Well it looks like it's not going to happen for us this time.
Last week I buzzed around the house cleaning everything (the toilets in particular) preparing for my pregnancy symptoms to kick in...but they never did. I've been obsessively taking HPT's and on the weekend I noticed that the 2nd line was getting lighter not darker. At that that point I was pretty sure it was over. I spent several days Googling trying to find any possible explanation but there wasn't any. The embryo had stopped developing and wasn't producing hCG anymore.
I took one of those digital tests that tells you the weeks since conception and it read 1-2 (when it should have been 4). Based on that, my clinic agreed to do a repeat beta and it came back at only 270 (it should be at least 8,000 by now). So we are stopping meds and waiting for the inevitable. I'm disappointed but certainly not devastated. I expected it and I'm so glad we found out now and on our own terms. It would have really sucked to go to the viability scan and instead of heart-beat to see nothing there.
This just makes me feel even more grateful that we were so lucky the first time around. I'll be hugging the twins extra hard tonight.
They're going to monitor my hCG until it drops to nothing in case it's an ectopic or something that requires more intervention. After that I hope we can get lined up to transfer our remaining embies as soon as possible.
Goodbye Baby C. It was wonderful to have you with us, if only for a couple of weeks. I wish it hadn't ended so soon. I was really looking forward to sharing a birthday with you.
Wednesday, November 30
Friday, November 18
Stating point of view
4 weeks 5 days:
138. That was my second beta. It definitely doubling. I still can't believe we've been so fortunate to blessed like this twice. Next step is the 7 week viability ultra-sound. If that scan looks good and there is a heartbeat, the risk of miscarriage drops to less than 5%.
In other news, I went to pharmacy to pick up another $1,000 of presciptions. Since I didn't ovulate naturally I will have to keep taking progesterone and estrogen for another few weeks until the placenta takes over this job. Both these hormones are vital to maintaining the pregnancy and embryonic development. No more screwing around and forgetting to take a dose. Baby C's life depends on it now. That's was Greg and I are calling him, btw. The twins were Baby A and B. And "him" because I think it's going to be a boy.
138. That was my second beta. It definitely doubling. I still can't believe we've been so fortunate to blessed like this twice. Next step is the 7 week viability ultra-sound. If that scan looks good and there is a heartbeat, the risk of miscarriage drops to less than 5%.
In other news, I went to pharmacy to pick up another $1,000 of presciptions. Since I didn't ovulate naturally I will have to keep taking progesterone and estrogen for another few weeks until the placenta takes over this job. Both these hormones are vital to maintaining the pregnancy and embryonic development. No more screwing around and forgetting to take a dose. Baby C's life depends on it now. That's was Greg and I are calling him, btw. The twins were Baby A and B. And "him" because I think it's going to be a boy.
Thursday, November 17
Fill in a form
4 weeks 4 days :
I had my 2nd Beta yesterday. I called first thing this morning to check the results. They weren't in yet but I did discover something very disturbing about my clinic. They have a "no news is good news" policy about 2nd betas. The nurse told me that they would only call me if the Beta wasn't doubling. I'm not sure this works for me. You'd think that an IVF clinic would have a better appreciation of how a fertility patient's mind works - we're a neurotic bunch.
So I didn't go to work today. I sat here waiting by the phone praying that it wouldn't ring. It's now 10 pm and no phone call. I guess that means I'm pregnant.....or perhaps the lab lost my results and never sent them to the clinic. I still feel in limbo. I'm going to call them tomorrow to check.
I had my 2nd Beta yesterday. I called first thing this morning to check the results. They weren't in yet but I did discover something very disturbing about my clinic. They have a "no news is good news" policy about 2nd betas. The nurse told me that they would only call me if the Beta wasn't doubling. I'm not sure this works for me. You'd think that an IVF clinic would have a better appreciation of how a fertility patient's mind works - we're a neurotic bunch.
So I didn't go to work today. I sat here waiting by the phone praying that it wouldn't ring. It's now 10 pm and no phone call. I guess that means I'm pregnant.....or perhaps the lab lost my results and never sent them to the clinic. I still feel in limbo. I'm going to call them tomorrow to check.
Tuesday, November 15
Give me your answer
58
I went for my formal pregnancy test yesterday (called a Beta hCG or Beta for short). Most fertility patients get their results back the same day but since I use an out-of-town lab, I had to wait until the next morning (aka torture myself sitting up half the night staring at my home pregnancy tests trying to figure out if the line was getting darker).
This morning I finally got the call and my number is 58. It seems low to me but the nurse said they consider it a positive. For comparison, my first beta with the twins was 178 and we tested one day earlier.
I'm obsessively Googling the Internet for verification. http://www.betabase.info/ (a great statistical resource for neurotic fertility patients) tells me that the average result reported for a singleton pregnancy on this day is 139. The nurse told me that the betas for frozen transfers are usually lower than fresh transfers. She didn't know why but it suppose frozen embryos might implant a little later. It's logical that they would need a day or two to recover from being in a giant freezer for 3 years.
Supposedly it doesn't matter what the number is as long as it's increasing. In a viable pregnancy, the Beta should increase exponentially. At this point it should double at least every 48 hours. So I go back for another blood test on Wednesday.
In summary, we are excited but not wanting to get our hopes up.
PS: the due date is July 23rd. 3 days before my birthday :-).
I went for my formal pregnancy test yesterday (called a Beta hCG or Beta for short). Most fertility patients get their results back the same day but since I use an out-of-town lab, I had to wait until the next morning (aka torture myself sitting up half the night staring at my home pregnancy tests trying to figure out if the line was getting darker).
This morning I finally got the call and my number is 58. It seems low to me but the nurse said they consider it a positive. For comparison, my first beta with the twins was 178 and we tested one day earlier.
I'm obsessively Googling the Internet for verification. http://www.betabase.info/ (a great statistical resource for neurotic fertility patients) tells me that the average result reported for a singleton pregnancy on this day is 139. The nurse told me that the betas for frozen transfers are usually lower than fresh transfers. She didn't know why but it suppose frozen embryos might implant a little later. It's logical that they would need a day or two to recover from being in a giant freezer for 3 years.
Supposedly it doesn't matter what the number is as long as it's increasing. In a viable pregnancy, the Beta should increase exponentially. At this point it should double at least every 48 hours. So I go back for another blood test on Wednesday.
In summary, we are excited but not wanting to get our hopes up.
PS: the due date is July 23rd. 3 days before my birthday :-).
Sunday, November 13
Drop me a line
9dp5dt:
Two lines!!!! We finally caved and tested today and its a faint positive! So faint that Greg didn't entirely believe it. At this point with the twins, the 2nd line was as dark at the control line. Nothing is guaranteed yet - it could be something called a "chemical pregnancy" were the embryo implants long enough for your to get positive pregnancy test and then stops developing. We'll have to wait for tomorrow's blood test to be sure but at least we are not "not pregnant".
Friday, November 11
Send me a postcard
7dp5dt:
Crap. I am now the proud owned of $50 worth of home pregnancy tests. We ran out of baby wipes and I had to stop at the drug store on the way home from work. I never had a chance.
I'm happy to say that I haven't cracked one open yet. If I can even hold off until tomorrow morning, it will be a victory.
Crap. I am now the proud owned of $50 worth of home pregnancy tests. We ran out of baby wipes and I had to stop at the drug store on the way home from work. I never had a chance.
I'm happy to say that I haven't cracked one open yet. If I can even hold off until tomorrow morning, it will be a victory.
Thursday, November 10
Yours sincerely, wasting away
6dp5dt:
Ok, no more fooling around. Now I'm getting excited.
I spent much of today playing a fun game called "pregnancy or progesterone". That's where I analyze every little twinge and sensation in my body and try to figure out if it's an early pregnancy symptom or just a side effect of progesterone. It's all futile of course. Even if I were pregnant, it's much too early to have any symptoms.
There is definitely something going on in my uterus though. I'm cramping up a storm and my c-section scar hurts. Could be implantation but could also be a side effect of the progesterone. I've gotta stop obsessing about this.
My goal this time around is to NOT test early with a home pregnancy test. I want to wait until the actual blood test on Monday. I've peed on a lot of sticks in my time and it just doesn't help. If the pee-stick is negative, you feel like crap and yet there is no closure (you keep hoping that the HPT was wrong or you tested too soon). Even when you get a positive, the happiness is short-lived. Until you get the numbers from your blood tests, you can't be sure that your HCG levels are rising and the pregnancy is viable. With the twins I was taking 4 tests a day and compulsively lining them up, straining my eyes trying to see if the 2nd line was getting any darker. One minute I was ecstatically happy and the next I was in tears convinced it was over.
The only way this can work is if I keep the pregnancy tests out of the house altogether. I stocked up on a ton of groceries on the week-end because I know that if I step foot in a grocery story this week, I won't be able to resist buying a test. Must stay strong.
Ok, no more fooling around. Now I'm getting excited.
I spent much of today playing a fun game called "pregnancy or progesterone". That's where I analyze every little twinge and sensation in my body and try to figure out if it's an early pregnancy symptom or just a side effect of progesterone. It's all futile of course. Even if I were pregnant, it's much too early to have any symptoms.
There is definitely something going on in my uterus though. I'm cramping up a storm and my c-section scar hurts. Could be implantation but could also be a side effect of the progesterone. I've gotta stop obsessing about this.
My goal this time around is to NOT test early with a home pregnancy test. I want to wait until the actual blood test on Monday. I've peed on a lot of sticks in my time and it just doesn't help. If the pee-stick is negative, you feel like crap and yet there is no closure (you keep hoping that the HPT was wrong or you tested too soon). Even when you get a positive, the happiness is short-lived. Until you get the numbers from your blood tests, you can't be sure that your HCG levels are rising and the pregnancy is viable. With the twins I was taking 4 tests a day and compulsively lining them up, straining my eyes trying to see if the 2nd line was getting any darker. One minute I was ecstatically happy and the next I was in tears convinced it was over.
The only way this can work is if I keep the pregnancy tests out of the house altogether. I stocked up on a ton of groceries on the week-end because I know that if I step foot in a grocery story this week, I won't be able to resist buying a test. Must stay strong.
Monday, November 7
Doing the garden, digging the weeds
3dp5dt (3 days post 5 day transfer)
It's funny how much things have changed in 3 years.
March 2008:
After our first embryo transfer I went on virtual bedrest. We drove back to Edmonton with my seat reclined so I could remain prone to encourage implantation. We worried the entire time that the vibrations from the car would somehow damage the embryos . I even ate dinner laying down in our hotel room bed. When we arrived home, I treated myself like I was made of glass. I laid in bed, no housework and wouldn't dream of lifting anything heavier than a carton of milk. Greg doted on me and talked to my belly. I remember thinking that it would be ok if it didn't take because it felt so good to be pregnant even for just that one week.
November 2011:
The clinic's specific instructions were:
1) No strenuous exercise
2) No swimming (not sure why that's not allowed)
3) No hot tubs or hot baths
4) No sex
As far as I'm concerned, anything else goes. Since arriving home I've done the following:
1) Helped clean up the yard for winter (lifting, carrying planters, clearing out dead plants, hauling the wheelbarrow etc.)
2) Carried 60+ lbs of squirmy toddlers up and down the stairs repeatedly.
3) Scooped the cat litter box.
4) Ate popcorn for supper and potentially listeria-ridden deli meat for lunch.
Now I'm back at work and dealing with some seriously stressful crap (a big shakeup is occurring complete with backstabbing, betrayal and lots of politics). If this cycle is successful, it will be proof positive that "relaxing" and having a positive attitude has no impact on your outcome. Oh and also the twins are have croup and are sick and miserable. When it rains it pours.
I think that being busy is probably a good thing. It's much better than dwelling on the count-down to beta. The first 3 days have flown by and I've barely thought about it.
I am not feeling as optimistic as last week. No particular reason to be doubtful. I just don't feel that it's going to work. I hope I'm wrong.
It's funny how much things have changed in 3 years.
March 2008:
After our first embryo transfer I went on virtual bedrest. We drove back to Edmonton with my seat reclined so I could remain prone to encourage implantation. We worried the entire time that the vibrations from the car would somehow damage the embryos . I even ate dinner laying down in our hotel room bed. When we arrived home, I treated myself like I was made of glass. I laid in bed, no housework and wouldn't dream of lifting anything heavier than a carton of milk. Greg doted on me and talked to my belly. I remember thinking that it would be ok if it didn't take because it felt so good to be pregnant even for just that one week.
November 2011:
The clinic's specific instructions were:
1) No strenuous exercise
2) No swimming (not sure why that's not allowed)
3) No hot tubs or hot baths
4) No sex
As far as I'm concerned, anything else goes. Since arriving home I've done the following:
1) Helped clean up the yard for winter (lifting, carrying planters, clearing out dead plants, hauling the wheelbarrow etc.)
2) Carried 60+ lbs of squirmy toddlers up and down the stairs repeatedly.
3) Scooped the cat litter box.
4) Ate popcorn for supper and potentially listeria-ridden deli meat for lunch.
Now I'm back at work and dealing with some seriously stressful crap (a big shakeup is occurring complete with backstabbing, betrayal and lots of politics). If this cycle is successful, it will be proof positive that "relaxing" and having a positive attitude has no impact on your outcome. Oh and also the twins are have croup and are sick and miserable. When it rains it pours.
I think that being busy is probably a good thing. It's much better than dwelling on the count-down to beta. The first 3 days have flown by and I've barely thought about it.
I am not feeling as optimistic as last week. No particular reason to be doubtful. I just don't feel that it's going to work. I hope I'm wrong.
Friday, November 4
If you say the word, I could stay with you
Embryo Transfer:
Today was a success all told. The first embryo survived the thaw and was transfered without incident. It is such a relief that we still have embryos left and we can go one more round.
The blast we transferred is graded 3BB (average). It was too soon to tell if the cells would start dividing again but at least all the structures were intact. My clinic doesn't give pictures but here's one from the interweb of somebody else's 3BB blast.
Now the waiting begins. Nothing to do but pray that this little guy decides to burrow in and grow. Go Brian go!
Today was a success all told. The first embryo survived the thaw and was transfered without incident. It is such a relief that we still have embryos left and we can go one more round.
The blast we transferred is graded 3BB (average). It was too soon to tell if the cells would start dividing again but at least all the structures were intact. My clinic doesn't give pictures but here's one from the interweb of somebody else's 3BB blast.
Now the waiting begins. Nothing to do but pray that this little guy decides to burrow in and grow. Go Brian go!
Thursday, November 3
Sunday morning, go for ride
It's the night before transfer. I have everything ready (I hope) but I'm too excited/anxious to sleep. Here's the plan for tomorrow:
5 am: Up and shower with unscented soap purchased specifically for this occasion (apparently embryos are very sensitive to scented beauty products). Shave legs and pick out cute socks so I'll look fashionable in the stirrups - as if anyone cares.
6:30 am: Leave house, drop off kids at my sister's and drive to the airport.
8:45 am: Our flight leaves.
This will be the most stressful part of the day for me. I have an irrational fear of flying and I'm so dreading the flight. It's not even the normal kind of fear - I'm not afraid of crashing (although I certainly would prefer not to do that). I'm not afraid of terrorists or mechanical failure or human error either. I know that those things are statistically unlikely and that flying is absolutely the safest way to travel. What I fear happens every single time I set foot on a plane. Namely being sealed in a pressurized tube and hurdled through the air at 500 mph, 40,000 feet above the ground and there is no way to get down until the flight is over. It's a combination of claustrophobia, fear of heights, and lack of control. It scares the beejebus out of me. When we did our fresh cycle, we drove out to Vancouver but I certainly can't justify doing that for only one day. I will be so relieved when it's over.
9:20 am (Pacific time): Arrive in Vancouver and make our way leisurely to our clinic in Burnaby for our 12:30 appointment.
1 pm: Embryo transfer
At my clinic, the vibe is more like a spa than a doctor's office. First you change into a white robe and slippers and then you sit waiting in a recliner and the nurse covers you in a warmed blanket so you don't get chilly. Then the embryologist comes to tell you about the embryo(s) that will be transferred. The nurses, doctors, embryologist etc. are all smiles and cheerful small talk. This is one of the happiest times at a fertility clinic. It's all hope and potential. The procedure itself is fairly quick and simple. They insert a catheter through the cervix into the uterus and inject the embryo into place. It takes skill though to make sure the embryo is deposited in the right spot. Then we wait with me laying down for 15 minutes for things to settle in.
The transfer is done on a full bladder because they guide the catheter by ultrasound. This was a big issue last time because I drank WAY too much water. I was in agony, I thought my bladder would burst. During the 15 minute wait, Greg was praying for success and all I could think about "don't pee yourself...don't pee yourself" I've learned my lesson though and I won't make that mistake this time.
5 pm: Fly back to Edmonton (again with a very high terror index for me)
That morning the lab will start thawing embryos. It take about one hour to complete the process. They will thaw the first blast, if it doesn't survive, they will thaw the next one. If none of them survive, they will call us and tell us not to bother coming in. If that's the case, I guess we will just have a really expensive lunch date in Vancouver.
Our frosties were preserved using an older slow freeze technology where the water is first removed from the cells so that it doesn't crystallize and harm the cell structures upon freezing (that crystallization is what causes the damage when people get frostbite). Nowadays, most clinics freeze their embryos using a process called vitrification. This is where the embryo is plunged directly into a vat of liquid nitrogen and the cells freeze so quickly that the water doesn't have time to crystallize. Instead it freezes clear like glass. That's how the procedure gets it's name, "vitri" comes from the latin word for glass (your fun fact for the day)
Statistically, 50 to 60% of blasts will survive the thaw so odds are pretty good that we'll have one embryo to transfer. I'm feeling surprisingly optimistic.
5 am: Up and shower with unscented soap purchased specifically for this occasion (apparently embryos are very sensitive to scented beauty products). Shave legs and pick out cute socks so I'll look fashionable in the stirrups - as if anyone cares.
6:30 am: Leave house, drop off kids at my sister's and drive to the airport.
8:45 am: Our flight leaves.
This will be the most stressful part of the day for me. I have an irrational fear of flying and I'm so dreading the flight. It's not even the normal kind of fear - I'm not afraid of crashing (although I certainly would prefer not to do that). I'm not afraid of terrorists or mechanical failure or human error either. I know that those things are statistically unlikely and that flying is absolutely the safest way to travel. What I fear happens every single time I set foot on a plane. Namely being sealed in a pressurized tube and hurdled through the air at 500 mph, 40,000 feet above the ground and there is no way to get down until the flight is over. It's a combination of claustrophobia, fear of heights, and lack of control. It scares the beejebus out of me. When we did our fresh cycle, we drove out to Vancouver but I certainly can't justify doing that for only one day. I will be so relieved when it's over.
9:20 am (Pacific time): Arrive in Vancouver and make our way leisurely to our clinic in Burnaby for our 12:30 appointment.
1 pm: Embryo transfer
At my clinic, the vibe is more like a spa than a doctor's office. First you change into a white robe and slippers and then you sit waiting in a recliner and the nurse covers you in a warmed blanket so you don't get chilly. Then the embryologist comes to tell you about the embryo(s) that will be transferred. The nurses, doctors, embryologist etc. are all smiles and cheerful small talk. This is one of the happiest times at a fertility clinic. It's all hope and potential. The procedure itself is fairly quick and simple. They insert a catheter through the cervix into the uterus and inject the embryo into place. It takes skill though to make sure the embryo is deposited in the right spot. Then we wait with me laying down for 15 minutes for things to settle in.
The transfer is done on a full bladder because they guide the catheter by ultrasound. This was a big issue last time because I drank WAY too much water. I was in agony, I thought my bladder would burst. During the 15 minute wait, Greg was praying for success and all I could think about "don't pee yourself...don't pee yourself" I've learned my lesson though and I won't make that mistake this time.
5 pm: Fly back to Edmonton (again with a very high terror index for me)
That morning the lab will start thawing embryos. It take about one hour to complete the process. They will thaw the first blast, if it doesn't survive, they will thaw the next one. If none of them survive, they will call us and tell us not to bother coming in. If that's the case, I guess we will just have a really expensive lunch date in Vancouver.
Our frosties were preserved using an older slow freeze technology where the water is first removed from the cells so that it doesn't crystallize and harm the cell structures upon freezing (that crystallization is what causes the damage when people get frostbite). Nowadays, most clinics freeze their embryos using a process called vitrification. This is where the embryo is plunged directly into a vat of liquid nitrogen and the cells freeze so quickly that the water doesn't have time to crystallize. Instead it freezes clear like glass. That's how the procedure gets it's name, "vitri" comes from the latin word for glass (your fun fact for the day)
Statistically, 50 to 60% of blasts will survive the thaw so odds are pretty good that we'll have one embryo to transfer. I'm feeling surprisingly optimistic.
Tuesday, November 1
We shall scrimp and save
So I've been running some numbers and this FET business is not cheap. When we signed up I remember looking at the price in the brochure and thinking it was peanuts. However, once we included the medications, travel to vancouver and the monitoring fees the cost is adding up!
| Cost of my FET: | |
| FET fee | $ 1,000.00 |
| Remote cycle fee | 250.00 |
| SIS fee | 250.00 |
| Bloodwork | 45.00 |
| Ultrasound X 2 | 340.00 |
| Parking for u/s | 30.00 |
| Lupron | 245.00 |
| Estradiol | 60.00 |
| Antibiotics | 20.00 |
| Crinone | 490.00 |
| Airfare - SIS | 430.00 |
| Cabfare - SIS | 50.00 |
| Airfare - ET | 950.00 |
| Cabfare - ET | 50.00 |
| Cost if BFN | 4,210.00 |
| Crinone refills | 980.00 |
| Estradiol refill | 30.00 |
| Cost if BFP | $ 5,220.00 |
Friday, October 28
Who could ask for more
Lining Check:
I might as well re-name this blog: Sandra's half-ass FET. I've been on estrace for 2 weeks now and I've been just as negligent as with the BCP. I'm supposed to take 3 pills a day 8 hours apart but I honestly have no idea how many I've been taking. Might be 1 a day, might be 4. It doesn't help that I'm taking a bunch of vitamins and supplements too. I keep forgetting what I've already taken. I gotta get one of those idiot-proof pill organizers that seniors use. The good news is that yet again, my neglect doesn't seem to matter. The clinic called this afternoon and my lining looks great. We are good to go forward with transfer next Friday. On Monday, I stop the lupron and start taking progesterone which I'm sure will cause all sorts of new hormonal roller coasters.
This morning's ultrasound was preceded by much less drama. It was still ridiculously long though - I think she did another full pelvic u/s. By some design flaw the radiology clinic was fitted with overhead halogen lights. They do try to make it more pleasant by diming the lights but it's still very distracting. Imagine staring at this for 45 minutes.
In other news, I am freaking out. It finally hit me that if this doesn't work, it will be over and there will be no second chances. We decided years ago that we won't do another fresh cycle. Really we should be happy with what we have. We've already been awarded the infertility holy grail. (ie boy/girl twins). At times, it does seem greedy to want more. But babies aren't like handbags. I love the twins so much, how could I not want another child. Actually that's a terrible analogy because really, one can never have too many handbags either.
I'm frantically grasping at straws to come up with a plan B. I called my local clinic yesterday to set up a consult (they're really busy and it takes months to get an appointment.) We might try doing a few IUI's. Given our various fertility challeges, it's unlikely to work but better than giving up altogether.
I might as well re-name this blog: Sandra's half-ass FET. I've been on estrace for 2 weeks now and I've been just as negligent as with the BCP. I'm supposed to take 3 pills a day 8 hours apart but I honestly have no idea how many I've been taking. Might be 1 a day, might be 4. It doesn't help that I'm taking a bunch of vitamins and supplements too. I keep forgetting what I've already taken. I gotta get one of those idiot-proof pill organizers that seniors use. The good news is that yet again, my neglect doesn't seem to matter. The clinic called this afternoon and my lining looks great. We are good to go forward with transfer next Friday. On Monday, I stop the lupron and start taking progesterone which I'm sure will cause all sorts of new hormonal roller coasters.
This morning's ultrasound was preceded by much less drama. It was still ridiculously long though - I think she did another full pelvic u/s. By some design flaw the radiology clinic was fitted with overhead halogen lights. They do try to make it more pleasant by diming the lights but it's still very distracting. Imagine staring at this for 45 minutes.
 |
| This was my view for 45 minutes. |
For variety, I would occasionally shut my eyes so I could instead stare at the mirror image burned on my retina which looked kind of like the Eye of Sauron.
 |
| One ring to rule them all... |
I'm frantically grasping at straws to come up with a plan B. I called my local clinic yesterday to set up a consult (they're really busy and it takes months to get an appointment.) We might try doing a few IUI's. Given our various fertility challeges, it's unlikely to work but better than giving up altogether.
Wednesday, October 26
Vera, Chuck and Dave
When we did our fresh cycle, we named our embryos. It was mostly a joke to help alleviate the tension. On day 3, all 6 were rated as average and Greg and I worried that they wouldn't make it to blastocyst. Greg suggested that we name them so they would know that they were all wanted (6 kids? Sure, why not?).
We rattled off 6 names that started with E (for embryo). I can't remember them all except that they were very uncreative (like Emily, Ed, Emma etc.). On day 4 the embryos reached the morula stage of development so we renamed them with six M names (Maverick, Miranda, Mark, Mary, Mork and Mindy). On day 5, the embryos reached the blastocyst stage. We transferred "Beneto" and "Bianca". In the freezer are "Brian", "Brianna" and "Brenda". Sadly Mork arrested on day 5. Greg is convinced it was a result of us having given him such a lame morula name.
We rattled off 6 names that started with E (for embryo). I can't remember them all except that they were very uncreative (like Emily, Ed, Emma etc.). On day 4 the embryos reached the morula stage of development so we renamed them with six M names (Maverick, Miranda, Mark, Mary, Mork and Mindy). On day 5, the embryos reached the blastocyst stage. We transferred "Beneto" and "Bianca". In the freezer are "Brian", "Brianna" and "Brenda". Sadly Mork arrested on day 5. Greg is convinced it was a result of us having given him such a lame morula name.
Sunday, October 16
If I'd been out 'til quarter to three
One thing I've have been hesitant to mention is how much the Lupron injections hurt this time around... tons more painful than I remembered. I really have to jam the needle in and the injection site often bleeds and bruises. This puzzled me because I remember Lupron used to be the easy injection - it never hurt (not compared to Menopur or those awful IM shots of progesterone). I figured I must have gotten really wimpy in my old age. But now I know the real reason. Those fancy needles that came with my prescription were freaking HUGE!!!! I used the last one on Friday so yesterday I cracked open the bag of insulin syringes and look at the difference!!
I've been torturing myself for no reason, I could have been using those lovely 8mm 30 gage insulin syringes the whole time!!! WTF!?!
In other news, yesterday I dropped Lupron to 5 units and started estrace, 2mg a day. My headache was gone within 6 hours. Yee ha! Although I am apparently stilla raving lunatic experiencing some irritability.
 |
| Which would you rather stick in your tummy? |
In other news, yesterday I dropped Lupron to 5 units and started estrace, 2mg a day. My headache was gone within 6 hours. Yee ha! Although I am apparently still
Saturday, October 15
Would you lock the door?
Confession time:
I've been absolutely terrible at taking medication this cycle.
First I screwed up the BCP; I started taking them backwards in the package and then couldn't figure out what day I was on. I missed some days and then doubled up on others. On my official last day of BCP (Oct 5), I still had 3 pills left in the package. It's a good thing I never had to rely those things for actual birth control. I'd have ended up like Michelle Dugger or something.
Then I missed my first dose of Lupron. I was all set to take it but I wanted to get the twins to sleep first so I'd have time to review the instructions and concentrate on what I was doing. So I laid down with the kids and promptly fell asleep. I woke up in a panic at 2am and rushed out to the kitchen to do it. And it's happened several times since then. I just completely forget to take it then end up doing a catch-up dose the next morning. The good news it that it didn't matter one bit. The clinic called with the results of u/s and it was all clear. The cyst is gone and my ovaries are completely suppressed despite my being a disorganized basket case.
I blame my absent mindedness on my kids. When I did IVF in 2008 I would have NEVER missed a dose. The entire focal point of my day was the ritual of taking my injections. But now the twins are my focus and everything else comes 2nd.
On the infertility website that I follow (ivf.ca), there are many ladies with secondary infertility (they have one child but are struggling to conceive #2). They often talk about the logistical challenges of doing IVF when you have a toddler (or two) in tow. I had thought they were exaggerating, but I get it now. And I'm only doing an FET. A fresh IVF cycle would be much more hectic, the additional medications (which REALLY do need to be taken at the same time each day), the early morning monitoring appointments etc.
In other news, it turns out the whole Dynalife drama was all for naught. My clinic didn't get the bloodwork; they called Dynalife and they have no record of it. Despite the fact that they happily took my $47 for rush bloodword. Grrr. Fortunately, since my cyst is gone, the RE decided that I was ok to go ahead anyway without bloodwork. Snaps for my ovaries!! Boo for Dynalife!
I've been absolutely terrible at taking medication this cycle.
First I screwed up the BCP; I started taking them backwards in the package and then couldn't figure out what day I was on. I missed some days and then doubled up on others. On my official last day of BCP (Oct 5), I still had 3 pills left in the package. It's a good thing I never had to rely those things for actual birth control. I'd have ended up like Michelle Dugger or something.
Then I missed my first dose of Lupron. I was all set to take it but I wanted to get the twins to sleep first so I'd have time to review the instructions and concentrate on what I was doing. So I laid down with the kids and promptly fell asleep. I woke up in a panic at 2am and rushed out to the kitchen to do it. And it's happened several times since then. I just completely forget to take it then end up doing a catch-up dose the next morning. The good news it that it didn't matter one bit. The clinic called with the results of u/s and it was all clear. The cyst is gone and my ovaries are completely suppressed despite my being a disorganized basket case.
I blame my absent mindedness on my kids. When I did IVF in 2008 I would have NEVER missed a dose. The entire focal point of my day was the ritual of taking my injections. But now the twins are my focus and everything else comes 2nd.
On the infertility website that I follow (ivf.ca), there are many ladies with secondary infertility (they have one child but are struggling to conceive #2). They often talk about the logistical challenges of doing IVF when you have a toddler (or two) in tow. I had thought they were exaggerating, but I get it now. And I'm only doing an FET. A fresh IVF cycle would be much more hectic, the additional medications (which REALLY do need to be taken at the same time each day), the early morning monitoring appointments etc.
In other news, it turns out the whole Dynalife drama was all for naught. My clinic didn't get the bloodwork; they called Dynalife and they have no record of it. Despite the fact that they happily took my $47 for rush bloodword. Grrr. Fortunately, since my cyst is gone, the RE decided that I was ok to go ahead anyway without bloodwork. Snaps for my ovaries!! Boo for Dynalife!
Friday, October 14
Indicate precisely what you mean to say
Baseline ultrasound and bloodwork:
As with everything else in my life lately, it was a disorganized gong show.
Yesterday afternoon I pulled out my requisitions to confirm the times/places. My u/s was booked at MIC (a radiology clinic downtown) at 8:50 am. I vaguely recall a clinic nurse telling me to go to the lab at the Royal Alex hospital first to get the blood-work done. I didn’t question this at the time because that's where the Edmonton Fertility Clinic sent their patients and I know that lab does rush fertility bloodwork (the clinic needs the results back that morning).
Here's the problem. The hospital lab is first come/first serve and opens up at 8 am. It's very unlikely that I would be done in time to make it to MIC by 8:50 am. And I’d need to drop the twins off at dayhome first so I couldn't go to the lab early and line-up. MIC is where I got all my pre-natal scans so I know that if I was late, they wouldn’t hold my spot. I’d be SOL.
Then I looked at the bloodwork requisition again. The lab was listed as Dynalife (a local private lab which is not affiliated with Royal Alex lab). So was I even going to the right place??? I called my clinic to ask but the nurses had already gone home for the day.
In my usual responsible fashion, I went home and promptly forgot about the issue in the whirlwind of dinner prep and bedtime routines. I woke up early the next morning in a complete panic. I had no plan. I’m the kind of person who always needs a plan. Even a bad one. Greg had to leave at 5:30 am so he couldn’t help me…although he was surprisingly sympathetic and tried to talk me off the ledge before he left.
The solution was embarrassingly obvious once I calmed down. I would go to Dynalife first (taking the kids if necessary) and if they couldn’t do the bloodwork, I would go to the Alex after the u/s. Duh.
So I woke up kids, got them dressed and packed up. I called and woke up my sister (and totally awesome dayhome provider) to ask if I could pretty please drop off the kids early to which she graciously agreed. Happily, Dynalife could do the bloodwork. I got out of there by 8am and had a very relaxing drive to MIC.
The u/s part took forever. I was in there for almost 90 minutes. First they couldn’t find the instructions from my clinic so we had to wait for them to be re-faxed. Then the u/s tech did the most thorough scan of my ovaries that I’ve EVER had. She must have taken 50 pictures of each one. All my previous u/s have been at a fertility clinic and the baseline normally takes like 45 seconds. I guess that’s because my RE knows exactly what he’s looking for.
So it all turned out ok in the end. And yes, I do realize that all the drama could have been avoided if I’d just looked into things a day earlier and made a few phone calls. The fact is that I am a complete and total basketcase.
As with everything else in my life lately, it was a disorganized gong show.
Yesterday afternoon I pulled out my requisitions to confirm the times/places. My u/s was booked at MIC (a radiology clinic downtown) at 8:50 am. I vaguely recall a clinic nurse telling me to go to the lab at the Royal Alex hospital first to get the blood-work done. I didn’t question this at the time because that's where the Edmonton Fertility Clinic sent their patients and I know that lab does rush fertility bloodwork (the clinic needs the results back that morning).
Here's the problem. The hospital lab is first come/first serve and opens up at 8 am. It's very unlikely that I would be done in time to make it to MIC by 8:50 am. And I’d need to drop the twins off at dayhome first so I couldn't go to the lab early and line-up. MIC is where I got all my pre-natal scans so I know that if I was late, they wouldn’t hold my spot. I’d be SOL.
Then I looked at the bloodwork requisition again. The lab was listed as Dynalife (a local private lab which is not affiliated with Royal Alex lab). So was I even going to the right place??? I called my clinic to ask but the nurses had already gone home for the day.
In my usual responsible fashion, I went home and promptly forgot about the issue in the whirlwind of dinner prep and bedtime routines. I woke up early the next morning in a complete panic. I had no plan. I’m the kind of person who always needs a plan. Even a bad one. Greg had to leave at 5:30 am so he couldn’t help me…although he was surprisingly sympathetic and tried to talk me off the ledge before he left.
The solution was embarrassingly obvious once I calmed down. I would go to Dynalife first (taking the kids if necessary) and if they couldn’t do the bloodwork, I would go to the Alex after the u/s. Duh.
So I woke up kids, got them dressed and packed up. I called and woke up my sister (and totally awesome dayhome provider) to ask if I could pretty please drop off the kids early to which she graciously agreed. Happily, Dynalife could do the bloodwork. I got out of there by 8am and had a very relaxing drive to MIC.
The u/s part took forever. I was in there for almost 90 minutes. First they couldn’t find the instructions from my clinic so we had to wait for them to be re-faxed. Then the u/s tech did the most thorough scan of my ovaries that I’ve EVER had. She must have taken 50 pictures of each one. All my previous u/s have been at a fertility clinic and the baseline normally takes like 45 seconds. I guess that’s because my RE knows exactly what he’s looking for.
So it all turned out ok in the end. And yes, I do realize that all the drama could have been avoided if I’d just looked into things a day earlier and made a few phone calls. The fact is that I am a complete and total basketcase.
Tuesday, October 11
When I get older, losing my hair
Hello Menopause:
The Lupron side-effects started this week. It's a fun preview of what menopause will be like.
I've had a headache for 3 days now but at least Tylenol does help (unlike with migraines). I can also feel my body temperature increasing. I don't mind the hot flushes actually. I'm the kind of person who is always cold so Lupron is like a mini tropical vacation for me.
Greg tells me that the irritability is kicking in too. Although I prefer to think of it as me suddenly gaining an extra dose of assertiveness.
Today's rant is how the pharmacy was out of sharps containers. I've never once been issued a real sharps container to dispose of my used needles. The pharmacist always tells me to just use a coffee can or something. But the thing is that I need my coffee can...that's where I store my coffee...I can't put needles in there. So this is what I've been using instead.
A squished milk jug that I pulled out of my recycle bin. Not only is it hugely ghetto, it's also completely non-functional. Since it's made of soft plastic, the needles can just poke right through it.
The Lupron side-effects started this week. It's a fun preview of what menopause will be like.
I've had a headache for 3 days now but at least Tylenol does help (unlike with migraines). I can also feel my body temperature increasing. I don't mind the hot flushes actually. I'm the kind of person who is always cold so Lupron is like a mini tropical vacation for me.
Greg tells me that the irritability is kicking in too. Although I prefer to think of it as me suddenly gaining an extra dose of assertiveness.
Today's rant is how the pharmacy was out of sharps containers. I've never once been issued a real sharps container to dispose of my used needles. The pharmacist always tells me to just use a coffee can or something. But the thing is that I need my coffee can...that's where I store my coffee...I can't put needles in there. So this is what I've been using instead.
A squished milk jug that I pulled out of my recycle bin. Not only is it hugely ghetto, it's also completely non-functional. Since it's made of soft plastic, the needles can just poke right through it.
Why can't I just have a freaking sharps containers like everyone else?!? Is that so hard?!? Even the heroin addicts at the safe injection site get real sharps containers!!
Look how cool they are. All orange and official looking. And a biohazard symbol too!
I'm going to look like a total douche when I go to drop off my needles with that stupid milk jug. Well, maybe I won't drop them off. Maybe I'll just throw them out with the trash. That would show them. Or I'll bury the jug in the back-yard for future generations like some time capsule of the phamacy's incompetence.
Oh and btw, I'm totally going to kick menopause's ass when it gets here for real. Bring it on!!!
Sunday, October 2
I could be handy, mending a fuse
First Lupron injection:
Let's get this party started!!!
Let's get this party started!!!
And also, let's get some moisturizer...and maybe a manicure. My hands look like they belong to a 50 year old man.
Friday, September 30
Will you still be sending me a valentine, birthday greetings, bottle of wine?
I picked up all my medications today and in the proud tradition of other IVF bloggers, I lined everything up and took pictures.
The little vial contains the Lupron. The bottles contain the estrace and the boxes contain the first 2 weeks of progesterone suppositories. And yes, if you look closely in the background, there is a big stack of wine and liquor bottles (which will come into play if we get a BFN)
This lot cost $850 which seems excessive for an FET but of course much better than the $5,000+ plus we spent on drugs for our fresh cycle.
This is the first time I've gotten Lupron from a regular drugstore, in the past I've ordered it directly from the clinic pharmacy. It came in a big box with 14 super-fancy syringes in ultra-safe hermetically sealed plastic containers. Since I'll be using for more than 2 weeks, they also gave me a couple of bags of extra insulin syringes.
Picking up the medication was a gong show; it took over a hour. Despite the instructions faxed by my clinic, the pharmacy techs couldn't figure out what they were supposed to give me. They asked me a million questions which I couldn't answer and ended up calling the pharmacist at home and then my clinic to get the details straight. But now I've got everything and I'm ready to go.
I'm trying not to get excited because I don't want to get my hopes up. It's hard though. I do so want this to work.
The little vial contains the Lupron. The bottles contain the estrace and the boxes contain the first 2 weeks of progesterone suppositories. And yes, if you look closely in the background, there is a big stack of wine and liquor bottles (which will come into play if we get a BFN)
This lot cost $850 which seems excessive for an FET but of course much better than the $5,000+ plus we spent on drugs for our fresh cycle.
This is the first time I've gotten Lupron from a regular drugstore, in the past I've ordered it directly from the clinic pharmacy. It came in a big box with 14 super-fancy syringes in ultra-safe hermetically sealed plastic containers. Since I'll be using for more than 2 weeks, they also gave me a couple of bags of extra insulin syringes.
Picking up the medication was a gong show; it took over a hour. Despite the instructions faxed by my clinic, the pharmacy techs couldn't figure out what they were supposed to give me. They asked me a million questions which I couldn't answer and ended up calling the pharmacist at home and then my clinic to get the details straight. But now I've got everything and I'm ready to go.
I'm trying not to get excited because I don't want to get my hopes up. It's hard though. I do so want this to work.
Tuesday, September 27
When I'm 64
You're probably wondering about the significance of the title of this blog.
I'm a big fan of the book Spirit Babies by Walter Makichen - it was my #1 favorite “infertility” book. The author is a clairvoyant medium whose practice was centered around communicating with spirit babies (ie the souls of the child you are meant to have). He says that infertility can have both metaphysical and well as physical causes and the book contains a series of meditations and techniques to help overcome metaphysical roadblocks to conception. Now I’m not normally a spiritual or new agey type person, but something about this book just rang true for me. I can't say for sure if the meditations helped me get pregnant the first time, but they were definitely relaxing and made be feel good. And I did have a number of enlightening revelations about my fears and motivations.
So I've been doing the meditations again as part of the FET cycle and I'm having a rather weird experience. While I'm meditating, I keep hearing the song “When I’m 64” by the Beatles repeating over and over again in my head. And it’s all the lyrics clear as day even though in real life, I could probably only remember a couple of lines.
Is my subconscious trying to tell me something really insightful? Is there a part of me afraid of committing to caring for another child? Is it a message from a my spirit baby? What can it mean?!?
Edited October 14, 2011:
That song is constantly in my head all day now. I decided to pop an email about it to my sister (who is the most spiritually in tune person that I know). Here is an excerpt from her response. I like it and I'm going to give it a try!
I'm a big fan of the book Spirit Babies by Walter Makichen - it was my #1 favorite “infertility” book. The author is a clairvoyant medium whose practice was centered around communicating with spirit babies (ie the souls of the child you are meant to have). He says that infertility can have both metaphysical and well as physical causes and the book contains a series of meditations and techniques to help overcome metaphysical roadblocks to conception. Now I’m not normally a spiritual or new agey type person, but something about this book just rang true for me. I can't say for sure if the meditations helped me get pregnant the first time, but they were definitely relaxing and made be feel good. And I did have a number of enlightening revelations about my fears and motivations.
So I've been doing the meditations again as part of the FET cycle and I'm having a rather weird experience. While I'm meditating, I keep hearing the song “When I’m 64” by the Beatles repeating over and over again in my head. And it’s all the lyrics clear as day even though in real life, I could probably only remember a couple of lines.
Is my subconscious trying to tell me something really insightful? Is there a part of me afraid of committing to caring for another child? Is it a message from a my spirit baby? What can it mean?!?
When I'm 64
Songwriters: Mccartney, Paul; Lennon, John;
When I get older, losing my hair, many years from now
Will you still be sending me a valentine, birthday greetings, bottle of wine?
If I'd been out 'til quarter to three, would you lock the door?
Will you still need me, will you still feed me when I'm sixty-four?
You'll be older too
Ah, and if you say the word, I could stay with you
I could be handy, mending a fuse when your lights have gone
You can knit a sweater by the fireside, Sunday mornings, go for a ride
Doing the garden, digging the weeds, who could ask for more?
Will you still need me, will you still feed me when I'm sixty-four?
Every summer we can rent a cottage
In the Isle of Wight if it's not to, dear
We shall scrimp and save
Ah, grandchildren on your knee, Vera, Chuck and Dave
Send me a postcard, drop me a line stating point of view
Indicate precisely what you mean to say, yours sincerely wasting away
Give me your answer, fill in a form, mine forever more
Will you still need me, will you still feed me when I'm sixty-four?
Edited October 14, 2011:
That song is constantly in my head all day now. I decided to pop an email about it to my sister (who is the most spiritually in tune person that I know). Here is an excerpt from her response. I like it and I'm going to give it a try!
It is not necessarily a romantic song, rather a song about a life-long familial relationship. And I wouldn't get hung up on the number 64 as an age or on who plays what role in the song (but keep it in mind). Think of it as a potential child asking if s/he could become part of your life. "..if you say the word, I could stay with you." It is a picture of a charming future family life, grandchildren on your knee....I'd try writing a postcard, dropping a line stating your point of view. Try imagining the song is a proposal and saying "yes" when you hear the song and see what it feels like.
I don't have time to type more but I absolutely believe that songs replaying in one's head can be spiritual messages
Monday, September 26
FET for dummies
This post is an overview of what we're doing and where we're at so far.
I first called the clinic way back in January to get this process rolling (we wanted to transfer in July). There have been some issues with the testing and other problems that got the cycle delayed until now.
I've done a bunch of blood work and last month, I flew to Vancouver to have an SIS which is an ultrasound where they inject saline dye into the uterus to check if it would be a happy place for an embryo to live (ie no polyps or other issues). At that time they found I had yet another ovarian cyst but we are moving forward anyways in hopes that the combination of BCP and Lupron will resolve it. If not, we'll have to postpone this even further.
There are a number of different protocols for an FET (frozen embryo transfer). The simplest is the natural cycle. That's where the women takes no medications, just goes through her regular monthly cycle. After she ovulates, the clinic thaws the embryos and then transfers them into her uterus. A natural cycle can also be supplemented with medications to tweak various hormone imbalances etc. depending on the women's medical situation.
The type of FET I'm doing is called a "Suppression/endometrial stimulation cycle". This is a completely artificial cycle for women like me who don't trust their reproductive system to do ANYTHING right on its own.
Here's how it will work:
BCP: On the first day of my period, I started taking birth control pills. This was for a couple of reasons:
1) to control the length of my cycle so the start of my treatment can be scheduled for a fixed date.
2) to prevent a natural pregnancy (ha ha! as if!) If by some miracle, I got pregnant naturally, it would be dangerous to take Lupron or the other drugs.
Suppression: On October 1, I will start a suppression drug called Lupron to prevent my ovaries from producing follicles or ovulating. It will be like artificial menopause and I'll experience similar symptoms. And yes, I do see the irony that the first step in trying to get pregnant is to take birth control and then step 2 is to completely shut down my reproductive system.
Lupron (like most IVF drugs) is taken by daily subcutaneous injection. The needles go in the soft fleshy part of the tummy (I got lots of that) and it's not as bad as it sounds because they don't hurt nearly as much as say a vaccination or a blood draw does.
Baseline: I'll go for blood work and an ultrasound on October 14th to ensure that my ovaries are suppressed (and hopefully that cyst is gone).
Endometrial Stimulation: If the baseline is good, I'll start taking Estrace (estrogen) pills to build up my lining (since I won't be growing any eggs, I won't produce any estrogen naturally). I'll go for another ultrasound on October 28th to check my lining.
Progesterone: If my lining is good, I will start my progesterone supplement on October 31st.
Embryo transfer: If all goes well, my transfer is scheduled for November 4th. I live 12 hours away from my clinic so we will fly out there to do the transfer (the rest of my tests can be done here). The plan is to thaw one embryo at a time and if it starts growing, we will transfer it. If not, we will thaw the next one.
BETA: 9 days after transfer, I'll take a blood test to see if it worked.
Ok I promise that this will be the last boring post about protocols and hormones. I'll even restrain myself from posting a explanation of how Lupron works - even though it's totally cool and I could draw diagrams of what the GnRH receptors look like.
I first called the clinic way back in January to get this process rolling (we wanted to transfer in July). There have been some issues with the testing and other problems that got the cycle delayed until now.
I've done a bunch of blood work and last month, I flew to Vancouver to have an SIS which is an ultrasound where they inject saline dye into the uterus to check if it would be a happy place for an embryo to live (ie no polyps or other issues). At that time they found I had yet another ovarian cyst but we are moving forward anyways in hopes that the combination of BCP and Lupron will resolve it. If not, we'll have to postpone this even further.
There are a number of different protocols for an FET (frozen embryo transfer). The simplest is the natural cycle. That's where the women takes no medications, just goes through her regular monthly cycle. After she ovulates, the clinic thaws the embryos and then transfers them into her uterus. A natural cycle can also be supplemented with medications to tweak various hormone imbalances etc. depending on the women's medical situation.
The type of FET I'm doing is called a "Suppression/endometrial stimulation cycle". This is a completely artificial cycle for women like me who don't trust their reproductive system to do ANYTHING right on its own.
Here's how it will work:
BCP: On the first day of my period, I started taking birth control pills. This was for a couple of reasons:
1) to control the length of my cycle so the start of my treatment can be scheduled for a fixed date.
2) to prevent a natural pregnancy (ha ha! as if!) If by some miracle, I got pregnant naturally, it would be dangerous to take Lupron or the other drugs.
Suppression: On October 1, I will start a suppression drug called Lupron to prevent my ovaries from producing follicles or ovulating. It will be like artificial menopause and I'll experience similar symptoms. And yes, I do see the irony that the first step in trying to get pregnant is to take birth control and then step 2 is to completely shut down my reproductive system.
Lupron (like most IVF drugs) is taken by daily subcutaneous injection. The needles go in the soft fleshy part of the tummy (I got lots of that) and it's not as bad as it sounds because they don't hurt nearly as much as say a vaccination or a blood draw does.
Baseline: I'll go for blood work and an ultrasound on October 14th to ensure that my ovaries are suppressed (and hopefully that cyst is gone).
Endometrial Stimulation: If the baseline is good, I'll start taking Estrace (estrogen) pills to build up my lining (since I won't be growing any eggs, I won't produce any estrogen naturally). I'll go for another ultrasound on October 28th to check my lining.
Progesterone: If my lining is good, I will start my progesterone supplement on October 31st.
Embryo transfer: If all goes well, my transfer is scheduled for November 4th. I live 12 hours away from my clinic so we will fly out there to do the transfer (the rest of my tests can be done here). The plan is to thaw one embryo at a time and if it starts growing, we will transfer it. If not, we will thaw the next one.
BETA: 9 days after transfer, I'll take a blood test to see if it worked.
Ok I promise that this will be the last boring post about protocols and hormones. I'll even restrain myself from posting a explanation of how Lupron works - even though it's totally cool and I could draw diagrams of what the GnRH receptors look like.
Saturday, September 24
IVF for Dummies
My infertile friends can probably skip this post.
And also anyone else who doesn't want to read a bunch of dull science-type crap. Actually you folks should just probably skip the whole blog because really, it's pretty much ALL going to be science-type crap.
How it's supposed to work:
The egg is released into the abdominal cavity and is picked up by the fallopian tube. Sperm fertilizes the egg and if the embryo is viable it will grow for several days in the tube as it makes it's journey to the uterus. In most cases the embryo would emerge into the uterus at the blastocyst stage (about 5 or 6 days old). If conditions are right, the blast will implant into the uterine lining and start growing into a baby.
After the egg is released, the follicle on the ovary becomes a corpeus luteum and produces progesterone which is necessary to maintain a pregnancy until the placenta is mature enough to produce this hormone on it own.
How Infertility (IF) works:
The human reproductive system is super complicated and there are a gazillion things that can go wrong which will prevent a couple from conceiving. Here's a few examples.
How Invitro Fertilization IVF works:
There are a number of different protocols but I'm going to give a brief description of the most common one.
Step 1 Suppression: With IVF, the ovaries are artificially stimulated to produce multiple eggs instead of just one. Prior do this, the woman takes a suppression drug to stop the pituitary gland from producing FSH so the body's natural hormones and biofeedback mechanism don't interfere with this goal.
Step 2 Stimulation: The woman takes daily injections of FSH (and sometimes LH) to stimulate the ovaries to produce multiple follicles (ideally between 10 and 20). The RE monitors the follicles by ultrasound until they are large enough. Assuming this phase is successful and there are a sufficient number of follicles, the woman takes an "trigger" injection to mature the eggs.
Step 3 Retrieval: The woman undergoes a minor surgical procedure to extract the eggs from the ovaries.
Step 4 Fertilization and culture: The eggs are fertilized in the lab and the embryos are grown in a petri dish for up to five days. (Note: despite the term "Test Tube Babies" no actual test tubes are used in this procedure.)
Not all eggs will fertilize and there is a natural attrition among the embryos as the genetically abnormal ones stop growing. This is a very clinical description that doesn't do justice to how excruciating that week is. I woke up every morning at 4am unable to sleep and sat by the phone waiting to for the embryologist to call and tell me how many of my embryos made it through the night. Are your hopes (and a great deal of money) are invested in something that's completely beyond your control. It's not uncommon for none of the embryos survive the culture period.
Step 5 Embryo transfer: The embryologist selects one or two of the best quality embryos and the RE transfers them into the uterus. If there are any good quality embryos remaining, they are cryogenically preserved (ie frozen) to be transferred again at a later date. In some cases, the clinic will transfer more than 2 but this isn't common because it increases the risk of triplets or other higher order multiples. The woman takes a progesterone supplement because since she didn't ovulate, her body isn't producing this hormone naturally.
Step 6 Beta: About two weeks later you take pregnancy blood test called a beta. A positive beta test does not guarantee a viable pregnancy. About 1/3 of pregnancies end in miscarriage. Most fertile women don't even know they were pregnant when they have one of these early miscarriages. So IVF patients have a 2nd blood test to ensure that the HCG levels are increasing and then an ultrasound at around 8 weeks. If the embryo has a heart-beat at that ultrasound, its counted as a pregnancy in the clinic's stats.
At my clinic, the pregnancy rate when for patients that transfer 2 embryos is about 60% . This excludes the couples who didn't make it to transfer because none of their embryos were viable, or those couples whose cycles were cancelled before retrieval because they weren't producing enough follicles. On average, if you start an IVF cycle, the chances of getting pregnant are about 35 to 40%. It may take several cycles for a couple to become pregnant and some couples will never become pregnant because IVF isn't enough to help them overcome the medical condition which causes their infertility.
An average IVF cycle in Canada costs between $8,000 to $15,000 (including meds) which is not covered by public health care except in Quebec (and in some circumstances in Ontario). More complex cycles can cost even more. Is it worth the cost? Yes, absolutely! We had tried for almost 5 years before we tried IVF and getting pregnant with the twins felt like a miracle for us. A true blessing.
Our IVF Cycle:
We had a very successful initial IVF cycle. It started out slow; we only retrieved 6 mature eggs which is considered a low response. However, the fertilization and culture went very well. At day 5, we still had 5 good quality embryos (we transferred 2 and froze the rest).
Wow, this post turned out to be much longer and detailed than I indended. Hopefully somebody cares...well I care at least and that's the important thing.
In case you're curious...
Kate Goselin (from Jon and Kate Plus Eight) did not use IVF to conceive her famous sextuplets. She used a much cheaper treatment called IUI. She took medication that caused her to produce multiple eggs but instead of having them removed and cultured in a lab, she ovulated and had a sample of Jon's little swimmers injected into her uterus. This procedure is popular because it's cheaper but the success rate is lower than IVF and it has a higher risk of multiples.
Octomom: Nutcase Nadia Suleman did do IVF but conceived her record 8 babies because her equally nutty doctor transferred 12 embryos into her uterus when the industry standard is 2 to 3. My RE privately referred to it as criminal negligence. Nadia's doctor later lost his medical license (quite rightly).
And also anyone else who doesn't want to read a bunch of dull science-type crap. Actually you folks should just probably skip the whole blog because really, it's pretty much ALL going to be science-type crap.
How it's supposed to work:
First off, let's review some basic biology of the reproductive system. Each month a woman's pituitary gland secretes a hormone called FSH (follicle stimulating hormone). FSH stimulates the ovaries to produce follicles in which eggs can grow. The ovaries start off producing lots of follicles but soon the largest one will become dominate. The growing follicles produce estrogen which operates as a biofeedback mechanism to slow the production of FSH in the pituitary gland. Reduced FSH stops the growth of the lesser follicles and the ovaries ends up producing only one (or sometimes two) eggs.
The egg is released into the abdominal cavity and is picked up by the fallopian tube. Sperm fertilizes the egg and if the embryo is viable it will grow for several days in the tube as it makes it's journey to the uterus. In most cases the embryo would emerge into the uterus at the blastocyst stage (about 5 or 6 days old). If conditions are right, the blast will implant into the uterine lining and start growing into a baby.
After the egg is released, the follicle on the ovary becomes a corpeus luteum and produces progesterone which is necessary to maintain a pregnancy until the placenta is mature enough to produce this hormone on it own.
How Infertility (IF) works:
The human reproductive system is super complicated and there are a gazillion things that can go wrong which will prevent a couple from conceiving. Here's a few examples.
- Sperm can't reach egg: This can be due to structural issues like blocked tubes (in the girl or the guy) or chemical issues like hostile cervical mucus, or the man may have low sperm volume or poor quality.
- Poor egg quality: This issue is more common in woman over 35 but it can effect ladies in their 20's.
- No ovulation: Some women don't ovulate due to hormone imbalances (like PCOS) or for other reasons.
- Embryo can't implant: Due to poor quality lining, overactive immune system which attacks the embryo or other reasons.
- Recurrent miscarriages: The embryos might have genetic abnormalities which cause the pregnancy to fail or the mom may have some condition or hormone imbalance which makes it difficult for the body to sustain a pregnancy.
How Invitro Fertilization IVF works:
There are a number of different protocols but I'm going to give a brief description of the most common one.
Step 1 Suppression: With IVF, the ovaries are artificially stimulated to produce multiple eggs instead of just one. Prior do this, the woman takes a suppression drug to stop the pituitary gland from producing FSH so the body's natural hormones and biofeedback mechanism don't interfere with this goal.
Step 2 Stimulation: The woman takes daily injections of FSH (and sometimes LH) to stimulate the ovaries to produce multiple follicles (ideally between 10 and 20). The RE monitors the follicles by ultrasound until they are large enough. Assuming this phase is successful and there are a sufficient number of follicles, the woman takes an "trigger" injection to mature the eggs.
Step 3 Retrieval: The woman undergoes a minor surgical procedure to extract the eggs from the ovaries.
Step 4 Fertilization and culture: The eggs are fertilized in the lab and the embryos are grown in a petri dish for up to five days. (Note: despite the term "Test Tube Babies" no actual test tubes are used in this procedure.)
Not all eggs will fertilize and there is a natural attrition among the embryos as the genetically abnormal ones stop growing. This is a very clinical description that doesn't do justice to how excruciating that week is. I woke up every morning at 4am unable to sleep and sat by the phone waiting to for the embryologist to call and tell me how many of my embryos made it through the night. Are your hopes (and a great deal of money) are invested in something that's completely beyond your control. It's not uncommon for none of the embryos survive the culture period.
Step 5 Embryo transfer: The embryologist selects one or two of the best quality embryos and the RE transfers them into the uterus. If there are any good quality embryos remaining, they are cryogenically preserved (ie frozen) to be transferred again at a later date. In some cases, the clinic will transfer more than 2 but this isn't common because it increases the risk of triplets or other higher order multiples. The woman takes a progesterone supplement because since she didn't ovulate, her body isn't producing this hormone naturally.
Step 6 Beta: About two weeks later you take pregnancy blood test called a beta. A positive beta test does not guarantee a viable pregnancy. About 1/3 of pregnancies end in miscarriage. Most fertile women don't even know they were pregnant when they have one of these early miscarriages. So IVF patients have a 2nd blood test to ensure that the HCG levels are increasing and then an ultrasound at around 8 weeks. If the embryo has a heart-beat at that ultrasound, its counted as a pregnancy in the clinic's stats.
At my clinic, the pregnancy rate when for patients that transfer 2 embryos is about 60% . This excludes the couples who didn't make it to transfer because none of their embryos were viable, or those couples whose cycles were cancelled before retrieval because they weren't producing enough follicles. On average, if you start an IVF cycle, the chances of getting pregnant are about 35 to 40%. It may take several cycles for a couple to become pregnant and some couples will never become pregnant because IVF isn't enough to help them overcome the medical condition which causes their infertility.
An average IVF cycle in Canada costs between $8,000 to $15,000 (including meds) which is not covered by public health care except in Quebec (and in some circumstances in Ontario). More complex cycles can cost even more. Is it worth the cost? Yes, absolutely! We had tried for almost 5 years before we tried IVF and getting pregnant with the twins felt like a miracle for us. A true blessing.
Our IVF Cycle:
We had a very successful initial IVF cycle. It started out slow; we only retrieved 6 mature eggs which is considered a low response. However, the fertilization and culture went very well. At day 5, we still had 5 good quality embryos (we transferred 2 and froze the rest).
Wow, this post turned out to be much longer and detailed than I indended. Hopefully somebody cares...well I care at least and that's the important thing.
In case you're curious...
Kate Goselin (from Jon and Kate Plus Eight) did not use IVF to conceive her famous sextuplets. She used a much cheaper treatment called IUI. She took medication that caused her to produce multiple eggs but instead of having them removed and cultured in a lab, she ovulated and had a sample of Jon's little swimmers injected into her uterus. This procedure is popular because it's cheaper but the success rate is lower than IVF and it has a higher risk of multiples.
Octomom: Nutcase Nadia Suleman did do IVF but conceived her record 8 babies because her equally nutty doctor transferred 12 embryos into her uterus when the industry standard is 2 to 3. My RE privately referred to it as criminal negligence. Nadia's doctor later lost his medical license (quite rightly).
Sunday, September 18
The plan
Here’s what’s on the agenda for October:
1) Quit my job because it is sucking the life out of me.
2) Plan the twins’ 3rd birthday party.
3) Attempt to get pregnant.
That’s right, I’m going to reach new heights of oversharing and chronicle our attempt to conceive in my blog. After consultation with Greg, we agreed that I would not post any entries about this in my main blog (that our friends and family know about) until after everything was done and we were ready to announce the results publicly (good or bad). So I started writing these entries but not posting them. That was getting too confusing for me, so now I'm going to post all the TTC (trying to conceive) entries in this new new super-secret blog which I will link or merge with my main blog if and when it's appropriate.
When most couples decide to try for another baby, they might buy a bottle of wine and plan a romantic weekend away. For us infertiles, we whip out our credit card and set up an injection centre in the bathroom. We have 3 embryos in cryogenic storage at our fertility clinic in Burnaby. We are going to unthaw and transfer these embryos (one at a time!) into my uterus in hope of adding to our family. Well actually this will be done by a team of highly qualified reproductive endocrinologists and embryologists. Greg and I will just be doing the hoping and praying part.
Why?
Why try again you may ask? Wouldn't that be pushing our luck considering how fortunate we were last time around to have the twins? And hey, aren't I always complaining about how overwhelmed and stressed out I am balancing work and family? Would I really want to add another child into the mix?
Yes, this may be a crazy bad idea but Greg and I would still absolutely love to have another baby. The twins are a lot of work and sometimes they drive us nuts, but they are also an absolute joy. And I feel like somehow there is supposed to be another member of our family and we need to give him/her a chance to join the insanity. Also, with twins, everything goes by so fast: all the milestones and the adorable baby stuff. I so wish I could do it again.
The odds of success:
I'm not going to quote the success rates and statistics for a frozen embryo transfer (FET) because they're actually pretty discouraging. FET rates are always lower than a fresh IVF cycle because we have already transferred the 2 best embryos of the bunch and the remaining ones are of lesser quality and may not be viable. As info for my non-infertile friends: even with regular people, only about half of fertilized eggs have the potential to become babies, the remainder have genetic abnormalities which will cause the embryo to stop growing in the first couple of weeks. This rate gets even worse as a woman gets older (ie over 35). This is part of the reason that even fertile people don't get pregnant every month that they try.
Our fertility doctor (aka reproductive endocrinologist or RE) has given us a 30% chance of this working. Namely that if we thawed and transferred all 3 embryos, we have a 30% chance of having one baby. That's certainly good enough odds for us to take the chance.
Let the fun begin!
1) Quit my job because it is sucking the life out of me.
2) Plan the twins’ 3rd birthday party.
3) Attempt to get pregnant.
That’s right, I’m going to reach new heights of oversharing and chronicle our attempt to conceive in my blog. After consultation with Greg, we agreed that I would not post any entries about this in my main blog (that our friends and family know about) until after everything was done and we were ready to announce the results publicly (good or bad). So I started writing these entries but not posting them. That was getting too confusing for me, so now I'm going to post all the TTC (trying to conceive) entries in this new new super-secret blog which I will link or merge with my main blog if and when it's appropriate.
When most couples decide to try for another baby, they might buy a bottle of wine and plan a romantic weekend away. For us infertiles, we whip out our credit card and set up an injection centre in the bathroom. We have 3 embryos in cryogenic storage at our fertility clinic in Burnaby. We are going to unthaw and transfer these embryos (one at a time!) into my uterus in hope of adding to our family. Well actually this will be done by a team of highly qualified reproductive endocrinologists and embryologists. Greg and I will just be doing the hoping and praying part.
Why?
Why try again you may ask? Wouldn't that be pushing our luck considering how fortunate we were last time around to have the twins? And hey, aren't I always complaining about how overwhelmed and stressed out I am balancing work and family? Would I really want to add another child into the mix?
Yes, this may be a crazy bad idea but Greg and I would still absolutely love to have another baby. The twins are a lot of work and sometimes they drive us nuts, but they are also an absolute joy. And I feel like somehow there is supposed to be another member of our family and we need to give him/her a chance to join the insanity. Also, with twins, everything goes by so fast: all the milestones and the adorable baby stuff. I so wish I could do it again.
The odds of success:
I'm not going to quote the success rates and statistics for a frozen embryo transfer (FET) because they're actually pretty discouraging. FET rates are always lower than a fresh IVF cycle because we have already transferred the 2 best embryos of the bunch and the remaining ones are of lesser quality and may not be viable. As info for my non-infertile friends: even with regular people, only about half of fertilized eggs have the potential to become babies, the remainder have genetic abnormalities which will cause the embryo to stop growing in the first couple of weeks. This rate gets even worse as a woman gets older (ie over 35). This is part of the reason that even fertile people don't get pregnant every month that they try.
Our fertility doctor (aka reproductive endocrinologist or RE) has given us a 30% chance of this working. Namely that if we thawed and transferred all 3 embryos, we have a 30% chance of having one baby. That's certainly good enough odds for us to take the chance.
Let the fun begin!
Subscribe to:
Posts (Atom)