Pulling out all the stops.

I will admit that I’m one of those kooky people that really believes in the mind-body-spirit connection. I won’t say that I go overboard and chant, hug crystals, eat only organic, and all that, but I do believe that there is something to the connection that your body has with all elements of life. I considered very strongly starting acupuncture treatments with this IVF cycle, but after learning that there is very differing opinions out there about the effectiveness of acupuncture and infertility, I decided against it. Ever the practical person, I also learned that our insurance doesn’t cover it, and adding more of a financial burden to our treatment would certainly not help the stress-level right now. On the other hand, having had chiropractic care in the past, I opted to start seeing chiropractor again. Similar to the acupuncture results, the link between chiropractic care and infertility (and even IVF treatments) is spotty at best. So why am I bothering? First of all, my migraines have come back full-force since stopping the last IVF cycle. Second, I’ve also been lugging around a 38 pound child on a semi-daily basis, so my back and neck are completely out of whack and I can feel it getting worse. My first hope is that the headaches will get better, but I won’t deny that I’m hoping the general feeling of well-being that chiropractic care can bring will benefit this second IVF cycle. My first appointment with the new chiropractor is on Monday.

And, if chiropractic care wasn’t enough, I’ve also borrowed a friend’s yoga tapes and I’m going to try to do it twice a week as soon as this cold stops kicking my butt. I already asked R to get me a gift certificate to a yoga studio so that I can start taking classes again. I took prenatal yoga when I was pregnant with E and I just loved it.

When I was researching the insurance coverage of the acupuncture, I logged onto my health insurance account to look at the claims. It’s still too early to tell, but it looks like some, if not all of the anesthesia costs from my egg retrieval were covered by insurance. When I called the insurance company to ask her about it, she said that it was covered and I shouldn’t see another bill. I’m confused because the IVF financial counselor said that we would have to pay for that portion out-of-pocket when we went for our first IVF meeting, but the claim when through. I called the IVF financial office to see if they had any outstanding balances due, but I’m still waiting for her call back. I don’t want to jump the gun, but if those costs were covered, that saves us $600 per cycle! That, combined with the fact that we don't need ICSI with cycle #2 means that we'll save about $1,000 this coming cycle.

The RE’s office called twice in the past two days to make sure that I know that they got my message about starting our next IVF cycle. The IVF coordinator is out of the office today, but they said that she should be back to me with my cycle dates by December 3 or 4. In the meantime, I’m still just taking the birth control pills and biding my time, trying to get the rest of my ducks in a row.

Blind hope and more...

I realized that in the midst of my post yesterday that I forgot to update on what the treatment will be for our poor embryo quality. Even though he was concerned about the poor quality of the embryos at the end of the fertilization, he agrees that they were going along perfectly at day 3 which is why, as I mentioned in the previous post, we’ll go with a day three instead of a day 5 transfer. What I forgot to mention was that we’ll also be doing a procedure called “assisted hatching” with our day three embryos. Basically, once the embryos get to day three, they will put a tiny drop of an acidic solution on the embryos to thin the outer shell of the embryos. When embryos attempt to implant, they have to break out of their ‘shell’ and they send cells out of the shell to attach to the uterus. If they apply this little bit of acid to the shell, the hope is that the cells will have an easier time breaking out and attaching to the uterus, thereby making implantation easier. If you Google the term “IVF Assisted hatching” you can read about how important AH has become in some IVF treatments. Our RE thinks that AH is our best chance on getting those embryos to attach and grow.

Despite the fact that I’m starting to get a nasty cold, I’m feeling much better about things. I’ll admit that it sucks having to start another IVF cycle all over again, but it feels good to still be doing something. It would have just killed me to take another few months off. Right now I’m just taking my daily birth control pill and anxiously awaiting the scheduling phone call from the RE’s IVF coordinator. With any luck I’ll be starting the Lupron injections in about two weeks. I hope you realize how perverse it is that I am excited about taking injections again.

A friend at work put me in touch with another IVF veteran whom I’ll call K. Like me, K had no known fertility problems. She had five (or six, she can’t remember) IUIs which all failed, two IVF’s which failed and then finally got pregnant with triplets on her third IVF attempt. It was so great to talk to someone who’s actually been through it before and even better to talk to someone who has been successful at it. It gave me this unbelievable sense of hope, something I’ve been struggling with since we lost all 12 embryos. She even used the same practice that I’m using, although with a different doctor.

K validated all the terrible things that I’ve been feeling and was a nice reminder that I am really not alone in this fight. As much as I can talk about this with R and with my best friend and with sympathetic friends at work, it just isn’t the same. It’s extremely difficult for all those people to really understand what I’m going through when they haven’t gone through it themselves. I could not do it without them, but it feels good when someone who’s done it says “You have to have hope because it WILL work for you!” Sometimes blind hope is all you need to keep you sustained for a little longer. Blind hope is all I’m clinging to these days. Blind hope and the deep feeling, almost an intuition, that it will work for us this time around. Which brings me to another point…

I realized the other night while perusing through some old posts on this blog that I haven’t been entirely honest about some of the things that I’ve been posting. I’ve held back some of the things I’ve been thinking because I was too afraid to jinx myself by putting them out there. I felt like if I wrote them down I would be admitting something that I didn’t want to admit and was afraid of what I might be manifesting by writing the thoughts down. Enough of that. It’s time to be honest with myself and if something goes through my head, it’s worth writing down even if it’s ugly. The reason I bring all of this up is because of a conversation I had with a friend (P) in the beginning of October. Before I had even started a single injection, before we officially started our first IVF cycle I stood at her desk and told her that I was certain that the first IVF cycle would fail but that the second would be a success. I don’t know where the thought came from and it didn’t really bother me all that much, but I was as certain of it as I am of my own name. And sure enough, the first cycle failed even though all the signs (pre-fertilization) were pointing to a successful cycle. P thought I was crazy, that I was going to jinx myself, but I told her as plain as I could that I was sure the first one would fail but something was telling me that the second cycle would work. Whether or not it was because we fixed the lining issue, or changed the protocol or what, it was just going to work.

And there you have it: honesty. I’m not saying that I’m forecasting a perfect second cycle, but I’m going along with that intuition that never seems to fail me. When I get these ‘feelings’, it’s almost like someone turns a light on in my head and shines it on the truth and whatever that intuition is just feels true. It’s hard to explain, but I had the same experience before I married R. Something ‘told’ me to marry him and I just knew it was the right thing to do. With that ‘feeling’, it just became a fact that it was the way it was supposed to be. The same thing happened when I got pregnant with E: that voice just said it worked and that I was pregnant. I didn’t even take a test until the day after my period was due and I still knew that it would be a positive test. There was no doubt in my mind and lo-and-behold, it was. Three weeks later, when I was about six weeks pregnant I had another ‘feeling’ that I was pregnant with a boy and a few months later, at our 21 week ultrasound they confirmed E was indeed a boy. These ‘feelings’ just happen and I can’t remember one time when I really believed in it that it wasn’t true. And the same thing happened when I had the conversation with P; I really believed that the first one wasn’t going to work, but the second cycle would.

And as I embark on this cycle, I’m going to let that feeling about this IVF journey sustain me. Those feelings haven’t been wrong yet. I’m going to keep the faith in my own intuition and keep hope alive.

Back in the saddle...

The appointment didn’t exactly go as I expected, but we’re back in the IVF game again. I started my first birth control pill last night and our second IVF retrieval should happen around mid-January.

We had a long talk with the RE about the last cycle and he basically dropped a bomb on us: he’s very concerned about our embryo quality. He was shocked that all 10 embryos that were left after transfer failed and that we didn’t have a single one to freeze. Basically, the embryos all died after day 5 and that’s probably why it didn’t work out for us. The stress on them was just too much and even though the two that we transferred were near-perfect, there’s still no known cause why they would fail. It’s just hard to understand. The worst part is that if we had gone with the day three transfer, he’s certain we would have had at least 6 good embryos to freeze. Sigh. It was just so hard to hear because there’s nothing, NOTHING that we can do to improve embryo quality. The RE said that there’s no evidence that there’s anything wrong with R’s sperm, or that there’s any egg quality problems, so he’s convinced that we should try again as soon as possible. This time, however, even if we have another 12 embryos fertilize, we’ll go with a day three transfer instead of a day five. His thought is that if we get the embryos back to where they belong sooner, it’ll help protect them and hopefully they’ll implant like they should. Hopefully. There are still no guarantees on any of this. Sigh again.

I asked him about the Viagra and the thin lining and he is not concerned about my lining at all. He doesn’t think it had anything to do with our failed cycle. I harped on it so much that I could tell he was getting a little exasperated, but he handled it and basically said that if I wanted, we could start the Estrace earlier this time around to see if it helps. But, when I said I was concerned about how thin the lining was, he replied “But it was beautiful. And there was nothing about the lining that would cause me to cancel your cycle.” He’s still sticking with the thought that as long as it has a triple-stripe, he’s saying it’s alright. I asked him if E’s delivery could have caused my lining to thin over the years and he said that the sonohystogram that we did two months ago would have shown scarring or other problems and there was nothing like that found on any of the results. I asked about the Viagra instead of the estrogen and he said that he’s not convinced about the benefits and does not want me to use it. So, I’ll have to live with it for now. I’m not sure what else to do about it. I guess I could go ahead and find a doctor that goes along with what I want to do, but I’m not sure if that would help or hinder us. There’s really only one IVF clinic in RI and I’m there. My only other choice is to go to Boston and working in the East Bay doesn’t make getting to Boston very easy. It would take me 60 minutes each way for a 7:00am doctor’s appointment. I’m not sure the stress would help…

There you have it. I’m not sure how I feel. Part of me is glad to be starting over, but the other part is just plain tired of all of this. I really just want to get this part of my life over with and get pregnant and be done with it. R is not happy about going through another cycle, but I can’t let it rest right now. I have to keep moving, keep going to make myself feel at peace with being infertile. It isn’t something he can understand and it’s caused a lot of problems in our marriage, but it is what it is. I can’t help the way I feel about this and neither can he.

A slave to the (reproductive) system.

The RE’s office called yesterday (and again this morning) to tell me that I still needed to have my beta, even though I got my period and even though I’ve taken TWO different HPTs that were negative. I even took one last night, just to prove to myself that it really was negative and they STILL want to run a beta. So, I get to have yet another person tell me that I’m not pregnant. The joy of it all. The funniest part is that the nurse asked me if I was still taking the progesterone. I told her no, I didn’t think it was worth it since I was bleeding so much and I had two negative tests. Her reply? “It shouldn’t be a problem if you need to start it up again after the beta.” Um, what part of I’M NOT PREGNANT are you not understanding?

So, my original post-IVF consult was supposed to be on December 6, but I made them change it to tomorrow at 3:30pm. I’m a pesky little bugger, aren’t I? No time like the present to jump back on that horse, right? (See that funny little way I combined two bumper-sticker sayings? At least I didn’t lose my sense of humor along with those two embryos…) Knowing my RE the way that I do, I’m 99% sure I already know what he’s going to say about our failed cycle. He’s going to tell us that the cycle wasn’t a true failure because we learned a heck of a lot about what’s going on. We learned that ovulation isn’t our problem because I had plenty of eggs to harvest; we learned that fertilization isn’t our problem because out of the 9 that they fertilized naturally (without ICSI), all 9 fertilized just fine, which also means that egg quality and sperm quality aren’t issues for us. So, the next issue that we have to think about it what’s happening in my uterus that isn’t allowing those embryos to implant. I’ve done some research and there are two thinks that I want him to investigate and one new treatment I want to try:

1. I found that one of the reasons for a thin lining is the uterus’ inability to absorb estrogen properly. We pumped my body FULL of estrogen but my lining stayed put at below 6mm. Studies show that anything below an 8mm lining is a recipe for IVF failure. One of the reasons that the uterus may be unable to properly absorb estrogen is because of a septic delivery. Most septic deliveries happen when the delivery is unplanned (i.e., mother doesn’t make it to the hospital and gives birth somewhere other than a hospital) or when the mother has an infection of some sort after the birth. When I had E, the placenta was sent off to the lab because the OB thought it looked strange. It turns out that it was infected and so they put me on IV antibiotics for 48 hours. Every time I brought it up with my OB, she said it wasn’t a problem. I’ve always thought it was strange, so I’m going to bring it up again and see what the RE says.

2. Both E and R are O+ blood types; I’m A-. I’m still thinking that because of the infection and the delivery when I had E that our bloods mixed and I developed rH antibodies against R’s bloodtype. I’ve heard of it happening before, but again, when I bring it up, the OB said that the rH shot should take care of that. I’m not convinced that something didn’t happen to make this a problem.

3. A new treatment option: Viagra. Ok, laugh your little head off, but there’s been some very interesting research done in the past 10 years about women with IVF problems using Viagra to solve thin uterine lining issues. Read all about it here:

http://www.fertilitycommunity.com/fertility/viagra-for-infertility-treatment.html

http://archives.cnn.com/2000/HEALTH/women/03/23/viagra.pregnancies/index.html

http://www.inciid.org/article.php?cat=&id=315

So, there you have it. Just one more thing to stick where the sun don’t shine. And since I’m not sure if my RE will consider using it, I’m going to bug him about it until he either does use it or comes up with something as aggressive.

I dragged out the old fertility monitor last night in preparation for the fact that the RE may want us to sit out the month of December. HA! As if I’d let a little thing like infertility stop me in my baby-making plans. I figure that if the doctor won’t let us try with medical intervention, then we’ll have to resort to the old-fashioned way again. Maybe he’ll let us try ‘home relations’ with the Viagra this month, just to see if the lining improves. Maybe we’ll try another IUI with the Viagra. I’m guessing the possibilities are endless right now.

Picking up the pieces

I won't lie and say this has been easy to deal with. It's like a nightmare and every second that I'm awake, I think "God, it failed. I'm not pregnant." It's still such a raw, terrible, lonely feeling. And being with R's family for the holidays doesn't make it any easier. I hate being up here while I'm trying to deal with this. Every time I start to grieve, we have to go somewhere and see someone. It's not helping. We just dropped E off at R's parents house and as soon as I walked in, there were two tiny babies and one pregnant woman on the way over. R just looked at me and I couldn't say a thing. So he dropped me back off at the hotel and he went back over to his parent's house to stay with E. It just couldn't get more uncomfortable and awkward.

My mind keeps coming back to those two embryos that we transferred. It bothers me that they're still in there, dead. It's like I killed them. Like I wasn't strong enough to support them and they just didn't make it. I feel like I did everything right this time around and they still weren't able to survive. It breaks my heart to know that in someone else's body they might have been able to survive and become the children they were supposed to be. But not in my body. I feel like I'm poison. I feel like a complete failure.

I keep looking at E and thinking what if he's all I'm ever going to have? It isn't fair. It really isn't fair. Nothing about this is fair. I'm sick of hearing about people that take only a few months to get pregnant and they weep and cry about it. It's taken me two years, five IUI's and now one failed IVF and I have nothing to show for it except a broken heart, a suffering marriage and 12 dead embryos.

R has always said he doesn't want to try in December because of the holiday, which I find incredibly selfish, but that's another story. He says he 'can't balance his family, our infertility and the holidays all at the same time'. Since the lab is closed anyways, I didn't argue. But it's the point that he 'can't balance it all' that pisses me off. Never mind that I balance taking two injections and three different pills during an IVF cycle, while also getting my blood taken, having daily ultrasounds, going through an egg retrieval and transfer. And HE can't balance it all. No wonder women are the ones to carry kids.

As always, I need something else to focus on, something to keep me going and so I've started thinking about what the RE should start testing for. I'm still convinced that something happened while I was carrying E and I'm starting to think that I've developed antibodies against R's bloodtype. Which would probably cause implantation problems. Since we can't try during December, I'm going to make sure they run every freaking test in the book to fix this problem. I'm sick of being a failure. I've got to beat this.

Goddamn intuition...

Another negative test. I'm not surprised but it's still shocking to see. I was hoping that my intuition was wrong, but somehow I knew it was going to end this way.

I don't even know where to start...

T-minus one day...

I chickened out this morning. I fully admit it. I just couldn't test. I was about three seconds from opening that pregnancy test but I just couldn't do it. I'm really, really scared that this cycle didn't work and I wasn't mentally prepared to see another negative test. So I skipped it. I figure that my fate is pretty much sealed at this point anyway, so why not just wait until tomorrow. It isn't like I could do anything to change it.

So, I'm saying it right here and now, I'm thinking the test is going to be negative. Not only am I not 'feeling' pregnant, but the bloating is going away, my skin is a complete and utter mess, my boobs aren't the least bit sore and I'm still a moody freak. Add all those together and I'm thinking NOT PREGNANT, since those are ALL symptoms that usually happen right before I get my period. All of them, just like clockwork. Ugh. The only thing that I can honestly count in the 'Hmmmm... It's a possibility' column is the fact that if I don't eat every four hours I start to feel nauseous, which is something that happened pretty early on when I was pregnant with E. But that's the only symptom and it could also be nerves. As much as I try to talk myself out of feeling so negative, the fact remains that for the past 20-plus months my intuition has been pretty much close to the mark every time. Listening to that intuition this time around means admitting that my inner-voice is saying “Sorry, not this time around”. I keep repeating “60% success… 60%...” to myself to try to bolster what little hope I have, but it’s not really working anymore.

What am I going to do? It will be so devastating if this didn't work. The worst part is that we won't even have the possibility of trying again until after 2008 because the IVF lab closes for the month of December for maintenance and cleaning. So, no more chances for at least five weeks. Oh god, that makes me just want to cry. Five more weeks of infertility hell.

What in the world am I going to do? Why does this have to be so damn hard?

Moody, moody gal.

I know I'm supposed to be concentrating on remaining positive and upbeat about the possibilities right now, but I'm finding it really, really hard. I'm just in the foulest mood and it's not good. I'm sure it's probably all the stinking hormones I'm on right now combined with the fact that I am bloated beyond all recognition, but this is just awful. And before you start thinking that the bloating is a good sign, let me remind you that in addition to the dry mouth, sore breasts, worry, and bad skin, bloating is one of the expected side effects of the progesterone I'm taking (vaginally!) three times a day. Life is just a ball of fun for me these days.

The last few days before taking a test are always the worst, but add to that the fact that my SIL is in town with her new four-month-old and you have a recipe for one moody, moody gal. I'm just not in the mood to hear "oh, isn't he the cutest?" and "Oh, look E, here's your new cousin!" and "Look what he can do now!" I'm just not in the mood. And I can't even talk to R about it because, according to him, I should be happy to meet my new nephew for the first time. It's enough to make me want to cry right now. Thank GOD they are only here until tomorrow morning.

E has been trying his hardest at potty training these days. He's actually getting to the point where he can tell us when he needs to poop about 50% of the time, which is a big feat for him. He's dry probably 90% of the time, except after naps and during the night. But at least he's moving in the right direction. The only problem is that his preschool wants to start transitioning him into Pre-K in the next few months. Except that he needs to be potty-trained before advancing. So now the pressure is on. I knew it would come, but at least it's at a time of year when I have more days off so I can concentrate on it. Small favors and all...

So, as usual, I spend most of the time I'm awake analyzing every twitch, pain, or cramp and wondering if it's a 'sign'. I also spend quite a bit of time trying to visualize what the heck might be happening within my uterus these days. I keep trying to listen for that voice that says "You're pregnant!", but it's not coming. And that's what's worrying me. There, I said it. I'm just not feeling it these days. I thought I would be overjoyed knowing that those embryos are back with me, but I'm just not feeling like I thought I would: pregnant. Nothing. Zip. And it's freaking me out. I feel like I can't say it out loud because everyone will chastize me for being too negative and if I start hearing that, I'll not only lose it, but I'll start to worry that I'm the reason it's not working. Like my mind poisoned my body somehow. I know the mind is a powerful thing, but I have to believe that it's not THAT powerful, because if it was why didn't it work the other way? If it's that powerful, why haven't the past two years of wishing and wishing to be pregnant made me pregnant?

I feel alone in a way that I can't even explain. I want to feel something. I need to feel something. Anything, any sign. Something.

Focusing on the positive...

R called the IVF lab yesterday to find out what happened with the embryos and he was able to talk to the lab’s Asst. Director for about 30 minutes. Because their policy is to not tell you the embryo grades while they are still fertilizing we had no idea how they were all doing, just that they were all still growing and reaching their milestones. It turns out that the two blasts that they transferred were both AA (the highest grade that blasts can be). The other two blasts were BB and the other 8 embryos didn't make it to full blast stage and so couldn't be graded or frozen. The lab’s policy is to not freeze anything below AA blasts, and so none were of the quality that they would have wanted to freeze, not even the other two that they didn’t transfer but that made it to blast stage. I was glad to hear that we were able to get two AA blasts, but part of me wishes that we could have known their grades before Day 5. It stinks that they told me that four made it to blast, but still only two were of a grade that were good enough to transfer and the other two couldn't even be frozen.

The Asst. Director told R that he honestly feels as though we made the right decision to wait for a day 5 transfer because even if we went with a day 3 transfer, we’d have no way of knowing which of those 12 embryos were the best grade; waiting until day 5 allowed us to ‘weed’ the less-than-great ones out. The Asst. Director felt that we would have ended up in the same exact position we were in if we had gone for a Day 3 transfer because the two that they would have chosen may not have been the two that eventually made it to AA blast. HE also said that by waiting until Day 5, we’ve increased our chance of success from the usual 48% chance to a 60% chance. R agreed that he’d rather have waited for the Day 5 and increase our chances to 60% than to have the unknown factor of wondering about the quality of what we transferred. Still, it’s very scary feeling like we have nothing to fall back on. Very, very frightening to think that we may have to do this all over again if this fails.

Right now I’m trying to focus all of my energy on encouraging these little ones to grow, grow, grow. Everyone that knows what I’m going through has been so supportive and it really, really helps. My friend from work, T, was so great this morning when I practically broke down telling her that we lost the remaining 10 embryos. She said that she believes that God has a perfect plan for me and that this is all going to work out somehow. I know she’s right but the journey there is so darned hard. Just so hard.

On a lighter note, one of the girls that I know from an on-line IVF community that I belong to brought up a good point. Right now I am officially pregnant until proven otherwise. Nice way to think about it.

In the meantime, keep all those positive thoughts coming. I need them more than you know.

Fertilization Report, Day 6 (aka The post-transfer report)

I just called the IVF lab and the report on the remaining 10 embryos is not good. There were none that were viable for freezing. None. I could just cry. I’m so scared now. If this doesn’t work we’ll have to do the whole thing over again.

Oh god. IVF is worse than I ever could have imagined.

Fertilization Report, Day 5 and Transfer!

It was a long night, I can tell you that. I must have woken up about ten times waiting for that sun to rise. E came into my room at about 6:15am, but at that point I was glad for the distraction. We took a shower together and ate some breakfast while I waited on pins and needles for the lab to call. At 7:01am, the embryologist called. My hands were shaking so much I could barely hold the phone. The report: FOUR embryos made it to day 5! Our transfer was booked! I was a little disconcerted by the low number, but she said that all 12 were still growing, but since four had gotten to blast stage, they were going to transfer two and culture the others until day 6 to see how many could be frozen. So, I spent the next ten minutes making all my phone calls: called R with an update, called work to fake sick and the Nanny to bring E to school. I quickly made E’s lunch, packed him up for school and drove him over to the Nanny’s house so she could bring him to school. Then I headed to the RE’s office to get pregnant.

I didn’t have to sit in the waiting room long before the IVF nurse came to fetch me. I changed into my waist-sheet and sat in the recovery area, joking with the nurses and waiting for the RE to finish another transfer before me. Finally, when it was my turn, the nurse came out to get me and we walked into the transfer room. The RE was already there, in scrubs and all. I hopped up onto the table and the nurse checked my bladder to see that it was nice and full. Then the RE and I went over the embryo report. Out of the 19 retrieved, 12 had made it to fertilization and four had made it to blast stage. He showed me pictures of the two that they had chosen for transfer and I couldn’t help but ooh-and-ahh just a little bit. There were my babies-to-be, after all! I have to say, they were two good-looking embryos. The other 10 embryos were still hanging on, with two additional ones getting to the blast stage and the other eight growing, but slowly. The RE said that they were going to culture them one day longer to see how many would be viable for freezing.

So, for one last time the RE tried to talk me out of transferring two back, but I told him that because we were still in that ‘unexplained infertility’ trap, I couldn’t give up on transferring two and he said that was fine. Normally if he agrees with you, he’ll say “I couldn’t agree more”, but this time he just said “alright then” and reminded me that I will have a 25% chance of having multiples. I told him I completely understood and we were willing to accept that chance. With that, the transfer began.

Now, it sounds a whole hell of a lot harder than it is, but an embryo transfer is just like an IUI and since we know I’m a pro at those, this was a breeze. The nurse put that damn freezing-cold ultrasound wand on my belly while the RE inserted the catheter to make sure it was getting into my cervix without a problem. Once he saw it was where it needed to be on the ultrasound, he told the embryologist to get the embryos. She left the room and went to the lab to fetch my babies-to-be. She came back with a small Petri dish lid and a catheter with the two embryos inside and then verified that my name and date of birth were correct. The RE attached that catheter to the one already in my cervix and then told me to watch the ultrasound screen. He told me to watch the two little white dots, and amazingly enough, I saw those two dots going right into my uterus. Those dots were my future babies and I actually got to see them go back where they belong. It was pretty wild.

So, that’s it. I’m officially semi-pregnant. Now we just have to wait another week or so until I can take a home test to see if these babies stick around. And I honestly believe they will. Think about it: if these two little embryos can survive in less than ideal conditions, like the incubation room at the lab, then I believe with all my heart that they’ll be strong enough to hang on and implant where they need to be. These kids are fighters, just like E was. I just have to keep my hopes alive. These babies will make it.

In Fertilization Limbo (aka Day 4)

Oh, this is Hell. Pure and utter HELL. I am a nervous freaking wreck. I can't even tell you how awful this waiting is. I took E to the local Children's Museum this morning to get my mind off everything, which worked pretty well. We got home just before lunch and when I checked the caller ID, I noticed that the IVF lab called but DIDN'T LEAVE A MESSAGE. I totally panicked. I kept thinking "Oh god, they wouldn't want to leave bad news on the machine. That's why they didn't leave a message. Oh god, oh god." I called them and asked if someone was looking for me. The girl pulled my chart and said "Oh, I called you. I don't have an embryo update, but I wanted to let you know that if the transfer does happen tomorrow, it will be really early, like 8:00am. Is that alright?" Of course, I said yes it would, but inside I'm flipping out. What does she mean IF it happens tomorrow? IF??? I asked her "So, there's no new news with the embryos, right?" and she answered "No, we don't even look at them on Day 4. We just leave them in the incubators until tomorrow when we check on them again." So technically she hasn't seen them and isn't holding back bad news from me. I know, I'm sick to think that way, but I'm freaking out here. I can't help it. I feel like my life as I know it is hanging in the balance. And the worst part is that R is in Chicago right now and can't talk me off the ledge.

Oh god, this is torture. I just want this over with. I want those little babies-to-be back where they're supposed to be. I can't take this waiting.

Fertilization Report, Day 3

Got my daily call from the IVF lab this morning and the news is great: all 12 have gone onto the 6 - 8 cell stage and are doing just what they should be doing. So now we've been cleared for a day 5 transfer. I asked the embryologist if she thought we would need to go to day 6 and she said that she's pretty sure that all 12 will get to the blast stage but she's not sure if we'll need a day 5 or day 6 transfer. If they are slow getting to blast stage, they'll wait until day 6.

I'm feeling better since all 12 got to Day 3, but still a little nervous about the next two days. Day 4 seems to be the biggest hurdle and the IVF lab doesn't call on Day 4. There's just nothing for them to report because of the way they develop, but it's going to freak me out knowing that I have to wait until Day 5 to see how my little ones are doing. I'm praying and praying that at least 10 get to Day 5 blast stage. I'd love to be able to transfer two and freeze the other 8, just in case we need to do this all over again.

I'm sure you don't need me to explain how much this is on my mind, but you would not believe the crazy dreams I had last night. I kept dreaming that the lab called and told me that only three made it to day 3. In my dream, I said to myself "this has to be a dream, this can't be happening. I have to wake up." And then I would wake up, in my dream, and it would happen all over again. When I finally DID really wake up, I was a nervous wreck. I was SO glad that the lab calls at 7:00am... it would have been torture to have to wait until the afternoon for another report!

So, for now, I'll keep praying for my little babies-to-be and willing them to grow stronger and stronger. Grow, babies, grow...

Fertilization Report, Day 2

The IVF lab called this morning to give us the embryo update. They called about three hours earlier than I expected, so it threw me off a little. Of course, what she had to tell me threw me off even more: all 12 of our embryos have made it to Day 2! The embryologist said that some of them were three cells, some were five cells but the majority were four-celled. She also said that this is exactly where they would expect them to be at this point. Holy COW! What fantastic news! I was really, really surprised and for a quick second I let myself just revel in the fact that this might actually work! I might be pregnant within the next week!!!

Now the next dilemma starts... when to do the transfer. The RE's office "policy" is that if you have 10 or more eggs that make it to Day 3, they wait it out until Day 5 to see if the embryos can get to the blastocyst stage. The theory is that if the embryos can make it to the blast stage, they'll have a higher likelihood of implanting and surviving. That's all fine and good, except that studies show that and average of 50% of embryos fail on Day 4, meaning that they don't get to the Day 5 blast stage. Remember this is an average... we could have none fail or we could have all fail. Which is why my RE's office only allows Day 5 transfers if you have more than ten. They figure that if you have that many that make it to the Day 5 stage, you're in good shape. Right now we have 12 embryos at Day 2.

This could all change, of course, with tomorrow's phone call from the lab. If three of our babies-to-be decide that they can't hold on and make it to Day 3, our decision is made for us. We'll have less than the ten-embryo-minimum for the Day 5 transfer protocol and I'll be putting two back tomorrow and freezing the other seven or so. BUT, if all 12 make it to Day 3, then we have the dilemma of waiting it out to Day 5 or calling our RE and begging for a Day 3 transfer. All the literature that I've read says that if you can hold out for a Day 5 transfer, it's worth the gamble. But in the same paragraph they say that the implantation rate is approximately the same for Day 3 versus Day 5 transfers. It's all so damn confusing.

I guess what it comes down to is are we willing to hang in there for another few days to see if they can survive? Part of me says hang in there, that if all 12 of these little embryos have made it to Day 2, it's worth seeing how many can make it to Day 5. Even if we lose 50%, we'd still have six left; two to transfer and four to freeze. The other part of me says that I've monkeyed around with nature enough now and I just want the two best put back where they belong. If we did that, we'd have ten Day 3 embryos to freeze versus four Day 5. R says to leave it up to the RE and let him make the decision, but personally he's leaning toward wanting a Day 3 transfer. Of course, his reasons are completely different than mine. He's leaving for Chicago on Monday morning and won't be back until later on Tuesday and he'd like to see this over and done with before he leaves so he'll have one less thing to worry about. Plus, I've already taken Monday off and have the Nanny coming to get E so that I can rest on Monday (which was originally supposed to be one day post transfer). Granted, it'll suck out loud (as far as my work) if I have to take Tuesday off, since I already took Monday. But I'll deal with it.

So, now we're just waiting for that phone call tomorrow morning. And in the meantime, I'm chanting 'grow, grow, grow' every waking second. Come on little ones, you can hang in there.

Fertilization Report, Day 1

I just called the IVF lab to get my fertilization report and we officially have 12 eggs fertilized! They divided the 19 eggs into two groups, 9 to be fertilized naturally and 10 for ICSI (where they inject one sperm into the egg). Out of the 9 to be fertilized naturally, 6 fertilized and three didn’t; for the ICSI group, 6 fertilized and 4 were immature and didn’t fertilized.

I will most likely have my transfer on Sunday, November 11. The RE didn’t even mention doing a 5 day transfer as an option and told DH to keep Sunday (day 3) open for the transfer. I’m finally starting to feel a little excited about our chances! Amazing to think that our genetic material is sitting in an incubator two miles away, waiting to be put back. So the first big hurdle has been passed… now if we can just get those soon-to-be-babies to grow where they’re supposed to grow, we’ll be home free.

The Fall harvest is complete!

The egg retrieval is over and done with! I went in yesterday morning at 8:15am and by 10:30am I was sitting in the recovery area, being wrapped in warmed blankets. Honestly, I don't remember a single thing. The last thing I remember was them having me move to the operating table and then I woke up in the recovery area with the nurse telling me that the RE was able to retrieve 19 eggs from the 21 follicles that were there. He was very pleased (and a little shocked!) with the high numbers. Now the first part of the waiting begins: the fertilization reports. I have to call the IVF lab this afternoon between 2:00pm and 4:00pm to see how many of our little eggs have made it past the first stage and have fertilized. I won’t deny that I am nervous as hell about it, especially since we don’t know the reason why I can’t get pregnant. It’s entirely possible that my eggs aren’t able to be fertilized and that’s why all the IUIs failed, so a whole hell of a lot depends on this fertilization report.

So, while we’re on the subject, here’s the plan for the next few days. If everything goes well and we have a decent fertilization rate, the RE will put the two best embryos back on Sunday morning. In the meantime, we have to wait to see how they progress. Today is Day 1: they have to form into two-celled pronuclei this afternoon. Tomorrow, on Day 2, they have to convert to four-celled embryos. On Day 3, they want to see them formed with either seven or eight cells and if that happens, we’ll be all set for the transfer. A very small percentage (around 5%) of women wait until Day 5 when the embryos have 100 cells in them and are now called blastocysts. The RE already told R and I to plan on a Day 3 transfer, so we’ll probably stick with that. There’s no real documentation that a Day 3 is better than a Day 5 transfer and some doctors say that the embryos are better off getting to where they need to be earlier instead of sitting in a Petri dish until Day 5.

The transfer is a heck of a lot easier than the retrieval. In fact, it’s very similar to an IUI except that they’re putting embryos into the uterus instead of just washed sperm.

And then the real painful part begins: waiting for the blood test. My beta is scheduled for the day after Thanksgiving, November 23. I’m trying very hard not to take the fact that 23 is my ‘lucky’ number into account.

Even chickens don't even have this many eggs...

What a difference a few addtional days can make. The follicle count is somewhere near 21 or above. I've lost count. I was so tired and dazed at the RE's office yesterday that I actually lost count. The biggest one was an 18mm with a few 16 and 15mm ones lined up. That, along with my estrogen being over 3400, was enough for the RE to schedule my egg retrieval. The grand event will take place on Thursday, November 8 at 8:15am. So last night was my last injection, hopefully for a very, very long time. I’ve been pretty sore the last few days, probably due to that fact that my ovaries are about four times their normal size. My back is just killing me but I can’t figure out if I pulled something or if it’s egg related. Add to that the fact that my boobs are about as sore as you can imagine and you have one tired, sore momma-to-be.

I’m praying for a good retrieval count. Even with 21 follicles, it’s very unlikely that all of them will contain viable eggs. I’m still praying for at least 12 good eggs, but we’ll find out tomorrow. I have to ignore that little worried voice inside my head and keep myself positive. I’m scared that all those follicles will be empty or that the eggs won’t be of decent quality. I’m also scared that something is wrong with our fertilization and then I start worrying that nothing will fertilize even if we do have good eggs. It’s all enough to drive me batty.

I just have to keep my hopes up and concentrate on the fact that THIS WILL WORK. It will. It has to.

Shhh… they’re listening

I think my right ovary was upset that I called it lazy yesterday. In the last 24 hours, four more follicles have appeared on the right and we’re now at seven total on the right ovary and a whopping 11 on the left ovary with three more biding their time. That makes the grand total right now is 18, with an additional three measuring less than 10mm. So it’s entirely possible that I’ll reach 21 follicles, not the 12 I was thinking about. Maybe my dyslexic mind swapped the numbers and thought 21 instead of 12.

I’ve been trying not to read too much into any of this right now, but I’m starting to get a little excited about it. 21 follicles is a good number. If we could have at least half of them fertilize, I would be ecstatic. I’m trying to ignore the little worries and fears that keep popping up in my head: what if they’re all empty? Can that even happen??? What if none of them fertilize? What if… god, I can’t even think it. This will work. It WILL work.

I’ve been taking the advice of all the books I read (before I instituted the No-IVF books ban, of course) and I’ve been pampering myself as much as possible. I went out and got a new haircut, my nails polished and I even bought two new pairs of shoes with the refund money that Rick got when the dry cleaner caught my skirt on fire. One of these pairs is a sassy little red pair that I cannot wait to wear. I’ve never owned a pair of red shoes before. I’m feeling almost, dare I say, girly. Oh dear. If I start spending more than my usual three minutes on my hair, someone please snap me out of it.

Keep 'em comin'

The ultrasound this morning found four more follicles lining up with the rest. I still only have three on my lazy right ovary, but my left is just producing them by leaps and bounds. I now have nine on my left ovary with four more waiting and three on my right with three more waiting. So, the number right now is 12, with seven more possible. It's funny, but I had set myself a goal of 12 and that's right where we're at. As if my 'goal' really has any bearing on what my ovaries are doing. Still, it makes me feel a little better that the numbers are growing and that I wasn't completely crazy with the lofty goal of at least 12 to harvest. I'm still nervous about the fact that my right ovary is being so lazy, and the fact that my estrogen seems to be staying low, but I have to just take one day at a time right now and hope for the best outcome possible: a baby.

As for timing, right now I'm at the beck and call of the ovaries and their follicle friends. The RE was hoping to do the harvest (AKA egg retrieval) on Wednesday, November 7 but I'm not sure when it'll happen since my ovaries seem to be taking their sweet time. Here's how it plays out: they want the follicles to be around 20mm before they will harvest the eggs. Follicles grow between 1mm and 2mm per day and the biggest one I have right now is about a 14 or so. So, that would give me at least three more days (2mm per day for three days to get to 20mm total), but since the largest is 14, they may wait a little longer to wait to see when the others will catch up. So, at the very least I have three more days before the retrieval, but it'll probably be more like five days.

Did I mention that I'm so bloated that I have to walk around the house with my pants unbuttoned? Fun, fun, fun!

The more, the merrier! (Tell it to the ovaries, baby)

Today's daily probing and poking was much more productive... or should I say reproductive? Either way, it was better news. The nurse was able to find five follicles on my left ovary (with up to four or five more hiding out) and three on my right (with two more waiting in the wings). So, as of right now I have eight developing with up to seven more waiting; 15 potential eggs. Much better news than Wednesday!

Of course, I wouldn't be me without some bad news to temper the good: my lining is still very thin. Oh, come on. I know you’re not surprised. The nurse said that the RE would most likely want me to start the Estrace tablets again in the next few days to build up the lining. I asked her if it would interfere with my follicle development, since the last time I took estrogen I didn’t ovulate at all. She said “We’re not worried about you ovulating now.”, which is true, but she said that it shouldn't affect the follicles at all. Shouldn’t. I hate that word. I really do. I would prefer “won’t”, but I’ll have to take what I can get.

The bloodwork on Wednesday wasn’t much to admire either. The nurse that called that afternoon told me the E2 had risen to 149 which isn’t great. Of course, this could have a lot to do with the thin lining. The good part is that the Estrace seemed to work for me last time around, plumping the lining up to a passable 7.4mm. The bad part is that I’ll be leaking blue again for the rest of the week. Oh, the joy of infertility!

As for other side effects, I’m dealing. The headache is gone and the cramps and sore belly has started (mostly due to my ovaries being inflated like little fertility balloons), but it’s nothing I can’t handle. Not yet at least.