Embryo Biopsy and Freezing

I got a call from Ashley today with the final tally on frozen embryos. The final number is 11. Two out of the fourteen embryos that had grown stopped growing before the biopsy. One of the 12 embryos that were biopsied did not make it through the freezing process. We are of course, thrilled to have 11 embryos left but we are still kinda bummed about the 3 that didn't make it.

In an effort to not bore you by spewing out a bunch of terms and numbers, here are some examples of what our embryos have been doing over the past 5 days! Be sure to read the captions next to the pictures or the rest of this blog will get very confusing...

Most of the Embryos have grown into Early Blastocysts.
Only one of them is still compacting to turn into an Early Blastocyst.

3 of them are Hatching Blastocysts

3 of the embryos were mature enough to biopsy on Tuesday
1 young Blast - Grade 1
1 Young Blast - Grade 1 Plus (we got a show-off over here!)
1 Young Blast - Grade 3

The others were biopsied and frozen this morning
1 Young Blast - Grade 2 Plus
1 Hatching Blast - Grade 2 Plus
1 Young Blast - Grade 2
2 Hatching Blasts - Grade 2
1 Compacting embryo - Grade 2
1 Young Blast - Grade 3
1 Hatching Blast - Grade 3

I went over the grading scale a little bit in my last post. Obviously a Grade 1 is preferred over a Grade 3, however all of our embryos have a good chance of creating a healthy pregnancy. I don't really understand the grading scale so I'm not even going to try explaining it any more.


I will start nightly Lupron injections on Friday. I'll be on the Lupron at least until we have the results of the embryo biopsies which will be 2-3 weeks. Once we have the results, we will schedule my embryo transfer and I'll have to be on estrogen for 21 days before the scheduled transfer date. There will be more blood tests, ultrasounds and all that full stuff along the way, but we are getting closer!!

- Emily

Embryo Progress

My doctors were able to retrieve 16 eggs during the egg retrieval on Friday. We were obviously thrilled! On Saturday morning they called to let us know the results of the fertilization. Only one of the eggs was immature so they did not attempt to fertilize that one. They performed ICSI, intracytoplasmic sperm injection (they pretty much just inject a single sperm into each egg) on 15 of the eggs and one of them was not successfully fertilized. 14 embryos! Thrilled again!

Brian spoke with a nurse, Sandy, today and got an update on the embryos. We were prepared for a few of them to stop growing or not develop properly as this often happens. To our surprise all 14 of the embryos have continued to grow! The majority of the embryos are grade 1 and 2, which Sandy said was "excellent!" 2 or 3 of them are grade 3 which is "fair" according to their standards. The grading scale is just a way to numerically determine which embryos are most likely to result in successful pregnancy. The grade 3 embryos could result in a pregnancy as healthy and successful as a grade 1. The scale is just a way to measure probability, I guess. Sandy did say one of the embryos was "compacted" but she didn't really explain that to Brian. From what I have found online that is just another stage of embryo development. 

In regards to my healing from the egg retrieval, that procedure is no joke! It was a lot more invasive than I had anticipated. My stomach has hurt since the procedure and there's still a lot of pressure in my abdomen. I woke up around 4 AM on sunday morning in excruciating pain. I thought my abdomen was about to rupture it hurt so bad. Brian woke up to me screaming and was obviously pretty freaked out. He had to help me sit up due to increased pain whenever I tried to do so on my own. I never realized how much you use your core muscles just to sit up in bed. It turned out my bladder was just extremely full and on top of the swelling from the procedure it was putting a lot of pressure on my abdomen. 

The embryologist from RGI will be coming tomorrow to take biopsies from each of the embryos. Once the biopsies are retrieved they will freeze the embryos. They will then take the biopsies back to chicago and run the DNA tests to determine which ones have Brian's mutation. In a couple weeks we will know the results and will be ready to prep for the embryo transfer. 

-Emily

Day 15 - Egg Retrieval!

Day 15: Friday, September 23. Poke count 47

16 Eggs Retrieved!! 

That's 16 possible embryos! Statistically half of those will not be mature and half of the embryos that do grow to 5 days will have the defective gene. If everything goes by those numbers we should have around 4 healthy embryos!

I took a sedative, an antibiotic and Tylenol at 6:45AM and we went to the fertility center. We live less than 5 minutes from the center so we luckily don't have to go too far. They brought us back to a procedure room and had me change into a gown, foot covers and a super sexy hair net. The nurse came in to start my IV but had no luck. The vein in my left arm likes to roll around and the one in the left "goes all crazy" and shoots to the side right where they always try to draw blood. How may people does it take to start an IV? apparently 3, two nurses and an anesthesiologist. they finally got one started in my left hand.

Once they took me to the procedure room everything moved pretty quickly. I layed there for a few minutes watching them hook up machines and getting everything ready. They had me confirm my name and birthday, sign a piece of paper and then it was time to start. It's a strange feeling not remembering an entire chunk of time with several people staring at your...parts. The last thing I remember is the anesthesiologist talking about how he loved the Eagles music that was playing on the radio and him injecting the anesthesia into the IV tube. Brian said at one point they opened the door and he could hear the suction machine they use to retrieve the eggs and it sounded like a small generator.

When I woke up from the anesthesia I remember telling Brian about the "moon boots" I got to wear. They use stirrups like they do for any annual exam, but they have these boots that hook onto them to keep your legs in place while you are asleep.Brian said I told him I was feeling emotional and wanted to cry. He said "It's ok, you can cry"...and I did. I cried and cried and cried. I think I reacted the same way to anesthesia when I had my tonsils removed. I just become very emotional when I finally do wake up. I was in a great deal of pain too. I was having shooting pains from my lower abdomen all the way down through my legs. They gave me a heat pack for my stomach, which helped a little bit but they said everything I felt was normal.

We got home around 9:30Am and I went straight to bed. I woke up around noon for a few minutes and went back to sleep till after 3PM at which point I was still feeling pretty crappy. I felt like someone had punched me repeatedly in the abdomen and had severe pelvic pain. I have just been on the couch the rest of the day and the pain comes in waves. If I'm sitting in the right position I can get pretty comfortable but any movement hurts all over. It's slowly getting better as the night goes on and hopefully I'll be feeling great tomorrow morning.

They will call us tomorrow and let us know how many eggs were successfully fertilized. We are, of course, hoping for all 16! I'll start Lupron injections in the next couple weeks and once I get a period I will start taking estrogen. This will help prepare my uterus for the embryo transfer in 4-6 weeks. I have a post-op appointment in 2 weeks, but other than that no more appointments for a bit!

-Emily

IVF Cycle: Stims Day 13

Day 13: Wednesday 9/21 Poke Count 44

Today was eventful! I started the day with my cetrotide injection and stopped by the fertility center on my way to work to have my blood drawn. Around 1PM (an hour after I got back from my lunch break) I got a call from Ashley) My Estrogen levels had dropped from 2254 pg/ml yesterday down to 1578 pg/ml today...not good! They have no idea why this would happen, but if it continued to drop, the follicles would stop growing. I told her I had half a vial of Gonal-F left at home and she wanted me to come to the office right away to get some Menopur. They never have medication in the office and they just happened to have 2 vials that someone had donated. I left work, picked up the medication and went home to get the Gonal-F...this is where things got interesting.

The past week or so, my brain has been mush. I am constantly losing things and forgetting the name of things. I don't know if its a side effect of the medication or I just have so much on my mind, but its not fun. Anyway, I haven't been able to find my house keys since Monday. I left a door open so I could come home on lunch, but I locked that one when I headed back to work after my break today. Brian had opened the dining room window yesterday, so I could wiggle it open and climb inside. I went through the gate into the back yard and found a new, disgusting, wriggly friend making a run (or slither) for it to the Hosta....there was a snake moving very quickly through the grass! I had my little mental freak-out, bolted up the stairs to the deck by the dining room window.

I had to break part of the screen to get to the actual window and I was just barely able to open the window enough to get through. The whole time the dog is barking at me and I'm worried the neighbors will think someone is trying to break in. Excitement aside, I got the medication, gave myself both injections and headed back to work. The Fertility Center called again and told me they still plan on doing my egg retrieval on Friday at 7:45AM! I have to do my Pregnyl (trigger) ingection tonight at 8:15PM and an injection of Lupron at the same time. My mom is actually coming over to give me the Pregnyl shot since its an intramuscular injection. She gives shots all the time at work and I've only done the subcutaneous ones in the belly. Brian is not too fond on stabbing his wife, so I'll let my mom show me how to do it! By the end of today, I will have had 44 pokes since the start of IVF! It really doesn't seem like its been that many!

Thursday night I'll take Valium before bed and take a few more meds in the morning on Friday. Ill need to take a Z-pac to prevent infection, 1000mg of Tylenol and a light sedative. I'll be put under for the procedure and then they will create our embryos!! We will know how many eggs were retrieved immediately and we will get updates on the embryos almost daily until they are biopsied and frozen. Keep your fingers crossed for lots of eggs and lots of embryo growth!

-Emily

IVF Cycle: Stims Days 9-12

Day 9: Saturday, September 18. Poke count:28

I woke up at 6 today and gave myself the Cetrotide injection. I then fell back asleep until almost 11:00AM! I am starting to feel extremely tired throughout the day. The headache's don't seem too bad anymore, they have gotten less frequent. My Cenopur injection was strange today. I don't know if I hit a vein or something, but my entire left hip burned and went numb for a minute. It went away pretty quickly, but it hurt pretty bad!

We are spending the weekend in Ypsilanti visiting friends who will be moving to Canada next month. I made sure to pack an entire box of medication this time! Driving back home from Ypsilanti would be much more inconvenient than my drive home from Muskegon last week. I'm super lame and went to bed before anybody left the going away party! I was just way too tired to keep my eyes open and nearly fell asleep on the couch.

Day 10: Sunday, September 19 Poke Count: 31

I didn't feel much better this morning. I still felt very tired and am feeling more full by the day. I went to a baby shower for a friend and it was a nice reminder of why we are doing all of this. Seeing her all adorable and pregnant, anxiously awaiting her baby girl to be born would make anyone forget the annoyance of hormone injections.

Of course, we played some oh-so-entertaining shower games and got a glimpse into the future of pregnant, Emily.

I am not nearly as cute with a balloon belly as Caitlin!!
(Please don't kill me for posting this picture!)

I have an appointment for another ultrasound and bloodwork tomorrow and I am praying I'll be ready for the egg retrieval soon!

Day 11: Monday, September 20. Poke count 35

My ultrasound and bloodwork was all normal, but unfortunately the follicles still have some growing to do. They thought this might be the case, so it's a good thing I ordered more Menopur. I'll stay on the injections for another night and they want me to come back in tomorrow morning for another ultrasound and blood tests.

I looked through my other meds this morning just in case I would be ready for my trigger shot and I noticed I was missing a syringe. They sent a needle with the trigger shot, but no syringe! The nurse was able to find an extra syringe to give me. I'm really glad I realized this today, and not at midnight when I'm sleepily preparing the injection.

Day 12: Tuesday, September 21. Poke Count: 39

I had another appointment today for an ultrasound and bloodwork. The bigger follicles had grown a little more than a millimeter today, but quite a few of them are still small. I rushed back to work for a 9:30 meeting so I didn't have time to wait for instructions. I received a call around noon and said they want me to stay on the injections for another night and come back in the morning for another blood draw. One problem...I'm out of Menopur! They told me to double the dosage of Gonal - F and that should be OK.

My egg retrieval is planned for Friday but I don't know what time yet. After the bloodwork tomorrow they will plan the time for my egg retrieval on Friday and tell me when to do my "trigger" shot. There is a light at the end of this hormone filled tunnel!

-Emily

IVF cycle: stims day 7 and 8

Day 7: Thursday, September 15: poke count: 21

There is so much pressure in my lower abdomen I feel like I might pop! I'm getting flashbacks to 5th grade frog dissections. There's always a few female frogs who just explode with eggs when you cut them open...I am the frog. I feel like I have developed a waddle! Every step I take puts more pressure on my abdomen.

This rubber ball is my spirit animal

I started the Cetrotide this morning so I won't ovulate. The only difference between Cetrotide and the other injections I have done is that it is refrigerated. It took a lot longer for the powder to dissolve in the fluid with it being cold. I actually had to mix it up a bit where the other meds that I have to mix dissolve in a flash. The temperature also makes the liquid thicker so it's harder to push the plunger down on the syringe.
No change in the headaches. Still just a dull pain for the majority of the day. I am really hoping that the follicles will have grown enough by tomorrow's appointment so we can schedule the egg retrieval.  It's only been one week and I'm ready to be done with the stimulation phase!

Day 8: Friday, September 16. Poke count: 25

My 3rd appointment for ultrasounds and bloodwork was today. There are 8 follicles on the left ovary and 8 on the right. Each of the follicles range from 7mm to 15mm and they need to get to around 20mm. They are growing as they should but some of them are still small. They want me to continue with the Menopur and gonal- f through Monday, meaning I have to order more medication. I only had enough meds to get me through Sunday night so I had to order an entire vial of gonal-f just for one more dose...bummer! That stuff ain't cheap!

I have another appointment on Monday at 7:30AM and they are almost positive that I will be ready for my trigger shot at that time. The trigger will help the eggs break away from the follicle wall and make the egg retrieval easier. Hopefully this weekend will bring on more follicle growth and we can get lots of eggs next week!

-Emily

IVF Cycle: Stims Day 4-6

Day 4: Monday, September 12. Poke count: 13

I woke up feeling great this morning. Other than sleeping through my alarm and waking up 40 minutes late, I was good! My ultrasound and bloodwork went well. There are 11 visible follicles on my right ovary and 8 on the left. 19 follicles already! Ashley said that more could pop up in the following days since I've only been on meds for 4 days. They are still small, but that is to be expected at this point. They decided on no change in my meds for the next couple days.

I did wind up with a nice, dark blue bruise from where they drew blood. The vein in my right arm totally changes direction right where the needle goes for a blood draw. Either they can't find the vein, or they "kind of" find it and I wind up looking like a junkie.

Day 5: Tuesday, September 13th. Poke count: 15

I am starting to become increasingly uncomfortable throughout the day. There is a lot more pressure in my lower abdomen as the follicles on my ovaries grow. It hurts if my bladder is too full and it also hurts to empty my bladder! Pretty much anything that puts pressure on my ovaries hurts. The right side hurts much more than the left, but it hurts more to lay on my left side. I pretty much just want to wear sweatpants and lounge around the house all day.

My headaches are getting much more frequent as well. Instead of waking up with a headache and it going away quickly, I wake up feeling fine and it gets worse as the day goes on. I spend the majority of my day staring at a computer screen so I'm sure that doesn't help. I've been trying to stay hydrated to hopefully get rid of some of these headaches. So far all that has done is increased my trips to the bathroom!

I still can't really complain about the overall side effects of the medication. Everyone I have spoken to and everything I have read made this medication sound like torture. Even my mom said "Oh that stuff makes you crazy!" I have had a couple moments where I wanted to cry over absolutely nothing, but I hardly think I am crazy. The headaches and pressure are definitely tolerable. I just hope it stays this mild for the rest of the cycle.

Day 6 Wednesday September 14th: pole count: 18

I had an ultrasound this morning and everything is looking good. They only saw 16 follicles this time but they said sometimes you can't see the smaller ones. The ones we could see were definitely growing! They are actually visible and I can make out the individual circles on the monitor instead of just a blur of black. I was able to sneak a picture of the monitor. You can only see 3 of the follicles, but this gives you an idea of what they are looking for in the scans.

My estrogen levels from Today and Monday's blood work were good, so no change in the Menopur or Gonal- f for the next couple days. I will start the Cetrotide injections tomorrow morning, which will stop me from ovulating before they want me to. My next appointment is on Friday and hopefully the follicles will be big enough to plan my egg retrieval.

-Emily

IVF Cycle:Stims Days 1-3

Day 1: Friday, September 9^th. Total Poke Count: 6 (including previous bloodwork for IVF)

I started my medication today with 150IU of Gonal-F and 2 vials of Menopur. I got all my supplies ready on the bathroom counter and immediately had a little mental freak out. I have heard from so many other women that when they gave their first shot, they hesitated for a long time. My plan was to have the medication all ready in the syringes so when it was actually time for the shot I could just quickly get it over with. That didn’t work out so well. I had everything ready, but I still hesitated a little bit. I took the cap off the syringe and just stood there looking at the needle and said to Brian, “I don’t want to stab myself!” Brian was just standing there asking me what I wanted him to do.

“Do you want a hug or anything?”

 “No, don’t touch me!”

I finally started the first injection and didn’t push hard enough on the syringe.

“Brian, it won’t go in”

“Yes it will, just push harder!”

The whole conversation was quite comical. I eventually did get the needle to go in, but I was surprised at how hard you have to push to actually puncture the skin. The needle slid in and I kid you not I didn’t feel it at all, not even a little pinch!

“Brian, it doesn’t hurt at all! I didn’t even feel it!”

Brian looked over and saw the needle still in my belly, cringed and walked out of the room. I finished the first injection and went right onto the second one. The Menopur needle didn’t hurt at all, but the medication did burn a little bit going in.

Overall I was pleasantly surprised by how simple the injections were once I had everything situated. They didn’t hurt and I thought I had a pretty good grasp on the whole process. We went out to dinner for my mom’s birthday and I felt fine the whole night. I did have a little bit of a headache, but my head was hurting earlier in the day so I thought it was probably just stress.

Day 2: Saturday, September 10^th. Poke count: 8

I woke up with a slight headache, but nothing horrible. I took some Tylenol and it went away pretty quickly. I took Renly to the vet this morning after him waking us up several times the past few nights to go to the bathroom. He hasn’t been interested in his food, drinking a ton of water and has had loose stools. The vet agreed that she suspects a UTI, but we couldn’t get a urine sample. She gave us some antibiotics for him and suggested Imodium for the tummy issues.

Mid-afternoon I started feeling a slight pinching feeling in my lower right abdomen around where I assume my ovary is. I don’t know if this was from the medication or just in my head. It lasted the rest of the day though. 

We spent the afternoon at my mom’s, playing with my 2 year old niece and eating cupcakes I made for my mom’s birthday. I have felt mostly fine all day.

Look at all that red hair!! 

We packed up the dog and my medication and went to Fruitport for the night to celebrate Brian’s mom’s birthday. Yes, my mom’s birthday is on the 9^th and Brian's mom's is on the 10^th….and his uncle's is on the 11^th! It makes it super easy for us to remember birthdays.  We went out to dinner that evening, and around 6:15 Brian and I headed back to his parent's house for my medication. I was going to give myself the shots and then head back to the bar to celebrate some more. What should have taken 15 minutes turned into a 2 hour ordeal. I pulled out the bag with my medication and I HAD PACKED THE WRONG VIAL!!! Stupid! I thought I was super organized. I even have all of my non-refrigerated meds and supplies all situated in a shoe organizer. Apparently I’m not organized enough.

I like to pretend I'm super organized

I drove back to Grand Rapids, gave myself the medication while I was super flustered and drove back to Fruitport. Both of the shots hurt more this time, but I was kind of hurried so I wasn’t as careful as last time.

I had a slight headache by the time we got back to the bar around 8:30PM but I again decided it was just a stress headache. Tylenol took care of it quickly. We got back from the bar around 10PM and Renly’s Tummy problems had gotten MUCH worse. We keep him in the spare room when we stay at Brian’s Parent’s house and he is usually fine. There was poop by the door, the window, the wall and by the bed….he had exploded! It all cleaned up pretty easily and Brian’s parents didn’t seem too mad. We didn’t really tell them how bad it was at the time, although I guess they will know after reading this. :)

Renly got an Imodium, started throwing up and spent the night in the garage. Don’t worry, he had his bed, water, his bone and it was nice and warm.

Day 3 Sunday, September 11^th. Poke count: 10

I woke up with a splitting headache. The kind where you just have to close your eyes really hard and wait for the wave of pain to go away. Once I actually got up and got dressed it was a little bit better, but definitely still there. I am now convinced that it is the medication causing the headaches. I took more Tylenol with breakfast and it has been fine the rest of the day. The pinching feeling has continued today and gotten a little stronger. It is on both sides now. I don’t think it’s in my head anymore. I pushed on my stomach and it was a bit tender. Hopefully this all means the medication is doing what it is supposed to!

The Menopur burned a lot more tonight. It still wasn’t horrible, but noticeably worse. Overall I am pleased with how little the injections have hurt and how little side effects I am experiencing. The headaches and pinching feeling are obviously not pleasant, but they are definitely not intolerable. I have an ultrasound and bloodwork tomorrow at 8AM, so I’ll get to see how the follicles are growing at that time.

Renly seems to be feeling better too. I think the antibiotics upset his stomach more so we are putting him on a bland diet and giving him some pumpkin. He should be a happy puppy again in just a few days. 

Emily

IVF Update

Last week we got the green light from RGI to start our IVF cycle. On Monday I had an ultrasound and everything looked normal. There are no cysts on my ovaries and the follicles look good. They told me to take my last birth control pill on Tuesday and to start my injections on Sunday. They just had to schedule the embryologist to come take the biopsies. Later that day I got a call that the embryologist has another travel case around the same time so they will not be available. I was told to take another birth control pill and they would call on Tuesday with an updated plan. At the end of the day they still had not heard from RGI. I took another pill and was told they would call on Wednesday. Wednesday was the same story, nothing from RGI. Finally this morning I got a call from our nurse, Ashley, saying that they had heard back from RGI!

I will take my last birth control pill on Sunday 9/4 and start the injections of Menopur and Gonal-F on Friday 9/9. I will give myself those injections for 3 days and have an ultrasound and blood work Monday, Wednesday and Friday morning. Based off of how I am responding to the medication, they will adjust my dosage of meds. With the idea that I will be on the medication for 10 days total, my egg retrieval will be scheduled around 9/21.

I am incredibly lucky to have a boss who has allowed me the flexibility in my schedule to make this happen. Whenever I need to leave early or take a long lunch for an appointment, it is no problem. When we first started this process I told her how stressed I was about the whole thing. She reassured me that taking the time off from work for all of appointments was one less thing that I need to stress about. I told her today that Ill need to come in late after all my ultrasounds and she simply said :we will make it work". I couldn't ask for a more understanding employer.

Now that it is almost time to start everything I need to remind myself just to relax and take it one day at a time. We will be camping near Traverse City for the weekend and we are so looking forward to just relaxing and spending some time together. It will be nice to get away before starting our IVF cycle.

One last note:Today is Renly's first birthday and since we don't have human babies (yet!) we spoiled him rotten. I made him a pupcake (puppy cupcake) with apples, peanut butter and bacon and Brian got him a new rope toy that he absolutely loves. How did our little puppy grow so much in just a year?!