you helped me stay together. Thank you all!

This last week has been a very very anxious week for us. DH and I have had numerous conversations, preparing ourselves for a phone call that begins with "I'm sorry". I was worried for DH because he doesn't vent out his anxiety like I do. He keeps it all bottled up, and there's a lot of anxiety in him because he feels responsible, yet helpless. He said he has been seeing the stress I've been under since the ER, and he knows that his BT, and the fact that everything boils down to numbers at the end of it is what is causing that stress to me, and he feels responsible. I was worrying for him while he was worrying for me.

We talked about closing this chapter and moving on. We talked about being strong for each other, and at the very least, resting in the knowledge that we've done all we could. We've been brave and strong, and have taken the bull by the horns for as long as we could. We also came to the agreement that we couldn't do this any longer. If we got a bad PGD result today, we would close the chapter.

We almost didn't want to answer the phone when it rang! The genetic counselor and our nurse were both on the line together. You could tell they were so excited! They said they had screamed and hugged each other in the corridors of CCRM when they got our results, causing other nurses and people to stick their heads out of their offices to see what was going on!

We have 4 normal blasts, and the grades are:
4AA
4AA
4BB
3BA

This is the best result we've had so far! I know I'm going to have a relaxed weekend now. It feels like a horrible weight has been lifted off our shoulders, and we can breathe again! Phew!

We know it's not over yet - it's FAR from over. It's not over till we get to come home with a healthy baby in our arms (or possibly it's not over till that healthy baby grows up and goes to college!). It's not over yet, but it's a bug hurdle crossed. A big big hurdle, and we're glad to have made it so far.

(Oh, I have to tell you about my dreams last night. I had 2 dreams. In the first, we were told we have 4 normal blasts, and their grades are 4DMR {Don't ask me what that means!!}. In my second dream we had 2 normal blasts that we transferred. I told the nurse and the counselor about my dream, and they told me to try and dream about being pregnant. I'm going to focus on that now!!)

Patience!

Waiting sucks! IF sucks! Currently, my life sucks! They told me that FISH analysis results take 24-48 hours, and given the fact that we've frozen our blasts and the PGD lab is aware that they need not rush for results, they may take an extra day or so. So we should have heard back on Monday. No. OK - Tuesday? No. Now Wednesday has gone past as well! I mean, how on earth am I expected to stay calm and patient any more?

I emailed the geneticist this morning and requested her to follow up and see what was holding the results up. She said she would check and let me know. I emailed her again in the afternoon. No response. Finally I called CCRM - I HATE the fact that their front desk doesn't put you through to the embryology lab directly. They're like security guards for the lab. There's always this uncomfortable conversation that makes me feel like I'm bothering them and wasting their time!

Them:"Have you called your nurse?"
Me: "I emailed the genetic counselor, and she said she'd check. I haven't heard anything after that."
Them: "Well, it's been really busy today. Give the genetic counselor time till tomorrow to respond to you."
Me: "OK. It's just that I was told to expect the results on Monday or Tuesday, and now it's almost the end of Wednesday and I haven't heard."
Uncomfortable silence.
Me: "Hello?"
Them: "Sigh. OK, I can email the lab and ask them to call you."
Me: "Would you please? Thank you. Here is my name and number again".

I never did get that call from the lab. However, the genetic counselor emailed me back finally, only to say that the PGD lab will "report the results on Friday". WHAT????? I don't know if that means CCRM will hear by Friday. In which case, I don't know if they will tell me on Friday or if I have to pull my remaining hair out before I finally get my results!!!

This whole IVF cycle has been so extremely stressful it's not funny. So stressful! Now I have 2 more days to chew my nails and pull out my hair before we hear if we're having a transfer. I'm supposed to get and fill prescriptions for Vivelle patches, and I don't want to do that unless we are sure we have a transfer. We have tickets, hotel, rental car that will need to be booked, and I don't want to do any of that till we hear back. Yes, there's still time, but I wish we could hear quickly so I can move on with other things that need to get done!

I know I need to be patient till we at least find out our PGD results, but my mind is spiraling downwards into panic mode. I'm not doing well with the waiting. I wish they had set our expectations right from the beginning and told us when they would have the results back realistically. I've literally spent the last 3 days not letting my cell phone out of my hand because I don't want to miss their call! I've checked my phone multiple times to see if it's working! Is it charged, do I have reception, is my ringer on etc etc etc! I'm going hysterical here.

I find myself running out of hope entirely now. It's just getting harder and harder. I can't picture myself pregnant, I can't picture us with a little baby. On top of it, it has been confirmed that this was our last covered IVF. We can't afford to pay out of pocket for any more treatment. We could have, but we've been burning through our savings for the last year. I think I need to pull up my socks and go look for a job. That thought is sending extra shivers down my spine. My confidence is at an all time low, and I'm feeling so unfit to be hired by any kind of job whatsoever. I don't know what to do anymore. I've been looking at job listings online, and the listings and job descriptions scare me. I don't think I can do anything that any job requires!! :-(

How did I let it come to this? How did I let myself go so far down? How did I allow IF to take SO MUCH from me?

Pregnant sightings!

They’re everywhere. EVERYWHERE. In real life, in Hollywood, on the news, on social networking sites, EVERYWHERE!!! We closed myself in, and isolated ourselves from so many IRL friends because we couldn’t deal with their pregnancies or baby news or baby views. Many shut us out because they didn’t know what to say to us any more. Now – now I have one friend who calls and checks on me frequently. Other than her calls, my phone rings only when CCRM calls me. I get emails when I get comments from you guys. Other than that – almost nothing.

What did we do? We turned to television. In 30 minute spurts, the telly has become our escape from reality. How I met your mother, Two and a Half Men, Big Bang Theory, Law and Order have helped us keep our sanity, and in some cases, our humor alive.

This last season, we also started watching a new series called “The Worst Week”. It made us laugh. The poor guy got into trouble and his life sucked apparently more than ours – all the time! But there was a theme on the show – the girl was pregnant. It was ok in the beginning, but then they had to start showing her pregnant. We stopped watching the show then.

The other day I read somewhere that Cobie Smulders and Alyson Hannigan are pregnant in real life. They are both on How I met your Mother. Yesterday, Cobie’s character Robin visibly LOOKED bigger. I love the show, but I’m sure it will be another one that we’ll stop watching soon.

Two and a Half Men – I mean, cheap, crass, in your face type of stuff. Hilarious. Yesterday, Marin Hinkle’s character (Judith) waddles out 5 months pregnant, and half the show was about painting the nursery, and selecting the baby girl’s name. Blech!! Another show I’m going to stop watching?

How sad is it when you end up needing to escape FROM your escape? Pathetic. Really pathetic.

This season I think we’re going to stick to Kitchen Nightmares, Hell’s Kitchen and American Idol. Whatever they do on those shows, hopefully they won’t paint nurseries and choose baby names, and shove their fertility in our faces! Angry, filthy mouthed, British accented Chef Gordon Ramsey, and Simon, Randy, Paula and the new chick are probably NOT going to suddenly show up pregnant any time soon. (Or so we hope!)

Now for my PGD update – no news. I had asked the nurse yesterday when we spoke. She had checked with the lab, and they had told her they hadn’t heard back from the PGD lab yet. They said it could take a few more days. I am running out of patience but I don’t have another option. Nothing I can do but wait. The embryologist told me they expected to hear back by Friday last or Monday/ Tuesday. I’m going to keep quiet and calm till tomorrow. And then I’ll follow up. I do know that they didn’t have the results yesterday. I’ll give them today, and then start calling them.

Another day goes by

There's still no news on the PGD results. I was hoping everything would be super efficient and we'd have the results on Friday. And then on Friday evening I thought, OK - let's just get through the weekend, and we'll have the results on Monday. Now it's Monday evening. Still nothing. 

My miserable Aunt F decided that SHE should visit me before her time! Well, one less thing I'm waiting for! I don't mind Aunt F per se, but I don't particularly like her baggage. All the cramping, paining, bloating (on top of my IVF bloating), migraine. If only she'd visit, quietly, like a well behaved old aunt. Nooooo - she likes to be mean - she has to bring all these agonizing "cousins" with her!! 

So anyway, since AF was here, and while we're still in limbo about our PGD results, I decided I should at least get onto my BCP protocol or whatever it is that they need me to get started on, ASSUMING we will have a transfer some time next month. I spoke with the nurse at CCRM and got my calendar and schedule running. 

I looked at my old BCP packs, and I had 12 pills remaining across 2 old packs. The nurse had told me she would have me on BCP for 14 days. I asked her if we could tweak that to 12 days, so I could avoid buying a new BCP pack, and using only 2 pills out of it. She said she could, and the bare minimum we needed was 12 days on BCP, so it worked out perfectly. What made it even more perfect was the fact that with the 12 days on BCP schedule, my transfer date falls on 2/25. Dr. Schoolcraft is going out of town on 2/26, and he's booked out heavily till 2/24. So, 2/25 is the only day I could have been squeezed in anyway. So it's falling into place beautifully. 

That is, IF WE HAVE A NORMAL BLAST TO TRANSFER!!

If not, there is no Plan B. Really - there is no plan B for life. What am I going to do with myself if there is no transfer, and if all this fizzles out over the next couple of days? 

Anyhow, for now, I'm starting on BCP tomorrow. 

Update on my plant - it's still all dried up and brown. For those that asked, it's a bougainvillea, and any tips on a dried up bougainvillea in particular will be much appreciated!

Taking Charge of your Fertility

When we first started trying to conceive - way back in 2001, and when we realized the going wasn't all a bed of roses, I started lurking on a lot of message boards, trying to understand if we were timing things right, if there were things we were missing. 

I used to hang out on the "Just Starting Out" boards, well, not "hang out", but lurk mostly. I was too shy to talk about my failed attempts at trying to get pregnant. It was such a private matter. How could I discuss what happens in my bedroom with an internet full of strangers? 

Many people would talk about this book called Taking Charge of your Fertility - they swore by it, and it was like a TTC bible of some sorts. Written by Toni Weschler, it talks about managing your fertility - charting temperatures, tracking CM, cervical position etc. So for someone that can actually get pregnant on their own, this is a good book to have / read. 

I was a naive, innocent hopeful then. Little did I know that I was going to grow into someone who is infertile by even infertile standards. The joys of innocence! :-) I bought the book in 2001. The first page has my name and "2001" written on it. I read it, learnt a lot from it, but nothing happened. Over the years, the book got put away and forgotten in the bookshelves somewhere. 

Then a few years ago, one of our friends was talking about seeing a doctor. She and her husband were trying to get pregnant, and it wasn't working. I thought of this book and went looked for it, and lent it to her. She returned it a few months later saying she was pregnant. She had a son. 

A short while after that, another friend was in panic mode. And by that I mean complete panic mode "We have been trying for 7 months, I think we should talk to a doctor about doing IVF, nothing is working!!!!" She even took her husband to see a doctor about doing IVF. The doctor had a sense of humor, and made them sit through a presentation of the IVF process. That scared them into going home and trying on their own again. I lent her this book. She too has a son now. 

A third couple had been trying for a while. The girl had also seen a doctor, and had gone through an HSG. She was supposed to meet the doctor after her HSG to get started on treatment. I had lent my book to them a few months ago. They have returned it to me with a pregnancy announcement. I don't know if she's having a son yet. 

All these people probably would have got pregnant without having borrowed this book from me. But I choose to believe the book is lucky. I don't know it the contents did the trick, or just the book itself. 

I've been joking about this book and telling everyone that it has brought luck to everyone I have lent it to. One hundred percent - all 3 couples! Unfortunately the luck works only when I lend the book out. It doesn't seem to work with me!! My friend who returned the book this time said she was returning it in the hope that the book would work its magic on me as well.  

The book is lying here. I don't know if it's working it's magic. I don't know if it has any magic to work. Because honestly, all those couples would probably have got pregnant on their own anyway. But I hope it has magic. And I hope some of its magic is flying around us right now. 

God - anything to make this cycle work!!

I'm waiting for the PGD results. They haven't called, and now I don't think they will call today any more. It will be Monday / Tuesday before I know anything. I'm trying to hang in there. Some hours go past quicker than the others! 

A couple of random rants - the counter on my blog stopped working. I have no idea why. And I don't know why, but it's bothering me! Anyone know how to fix it? 

The plant we had planted on my baby's due date (the picture on my profile picture) is all brown and dry. We got back from CO and noticed it all dried up. We're trying to revive it, but I'm heart broken, and really scared it won't revive. It was fine and then suddenly it's gone. There were a few cold waves, I don't know if that's what did it. It's our "tribute to our lost babies" plant, and I don't know what I'll do if it doesn't sprout green again!! Any tips people? I'm not particularly green thumbed, but we have plenty of plants, and we do manage to keep them alive! 

---------------------------------------

Update - Never mind. The counter is back. On its own. After showing up as a ? for over a week! I should have whined about it earlier! :-)

On the 7th day of ER

The embryologist called, and I think I have finally exhaled now, after days of bated breath, days of wondering, hoping, panicking, all at the same time!

Our latest update is more heartening. They were able to biopsy and vitrify 4 more embryos on Day 6. There was one more they were watching, but that one didn't make it. So all in all, we now have 6 that have been biopsied and vitrified, ie frozen in time.

The biopsied cells were fixed on glass slides, and these slides are being sent to the PGD lab today. The lab should be working on our slides tomorrow and on Friday. They could technically have the results by Friday, but since they know there is no time pressure of a fresh transfer, and since they are aware that these blastocysts have been vitrified, they may not be in a rush to send the results back. CCRM will call us as soon as they hear, and this could happen on Monday or maybe even Tuesday.

I'm feeling a little more relaxed, and am daring to hope that there WILL be a transfer. I'm reminded on our President Elect's speech and book title and phrases - The Audacity of Hope. He said "Hope in the face of difficulty. Hope in the face of uncertainty. The Audacity of Hope."

Out of our 6 blastocysts being genetically tested, can we hope for at least one that we can transfer? Please God, I hope so. Please don't let it be otherwise. 

I had promised I would share with you the grading system for blastocysts. I went online to look for pictures which I could post with my description. In my searches I came across a website which actually describes the grading of blastocysts much better than I could ever dream of doing. So I'm going to link you to this article on blastocyst grades.

I want to thank every one of you for reaching out and supporting me during the crazy roller coaster of the last week. From 1/7 to 1/14 - it seems like an eternity! A tiring, exhausting eternity, and I don't think I could have stayed sane without the hands of my blogosphere friends, holding me up. 

It's not over yet, it's far from over, but it's one step forward it the right direction. 

Perspective on things

I’m still pretty shocked and numb from yesterday’s news on our embryos / blastocysts. I’m sure you must think that I just whine unnecessarily, and that in the past 1 week itself I’ve shown all kinds of varying emotions. I started with being worried about a low number of follicles, to being ecstatic about a good ER, to being devastated about the fert report, to being ok with the Day 3 report, to yesterday, when everything crashed around me.

I’m trying to see the positive side of things. DH and I sat down to analyze our results from our past IVF/PGD cycles and compare them with this current cycle. We think we’re seeing a little pattern here, and I’m going to try and explain it to you.

The obvious difference in this cycle was the fact that the biopsy for PGD / FISH testing was done on Day 5. Most other labs / clinics do the biopsy on Day 3. Had CCRM done the biopsy on Day 3, we would have had 12 embryos from the first batch, and possibly a couple more from the later batch that would have been biopsied and tested. And with that, the numbers would have been similar (and slightly better) than our previous 3 cycles.

In my mind, I’m trying to string together the results of the previous PGD cycles, with the outcomes on Day 5 with regards to the development of our embryos.

This is from October 2007. During this cycle, the normal / balanced 5AA blastocyst was transferred and we got a BFP. I had a missed miscarriage in the 9th week




This is from April 2008. During this cycle a poor quality (5CB) blastocyst was transferred. It ended in a biochemical pregnancy.



This is from June 2008. 2 blastocysts of 5AB and 5AC grade were transferred. This resulted in my ectopic pregnancy.


Do you see why I was stressing about needing higher numbers? See how many Unbalanced embryos we've had in the past. That is why, with a genetic / chromosomal abnormality involved, everything becomes a big numbers game at the end. 

On the other hand, do you see the pattern I’m talking about? It does seem like the embryos that were normal or balanced for the translocation did survive and develop into blastocysts. That’s on the one hand. On the other, all blastocysts were not always normal or balanced. We had some good-looking 5AA quality blastocysts, which had an unbalanced translocation.

So I’m yet again trying to hold on to the hope that the ones that made it to blast COULD be normal. I realize I must appear so desperate – clinging on to any straw of hope that I can. Who knows which straw will keep us afloat, really!

This one has by far been the most stressful IVF cycle I’ve been through. I’m pretty sure that after this my mind and body are not going to be ready to go through this again. (I am hoping against hope that I don’t NEED another cycle, but you know what I mean.)

I have not heard from the embryologists today. By this time yesterday I was climbing the walls in despair. Today I feel like the news can’t get any worse. The anticipation of the bad news phone call is gone. If at all, today’s news would / will be good news. If they call, good. If they don’t – well, what can be worse than going from 31 eggs to 2 blastocysts in under a week?

PS: Some of you mentioned my last post was technical, and that the grading was hard to understand. I will write out a post and explain the grading for the benefit of those that didn’t get it. But I will do that tomorrow.

I'm tired of stressing

I have literally spent the entire day staring at my phone, willing it to ring. I was waiting for my day 5 update. I've chewed my fingernails down to stubs, I've paced up and down, I've panicked and done everything else I could. I called and left a message, I emailed the nurse to follow up - I did EVERYTHING!!

Finally the embryologist called. Once again, it's not good. 

Here were my numbers on Day 3, with the cell break down:

12 embryos that were growing

2 at 10 cell

2 at 9 cell

5 at 8 cell

3 at 7 cell

The 2 that weren't being counted were 1 at 5 cell, and 1 at 3 cell.

The 3 late bloomers were at 2 cell, 4 cell and 5 cell. 

Flash forward to Day 5 - i.e. Today.  The story looks different now.

They were able to biopsy and vitrify 2 blastocysts. Yes, 2. That's all. And the 2 are graded as follows:

1 at 4BB

1 at 3BA 

They are watching a few more that MAY still develop by tomorrow:

2 stage 2 early blastocysts

2 stage 1 early blastocysts

3 at compacting stage (ie, they are significantly delayed) 

5 have arrested development (the 2 that didn't make day 3, plus 3 more)

From the late bloomers - none are looking close to being even early blastocysts right now. They will watch them tomorrow and on Wednesday. 

So in effect, we're down to 2 that have reached where they were supposed to in terms of growth. But even then they are not the best quality. It is a touch and go situation with the remaining, and they will call us tomorrow to update us on those and their progress. 

I don't know what to make of this. I'm devastated because I'm thinking there is no way we'll get one normal out of 2. I have a horrible sinking feeling in my heart that I should stop hoping. I don't know what to do now. And I don't know why everything has to be so hard. I don't know if I should keep any hopes up for the remaining embryos, or for the 2 that have been biopsied or for the ones that matured later, or for this cycle over all. 

I just want to wake up from this nightmare and find out none of this ever happened. I don't have the energy or the will to fight and hope any more. I don't even have the energy to panic anymore. 

I give up. 

And then there were...

Day 3 embryo progress report is in. I was so nervous that the numbers would drop significantly. But thankfully it's not that bad. In fact, it's not bad at all!

Out of the 14, we have 12 that are growing well. Minimal to no fragmentation, good cell division, and according the the embryologist, they are just where we want them to be. 

Out of the 4 eggs that matured late and on which "rescue ICSI" was done, 1 is at 5 cells, 1 at 3 cells, 1 at 2 cells and one didn't cleave at all. The 5 cell and 3 cell embryos look promising - they will continue to watch these over the next couple of days.

So as of now, on Monday, the 12 embryos will be biopsied (hopefully all 12 will still be growing then) and vitrified. On Tuesday or Wednesday they will biopsy any of the late bloomers that are still growing at that time, and will vitrify them. This is delayed because these are the late maturing eggs that were fertilized later, and they are physiologically a day or more behind the earlier batch. 

We will now hear from them on Monday after the biopsy. The FISH results should be in within a couple of days after that. 

I'm feeling more at peace with the numbers now. I was worried that we would lose some from Day 1 to Day 3, and thankfully most of our embryos seem to have grown well. I hope they continue to grow, and form good looking blastocysts on Monday. 

I have not heard anything from the insurance guys after my conversation with them yesterday. Given that it's the weekend, I probably won't hear till next week now any way. 

Physically I'm doing ok - I think. I'm still very very bloated, and my left ovary hurts when I stand or walk. I have been having a lot of heartburn as well. Painful heartburn. And my back is a little painful. I hope these aren't related with OHSS in any way. I'm trying to drink water and gatorade (DH disagrees, he thinks I'm not drinking enough. I've been telling him to put an IV on me with gatorade dripping into me constantly!!) 

Updates

Many things in life aren't fair. Many times you're blindsided or sucker-punched, and it sucks when that happens. But I'm not giving up without a fair fight. We've fought long and hard at this, and I'm going to claw my way back up. 

I've spent a major portion of yesterday licking my wounds and feeling sorry for myself. Many of you came to my pity party - thanks for dropping by. Sorry I didn't serve good booze ;-)

Here's what has transpired since my last post.

I emailed the nurse at CCRM saying I was disappointed with our results and could she check if any of the immature eggs had any hope. She had the embryologist call me again. We went through all the numbers again.

Oocytes Retrieved: 31

Mature eggs: 24

ICSI done on: 24

The break down of the ICSIed eggs:

Normally fertilized: 14

Didn't survive the ICSI procedure due to being fragile: 2

Fertilized abnormally (with multiple nuclei / too much DNA): 6

Mature but damaged egg: 1

Mature but "giant" egg: 1

I asked the embryologist if we had any hopes of any of the other eggs maturing. She said she looked, and it did look like there were 2, possibly 3 that may mature. She would perform ICSI on them, and would call me today with the report. I asked her if it was normal to have so many abnormally fertilized with ICSI. She said it does seem like we had a large number. She also mentioned that some of our embryos are looking "vacuolated". I asked her what that meant, and she said "I'm not sure I know how to explain it, but it looks like your embryos have pockets or vacuoles". 

In 4 previous IVFs and several embryos that have been formed and tested and transferred, nobody has every mentioned a quality issue. No egg quality issue, no embryo quality issue. Yes, I accept that all those previous IVFs were done previously, ie, I was younger, if only by a few months. So has the downhill aging process caught up so quickly? 

Today, I emailed the sales rep at the insurance company who has been dealing with my ex employer. (I was put in touch with him yesterday by the HR assistant). He called and has confirmed that I do have infertility coverage, and he apologized for the bad information that was given to me. He said he would work with the concerned people to get me my pre-authorizations. He also wished me good luck with the cycle - I thought that was very sweet of him. I have given him all the information he needed, and now I'm waiting for him or someone from his team to get my authorizations done. Thankfully that's one step closer to closure. 

Then I called CCRM, and spoke with the embryologist. He said they managed to mature 4 more eggs, and did ICSI on all 4 yesterday. One of them is showing 2 cells today, but they're not sure if it is fertilized or not. (Huh???) The others don't seem to have done anything, but he will leave them in the culture and watch them to see if something happens. 

I asked him about the vacuolation and asked if it was a bad thing to have vacuolated embryos. He said it need not necessarily be a bad thing. It's just an observation, but that they really don't know much about vacuolation. 

So as of now, we have the 14, and possibly 1 additional that has done some sort of division.

They will call us tomorrow with Day 3 progress and will biopsy the embryos on Monday for PGD. We don't know what the outcome will be. I hope we will have at least something to transfer. 

I had got into this cycle thinking I was going to be ok with the knowledge that we tried all we could, no matter what the outcome. But it seems like I am a lot more invested into the process and a failure (God forbid) will be hard to take. 

We are back home in CA - for the first time this year! We saw Simba for the first time this year. I slept for 10 hours straight last night - I guess it's good to be home! 

Don't tell me I used up my share of magic yesterday

It's always something isn't it? I was for once SO happy and excited yesterday with my ER numbers. I was ecstatic - I mean, this was the best result I'd had - ever! And I'm the oldest I've ever been! 

I just jinx myself by feeling happy. I should just stay in the "fuck it" mode! 

I got my fert report. Out of 31 eggs, 24 were mature. They ICSId the 24, and we have only 14 that fertilized! I don't get it! This is the first time we've used ICSI and I think this is the worst fertilization rate we've had. I thought ICSI should make the rates go up! And I know that 14 would be a great number for someone that was not dealing with genetic interferences. But given our situation, we needed way way more than what we're getting! 

I don't have all my numbers here, but this is what I know and remember from my previous cycles:

2005, IVF 1

Eggs retrieved: 29

Fertilized: 21

Day 3 update: 15 embryos growing. 

2 embryos transferred on day 3, 13 frozen.

2007, IVF 2

Eggs retrieved: 17

I am not sure how many fertilized, but we had 10 for biopsy on day 3

PGD result: 1 normal

2008 IVF 3

Eggs retrieved: 14

Fertilized: 9, and 9 survived for biopsy

PGD result: 1 normal (but not good grade on day 5)

2008: IVF 4

Eggs retrieved: 17

Fertilized: 13

Day 3 - 11 survived for biopsy

PGD result - 2 normal 

2009: IVF 5

Eggs retrieved: 31

Fertilized (with ICSI) 14

Biopsy will be on day 5, and now I wonder how many will make it. Given our ratios earlier, we will be lucky to have 1 normal for transfer! :-(

So I'm bummed. To say the least. I don't know what else one can do to make the odds turn more in our favor. I don't know why this is so hard.

And that's not enough. Remember my new insurance? I got active on that on 1/1 and with the holidays and then with stims and doctors and ER etc, I wasn't able to talk to them till today to confirm all my coverage. CCRM also needs a written authorization from the insurance, and as they had said, it would be easier for us to get the authorizations.

But, get this, the insurance tells me I have no infertility coverage. None. Whatsoever. WTF????? It is a state mandate, my ex-employer is NJ based. The benefits summary I got says I have coverage. The website member zone shows me I have coverage. But no. The customer service reps (and we called back twice, just in case we were talking to a moron the first time), tell us we have no coverage. That my employer opted for "Benefits Exclusion" and excluded infertility! WTF!!!!!! 

I am now going between emails and phone calls with CCRM (to see if there is any way we can expect maybe a couple more eggs to mature and fertilize) and with my employer (my HR manager is not in office, and the HR assistant says she doesn't understand my question, and can I please email her the terms I'm using, so she can call the rep at the insurance company). 

I'm in a funk right now - why the hell does everything have to be so hard? People get drunk and get pregnant for free! People complain about the work it is to have a baby. I have quit my work TO have that baby, and I'm paying through my nose for everything, and still it's like I'm attempting the impossible!

WTF!

They definitely do some magic

They use the same medications that all other doctors use. They don't use any magic potion of any kind. In fact, in my case, the dosage was half what my local RE would put me on. 

They do monitor you VERY VERY closely. Many REs across the country don't believe in such close monitoring. Many don't believe in the blood monitoring, they just go by follicle sizes. 

CCRM leaves nothing to chance. They take into account everything that could make a tiny bit of difference. 

And here are the results they are able to get from my old ovaries - 31 eggs were retrieved today. Yes, 31, and I'm still in shock!! They don't know yet how many were mature eggs, but they got 31!!! 

The day began bright and early, and we were at the clinic by 7:45 AM. I love their special entry for surgery patients - it's all very James Bond-ish. Announce your name and the garage door is opened up for you. You go directly into the surgery center from the garage. 

They took a long time to be able to set up my IV today. My veins were not very cooperative for some reason. First they put that hot towel on my left hand, and the nurse tried to poke a vein on my wrist. She put in the local anesthetic, and then went in with the catheter. Apparently my vein moved after that! So she went to another vein a few cm away. Same thing. She put the anesthetic, and the catheter, but my veins were in a slippery mood this morning. She decided she didn't want to poke me any more, and went and called another nurse, who tried on my right hand, and thankfully got a vein to stay in place long enough for the IV to get set. 

The anesthesiologist came in, and then Dr Surrey came in. He did my ER today, and he was so warm and friendly! Once I had signed all my consents, they gave me a little cocktail and that's the last I remember. I used to be a fighter, now I'm knocked out even before I am wheeled out of the prep room!! 

The next thing I remember is waking up in the recovery room. I saw JJ being wheeled out to the recovery room after her ER. Once I was allowed to get up, I asked the nurses if I could say hi to JJ. That was the highlight of the day - it was so nice to meet her! J - I have to tell you, you're beautiful!! Even in my drugged state, and your drugged state, you looked lovely! 

It was so sweet of the nurses to allow me to shuffle over to JJ's recovery area - and can you imagine the sight? Me shuffling there in the back open gown, with a sheet wrapped around me for modesty, my feet in those blue booties, with DH walking with me, carrying my IV bag! Comical, aren't we? 

We will find out the fert report tomorrow. And because of the large number of eggs they got, they want me to come in for an ultrasound tomorrow morning to see if my ovaries look ok. Also, Dr Schoolcraft decided they would do ICSI after all. I'm trusting them wholeheartedly now, so I didn't refuse or argue. 

We plan to fly back to CA tomorrow evening, after we get the fert report in. 

That's it people - I'm going to get some sleep now. I'm still whoozy from the anesthesia, but I can't tell you how quickly I got up and sat up once I heard how many eggs they got! Thanks for your prayers and vibes, and thank you God for listening to my prayers! 

PS - On a side note: This morning, while we were waiting for the garage door to be opened for us, we saw Dr School.craft in his car, on the phone, in the parking lot. He drives a fancy shmancy BMW 750i - one that many of us have helped pay for! Just a little tidbit of general knowledge for you guys!

Laying eggs....

The other day, my cousin had called to wish us Happy New Year. She said she had tried me at home, but didn't get us, and she was asking where we were. I told her we were in Denver (I did not want to get into details, but did not want to lie either, so I was trying to be vague and ambiguous by mentioning we were here for "some work"). She wasn't buying. She wanted to know how come we weren't off for New Years. So I told her we were seeing a doctor in Denver. And in the course of my conversation with her, she asked "So what are you doing in Denver this trip?" And I almost said "Oh I'm just here to lay my eggs!" 

Yeah, that's what I'm doing technically. I'm just going to lay my eggs and scoot back to CA. Hopefully my eggs will hatch and all of that, and in the end I will succeed in becoming Mother Hen! 

The way forward from here was what we discussed with the nurse for a long time yesterday. I of course wanted the shortest wait between ER and FET, because as you all know, I've been waiting forever, and I'm running out of patience, money, and things to do! 

We have 2 options. One is to wait for AF after ER, put me on estrogen patches, and come in for FET when the lining looks ready. This is the shorter option - but this would also take about 4 weeks. 

The second option is to wait for AF after ER, start on BCP for 14 days, overlap with Lupron, get another AF, and start estrogen patches thereafter to thicken the lining. 

CCRM suggests the second option. They say this way we have a few advantages:

1) My body will completely be rid of the hormones that are racing through it right now. 

2) 2 AFs is better to shed all the old / hormonal lining and get started with fresh lining.

3) They can time everything better if they have me on BCP so they can predict what will happen when.

Much as I hated doing this, but I found myself telling the nurse that we would go with her suggestion of Option 2. Having come this far, I don't want to compromise ANYTHING. In the grand scheme of things, a few extra weeks don't matter (Of course it's beside the point that my grand scheme of things has been dragging on and in the making since 2001!!!)

The trigger shot went well last night. I didn't even feel the needle, so I promptly gave credit to the lard I'm carrying on my butt. DH was annoyed that I didn't give him the credit for giving me a painless injection! I went in this morning to have my blood drawn AGAIN!! They just want to check if the HcG got absorbed as expected. They said that sometimes they have to call patients in to give them another shot if the absorption didn't happen like they need it to. 

So the egg farm is getting ready for harvest tomorrow! I will post an update tomorrow when I'm able to. I hope we get a good harvest. Please keep your fingers crossed for me!

And now, some pictures of the infertility mecca we know is CCRM:

This is in the waiting area - this is where you go in for your blood work and ultrasounds or meetings with your nurse etc. The doctors see you on the other side of the hall. 

Another view of the waiting area:

This is the entrance area:

This is a shot of the clinic from the road - the entrance is at the back of the building:

Trigger tonight!

Whoot whoot whoot! I am triggering tonight! 

Today went really well. I took DH in with me for the u/s, and he counted more than 20 follicles. That put my mind at rest immediately. Then the nurse came in and she also said things looked great, and she was pretty sure I would get to trigger tonight. 

Thereafter we got to spend time with the genetic counselor, who took us through the details of the chromosome translocation issue we're dealing with, told us the details of the FISH analysis that we need our embryos to go through. She had us sign some 1 million consents - basically, anything that can go wrong and does go wrong is not their fault! :-)

We spent some time with our nurse after that, and she answered some questions I had. When I was given my protocol, they had said they would do ICSI for us, and somehow that was stuck in my head as something which COULD be bad for us. Why? Because of DH's translocation. I was just worried that if we hand select the sperm and ICSI the eggs to fertilize, what if we choose sperm that are unbalanced? There's no way of telling from the outside. There's no way of testing the sperm and selecting normal ones, because the test is a destructive test, ie, it needs a cell to be taken out for testing, and that's the one cell the sperm has. After testing, there's no sperm left. So we felt it would be better to leave it to nature and let whatever  balanced / unbalanced embryos form on their own. The nurse called the genetic counselor in, and all of us decided that it was best to let fertilization happen on it's own. 

My E2 today was 4239, P4 at .3 something, and I've been instructed to take the trigger shot at 10 PM tonight. I do have to go in for blood work tomorrow, but it's going to be a shot free day otherwise! Yippee!!! 

ER will be at 9 AM on Jan 7. 

(How awesome is it that my calendar has gone EXACTLY according to the schedule they gave me 2 months ago?) 

Quick little update

Thanks for your support - I'm trying not to panic. I'm trying to remember that there's NOTHING we can do to make more eggs and follicles, and I am going to continue to trust the doctors. Like all of you have told me, they are among the best in their field for a reason, and I'm going to let them do their job. 

My E2 today is at 3084, LH at 1.7, and P4 at .3 something. They have asked me to reduce Gonal F to 37.5 iu for tonight and NOT do Menopur tomorrow morning. Huh - I've never even heard of a 37.5 iu Gonal F dose before! But then again - they are experts in this field for a reason. They are obviously on top of everything and are monitoring me so closely. So yes, tiny little injection today - 37.5 iu is just one click of the pen (those of you that have used the pen will know what I'm talking about!) :-)

I get the feeling I'll get to trigger tomorrow - what do you guys think? And yes, I'm going to make DH come in for the u/s with me tomorrow. I want him to see the follicles and count them for me!

What if...........???

I’m going to panic a little here today. I know I’ve been going in for my daily monitoring, and I know my follicles are growing, and I’ve been sharing the pictures of the measurements with you guys. Everyday after the u/s, they have you wait in a meeting room, and a nurse comes and goes over your follicle sizes with you. So far every day the nurse (and it’s been a different nurse EVERYDAY!) has been coming in and gushing over how great things look, and how well I’m responding.

And I’ve been believing that. I’ve asked the u/s tech a couple of times how many follicles total they see there, and the response has been “Oh, plenty!” or “Don’t worry, there’s a whole bunch”. In fact this morning, the tech said “It looks like a cluster of grapes in there.”

However, this morning, the nurse that met me after my u/s said “It looks like we have 11 follicles.” I flipped. What if I get only 11 follicles and only 11 eggs total?

Now, at my age, 11 is not bad. But, 11 would be the worst I’ve ever had in an IVF cycle. And, given DH’s translocation, and the fact that our embryos need to go through PGD, I need to be making WAY more than 11 eggs! That’s just to account for eggs that may not be mature, or eggs that may not fertilize, or embryos that may not divide and grow normally, and most importantly, embryos that will have abnormal PGD results. There’s going to be egg / embryo waste at each stage, and if we’re starting with 11, we may have nothing left to transfer! 

Just going by history, in the last 3 IVF cycles, we have had between 10-13 embryos that went in for biopsy and PGD, and we got only 1, 1 and 2 normals in each cycle, respectively. So 90% of our embryos have historically been unbalanced by the translocation! So to have even 1 normal, we need around 10 blastocysts on day 5 to biopsy!! 

I guess part of my panic is coming from not knowing. See, in CA, my local RE would count all my follicles, and we usually were pretty much on track with how many we’d get eventually. Here, a) they are counting only the big ones, and b) the monitors are usually sort of turned away, and I can’t see for myself if there are any more that I can count. Also, in CA, DH always came into the u/s room with me, and if I couldn’t see the monitor, he could stand where he could see the monitor and could count the follicles for us. Here, none of the DH’s seem to go in when the u/s tech calls out names. So he’s been waiting outside while I go in on my own.

I think tomorrow I’m going to make him come inside with me for my u/s, so he can see what I can’t. Oh my goodness – I hope there is an u/s tomorrow! What if I’m triggering tonight? Oh God, now I’m going to be freaking out till they call me with instructions today!

Calming vibes please? Please knock some sense into my head! I know I’m in panic mode but I don’t know what to do about it right now.

Getting there

I'm glad we ran around (or drove around) during the last couple of days and did the touristy sightseeing stuff around here. I was able to keep up with the exertion. But I think that's done - no more running around for me for a few days.  Today, I'm feeling the watermelons that have replaced my ovaries! Goodness!! Bye Bye jeans, hello sweat pants! 

Also, the good weather that we were having is gone. It's snowing today, and cowardly me doesn't have it in me to venture out and brave it! 

Follicle factory doing well - things are progressing as planned. My e2 yesterday was at 1138, and today's level is at 1800-something (I forget the actual number) {That's my E2 level, not a 1-800 number for 'something'} 

If you're interested, here is today's follicle picture:

Now for the not so good part. I'm feeling a little nauseous and queasy today. The nurse also cautioned me about OHSS, because I seem to have a big bunch of follicles that are growing in there. She said however, that my E2 levels were good, so I will probably be alright. So I'm keeping myself hydrated, and am trying to eat well as well. (By the way, I had my physical yesterday to prepare for ER, and they found my iron level to be slightly low, and want me to eat iron rich foods)

I hope I don't hyperstimulate - that won't be fun. 

(I think my posts in the past couple of weeks have been so boring. So "journal entry" type and report like. I'm not feeling very creative these days, and really, a large part of the intention right now IS just that - to have a journal of the progress of this cycle. So I apologize if you're getting bored reading, I promise to think of some interesting things to talk about soon!)

Today

60 something degrees today, but now we know, it's the "warm before the storm". Snow is expected tomorrow. I'm looking forward to it, but I'm also extremely thankful we got such awesome weather during our trip here. We were able to do so much outdoor stuff! 

My appointment today went well too. Follicles are growing well, and I have been asked to ~ get this ~ lower my Gonal F dose for today! I didn't get to talk to the nurse when she called me with instructions, so I don't have my blood hormone numbers for today. I go back tomorrow morning, and will try and get the numbers then. 

Here is today's cell phone picture of the follicles the u/s tech measured:



We went and spent the day at Estes Park and Rocky Mountain National Park. The drive up there was gorgeous, and as we went up into the hills, the snow was beautiful! Here are some pictures: 

This was on the way from CCRM towards Estes Park.


This is at the entrance of Estes Park (as is obvious in the picture!)

This is Estes Park Lake - the color was an amazing deep blue - it was so pretty!! 

This is in Rocky Mountain National Park. Bear Lake - completely frozen! 

We also saw a bunch of wildlife - loads of elk etc. 

I'm mentally pretty relaxed, and am looking forward to seeing how many eggs they can retrieve. The nurse said we should be looking at triggering maybe on Monday or Tuesday. The largest follicles today were in the 15 mm range. I am feeling bloated and I can feel the twinges going on inside. They are asking me to stay hydrated and not exert myself too much. I'm chugging on water, and I told the nurse we were planning to go to Estes Park today, and she said it was ok as long as I didn't trek too much. So we drove around a lot. 

We're now back in the room. DH is cooking dinner, and I'm watching TV, and blogging. What more can a girl want? :-)

What???? Where’s the snow?

So here we are in Colorado, but where’s the snow? Today was a nice warm 54 degree day here, no sign of any snow or anything! No no no, I’m not complaining! I’m loving it!

We arrived yesterday, found our way to the rental car, and to the hotel, checked in, then went hunting for a grocery store, picked up some essentials, had dinner, and came back to the room to wait for the remaining hours of 2008 to go away.

This morning, my u/s appointment at CCRM went well. The u/s tech didn’t measure all the follicles – she said that it’s enough to measure the larger ones, because they just want to get an idea of the progress. My larger couple of follicles are in the 12 mm range, and there are a bunch of them in the 11 and 10 mm range. So it looks like the scare of one follicle gaining dominance is gone. The tech was listing the measurements on the screen, and I took a picture from my cell phone before I left the room – it’s a little shaky, but hopefully you’ll be able to see something!





My blood results looked ok too – P4 at 0.2, E2 at 646, LH at 1.2. CCRM wants me to continue on the same dose tonight, and I go back to see them tomorrow.

Since we’re here in CO, and since we’ve paid so much for the trip, we have decided to make a vacation of it as well. We spent a gorgeous day outside today. It was just breath-taking! We went to the Garden of the Gods, which has amazing red rock formations – the views are spectacular!! Then we went through the historic town of Manitou Springs, and went ahead to the Caves of the Winds. Again, beautiful! The visit to the caves was like a visit back to high school, to geography lessons. I could picture my Geography teacher, drilling “stalactites and stalagmites” into our heads. I don’t think I’ve ever seen a stalactite or a stalagmite in real life before. These caves had hundreds – beautiful gorgeous formations! After that we went up into the hills on a dirt road off of the highway. Both DH and I LOVE these drives into the hills – that’s like a weekly pastime for us! We just love to drive into nature, without maps, without knowing where the next turn will lead us! Here are some pictures:











So all in all, we’ve had a lovely day. I’m feeling good about 2009. So good, that I thought I’d check my “annual horoscope” on MSN. Hahahaha – I shouldn’t have! Here’s what it said:

Anyhow, we're here, we're doing what we have to. The rest is up to fate. We've dealt with everything for so long, we'll deal with whatever comes our way now.

Happy New Year everyone!