Not Telling, Encouraging Stats, Rooting for Pie

Ahh, it's a lazy Saturday morning! I love it. Thought I'd do an update on a couple of things:

I made it through the meeting with the boss yesterday without any inquiries about the outcome of the FET. I was ready, thanks to comments on my previous post, but didn't even need to evade any questions. I had a stroke of luck, actually, and was able to preempt any inquiries by bringing it up first. My boss told me that one our colleagues, a man with a big personality who's always making people laugh, is leaving the organization. This is a big loss for us. I was saying things like, "Oh no!!!! This is terrible!" Well, this guy always conducts a "baby pool" among all staff whenever a woman is expecting. (I have never participated but basically, people bet on when the baby will be born and the person who's closest wins the pot of money.) In the midst of my very genuine "oh no" reaction, something flashed through my mind. My opportunity! So I said, "WHO is going to do my baby pool when I have a baby someday?!" Somehow I knew that my boss, who I know pretty well, would not ask me about the FET after I said this. She just said, "I don't know. I guess someone else will have to do it." And that was it! Ha! I am probably safe until my next meeting with her, which isn't until after the six week ultrasound. Whew!

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I left work a little bit early yesterday because I worked so late Thursday night. I went home to rest a bit and found myself feeling anxious about making it nearly 2 more weeks to the six week ultrasound. This is a whole 'nother 2ww! I pulled up an old email from CCRM's genetic counselor in which she provided me with a statistical summary for people who've had comprehensive chromosone screening (CCS). Here it is, verbatim:

2007-2009 Blastocyst-CCS General Update
N = 154 transfers
Average maternal age = 37.5
Average number of embryos transferred = 1.87
97% survival post vitrification
~61 % implantation rate
~74% clinical pregnancy rate (6 week ultrasound)
~71% ongoing clinical pregnancy

13% of patients who undergo blast biopsy had all aneuploid* embryos. This means 87% of the patients had at least one normal embryo available to transfer. Of the 154 woman who have had transfers (this does not include the patients whose embryos were all abnormal) of euploid** blastocyst embryos, ~110 have delivered a healthy baby (or babies). I calculated this number by taking 71% of 154 (see stats above).

* “aneuploid” means chromosomally abnormal
** “euploid” means chromosomally normal

I wanted to know where I am in those statistics now, so I called her -- and luck was on my side, I caught her! -- to ask a few clarifying questions. I was thinking the 61% implantation rate was a typo but she said it is not, because it is a calculation of implantation of each embryo transferred.

I asked about rates of miscarriage and she said they don't track them at every step of the way. BUT what she did say was very good news -- the miscarriage rate for women in this study after they had positive betas was just 4 to 5 percent!! This is exactly the kind of reassuring information I was seeking. I could, of course, be in that 4-5 percent, but my mind is at peace with those odds.

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Last but not least, today I am thinking a lot about Pie, whose beta is tomorrow -- on Mother's Day! That's just wrong. And to top it off, her husband is out of town until tomorrow. If you have a minute today, say a prayer, send some sticky vibes, or visit Pie's blog and leave an encouraging comment. Pie, I am rooting for you!

Symptoms?

6dp5dt -- 3 days to go until beta!

There's been a lot of "activity" in my body today. I've felt slightly crampy, with some lower back pain, and I had some feelings I don't think I've ever felt before. My breasts are also a bit tingly. All of this been happening off and on for several days but I wasn't so sure that some of it wasn't just effects of the estrogen patches and progesterone or wishful thinking for symptoms. There's no doubt that I'm not imagining this stuff now. But it still could be the meds.

I am not going to POAS (pee on a stick) because I just don't want to have to process the results. I won't believe it either way and if it's negative, that could really mess with my head. I am doing pretty well and just don't need to go there.

Amazingly, I've somehow convinced myself that the beta is just one more hoop to jump through, like the egg retrieval, the fertilization report, the wait for embryos to develop and grow to become blasts, the comprehensive genetic testing of embryos, the thaw of the two they transferred.... So many things have to happen "just so" that getting past this first beta is sort of just another hoop to jump through. If it is positive, I still have to jump through the second beta hoop, the ultrasound-looking-for-a-heartbeat hoop, and who knows how many more hoops before I end up with a live infant or two.

How have I ended up thinking like this? I think my experience a year ago was so traumatic, I just don't want to let myself go there again. I am the only person I've ever known to cry her eyes out before leaving the RE's office  (while standing in line to check out, in full view of everyone in the waiting room, waiting for their own good or bad news). But yes, that was me last May when the doc finally said there was no hope for a viable pregnancy to develop. I just couldn't hold it in until the parking lot. It had only been about 12 days since the first beta and six days since they started using the phrase "not genetically viable" but my hope was so fierce, I was determined to see those HCG levels rise. Tears streaming down my face, I apologized to the check-out girl saying, "Sorry. I know this is bad for business." Our train wreck cycle followed that -- 3 eggs, 0 fertilized. Then we were kicked out of the Attain financing program. After that, I crashed emotionally and did not begin to believe that perhaps I could conceive a child with my eggs until some time after our one day workup at CCRM.

Our experience with CCRM has been so enchanting. And it really isn't CCRM as much as it is their results. I mean, they retrieved 17 eggs and created 5 normal embryos in their lab. Hope was reborn. But there are limits to where I will let myself go. On Saturday, if I get a BFP, believe me, I will shout it to the mountaintops of this blog. But then I'll start thinking about Monday's beta. It sort of seems like the hoop-jumping could be never-ending, possibly sending me to crazytown pretty quickly. So instead, I'm trying to enjoy each day of this experience . After all, being PUPO (pregnant until proven otherwise) may be the only "pregnant" I ever am. I want to enjoy it as much as I can.

It will be interesting to see if I can keep this up. I feel healthy and at peace at the moment. Time will tell!

One last note: I am getting pretty good at telling people who know my infertility story -- and even know about Denver and in some cases, the transfer last week -- that we're just not telling. For example, here's what I said to a good friend who emailed me tonight with an "any news?" question: "We had a frozen embryo transfer (2) last week, so we hope to have some good news this summer! Once we get the initial result, we plan to hold back on sharing it until we’re feeling more confident that it’s really going to happen this time." People have been very respectful.

What do you think?

Something occurred to me a few days ago before I got distracted by AF's delay (she still isn't here yet) . . .  I was thinking about the transfer scheduled for late April, the two-week wait, and the fact that without a doubt, my mom and mother-in-law will each in her own special way display heightened interest in all of this.

Here's what I'm curious about: what if I informed the moms that I'm going to stop giving the play-by-play after the transfer until I'm ready to share the outcome with them? This idea appeals to me.

Is it selfish?
Has anyone tried something like this? If so, how did it work?

I think it could help me manage the highs and lows of the 2ww and the first several weeks of pregnancy. It could give us the opportunity to try to surprise our moms with a more traditional pregnancy announcement at a time when we're ready to share it.

What do you think?

Meet Eenie and Meenie

Last Wednesday we had the egg retrieval and got seven mature eggs. I was sedated, so I didn't remember anything at all. After the retrieval, I spent the day at home sleeping. Thursday morning on the way to work, the embryologist called with a report. When he said, "unfortunately" my heart sank. Only two of the seven eggs fertilized. We had planned to name them "Eenie, Meenie, Miney, Moe" so this meant we just had Eenie and Meenie. When I told one of my coworkers, I started to cry, which told me that I was more upset than I realized. I didn't have time to think a lot about it at work though, so I emailed my mom to let her know and dove into work. Mom's reply -- that Eenie and Meenie are survivors -- was encouraging.

That night I reread the paperwork I had signed weeks ago -- a 17-page document that explained the process. You know, you read the stuff ahead of time but until you're living it, it just doesn't all sink in. I read all of the things that could happen to make an IVF cycle unsuccessful and I also did some reading online. There's a clinic in Chicago with lots of good info online. Their site is www.advancedfertility.com. This reading was all a good reality check. As a result, I was prepared for a call Saturday morning that said not to come in because Eenie and Meenie didn't make it.

I went to the acupuncturist at 8 on Saturday and when I told her I was half-way expecting that call, I could tell she was disappointed with my attitude. She emphatically said that although people think this is hocus-pocus there are studies that show that our energy effects everything going on out there. I thought, "Oh great. So if Eenie and Meenie die, I killed them." Of course I didn't say this to her. I assured her that I'm hopeful as well as aware of the possibilities.

But you know what? The call didn't come!

After my acupuncture treatment I ran home to start drinking 64 oz. of water -- you have to have a full bladder for the transfer -- and to take 4 Advil and one Zanax as prescribed by my doctor. We arrived at the clinic for our 10:15 transfer at 9:45. I was excited but still bracing for the moment of truth when we learned whether it would be Eenie and Meenie or just Eenie. After changing into a gown (and my husband changed into scrubs so he could be in the OR with me) they did a quick ultrasound to see if my bladder was full... It was NOT! So the nurse asked me to keep drinking.

A few minutes later I was ready so we met the embryologist, who gave us a photo of E & M. She explained that they grade the embryos on a scale of 1 to 4. One is excellent and 4 is not good. Both E & M were 3s. She called them average. (Of course I thought, "No embryo of mine is average!!") She said they are both eight cells, which is exactly what they want to see on day 3 (day 3 after retrieval) but they have some fragmentation, which could make it difficult for them to implant.

We watched on the monitor as the doctor inserted the catheter into my uterus and injected E & M in there, too. He pointed out the little white dot on the screen, which was E & M, and then he circled it and printed it out. He said the placement was excellent.

They said -- and things I read on that web site noted above also said -- that they are perfectly viable embryos, even though they are fragmented. So the likelihood is less than if they were not fragmented at all, but the doctor said a twin pregnancy is a possibility.

I went back to the acupuncturist for a second treatment after the transfer and by that time, the Zanax had REALLY kicked in. I was feeling it in my head. My husband took me home afterwards and I laid on the couch the rest of the day. Today I got up and went to church and then to the local museum (for a quick 30-minute jaunt through a famous exhibit that was closing today). After that I had planned to run some errands but was feeling tired. I had a big nap on the couch and have pretty much been laying around since then. I didn't want to overdo it, so I figured since it's the weekend, I may as well take advantage and do all I can to rest up.

I've felt an odd "tightness" in my uterus today. Not exactly cramping. Almost like someone has a string tied to my insides and is pulling it together. It is way too early for any sort of symptoms so I'm thinking this is just an after-effect of something I've subjected my poor body to in recent weeks -- high-powered drugs, a needle through my vagina that sucks the eggs out of my follicles, two acupuncture treatments in one day, the transfer.... Who knows?

I am on progesterone and estrogen and have to occupy myself until next Thursday, April 30, for the results. I'm feeling fairly patient at the moment. I'm just really glad I got to see this cycle through to the end. I was going to be upset if it was cancelled because I would've felt like we didn't get a full shot this go 'round. We're on one of those financing programs where you get three tries (more if you have eggs to freeze) so I want to make the most of each attempt.

I should be able to keep myself pretty busy with work, so hopefully I won't get too emotionally erratic during the next 11 days. Will keep you posted!