Hardest Transfer of the Year Award...

The RE actually said that!  Haha!  I am really glad I can laugh about it. My transfer took an 1.5 hours! I had 2 RE's try to thread the catheter (they don't usually use ultrasound guidance at my clinic) and then they pulled out the ultrasound. My trial transfer was easy, breezy but it turns out since my ovaries are so big still, it displaced my uterus all the way to my left side and it kind of folded over itself! They had all the residents come in to watch because "they haven't seen this difficult of a transfer before". Glad I could be a learning tool. They made me fill my bladder to use the ultrasound and that was the worst part! I felt like I was going to pee all over everyone!

My embies that they transferred were perfect blastocysts, no hatching yet. One of the embies didn't make it to today. Of the three left, 2 were early blasts and the other was at the morula stage still. They will call me tomorrow to let me know if they were able to freeze them. Fingers crossed but I'm not holding my breath. Overall, I was really happy and I am officially P.U.P.O.!  PUPO is a term that means Pregnant Until Proven Otherwise.  They gave us a little card with a picture of the embryos that said something to the effect, "thank you for choosing us".  I've tried to post it but it's been difficult...I will later.

They reassured me that the difficulty placing the catheter had no bearing on the success. They even joked that since my uterus is folded, the babies can't fall out! They told me I still have a 70% chance of getting pregnant and 35% of twins...yikes.  I am flat in bed all day today, same tomorrow, and resting for the next three days after that.  Oh gosh, I hope this works.  

Not-So-Wordless-Wednesday...

I have been wanting to post an update all day but I had school in the morning, ripping my fingernails off in the afternoon, and then work this evening.  Oh!  I was ripping my fingernails off (it's okay, they were too long anyway) because I was waiting for the embryologist to call me this morning, which ended up not being in the morning, it was afternoon by the time he called.  I couldn't concentrate in class, I was staring at my phone, willing it to ring.  I have been in few situations in my life where nothing matters but that phone call and really, it should be a form of torture.  Then, it finally rings or you get a text and it's someone else (memo: I will call you Mom when I have news), baaaah!

Michael and I placed bets on how many embies we thought made it through the last couple of days.  Neither of us thought it would be more than four and we would be nervous but fine with that.  Well, all 6 are still "dividing beautifully"!  They are all 8-cells which is right where they should be.  What?!  I was so happy.  I'm praying tomorrow that they are all blastocysts (very important) and hatching out of their shells.  Yes, they actually have to hatch before they can implant.  The embryologist gave me instructions to arrive tomorrow at 9:30am and the RE will go over the procedure (they thread a catheter containing the best two embies through my cervix and place it 2cm from the fundus of my uterus), the grading of the embies (important for choosing the best two), and what to do after (stay in bed!).  The best part about tomorrow, other than the fact I get my embabies put back in me...Valium!  Finally, something forcing me to relax!  I have to say I am quite proud of myself for being so calm up to this point.  I thought I would be clinical by now.  I was anxious this morning before getting the phone call but I am fine now.  I know my demeanor is because of all the prayers.  It's definitely not in my nature to be calm about most things (I'm my mother's daughter after all...just kidding mom!).  I tend to freak out about things that have not happened yet.

I'm hoping that I've developed nerves of steel in the last couple of weeks because the next few weeks, until we find out if I really am pregnant, are going to be the hardest, most agonizing weeks of my life.  There is too much damage that can be done with a girl, her embies, and her brain.  Too many thoughts.  No, no, only positive thoughts here.  I can wait until I'm PUPO (more on that....stay tuned)!

A hatching blastocyst

After tomorrow, this is what I will be imagining my little embies doing.  Implantation.

Fert Report...

What an exhausting 48 hours!  I didn't sleep much last night because I knew sometime this morning we would be getting the call to tell us how everything was progressing.  Anything can happen and that terrifies me!  At 8am exactly I got the call from the embryologist.  I'm sure he thought I was a weirdo because I was hyperventilating and begging him to give me good news.  He relayed the news that out of the 9 retrieved, 6 eggs were mature, all 6 fertilized normally, and all 6 were "dividing beautifully".  He said it will definitely be a 5 day transfer which is fantastic news!  They will call back on Wednesday when they open the incubator again and give me another update of how my babies are growing and give me instructions about our Thursday transfer.

It's a funny feeling knowing we (along with a team of fertility specialists) may have just conceived our entire family and I already feel kind of like a protective mama bear.  I want all my 6 embies to make it, to have a shot.  I feel very strong today and I KNOW this is going to work.  I just have to survive until Thursday.  I'm going to try to keep myself busy with studying and getting things ready to be in bed in for 5 days.  And of course, I will keep praying.

This is what all 6 look like today.  4-cell embies.  They should be 8-cells by Wednesday!

Precious Sunday...

I had a great Sunday today.  One of the best ever.  I cannot say too much how much I believe in the power prayer and fasting.  I feel so strengthen and supported by all the people who have remembered us in our prayers and taken time out their lives to email or call and see how we are doing and wish us well.  We had a special fast today and the power that comes from that is heavenly.  The Lord is in charge.  It's in His hands now and all we can do from now until the transfer and then the test, is pray and have faith.  It's a much harder concept than I'd like to admit.  I like to be in control and I'm not.  But, I'm willing to trust in the Lord and let his will be done.

I'm doing much better today than I was yesterday.  I know this is going to work.  It just has to.  I have felt for a long time now that it is going to work and only 9 eggs shouldn't change that.  I was just told of two women I know who both got pregnant with IVF, one only had 3 eggs retrieved (twins) and the other, 7 eggs (triplets and a singleton!).  They both even had embies to freeze.  I know our embryos are going to survive long enough to be placed back where they belong.  We want this so much but right now...we wait.  What a test of faith.  Just because things didn't go quite as planned, just because things got a little hard, doesn't mean it won't work.  I bore my testimony in Relief Society today after I resisted the urge in sacrament.  I was so overcome by gratitude to my Heavenly Father, I could not speak.  I know He knows me and knows my heart's desire and I am so grateful for the atonement because this process can be so lonely and I know my Savior has suffered right along with me.

Retrieval...

Woke-up very early this morning and got ready to head to the clinic. We arrived 10 mins early which I was happy about because we are not exactly always on time for things.  Michael started to feel sick because he took his antibiotic on an empty stomach (silly boy) and they were very nice and made him oatmeal. They took me back to change and start my IV.

Michael was not allowed to come in with me which surprised me because we were told by my friend her hubby was there the whole time.  He was able to be with me when I woke-up though. They had to give me more medicine at first because I could feel everything.  I knew they would because every time I have that kind of anesthesia, it's never enough.  It really hurt.

Now, about my follies. I started to cry when I woke-up because the first thing I asked Michael was how many eggs were retrieved. He told me 9. NINE? I thought he was joking. I had 22 follicles! I had to ask him several times if he was not joking. The nurse came back in because my blood pressure was up due to being so upset. She told me I should not be upset because their average number of eggs retrieved is 6. The RE was not going to come back in but the nurse said she's have her come talk to me since I was so upset. I just had no idea what could have happened when I had 22 good sized follies?  I certainly wasn't prepared for the possibility of having no eggs in the follicles.

The RE came in a was little surprised I was upset because she was very pleased with the results.  I asked what happened to all the other eggs when I had so many follies. She said that a lot of the time the bigger ones will start to deteriorate when the smaller ones catch-up.  I implied that maybe it was mistake to go the extra day and she said that if we retrieved the day before I probably would have more eggs but they would not have been mature.  Quality over quantity in this case.  I gave her examples of my two friends who had over 20 eggs retrieved and one ended up with two great embies to transfer and 16 frozen embies and the other ended with nothing to freeze and two, not so great embies to transfer. Both got pregnant but both very different. She said I was probably somewhere in the middle of them and reassured me that my chances of getting pregnant are still the same today as they were this morning, yesterday, and the day before. She guessed that with my E2 level, there was a good chance that they would all be mature and still had a good chance there would be a few to freeze...just a guess though.

I still have no idea what happened even after she explained everything to me. I had NO idea that having no eggs in the follies was possible. I expected to have the 22 eggs and be told on Monday that only a percentage were mature and a percentage of those fertilized normally. I just feel blindsided and I'm kind of sad.  I won't know anything about anything until Monday and the worst part of this whole process begins....waiting.


58 needles...stared Progesterone today.  

This is what's going on right now with our eggs.  That needle is the 1/10 the size of a human hair.

Day 12: Stims, Ultrasound, Trigger...Oh, My!...

So, yesterday we went for my ultrasound and oh, boy...did I grow!  I still have 22 follies but 14 of them were over 17mm, 4 of them were 15-16mm, and 4 were 11-14mm.  That is crazy growth from the day before.  My doctor said she was going to wait until my E2 levels came back but she was positive the trigger was going to be that night.  My E2 levels came back at 2888 which is beyond perfect (it should double every 48 hours) and the nurse gave me instructions to trigger last night!  She said I was going to trigger at exactly 8pm and that I was to have nothing to eat after midnight on Friday.  I am also to start the antibiotic Friday night and Michael should take his last on Saturday morning.  My retrieval is set for Saturday morning at 8am and we need to show up at 7:30am.  I will be given an IV and sign paperwork and Michael will umm...do his business.  We are out of our minds excited today.  Work has been pretty tough for Michael lately and he called me on his way home, after I told him we were trigger last night, and his voice was so different.  He was still tired but I could tell he was so happy that this is actually happening.


We got everything ready for the trigger shot and just waited until the clock said 8pm exactly.  I was so nervous.  Michael has never given a shot like that before and it is not fun to think about a gigantic needle being shoved into your hip.  I, personally, hate giving those kinds of shots because I am always afraid I'm going to hit bone even though that is very difficult to do, but still...I was not excited even knowing I knew that anticipation was much worse than it was actually going to be.  He counted to three and it was over.  The HcG stung a little going in but it was not bad at all and I barely felt the needle.  I have been told that it gets worse though.  I start taking Progesterone the day of the retrieval and you eventually run out of places on your hip that are not sore after a couple weeks.

I feel like everything is falling into place.  We have all confidence in our doctors but this last week, we questioned whether they maybe have been too conservative with me since I am, as they say, still so "young".  We have said, "do they really know what they are doing?"  Well, they absolutely know what they are doing.  Going an extra day made me nervous because I felt like that was "not normal" but it was 100% the right decision.  I've got so much potential with these eggs and I am even starting to think that we might have a few good ones to freeze.  We just want to get one healthy baby but having embies to freeze would be gravy.
We are just excited that it is actually to this point in the process.  We get a call tomorrow letting us know how many eggs were retrieved, how many were mature, and how many fertilized and then it's just a waiting game with daily updates about how our embies are developing.  Oh, gosh...I'm getting anxious.  Prayers are welcome.

56 needles...

Day 10: Stims, U/S, No Trigger...

Day 10...I can't believe it! Yesterday's appointment was weird. I wasn't paying attention to the growth I had over the past day and left feeling very confused. I felt like I hadn't made any progress and that it was going to be forever until I was ready for retrieval. They had me order another days worth of meds (a precautionary $230) but when I went home to dose myself for the day I realized I had enough on one med to last me through Thursday. The injection pens have over-fill in them so I got a free dose and didn't have to pay for all of the meds. Pheww! I called the nurse to tell her this and also asked her to go over the numbers with since I left feeling confused. I actually had quite a growth spurt. I had 8 follicles over the 16mm range, 6 over the 11mm range, and 6 under 10mm.


Today.

I have 10 in the 16mm-22mm range, 6 in the 11mm-15mm range, and 6 still under 10mm. My RE said I had a 75% chance of triggering tonight but wanted to wait until the my E2 (estradiol, a form of estrogen) levels came back. My E2 level came back at 1800 which is good but the nurse said the doctor thinks I still have room to grow. I'm fine with that. One more day of growth is one more day of growth. She didn't have me order more meds so most likely my retrieval will be Saturday morning. This is good, I will not have to miss school or work next week since the transfer will be on Thursday instead of Wednesday. I go back again tomorrow morning for more blood work and another lovely ultrasound. I feel so bad for Michael. I've spent a week in his shoes having to drive the 30 miles to the U every morning and it totally blows. The traffic is horrible and the rising sun is blinding and it is SO early! I made our appointment for tomorrow a little later (8:30am instead of 7:45am) but Michael said with the time difference, the traffic is even worse so we will basically have to leave at the same time. Ugh.

Ahhhh! I'm getting super nervous. I hope my ovaries kick it into high gear!


Caution: Science ahead...ignore the information below if you don't care why the estrogen levels are so important.


Estradiol is a hormone that stimulates the lining of the uterus, causing the lining to grow, and to make itself ready for embryo arrival. (This is not estradiol's only function, but for us, it's the important one). Estradiol is tied into pregnancy by it's method of production: oocytes (eggs) contain follicles. These developing follicles contain 'granulosa cells'. These granulosa cells synthesize the estradiol and release it into the blood circulation.


 This means that more follicles produce more estradiol. This helps measure how many follicles are actively developing. The longer they continue to develop, the longer the estradiol level continues. As they develop, the level continues to rise. This rise can further indicate that the oocyte within the follicles is reaching its maturity.


 An example of the use of estradiol level is when it is measured during down-regulation cycles. In down-regulation we expect low levels of estradiol: below 30pg/ml. If levels are not this low, this suggests that the ovaries are not yet suppressed, and that the down-regulation should continue a little longer, until they actually are suppressed.


 Estradiol And Ultrasound Scans
Blood estradiol is also used in combination with ultrasound scans. Taken together they help indicate how (and if) the ovaries are responding to stimulation. Is there a response? Is it adequate? Is it excessive? To tell us this, the blood level has to be viewed in relation to the stage of pregnancy and the day in the cycle in which the level is being taken.

 For example, a level of 1500 pg/ml on day eleven might be considered acceptable in a stimulated cycle, as reflecting the presence of a reasonable number of mature follicles. However, if this level were present on day eight, it would be considered unacceptably high. It would almost certainly reflect the presence of an excess of follicles. At this stage (day eight) they would still be Immature ones. Their quantity, however, would suggest that continued stimulation would carry an unacceptable risk of developing OHSS-- ovarian hyperstimulation syndrome.

 Don't Expect Easy Comparison
Before we continue, one important point: levels of estradiol are not the same from person to person. They cannot simply be compared from one to another. People vary-- everyone is slightly different, and everyone responds to a different degree. Some more so than others. A level that is dangerously high in one person-- or dangerously low in a second-- might be normal and healthy for a third. This is why blood levels can't just simply be compared. It's also why blood levels can't always be interpreted with complete certainty in the first cycles. Without prior cycles to 'calibrate' the levels, the meaning of a level can only be determined as to what it usually means-- what it 'probably', or perhaps even 'almost certainly' means.

 Despite individual variation, estradiol level does provide very useful information.
 A Rough Rule-of-Thumb for Good Estradiol Levels.
Exact figures are not possible. As a rough guide, however, a level in the range of 150 to 500 pg/ml is generally considered reasonable for the eighth day of a stimulated cycle. An approximate doubling of this level every 48 hours is considered promising, as a sign of continued good follicle development.


48 needles! My belly gets a rest in a couple of days and then the butt gets all the abuse!