Tuesday, December 20, 2016

Second Ultrasound

U/S from 12/19/16: Heartbeat (178 bpm) seen,
small SCH superior to (above) fetus; measuring at 8 weeks, 2 days; 
CRL: 17.8 mm, Yolk Sac: 3.7 mm; SCH: 2.2 x 0.7 x 1.9 CM
Yesterday we had our second U/S (at 8 weeks, 2 days). The tech found the baby instantly and we could see the heart beating away (at 178 bpm). The fetus is starting to resemble a baby and we could see the limb buds developing, our little gummy bear. :) The tech showed us the head, and the black circle where the brain is developing. She also showed us the umbilical cord.

It's amazing how much Baby Nelson has grown in just over a week. S/he is still relatively small (the size of a raspberry), but is still bigger than the last U/S (the size of a blueberry)!

The SCH is still there, and is actually a little larger than it was last time. I'm waiting to hear back from my doctor to see if he is at all concerned. If everything looks good, it's possible that he will officially release me into the care of my OB/GYN tomorrow!

Sunday, December 11, 2016

Update - Part 2

On the afternoon of 11/30/16, I was sitting in my colleague's office and I started getting sharp abdominal (period-like) cramps. I didn't think much of it, as I had had occasional cramping here and there. When I got home a couple hours later, I was devastated to see blood. I knew that spotting was ok, but this to me seemed to be way more than spotting. With shaking hands, I texted David: "I think I'm having a miscarriage." He thought I was just worrying, and told me not to worry, but all I could manage to get out was "No. You need to come home now." The on-call nurse at the fertility clinic was very kind and asked me how much blood I saw, what it looked like, and said that I should try to schedule an U/S with the OBGYN in the morning. She said if I felt like I couldn't relax, I could go to the ER, but that they may or may not have the means to do much. I decided I couldn't wait, and as soon as David got home, we immediately drove to the ER.

When I was waiting to be triaged, I realized I had left some notes (my medication information) at home, so David kindly went back home to retrieve them (as well as my injection). I had just been triaged when he returned. My coworker was so kind and came to see me while I was waiting. I was not expecting to see her, and immediately burst into tears when she gave me a hug. It meant so much to me to know that she cared about me and my well-being. Not long after, I was called back to a hospital bed where the nurse took down my information, took my vitals, and inserted an IV catheter into my arm to draw blood. Awhile later, the doctor came in and spoke to me. By this time, it was nearly 10pm. He ordered an ultrasound. The U/S technician wheeled me away and first did an abdominal U/S and then a transvaginal U/S. It was killing me because I couldn't see the screen, and she didn't say what she saw or what she was taking measurements of. When I got back to the hospital bed, I was so tired, and got a little bit of sleep. A little bit after midnight, the doctor came back in and told me that the cause of my bleed was from a small subchorionic hematoma (SCH), which was one of the better things I could have hoped for. He said that they were able to see the fetal pole and a yolk sac, but no heartbeat, which was ok, since it was still early. He said I was measuring at exactly 5 weeks, 6 days gestation (2 days more than I was expecting). I was just so glad to hear that I hadn't miscarried, and that the baby was developing as expected. My first U/S was not scheduled until 12/8/16, so it was great news to hear this. My HCG had also increased to 9,177 which was more good news. While the SCH was (and is) scary to me, I know it's something that happens more often with IVF patients, and I know that it is something that can often times resolve on its own. However, a SCH could possibly cause the placenta to separate from the uterine wall, and may be linked to an elevated risk of miscarriage and pre-term labor...so I was advised to be cautiously optimistic. The doctor told me to take it easy for the next few days and try to get into the OBGYN for another U/S. We were at the ER for 6+ hours that night!

After speaking to the OBGYN office the next day, we decided to keep my U/S appointment scheduled for 12/8/16. I took the day off and rested the entire weekend. On Monday, I went back to work (cautiously) and made a point to sit down, take the elevator, and rest as much as I could. Thankfully, this week was Reading Week (and next week is Finals), so my schedule has allowed for me to take it pretty easy.


U/S from 12/8/16: Fetal pole, yolk sac, & heartbeat (132 bpm) seen,
small SCH superior to (above) fetus; measuring at 6 weeks, 5 days; 

CRL: 7.6 mm, Yolk Sac: 2.1 mm; SCH: 1.3 x 0.4 x 1.2 CM
Yesterday (12/8/16), the entire day dragged as I waited for my U/S appointment at 2:40pm. When it was finally time, David met me in the waiting room. We were then led back to the U/S technician's office where I gave her a brief history of our IVF story as well as the ER visit. I was so nervous when she started the U/S. What if there's no heartbeat? What if the baby stopped developing? What if there's no baby and just an empty sac? What if the SCH has gotten bigger? What if I've miscarried? Every possible thought ran through my head. I got nervous when David stood up to look at the screen, and suddenly, the tech turned it to show us, and she said "There's the heartbeat." 

I was immediately flooded with an overwhelming amount of emotions and started crying. I wasn't even expecting to see the heartbeat flicker, and here it was beating away at 132 beats per minute, right in the expected range! She showed us the womb, the fetal pole, and the yolk sac. It was an amazing site and I'm still on cloud nine thinking about it!

Our next U/S is scheduled for Monday, 12/19/16. I will be finished with the semester by then, and if it's good news, hopefully my doctor will release me into the care of my OBGYN! I have my first prenatal appointment scheduled for 12/28/16. David and I told his family the good news today (Sunday, 12/11/16). It was bittersweet, as we were planning to drive up to Coeur d'Alene, ID this year to celebrate Christmas in a beautiful rented lake house. However, with it being so early in the pregnancy, and now with the higher risks attributed to the SCH, it is best for us to stay in town should anything go wrong. We were bummed to break the news that we couldn't join them for Christmas after all, but we were also so excited to share the news that we're pregnant!

Update - Part 1

It has been a month since my transfer and boy, has it been a whirlwind!

My transfer (on Thursday, 11/10/16) went well. I went to my acupuncture appointment beforehand, suffered through the discomfort of a full bladder during the transfer, went to my follow up acupuncture appointment, and then went home and rested. While I took things pretty easy last time, I was even more "lazy" this time around and stayed in bed (or lied on the couch) for essentially the entire time I was at home (Thursday-Monday). I even switched my flight to a day later to give myself an extra day. I ate pineapple core, walnuts and Brazil nuts, drank pomegranate juice, and kept my feet warm. I was extra careful to sleep on my back only, and then eventually started sleeping on my sides as well. 
Embryo (5 days)


On Tuesday, 11/15/16, I flew back home. David met me at the airport, and as soon as we got my luggage, we hopped in the car and stopped in a random parking lot so he could give me my Progesterone injection. The next day, I went back to work. I had 2 days of work that week, and thankfully, only 1 the next (since it was the week of Thanksgiving). I tried to use automatic doors and take the elevator as much as I possibly could. We spent Thanksgiving with friends, but other than that, I laid low and tried to use as little energy/strength as possible.

I had every intention of not doing a HPT, but on the evening of Friday, 11/18/16 (8dp5dt), David (forgot) and playfully smacked me on my butt, which immediately made me start freaking out. I gave in to my anxieties and took a cheap dollar store test, fully expecting it to be negative...except a faint second line finally appeared after the full 5 minute wait! At first, I thought it was a phantom line, and I read and re-read the instructions. After the wait time, it was clear that while light, there was definitely a second line! I called him into the bathroom and asked him what he saw. I think his reply was something like, "I'm going to be very cautious before believing anything." All the anxieties, fear, and worry, immediately rushed away. I could not believe it!

The next day, and the next day, and the next day, I took several more dollar store tests. I checked to see if the second line was still there and if it was getting darker. I even splurged and got a First Response Early Result test, and the second line was darker than the control line.

What was so weird was that during my 2ww, I did not have many symptoms at all, if any. The first transfer, I had headaches, cramping, heartburn, nausea...this time around, I had a couple headaches that I attributed to the injections...but a few days before taking the HPT, I remember sleeping with my hands on my abdomen, and I felt pregnant. Of course, I dismissed the idea, since I didn't know what it felt like to be pregnant. 

Finding out I was pregnant was the most amazing feeling in the world, but it sucked because the only person I could share it with was David. We didn't want to share it with anyone else until I had passed all my beta tests and possibly even heard the heartbeat. My first beta was scheduled for the day before Thanksgiving, so we thought it would be perfect to tell my parents (who were visiting my brother) on Thanksgiving day. I was so nervous on the day of the beta (11/23/16), but was so excited when my nurse called me. She said, "Congratulations. You're pregnant!" and told me that my HCG level was at 665.7, which was higher than I had expected. My second beta was scheduled for the day after Thanksgiving, 11/25/16, and the number rose to 1,690. The third was that following Monday, 11/28/16, and it was 6,013!

I thought that getting a positive on a HPT would make everything super easy from there on out, but I was so wrong. With IVF, you are faced with so many hurdles during the entire process, and no sooner do you make it over one, that you are faced with ten more. The doctor wants to see your betas rise (preferably by 65%) with each test. After that, you are scheduled for ultrasounds at 6-7 weeks and then again at 8-9 weeks. He expects to see major milestones in development such as a fetal pole and yolk sac, and a heartbeat, before he is comfortable enough to release you into the care of your OBGYN. After each of these tests, I would be relieved to receive good results, but then start worrying about what would happen next. 

To be continued...

Tuesday, November 8, 2016

FET Schedule

I just got a voicemail from my nurse. My FET is scheduled for 2:00pm, but I need to check in at 1:30pm. 75 minutes prior to the FET, I need to empty my bladder and then drink 20 oz. of water (from 12:45pm-1:00pm). I am not looking forward to the full bladder part--that was absolutely awful last time!

My pre-FET acupuncture appointment is scheduled for 12:00pm (45-minute appt.). Then I will drink my water and check in for my FET appt. After the procedure, I will go back and do my post-FET acupuncture appointment, then go home and rest.

I will take it easy for 2-3 days (no lifting anything over 25 lb.), and continue my oral/vaginal Estrace and Progesterone injections until my first blood pregnancy test (scheduled for Wednesday, 11/23/16).

I am a little less nervous/anxious this time around, but of course I'm sure that will change as I enter the 2WW! 

FET Schedule for Thursday, 11/10/16:
  • 12:00pm – 1st Acupuncture Appt.
  • 12:45pm – Empty bladder, then drink 20 oz. of water before 1:00pm
  • 1:30pm – Check in (4th floor) for FET Appt. (Bring photo ID)
  • 2:00pm – FET procedure
  • ~2:450pm – 2nd Acupuncture Appt. (exact time TBD)

After Transfer:

  • Take it easy for 2-3 days; no heavy lifting
  • Continue medications  until first blood pregnancy test

Wednesday, October 26, 2016

Not-So-Oral Estrace

Last time I spoke to the doctor, he had mentioned that my lining (at the last FET) was about 8.6mm (they aim for over 8) but that he would consider adding in an Estrace suppository this time around. I asked the nurse about this, and the doctor agreed that I could add in the vaginal Estrace. I was expecting her to call in a new script, but (unlike Progesterone), there is no "official Estrace suppository" and you just take the exact same pill vaginally! That's right...you stick that little blue pill up there.

I started this last night and am hoping it will help to increase my lining this time. It is a bizarre thing to do, but I spoke to two nurses about it (and read a few online message boards). I highly recommend wearing a pantyliner!

All in all, even with the extra steps of taking 2 pills (orally and vaginally) 2 times a day, it is much better to take the pills than to do the injections. You only have to do the injection once every few days, but there's so much involved with the injection (time of night, numbing, drawing up medication, switching needles, injecting, heating pad, etc.)...not to mention that I can't give it to myself since it's very hard to reach back there. The pills allow me to be much more independent, but just require that I have 2 alarms set every day.

I was looking at my calendar and I can't believe the transfer is only about 2 weeks away. I am not looking forward to the actual transfer (with the full bladder) and I am certainly not looking forward to the 2-week wait! Hopefully, it won't be as dreadful this time around. I am telling myself now that I will not do any at-home pregnancy tests this time. I am hoping I can exercise enough self-control.

Wednesday, October 19, 2016

Here We Go Again...

After our negative pregnancy test (7/28/16) and then stopping the Estrogen and Progesterone injections, I got my menses relatively quickly (8/3/16)...but I kept waiting and waiting for it to come again so we could start birth control to prepare for our next FET, and it just wouldn't come. After nearly 60 days, I had the nurse order a no menses panel which included: STAT Estrogen (E2), Progesterone (P4), and HCG (Quantitative) blood tests...so I drove 3 hours to the closest fertility clinic that could fit me in (on 9/23/16)...only to find out later that day that my menses "was on its way" and the doctor felt I should wait instead of inducing. It did end up coming a few days later (on 9/27/16). I was finally able to get my official protocol for our FET (scheduled for 11/10/16).

I started birth control on 10/1/16 and took my last pill on 10/15/16. Two days later, I drove another 3 hours to get my bloodwork done at an outside lab and then went to (yet another) fertility clinic for my baseline ultrasound. Long story short, I found out later that afternoon that the lab I went to did not/was not able to STAT one of my tests, so my nurse/doctor never got the results and didn't call me to tell me if I should begin my Estrogen. I was incredibly frustrated with this situation, as I had only made my appointment with this particular lab after calling first to find out if same-day results were available, and what the price was. (It was significantly cheaper than having it done at the fertility clinic.) Things turned out ok in the end (after multiple calls to the lab as well as the answering service and on-call nurse at my clinic). I started oral Estrace that evening (10/17/16). 

There is currently a nationwide shortage of injectable Estrogen so the doctor switched me to oral Estrace (2mg tablets 2x/day). My next appointment (bloodwork and u/s lining check) are scheduled for 11/5/16. I do have to say that oral Estrace (though I have to take it twice a day, 12 hours apart) is a lot easier than having to do IM injections, since I have to have someone do those injections for me. When/if I start Progesterone after my lining check, I will have to begin daily injections of those. 

My plan for the FET is to fly to my parents' house that Wednesday (11/9/16), do the transfer on 11/10/16, then fly back here on Monday, 11/14/16. I'm hoping that resting for ~3 to 4 days will be enough before I have to go back to work. I am not getting my hopes up for this transfer, specifically because the embryo had to be biopsied twice (thawed and frozen twice), which decreases the chances a little bit...but of course part of me is still hoping (and praying) it will work. I did end up finding an acupuncturist here in town that specializes in fertility, and my first appointment was last Friday (10/14/16). I will go to her another three times and will also do appointments at the place connected to my clinic before and after the transfer.

Trying to manage everything with outside clinics (3 hours away) and my home clinic (which is 3 hours ahead of us) while teaching full-time, has been somewhat of a nightmare. Not only do I have an extra busy semester this fall, but I also made the (crazy?) decision to take on a supplemental position with the business school, which requires an additional 8 hours/week of my time. I have been working 10-11 hour days, 6 days a week...and it's been exhausting. David and I were able to escape to Disneyland two weeks ago for a much needed 4-night, 5-day getaway, and an absolute blast. :)

The second time around, I am hoping my emotions will be less up and down. I am hoping that now that I know what to expect, I will be able to relax more and that I will be able to bounce back more quickly from any disappointment. I am determined that one of these six cycles will eventually work...

Monday, August 8, 2016

The Next Step

Today I met with the doctor to discuss the next steps. At first we discussed doing the FET of the final embryo this December/January while I'm on Winter Break, but after realizing that the chances of pregnancy/implantation are lower (due to the re-biopsy and re-freezing), I asked what he thought about just going into another cycle. He suggested that we do the FET some time in early November, and should that fail, plan to start another cycle in December (with ER in January). With this plan, I will hopefully be able to do another FET during Spring Break (in March) and then go from there.

I felt better after coming up with this plan, because I'll start BC again soon which makes me feel like I'm actually doing something even if it's just syncing up my period to the right date. He didn't really have an answer as to why the FET failed, and said there could have been a number of different things. My uterine lining was at ~8.6mm (and they aim for over 8). He said that with the next FET cycle, he wanted to add in an Estrace suppository in addition to the Del Estrogen and Progesterone linings and aim for 9mm. He also mentioned that there is a uterine lining test that can be done, but he usually doesn't recommend that until multiple failed transfers.

I am still feeling a little down, but am much better than I was. I think the fact that the school year is starting (and that I am not prepared) definitely affected my mood too. I am headed back home tomorrow (with my dad and dog) and will hopefully get back into the groove of things soon. Although I am not looking forward to starting school again, I'm hoping that teaching and working again will help keep me occupied until November!

David and I are also looking into planning a little anniversary vacation somewhere warm! :) 

Tuesday, August 2, 2016

Not-So-Good Grief

Prior to starting our cycle I bought 4 different books on IVF and infertility. None of them cover the grief/loss period in detail. The majority of the books talk about the process of finding a doctor, different fertility treatment options, the STIMS process, transfers, etc. but then spend very little time on what happens if it doesn't work. Infertility for Dummies by Sharon Perkins and Jackie Meyers-Thompson talks about the grief process for 2 half pages (barely 1 full page). 


Injection sites after 4.5 weeks of del Estrogen and Progesterone
I think I've gone through the majority of the grief stages they discuss (borrowing from On Death and Dying by Elisabeth Kubler-Ross): Denial, Anger, Bargaining, Depression, and Acceptance. I'd say right now I'm still in the Depression stage, although every once in awhile I feel like I might be moving into the Acceptance stage...but then I go to sleep, wake up, and the depression hits me again. Someone told me it was "okay" for me to be "mad at God." The thing is, I'm not. I'm not mad at God. I'm not mad at my doctors. I'm not mad at myself nor my husband. I'm just sad. I'm grieving not only the fact that it didn't work, but also the time lost, the money lost, the hope lost, the babies lost.

The doctor retrieved 19 eggs on the day of ER. The next day, we found out that 17 of those 19 eggs were mature, and 11 had fertilized. That day we already went from 19 to 17 to 11. Then by Day 7, we were left with only 4 embryos that made it to blast. That day I grieved the loss of the 7 embryos that didn't make it. A couple weeks later, we got our PGS results back and I grieved the loss of 2 more that were abnormal. The day of the beta, I grieved the loss of the embryo that made it into my womb, but didn't hold on. I'm still grieving this loss.

The past month has been full of difficult things. Our lawnmower broke. My husband's car broke down. There was an issue with my credit when we tried to refinance our home. A water pipe broke. My dog had to go to the ER. I try to look on the bright side of each of these things, but it's pretty tough to do when it feels like everything is going wrong at once. 

I really need a vacation.

Sunday, July 31, 2016

Negative

I got the beta results on Wednesday (7.27.16): negative, as suspected. My HCG level was <1. I wasn't surprised to hear the news. The nurse did have some good news. The PGS results for our last (nonconcurrent embryo) came back and the embryo (grade AA) is normal. I will speak to the doctor on 8.10.16 to discuss our next steps. I think he will want to go ahead with another FET of the last embryo before moving forward with another cycle.

I start teaching at the end of August, so the next time I will have the required time off (for an FET cycle) will be in December during Winter Break--although the clinic shuts down during the holidays, so this will also be an obstacle. Another STIM cycle would have to wait until next May...this is what makes things so hard. The failed transfer is devastating, but it's even harder having to wait so long until we can try again. I worry about timing and the clock ticking, and getting through a semester (or two) of teaching. 

The day I got the news, I felt okay...and was happy to hear the news about the normal embryo...but in the days following, and especially this weekend, I have gotten more depressed. It is hard to get out of bed, to eat, to take showers. I don't want to do anything. I have 4 classes to prep for this upcoming semester, plus a textbook chapter to write, and I do not have the energy or ability to do so. I feel like I'm dying.

Did I mention that my best friend had her (first) baby the day after I found out? Of course I am happy for her, but I have to tell you I have had to unfollow so many people on social media this week. It seems like everyone is posting pictures of their baby bumps, showers, baby rooms, kids, etc. (I also decided to unfollow people who have been posting election-related stuff that I disagree with...because, really, who needs that?) 

I did come across this article about HGTV's Flip or Flop couple, Tarek and Christina El Moussa. It turns out that after they found out about Tarek's thyroid cancer, they were told they should not try to get pregnant for 6 months to a year, so they decided to sperm-bank and do IVF. It took them 3 tries and 2 doctors, but they got pregnant with their baby boy, Brayden James. I have had the pleasure of speaking to Christina a few years ago, and I reached out to her again and got a sweet message back from her last night. It is nice knowing that others have gone through this, and that it took them several attempts.

There are actually a number of celebrities who suffer from (or have suffered from) infertility and/or have gone through IVF. It is somewhat encouraging to know you're not alone in this. Something that Jennifer Aniston wrote recently in a letter really stood out to me: "We are complete with or without a mate, with or without a child. We get to decide for ourselves what is beautiful when it comes to our bodies. That decision is ours and ours alone."

Tuesday, July 26, 2016

Preparing for the Worst

I hate these things! (And they are so expensive!)
My beta is tomorrow morning at 10:30am and I am preparing for the worst.

 I ended up taking HPTs on Days 6, 8, 9, 10, and 12. All negative. I started getting worried on Day 8, and the rest of my hope disseminated with each test I took. It was like letting air out of a balloon. HPTs are the devil.

I have to say that perusing message boards at this time was not helpful, especially when other women, who had transfers on or around the same day as me, were starting to see faint positive lines on their tests. I would say probably 90% of the messages I read of people with successful betas had seen positive lines by Days 5-9 or were those who never did HPTs at home. I had pretty much succumbed to defeat until I spoke to my friend Anna online last night. She started the IVF process a month ahead of me (and did a fresh transfer) and is now at the beginning of her 2nd trimester with a baby girl. She told me she did not get a positive until the morning of her beta (Day 14). That did give me a faint glimmer of hope, but the cheap dollar store HPT I took today (Day 12) was clearly negative, so that quickly went out the door.

Part of me is still praying for a miracle, but I know I should not get my hopes up or count on anything positive coming out of tomorrow. I'm dreading the phone call tomorrow afternoon because I know it will be the last nail in the coffin. And let me tell you, each of the negatives on these tests killed me a little bit. You build up so much anxiety and hope to see the faintest of lines because maybe, just maybe today your body has made enough HCG to detect, and even just a faint line is enough to give you some sort of relief...and of course, that positive line would of course provide that relief...but no line means the exact opposite of relief. It's devastation. It's getting the wind knocked out of you. It's having your heart wrenched out of your chest. It's your world crashing down. It's the worst stomachache in the world. It's absolutely the worst feeling in the world, and nobody else could ever possibly understand it unless they've been in your exact shoes. 

I just devoted 4 months (and my entire summer vacation) to this, the countless injections, the hormones, the pain, the dietary restrictions, the physical restrictions, the mental anguish, the loss, the mourning, the money, putting all my eggs (literally) into 1 basket...and to watch it succumb to nothing.

My biggest frustration is we have to start all over again. We only had the 1 normal embryo (and 1 that is currently being re-tested)...so unless the last embryo is normal, we will have to go through STIMS once again, and then more testing, and then another FET...and the next time I will have 4 months to devote to this is next summer, a year from now. Right now I do not know how I can possibly get through teaching another 2 semesters before we can try again. This does not even seem feasible to me. I do not have the energy, strength, or capability to even think about prepping 4 classes which start in less than a month. 

One thing I've learned from this FET cycle is that HPTs are a bad idea. I do not recommend them to anyone. The best case scenario is that you see a positive at some point and your joy comes sooner than your beta. The worst case scenario is that your hope is crushed a little bit each time you test, and then crushed completely on beta day. I think that having it crushed just one time would be so much better than 6 times. I can't promise I wouldn't do them again next time, but I do know I wish I hadn't done them this time.

The beta is in 10.5 hours. Praying for the best; preparing for the worst.


Wednesday, July 20, 2016

I Caved.

I was sitting at my desk doing some work for my summer class and I started getting those Aunt Flo cramps. Not only have I been feeling those cramps, but I have had that "heavy" feeling exactly the way I feel when I know my period is coming. My period is due on or around Friday, 7.22.16 (which is in ~2 days). I was so "sure" that they were period cramps that I caved and took a home pregnancy test (HPT). My hands were literally shaking as I tried to unwrap the plastic from the box. Results? Negative.

Right now I am really discouraged and bummed. I know it may be too early to take a pregnancy test or expect to see any sort of positive result (~5dp5dt) but I was hoping to see at least the faintest of lines so that I could stop worrying.

I am mad at myself for caving and taking the dang test, but I'm also just upset at the results and this entire process. I know the road's not over yet, but I just know my period is coming...I can feel it. I know there are many women out there who felt period-like symptoms, had a negative HPT at 5 days post transfer, and went on to have a positive a few days later...but I just can't help but worry that that's not the case for me.

This. Is. Seriously. The. Worst.

Tuesday, July 19, 2016

This. Is. The. Worst.

The TWW is THE WORST. Throughout this entire process--the countless injections, the numerous visits to the doctor, all the ultrasounds, the daily blood draws, the violating ultrasounds, the bloating and headaches--this is the worst!

I am currently 5dp5dt (5 days post 5-day [embryo] transfer) and I still have 8 days until my beta pregnancy test (7.27.16). I seriously don't know how I will last that long. I have 2 boxes of FRER Pregnancy Tests sitting on the kitchen table, but I am hoping I will somehow make it to the beta without opening them! Perusing all the online forums, so many women begin POAS (peeing on a stick) starting on day 5, although many of them get a negative at such an early stage. I don't know if I have it in me to do it and get a disappointing result. More seem to get (very) faint lines starting on days 7-9. Day 9 (for me) is this Saturday (7.23.16), which is only a day after I should be expecting Aunt Flo, and only 4 days before the beta, so I keep telling myself if I can wait that long, I can wait a few days more. Who knows. I'm literally taking things a day at a time...an hour at a time?

I cannot even begin to describe how ridiculously difficult these first 5 days has been. Right after the transfer, you start noticing, feeling, and being aware of the tiniest things you (and your body) are doing. Am I peeing too hard? Am I putting too much weight in each step as I walk? Should I drink/eat that? Did I stretch myself too much when I was: putting on my seat belt, reaching for the remote, grabbing my phone, petting the dog, using the microwave, tying my shoe, washing my hair, laughing, breathing, sleeping...every movement, every gesture, every thought, you are worried about jeopardizing the implantation of the embryo(s). You're just certain that that one decision you made (drinking something too cold, laughing too hard, putting on your shirt, reaching for that towel, eating that piece of chocolate) has jeopardized the embryo in some way/shape form! It's a nightmare.
IM injection sites: Honestly, the bruising
and pain is nothing compared to the TWW!

Don't even get me started on the hormones! At this stage, I'm taking nightly injections of Progesterone as well as injections of Del Estrogen every 3 nights. (Del Estrogen is an injectable form of estrogen that is given to help thicken the endometrial lining. Progesterone is produced by the ovary after ovulation, and is given to support embryo implantation.) So here you are naturally worrying about the implantation that is supposed to occur over this 2-week period, and your hormones are completely out of wack. Don't forget that if God forbid, you aren't pregnant, then that means you're about to start your period, so you're possibly PMSing...and if you are pregnant, you have all those hormonal changes/imbalances going on too. I was watching an old episode of 16 and Pregnant yesterday where Farrah gave birth, and as soon as the baby was born and the doctor said "Happy Birthday," I burst into tears. 

Every day, night, hour, I am feeling different symptoms that could mean implantation or could mean miscarriage or could mean my period is coming. And unfortunately, after an FET, with all these different things going on, and especially because of the hormone injections, could mean absolutely anything. Also, the Progesterone could prevent a period from coming, so even if you aren't pregnant, and you should be getting your period, you might not, because of the Progesterone.

Normally I can take my mind off things by going to the gym for a couple hours or taking the dog for a walk, but both of these things are a no-no. I can't do my normal stress-reducing workouts and it's too hot during the day to take the dog out (plus he pulls on the leash)...so I am stuck at home watching TV, trying not to eat too much, and constantly perusing message boards (which I need to stop doing).

July 27 cannot come soon enough!



Friday, July 15, 2016

The Transfer

I had my transfer yesterday! My mom and I left the house at around 9:30am, and got to the clinic a little early. I went in for my pre-FET acupuncture appointment at 10:45am. The acupuncture points were a little different than last time. They were on different parts of my limbs and included my inner wrists. After my appointment, my mom and I went to lunch at Panera before I had to empty my bladder and start drinking 20 oz. of water. By this time, I had not gotten a call in the morning saying anything went wrong with the embryo thaw, so I breathed a sigh of relief, assuming that the embryo thawed without complications.

Drinking the 20 oz. of water was no problem, but right before I was called back for my appointment (around 1:45pm) I started feeling the fullness in my bladder. Then my mom and I sat in the room waiting for awhile and it kept getting worse and worse. I should explain that I already have a teeny tiny bladder to begin with...20 oz. of water is a ridiculously large amount of liquid for my little bladder to hold! Before the doctor game in, I absolutely couldn't hold it any longer so I scrambled to put my shorts back on and ran out the door into the nurses about to come into the room! They told me I could relieve myself for a (very fast) count to 10. I counted to 5 and (surprisingly) was able to stop mid-stream. 

Our little embryo! The embryologist gave us the cutest little
card framing a photo of the little nugget!
I went back into the room and they came in to start the transfer. I'll be completely honest. The fullness in my bladder was so incredibly uncomfortable that I don't remember much of the procedure, except that the catheter going into the cervix felt like nothing compared to the U/S tech pressing the wand on my abdomen. The doctor tried to distract me by asking me about my students, and I tried to answer him as best as I can. He showed me my embryo on the screen before the procedure, and then I got to watch as the catheter was threaded through my cervix into the uterus, and then as the embryo was released! There was a clip on the monitor that they replayed several times so I was able to record it on my phone.

After the procedure (which probably didn't take more than 15 minutes total), the doctor told me to stay lying down for 5 minutes, during which a nurse would come in with discharge instructions. I was just about to get up to go to the bathroom (because I couldn't hold it any longer) when the nurse came in...so I (begrudgingly) listened to her as she gave me the instructions. (I told my mom to listen closely since I wouldn't be able to pay much attention!)

After I was finished, I went to my post-FET acupuncture appointment. The points were similar to the first time, except the acupuncturist did not put them in my abdomen and concentrated the heat lamp on my feet (instead of abdomen). After my appointment, I was headed toward the bathroom and almost tripped on my feet. I didn't trip/fall, but just kind of stumbled a little and landed on my left foot harder than I would have liked. Of course I started freaking out because I was worried I dislodged the embryo or moved it or something. In the car on the drive home, I frantically called the office in a panic until a nurse finally got back to me and said the doctor said I would be fine. After we got home, I spent the rest of the afternoon/evening in bed and lounging on the couch. 

Today I took it pretty easy too. I started getting some abdominal cramps during the late afternoon that started on the left side. I took a nap to sleep it off, and when I woke up the cramps had radiated toward the right side as well. I called the on-call nurse who said cramping is normal. She did say I could take Tylenol (not Advil) although it may not help much with cramping. It did seem to help a little though. Then after I ate dinner, I got heartburn. I spoke to another nurse (the one who did my first at-home IM injection for me) and she said I could take TUMS, Pepcid of Zantac as needed and that sometimes cramps and heartburn could be early signs of pregnancy! I don't want to get my hopes up, but that makes me feel a little better.

Tuesday, July 12, 2016

FET Schedule

I just got off the phone with my nurse. My FET is scheduled for 1:45pm, but I need to check in at 1:15pm. 75 minutes prior to the FET, I need to empty my bladder and then drink 20 oz. of water (12:30pm-12:45pm). They prefer you have a full bladder during the transfer so that they have better visualization during the abdominal ultrasound to help the doctor know where best to implant the embryo.

I am planning on going in for my pre-FET acupuncture appointment at 10:45am (45-minute appt.), then go to lunch with my mom, drink my water, then check in for my FET appt. After the procedure, I will go back and do my post-FET acupuncture appointment, then go home and rest.

The nurse recommends I take it easy for the 2-3 days after the transfer, with no heavy lifting, and light aerobics only (walking, yoga, swimming). I am to continue my del Estrogen and Progesterone injections until the first blood pregnancy test (2 weeks later).

I am getting super nervous/anxious, especially since we are still waiting on the embryology lab to re-biopsy the non-concurrent embryo (they are taking their sweet time!)...in the mean time, I am doing a whole lot of meditating and praying to get me through today and tomorrow!



FET Schedule for Thursday, 7/14/16:
  • 10:45am – 1st Acupuncture Appt.
  • 12:30pm – Empty bladder, then drink 20 oz. of water before 12:45pm
  • 1:15pm – Check in (4th floor) for FET Appt. (Bring photo ID)
  • 1:45pm – FET procedure
  • ~2:30pm – 2nd Acupuncture Appt. (exact time TBD)


After Transfer:
  • Take it easy for 2-3 days; no heavy lifting, light aerobics only (walking, yoga, swimming)
  • Continue injections until first blood pregnancy test

Sunday, July 10, 2016

Preparing for FET

I got back from my short visit home on Friday. Unfortunately, my connecting flight got canceled, so I had to kiss my checked suitcase goodbye as I tried to find another flight. Luckily, I found one that would get me home around the same time, but it meant that my Early Bird Check-In status was gone. Luckily, I found a window seat (next to a couple) on my first flight, and since I was riding in the same plane to my 2nd destination, I was able to switch seats after we landed, and I got a first row seat with extra leg room. As I suspected, my bag was lost, but I got it back the next morning after my lining check.

Speaking of my lining check (yesterday, Saturday, 7.9.16), I was super nervous in the days leading up to it. I made the mistake of perusing message boards online (which can be good or bad), and came across a post where a woman's FET was canceled because she had ovulated. I immediately started panicking because I had no idea that your FET cycle could be canceled due to something like that. Of course, I was worried because I had some ovulation-like discharge, so I brought out my trusty ovulation predictor kits (OPK)...which I thought I was done with forever! I went to my lining check appointment yesterday morning, and the sonographer said my uterine lining looked great (8.6mm vs. 3.4mm at baseline), so I just had to wait for the nurse's phone call with my blood work results. She called later in the afternoon and told me everything looked great, that I had not ovulated, and that I would start nightly Progesterone in Oil injections (1 cc) in the evening. Everything seems to be a go for my FET scheduled for Thursday, 7.14.16.

I am trying to get as many sessions in at the gym as I can, because I won't be working out for awhile after the transfer. I'm also still planning on doing acupuncture sessions before and after the FET. I've even stocked up on walnuts and Brazil nuts, and plan to get a pineapple for the week after. Eating those things may be an old wive's tale, but I'm willing to do anything to up the chances of a pregnancy!



Wednesday, June 29, 2016

Acupuncture

Figuring out flights and travel plans has been so stressful. When we originally started planning everything, we thought I'd be done with the transfer by now. Here we are, and my (original) flight home is scheduled for tomorrow, and my transfer is not until 7.14.16! I have decided I will go home for a week, and then come back for my next lining check (on 7.9.16). Unfortunately, this means I will be missing a good friend's wedding. :(

I will come back, do the lining check, and then the transfer 5 days later. After that, I begin the two week wait (2ww) for my first pregnancy test (7.26.16). Last night while lying in bed (not sleeping), I started thinking about things I could do to help with the transfer. I read different things about eating pineapple core, walnuts, Brazil nuts, and doing acupuncture. I had completely forgotten about acupuncture, but there seem to be a lot of people who have done it during their cycles. I reached out to a couple local clinics and got a call back from the clinic that happens to be in the same building as my IVF clinic. They offered a package with a consultation/treatment, plus treatments pre- and post-transfer. I was able to schedule the consult for today (right after a much-needed massage). 

The massage I had (although shorter than expected) was just what I needed--I fell asleep on the table as soon as I flipped onto my stomach! After that, I drove to the acupuncture clinic and met with the acupuncturist. She spent some time going over my intake paperwork, asking me questions about my health and our fertility procedures, and then she brought me to the room where we got started. I don't know exactly how many needles she used, but I know she put some in my scalp, forehead, hands, abdomen, and feet. After that, she covered my eyes with a mask, and told me to rest for 30 minutes. Again, I fell asleep! I didn't even realize that the needles were still in my extremities until I moved my hand. 

While I don't typically practice holistic medicine (except for chiropractic), and I don't know how that acupuncture will really help with the FET, I do know that after the procedure, I felt extremely relaxed. That in itself, I feel, could help improve the chances of implantation since it's so important for you to be rested and relaxed. Some studies have shown that "when used in conduction with Western fertility treatments, acupuncture increases conception rates by 26%" (Pacific College of Oriental Medicine, 2015). While I don't know how true that is, "in fairness...acupuncture is not harmful and most of those so treated swear by it. For the nay-sayers, what can be said with certainty is that at the very least acupuncture has a 'feel good' aspect to it and in most, evokes a psychological benefit that should not be discounted" (Sher Fertility, 2016). My thoughts are that although there may not be much scientific proof of acupuncture increasing implantation rates, it's not going to hurt anything, so if you can afford it, why not give it a shot? I plan to go in for (same day) procedures before and after the transfer.

Right now, I'm all packed and ready to head back home for a week. The only thing I have to worry about while there is giving myself two IM injections. Other than that, I plan to RELAX!



Saturday, June 25, 2016

First IM Injection

I had my baseline appointment on 6.23.16. It was similar to the other monitoring appointments during Stims. First, I had my blood drawn and then I had an U/S--except the U/S was to check my uterine lining instead of my follicles. My uterine lining was at 3.4mm.

I had a nurse come to give me my first Del Estrogen injection so she could show my parents how to give an intramuscular (IM) shot (in my rear). I was incredibly nervous given the size of the needles and the location (going in a muscle), but when she looked at the needle gauge and sized me up, she thought because of my BMI, I would be better using a smaller gauge (and shorter!) needle. (Thank God!) I iced the area for approximately 5 minutes while she went over the protocol of drawing up the medication and then she showed my parents how and where to give the injection. The actual injection was pretty painless (I assume because of the icing). I am really glad we hired her to come show us. She was so nice and understanding, and it turns out that not only does she work at our clinic as well, but she had two IVF babies from them that are now 8 and 12 years old! She got pregnant on the first cycle with each of them. It felt good to finally meet someone who went through what I am going through and has two actual beautiful children to show for it. It was so encouraging.

Yesterday, the nurse called to discuss the FET with me. Due to my doctor's schedule, we will be doing the FET on Thursday, 6.14.16 (instead of 6.12.16). This means that I will have my next moderating appointment (to check uterine lining) on 7.9.16. They want to do three pregnancy tests on 7.26.16, 7.28.16, and 8.1.16. Then they want to do two ultrasounds on 8.8.16 and 8.21.16. It's so hard to think that far in advance, and if we will even get to that point. 

Right now I am stressing out about plane tickets to fly back home so I can actually spend some time at home this summer before flying back here to get ready for the FET...then I have to fly back after all the pregnancy tests and ultrasounds. This entire process will have taken the majority of the summer (~15 weeks/3 months)!

Wednesday, June 22, 2016

PGS Results

Last Friday (6/17/16) the nurse called me with the PGS results (a week sooner than expected). The news was not great. Out of the 4 blasts biopsied, only 1 was normal. Two were abnormal (1 missing chromosome 2, 1 missing chromosome 17), and the 4th was non-concurrent (inconclusive without further biopsy/testing). To make matters worse, my doctor wasn't able to discuss things until today (5 days later), so there was a lot of anxiety and replaying different scenarios in my mind all weekend long.

I finally spoke to the doctor today and we discussed moving forward with a FET of the normal blast, and the possibility of re-testing the non-concurrent one either now or later on. He said with where we are now (with PGS testing concluding a normal blast), there is a 65% chance of pregnancy, 10% chance of miscarriage, and 58% chance of live birth. Without the PGS, the birth rate would go down to 50%. He said that my attrition rates have been pretty average so far, (although 1 normal out of 3 would be slightly below average; 2 out of 4 would be average).

Part of me is excited to move forward. I am happy that we even get to move forward, but of course my mind starts thinking that if this doesn't work, and the 4th embryo is also abnormal, I'll have to start another cycle...and if I start another cycle, when could that possibly be because I don't have another long break from work until December. I also can't help but think that not having any extra (normal) embryos means there's no chance of a second baby...which is silly because at this point, I should only be focusing on having even one baby--which I would be thrilled, overjoyed, elated, and so blessed to have!

Today will be my last day of birth control, and I have a baseline BW and U/S appointment tomorrow morning at 7:45am. I'm scheduled to start Del Estrogen injections (intramuscularly!) tomorrow evening. We have decided to hire a nurse to come to the house to teach us how to do the first intramuscular (IM) injection. I am thinking my mom will be the one to give me those! Not looking forward to that...

Thursday, June 9, 2016

Day 7

Yesterday was Day 7. In the morning, I received an email from my nurse stating that the remaining embryos did not make any changes overnight and the culture was terminated. :( The total number of embryos that we biopsied and froze for PGS was 4. I am disappointed with the number we ended up with. I had planned for attrition, but did not expect it to be so quick! I was hoping for at least 5 or 6 blasts, but given that we only had 2 on Day 5, I am thankful for the 2 more we got on Day 6. My nurse also told me that she has moved to a different position within the clinic and I will be working with a new nurse.

I am supposed to start birth control again tomorrow, Friday, 6.10.16, and will take it for 18 days. The PGS biopsies are supposed to go out by tomorrow and the results should come back within 2 weeks. At that time we will discuss the date for the embryo transfer. 

The 4 frozen embryos are graded AA, which is great. Although clinics often grade their embryos differently, an AA grade generally means that the inner cell mass quality is good (many cells, tightly packed) and that the trophectoderm quality is also good (many cells, forming a cohesive layer). They didn't give me a grade for the expansion (usually a number from 1-6).

Everyone always talks about the 2 week wait (2ww) for after implantation, but for me, the 2ww starts with waiting for PGS results!

Tuesday, June 7, 2016

Day 6 after ER

I received phone calls from the nurse on Days 1-2, and today, Day 5. The ER counts as Day 0, and we left knowing they had retrieved a total of 19 eggs. On Day 1, the nurse called to tell me that of the 19 eggs retrieved, 17 were mature, and 11 had fertilized successfully. On Day 2, we found out that of the 11 embryos, we had 2 x 2-cells, 3 x 3-cells, 4 x 4-cells, and 2 x 5-cells. Days 3-4 fell on the weekend, and the lab likes to allow the embryos to develop undisturbed during those 2 days. Monday was Day 5, which is the day most embryos become blastocysts. Traditionally, embryos were transferred to the uterus on the 2nd or 3rd day of development after IVF because they were only able to sustain growth for 2-3 days in a lab setting. Advances in medicine have allowed them to survive longer than this, after 5 days of growth, in which the cells should have divided many times, with those surviving to this stage likely being stronger and healthier. Basically, a blastocyst is an embryo that has developed for 5-7 days after fertilization, and has 2 distinct cell types and a central cavity filled with fluid (Advanced Fertility, 2016).

On Day 5 (Monday), the nurse called to tell me that 2 of the embryos had reached blastocyst and were biopsied and frozen. (We are doing PGS, so the biopsy will be sent to the lab and the embryos will be frozen until we are ready to transfer.) She told me that there were 3 embryos at the early blastocyst stage, and that the remaining embryos were as follows: 1 x 3-cells, 4 x 6-cells, and 1 x 7-cells. She said that they were going to check again tomorrow to see if any of the early blasts had reached full blast stage and also to check on the progress of the remaining 6. To be honest, this news hit me pretty hard. I was expecting the numbers to go down every day, but I hadn't expected to go from 11 to 2. I immediately started worrying and bracing myself for a failed cycle. What's worse is that David had to leave yesterday so I got the news right as we were eating lunch together, before heading to the airport. :(

Today was Day 6, and I was incredibly nervous when I answered the phone. The nurse told me that 2 more had made it to blastocyst and they were able to biopsy and freeze them. I immediately felt better, knowing we now have 4 embryos that made it. We still have 3 more compacted morula, that are not quite blastocysts yet. When they are compacted, the cells and cell borders are becoming fuzzy as the embryo "compacts" or melts together. This is basically the stage right before blastocyst. So I am praying hard for those compacted embryos to grow tonight and make it to the blastocyst stage tomorrow. Tomorrow is Day 7, the last day they will be allowed to grow to. After this, the embryos that haven't reached blastocyst will be discarded. The remaining 4 embryos are as follows: 1 x 3-cells, 2 x 6-cells, and 1 x 7-cells. Most likely these will not make it to blastocyst by tomorrow (Day 7), but I am praying for a miracle.

As silly as it sounds, throughout these 6 days, I have gotten attached to these 11 embryos. The night of Day 2, after the nurse told us 11 had fertilized successfully, I started praying hard for each of those 11 embryos. It was amazing to me to know that conception had occurred, that this had actually happened, and these could be our future babies. Knowing that some of the embryos won't make it makes me a little sad. I have been rooting for them and praying for them and and thinking about them, and it's upsetting to think about them being discarded. I know that this happens naturally in our bodies, and that the reason they are discarded is because they would not survive beyond this, but part of me can't help but be a little sad and grieve for them.

On a happier note, I weighed myself this morning and I am back down to my original weight (before starting stims), so at least the bloating is going down.