Embryo Report #2

It still blows my mind how fast everything has gone. Disneyland seems like forever ago, but we've only been home two and a half weeks since we were there! 
Times files when you're on drugs ;)
Fertility drugs that is. 

Today we got our day 3 embryo report. When I answered the phone the nurse almost sounded remorseful. Of course my heart started racing and I assumed the worse. She then went on to give me the report and it wasn't bad at all! One of our embryos was even graded as excellent which is pretty rare. Grading systems vary from clinic to clinic and are always subjective. The embryo grading does not tell us what is going on inside the embryo genetically, so even a poor embryo could develop into a successful pregnancy and a good embryo might not. The grading system does help to determine which embryos they will want to transfer and which they will want to freeze.You'll notice that we lost one, which is normal, but we still have 9 embryos and that is awesome. They like to see around 8 cells on day three.

I organized them by grade and then by number of cells.

 Day 3 embryos are called clevage stage embryos. They are called this because they are dividing (also known as cleaving, hence the name), but they are not growing at this stage. I heard it explained like a pizza. When you slice it, you get more pieces, but the pizza does not get larger. The cells divide and the genetic material duplicates, but the volume of the embryo is no different than the volume of an unfertilized egg.

Here's what an 8 cell embryo looks like:

Can you believe that a bunch of little cells grow into a living, breathing, human? I've seriously learned more through our infertility than I did in all my science/biology classes combined. There's such a difference when it directly applies to you.

I still don't have any symptoms of OHSS, thank goodness. Hopefully I'm in the clear. I'm still super bloated to the point that I actually look pregnant, but it's slowly going away. Most of my pain comes at night which is strange, but at least I eventually fall back asleep. Transfer is still set for Saturday morning...can't wait!

Embryo Report

I have been anxious ALL day to get a call from my clinic. We find out how many eggs were fertilized today! It's incredible the technology available to allow in vitro fertilization.

I remember telling Chris yesterday that I would be elated if we got 10 fertilized. I thought that would be the perfect number. 

Well my phone finally rang. I was nervous and excited. Here's the news!

I got my perfect number! We are anticipating a day 5 blastocyst transfer for Saturday morning! I am so excited! So far I haven't had any symptoms of OHSS (Ovarian Hyperstimulation Syndrom) which is very very good. If I do happen to get OHSS (I'm at risk of it due to very high estrogen levels) they would want to freeze all the embryos and do a frozen transfer at a later time. I am praying my heart out that I do not get OHSS because I simply can't wait any longer. I want a kid this year please! Unfortunately not all embryos make it and some may die. I should be getting a call this Thursday with another report. We are just continuing to be watched over! So many precious miracles already.

Egg Retrieval

Instead of being scared out of my wits, I've been really excited for egg retrieval day. Chris and I have been watching the show House a lot and I just love learning about the body and different medical procedures. So I was somewhat thrilled about having surgery and "going under" since it's something I've never experienced before. 

I think if I could sum up the surgery in one word it would probably be "awesome". How often does someone think surgery is awesome? Perhaps it's because I feel one step closer to our end goal. (And recovery isn't terrible). 

We got to the clinic at 8:30 and went back into a private consult room. Chris left to go do his part (collection) and a nurse took me back to get changed into a very stylish gown, blue booties, and a sexy cap.

Pre-Surgery

Then they brought me into the OR and had me lay down with some warm blankets. The anesthetist poked and prodded until he finally found a vein for my IV. He was cracking jokes the whole time and said the vein on my neck looked very inviting. No thanks! Then the embryologist came in and introduced herself. She acted like she just drank about 20 cups of coffee. The anesthetist told me he was starting the IV and that I should feel calm. I asked if that was the stuff that would put me out and he said he would administer that soon. Next thing I knew I was a giggling mess in a different room and in a different bed. I immediately realized what happened and told Chris, "That was the coolest thing ever!" Still groggy and giggly, a nurse came in and said they got 19 eggs.

"19! 19! Chris, 19? That's so cool! 19!" I was high. And elated. Chris said that the doctor already told him and that he sounded pretty excited about the success. I've heard of people getting more, but I didn't expect I would have 19 eggs worth retrieving.  

Apparently at one point I said, "I could do this everyday if I didn't have to go to work!" Obviously the pain medicine hadn't worn off yet. 

I then went on about how the anesthetist was a liar and put me out earlier than I was expecting. I thought I would have to count down like they do in the movies. I still can't get over how cool it was. The nurse gave me a heating pad which helped with the intense cramping. She also brought us apple juice and bunny crackers which further elevated my super excited high state.The nurse went over some things with me and helped me to stand and see if I was good to go home. Shortly after I got changed and Chris helped me walk out to the car. I just laid on the couch the rest of the day. It wasn't too painful, just a lot of cramping and back pain. 

Post-Surgery

Chris had to work that afternoon since end of month is always really crazy. Ashley would check on me every now and then and our wonderful Primary President brought us dinner. It definitely put my cooking to shame. Probably the best chicken enchiladas we've ever had. 

Well now it's the day after and I'm doing really good. I haven't even taken pain killers today. I went to work and took it easy. The heating pad Ashley let me borrow is probably my favorite thing in the world right now.

The hCG shot and other meds, plus the huge amount of bloating from the surgery has really messed with my digestive system. I'm either nauseous or craving things. Seriously, all I can think about right now is ice cream.

Ice cream...

Blood Draws

I had to give blood both Saturday and Sunday which meant my favorite phlebotomist wasn't there, so I got to be poked around by about 4 different people. And they ran out of heat packs so the gave me a glove filled with hot water. I love my veins...Fifth time's the charm right?

My "I'm getting sick of this" look

Egg retrival is set for tomorrow morning at 9!

A Day in the Life of an IVF Patient

7 am, the usual morning line up...

Chug down the pills and swollow then start to clean!

Can you tell we've been listening to Disney songs a lot? :)

I thought I would share my oh so fun daily routine of being an IVF patient.

Here is my daily line up of pills/vitamins/injections that start at 7am, how fitting!

7:00am - Synthroid for hypothyroidism.

8:30am - Dr. Appointment: Estradiol blood draw and ultrasound to check follicle sizes

10:00am - Co-Q 10 vitamins and Vitamin D. My doctor wants me on Co-Q 10 for egg quality and Vitamin D since most women have a deficiency.

10:45am - Metformin. Makes me feel nauseous. Hate it!

5:00pm - Call from Dr. with adjusted doses for my injections based on my estradiol levels and to set an appointment for the next day. 

6:00pm - Round two of Co-Q 10, Prenatal vitamin, and extra Folic Acid

9:15pm - 1 injection of FSH (follicle stimulating hormone), 1 injection of Low-dose hCG (human chorionic gonadotropin), and 1 injection of Cetrotide to prevent early ovulation

9:30 - Round two of Metformin. Ugh. It's the Devil's pill.

 Repeat the next day!

When I was doing my IUIs I was so stressed about just 1 shot every couple days. Now I'm taking all sorts of pills and doing 3 injections a day and I'm not stressed at all! If this is what I have to do, I do it! It takes hard work to achieve your dreams.

On another note, I sat down at work this morning and was surprised because I can tell my ovaries are stretching. They are growing WAY more follicles than normal so it feels like I've got two tennis balls inside me. We will see how big my little follies are at my appointment later today! Everyday is a day closer to retrieval and I am so excited.

Just A Thought

In vitro fertilization opens a door to avenues you would never consider when getting pregnant on your own. I've been going through my 23 page packet of documents I need to sign and it is amazing to me how much we will be getting involved with the potential creation of our baby. Some things we've had to consider include:

• ICSI (Intra-cytoplasmic sperm injection) - Where they chose a single healthy sperm and inject it right into an egg for fertilization.
•  Assisted hatching - Before an embryo can attach to the womb, it has to break out of its outside layer called the zona pellucida. Assisted hatching helps in this process.
•  Cryopreservation - Freezing remaining embryos. Unfortunately insurance doesn't cover this, but we paid for it anyway for future attempts. We also needed to decide if we will freeze them in groups or individually.
• Custody Consents - We have had to choose options for the custody of our frozen embryos for multiple scenarios, including the death or disability of one or both of us, if we decide to not use any remaining embryos, if I am incapable of carrying a baby to term, and more. 
• Genetic Mutation Screening - A test that scans us for over 100 diseases we could pass onto our children if we are both carriers. If we found out we are, they can do a preimplantation genetic diagnosis and biopsy the embryos to see if it carries a genetic abnormality. This allows the opportunity for selecting to transfer only the most healthy embryos and avoiding the risk of having a child with a genetic disease. I still do not have an opinion on this process, however it is too late to consider it for our fresh transfer. 
• Embryo Transfer - How many we will choose to transfer and if they it will be a clevage stage embryo or a blostocyst, as well as the risks of multiple gestation on both the mother and babies. 

 Of course there is more, but I don't want to bore you with 23 pages of questions you would probably never consider if you could conceive naturally. I was afraid all this was getting too involved with our powers to procreate but a thought ran through my head today of what an amazing opportunity this is for us. We have the chance to experience creating a life in the earliest stages, to make decisions between me, Chris, and our Heavenly Father. We want the very best for our family and we get to start in some of the earliest ways possible. Not knowing exactly when life begins makes it extremely difficult to make some of these decisions, but I feel guided by our Heavenly Father and feel comfort in decisions we are making. Normally I would be overwhelmed with stress through this process, but as I mentioned before, I truly feel that I am being carried through all this.It is such a blessing.

IVF - This is happening!

On Monday I had a phone appointment with my Reproductive Endocrinologist. We went over my past treatments and made a plan for IVF. Since I've been on birth control the past 3 weeks it shortened the treatment plan by three weeks and I get to start medications today. I had a 2 hour appointment yesterday for another ultrasound, blood work (6 vials this time, yuck), urine sample, and to sign a ton of paperwork which also included paper work for freezing the embryos. Unfortunately insurance doesn't cover freezing so I had to write a huge check in advance. I will be going to the doctor numerous times this coming week. I already have more blood work for Friday and Chris is having blood work and a Kruger test to have a closer look at his sperm morphology on Saturday. The test looks at the shape of his sperm to see if they're developing properly. If a man has a decreased number of normally shaped sperm on the Kruger analysis, he is at risk of fertilization failure or lower rates of fertilization. Then I have more blood work and an ultrasound on Sunday. That appointment will determine next weeks appointments and how many more ultrasounds I will have. It sounds like they will be every other day since it's extremely important to monitor the growth of the follicles. 

If a man has a decreased number of normally shaped sperm on the Krueger strict morphology analysis, he is at risk of fertilization failure or at least low rates of fertilization. - See more at: http://www.babymed.com/male-infertility/sperm-morphology-kruger-sperm-function-test#sthash.ovotEWTi.dpuf

If a man has a decreased number of normally shaped sperm on the Krueger strict morphology analysis, he is at risk of fertilization failure or at least low rates of fertilization. - See more at: http://www.babymed.com/male-infertility/sperm-morphology-kruger-sperm-function-test#sthash.ovotEWTi.dpuf

I'm actually not nervous at all. Even though I will be starting multiple medications, injections, and going to numerous appointments, I am SO excited. I really feel like we are being guided right now and that Heavenly Father is watching out for us. I've been feeling his calming love so much. I literally feel like I am being carried. My heart is full.

Disneyland!

What a week last week was! I had a baseline ultrasound on Tuesday. Everything looked good and the birth control worked it's magic, so I was cleared to continue another IUI cycle. I still have that big cyst on the outside of my ovary, but it's not causing any harm. I asked about IVF and how we've been considering trying it. During the appointment I was pretty set on trying one more IUI and then doing IVF if the IUI failed. Well, that night Chris and I talked about it and I went to sleep still thinking that we should try one more IUI. I woke up the next morning with any undeniable impression that we need to do IVF next. I called my doctor and left a message to see what we need to do moving forward. And then that night...wait for it...we flew to Disneyland!

I had been under so much stress with treatments that I broke down one night and planned a very spontaneous, yet fairly inexpensive (thank you Southwest miles!), trip to Disneyland a week and a half later. Chris and I really enjoyed the time off work and getting to spend 4 days with each other having fun. I think it was just what we needed before the crazy storm that's headed our way. By that I mean doing IVF as well as Chris getting knee surgery. We loved walking around Disneyland and seeing kids' reactions. We couldn't stop talking about how we can't wait to take our kids to Disneyland someday. Our time together was definitely enjoyed. It felt like it was kind of our last hurrah until we start a family and things get harder to do.

Here are some of my favorite parts of our trip:

-Stuffing our faces every morning at our free continental breakfast
-Riding Space Mountain again and again
-Learning to draw Disney characters at the Animation Academy
-Riding California Screamin' again and again
-Beating Chris on the Buzz Lightyear Astro Blasters ride
-Eating ice cream everyday
-The firework show was awesome! Not only did they have fireworks behind the castle, they also had fireworks shooting from all corners of the park at times to make you feel in the middle of it all
-Exploring Tom Sayer Island, something I'd never done before!
-Riding the little kids rides, especially the Casey Jr. Circus Train
-Being absolutely terrified on Mickey's Fun Wheel...scariest ride there
-Watching a cute little theatre rendition of Tangled. Rapunzel was perfect!

I wish I was back standing in line with my cute husband all day, but back to life we go!