Tag: stim cycle

And then there were two: PGS results

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After the cliffhanger of my last post, I’ll go ahead and immediately spoil the ending of this one with the title. We have two PGS-normal embryos.

TWO. NORMAL. EMBRYOS.

I felt a little like this:

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Okay, rewind… As of day 3, I had 14. I knew well enough to know that over the next two and three days, the lab would see a drop-off of at least half, and I was fine with that. The entire goal of Stim Part Deux: Electric Boogaloo was quality over quantity. Quantity, in my previous experience, hasn’t made a damn bit of difference for me. Five of my six embryos from my first stim cycle didn’t stick, and Kristoff, the lone embryo still frozen, had the lowest grading of that pack. The odds weren’t in his favor.

Quality, of course, is much harder to measure. I’d done the work I could do to potentially improve the quality of my much-older-than-my-age-and-AMH eggs by losing 35 pounds. But, other than feeling better than I had in a long time, I didn’t know if that would prove fruitful fertility-wise.

When day 5 arrived I think I stared at my phone all day. For previous updates the lab had emailed me in the morning, so by lunchtime I was a ball of anxiety. Did this mean none had progressed? Was the news so bad that the lab would have my doctor break it to me? What day is it? Do I still remember how to count to five? By 3:00, I simply couldn’t stand it anymore and emailed the greatest nurse on the planet. Hey if you could just do me a solid and walk down the hall to the lab… She was like calm down, crazy, since you’re doing PGS the lab will wait until tomorrow to give you the final results of how many made it to blastocyst to be biopsied.

“However, you have 2 for biopsy today 🙂 And likely many more for tomorrow. Yay!!!!”

There was crying.

Day 6 went by so damn slowly. But then the email came…

Five.

Plus, Kristoff had survived the thaw for biopsy and continued to develop.

Even more crying. So much crying that my husband only understood every seven words that I said on the phone when I called with the news.

Six embryos held all of my hopes and dreams: 5BB, 5BB, 6AA, 5AA, 5CB and 5BC. No pressure, kids, but my entire future is riding on you…

The nine days between hearing that number from the lab and getting the call from the greatest nurse on the planet with our PGS results were absolutely on-par with the two-week wait. I did my best to stay busy and keep my mind occupied, but if I’m being real those results were the only thing of substance I could think about.

On the afternoon when my nurse called, she admitted she was very scared to tell me there were two normal embryos. Two of six is a poor ratio, all things considered. But as soon as she said two, everything else fell away. I’d save the questions about the others for another day. When you’re terrified that you’re going to hear zero, two sounds like a million. I was so unbelievably grateful for two.

Lots more crying. All the crying.

So here we are… Two. It’s my new favorite number.

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Ps… Kristoff wasn’t one of the normals. And she’s actually a Kristoffina.

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34 Farm-fresh eggs

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I am, once again, a human farm animal. Such is #IVFlife.

And as I suspected, each stim cycle is a little bit different.  To recap: During my first, in June 2016, the doctors retrieved 23 mature eggs, which resulted in six embryos making it to blastocyst stage. While the meds no doubt kicked my ass then, the much more (physically) unpleasant experience came following my egg retrieval.

I’ll get to the good stuff straight-away, I know that’s what you’re here for… Somehow my doctor managed to find 34 eggs in my swollen stomach. As I was coming out of my anesthesia following the procedure, the greatest nurse on the planet popped her head in to say, “34,” with her big, bright smile. If I didn’t actually ask her at the time, I certainly wanted to say, geez, are you sure they were all mine? They claim they are. Thirty-four was more than my brain could actually process in the moment. Then she said something that I will stick with me, and will be a key piece of the story I tell my daughter or son about how they came into our family…

“One of those eggs is your baby.”

She said it with such hope and conviction that my heart swelled to match my enormous ovaries and I felt so strongly that she was going to be right.

“One of those eggs is your baby.”

To every woman who has felt beaten and broken by infertility, I wish you a moment just like this. I felt renewed and ready. I’ve been so careful not to ever really let myself believe this could still be possible in case it wasn’t. In that moment I let go of so much negativity, and let those words sink in.

Of those 34 eggs retrieved, 21 were mature. I did find it pretty surprising (and encouraging) that it was only two fewer than my first cycle, when I was the better part of two years younger. Physically the process of stimming felt much more intense this time than I remembered, and I again went for the full 12 nights. Perhaps it was because I knew this would be my last time, but I was feeling SO done before I’d even gotten to the trigger shot. The bloat and the fatigue felt especially powerful in the last few days of injections. And I was a straight-up nightmare emotionally-speaking.

Despite the more intense stim (guess that meant it I was firing on all cylinders?), the retrieval recovery was a breeze compared to my Dark Willow situation last time.

When the lab reported that 21 eggs were mature, they relayed that 14 of those had fertilized. This was virtually the same ratio as my previous IVF cycle, and I felt fine with that and eager to see how many of those would progress.

On day three, I waited for news from the lab. And it was good… ALL 14 embryos were developing! I read the message a few times, and then squealed and cried. Things hadn’t gone down this way before. To still have all of them thriving on day three? It was the injection (ha!) of encouragement we needed.

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I agree, Ron. Stay tuned…

Wounds of war

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The scary thing isn’t the bruises of IVF, it’s sharing a photo of your far from flat, stretch mark-filled tummy on the Internet.

Yes, the bruising and soreness and feeling crappy 110% of the time sucks. But such is stimming. I leave this here for posterity, to say these bruises may be the wounds of war necessary to finally get a baby.

Good luck, IVF sisters. I’m with ya.

Stim Part Deux: Electric Boogaloo

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Friends, the day has arrived (finally): Day one of my stim cycle. Let’s grow some follicles and make some good quality eggs, shall we?

Pending the results of this morning’s progesterone check, I begin Lupron injections this evening. Here’s a fun refresher on the types of side effects I may experience during this phase of the cycle: fatigue, increased sweating, headaches, acne, trouble sleeping… Oh boy! During my first cycle nearly two years ago, I wrote about the frequent urination hitting me hard by day 8. Guaranteed that one pops up again.

Knowing what to expect physically and emotionally during a stimulation doesn’t make me excited to start injecting myself with hormones every night, but it does give me some comfort. One of the most difficult mental hurdles last time I did this was overcoming the fear of the unknown. Perhaps no two cycles are alike, though?

Mentally, where am I? That is, of course, more complicated. Knowing that I can get through to the egg retrieval is one thing. I can handle tired, peeing a lot and crying at the drop of a hat. After the retrieval, though, the next six days are out of my hands. I’ll wait to hear how many eggs fertilize and grow to blastocyst stage. Then the embryos are biopsied and shipped for PGS and I’ll wait some more. That wait, though… that’s going to be the toughest one. It determines our next few months, our entire path for moving forward. Will there be any normal embryos? If so, how many? If not, how will I feel? Will I want to move right into adoption, or will I need to grieve the loss of my fertility?

None of these questions will have answers for at least the next month. As we get dangerously close to April, no less. The worst month of the year.

So stay tuned for some fun!

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(I really love Happy Endings. Can you tell?)

Understanding PGS: Why we’re doing it

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PGS (pre-implantation genetic screening) is a complicated topic. While I knew we would opt to use PGS during our upcoming stim cycle prior to a transfer very early on, I didn’t know much about it. I’d watched an animated video on the website of the laboratory that my clinic uses for PGS, and it felt a bit Schoolhouse Rock-esque, without the clever puns and music. This video could have used those. I felt like I knew the basics of what happens to the embryo/blastocyst during the PGS testing, the lab counts chromosomes, … blah, blah blah… and then following testing my husband and I would see a report on our embyros each characterized into two neat little columns — normal or abnormal.

At least some of that was correct.

I’ll say before I move on that I am not usually one of those infertiles that spends hours in the middle of the night on message boards comparing IVF stories with other women. I’m not passing judgement on the women that do that, mind you. For me, and my mental health, I have to sometimes turn down the fire hose of infertility information. I very much pick and choose when I consult Dr. Google or the message boards because when I know too much, my anxiety hits dangerous (read: 1947-era padded room, straight jacket) levels. Too much research can cripple me. I try to be well-informed about my treatment options and protocols, and I think I am, but I know my limits. I’m good without knowing that Jane Doe in Oregon also had a Lupron-down protocol resulting in 20 eggs at her retrieval and then experienced this freak thing… yeah. I, personally, don’t need to know. I advocate for myself but I also trust my doctor and the greatest nurse on the planet.

So while I knew I’d move forward with PGS almost regardless of my research, I still wanted to learn more about it. If anything, I wanted to confirm that I was making the right call about doing it, and gain confidence that we’d have some clear answers after the tests were complete.

Where did I land? Well, I will say that PGS is (still) the absolute right step for us at this point (more on that in a bit). But, dayum, I got schooled.

First, all hail FertilityIQ. Their online course on PGS is the absolute best, most comprehensive resource on the subject I’ve found. If you’re considering this as part of your treatment plan, take 30 minutes to watch their helpful videos and read through their detailed written material. Deborah and Jake, the founders of the site, host the videos and I’d like to be friends with them. They’re clearly knowledgeable (fertility clinic vets so they totally get it), but they also include interviews with doctors on both sides of the aisle in this PGS debate. The course has easy to understand patient examples, visuals and just a ton of great information. Honestly, it’s not only worth your time, but in my opinion you owe it to yourself to understand the intricacies of such a complex fertility topic.

This post isn’t sponsored by the site, nor do I have any relationship to it, I am just a big fan. Also, I probably don’t need to mention this but I am NOT. A. DOCTOR. I am a fellow infertile sharing her experience. 

Remember when I said that I thought after PGS all of our created embryos (and Kristoff) would be put into two nice little black and white buckets? Nooope. Because mosaic embryos are a thing. As a woman lumped into the unexplained infertility category I’ll say they are a potentially confusing, frustrating thing. I don’t need more unexplained science, world! I need answers. The FertilityIQ videos and text were extremely helpful in explaining not only what mosaicism is, but that there are questions I need to ask my clinic about their policies on identifying these gray area embryos. (Aside: And because I now knew to ask this question I got an answer about my clinic’s policy! #winning)

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What this all comes down to is that I’m glad I did the research on PGS. While the idea of mosaic embryos does kinda make me want to cry in the corner, simply because it’s just more uncertainty when I’ve had my fill of that, I’m glad I’m armed with this information to better advocate for myself and my future blastocysts. I can ask the questions of my clinic, talk to a genetic counselor if I’m in a position where we only have mosaic embryos available, and then decide what’s right for us. If any of that happens.

Here’s why PGS is right for us at this moment in time: I’m 36. I’ve had two miscarriages, a chemical pregnancy and three failed embryo transfers (with a total of five embryos). Other than chronic endometritis, three years of infertility treatments and countless tests have not brought us any closer to a baby. This road is ending for us soon, with or without a biological child. I’m tired. We’ve reached our debt ceiling. PGS will allow us the best possible opportunity to have that baby. We will carry more debt with us because of it, but we’re going for broke this time (perhaps literally as well as figuratively). This is it.

If there’s one thing I feel really positive about heading into this last stim cycle, it’s the decision to have our embryos tested. And honestly, I really need that sliver of hope.

Infertility is really just a crap-ton of waiting

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I’m a few days from starting my period. While nothing tops the two-week wait (TWW) on the anxiety scale, the time waiting to start your next IVF cycle is also stressful. In early January my husband and I repeated our lab work, and I had my 8,000th mock transfer and saline ultrasound to ensure all systems were go to start my last stim cycle. Other than a high TSH (thyroid) level, I’m all set. I wasn’t that surprised that my thyroid check was elevated since I’d been off my hypothyroidism meds for about 10 weeks because it conflicted with the prescribed appetite suppressant I was on for weight loss.

[Quick update on the weight loss: Somehow I’ve managed to quell my emotional eating inner demons, and am down 29.5 pounds! I picked up good habits and flipped that elusive switch that allowed me to rethink how I approach food. Particularly sugar. Perhaps the only person more surprised with my progress than me is my husband who knew all too well how unlikely I was to follow-through with this. It certainly has been challenging, but it’s pretty nice to feel like I am crushing. it. in just this one aspect of my life. Having said that, I’m about to stim again with hormones aplenty, so we’ll see what I’m made of over the next few weeks.]

It feels like there’s nothing but waiting. It’s often infuriating. Particularly in those rare time frames when I actually feel physically and emotionally ready to go down the IVF rabbit hole again. Like, ya know, now.

The downtime between completing one cycle and starting another always varies wildly. In my case, it’s almost always been months when it comes to IVF. I did my first stim (and fresh transfer) in June 2016. In fertility terms, that’s probably 25 potentially good eggs ago. Who knows if it was one of those “wasted” eggs that was the golden one?

Then we did our first FET in November 2016. Bust. The second FET didn’t happen for another ten months. Then I got a little bit pregnant. While money was probably the most significant factor in that span of time, getting answers to why three perfectly normal-looking embryos in an otherwise healthy woman simply didn’t stick (spoiler alert: it was endometritis) was also on the list. Not to mention my emotional health.

Moving into this last cycle, we’re already several months removed from the chemical pregnancy, and we’ve decided to leave our last frozen embryo from our OG stim cycle in the freezer (we’ll test Kristoff with his future embryo sibs). Which, another aside: If Kristoff is the ONE embryo that turns out to be genetically normal after PGS I think my brain may actually explode.

While the Clomid made me insane and pack on the pounds, at least IUIs keep the pace moving. I knocked a bunch of those out in a couple of months.

So we’re into another year of this waiting. Year five. We’ve reached the five-year milestone in infertility even before we did in our marriage. How’s that irony. Just delightful.

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What if there’s nothing left

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2018. Will this be the year that we finally… no, don’t bother finishing that sentence. We all know how it goes, right?

We started with our fertility clinic in January of 2015 after trying for two years. 2018 will be the end of this road, no matter where it leads.

We’re putting together the financials for one more stim cycle, to hopefully begin shortly after the new year. I’ll pump myself full of hormones until my belly feels ready to pop, and then we’ll wait. Hold our collective breath to see if we have any normal embryos.

Last time I stimmed, my doctor retrieved 23 eggs. Those resulted in only six blastocysts. One of which remains frozen and waiting. I remember being excited to hear that we had six. I thought, well I’m certainly not going to have six kids, so we’re fiiiine. Naive. I was tested but still untested.

This time I will be nearly two years older. To my credit (since I take so little of it), my AMH is still good for 36. I have little doubt that stimming this time will be easy. Easy in the sense that my body will respond appropriately. But not easy at all.

Listen, I’m terrified that we won’t get any normal embryos after PGS testing. That’s what I just have to say. The five previously were not good, but we didn’t know that then. 3AB and her Frozen siblings, Anna, Elsa, Olaf and, then, Anakin. None of them found their home.

I liked the whimsy of having named my embryos. It brought me some levity to the science of it all. But I’m not sure I can name them this time. Really, I just want at least one to have the option of naming.

Just give me one and I’ll shut the hell up.

When your heart keeps breaking

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Going into my first IVF cycle I didn’t understand just how high my hopes would be. I thought, as long as we come out of this stim cycle with frozen embryos, I’m good. And we did.

But I’m not good. I got my period several days ago and have been stewing ever since. I went through the stages of grief. Spotting is normal during implantation and this is only a little more than that… Then my period would all but stop and I’d feel relieved and silly that I overreacted. Then, hours later, more red.

Little 3AB didn’t stick around and that sucks. It really just sucks. I’m angry that for what I’ve put my body through over the last several weeks I don’t have much to show for it. I’m still waiting. How am I still waiting?!

How has this thing that happens for a majority of the population — often by accident — not happened for me after three and a half years of time, money and effort? I’m angry. I’m sad. I don’t understand it. I can’t understand it. I can’t let it go.

I’ll focus on the positive — a future Frozen Embryo Transfer (FET) — later. I’ll dust myself off and gather the pieces… later. For now my heart is broken again. It’s my new normal and I hate it.

IVF: TWW

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Right now, there’s a blastocyst swimming around in my uterus looking for a cozy spot to park and grow. I picture it a little like Dory in Finding Nemo, actually, but I biologically know it doesn’t really swim. The embryo we transferred on Wednesday was a grade 3AB, which I’m told by the many, many trained professionals that have seen my anatomy in the last week, is great.

The transfer went smoothly and was not at all painful like my egg retrieval. Some discomfort and pressure with a very full bladder, but a cake-walk, relatively speaking. It took about 10 minutes from start to finish and was fascinating to watch on the ultrasound screen. On the grainy screen, my husband and I watched the entire process as my doctor put little 3AB in where he/she belongs.

Now, we wait…

I’m relieved to have the injections over, and certainly grateful for the end of the pain of my Dark Willow ovary. Every other time I’ve been in this TWW limbo has been me white-knuckling through the anxiety of the wait. And while I’m certainly eager to see if 3AB is successful, I feel mostly relief that I have my first IVF cycle behind me, regardless of the outcome. 3AB is in there now and I just have to keep it as safe as I can.

While 3AB swims around looking for that warm and inviting spot, Anna, Elsa, Olaf, Kristoff and Anakin are now on ice. We were able to freeze five embryos. Two more of good quality (two more 3ABs), and three more of good/fair that appeared likely to survive the freezing and thawing process. When I texted my sister-in-law  about this process, she sent me a gif from Frozen, and the embryo “names” were born. Its become an amusing inside joke, and one I’m sure I’ll repeat pretty regularly over the next few decades. I’ve denoted Anna and Elsa as the two superior embryos, only because they were frozen together, but I’m personally pulling for Olaf to make it to my uterus next time. If only because it will be endlessly funny to call him Olaf in utero.

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