Monday, December 28, 2020

Another BFN

We didn't get a Christmas miracle.  Instead, we got another BFN.  In the world of virtual infertility support, BFN stands for big fat negative.  

I went to Labcorp on that following Monday for my blood pregnancy test, and that test was ordered STAT so that I could have results by the end of the day.  But the end of the day came and my nurse said they still hadn't received the report.  We knew the answer, though, because I took another home pregnancy test and it was negative.  

I got the call from my nurse the next day after she finally got the report and the negative was confirmed.  My HCG level dropped to <1.  I think we had already processed the emotions of sadness and anger, so at this point we felt pretty numb to it.  I mean, this is nothing new to us, we've been here before.  

We have two embryos left.  We want to find answers.  We want to know why I've miscarried and why I've lost 6 embryos that could have been our babies.  We want to get this figured out before going through another transfer.

So, we've started doing our own research and we've made an appointment with a Reproductive Immunologist (RI) for a consult.  We've always thought that my body was fighting off pregnancies and rejecting the embryos, ever since I got super sick with our first pregnancy (miscarriage), second pregnancy (Chase), and at least the first IVF transfer.  We've also wondered if our blood types are incompatible for conception.  We have a lot of thoughts on what might be going wrong, and it's frustrating that no doctor has been looking for it.  Of course, we've only been working with Reproductive Endocrinologists (RE) and they don't typically consider the immune system nor do they typically play nice with an RI.  So, we are taking this into our own hands and doing our own research and advocating for ourselves.  We don't know what the outcome will be, but our consult with an RI is on January 12th as is our regroup with our RE.

In the meantime, I've joined two Facebook support groups specifically for women/couples who have failed IVF multiple times and are seeking reproductive immunology care/treatment, and I'm learning a lot.  I'm also reading this book and have become obsessed with learning everything I possibly can:

  


Chase knows that we are trying and that the doctors are trying to help us, but he also knows that it isn't working out.  He will pat my tummy or his tummy and say that he is sad, and it breaks my heart.  As juvenile as it sounds, it's just not fair.  It's not fair that we can't have the family that we've dreamed of.  It's not fair that Chase can't have a sibling no matter how hard we try.  It's not fair that my body won't do what a woman's body is supposed to do.  And it's not fair that we have to have such a huge financial burden to try building our family (because health insurance doesn't pay for any of it).

Hoping that the RI can give us some answers and help us.  It will take a lot more time, and we are all getting older, but I'm so hopeful that the wait will be worth it.

We are also coming to realize that we may need to seriously seek out a surrogate in case we can't be helped.  I don't want to go through an agency or someone I don't know (nor can we afford it after paying for 4 cycles of IVF).  If we have to go that route, I'm hoping to find someone that we know and trust, that has had no issues with conception, and that would allow us to be a large part of the pregnancy.  But fingers crossed that this is not the path we have to go down.  Hopefully we will find out soon.

Friday, December 18, 2020

Transfer Day to Beta Day

Since our last update, I continued to prep for Transfer Day with lots of pills, patches, and shots every day.  I also had an intralipid infusion to help my immune system.  And, of course, Andrew did everything he could to reduce my stress levels to keep my heart rate and blood flow as good as possible.

Finally, Monday, December 7th came - Transfer Day!  


That morning, after waking up at 5:30am to take one of my shots, I opened Facebook and a memory popped up that exactly 5 years ago on Dec. 7th, I had an embryo transfer at our second clinic, CCRM.  What a surprise.  I had no idea that I was doing the exact same thing on Dec. 7th only 5 years earlier.


Interestingly, this nurse, Cindy, (pictured with me) from CCRM is now at our current clinic, Conceptions.  While she's not my current nurse, I was able to send her a message with this picture, and received this sweet message in return (through my current nurse):

OMGOSH! This made my day! She's the absolute sweetest and I know it will go well!!! If you speak with her please send her my love!!! THANK YOU!!!!!!!!

Transfer Day went perfectly!  I took a Valium to get relaxed, went through acupuncture twice, and had a smooth transfer.  Our embryo thawed beautifully and starting hatching - a great sign!   


And I wore Wonder Woman socks that my friend, Leslie, gave me for my birthday. 💪


Once home, I slept and rested a lot.  I was even showered with floral arrangements and food from my awesome family and friends.  


But I was feeling antsy and I knew that I couldn't wait 11 days until the blood pregnancy test to find out what was happening.  Sooo, I convinced Andrew to buy a pregnancy test and support my desire to take one.   On day 3 (3dp5dt = 3 days post 5 day transfer), I took a test.  It was so early, and neither of us expected a positive, but I still wanted to test.  


You guys!!!!  😍😍😍  This is the first time we've seen a positive pregnancy since Chase's, 8 years ago.  Andrew looked at the test first, and I'll never forget his face - surprised look with tears in his eyes - it was the most amazing thing! 


I had to go back to the clinic a day or two later for blood work to make sure that my hormone levels were appropriate.  And they were - everything was looking up.

And then.....I suddenly realized that I was on a different medication that I had not taken in my previous three transfers, and I wondered...could this medication give me a false positive?  Of course, I checked with Dr. Google, and as it turned out, yes, a false positive was possible.  Dang...ok.  Test again.


On day 6, we got another positive!  I was still feeling high, even though it may be false.  But I had so many symptoms - elevated heart rate, nausea, fatigue, mild cramping - so I was hopeful.  Test again.


Day 8.  Not pregnant??  Our hearts dropped.  My world felt crushed.  I couldn't believe it.  I was NOT expecting this.  It was an extremely rough day.  I remember telling Andrew, through tears, that I feel so stupid for repeatedly putting us through these IVF cycles.  Cycle, fail, cycle, fail, cycle, fail, cycle, fail.  Why do we continue to put ourselves through this? 


Day 10.  My sadness turned to anger.  The excuse for my previous failures was always because of my bad eggs.  But now we are using healthy donor eggs, and that excuse can't be used anymore.  So what's the deal?  Andrew and I really feel like there is a missing piece, something that no doctor has been able to find, something that no doctor has even looked for, but something wrong with my body.  

Holding on to very little hope, I went in for the blood pregnancy test today, December 18th.  About 6.5 hours went by and we got the call from a nurse.  Hormone levels looked awesome.  For the beta HCG, they consider anything over 5 to be positive, and on day 11, they would expect to see the level around 50-100.  My level... 2.4.  Not high enough to be positive, but not low enough to stop all meds and call it quits.  We are not expecting any miracles here, but I have to get another blood pregnancy test on Monday, December 21st to confirm that it's not positive.  As if the wait isn't long enough, we have to wait even more.  

I soooo sooo sooo wanted to share amazing news today.  But it looks like I've now failed 4 transfers and have lost 6 embryos.  Sigh... Until Monday...



Monday, November 23, 2020

Preparing for Transfer!

I can't believe how much time has passed since our last update.  Life has been busy, but I guess there's some good in that since the time has passed quickly without much thought.  But so many of our amazing friends and family have reached out to ask how things are going, so I knew it was time to write another update.

In the last update, we shared that our egg donor had 10 mature eggs retrieved and 7 of those fertilized with a possible 8th.  At that point, we were waiting on our Day 5 Blast Report.  Well, day 5 came around and we found out that 3 of our embryos made it to the blast stage with 1 more possible.  Those 3 embryos were all graded 5BB (good!), biopsied for chromosomal testing, and frozen.  The embryology team continued to follow that 1 other embryo through day 6 and day 7, but it never made it to blast.  

On one hand, I felt great that we had 3 embryos - in all of our previous cycles we never had more than 2, so this felt good.  But on the other hand, with donor eggs, I was really disappointed that we only ended up with 3 blasts.

Based on the donor's age, egg quality, etc., the embryologist said they would expect 65% of those 3 embryos to be euploid, or chromosomally normal.  At that point, I felt disheartened.  It sounded to me like we could only have 2 embryos come back euploid.  The results took longer than expected - 10-14 days is the usual, but we finally got the call on a Sunday, after 3 weeks of waiting.  All 3 embryos came back NORMAL!  We were all smiles and felt like celebrating!  With 3 chromosomally normal embryos, we have at least 3 chances of getting a transfer right, whew!

Next step was uterine testing and labwork for me.  I had to have a full bladder for that uterine testing, so here I am, sitting in my car before the appointment, chugging 32 ounces of water.  Fun times! 


Most everything came back normal.  Just a little off on the blood flow to the uterus, but my doctor is trying to correct that with medication.  Speaking of medication, here's a glimpse at the meds I'm currently on.  Pills, shots, patches, you name it.


I even have an old lady pill box with AM and PM side that I have to carry around with me! 😄




All of this is helping my body prep for the upcoming transfer of the first embryo.  Because I have a uterine window, or an area near my c-section scar that is thin and didn't close up properly, my OB is limiting the transfer to only one embryo.  In addition, I'll have to deliver 4 weeks early.  This is all to prevent a limb from escaping the uterus!  😳

December 7th is our transfer date!  Two weeks from today.  I have three more doctor appointments between now and then to ensure that my uterus and hormones are cooperating and will be appropriate for the transfer.  I'll also be going through an intralipid infusion to help strengthen my immune system and prevent it from trying to fight off the embryo, which I truly believe my body has done every other time.  The intralipids are thought to suppress natural killer cells that could be involved in repeated miscarriage (I've had one) and/or repeated implantation failure (I've had 5 embryos failed to implant over three transfers).

Now, we'd love to hear from you all!  Since the embryos went through chromosomal testing, we know the gender of all three.  Are we planning to transfer a boy or a girl?  If you ask me, I want to be a boy mom all the way!  I can't imagine it any other way.  Plus, I've hoarded all of Chase's stuff since he was an infant, so we have all of the boy stuff still. 😆  If you ask Andrew, he wants a daddy's girl and to experience all of the father/daughter events.  We are in total disagreement 😂  And if you ask Chase, I think his answer differs by the day.  So, what do you think - boy or girl?!

Saturday, September 26, 2020

Annnnnnd, we're back!!

It's been 2.5 years since our last update.  A lot has happened in that time with my reproductive health and our journey, and I swear, you can't make this stuff up. 😆

In those past 2.5 years, we continued to explore ways to grow our family.  We started the process to foster and foster-to-adopt....twice.  But each time, as we got further into the process, we realized it was just not the right time for us to complete the process and become foster parents.  

In early 2019, we started looking into a donor egg cycle again (the last time was in early 2017).  We started comparing fertility clinics - cost of cycle, success rates, location and feasibility - and we actually landed on consulting with the very first fertility clinic that we worked with years ago.  We were very hesitant, because there was so much that we were unhappy with at that clinic, but we felt good about the cost of the cycle, the clinic's success rates, and how convenient the clinic is located to us (and really, that fertility specialist was the first to ever tell us that we should use donor eggs).  We set up a consult and got started with the process as soon as we could.  But, right away, we were reminded of why we became so unhappy with that clinic years ago.  Disorganization and lack of communication topped the chart.  

In the middle of this, I started having a lot of pelvic pain, which is normal with endometriosis, but it was feeling more severe this time.  I was often doubled over in pain and had trouble moving from one position to another, like laying down to sitting up or sitting to standing up.  At that point, our fertility specialist started the work-up and testing to see if I am even able to carry another pregnancy (still), and she found that I had large endometriomas on both of my ovaries, so severe that medical intervention was not an option.  The recommendation?  To have both of my ovaries and tubes surgically removed.  The first hiccup in this donor egg cycle.  This surgery, supposedly, would improve my quality of life (no more pain) and still give us the option to go through a donor egg cycle (since my uterus looked ok for pregnancy).  However, this would put me in early menopause.

After numerous discussions and consults, I opted to go through the surgery to have both ovaries and tubes removed.  Because of the severity of my endometriosis, a gynecologic oncologist was called on to perform the surgery.  I went through that surgery in August of 2019.  Immediately, due to our gut instinct and the recommendation of the gynecologic oncologist, we called back our third fertility clinic, Conceptions, and started moving forward with the donor egg cycle there.

It was taking some time, but I finally came to terms with being in early menopause.  Except that I wasn't...  

In November, I started a period.  What??  And that started some labwork, ultrasounds, and testing that found that I still had ovarian tissue somewhere in my body that was causing me to have hormone levels consistent with a young menstruating female.  Hiccup #2 in this donor egg cycle.

My fertility specialist, the gynecologic oncologist, and my ob-gyn all discussed this and decided that the hormones could be controlled with medication during a donor egg cycle, and that the remaining ovarian tissue could be removed during a c-section if there is a successful pregnancy.  So, onward!

At Conceptions, I then started the work-up to make sure that my uterus is capable of carrying a pregnancy.  At ultrasound #1, the sonographer took a picture and labeled it "right ovary."  Oh boy...  At ultrasound #2, a different sonographer took a picture and labeled it "left ovary."  Part of me wanted to chuckle because my reproductive history is such a joke.  But part of me felt angry that the surgery I recently went through wasn't 100% successful.  My fertility specialist, however, assured me that this is not a problem for pregnancy with a donor egg.

Ok, so we continued to move forward.  The next step was to choose an egg donor!  Because we are older and cannot go through too many more pregnancies at my age, we needed to choose a donor that is eligible for a "split cycle."  This means that we and another couple who is seeking eggs would split the eggs from one donor.  When there are two couples (or recipients) who are sharing the eggs, one is termed primary and one secondary.  

There's some advantage to being primary.  If there are an odd number of eggs collected, the primary recipient gets the extra egg after an even split between the recipients.  Or, if the egg donor is not producing enough eggs in the cycle, the doctor may decide to offer the entire batch of eggs to the primary recipient rather than splitting the eggs between the two recipients.  

To become the primary recipient, you must be the first recipient to "match with" or choose a specific donor.  Once you match with a donor, you then have to wait until another recipient chooses the same donor to move forward.  This could take a week, three months, a year...it's hard to say.  But, if a recipient chooses a donor who has already matched with another recipient, the primary, then that recipient becomes secondary, and things can move along quickly from there.

Andrew and I spent some time going through the profiles of the available egg donors.  We compared their age, physical characteristics, medical history, family medical history, any prior pregnancies, and any prior egg donations.  We finally landed on a donor.  Her physical characteristics were close to mine, she was younger than me, had her own successful pregnancy, had twins in her family, had successfully donated eggs previously, had a good family medical history....it was all lining up.  We matched with her and found out that we were the secondary recipient.  Ok, no problem, we thought.  And a little while later, our nurse called to tell us that the donor made a decision to move to Europe and could no longer donate eggs.  The third hiccup in this donor egg cycle.

Back to scratch looking for an egg donor.  And then, COVID hits and fertility treatments are stopped.  We couldn't do anything at this point but wait until treatments were able to be resumed.  Hiccup #4.

Three months later, we were ready to roll again.  However, we had to sign documents noting that if any party (us, the other recipient/couple, or the donor) tests positive with COVID during the donor egg cycle, the entire cycle could be cancelled.  We decided to take our chances, and we started comparing profiles again.  We finally landed on another egg donor who actually had Chase's physical characteristics (blonde hair, blue eyes), and everything else looked great and lined up with what we were looking for.  Her AMH (egg quality) and resting follicle count looked AMAZING.  She had never donated eggs before, but the doctors at my fertility clinic had no doubt that she would produce a fantastic number of high-quality eggs.  Surprisingly, the other couple that we had matched with on the first donor wanted to match with this donor, too.  On the positive side, it helped things move along quickly.  

But on the negative side, we became secondary with this donor.  Even though we matched with this donor first, the fertility clinic gave the other couple primary since they were primary with the first donor/match.  We were a little bummed, but felt ok given her AMH and resting follicle count.  Our nurse even predicted that primary vs secondary would be a moot point given what they expected this donor to produce.

So, we moved forward.  The donor started stimulating to create follicles that would hopefully hold mature eggs.  But as the updates from the clinic started rolling in, we were becoming less and less excited and more and more nervous.  The donor wasn't producing.  At the final update, she had 8-9 follicles present, when we were all expecting around 40.  The doctors and Medical Board at the clinic had never seen anything like this before (in fact, our nurse said this whole situation took the breath out from everyone), and had to make a decision - either cancel the cycle (meaning neither recipient gets eggs and both are out the money that was spent on the donor's medications) or offer the entire cycle to the primary recipient (instead of splitting between them and us).  They choose the latter, and the primary accepted.  Therefore, we got zero eggs.  Hiccup #5.

For the third time, we had to choose another egg donor.  The available donors change on a daily basis, so once again, we had to start from scratch.  But we found another donor that we became excited about.  She has a positive egg donation history and some physical characteristics like me.  We became the primary recipient (woohoo!) and then just had to wait for a secondary.  Luckily it was only a couple of weeks that we had to wait, and things have been moving quickly ever since.

Yesterday, 9/25 she actually donated her eggs.  After they were split, we ended up with 10 eggs, which is awesome!  With Andrew's sperm, 7 of those eggs have fertilized, with a possible 8th (they will keep an eye on that one).  So far, everything is looking great!  We will get another update from the embryologist on Wednesday 9/30 with how many of the fertilized eggs made it to the blastocyst phase (aka blast) -- that will be day 5; ideally, you want the embryos to grow to the blastocyst phase by day 5.  But we will also get an update on day 6 with any remaining embryos that might make it to blast by day 6.  

The next step will be to take a DNA sample of any blasts and test them for chromosomal abnormalities.  That usually takes 2 weeks.  By mid-October, we should know how many viable embryos we have to transfer.

Here's to hoping the next few weeks go quickly!