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We decided to head home early as travel was permitted by the clinic on the second day after the transfer. W has to head to Finland for work on Saturday so we decided it would be nice to spend a couple of days in our own house before he left.

I’m still on dexamethasone, folic acid, injectable progesterone and estradiol/progesterone suppositories. W has been awesome at giving my my nightly progesterone shot and I just realized on our way home that I wouldn’t have him around to give them to be in a few days! I’ve done all of my own shots, but never an intramuscular injection. I finally did it tonight by myself! I figured I’d better try a couple with him around in case I needed help. It was not nearly as bad as I was anticipating and now I feel good about doing them solo.

I got settled in for the night and was so disappointed that in the rush of the day, I hadn’t even thought about not hearing from the clinic about the final count of our frozen embryos! When we went in for the transfer we were told that there were 3 for sure frozen, 3 more that they anticipated freezing and a couple more that they were watching. I was doing my nightly routine and checking email and there was an email from our awesome clinical coordinator with an update! We officially have SEVEN – GRADE 2 embryos frozen for future use! I’m ecstatic about that! It’s more than I was hoping for! We started off with 12 eggs collected, all of which were mature. They say to only expect about 50% to make it to blastocyst stage for transfer or freezing so 7 frozen plus the 2 transferred were 75%! And all grade 2 with minimal fragmentation on top of that? I’ll take it!!

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I’m now 2dp5dt (IVF lingo that means 2 days past a 5 day transfer). I had a tiny bit of bleeding on the day of the transfer which the nurse said was completely normal and was most likely from cervical irritation from the actually transfer but nothing since. I’ve felt good other than the usual progesterone side effects. I’m tired and I try to tell W it’s from the progesterone but I feel like he thinks I’m milking it! I’ve had some very minor cramping off and on but nothing much to report! ….And now we wait…

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One little, two little embryos..

Today was transfer day! I didn’t feel nervous (or maybe I was telling myself that I wasn’t) but who are we kidding?

We arrived at the clinic with not much time to spare and they handed me a tiny nondescript manila envelope containing a pill and said, “take this”. We were escorted back to a room where I was instructed to assume the position. The nurse came in to tell us that we had 2 beautiful grade 2 embryos to transfer today and that we would discuss the others after the procedure. We were given a picture to keep of the two we were transferring.

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My bladder wasn’t quite full enough and they ended up having to cath me and insert what to me felt like approximately 5.5 gallons of fluid. That was seriously one of the worst feelings I’ve felt in my life! It was incredibly uncomfortable and made me eyes tear up! They inserted the catheter into my uterus and called for the embryologist to transfer the embryos. I wasn’t able to see the screen but W said it was pretty awesome to watch what was going on. The transfer went very well and the doctor had mercy on me and chose to cath me again to remove the fluid from my bladder. Thankfully, I was able to stay horizontal for the full 30 minutes without having to get up to go to the bathroom!

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We went over our calendars, lab draws and remaining embryos. Here’s the breakdown of what we have left:
⭐️THREE (grade 2) embryos that are frozen
⭐️THREE additional (grade 2) embryos that are expected to make it to freeze
⭐️A couple of embryos that they will continue to watch to see if they will make it to freeze.

We will get the final frozen count on Thursday.

We were given a 50-60% chance of pregnancy with a 25% chance of twins based on my age, etc. We should know in a couple of weeks if it worked and if so, a couple weeks after that how many. I’ve been instructed to be a couch potato today and then I’m allowed to resume mild activity tomorrow.

Thank you everyone for your well wishes, thoughts and prayers. You all mean a great deal!

Embryo Development Day 3

I had a “relaxing” day yesterday with my gatorade while W went hiking with some friends. I must admit, I was a bit jealous to not be able to go. The highlight of my afternoon was going to the grocery store to pick out some new gatorade flavors. My go to drink when I wasn’t feeling well in the past was gatorade but I feel like our relationship is changing!

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I also snuck out of the house for a couple hours last night with W and friends again. We went to dinner at Wicked Spoon at The Cosmopolitan. I tried to eat mostly sodium filled, high protein food (to help my OHSS) but I may or may not have had a few desserts! After that we went to see Penn and Teller at the Rio. Teller was nice enough to take a selfie of all of us with my phone.

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I got the update from the clinic about our embryos! Good news again! All 12 are STILL growing! Here’s the daily dirt on what’s to be expected..

“Within 72 hours of fertilization (day 3) it ideally should be 6-9 cells and by day 5 or 6 it should have reached the 100-cell+ stage with a fluid filled cavity inside (expanded blastocyst). Embryos that fail to reach 6-9 cells within 72 hours of fertilization are developing too slow or too fast and more often than not are aneuploid and “incompetent.” Also, cleaved embryos that contain significant cell fragments (fragmented embryos) are also more likely to be aneuploid.

Our research has demonstrated that failure of an embryo to reach the expanded blastocyst stage within 5 to 6 days of fertilization is almost always associated with aneuploidy. As stated such aneuploid embryos are thus “incompetent”.

On average, a 6-9 cell day-3 embryos transferred to the uterus would have about a 20-25% chance of propagating a live birth. If left in culture for 2-3 days longer, many (but not all) such aneuploid embryos will stop growing (arrest) and be culled out in the process. Those that make it to blastocysts are then more likely (35-40%) to develop into babies. Those that fail to survive to the blastocyst stage are “incompetent” and even if they had been transferred to the uterus earlier on, would almost always have failed to implant.”

Here’s the break down of what we have on Day 3 (all with minimal fragmentation):

  • 3- 7 cells
  • 7- 8 cells
  • 2- 10 cells

The clinic nurse said in a normal cycle, 50% of these embryos won’t make it to blastocyst stage (the stage where they would transfer). She said to not be alarmed if the numbers start dropping. I’m thankful to still have 12 so hopefully our end number will allow for freezing some. The tentative plan is to transfer on Tuesday if my OHSS is deemed well enough to the RE. We will (God willing) transfer 2 embryos and freeze the rest for future use. Image

Embryo Development Day 1 & 2

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Good news! We got a call yesterday that all 12 of our eggs had fertilized using ICSI! Today (Saturday) will be an observation day and we will get another call tomorrow to see how many are still growing. W thinks it’s slightly comical that there were a dozen collected and fertilized. He’s been calling me his hen! Here’s some information on what’s been taking place..

Day 1: The eggs are assessed for evidence of fertilization. Normal fertilization is evidenced by the presence of two pronuclei, one from the egg and one from the sperm. If there are too few or too many pronuclei, the embryo is considered abnormally fertilized. All normally fertilized embryos are put into a culture media that mimics the tubal fluid found in fallopian tubes and placed in an incubator.”

Day 2: The embryos are assessed for cell division. Most embryos develop 2-4 cells by day 2. Embryos are graded based on an embryologic grading system that incorporates number of cells, cell regularity and degree of fragmentation.”

Speaking of growing.. That’s what my poor belly has been doing since the retrieval. I showed a picture to a fellow NICU nurse friend of mine and she agreed that I could easily pass for 23 weeks pregnant. I spoke with the nurse at the clinic and she said mild OHSS was common with girls like me who have PCOS and produced a lot of follicles. She said as long as it doesn’t get markedly worse and as long as I’m not in significant pain that the best thing to do is drink fluids with electrolytes and hope for it to resolve soon. I can’t believe I’m posting this awful belly but I know that I appreciate being able to google other’s blogs and see real pictures of what to possibly expect!

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Here’s a brief description of OHSS. “During IVF, the stimulation medications cause the body to create and grow many follicles (versus the one a month a woman’s body produces without medical intervention). As these ovarian follicles grow, they release a number of different substances, the most important of which is estrogen. This estrogen allows the lining of the uterus to thicken so that the embryo can implant and snuggle in. Once the follicles have reached maturity, an IVF patient takes a “trigger” shot of HCG to cause ovulation. Harvesting of the follicles for eggs is now done and the follicles are aspirated with a needle, releasing all of the fluid. After this, huge amounts of estrogen-rich fluid pour out of the swollen and enlarged ovaries and into the abdominal cavity. Many women will then experience some mild OHSS symptoms (bloating, some abdominal discomfort, etc.) after retrieval. After retrieval, the follicles refill with fluid and are called corpus luteum, because they contain large stores of cholesterol that are used to produce the steroid hormones estrogen and progesterone. In addition, the follicles start to produce a number of other growth factors and chemicals like vascular endothelial growth factor (VEGF) and kallikrein-kinin, which then coat the lining of the abdominal cavity and cause it to become leaky. This is called ascitis. Fluid literally pours out of bloodstream into the peritoneal (abdominal) cavity because of the leakiness of the lining. The ovaries balloon in size and the abdomen swells.”

BINGO! Apparently I win. Hoping this will all be worth it in the end! (We were able to sneak out for a bit with some friends to do some shopping, have lunch and watch the fountains at the Bellagio. Put $5 in a slot machine and won $40. Might have to go back tonight and see if we can find some more IVF reimbursement! -ha)

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*On a side note: I keep reading these posts about fellow women who are struggling with infertility resenting their friends and family who get pregnant or have kids. They say that these pregnant women are insensitive to our struggles and that they should somehow put a cap on their excitement or filter everything they say. While I understand how hard it is to feel as if life is passing you by and to watch these women take for granted something that doesn’t come easily to us, I can’t help but think that sometimes WE are the insensitive ones. Who says that we should get to celebrate our BFPs (pregnancy) and they should keep quiet as not to upset us? It’s not their fault that they didn’t go through the same struggles as we did. Every woman deserves to celebrate such a precious time in their lives any way they see fit. We should be supporting each other as women, fertile or infertile instead of debating who gets to celebrate and who is insensitive. Yes, they may not know all of the pain, hormonal rages, stress and heartache that we go through but that’s a badge that I will wear proudly. You don’t have to know about my struggles or tiptoe around them because I know that everything that I’ve gone through has only made me stronger and has shaped me into the woman that I am today. You can’t control other people’s actions, only how you respond!

Egg Retrieval…

Woke up at 11pm on Tuesday for W to give me my trigger shot. I was so paranoid about not waking up that I set alarms on both of our phones and even had one of my night shift friends text me to make sure it got done! He gave it to me in my arm and he did great! Hardly felt it.

I’ve progressively gotten more and more bloated and sore, especially after the trigger. The more active I was, the worse it got. Still, nothing too bad. I do however feel like I look like this…

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I woke up this morning, the day of the egg retrieval, with some pretty good bloating and I was definitely the most sore I’ve been yet. We arrived at the office and were hurried to fill out the last bit of paperwork. I changed into my gown and they started an IV for fluids and access. They took me back, sedated me and before I knew it I was back in my recovery room. W said it took about 20 minutes.

Dr. S came by and said that things went great and they collected 12 eggs that were all mature.

I had a bit of nausea and got sick once after anesthesia but managed to eat something after I got home and I feel much better now. I was very crampy right after the retrieval but now as I’m resting, it’s not bad. They start to come back if I get up and move around but overall I feel pretty good!

The plan is to rest today and wait for the call tomorrow to see how many of the 12 eggs fertilized! Fingers crossed!

Welcome to Las Vegas!

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   We made it to Vegas last night for our two week IVF stay! We had a great dinner with family the night before we headed out. It was great to see everyone and we are so lucky to have such a great support system. Everything went incredibly smoothly and the dogs did great!  They even got a nice compliment from the flight attendants on how well behaved they were on the flight. (They are used to it, the little traveling fools.) The house we rented is perfect for us and the dogs have a little fenced in back yard to run around in. W’s mom and her husband drove up to visit us in Vegas and it’s been great to catch up with them. She brought an album of old pictures from W’s childhood. Seriously, how cute was he??

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   We had our first monitoring appointment this morning. They counted 25+ follicles, 15+ of which measured >1.5. (This means there’s a good chance that they contain an egg.) I was nervous about not having many to work with but it looks like if everything goes well, we should be just fine. There’s always a lot of hurdles to jump before the end result but you just have to go with the flow because there’s not much else you can do! Overall we had a great appointment. The staff and doctor were wonderful and he said I’m responding exactly like I should and we are on track to do one more night of stimulation medications tonight, trigger shot to mature the eggs tomorrow and then the egg retrieval on Thursday.

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I noticed last night that I looked pretty beat up and I thought that I should document it in case this works and I have an ungrateful teen 16 years from now! (kidding. sort of.)

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   We get to have an off day with no appointments tomorrow. I’ll update again when there’s something worth writing home about!

Will infuse for cupcakes..

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Results from the infamous unnecessary, necessary MRI are back. Normal! That means that they didn’t see anything (fibroids, etc.) in my uterus that could cause problems with the embryo implanting when we get to that point.
Today was my at home intralipids infusion day. IL is what they use to treat Natural Killer cells and this is what my nurse had to say about it..
“Natural Killer cells are a normal part of everyone’s immune system. They are what patrol our bodies trying to keep foreign things out of our bodies. Some people have Natural Killer cells that are a little more aggressive. In normal life, this is usually a good thing. Maybe they don’t get sick as often, or if a bad cold is going around it won’t hit them as hard. Natural Killers don’t realize there is a difference between embryos and germs though. They just see something is foreign and doesn’t belong and end up trying to keep the embryo from implanting inside the uterus. Dr. S has found that doing an Intralipids Infusion can help to calm these aggressive Natural Killer cells down to allow embryos a chance to implant inside the uterus. There would be an infusion prior to starting the monitoring process. After the embryo transfer if you are confirmed pregnant, there would be a second infusion done.”
Since I work in the medical field, they allowed me to do an at home infusion. Thankfully one of my wonderful friends agreed to swap cupcakes for helping me start an IV. Everything went well and the infusion lasted about 1.5 hours. The Stuffed French Toast cupcake was amazing. I have missed this particular cupcake shop!
W is back from Finland and we have plans to see family tomorrow before leaving for 2 weeks for our appointments. It’s really happening!!

To the lady who told me I needed a full bladder..

Special blessings to you today. May you feel the need to pee all. night. long..
I had my unnecessary,necessary MRI today. The lady scheduling it told me to drink 32oz of water in the hour or so leading up to the MRI. “Huh”, I thought. Sounded strange for an MRI but I didn’t want to sound like an idiot so I didn’t question it. I arrive and the tech performing it asks if I need to use the bathroom. This is probably what my face looked like..

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I tell her what the lady said and she tells me that a full bladder isn’t required for an MRI. Tinkle I go.. Fast forward 40 minutes..

Tech over the speaker: “We are having trouble getting clear images. We need you to stay really still.”

Me: “I am still. I’m not moving. Ehh.. How much longer? I really, really have to go to the bathroom!”

Tech: “Oh! That’s probably it. It’s probably distorted from you clenching trying not to pee.”

I would assume my face looked like this as she pulled the table out for me to get up..

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Upon completion..
Tech over speaker: “Ok, we are done. Yeah, that must have been it because the images after that were clear.”

So after my 2 hour, never-ending, bladder filling, bladder emptying, bladder filling, bladder emptying, unnecessary, necessary MRI… Bless you scheduling lady. I have no other words.

In other news: Interview, check. MRI, check. Started my stims tonight! Sure hope those results are good!

So much for the relaxation…

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Does it always have to be two steps forward, one step back with this process? I had a good morning with good results from my baseline ultrasound and it looks like I should be all set to start my stims tomorrow! (Now that I have taken injections to tell my body to be quiet, these new injections will attempt to hyper-stimulate my ovaries to produce more ‘mature’ eggs than normal.

I had been dealing with a local fertility clinic and switched to another out-of-state clinic for IVF when I wasn’t pleased with the care we had been receiving. This clinic still performed my outside monitoring and did such recently. Or so I thought! My new clinic called me this afternoon and informed me that they still had not received some labs that I had drawn as well as the results of a fluid ultrasound. After lots of phone tag, I was finally able to reach someone at my old clinic who found out that the laboratory they use never ran the labs that were drawn and ordered! On top of that.. They did the WRONG ULTRASOUND! I needed this ultrasound done before my period started and now it’s too late.

New clinic nurse says that my RE does not feel comfortable proceeding to the point of embryo transfer without having the results of that ultrasound (the one that never got done and is too late to do now). {{Cue the profuse sweating, world is closing in. I think I’m going to be sick}} She tells me that we could proceed, freeze the embryos and then come back at another time for frozen transfer or that we could delay the cycle. {{Hyperventilating}} It’s not that easy when you’re flying to another state to do this, not to mention when your husband is traveling overseas on a weekly basis for work! Then she slipped in that another option is for me to have a pelvic MRI, or rather a pelvic $$$ to rule out anything that would interfere with embryo transfer/implantation. Of course I jump on that offer! Thank God insurance is going to pay 85% of it. Part Most of me feels like the clinic that messed it up should eat the cost! So now my list this weeks looks like : interview for new job, start stimulation meds, have labs redrawn, schedule and have MRI, pack for our 2 week IVF “vacation”, take the dogs to the vet, 2 more rounds of acupuncture, meet with 2 contractors so they can bid some work on the house, hire a painter to paint the interior, oh and finish unpacking my entire house- all with a husband in Finland who is returning home the day before we leave. So much for low stress and relaxation! Maybe it’s a hidden gift in that it will keep my mind occupied making sure I get everything done! Enough ranting. I shall remain positive. What else have you got? Bring it at me!!!!

**In other news, I may or may not have made a huge mistake by asking my wonderful friend to chop 6″ off of my hair! In hindsight, it was probably hormone induced but I haven’t cried. Yet. (Note to self: no more major decisions on hormones.)

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Baby Magic!

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Who couldn’t use some, right? Found this little gem today. Wishful thinking perhaps? I felt that my first day of meds wouldn’t be complete without a baby bum scented bathroom! (ha) I’m a NICU nurse so it smells a bit like a good day at work. That smell of course means that baby is doing well enough to have a bath! (Or that a nice nurse has smeared it on their blankets for aromatherapy!)
My intralipids arrived today. They were frozen. Guess I’ll have to call and make sure that’s not an issue!
Did your Lupron shots bruise you? I’ve done follistim (subcutaneous) in the past and had never had an issue with bruising. I had some redness and itching for about an hour and bruised on my first injection! I have a feeling I’m going to look rough by the end of this!