IVF Cycle: The Home Stretch

IVF Cycle: Day 48 Poke count: 76

The past few weeks have been extremely uneventful as far as our IVF cycle goes.  We went to visit our good friend Kat this past weekend as she starts her new adventure in Toronto. She and her husband, Nate, will be living there for the next couple years due to his job. Brian and I had some excitement on the way up there when we realized we would need to use an actual map to find our way to her apartment after crossing the border. Who knew Verizon shuts everything off when you cross into another country? We pulled out an atlas that I had in my car from a road trip years ago, but unfortunately Canadian maps were not included. We wound up using the map that was frozen on my phone screen just to make sure we were on the right highway. Once we knew we were headed in the right direction, it was smooth sailing! We got to take the train into town, tour downtown Toronto and take a tour of a castle turned haunted house. It was a great little escape while we keep our minds occupied.

I had my last appointment before the embryo transfer on Monday. They performed an ultrasound to measure the lining of my uterus and make sure it was all set to implant an embryo! Brian accompanied me to this appointment and I had a good laugh. We got in the room and the nurse told me to undress from the waist down and the ultrasound tech would be in shortly. Brian looked at me and said "I thought they were just doing an ultrasound today??" maybe I haven't made it clear that all of these ultrasounds have been internal ultrasounds. They aren't the average belly ultrasounds where the only uncomfortable part is getting that gel off of your stomach. These are pretty uncomfortable in every aspect. They don't hurt or anything, they are just awkward.

As we were lying in bed last night we watched the training video for these injections. I told Brian that I needed him to be calm in the morning and act like it was no big deal for him to be stabbing me with a giant needle. He has been pretty freaked out about the whole idea of giving me an injection from day 1 and if he was upset, I would get upset. The little ones in the stomach are like nothing at this point. I even gave myself 2 of them in the car this past weekend and had no problems. The progesterone injections on the other hand are wayyyyyy scarier. The medicine is mixed with sesame oil, so the needle has to be big. It's also injected directly into the butt muscle/hip area which can be pretty painful. .

They have to be done in the morning so I'm not just going to bed and laying down for the next 6-8 hours. I'll have to keep moving to prevent the muscle from developing a bulge from the oil building up....FUN! We stood in the bathroom for about 15 minutes this morning while I stalled. First I had to get the dog a treat, then I had to pee, then the alcohol wasn't dry on my skin, then I just didn't want to do this! Brian did great and acted less nervous and more annoyed with my stalling..yeah, he was totally acting. Once I finally calmed down enough to let him give me the shot, it really was no big deal! It barely hurt at all! I really need to stop listening to what everyone else says. So many articles online are titled "the dreaded progesterone shot" or "tips on surviving your first progesterone injection". If I had known better, I would have avoided these articles altogether. They just made me stress over something that really wasn't even that bad.

I am still taking estrogen multiple times a day along with the progesterone and I am starting to notice some new side effects. In the last week of my Lupron injections, I developed little bruises on either side of my abdomen. I guess my skin was sick of the needles! In fact, my skin is probably in the worst condition ever. I am breaking out all over my neck...yes, my neck. One of the most random places to have a breakout. I'm assuming this is from the estrogen, but I'm not 100% sure. I have also gained some weight. I am not eating any worse, in fact I am eating healthier than I normally do, but I've still gained a few pounds. I guess this is normal, but that doesn't mean I like it! Other than a few extra pounds and a pimple covered neck, I haven't noticed any new side effects lately! 

My last post focused on the big decision of how many embryos to transfer. A few days after that post, we made our final, final decision. We will be transferring ONE embryo. The plan was to transfer 2 embryos from the beginning, so changing our plan was not an easy decision. Brian and I both separately spoke with our nurse and both feel that we should go with one at this point. I had been going back and forth since we found out we only had 4 embryos , however my mind has been at ease with this decision since we set our mind on a single embryo transfer. I am a firm believer in going with your gut, and I think this is the only time my gut feeling has done a complete 180. 

In less than one week, we will be in the procedure room ready for the embryo transfer. I thought that the pregnancy test would be done on the 8th day after the transfer, but I was mistaken. It is actually a full 10 days after the embryo transfer, so we should find out on November 11th if I am pregnant. I cannot believe this past 2 months has gone by so quickly. We may be saying goodbye to this long, drawn-out process and welcoming the beginning of a healthy pregnancy. Thinking happy thoughts! 

-Emily

IVF Cycle - Day 34

Day 34: October 12 Poke Count: 62

I have been taking the Lupron Injections for almost 2 weeks now and so far I haven't noticed any side effects. This has been a nice change from the Menopur and Gonal - F. Other than the results of the embryo biopsy, there has been almost nothing going on with our IVF Cycle. Just the injections and a whole lot of waiting around.

There has been one big decision weighing on us since we got the results of the embryo biopsy; "how many embryos do we transfer?!" Since we started this whole process, we have gone back and forth between one embryo or two. In the back of our minds the plan has always been 2. We would be thrilled with twins and it would give us a small increased chance in conceiving. We started questioning our decision to transfer 2 embryos when we got the news that we only have 4 healthy embryo's.

I spoke with our nurse, Ashley, on Monday and she thinks we should start with one embryo. If I do not get pregnant the first time, this would leave us with 3 healthy embryos. This would also decrease the chances of me becoming pregnant with twins. While Twins would be a welcomed blessing, multiple pregnancies come with additional risks for the mother and the babies, There has been an increased number of IVF patients who are choosing elective single embryo transfer (ESET) in recent years. ESET has shown a decrease in multiple births, but has not shown a decrease in live birth rates. My young age and relatively healthy body give me a higher chance of becoming pregnant, so my doctor and nurse think one embryo will be enough for me to become pregnant.

The doctors can give us guidance in how many embryos to transfer, but ultimately it is our decision and we have no idea what we want to do. We have the doctors advising us to transfer one and everyone else telling us we should transfer 2. Everyone wants us to have twins! I am praying for guidance and confidence in whatever decision we make. At this very moment I am leaning towards 1, but that could all change in about 20 minutes.

I started taking estrogen pills today. I will stay on the estrogen for 21 days before the embryo transfer. I have an ultrasound on October 24th and we will need to let them know our decision on the embryo's at that time. That leaves us 12 more days to change our minds over and over again.

-Emily

Embryo Biopsy Results

Brian and I are camping in Pentwater this weekend for Oktoberfest. What was supposed to be a relaxing weekend with family to keep our minds occupied while we wait for results turned into a much better weekend! I woke up this morning to a voicemail from The Fertility Center asking me to call them. I called right away and they gave us the results. Out of the 11 embryos that were tested, 7 of them tested positive for the Epidermolysis Bullosa gene mutation. That means we have 4 healthy unefected embryos that can be transferred back into my uterus. Not all at once of course!

I will stay on my Lupron injections for a few more days. I am currently injecting 20 units every evening. On Monday I will decrease that to 10 units every evening. On Wednesday I will start to take estrogen pills every morning and evening. In the following weeks I will increase that to 3 times daily. The estrogen will help build up the lining of my uterus to allow embryo implantation. I'll have an ultrasound somewhere in the next month to make sure the lining is healthy enough for an embryo transfer.

My embryo transfer is tentatively scheduled for November 1. On that date, they will transfer an embryo back into my uterus and I will officially be pregnant until proven otherwise!! After a little more than a week, I will have a blood test to tell if the embryo implanted and I am truly pregnant. If that test is positive, they will do another blood test the following day to see how my hormones are increasing. During the weeks following the embryo transfer I will be on progesterone injections to help with implantation and embryo growth.

While we were hoping for more embryos, we are thrilled that we have 4! That's 4 opportunities for an embryo transfer and possible pregnancy! We appreciate everyone's love and support while we continue this journey. Prayers for continued success are appreciated!

-Emily

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