Monday, October 22, 2012

Alterna-Transfer Day & Freezing Report

Since T and I already had planned to take the day off for the transfer, we didn't cancel our plans when the transfer was cancelled.  We instead decided to make an awesome day full of drinking and general debauchery - basically what responsible parents would NOT do on a Monday.  Hey - we're not parents today (it's not our day with T's daughter even), so why not?

The day started with sleeping in until NINE.  Seriously, I'm not sure the last time I've slept that late.  I have been on the couch the last couple nights.  That make T sound like an evil husband, but in reality, my APD (the progesterone allergy - same hormone, but unrelated to our transfer cancellation) was acting up.  Getting up multiple times in the night for trips to the freezer for my ice packs was pretty annoying.  So the couch is only a couple steps away from the freezer.  Blech.  I'll be glad when this part is over.

First order of business -- T made some phenomenal eggs benedict, I mixed up some bloody marys, and we settled in to catch up on last night's episode of Homeland (crazy awesome by the way).

After a little more relaxing, we went out to lunch at a local brewery.  Then went on to do what all classy people do on a Monday - GAMBLE!  :)  We had some twenties in our pockets and a casino calling our name.  I proceeded to lose it all, and T doubled his half, so we ended up even.  I call that teamwork at its finest.  We rounded out the outing with a trip to the roulette table with the plan to put some moolah on "2" (more on that).  We got confused with the betting process, and apparently did not put enough money on the "outside" when meeting the minimum.  Still confused on that, and she "cancelled" our bet after she had spun the wheel.  Sure enough, it lands on 2.  Dammit!  It would have been $1,000 if we had bet it all and had it count.  Oh, well.

Ended the afternoon with some appreciation for the fine weather -- and wine and cigars on the back deck.

Pretty sad to have to go back to the "real world" tomorrow.

The good news came while I was losing money on blackjack and slot machines.  TWO of our three embryos were frozen.  The freezing process the clinic has used for the last couple years is called vitrification, which is leaps and bounds beyond the "slow freeze" process used prior.  The process is still fairly new, so I'm excited our clinic uses it.  The old process had about a 50% success rate for frozen embryos surviving the thaw.  In vitrification, the success rate is around 95%.  Therefore, we'd have a great chance of both embies surviving the thaw.

In a way, we're happier with two than three.  If both survive, we are in the perfect situation of transferring both, as we'd be delighted with twins.  Three is a little more overwhelming, and I wouldn't purposely create a situation with triplets.  They generally freeze the embryos together, so we'd likely have to thaw all three if we had them.  And that would leave us in an uncomfortable situation with that last embryo.  Better that God decided it wasn't meant to grow anyway.

We weren't able to get a photograph before the freeze, which was unfortunate.  But we needed to name the two anyway, as we'll be thinking about them all the time.  Our mythology names didn't work out so well last time, so we needed something with a little more modern fictional oomph.  Multiple lives and surviving frozen situations doesn't hurt either.   So, if you think of us over the next couple months, be sure to think of Link and Zelda (from the Legends of Zelda video game series) as well!

I'll check in once in awhile, but certainly won't be posting often over the next several weeks.  It should be about 6-7 weeks before we can start the whole process again, so definitely check back by then at least!

Thursday, October 18, 2012

No dice

This will be short as I'm still really processing what we have in front of us.

Out of our 9 eggs, 5 were mature, and 3 fertilized.  That is actually the same proportion as last time (33% made it to fertilization).  Actually a better fertilization rate, since less were mature.

Given the overall low amount of fertilized embryos and my elevated progesterone, they cancelled my transfer.  We hope and pray that the three embryos make it until day 5.  They will freeze the good ones on day 5.  Then we hope and pray that the embryos survive the thaw when it is time to transfer.  Given all the rest cycles and suppression and other steps, the transfer would be sometime in January.

So....step 1:  make it to Wednesday with 2-3 embryos intact.  Step 2:  make it to January without having a nervous breakdown.  Step 3:  embryos survive the thaw.  Step 4:  ????????????????

Wednesday, October 17, 2012

Retrieval Update

A pretty short message this time as the retrieval was fairly non-eventful.  Unlike our craziness of the first cycle!

We got 9 eggs.  I'm pretty neutral on that.  Definitely better than the 6 eggs from last time, but I was aching to get in that double digit camp.  The number is fairly meaningless until tomorrow though.  That is when we'll find out how many were mature and fertilized, which will be some number less than 9.  I'm hoping and praying for 6.

The results tomorrow will help the doctor decide between our options for transfer.  He didn't give specifics, like X scenario = transfer, Y scenario = no transfer.  But the fertilized eggs will help him make the decision.  He'll be deciding between a 3 day transfer (on Saturday), a 5 day transfer (on Monday) or a "freeze all" option. 

The weird thing is that I'm been categorized as "at risk" for OHSS, which is when your ovaries are too hyperstimulated.  Normally that is associated with people who get some crazy egg count, like 20+.  So, per usual, my body doesn't react normally.  I have to have a high sodium diet over the next couple weeks, monitor my weight gain (> 3 lbs in a day would be bad), and generally watch my health.  Fingers crossed nothing happens there!

So more to come when we find out tomorrow...

Monday, October 15, 2012

Trigger Day, Part 2: Revenge of the Progesterone

It truly is always something.

Retrieval is still on for Wednesday.  That in itself is definite cause for for celebration.

However, my progesterone is currently 2.  Apparently, they like it to be below 1 during the cycle (as in basically nil).  Although, I am reading that other clinics like it "below 2", so it appears that I am definitely borderline.  The progesterone is what communicates with the uterus to "be ready" for implantation.  So if it is elevating too early, my lining could be ready too early, and already on the downhill by the time the transfer/implantation would actually occur.  Therefore, it could interfere with a successful implantation.

We won't really know more about what they want to do until Wednesday.  The "Plan B" is to fertilize any retrieved eggs and then freeze them all.  I wouldn't transfer next week, but would rather have to wait a cycle or 2, and then do a frozen embryo transfer.  I will be SO disappointed if that happens, but obviously we want to do what gives us the best chance for success.  The risk is that the embryos don't survive the thawing process and our cycle is over without a chance.

I just feel like this is my worst outcome.  I was ready to be at the end of this path...either due to a success or a failure.  I figured something would happen that would just extend the path without giving a clear sense of how it ends up...and here it is.  Awesome. 

Anyway, please keep us in your prayers, and hope that the doctors do make the best possible decision.  Whatever that might be. 

Trigger Day!

Looks like we'll be triggering at 10pm tonight for a Wednesday morning retrieval.  It is funny how much more laid back T and I are this time, since we actually know what will be going on.  I'm so excited that everything is progressing nicely...and my gut is VERY excited to have no more Repronex shots.  Just two trigger shots tonight, and I'll be leaving the belly alone to move on to the "in the ass" progesterone shots.

We had about 10 good size follicles, so we're hoping that equates to 10 (or more!) good eggs!

Friday, October 12, 2012

Day 5

Day 5 Update for anyone following the science:  E2 (estrogen) was 1,080 and I had "more than five" follicles on each ovary.  Before I left (before they know the estrogen results), she told me they'd like the E2 below 1,000.  Since it was slightly above, we're going in on Sunday for an extra checkup before our normally scheduled one on Monday.  This is the same as last year, and I love the free look.  So we're in good spirits. 

My stomach looks like crap and I currently weigh more than I ever have in my life.  Hopefully it's just a preview of things to come :)

Wednesday, October 10, 2012

Day 3 of Stims

T and I went this morning for my first bloodwork and ultrasound since stimming.  Like last time, I'm coming roaring out of the gate, which makes me nervous, as we want things to be consistent growth through retrieval.  I had about three measurable follicles on my left side, and about 5 or so on the right, along with smaller ones.  They don't do a lot of specific measurements and counts on day 3.  My estrogen level was 398.  Generally they like less than 100 at this point, but last cycle it was in the 500s, so I think generally we are better?  Especially since my dosages were actually higher to start.

Either way, they cut both my stimulation drugs down by a 1/3.  That's good news to my belly, as lower dosages hurt less. 

So that's that.  We go back on Friday and take it from there!

Tuesday, October 9, 2012

IVF#2 = Cycle 25

I'm a little down in the dumps today.  I'm bruising from my awful Repronex shots (taking 225 IU versus 150IU last time isn't helping), I can already play connect the dots on my stomach from the other injections, I'm starting to bloat enough that it looks like I gained two pounds just in my stomach.  Just from 1.5 days of stimulation.  Our cash flow is very ouchy after paying $10k+ to start off the process last week.  And I figured out today that our IVF is cycle 25 for us.  To be fair, last cycle was on birth control, so it was not really applicable.  But I duitifully record when aunt flo comes to visit, and the nice software turns the number to 25 for me. 

So while it is not quite two years on a calendar basis, we're at two years from a number of cycles perspective.  And a full calendar year with our infertility clinic, whom we first visited on October 3, 2011.  A full year of thinking "professional help" would get us the answer we desired.  Thank goodness we are literally only weeks away from a turning point.  I'm ready for a bit of hibernation from all this.

Sunday, October 7, 2012

Shots, shots, shots, shots!

Only in the warped world of IVF is anyone super excited when it comes time to start shots.  And due to having a pretty full social calendar through the time, we will be mastering the art of shooting up in a restaurant and/or bar bathroom.  Classy, right?

I wrapped up my birth control pills mid last week.  Unfortunately, my progesterone increased those last couple days (maybe I was making some naturally along with the exogenous progesterone from the pills?  I don't understand how bodies work during birth control - especially just taking a partial month).  Or possibly, my magic pill stopped working completely.  Either way, I had a couple miserable nights in a row where I was up every couple hours replacing the ice packs in my little booties.  Those booties are rock star, I tell you.  I just wish the ice packs would stay cold for longer.  I may have to install a freezer in our bedroom for the next month.

On a side note, there just is not enough information on APD out there.  It has been noted that it can cause early miscarriage in extreme cases, but generally it was because the body was suppressing the progesterone needed to carry a child, simply because it couldn't handle it.  That doesn't appear to be the case for me, as my progesterone was ridiculously high during the Clomid IUI cycles.  It was at levels that would carry you very safely through first trimester and even through the second potentially.  So it doesn't appear that it is causing issues, but if this doesn't work again, I'll always wonder if the autoimmune response would be connected to the implantation failures.  Maybe it will be one of those things where they find out more in the next few years, and we try again at some point down the road.  Who knows?

Anyway, we're moving forward with our thoughts on this cycle.  In the last cycle, I started shots about a week earlier, while I was still on birth control.  Those were the suppression shots to quiet my body down before stimulation.  This time, since I seemed to be oversuppressed, the docs were relying on solely the birth control to do its job.  I went for my baseline ultrasound on Thursday, when they make sure the ovaries are nice and sleepy.  Everything looked great, so it looks like the birth control was up to the challenge. 

So I started the Lupron (in a microdose version this time) just yesterday.  Rather than full suppression, at this point it is there to make sure I don't ovulate early on my own.  This whole thing would go to shit if all those follicles go out floating around without a chance of retrieval.

We went to out to dinner and to see a musical at our local civic center last night, so I was either going to need to do my shot in the restaurant bathroom or the civic center bathroom depending on timing.  We pre-filled the syringe before going out, so I was holding my purse gingerly the whole time scared that I would accidentally press down on the syringe.  Turned out we were still at the restaurant when I needed to shoot it in, so I appropriated the handicap stall to the dismay of the homecoming girls going to the bathroom in a group.  It was a lovely time.

Tonight we are saying good-bye to a dear friend that is moving away, so I will again get to take my Lupron with me and shoot up between bites of boar pizza.  Then I'll start stimming tomorrow, which I'm very excited about!  First ultrasound/blood draw on Wednesday, and ideally we'll be retrieving mid next week.  Grow follicles, grow!
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