Monday, September 14, 2015

The Cold Never Bothered Me Anyway!

Sean and I are smack in the middle of our next cycle, a frozen embryo cycle.  From our fresh cycle, we have three frozen blastocysts.  We will be transferring one; we cannot even think about what our lives with twins would be like; we don't even want to take the chance.

My emotions and thoughts about this cycle are really all over the place.  We have never had blastocysts to transfer at all during our infertility journey.  This time we have three almost perfect ones frozen.  Since the last time we froze our embryos, great advances have been made in the ways embryos are frozen and thawed.  In theory, these blastocysts should give us almost as good as a chance to get pregnant as a fresh cycle.  Some studies say that frozen cycles now are more successful, because they put less stress on you body.   This would also be the last cycle that would give us decent timing with school.  I would be due the beginning of June, so I would have a few weeks of maternity leave and then the summer.  Not the best, but still better than the next few months would give me.  All of this is making me very positive and happy about the cycle.  This is also technically cycle 4 (including our canceled cycle); I got pregnant with Olivia on our 4th cycle the first time through.

On the other hand, I'm still struggling with all the babies that around us.  There were numerous pregnant bellies welcoming me back to work.  My facebook feed is filled with new babies, many of which have siblings Olivia's age.  It is a continual reminder of what others can have and we can't.  This is not a thought I want to focus on, but it help but creep up.  Cycling, no matter how easy, also puts a lot of strain on our day to day life.  I find that I am more tired and less patient with Olivia's toddler actions (this may be due to the medications, being back to work, lack of caffeine or a combination).  It is not fair that she often pays a price for our infertility issues.  All this just compounds to make the cycle even harder to deal with.

No matter my feelings, we are pushing forward with the cycle.  Our transfer is scheduled for Saturday, September 19th.  A weekend actually throws in new challenges that a weekday does not.  Any given weekday, coverage for Olivia is already set.  Now that it is Saturday; we struggled to find someone to watch.   If everything goes well, they will thaw one blastocysts and transfer it.  If the blastocyst doesn't thaw correctly, they will thaw a second and transfer the one that survives.

Hopefully this will be it for us and won't need to do any more cycles.  If it doesn't work, I am seriously thinking about taking a break and meeting with the doctor again.  This will be our 3rd failed cycle (2 frozen and 1 fresh).  After 3 cycles last time (2 fresh 1 frozen), I changed clinics.  I have no desire to go back to a clinic that only does ART, but I definitely would like to try a different protocol. Also I don't want to have the chance to give birth in the summer (especially July) since it would give me no maternity leave other than summer break.

We will see.  Please send me all your fertile thoughts on Friday!

Thursday, August 20, 2015

It's just as difficult as before

This cycle I began so confident.  This is exactly the protocol that gave me Olivia after 3 failed IUIs and failed IVFs.  When I found out that we had 3 perfect frozen blastocysts, I was even more confident.  Then it came closer to my testing time.  I had none of the symptoms that I had when I was pregnant with Olivia.  I still refused to test; I held out hope that it still could be positive.

I woke up Monday morning with a really split mind; I was 50% sure it work and 50% sure it failed.  I got myself together and went in for my blood test.  Luckily the nurse called me early to put me out of misery.  The test was negative; I was not pregnant.  The "perfect" protocol didn't work.  The strong embryo that was transferred didn't work.  There is no way of us knowing what went wrong.  The embryo could have just arrested.  The assisted hatching may not have fully worked.  The uterine lining may not have been the right thickness.  It just didn't work.

I was heart broken.  This cycle was perfect for so many reasons.  It put a lot of stress on my family to complete a fresh cycle.  I was stressed and everyone else fed off that.  This is not something I would want to go through again, so it had to work.  This cycle would have given me an end of April baby, which is perfect for a teacher.  My maternity leave would bring me to the end of school.  I would have a full 8 weeks to bond with the new baby while Olivia was still in day care.  Then I would get the summer to bond with both of them.  We only did one frozen and one fresh cycle; this would be easy for us.  This cycle was just supposed to be the one, and it wasn't.

I just felt numb but needed to keep it together as much as I could, especially around Olivia.  She knew something was wrong even when I called my mother to tell her.  They were in the car together and at hearing my voice, Olivia asked "Mommy what is wrong? Your voice sounds funny."  There is no hiding anything from her.  So I bottled up as much as I could, but it ended up coming out that night.  I spent the night going through all the emotions that I hide away all day.  I thought about the fact that we have an empty room that really has no purpose.  I thought about the fact that Olivia needs a sibling.  I thought about the fact our family isn't complete.  I thought about the fact that so many people don't even come close to having to struggle with this.  Why do we?

Then I started going through all the things I did wrong.  I mean, there had to be something I did right?  There was a strong living embryo transferred and something happened within my body that stopped it from becoming a child.  Did I not enough healthy food?  Should I have avoided eating ice cream and drinking cold water which cooled my uterus?  Should I have worn socks all the time?  Should I have done my mediation every night?  Should I have eaten more orange foods after transfer?  Should I have drank more pomegranate juice prior to transfer?  Should I have tried not to get so stressed when Olivia was having temper tantrums?  Should I have not allowed her to snuggle on me much?  Should I have watched how I played with her?  Honestly I know deep down that I have done nothing to cause this to happen.  IVF is not a 100% guarantee of a pregnancy.  It doesn't make me feel any less guilty and less out of control.

So where do we go from here?  We have decided to go into one more frozen cycle before we take a break and revisit it all.  We have chosen not to meet with the doctor again before the cycle.  This appointment would push back the start date until next cycle which would give us a summer baby (sad that I really need to think about that).  We also know what frozen cycle entails even though this time we are using a blastocyst not an embryo.  Also what could the doctor possibly tell us?  There is no reason why it's not working.  If the next cycle doesn't work, I am going to ask for an appointment.  There must be something else going on.

As soon as we get approval from insurance we will begin our frozen cycle.  Because there is a new way of freezing the embryos, there is a much higher chance of survival and success rates are almost comparable to fresh cycle.    The cycle will follow the same protocol as the previous cycles:  baseline bloodwork, estrogen, ultrasound, progesterone.  Simple.  Hopefully this one works.  It's getting very hard to have to keep failing when we keep getting lapped by others.

Friday, August 14, 2015

Walk of Hope

I know that I said I would be taking a break from blogging during my 2 week wait, but this post isn't about my cycle; it's about something more important: RESOLVE New England Walk of Hope.

Before I ask for your support, I want to give you a little background on the organization and the walk.

According to their website, RESOLVE is "non-profit organization with the only established, nationwide network mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders."

The organization works to help support men and women are dealing with infertility.  They offer support groups, as well as advocacy groups.  The organization also helps to empower men and women to raise awareness about infertility on local and national stages.

The walk is "one morning, one mile to unite one community".  Not only is the walk a major fundraiser for RESOLVE, but it is also an opportunities for members of the infertility community to meet and support each other, no matter where they are in the journey.  Fur babies and ART babies, alike, are welcome to join their families.  

The money raised from the walk is used to support all the RESOLVE programming including support groups, up-to-date information and advocacy.  

This is the first time that the Walk of Hope has been held in the New England area.  It will be held on September 27th (a fantastic date...also my birthday) at the Endicott Estate in Dedham, MA.  

I have created a team (Works of ART).  Please consider donating or joining our team.  I would love to have you all.  I will provide T-shirts and breakfast to all that want to walk with us. 

Check out my team website at: Team Work of ART home page 

Now a  brief update on me:  Nothing much to say I will have my pregnancy test drawn on Monday.  I really don't have a feeling one way or the other.  Some days I'm convinced it work; others I'm convinced it didn't.  There really is no telling since mother nature was so nice to make early pregnancy symptoms almost identical to PMS symptoms.  Tired: Check. Cranky: Check. Crampy: Check.  At this point in time your guess is as good as mine, but I'm hoping I will have TWO works of ART by the time walk comes around.

To find about more about RESOLVE or the Walk of Hope, visit the Resolve homepage:

Tuesday, August 4, 2015

It's now a waiting game

After waiting what felt like weeks, Sean and I made our way into Boston for our embryo transfer.  We were told to be there at 11 for a noon transfer.  If our retrieval was any clue, we should have showed up 30 minutes late.   Actually we should have showed up 100 minutes late!  That's right they kept infertility patients waiting well over an hour and a half.  I made sure I had done my relaxation mediation on the way there, but that was basically out the window.  I did the best I could to keep my mind and body relaxed.  It wasn't easy with someone huffing and puffing next to me (I'm not naming names).

Thankfully, the nurse brought us back and we didn't have to wait much longer.  Sean got into his scrubs and I got into my lovely hospital gown.  The doctor came back and showed us our embryo.  It was a perfect 8 cell embryo.  It was time for us to get back into the OR.

Prior to transferring the embryo, the embryologists performed a procedure called assisted hatching.  During the procedure the embryologist uses a pipette to hold one side of the embryo while a section of the other side of the "shell" is dissolved.
The procedure helps to assist the embryo to break out of the shell and develop into a blastocyst.  We had this done with our last fresh cycle that gave us Olivia; this was the change that did the trick the first time around.

The actual transfer process is very easy.  It takes longer to be set up than it does to transfer the embryo.  I went in and the nurse helped get me in the stirrups and get my body in the correct position.  Once this is done, the doctor does a sample transfer with an empty catheter.  Then the embryologist brings in the "loaded" catheter.  As the doctor transfers the embryo, the nurse is using an ultrasound to help guide him.  Our nurse took a picture of the moment the embryo actually left the catheter.  It looks like a little shooting star.  We then wait for 2 minutes and the doctor removes the catheter and the embryologist checks to make sure it's empty.  I then stay sitting for a few minutes well the room is straightened and then I'm up and out.  Easy!

There is one more difference from my previous cycles: NO RESTRICTIONS! In my previous cycles before Olivia was born, I always had 24 hours of bed rest and then 24 hours of modified rest.  After that I had to continue to take it easy and couldn't exercise or lift anything over 20 pounds.  With my frozen transfers I just assumed things were the same.   Because of that, I often carried a lot of guilt about picking up Olivia and basically being a mom.  I decided to talk to my nurse.  My rules were to take the rest of the day to relax and then don't do any exercise that includes bouncing.  The exercise rule had nothing to do with injuring the pregnancy but with the swollen ovaries.  It will take about a month for my grapefruit size ovaries to shrink back down to normal; prior to that they could twist which can cause some major issues.  Honestly, these are easy rules for me to follow.  I don't exercise more than just walking, and they allow me to go back to my life without guilt.  I can pick up Olivia and actually be her mom without wondering if I am causing this cycle to fail, which I won't know one way or the other until the 17th.

Does that seem as far away to you as it does to me?  I try not to test before hand, but I don't know how well I will do with this cycle.  I have a lot of confidence that this will work, which isn't always the best thing.  Positive thoughts over the next two weeks!

I may or may not blog during that, but if I do, I probably will not share it since the bulk of my story is over.  Hopefully in a few weeks I will be bringing you all a celebratory post.  However until then I want to leave you with our perfect 8 cell embryo (Sean named it Caesar because I won't let that into consideration for a boy's name).  Notice the little mark on the right side; that is the assisting hatching.

Saturday, August 1, 2015

Enough eggs for an entire bakery!

Yesterday, Sean and I woke up early (Hello 5:15!) to head into Boston for my egg retrieval.  I was the first of the day, so they brought me right in got me prepped for surgery.  In addition to all the normal taking of vitals and putting in an IV, my nurse also fully instructed me on Ovarian Hyperstimulation Syndrome (OHSS).

As mentioned by my cycle nurse, I am at a high risk for this because of the number of measurable follicles and high estrogen levels.  OHSS causes your body to deal with liquids in a different manner and causes liquid to pool in the abdomen.  For many people, this simply causes bloating and some pain.  Others may need to go to the hospital to have the liquid drained.  Others may even need to be admitted to deal with issue.  Whatever the case, getting pregnant while dealing with OHSS is not a great idea.  The HCG (pregnancy hormone) causes the OHSS to become worse. This is one of the reasons why I only did a half a dose of the HCG trigger.  This is also why it would be not be a great idea to transfer an embryo if I was showing symptoms.  That would mean we would need to freeze all the embryos and do a frozen transfer.  Hearing that news my heart dropped!  I have not had a good history with frozen transfers.  Two I transferred only okay embryos and one I didn't transfer anything.  I know changes have been made, but I do NOT want to have gone through all this to not have a fresh cycle.

Not long after, I was brought into the operating room, and there was a flurry of commotion: doctor checking my cervix and uterus and all the machines, nurse getting my legs and body situated, anesthesiologists getting ready to put me asleep for the procedure.  I don't remember much of anything after that except I was dreaming about Olivia.  If I remember correctly, my first words to the nurse after I woke up was about her. Hopefully that was a good sign.

When I woke up a little more, I got the total of eggs retrieved.  Ready for it?  28!! How in the world was that possible?  I only had 20 measurable follicles two days earlier!  How did that happen?  I guess it explains my crazy high estrogen level; this is at least double what I have had before and almost 3 times what they want to see.  First thoughts to that were...uh oh!  I'm sure that not all the eggs were mature; if fact, I would not be surprised if about 10 weren't mature.

The doctor came not long after to discuss our options.  He had spoken to my personal doctor, and they have created a plan.  I will be taking a new medication (caberglobine) to help reduce any liquid  that may pool.  I am also drinking almost my weight in Gatorade.  The association of reproductive medication recommends drinking over 120 ounces daily for each of the days following retrieval to help.  I am also drinking a couple protein shakes to help.  I supposed to look for excessive bloating, weight gain of a couple pounds within a day (though my body does that anyways), sharp pains in the abdomen and dehydration.

At the time he said to help make sure they don't transfer before the symptoms arrive, we need to wait until day 5 to transfer.  Cue another panic.  We did not have good luck with day five transfers in the past, though MANY things have changed in the four years since we last tried.  If symptoms do show, the embryos will be frozen and the OHSS will be taken care of before we do a transfer.

Now how did those 28 eggs do with fertilization?  25 of them were mature and were injected with sperm and 23 became fertilized.  Fantastic news, right?  Then the on call doctor told me that we would be doing a 3dt or freezing on day 3.  I had no clue where this came.  I was told that this was in no way a possibility.  The on call called the doctor who did my egg retrieval yesterday to try to figure out what was going on.  According to her, he and my personal doc went back in forth for quite awhile yesterday afternoon trying to figure out the best plan.  Great right?  I'm glad they took the time, but at the same time the one thing I was told that wouldn't really be taken into consideration at all is the one thing that is pushing decision: my previous attempt at 5 day transfer at my old clinic.

If you remember from earlier posts, it was my concern about this that pushed us to want to do a 3 day transfer originally.  My doctor said that she was doing that for us even though she was totally confident that enough has changed in the 4 years since then that the results would be different.  I guess looking back at this changed her mind.

This means that I am going in for a 3 day transfer of one embryo on Monday.  If I show ANY signs of OHSS then they will freeze all on day 3.  There lies my issue with all of this.  If we have to freeze all, I do not want to have to freeze with day 3 embryos.  I have had 3 frozen cycles all with less than ideal thaw results.  I do not want to deal with that about  11 times!  I can't believe we are facing another cycle that is basically a waste.  I also know that I cannot handle having over a year's worth of frozen cycles before we can try a fresh again.  This cycle is such a whirlwind.  I have gone from feeling confident to distraught and back too many times.  I'm hoping for good news but preparing for the worse.  Hopefully I will be coming home with a strong embryo for the last time because I'm not sure how much more I can put myself through.  I don't know if I can deal with how bad of a mother and wife it makes.

Thursday, July 30, 2015

A day without shots....what?

You read that right!  Today I will not have a single needle injected into my body.  It seems strange.  (Which when you think about it strange in and of itself; I really want to give myself an injection....I need help!). The reason for the needless day is that I triggered yesterday.  Triggering is an injection of HCG that instructs the body to release all the eggs that have been developed.  This is specifically timed with egg retrieval occurring 36 hours later.  I took the injection at 8:30 last night, and I will be going into the operating room for my retrieval at 8:30.

The HCG shot was different than all the others I have been giving myself over the last few weeks.  For both my lupron and gonal injections, I had a nice little needle like this: 

Cute isn't it?  It would go into my stomach.  I would barely bleed (most days not all) and it wouldn't hurt...honestly.

Now my HCG gets injected intramuscularly (which means in my butt cheek) so it needs a slightly larger needle like this:
 Definitely a little more scary!  I won't lie these ones do hurt, but I try to ice it before hand (don't tell Olivia I use her Sofia the First BooBoo buddy) and it isn't as bad.  We used this "little" needle to inject 50,000 units of HCG into my body exactly at 8:30.  Now we wait and hope all things work the way they should.

How did they know I was ready for injection?  I have been going into Foxboro for monitoring (blood work and ultrasound) over the last couple days.  I had four appointments in total (Friday, Sunday, Tuesday and Wednesday).  At these appointment they test my estrogen level and count and measure the follicles in my ovaries.  At the final appointment, I had 10 measureable follicles in each ovary, so instead of feeling like this:
Lots of room for the few follicles to grow.  I was feeling more like this: 
No room for anymore growth or actually any movement.  I am definitely bloated and uncomfortable, though Olivia seems to think my stomach is a great pillow to jump on.  Gee thanks kid!

My estrogen level was the thing that really made them to push me to retrieval on Friday and not Saturday.  My estrogen is 3,500 and they don't like seeing it over 3,000.  It strange that my estrogen was low throughout both frozen cycles and now it sky rockets to possibly unhealthy levels.  High estrogen can lead to Ovarian Hyperstimulation Syndrome, which can be painful at best and deadly at worse.  The nurse said that there is a chance I could have a mild case after retrieval.  To help fight against this, they gave me half a dose of HCG. Instead of the normal 100,000 units I only took 50,000.  

Getting this news sent me to the one place that I shouldn't have gone: Google.  I have been reading all sorts of things about OHSS and high estrogen at trigger.  It can lead to poor egg quality and even early delivery if the embryo takes; it can push the RE to freeze all the embryos and not transfer anything.  After fully freaking myself out (You would think I would know not to go on Google!), I backed up and figured if it was going to be a huge issue (including possible complete freeze of the embryos) my nurse would've said something....right?  I will ask the nurse when I go in on Friday, but before that I will stock up on protein shakes and gatorade, both which help to ward off OHSS after retrieval.

I will give you all an update when I am done on Friday and am able to write coherent thought.  I will probably do a couple short posts for the retrieval and fertility report.  Send me all your positive thoughts for a good retrieval, strong eggs, and good fertilization.  

Tuesday, July 28, 2015

New cycle a little different than the old cycle

I've done this before and was actually successful one; I can totally handle this....maybe. For the most part this cycle is the same as the one that gave us Olivia.  The only the medication that I am not taking this cycle is an antibiotic after retrieval.  When I asked about the change, my doctor fully explained to me about the various studies that have been done over the last few years that show that the antibiotic is not helpful during IVF.  This is one of the reasons I chose Brigham and Women's; they are continuing to research and improve on their abilities.

My doctor has also been playing with my dosage of gonal.  I was supposed to start at 225 units, but after my baseline, my doctor lowered the dosage to 187 units.  I had a quite a few follicles so she wanted to take it slow.  I went in for my first follicle check after 4 days of stimulation.  I had only one follicle on each side, so my dosage went up to 225 to stimulate some of the "lazy" follicles that didn't want to grow.  Two days later I returned for another check and it worked!  I had a total of 12 follicles that had grown and still had quite a few smaller ones left.  To ensure that too many didn't pop up, my dosage was dropped back down to 187 units.  Ovarian stimulation is a careful dance between enough mature follicles and too many.  Not enough can lead to not enough mature eggs and lower chances of having success; too many can lead to poor quality eggs which can also lower chances of success.  I am actually glad with my yoyo dosage; it proves to me that she is actually looking at my scans and thinking about my cycle as a whole.  It's not just "continue with the plan".

While these are only small changes to my protocol, there definitely is a few things that I forgot.  I remember feeling full and uncomfortable, but it wasn't as bad as I remembered right?  It was only a couple days, right?  Not so much!  I am currently on day 8 of stimulation, and I can definitely say I'm uncomfortable.  During a normal cycle, your body produces 1 follicles right now I have 12 follicles growing and a handful that are still small.  There is only so much room in my body for all these to go, so it is becoming difficult to sit and to carry Olivia.  

This brings me to another difference with my earlier cycles:  a toddler!  Having a very active (very clingy) toddler while completing a fresh IVF cycle is definitely taxing.  Not only are my hormones all out of wack and I'm growing more eggs than any chicken in my ovaries, I need to entertain and care for an almost 3 year old.  In previous cycles, I could come home and relax when I was too sore to move or I could take a nap if I was tired from the medication and early morning monitoring.  These things aren't allowed with a toddler.  I have been trying to plan activities and go places because hopefully there will be other children or adults to help entertain Olivia.  Now I understand this sounds terrible and like I want to pawn my toddler off on other people, but it's not.  I can be a better mother if Olivia can play independently or with a friend even a few minutes at a time.  At home when it is just her and I, I normally don't get any of these moments.  It also helps me from having to come up with creative ways to entertain Olivia when I'm so tired I can barely function.  (Yes movies and TV have been part of my plan as well...MOTY I know).

Having Olivia with me also makes this cycle a lot easier.  With previous cycles, my IVF protocol and what was happening or could go wrong was on my mind 100% of the time.  This cycle I don't think about it constantly because I have a lovely distraction and IVF miracle with me most of the day.  While I'm still trying to do all the helpful things through this cycle (drinking pomegranate juice, drinking fertility tea, eating eggs and avocados, and meditating) I find I'm not able to do it every day and you know what that is okay.  My whole self-being isn't hinging on the success of this cycle.  Would I be heartbroken if the cycle didn't work?  Of course! However the emotions are different the second time through.  Firstly, I know it can work. I know it can work with this doctor at this hospital because it did.  I have living (and talking) proof of that.   I'm no longer in the "could it?" stage.  Secondly, if we could never have another child, we would actually be okay with that. Yes we want another child, and I know something would feel off if it didn't; however, we have Olivia and she could be enough if that is all we are able to have.  All this doesn't mean that we won't put all we have into trying for a second, but the need isn't as dire.

I went in this morning for my third follicle check.  I am feeling very full and uncomfortable.  According to the ultrasound tech, "it looks like it's time".  It is definitely up to the doctor when to trigger, but it could be this week.  If I trigger tonight, the retrieval will be on Thursday.  If I'm not quite there, I may have to go back in tomorrow or Thursday for more monitoring.  I will keep you updated!