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!

Coasting

I would not have predicted that I'd go three days before posting again since I'm in Denver now and I'm supposed to have all kinds of time on my hands. We actually have been pretty busy.

Thursday -- ultrasound and bloodwork, consult with genetic counselor, backup sperm sample, switched rooms in hotel (got the big one we wanted), dealt with work issues and internet problems in new hotel room

Friday -- IVF physical, electro acupunture, more internet problems in hotel room, trip into Denver to visit The Tattered Cover bookstore (thanks for the recommendation, Pie) and find a place to have birthday dinner, and oh -- intermittent gifts throughout the day from DH (he's so wonderful!)

Saturday -- ultrasound and bloodwork, spontaneous 300+ mile trip ino the mountains that took the rest of the day. It was so beautiful - lots of snow on the ground, bright and sunny

Today -- ultrasound and bloodwork, church, lunch, grocery store and Target, work projects due tomorrow, walk on treadmill, dinner at yummy Mexican restaurant out our back door

So that's what I've been doing, but here's the skinny:

Started stim meds 1/23 (Menopur, Follistim, Saizen (Saizen just for five days)

1/26 ultrasound/bloodwork
E2 593, P 0.3, LH 6.4
15 follicles

1/28 ultrasound/bloodwork
E2 1674, P 0.9, LH 6.5
11 follicles measured (L 13.5, 16.1, 11.9, 14 and R 14.6, 12.7, 13.5, 13.1, 15.2, 13.2, 11.5)
Need to watch P level -- if gets above 2.0, may have to freeze all embryos no matter how many we have

1/30 ultrasound/bloodwork and Doppler retest
E2 4076, P 1.7, LH 4.9 - stim meds discontinued p.m. to keep E2 from rising much more - "coasting"
11 follicles measured (L 12.4, 18.2, 13.1, 17.7,10.3 and R 17.2, 17.9, 13.9, 17.1, 14.0, 13.8)
Doppler results normal (PI down from 4.69 to 2.05 on R and 3.9 to 2.24 on L!)

1/31 ultrasound/bloodwork
E2 4815, P 1.9, LH 3.7
11 follicles measured (L 19.6, 18.3, 17.4, 15.3, 12.4 and R 18.2, 16.2, 15.1, 18.3, 16.5, 17.4)
Sonographer counted 17 but only measured the biggest ones.

I thought they might trigger me tonight, but I'm still coasting. I'm glad about this. My big problem in previous cycles has been getting enough mature eggs. Everyone here has been saying we should get double digits, which would be amazing. We got 7 last April and 3 in August.

When we met with the genetic counselor, we discussed plan A, plan B, plan C... Plan A is to get at least five eggs to fertilize so we can do the genetic testing. Plan B is either a fresh transfer or polar body testing. All of the possibilities are kind of mind boggling. I loved receiving the information that the genetic counselor shared, but it was a bit overwhelming when I started thinking about every little thing that could happen in our specific situation.

Tomorrow we have another ultrasound and bloodwork and a regroup with Dr. S. (we are now calling him Dr. Babycraft). In Atlanta, the docs often do the scans, so you get to have a pretty regular, ongoing dicussion with your doctor, which is nice. Here, they have a pretty different model for getting things done, which in many ways is also nice, but it doesn't give you the opportunity to regularly communicate with your doc directly, so I scheduled this appointment just to touch base. I'm so glad I did that. Can't wait to get his take on how I'm progressing.

I also asked today who is calling the shots over the weekend since Dr. Babycraft isn't on. I was pleased that he isn't totally out of the loop; he is apparently supervising the on-call doc's decisions. I asked about my chances for getting him for the retrieval and Nurse Julie explained that I can request him if that's what I want. I assured her that that's what I want because this is our last ditch effort at this and well, he's the man.

About the Doppler retest -- in November at our one-day workup, they discovered a problem with uterine bloodflow. I was told that a year's worth of acupuncture had been done incorrectly and that I needed to start doing electro acupuncture. My great acupuncturist in Atlanta talked to one in Denver who works with CCRM and she started treatments according to Denver's specifications. I was also told, "Absolutely no caffeine of any kind" so I eliminated Coke, tea, and chocolate (very painful, especially during the holidays). I started drinking at least 64 oz of water per day and walking 30 minutes each day. This new regimen was a pretty significant undertaking for me, but I decided to abide by these rules because I wanted to give this all I've got. And what do you know?! It worked!