Wednesday, April 29, 2009

Cautious Drum Roll.....

Yep, this is from this morning. I also have my first beta from this morning, a day early. 180 at 13DPO or 8dp5dt! That's a nice, strong number for 13DPO. Impressive.

Now, we're not jumping up and down just yet. The reason we have this information a day early is because I started bleeding bright red last night at about 11.30pm. My fear of POAS was immediately replaced with need to know and so I POAS. Two lines came up in a few seconds. So now we had a BFP (elated) and bright red blood (terrified). After a few minutes going back and forth about what to do - it was 12.30am by then - we decided this warranted a call to the nurse on call in Denver (at least it was only 10.30pm there). We were actually put through to a doctor, who told us to do a progesterone shot immediately in addition to the morning one and to go in this morning to check progesterone, estrogen and pregnancy hormone level, the test I was supposed to have tomorrow. All the numbers look fantastic. For those in the know, E2 was 867 and P4 was 59. I'm going in again on Friday to see if the beta has doubled as it should in 48 hours, or at least increased by 66%. Then and only then will we know if this might be a viable pregnancy. The doctor and nurses have told us since last night that bleeding can be very normal with IVF and especially with an FET. And I'm relieved to report that the bleeding has subsided for now. I've been told to take it very easy, not lift anything and rest. Thank goodness I work from home and can actually do that.

It's a shame the joy over a lovely BFP has been taken from us by this very frightening bleeding episode, but we'll take it all for a healthy pregnancy and baby. Having gone through what we've gone through to get here, we already know that we'll be nervous every single day of this pregnancy, if indeed it's viable.

Now we hold our breath until Friday.

Sunday, April 26, 2009

Struggling Through the 9-Day Wait

There's nothing much to update at this point. Only to say that I'm having a really hard time through this wait. We're at 5dp5dt or 10dpo today (5 days past 5-day transfer or 10 days past ovulation) and I'm too chicken by far to POAS this early on. I had some intense cramping overnight Friday to Saturday and then more mild after that. Initially the cramps were so bad they woke me up and I walked around for about ten minutes until they eased up. The intensity of them got me very worried - I suppose it could be a good or a bad sign. Implantation should have been happening at around that time, so I don't know what to make of it. Other than that, just some very vivid dreams the past couple of nights and sore boobs. As anyone who's gone through this knows, all of these "symptoms" can be caused by the progesterone, so it's nothing to jump up and down about. The progesterone "pregnancy symptoms" are just one more cruel joke in this process.

DH keeps running through all the positives for me: two normal, viable embryos, 100% thaw survival, a perfect transfer into an ideal environment from a lining thickness and pattern point of view, encouraging words from the embryologist and the doctor, plenty of rest afterwards, no blood issues due to the Lovenox shots, cramping at about the right time......... On paper it all looks so encouraging, but it's hard to be as hopeful when it's your own body having to manage what would seem like a complete miracle. I still haven't decided whether to POAS and, if so, when.

Thursday, April 23, 2009

Two Little Treasures

We're into the 9-day wait! Here’s a picture of the two embryos that were transferred on Tuesday. It's a picture of the screen since CCRM's policy is not to photograph the embryos directly, for fear of damaging them. I've been on bedrest since the transfer and decided it would be too difficult to update the blog lying flat on my back or slightly propped up. I wasn't allowed to sit up - no more than two pillows. Hence the late update.

We got a call last Sunday, as we were navigating New Mexico, with all our instructions for Tuesday's procedure, including the time of transfer and time of arrival at the clinic. I wasn't sure when they’d start thawing the embryos, nor did I really want to know, since it would cause more stress knowing the exact details. Given the call on Sunday, we weren't expecting to hear from them before we got there on Tuesday, so my heart absolutely stopped when my phone rang several hours before we were due to get there and it was CCRM. I immediately feared something had gone wrong with the embryo thaw. However, it was a quality control check, confirming that they were thawing both of our normal embryos. I was a bag of nerves until we got to the clinic and the process took over.

Much to our relief, the thawing and transfer couldn't have gone any better. We arrived about two hours before our transfer time to do bloodwork and the pre-transfer acupuncture session. The blood was taken to make sure my hormone doses wouldn't need to be increased. Once that was done, we were assigned a room and everything else happened in there. First a 25-minute acupuncture session, then valium (one of the main highlights of the day), then the transfer and then another 25-minute acupuncture session. The purpose of acupuncture at transfer is to calm the uterus and prevent any contractions or spasms during or after transfer. Cramping or contractions can traumatise the embryos. After our first acupuncture session, the embryologist came in to tell us that both embryos had survived the thaw 100% and were re-expanding normally. In fact, as can be seen on the picture, one of them was already hatching out of its shell. What an enormous relief – I duly burst into tears at the news. Shortly after that (and after I’d composed myself), Dr Sch came in and inserted the catheter through my cervix without any issues whatsoever – another huge relief, given what had happened last year. At that point the embryologist came back wheeling a little incubator containing our two embryos and they were transferred into my uterus. The whole procedure took no more than a few minutes, but the embryos went from their culture medium into my uterus in a matter of seconds. Once again, a fantastic experience at CCRM. Everybody we came in contact with was absolutely wonderful.

Now the dreaded wait. My blood pregnancy test is scheduled for Thursday, 30th of April. I’m not sure yet whether I’ll be able to overcome my usual cowardice and POAS (pee on a stick) before the blood test. We’re leaving later this morning on our drive home and hope to arrive back in Atlanta sometime on Saturday. I'll decide when we're home.

A huge, huge thanks for all your encouraging comments and to my book club girls for the gorgeous flowers delivered to our hotel room on Monday.

Thursday, April 16, 2009

This Is It

We’re leaving for Denver tomorrow for the transfer of our two embryos next Tuesday. After months and months just dragging on, in the end time seems to have flown by. Ever since we brought the transfer date forward by six days, it’s seemed like it was just round the corner. And now it really is.

Yesterday I passed the final two hurdles that were standing between us and the transfer. They wanted my E2 (estradiol) to be above 300. It was 303. Phew, only just, but above 300 nonetheless. My lining rocks at a thickness of 8.7mm. 8mm is considered ideal and it can’t be too thick or too thin. My ultrasound technician gave me a picture of my empty, but pretty lining, which I proudly took home. It’s my sincere belief that the next ultrasound picture I take home will gloriously display something nestling in that plump lining. I got the call from my nurse at CCRM last night clearing me for the next stage of the calendar. So this morning we were treated to not one, but two shots. The usual Lovenox in the stomach, the latter of which, may I add, is a mess of gargantuan proportions, and the progesterone in oil (PIO) shot in the upper buttock. I haven’t decided yet which shot is worse. The PIO may win – the needle is a pretty good diameter which hurts when it goes in. It’s also a nice length of 1.5”. Meanwhile, my stomach is not a pretty picture. It currently has four estrogen patches stuck to it and the remnants of four more that were removed this morning, leaving lots of greyish adhesive behind which is quite difficult to get off. It’s also adorned with a mixture of now-yellow bruises and purple dots from the shots. On top of that, the twice-weekly acupuncture seems to be leaving marks at the moment. I have to be careful to leave the acupuncture points free from patches and shot bruises/purple dots for my practitioner. As for my back, it’s also a sight for sore eyes. The cupping I have (and LOVE) each time I have acupuncture leaves some very suspect-looking circles all over my neck and back. I wear my hair down these days. I’m also starting an anti-biotic and a steroid tonight, which both have to be taken for four days.

We spoke to the legendary Dr S on Tuesday. We’d asked for a “regroup” just to talk through plans for the transfer. I’m not easily intimidated, but for some reason Dr S turns me into a stuttering idiot. I think it’s a combination of his unbelievable reputation – he’s the master of all masters, as evidenced by his amazing statistics for successful live births - and his straight-shooting style. He just doesn’t mince his words or soften them in any way, nor does he use several words where one will do. Usually those words are yes or no. I need to learn to ask more open-ended questions. However, his style is actually what we like about him most: we always know where we stand. As expected, he confirmed that his recommendation is to transfer both of our embryos together. This is also what we’d like. Due to our ages of forty-one and forty-eight there’ll be other weaknesses in the embryos, even though they’re genetically normal and graded as near-perfect and average respectively, so transferring two is a good idea in our case. We also talked about our bad experience at transfer last year, when the local doctor was unable to insert the catheter into my cervix and had to dilate it, which caused spasms and is very likely to have traumatised and/or expelled the embryos. Since we’ve had the laminaria, this seems to be less of a concern but we wanted to bring it up nonetheless. One of the things I’ve learnt from our struggles is to speak up when anything is bothering us or we have any doubts. The transfer is the most technically critical part of an IVF cycle and the embryos can be destroyed in an instant if anything goes wrong.

On the subject of anything going wrong, I’m really trying hard not to dwell on all the things that could go wrong. Will the embryos thaw correctly without any deterioration, will the transfer go smoothly, will my lining allow them to implant, is the Lovenox adequately taking care of my blood clotting disorder and so on and so forth. Having said all that, I’m feeling so hopeful that I could explode. We believe we’ve discovered and addressed absolutely everything over the last two years. We’ve taken care of the hormonal, mechanical, genetic and blood issues. Hope, trust and confidence. Hope for a future with our offspring, trust in the embryologist thawing our embryos and in our doctor for the transfer, and confidence in my body to be able to look after these precious embryos and to help them implant and grow.

Sunday, April 5, 2009

Date Change for the Big Reunion

Our frozen embryo transfer has actually been brought forward. This is the first time in this entire journey anything has happened earlier than planned. We’re now looking at April 21st! This is just over two weeks away, which is surreal after waiting this long. We’re really pleased about it generally, but also because we’ll know where we stand by the end of April when my job situation might be changing (possible new job). We were able to get an earlier transfer day because J the Elder’s previously planned business meetings during the week of the 20th were postponed. Luckily CCRM had a slot open that day.

I started my big gun drugs last Thursday on Cycle Day 3. In addition to the Lupron I’ve been on for a couple of weeks, now I’ve got an estrogen patch stuck to my stomach, some lovely, smallish purple dots from the Lovenox blood thinner shots also on my stomach and am popping the following pills daily: Baby Aspirin, Pre-Natals, Folgard x 2 (prescription folic acid for my MTHFR mutation), Calcium plus Vitamin D (to counteract the damaging effect of Lovenox on the bones) and an Iron Supplement.

The first of my three CBCs (complete blood counts) is tomorrow morning and then each other one is four day s later. They’ll check the platelets to see what effect the Lovenox is having on my blood. My first E2 check is on Wednesday. Three appointments this week and four next.

I had the Laminaria and, quite frankly, the less said about it the better. It was awful. Unbelievably painful during the procedure and for about twelve hours afterwards, made worse by the fact that the pain killers I was prescribed did nothing other than make me very sick. So I was out of it for most of that day and evening and was relieved to have it removed the next morning. Apparently my cervical opening went from “pinhole” to “radius of a pencil” in that time. I suppose it's no wonder I was in discomfort. The effect is expected to last for a while - CCRM like this procedure to be done no longer than thirty days before the transfer, but also prior to the period preceding the transfer.

We’ve decided to drive to Denver again, leaving on Saturday 18th. We were intending to fly there and drive back in a rental car, but this would add a huge cost to the trip, since there’s a large charge for dropping off a car in a different state. I don’t want to fly back, due to my fear of flying (documented earlier in this blog). I just don’t want any kind of stress or rushes of adrenaline going through my body when the embryos are trying to implant. We’ll be taking our dog Maddie with us again, since she was a great help last time. It was nice to have someone else to care for and focus on but ourselves and our nerves.

I'm beginning to feel like a bloated pin cushion, but very happy to be at this stage in the journey.