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.

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...

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?!

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!

A Year in Review

This morning, my husband shared this beautiful video with me.  It brought tears to my eyes--it's all so true!  But then I realized, "damn it, I want more babies."  And it made me think of where we are in the journey, and I looked back at this blog and found that I haven't posted an update since December 2016.

After that third failed cycle of IVF, we made an appointment with a new (third!) fertility clinic, Conceptions.  We had that appointment in January 2017, and we consulted with the doctor about a donor egg cycle.  We started going through photos and profiles of potential egg donors, and we were feeling like this was the path we wanted to go down, despite the big expense, once again.

But, then, something else happened in that month.  We found a house that we wanted to buy.  It was a quick sale, and before we knew it, we were using our savings for a down payment on our very first home purchase.  An exciting time, but we knew that, financially, we had to take a break from fertility treatments.

As the weeks and months went by, we realized that we were enjoying life again without the cost and limitations that come with IVF.  And what a time we had!  We became Godparents to our friends' daughter.  We traveled for weddings.  We visited family (the Hodels) in North Carolina, after we realized the last time we had been there was when I was pregnant with Chase, 4+ years before.  I got a promotion at work.  I co-chaired RESOLVE'S Walk of Hope.  Andrew and I each took a trip with our friends.

And I got this tattoo.  The emerald green circle represents Chase:  #miraclebaby #rainbowbaby #goldenegg #emeraldbirthstone  The non-colored circles represent all the ones that could have been, but were lost due to miscarriage or failure to implant.

But, we did some things around family building as well. First, we attended an adoption information night with a local adoption agency.  We learned that the average wait time to be matched with birth parents to adopt an infant is at least two years.  And the cost isn't that much different from a donor cycle.  I think that information night left us with more questions and concerns, and we decided not to move forward with it, for the time being.

Later, Andrew came across this article in the Belleville News Democrat.  He showed me the article, we read it, we discussed it, and we decided that the best way we could offer to help would be to approach them about an open adoption.  We knew it was a long shot, and we thought "maybe that would be too forward," but we couldn't let it pass us by.  So we contacted the pastor of the church that was working with the couple and asked if they had mentioned or considered adoption.  The pastor said they had not, but that we could put some information and pictures together, and he would present it to the couple.  We wrote a letter to the couple about our family, our inability to conceive, the idea of open adoption, how we would provide a safe and loving home, etc., and we included some photos of our family engaging in our favorite activities.  We sent it all to the pastor.  Days and then weeks went by, and we didn't hear back.  At that point we knew, it was just too forward.  But we reached out to the pastor to follow up.  We eventually got a response from him, with the devastating news that the father was back in jail and the mother miscarried the twins.

And finally, we started looking into fostering.  We aren't that deep into the process, so we don't have enough information yet to know if it's right for us.

I don't know where we will go from here, but I do know that we want more kids and we want Chase to have a sibling.  And it's a shame that people with infertility have to spend thousands of dollars to even try.  We are a $100,000 in, and in our mid to late 30s.  How much more can we spend?  How much longer can we try?

I recently opened a shop on Etsy with the hopes of earning extra income for this journey we've been on.  We'll see how that goes, but I think I'll turn 50 before I make/sell any significant amount, LOL.  Andrew and I named it WalkersWish, because it's our wish to keep growing our family.

I don't know what's going to happen next, but I'm keeping my fingers crossed that an opportunity comes our way, and soon.

Heartbreak #3

It's been almost one month since we got the news that our third IVF cycle failed (transfer 11/9/16, beta 11/18/16).  There were few emotions tied to this cycle, but the emotions that were present have pretty much subsided with time.

We lost these two embryos, these two potential precious babies.  We've now lost a total of five embryos.  From day one, we were told that my egg quality is poor.  After three failed cycles, we are now ready to move on.  We have accepted the fact that I will never have another biological child.  However, I do feel happy that I won't have to put my body through the trauma of IVF stimulation and egg retrieval again.

Although we are ready to move on, we still aren't ready to give up.  We've decided to seek a third opinion at a third clinic.  We started at Rocky Mountain Fertility Center (RMFC), then transferred to the world renowned Colorado Center for Reproductive Medicine (CCRM), and now we are giving Conceptions a shot. We have a consult scheduled on January 5th.  We don't expect to hear that they can do great things and get us pregnant with my eggs.  But we do hope to find that our new doctor will be supportive of our decision to move forward with donor eggs and test for immunologic disorders.  Donor eggs were recommended after our first failed cycle at RMFC, but weren't recommended at CCRM when we got a second opinion.  While we were initially happy that CCRM was confident that we could use my eggs, I'm now rather angry that we wasted so much time and money.

So, our next steps are to go to the consult at Conceptions on January 5th and to search for an egg donor.  In the meantime, I'm enjoying chocolate, gluten, soy, high-histamine foods, and wine :)

Hello, again...

Well, we can certainly tell this is our third IVF attempt.  I haven't been blogging as much this time around.  In fact, I haven't been thinking about it as much at all.  Andrew and I both feel fairly numb to the experience at this point.  We are only a few days away from our third embryo transfer, and we don't have many emotions towards it.

But, we are doing what needs to be done.

A few weeks ago I had an ultrasound and doppler.  At that time, they found cysts on both ovaries and low uterine blood flow.  I have been going to electroacupuncture twice a week for four weeks now.  I just had my follow up ultrasound and doppler.  The cysts are still present, but don't seem to be a problem since they are stable.  My uterine blood flow has significantly improved, so we are happy with the effort spent on electroacupuncture.

We also consulted with our fertility specialist about a reaction that we realized my body has every time I have been pregnant (twice) or have had an embryo transfer (twice).  Each time,  a few days after the positive pregnancy test or a few days after the embryo transfer, I have painful stomach cramps that turn into 24-36 hours of vomiting and diarrhea (I know, yuck).  So for this transfer, our doctor has put me on the antihistamine protocol.  I'll be taking a cocktail of antihistamine medications to help prevent this reaction, which is another thing that could be destroying the embryos each time (except the indestructible Chase embryo).

I have also been working with a Certified Nutrition Therapy Practitioner to ensure that I am getting adequate nutrients while avoiding harmful foods.  Until now, I didn't realize that some of my favorite foods are high histamine foods, such as strawberries, cashews, and chocolate.  I am doing my best to avoid these foods while eating more low histamine and anti-inflammatory foods.

We are hoping that all of these efforts will give us a successful outcome. So far, things are looking up.  Along with improved uterine blood flow, my recent ultrasound also found good perfusion, adequate uterine lining at 8.6 (they like to see it in between 8 and 10), and a triple stripe pattern of the uterine lining (a must!).

Our transfer is scheduled for Wednesday November 9th.  At this point, we have two "day 6 grade 4BB" embryos.  As long as they both survive the thawing process, we will move forward with the transfer on that day.

A week in review...

Wow, the week has flown by, and I just realized that we haven't posted any updates since before the egg retrieval!

On Saturday, 4/23 we had our third and final egg retrieval.  While we retrieved fewer eggs than expected, it was still the most we've ever gotten during a retrieval--11 eggs.  The next day, the embryologist called us with the fertilization report.  Nine of the 11 eggs were mature, but only five fertilized.  They tried to mature the other two eggs in the lab, but it was unsuccessful.

We were happy to have five fertilized eggs.  On day three, the embryologist called again with an update.  All five embryos were continuing to grow!  They were all within the normal range of cells for day three.  They also look for fragmentation of the embryos.  Two of ours had little to no fragmentation, and three had no fragmentation.  The embryologist told me that this indicates good quality embryos.  I was all smiles!

Today is officially day six.  The embryologist called us this morning with the blast report.  Three of our embryos stopped growing in between day three and day six, and two embryos made it to the blastocyst phase.  Both embryos have the exact same grade--day 6, 4BB.  For reference, a day 5, 5AA is best.  So, our embryos, once again, took longer to get to the blast phase.

I'm really not sure how to feel right now.  On one hand, I'm happy to have two embryos to work with.  On the other hand, I'm disappointed in the grade of both, and it's really hard to get excited for a transfer.  But, these roller coaster emotions are all part of the infertility life, and we are used to it by now.

We will likely have our transfer within the next two months.  But, first, we are going to regroup with our doctor to find out if we should transfer one or two embryos and to make sure that my body is truly ready.

It's trigger day!

I have been stimming for 13 long days now, waiting for follicles to grow.  My belly is bruised, swollen, and sore from all of the daily injections.  But, it is coming to end, and I am ready for my third and final egg retrieval.

At our first follicle check this round, I had very few follicles, and I starting doubting our decision to go for another round with my eggs.  But over the last 13 days, the follicles have continued to grow, and we now have a total of 15, which is a great number for me!  It is estimated that 13 of those follicles will have mature eggs (based on their growth).  This is our best round so far.  I'm trying to stay positive without getting my hopes up, because it all comes down to the quality of those eggs.  I hope that the acai, vitamin cocktail, and changes I've made all come together to help create good quality eggs that fertilize normally and make it to blastocyst.

The egg retrieval is on Saturday.  After 1-2 days, we will get our fertilization report -- how many eggs are mature and how many fertilize.  Another 4-5 days later will find out how many embryos make it to blastocyst.  From there, any embryos we have will be frozen while my body detoxifies from these horrible fertility drugs.  We haven't chosen a transfer date yet, but I imagine it will be approximately 2 months after the retrieval.

Round 3, here we go!

When we first decided to try IVF, over a year ago, I never imagined that there would be a round three.  I was naive and thought we would be successful after one cycle.  But here we are, calendar in hand, ready to face our third and final (yes, I said final) cycle using my own eggs.

I've spent the last two months trying to improve my egg quality.  With each IVF cycle, I've become more and more careful about what foods and beverages I put into my body.  I'm a generally healthy person, but I've had to change my dietary eating habits to match those that are associated with fertility treatments.

I've also been taking OvaHealth (acai--three times per day) and a female vitamin cocktail during the last two months in hopes of improving my egg quality.  The vitamin cocktail includes some antioxidants such as vitamins C and E and melatonin.  I am also taking a prescription prenatal vitamin, which contains adequate folic acid in a form that is easy to absorb.  DHA, Myo-Inositol, and CoQ10 are also on my daily list.  If a 34 year old woman carrying a large pill box around doesn't scream sexy, I don't know what does...

This cycle, I've not only been concerned about what I put in my body, but also what I put on my body.  I've been focusing on avoiding phthalates, parabens, and BPA, as all three have an association with infertility or poor egg quality (I've been doing my homework!).  I've changed my shampoo, conditioner, body wash, body lotion, deodorant, sunblock, and toothpaste.  I now look for these items without phthalates and parabens, and I look for them in BPA-free containers.  I've also changed our laundry detergent, fabric softener, dish soap, and dish washing detergent.  Even if this doesn't help my egg quality, I still feel good about the changes (regardless of the increased cost) as I am using more organic, vegan, and cruelty-free products.

We will start the stims (those fun injections) for the last time in about three weeks.  We are tentatively scheduled for our last egg retrieval on April 21st.  We will soon find out if all of the changes I've made are improving my egg quality.

Regroup update

It's been three weeks since our regroup appointment with our doctor.  Andrew and I have had time to discuss our options and wishes, and we can now provide an update.

Upon entering the consult room, Dr. Schoolcraft said, "this must be like deja vu for you two."  Well, yes, in a way it certainly was.  This was our second IVF fail regroup.  Except this time was easier since we weren't as naive as the first time.

 When we failed at the first clinic, Dr. Schoolcraft (our current specialist) thought that the lab might have been low-quality, prohibiting some of the embryos from developing, and that the two embryos we did have were destroyed after transfer by my hydrosalpinx.  Dr. Schoolcraft fixed the hydrosalpinx and tested me for any other problem that might prevent me from carrying--all is well!

So, why did we fail?  It all comes down to the quality of my eggs.  Andrew's sperm were tested for a number of things, and as always, they passed with flying colors.  Before starting this cycle, we knew that I have fewer eggs than normal and the quality of those eggs is poor (as compared to the average 34 year old female).  But, when 10 eggs were retrieved, we were hopeful.  The lab at CCRM is world-renowned, and Dr. Schoolcraft said they threw in every trick they know to fertilize my eggs and grow the embryos to blastocyst.  Seven of our ten eggs fertilized, but only one made it to blast.

Each day after fertilization, the cells in the embryo divide.  On day one, there are two cells.  On day two, there are four cells.  On day three, there are eight cells.  Well, that's how it goes if everything lines up perfectly.  On day three, we had zero eight cell embryos, including the one embryo that made it to blast.  On day three, some of the embryos were four cells, some were nine and ten cells.  It seems like the nine and ten cell embryos would be great--they are developing faster than they should be!  Not the case.  It just means that one or more cells in the embryo are not dividing appropriately, indicating that something is wrong.

So, the one embryo that we had started out poorly, it didn't divide correctly, and it took an extra day to make it to blast (it should only take five days; ours took six).  Yes, it was found to be chromosomally normal (after four long weeks of testing), but something wasn't right with it, presumably due to my egg, and it didn't implant.

At this point, Dr. Schoolcraft believes that I can still carry, but I might not be able to create a viable embryo (based on my history and test results).  Although, he pointed out that three years ago I "ovulated a golden egg," which gave us Chase, and it's possible that it could happen again.  So, we asked what our options are, and we were given two:

1) try another cycle with a different aggressive protocol (will likely yield the same results), or
2) try a cycle with donor eggs (with a 80% chance of success).

Believe it or not, but we've decided to go with option one.  We are not ready to give up, and we want to make sure that we try everything we possibly can before it's time to throw in the towel (will it ever be time?!  not likely.).

Here's the plan:  I've started taking a female vitamin cocktail that is loaded with antioxidants, and I've started taking CCRM's OvaHealth, which is acai straight from the Amazon (not the online retail store, lol).  This acai is a much more potent antioxidant than over-the-counter acai.  I will be taking the vitamin cocktail and the acai for 12 weeks, and our hope is that the antioxidants will repair any damage that my eggs have endured.  In fact, CCRM is currently conducting research with the acai, and they have seen an improvement in the number of eggs retrieved and the number of embryos making it to blast with the use of acai for 12 weeks prior to stims and retrieval.

The vitamin cocktail and acai buys us 12 weeks to come up with the large payment for a third IVF (yikes!).  We did not receive a grant, so we are hoping to secure another loan.  If that goes well, we will be set for our third cycle.  We hope the saying is true--third time's a charm!

The Results--Infertility Wins Again

The long wait is finally over.  This second cycle of IVF lasted nearly six months.  When we first started, the end seemed almost impossible to reach.  But, we are now nine days post frozen embryo transfer (FET) with results from the blood pregnancy test.

Before the transfer, we discussed whether or not we would use home pregnancy tests (HPT).  We were torn.  We knew I could get a false negative, which would cause stress.  Or I could get a positive without knowing that the HCG level is really too low or not doubling properly for a viable pregnancy.  But, as I scrolled through my online peer support group, I saw so many women sharing their positive HPTs (taken before their blood pregnancy test), and I knew that I wanted that too.  I started testing on day four, and kept testing every day until my blood test (today 12/16).  The results?

Negative.  Every single day.  It definitely caused a lot of stress and sadness for me.  I knew I should stop, but I became addicted, hoping to see a positive each time.

"Maybe it's a late implanter" is what many of my peers (from the support group) said.  But, I knew from that first test that it would not be a good outcome.  And today, we experienced what I feared--my HCG is negative, and we failed again.

How could this be??  We've been through so much in this journey.  I've been through multiple surgeries, I've transformed my diet (no more caffeine including chocolate--my favorite!, gluten-free, no alcohol, etc.), I've tried acupuncture, I've been poked hundreds of times between the injections and the blood work, and we've spent over $60,000 in the process.  I'm now being treated by a renowned physician at one of the nation's leading fertility clinics.  And we still failed.

We don't know what went wrong, especially since the embryo was chromosomally normal.  It could be the endometriosis.  Once the damage is done, there is no turning back.  The disease is not curable, the damage is not fixable.  We have a regroup scheduled with our doctor on January 5th.  So, at this time, we are taking a break and we will enjoy the holiday with our family and friends.

When I look back over this entire blog, I am reminded that we spent an entire year (all of 2015) in IVF.  The year and a half before that was just us doing what we could, trying to conceive naturally.  Two and a half years of the nightmare that is infertility.  We aren't done fighting, but we don't know what our next step will be.

Transfer Day 12/7/15

Monday, December 7th was the Transfer Day for our one surviving embryo--day 6, grade 5BB.  We were excited for this day, but we are both still nervous for the outcome.

Before heading up to the OR, we met with our nurse, who has been with us the entire journey at CCRM.  Since day one she has calmed us with her humor.  It continued as she told us "go get knocked up, you guys" before sending us up the elevator.

After blood work and my first round of acupuncture, the embryologist came to speak with us about our embryo.  We knew that there was a less than 5% chance that the embryo would not survive the thawing process.  But, the embryologist assured us that the embryo thawed nicely and was looking beautiful as it was starting to expand.  In the picture above you can see that it was already hatching, ready for implantation.

Here, I had just finished my first round of acupuncture (and a Valium!), and I was feeling ultra relaxed.

As I was being prepped by my doctor for the transfer, the embryologist was loading our embryo into a catheter.

The transfer itself was rather quick, but Andrew was able to video it on the monitor.  If you zoom in, you can actually see the embryo placed in my uterus.  Click here if you would like to view it.

I couldn't help but smile afterwards :)

It was simply amazing to watch the little ray of light enter me. 

It's crazy to think that we could already know the gender of our embryo.  It was determined during the chromosomal testing.  However, we have opted to wait until the first ultrasound to find out.  Chase, our 2-year-old, has requested a sister for months now.  He has even asked for two sisters, LOL!   What's amusing is that he said he wants to name his baby sister Frosty.  He has no idea that our little embaby WAS frosty (frozen) for two months. 

We now have the long 9 day wait until our blood pregnancy test.  It is currently scheduled for December 16th.  We will hopefully receive same day results.  We are nervous, but we hope to have exciting news to share with our loved ones.

One little embryo

Waiting three a half weeks for news that could potentially change your life feels more like three and half years.  This has definitely been the longest and most difficult wait for us thus far.  After our blast report, when we found out that we only had one embryo make it, we were told that the CCS (chromosomal) testing would take 2-3 weeks to determine if our embryo is normal.  Two weeks came, then three weeks, and still no news.  At three weeks and five days we finally got the call.

We knew that if we got a call saying our embryo is normal, we would be able to move forward with a transfer (yay!).  But, if we got a call saying that our only embryo is abnormal, then we would not have a transfer and we would be back to the beginning.

I was dreading this phone call.  While I wanted to be optimistic, I was certain that this one embryo would come back aneuploidy (abnormal).  My egg quality is shot, so it was really hard to stay positive about the whole thing.  While the wait for the phone call was long and agonizing, I was ok that the call didn't come each day, because I just didn't want to hear the words that the embryo is abnormal.

Turns out, I didn't have to hear those words.  My nurse called tonight after hours and shouted "It's normal!"  I cried happy tears to her over the phone, and I couldn't wait to tell Andrew.  We are both beyond happy, excited, joyful, you name it...  And now we are thrilled to share the news with all of you!  Our chromosomally normal, grade 5bb embryo will be transferred on December 7th.  We can't wait!

2nd blast report

One.  Today's call from the lab has left us with one embryo.  All of the other six embryos stopped developing, so we are left with the one grade 5bb embryo that we learned about yesterday.  We don't know why the embryos stopped developing, but we guess that it is due to my poor egg quality.  

While we are happy to have an embryo, we are devastated that this entire cycle, costing more than $30,000, has left us with only one.  Part of me hopes that this is a "Chase" embryo, meaning that it is strong and will make it through, but the other part of me doesn't want to hope for anything anymore because I am so tired of being let down.

Our one little embryo has been biopsied and will undergo genetic testing (did I mention that this test is costing us $7,000?!).  If the test reveals that the embryo is abnormal (non viable), we will walk away from the IVF cycle without a single embryo to transfer.  If it is normal, we will jump for joy and set a transfer date, likely in December, which is when my uterus will be ready.  We will be in suspense for the next 2-3 weeks until the test results come back.  

1st blast report

This update is a tough one to write.  I'm stuck in a whirlwind of emotions--sadness, anger, disappointment.  But at the same time, I just feel numb.

We just got the call from the lab with the first blastocyst report.  On day one, they were able to fertilize five eggs.  Today, three of those embryos are stuck at cleavage, approximately day three of cell division, when they should be closer to day six.  Chances are we will not be able to use those embryos.  A fourth embryo is at the early blastocyst phase, which is just slightly behind schedule.  The lab is going to grow this one out another day to see if it becomes a full blastocyst tomorrow.

The fifth embryo is currently our lucky one.  It is a full blastocyst, grade 5bb.  We are told this is good quality, but if you are really interested in learning about embryo grading, click here.
5 = hatching out of the shell
b = inner cell mass has several cells, loosely grouped
b = trophectoderm has few cells, forming a loose epithelium

On day two, the lab was able to fertilize two more embryos.  Today, one embryo is at cleavage, a bit behind.  The second embryo is a morula, which is at day four, when it should be closer to day five.   They will continue to grow these two embryos out another day in hopes of them becoming full blastocysts.

It's amazing how quickly things change in this journey.  One day we are beyond thrilled to have seven embryos.  The next day, we are saddened by the news that we might only have one embryo make it to blastocyst.  While we do have that one embryo, it still has to go through genetic testing.  If the testing reveals that the embryo is abnormal, it won't be transferred--not by our choice, rather by the policy of the center and lab.  We could walk out of this second round of IVF empty handed, just like the first.  And truthfully, if CCRM and the Fertility Lab can't make it happen, I don't think that anyone can.

The lab will call us again tomorrow with another update.  We hope to hear that several embryos finally made it to full blastocyst.  But, best case scenario, only two will.  

Fertilization report #2

From our first fertilization report, we were ecstatic to learn that five out of six mature eggs fertilized.  On Sunday we received the second fertilization report on the remaining four eggs.  Three of those eggs became mature in the lab, and two of them were successfully fertilized.  We now have seven embryos!  This is incredible and more than we were expecting.

On Thursday and Friday of this week we will learn how many embryos from the first and second fertilization report make it to blastocyst.  Then our little blasts will be biopsied and frozen until my body is ready for the transfer.

On a side note, our blog has reached 10,000 views!  As always, thanks for the support!

Fertilization report

Months of preparation and we were finally ready for egg retrieval yesterday.  Going into the retrieval, we knew that I had 11 follicles, but the number of eggs within those follicles could not be predetermined.  So, I went in with my new pink socks (a thing among CCRM patients), ready for whatever was to happen.

  When I woke up from the procedure, Andrew was there with a smile on his face.  He already knew how many eggs were retrieved--10!  That's a good number for me.  Embryology came in to speak with us and confirmed that 10 eggs were retrieved, and that they would attempt to fertilize those eggs within a few hours.

This morning I received a call from the embryology team with the fertilization report.  Of the 10 eggs retrieved, 6 were mature, and 5 of those mature eggs fertilized.  Again, this is a good number for me (considering that in our first round of IVF we had 9 eggs retrieved, with 7 of those eggs mature, and only 3 eggs fertilized).   So, it was good to hear that we have 5 embryos to work with.  But, it was also good to hear that they were trying to grow the other 4 immature eggs out to maturity in the lab and would try to fertilize them today.  We will get another call tomorrow with that fertilization report.  That will be last call we get until next Thursday, which is when the embryos will hopefully reach blastocyst, and then all embryos will be genetically tested and frozen until my body is ready for the transfer.

Stimulation, round two

I've been "stimming" for over a week now.  This means that I've been getting several injections each day, which stimulate my ovaries to produce follicles, which will hopefully have a mature egg once egg retrieval comes around.  This is the second time we've been through this, so we knew what to expect--bloating, cramps, moodiness, headaches, sleep deprivation.  The one thing we didn't expect--a prescription for Viagra.  For me.  That's right, I am now taking Viagra.  Apparently, the Viagra helps the stimulation meds be more effective.  I'm all for it if it's going to give us a baby.

After a few days on the "stims" I had a ultrasound and blood work to see how my ovaries are responding to the meds.  That ultrasound found that I had only 8 follicles--6 on the left, 2 on the right.  My right ovary has a large endometrioma, which is ovarian endometriosis in the form of a cyst.  The endometrioma is preventing the ovary from cooperating and producing follicles.  This leaves me with fewer than average follicles.  We were disappointed, but we also know that, in the end, it only takes one.

The few and slow growing follicles prompted the Viagra prescription.  By the second ultrasound, I had 10 follicles--8 on the left, 2 on the right.  However, many of them were still slow growing.  We only had three that were growing at an almost normal pace; the others lagging behind.  At this time, the nurse said one of two things could happen.  One being that the doctor could recommend retrieving the largest follicles at their appropriate time, which means that the smaller follicles will not be mature and cannot be fertilized (this would leave us with approximately three eggs).  Or, the doctor could recommend stimming a bit longer to grow the smaller follicles more.  However, in this case, we risk losing the biggest follicles and mature eggs, and stimming for too long can result in poorer quality eggs.  We knew we wouldn't have an answer until the next ultrasound and blood work.

Today, I had my third ultrasound.  I now have 11 follicles--8 on the left, 3 on the right.  The growth patterns indicate that I will likely be ready to retrieve on Friday, and that we may only get 8 mature eggs from the 11 follicles.

While eight sounds like a great number, it's really low, relatively speaking.  The attrition rate could knock us down to 1-2 embryos (just like the first round).  Not every mature egg will fertilize, not every fertilized egg (or embryo) will make it to the blastocyst phase, not every blastocyst will be chromosomally normal.

Once the retrieval happens, we will learn within 24 hours how many eggs were retrieved, how many were mature, and how many fertilized.  We will then have to wait five days to learn how many embryos grow to the blastocyst phase.  The embryos that make it to that phase will then be genetically tested to "weed out" the non-viable embryos.  We will have to wait 2-3 weeks to learn how many embryos we will have from this process for transfer.  Once we know that number, we can start prepping my body for the transfer, which will unfortunately take another 6-9 weeks.  We have been advised that our transfer will likely take place in December.  It's going to be a long wait, but will hopefully be worth it.  What a wonderful Christmas present it would be :)

Moving forward, round two

This round of IVF feels so much different than the first, in many ways.  We were so naive in the first round, thinking that all the work and money we put into it would give us a happy ending.  But, on May 1st, Chase's second birthday, we found out that we were wrong.  I think this is why I don't feel excited about this second round.  We haven't even been celebrating the small steps and progress we've made in this second journey.  We just want to get it over with.

"Get it over with."  I know that sounds terrible, but the process is grueling.  In the first cycle, I gained a lot of weight, I was emotional, and (Andrew would probably say) I was extra grumpy.  It's a series of highs and lows.  The medications and hormones are hard on the body, but are needed to retrieve the eggs and support a pregnancy.

"Get it over with."  We have our eyes on the prize, as the saying goes.  We are anxious to get through the brutal stimulation phase, the waiting-while-our-embryos-are-genetically-tested phase, and the transfer phase.  We want to fast forward to the date when we will find out if this was a successful round of IVF.

So, where are we right now in the cycle?  Well, after all the work up and testing and a surgery to correct a problem with my fallopian tubes, we are ready to rock and roll.  Last week, I started on some priming medications, and yesterday an ultrasound and blood work found that we are ready to start the stimulation phase.  For the next 2-3 weeks, we will be in IVF prison.  I have several injections that need to be administered at very specific times during the day.  Lupron has to be injected every 12 hours; right now we are on a 7am and 7pm schedule with that medication.  Menopur has to be injected in the morning, Follistim has to be injected in the evening, and Dexamethasone has to be taken at bedtime.  We either have to be home at the exact times that these meds are needed, or we have to take them with us wherever we go.  The latter is challenging because some of the meds have to be refrigerated (and sanitary conditions are needed).  Regardless, we are ready!

Those of you that donated to our online fundraiser helped us get to this second journey.  All of the money raised was used to pay for the initial work up and testing as insurance didn't pay for it all.  We applied for a grant, but were told that the committee won't meet until November or December of this year to determine if we are eligible.  We were finally able to take out a substantial loan, but this loan does not cover the total costs.  We are still fighting to pay out of pocket for the expenses while simultaneously making biweekly payments to the lender for the loan.  We initially estimated this round to cost $30k, but we are already over that amount and we aren't done paying yet.

This is our final attempt to build our family.  Financially, it has to be.  By the end of this year, we will know if Chase will be an only child or if he will have siblings.