Six on Day Six

And then there were six.

The lab called today to report that yesterday (day 5) they biopsied and vitrified four of our embryos and then today (day six), there were two more to biopsy and vitrify. When she said "four" my heart sank, but when she told me about the two today, I felt better. I was a little bit disappointed because I was sort of hoping for another astounding report (I imagined perhaps 7 to 10 making it to blast), but when I really thought about what we have achieved, six is wonderful.

Again I asked for the details and she told me the grades: 3AA, 4AB, 5AA, 5AA, and two "two-thirds." Has anyone heard of this "two-thirds" grade? She explained it and then I asked her to explain it again. She said they are early blastocysts and they can almost tell where the intracellular mass (cells that become the baby) will be, but not enough to give them a real grade. However, they are good enough to make it to the next round. The very nice lab lady said that anything higher than a BB is considered a good embryo.

I asked about the ones that didn't make the cut and she said there were two ones, two that looked the way they should look on day four (so they were a few days behind) (there was a name for that but I can't figure out what it was -- I googled it and still couldn't get it -- it started with an M and sounded like oreo), and 3 arrested.

I also asked if she thought this was good overall, considering we started with 17 eggs. She said it is about what they would expect. I was sooo glad she didn't end that statement with "for someone of your age." That was so nice. Does anyone else cringe inside when you sense that phrase coming?

So if this were American Idol, my entire reserve of eggs stood in line for days to audition in front of Simon, Randy and Cara; 17 eggs got the chance to actually sing for them; 14 made it to Hollywood; and now six have made it into the finals.

Too much TV, you think?

Too much time off work! I pretty happily went back today, even if it was a 10-hour day.  (And yes, I was very happy to come home and watch the first AI episode featuring Ellen D.)

So I feel good about where we are. I don't have any anxiety about waiting six weeks for genetic test results and I sincerely told two people today that if zero come back normal, I will not regret doing this. I am so happy that we went to Denver. I feel like we have done everything we could possibly do to conceive a child. If this fails, I think it will be a sign that it is time to move on to another approach to building our family.

I just realized that in the past two paragraphs, I've used the word "happy" (or some variation thereof) three times. Yes, I feel happy. I am happy that our biggest hurdle to IVF success (making eggs and thus, embryos) has been jumped. The only two embryos we made before were below average on day three. Until now, I'd never made a blast and I'm pretty happy that I made six with pretty good grades! I'm happy that the stimulation phase is over and I probably don't ever have to do that again. Our plan, since we don't have insurance for this, was always to try three times and then move on. If it doesn't happen in three attempts, maybe it's not supposed to happen this way.

In addition to happy, I also feel relieved. I have been hopefully anticipating the possibility of pregnancy and parenthood off and on for.... well... almost 17 years. That's a long time to wish for something intermittently and to have almost no indication of whether your hopes will ever come to fruition. I am happy because I know that one way or another, this not knowing about something so important will be over before too much longer. (I was married before, at age 22, for 11 years. We tried off and on with no success during that time. Never sought help for the issue because I wasn't convinced I wanted kids with him. Soooo glad that didn't happen!)

So. Final "happy" count in this post: Eleven

That's a lot of happy. (Twelve!)

Day Three

Just got the call from the lab for the Day 3 report.

For starters, the guy said everything looks excellent and that they would call me in a few more days with the final report. And that was all he was going to say!. But I said, "Okay I'm an information girl so I would like to know everything you can tell me about them at this point." He immediately said, "Okay, I'm going to read each embryo's number followed by the number of cells and then the grade. Do you have a pen and paper ready?"

Did I have pen and paper? Of course!

So here goes.

1. 8 cells, grade 4-
3. 8 cells, grade 4-
4. 8 cells, grade 4-
5. 8 cells, grade 4
6. 4 cells, grade 4-
7. 8 cells, grade 4-
9. 8 cells, grade 3+
10. 8 cells, grade 4-
11. 8 cells, grade 4-
12. 8 cells, grade 3
14. 8 cells, grade 4-
15. 10 cells, grade 4-
16. 5 cells, grade 4-
17. 6 cells, grade 4-

At first when he skipped number 2 I thought it was a mistake, but then I figured it out. 2, 8, and 13 were the eggs that didn't fertilize.

He said they rarely give full 4s because that's like perfect. So all the 4 minuses are still great, I think.

He said something about biopsying and vitrifying them on day 5 or 6 and I said something about most of them making it to that point. He said that the 4-, 5-, and 6-celled ones may not make it. If we had all but three make it to blast, that would still be 11!! We may have enough to make two babies out of this. But I won't go there yet. Six Months At  A Time, Susie.

Right now it should be more like Six Hours At A Time. That is more true than you know. At the risk of giving you waaay TMI, I'll say that my follow-up ultrasound this morning resulted in a diagnosis of not hyperstimulation but constipation. Eww. Apparently the anesthesia can do that to you. And so can eating out for 10 days! So in addition to a few over the counter meds to solve my problem, I actually bought some prune juice. It isn't as bad as I thought it was. But I haven't even had a full 5.5 oz can. So I'm waiting for that problem to be solved. The pill bottles say relief could come between 12 and 72 hours. Oh please not 72 hours! I can't wait to feel better because I feel pretty gross. I can't even eat. But I am relieved it is not OHSS -- the sonographer said there's no fluid in my abdomen. Whew!

The embryologist said they will call again in 3 days with the final report. As I wait for "my problem" to resolve itself, today is our last day in Denver. I wish I felt like going somewhere and doing something fun. We may drive to Boulder or go to the Denver Art Museum. If I feel like it.

Fert Report

I don't really know what to do with all of this good news. Seriously, DH and I were talking today about how we just aren't accustomed to having good outcomes from our IF procedures. Diagnostic tests, sure, everything looks fine. But IUIs? IVF cycles? No way. For nearly 3 years, nothing has really gone well with our treatments. Until now.

Believe it or not, 14 of my 17 eggs fertilized! The lab called around 11 am today. She said they were able to ICSI all 17, so I have a question for all of you people out there who are much more knowledgable than I am about all of this -- does this mean that all 17 were mature? She didn't say that and I was so astounded by the fact that 14 fertilzed, I couldn't think to ask her. It is inconsequential now, but I'm curious.

Now we wait for the day 3 call on Saturday. Also on Saturday, we have a follow up ultrasound to check for extra fluid that would indicate I'm hyperstimulating. I've still been drinking lots, trying to ward off OHSS like the plague.

We have thought some about naming our embryos, but can't come up with anything really cool. Last time we went with Eenie and Meenie (Miney and Moe), but I don't want to call the first two Eenie 2 and Meenie 2. That would be weird. I think I will wait to name them until we see how many make it to blasts. I know there will be a good bit of attrition here and that will be easier to take if they don't have names.

It gives me chills to think that there are 14 microscopic combinations of me and DH in the lab just about a mile from here. I wish I could visit them and see them under a microscope!

Unbelievable Retrievals

I'm calling this post "Unbelievable Retrievals" -- yep, plural -- because before I share today's ER report, I will remind you about my unbelievable retrieval from August of last year:  we got just 3 eggs as my Atlanta doc was hoping to improve upon the first cycle when we got 7 eggs. As I was waking up in recovery, I asked my DH repeatedly how many eggs we got. And then I kept saying, "Only three eggs?" I was very, very, very disappointed.

Fast forward to today, when I was hoping for vast improvement but bracing for something similar. Believe it or not, Dr. Surrey retrieved 17 eggs!! Seventeen! I definitely came to the right clinic.

Of course we have a long road ahead, starting with tomorrow's fertilization report. The genetic counselor said the fert rate is usually 65% and of those, 40-50% should make it to the blastocyst stage in 5-6 days. If we could have 11 fertilize, I would be shocked. And if we get 4 or 5 blasts, that would be unbelievable all over again. Even if we have two or three blasts, I'll be pleased.

But this is one reason why we came to Colorado -- the lab. I know without a doubt that my 17 eggs are being given the absolute best opportunity to fertilize and survive.

For now, I will rest and think positive thoughts. DH got Chinese takeout for dinner. My fortune cookie said this:

From your garden of dreams, many things will blossom.

I like that.

I "believe" in fortune cookie fortunes because about five years ago, my DH got one that read: "Your new love is already very near you" as his first marriage was ending. He kept it and guess what? It was right. I was very near him. I'd been sitting near him in church for like 18 months. (But he wouldn't speak to me... Totally maddening because I caught him looking at me all the time.) That fortune is now in a frame on our dresser in our bedroom.

Maybe we can add this one to it someday.

Thanks to all for your good wishes.

Good day before retrieval

Today's been a good day. Lots of down time. Time for checking in at work, doing laundry, and drinking lots and lots of water.

Trigger shot last night went just fine with a nurse for hire who seemed waaay too happy to be showing up at my hotel at 1:30 a.m. It was an IM shot in my bum, which I couldn't do and my DH was afraid to do. The nurse was good. It was much less irritating than the acupuncture I had yesterday.

We had a late lunch and then drove around a bit to find some dirt for my godson. Yep, you read it right. His kindergarten class is trying to collect dirt from all 50 states, so of course I had to get some Colorado dirt for him. S, if you're reading, it will be in the mail tomorrow, I hope! (It's good dirt. Nice and brown, unlike our red Georgia clay.) Ah the things we do for the children we love. And I do love this kid. And his sister, too. : )

After the dirt excursion, CCRM called with results from this morning's blood draw. E2 was up to 7,654 from 5,700-something yesterday. Wow. They gave me cabergoline tablets to take for 8 days starting tonight and 3 ganirelix shots to start tomorrow night. Having never heard of cabergoline, I scanned the patient insert and under precautions - psychiatric, it says, "Pathological gambling, increased libido, and hypersexuality have been reported in patients treated with dopamine antagonists including cabergoline." DH was excited to hear that! Considering that tomorrow I'm going to have 17 follicles aspirated and hopefully 10-17 eggs sucked out of them, I was most interested in the gambling precaution. Another funny thing about these pills? Nurse Ellie said I can take them orally but if they make me nauseous, I can take them vaginally. There's something not quite right about that.

I think we are going see Avatar -- the IMAX 3D version -- in just a bit, so I gotta go.

More later!

The Dark Tunnel

So I'm finally ready for the trigger shot! I had some major follicular growth overnight and I think the time has come. My lead was 25 mm today -- that's like 6 mm larger than yesterday. Seem impossible? My nurse said it could be attributed to having a different sonographer today from yesterday. Or maybe the growth hormone injections have a lingering effect!

Trigger is tonight at 1:45 a.m. and retrieval is Wednesday around noon.

My E2 shot up again to like 5,700 so the doc ordered an injection of certrotide. The nurse said it would help make sure I don't hyperstimulate.

We had our regroup with Dr. Babycraft today. If IVF is a roller coaster, meeting with him was like flying through a dark tunnel when you can't see anything and you're screaming your head off. For some reason I felt, well, a little bit terrified in Babycraft's presence. This is an unusual response for me -- with most people, I'm typically pretty composed and articulate, but in our meeting with him I felt like my questions were not well formed and his answers were impossible for me to understand. At one point I felt my emotions getting the best of me and I just wanted to get out of there. I did get a few questions answered but I generally felt like I'd unnecessarily taken up an appointment slot in his busy day.

"Do you think we wasted his time?" I asked my husband as soon as we left. He assured me that no, that wasn't the case. He pointed out that like with many brilliant people, Babycraft doesn't have the best people skills. My doc in Atlanta has the best people skills of any doc I've ever had, but I don't think she's got anything on Babycraft. So bottom line -- I'll take it. I know he's following me very closely and making careful decisions about what to do and when to do it. He doesn't have to be my best friend. He just has to practice his craft.

Although it didn't thrill me, our meeting with Babycraft was a good reality check -- a good reminder that my chances of success are still only like 35%. We also confirmed that no matter how many eggs we get and no matter how many fertilize, we will freeze all. As Babycraft put it, the lining of my uterus and my follicles aren't on the same page right now. My lining thinks I've already ovulated, so a transfer now would not be a good idea. This means another trip to Denver if we have something to work with.

This afternoon I found myself feeling impatient in an old familiar way -- the "I don't care what happens here, I just want this to be over" kind of way. Luckily that feeling didn't last. I tremendously care what happens here, of course. I'm just tired of being away from home and I miss my own bed and kitchen and bathroom and cat and car and and and... I even miss work.

More tomorrow.

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!