Thursday, 6 June 2013

Egg transfer and results

Sorry it's taken so long to update, but well, it's been a long several weeks.  I had to get my mind strong enough to actually be able to write this.  Obviously it does not end well.

I'll start with the egg transfer.  When I got there, they had me change into the usual hair covering, hospital gown and footies and wait in the surgical area.  I had my bladder uncomfortably full and was frankly miserable.  The bloating had gotten so bad, my stomach was protruding and I had gained 5 lbs. IT pushed against my bladder making me regularly miserable.  It was so bad, I couldn't stand up directly without pain, I had to slowly straighten as my insides made room for everything to shift.

There was another girl waiting so I was really miserable. I actually had to get up and pee a couple of times just to relieve the pressure.  They gave me a cup so I would know when to stop. I couldn't imagine waiting for another 1/2 hour. For whatever reason, they took me first.  I was grateful.

I got in there and it was the same as the mock transfer and retrieval, except I was fully awake.  I had forgotten to take pain reliever before hand which was a big mistake.  It's not that the procedure really hurts, but with the bloating, it really did.  I was so miserable.  She had to push down on the bloating to with the ultrasound device.  I just did deep breathing and waited for it to be over.  It didn't help that he tried twice with the speculum only to discover he needed a longer one....boy was that fun.

They did show me on the screen where the transferred embryo was, which was kind of cool, and gave me an ultrasound picture of it.  I was startled at how my heart tugged looking at it.  I so wished it would turn into my child.

I left with instructions to take it easy, no sex for two weeks and no physical activity for a couple of days.  No lifting more than 5 lbs.

As it turned out, the bloating just got worse.  Within days I was adding  more weight and by my check up Mon (transfer was Sat) I could barely move I was so bloated.  They ended up taking a "blood count" to see if my  blood was getting too thick, putting me at risk for clotting and renal failure.

You see, the bloating is really water from the blood stream collecting in your abdomen. The blood count would tell them if if I was any danger.  If that was the case, they would send me to hospital to have a catheter put in with a bag outside my body I could wear under my clothes.  Apparently, some RE's choose to drain with a needle.  However, my RE said this was just a quick fix as the fluid would just collect again.  The catheter would be a much better solution.

At this point I was on almost complete bed rest.  I just couldn't move very well.  Between Sat and Mon I had gained another 5 lbs and I just looked bad from what people told me.

I drank tons of gaterade and ate salty foods to help draw the fluid out.  This was bad advice for me.  AS it may have worked for some woman, it just made me retain the fluid.  I stopped the salty foods and added green tea to the mix and the fluid started draining on it's own.  By Wed's scan, I was much better and had lost 4 lbs.

The bloating slowly got better and better, but it took a good three weeks before I was closer to my normal body size.  Still seem to be holding onto a couple of those pounds though.  I think all that inactivity made me gain real weight - bummer.

Unfortunately, it just gets worse.  The embryo did not implant, and to add insult to injury ALL the embryos died.  Nothing made it freezing so the FET's are off the table too, unless we try to find a donor egg somewhere.  yeah good luck with that.  Like someone wants to give a 44 year old mother their egg.  Just like adoption, no one would choose me.

I have been heartsick and discouraged.  I feel like it's a sign I am too old that not even one made it to freezing.  My heart is so broken and I just don't understand why God has placed this burden on me.

I've decided to take at least one month off to let my body heal and recover.  I may even take two, but not more than that.  It's so scary going into this next cycle, the only other "fresh" try in our package because now I have the knowledge that I can go through all this, and not have an embryo even make it to transfer stage.  I've got to work up my courage for that kind of disapointment and heartbreak.

I keep telling myself it's just not fair and once again I am resenting all the women around me who can simply decide to have another child. Why do I have to wait for a miracle that won't even happen?

Thursday, 16 May 2013

12 little embies...

No transfer today which I frankly suspected.  The indication all along was a 5 day transfer and I feel better about that.

We didn't lose any last night, although one has only divided into 3 cells, so it will probably arrest.  The remainder are:

4 four cell
1 five cell
2 six cell and
4 eight cell

This isn't mine, but this is what an 8 cell looks like:



Was so happy to see some 8 cell in the mix. If they all make it to Sat, that means we can have three ledt over for FET tries.

They are all a grade 2.   I asked her if there was anything to indicate the quality yet, and she didn't really have a good answer for me.  I know grade 1 is the best, and grade 4 the worst, but still don't really know much other than some, not all  are starting to show signs of fragmentation.

Fragmentation is when the cells divide unevenly leaving some leftover over "junk" cytoplasm.  The higher level of fragmentation, the lower chances of pregnancy.  Anything with a grade of 3 or 4 is highly fragmented and likely won't make it to blastocyst stage.

Here's a visual on the grading:


I wish I knew more about how each one graded, but they seemed kind of busy today.  I know now what they meant by waiting on pins and needles for the embryologist report.  It's going to be a long time til Sat morning!!!

Wednesday, 15 May 2013

2 days post egg retrieval

Not a lot to report today, 2 days after the retrieval.  Embryology called early, around 7:45 to report that of the 15 eggs that fertilized 12 had survived and cells were dividing normally.  We again had the discussion about not wanting twins and she marked it in the file as there are three embryologists there.

She advised that they would tentatively schedule a transfer for tomorrow just in case.  But she did seem to echo that because we only want to transfer 1, it will most likely be Sat.  I find out tomorrow morning at 8am if we're a go.

I did wake up feeling significantly better.  I was glad I had showered the night before because while I was feeling better, I was still achey and I had to make some eggs for my share of the breakfast.

That was easy...spray non stick spray in a muffin tin, crack in eggs, add some leftover diced ham and a sprinkle of cheese, bake for 10 minutes in a preheated 350 oven.

After the meeting, I was really worn out and feeling pain again, so I came home and did nothing but drop off and pick up preschool, and order pizza online.

and so ends cd 28.

The "little" wait

So the day after retrieval, I was definitely sore.  I was able to get up and make a simple breakfast and pack lunches, but I was grateful for Rob's assistance with this.

Embryology called to let me know 15 of the 22 eggs fertilized.  They wanted to know if we were transferring 1 or 2 and I said, "that kind of depends on what you tell us about the embryo's."  I made it clear we really didn't want twins, so were leaning toward one.  But at the same time, wanted the best chance.  She said, based on that, they would probably lean towards a 5 day transfer but we would just have to wait and see.

They had said I could "go back to work" but I just don't see how anybody really could.  I mean, it wasn't pain like my c-section, but it was still tough to move around, bend over, walk very much.  I had so much going on that day....DAisy girls scouts (I am the leader), Set up for MOPS (I was supose to show the new coordinators for the next year what to do) and Josh's string concert.

Nope, nope and NOPE!

I stayed home and rested.  I got up just enough to feed myself and Noah.  Pulled a pre-cooked sliced ham from the freezer and called that dinner and rested.  I just wasn't up to it.

I was starting to get frustrated by not feeling much better, so I called another MOPS mom who I knew had been through IVF a couple of times to get her thoughts and experiences.  I felt so much better after because everything she described was exactly what I was feeling.  The bloat is unbelievable.  For those of you who have been pregnant, it's like that really heavy pressure you feel below your tummy during the last month of your pregnancy....  And there is so much stimulation, it presses against your bladder, so you have to go to the bathroom every 10 minutes.  And since you are suppose to drink 80 oz of water it ends up you need to pee every 5 minutes.

I was hoping I would feel better the next day, so I could go to the last Mops meeting of the year before summer break.  and I was looking forward to seeing how many son to be embryos would survive the night.  They said the wait for that can be brutal, but that's OK.  It's just a little wait.  The big wait will be the "dreaded 2ww."And so ends cd 27.

The Big day: Egg Retrieval!

I had set two alarms to go off at 6:00 so we could leave by 6:45 for our 8:30 retrieval.  I didn't have much to do.  I had showered the night before, and I wasn't allowed to eat, drink,  wear makeup or jewelry.  So I got dressed, took the nail polish off (so anesthesiology could watch my color) and freshened up my hair, and sat to wait for hubby.

The drive was uneventful and because we left so early, we had a bit of a wait.  (the only way to get there is a very unpredictable freeway that has a habit of bottlenecking when you least need it to!).  Once they called my name, they were again, super sweet and gentle.  I again went to the changing room to strip down, gown up, get my little footies on and hair cover.  Then I went to my cubicle with my nice warmed hospital blanket.

can I just say again, I want one of those blanket warmers!

So they spent about a half hour taking some more medical history, taking vitals and then setting up the iv line for the anesthesia.  AS usual, they couldn't find a vein, my right arm which was always so easy is completely scared (the veins, not the outside skin) and the left is so hard.  She tried my left hand, it bled all over and then burned whenever they ran fluid so out that came.  Then they tried my right hand - nope!  Right arm again?  nope, just too scarred.  Finally on the fourth try, they got my left arm.  In their defense, I really am a hard stick.  So was my mom, so was my grandma (I'll have to ask my sister if she is as well!)

Then it was hurry up and wait.  While I was initially very nervous, I calmed quickly.  AFter all, they were putting me out for the hard part, right?  I mean, how bad could it be?

In the mean time....TMI report - the usual protocol is for the Dad to provide the sample for fertilization AT the surgical center.  But because we lived within an hour, DH was allowed to do this at home.  I pushed for this because for obvious reasons, that part of it makes Dh really uncomfortable.  Thank goodness I did, because they didn't realize he had brought it, and started to show him to the room.  It was awful!  Very clinical, a pad on the chair and a tv on the wall.  Um, ewe.  He said another Dad to be was walking "the walk of shame" either into or out of the room.  Wheh....so glad I was able to push for him to do at home!


When it was my time, they walked me into the OR and I took my seat on the deluxe stirrup table - yay me-  I described for the hysteroscopy.  The only difference this time was they strapped my legs to the stirrups, I'm guessing so I couldn't fall off the table since I would be out.

At the point, the anesthesiologist told me she was starting and I would start to feel woozy or dizzy.  Somewhere right in between was what I felt.  I remember wondering what I should do.  I was very sleep from not sleeping the night before, or was that the meds?  I didn't want to fall asleep on them if they had more questions.  Then the anesthesiologist said she was going to give me the next medicine and shortly thereafter I was out.  I don't even remember Dr. G coming in.

What I do remember is them calling my name and telling it was time to wake up.  I woke up pretty easily and was just a but unsteady on my feet.  They walked me to my chair and had me just slowly recover.  Thank goodness Rob was allowed to come back and sit with me.  I felt very emotional and was crying but that was more because I just needed my husband, and we were having a tough time at the moment (not for a public forum, sorry!)  I did feel sore and bloated, but not in a really bad way.  I felt like I could bear it pretty easily.

They told me almost immediately that they were able to retrieve 22 eggs!  Wow!  That is just fantastic, from what I understand, for a woman my age.  I was over the moon happy!

Rob had a lot of questions though, but my Dr. G is such a great man, so kind.  He said, he had to do the next patient, but to just give him a few minutes and he would talk with him.  It was a retrieval for someone else, so he had to go but when he came back in about 15 minutes, he pulled a chair over and gave Rob his undivided attention. He didn't leave til all Rob's questions were answered. I'm telling you, if you're in Phila area, go see Dr. Gocial, RMA of Philadelphia.

After that, Rob seemed more at peace with the responses and it was time to go home.  He helped me get dressed - I was tender for sure, but OK.  Then they had Rob pull the car around to  a side entrance that was easier for me to get to, and they walked me to the car. After that, it was 24 hours of strict bed rest - bathroom breaks only.

I was definitely achey, and really tired, so I spent most of the day sleeping. I started the antibiotic and anti-rejection medicines that day - the end of cd 26.



22....

So a lot has happened since Friday.  It's just been busy, and I'm uncomfortable and frankly, sometimes you just have to step away from all this stuff to maintian your sanity, kwim?

So Saturday, I went in for another blood draw and scan and I was greeted with "looks like we're ready to discharge you."

Huh?

Am I through?  Was the whole thing a bust after all?  No, no, thank goodness.  All that meant was,  is they thought I was ready and that I would probably have the retrieval Monday instead of Tues.  So I would get the call later to determine would I take cetrotide (don't ovulate) or Pregnyl (hcg trigger). I was hoping it was the later because frankly, I didn't want to take that big old nasty cetrotide injection again.....

As it turns out, it was the later, so while I took menopur that Sat morning, I did not take the Gonal F or Cetrotide, but rather the HCG trigger that night at 8:30 so that 36 hours later, at precisely 8:30 Monday morning, I would ovulate and they could retriece the eggs....

That trigger has always made me nervous....I mean, it is so exact...How did they know exactly at 8:30 I'd be ready?  What if I was ready at 7:30 and they missed it?  While I didn't want to take it, it was so hard not to take the cetrotide... or to call the dr and say, how about a half dose?  I had to sit back and just trust my dr.

Sunday morning I went in just for blood work.  At this point, I must share that my arms are black and blue and i look a bit like a junkie. But they wanted to make sure everything was still on track, and that there was HCG in my system.  Actually, the way she said it was, "we want to make sure you took the shot correctly?"

Huh?   (scratching my head....) I've taken how many up until now, and you want to check this one?  Hey, whatever, they're the experts!  And it was Mother's Day, and we had to stuff to do, so short appointments are always good.  Quick in and out.

So, after the Mother's Day festivities (thank you to my sweet SIL, Christine who organized a lovely barbecue with awesome food....) I packed the kids up and dropped them off at my dad's to spend the night.  We were going to have to leave at 6:45 the next morning, and they all had school.....I have a great dad who got them all where they needed to be.

And then home to NOT sleep the night before the transfer.... (does anyone I wonder?)


Friday, 10 May 2013

Big needle = Big fear

So I had my blood work this morning, and another ultrasound.  All went well, My E2 was around 1600, continually on the rise, and p4 had risen to 2.63, LH stayed the same, around7.5.  What does all that mean?  Hell if I know, but apparently it tells Dr. G to start the cetrotide.

Cetrotide does the same thing as ganirelex or Lupron.  Since some of the follicles are really starting to mature, the worse thing would be that I ovulate now, with like 10 eggs or something crazy like that.  So the cetrotide shuts down my pituitary gland from sending the  "green light" hormone to ovulate.

The needle scared me to death.  It wasn't a half inch like the others I've been using, but more like a full inch.  But it has to to be done, and Rob is away on a business trip, so I gritted my teeth and got the job done myself.  At these times, I cheer-lead myself saying, it's all for a greater cause, and will be so worth it if we succeed.  It helps anyway.   I remember my IVF nurse telling me not to do it on the same side as the Gonal F or they could  interact in some way.  So to be safe, I opted to do it in my thigh.

Again, that big needle scared me (I am so glad they have worked these injections into sub-cu rather than intramuscular.  I simply cannot imagine getting stuck with those huge 27 gauge needles every day!) I knew right away I was going to try the icing trick.  It did work, while I did jam the needle down with a little more force, I did not feel it go in at all, nor the medicine like I do the menopur.  But now, after 10 minutes, and the my leg is warming up - it feels very sore and tender.

Speaking of sore and tender, that's me.  My ovaries are completed enlarged and stimmed and I really hurt.  No walking in the gym today, although I tried.  Bending over is too much, walking fast is too much, so I just kind of hobble about.  There was a little fluid on the scan, but not anything to worry about, or so I was told.  But my ovaries are now "kissing" ovaries.  They are so heavy, they are kind of flopping over each other and touching.  Nice, I hope they are encouraging each other on!

One quick funny bit...I saw another dr this morning, not one I often see.  She just doesn't come up on the rotation for me that often.  The minute she walked in, the first thing she says before anything else is, "how old are you?"  I very sheepishly admitted I was 44.  I thought she was going to give me grief because of the whole advanced maternal age thing.... but that wasn't it at all.  She said I am responding so well (or rather my ovaries are) that she thought my chart was wrong.  In her words "You're not responding like a 44 year old usually does." I said that's good, right?  And she affirmed that it was a good thing. Even the IVF nurse agreed and said "You're not even on a really big dose either!"   She (the dr.)  said she can't make any guarantee about eggs, but my ovaries were really good.  I found it really encouraging anyway.  Hopefully that means they can get tons of good eggs to work with.

On the way home, thinking about that morning's appointment, I couldn't help but think that the gluten free diet had to have contributed to this good outcome.  I can't prove it, have no scientific fact behind it, I just feel it in my gut.

So today's shots include 3 vials menopur in the morning, back to 225 Gonal-F in the evening, and add  .25 mg o f cetrotide.  And they want to see me again tomorrow, so I am guessing this starts the daily monitoring they mentioned would come just before retrieval.

I am trying to think positive.  I could be pregnant in slightly over 2 weeks.  Oh my gosh, I really hope so!

And so ends cycle day 23.