Lucky Friday the 13th

We left Thursday night around Lucy and Clara's bedtime for our trip to Long Island for my first ultrasound appointment. We had booked a hotel room that was about 5 minutes from Dr. Braverman's office so that we could drive down the night before and be close in the morning. The drive went pretty well despite hitting some snowy roads for about an hour in Pennslvania. My mom came along to help with the girls and to be able to watch them at the hotel during my appointment. 

We arrived at about 11:45 pm and W checked in while I waited in the car with my mom and the girls. We pulled around close to the room and waited while W unloaded the car (we didn't bring much because it was just overnight). He set up the pack and plays and then came down to get us. Lucy had first opened her eyes when W checked in. I asked my mom not to talk to her but she didn't really listen and was still making eye contact with her and smiling. 

We got up into the room and tried putting both girls right into the pack and plays. They both immediately started crying. So, we pulled them into our bed and laid down with them. Clara went back to sleep pretty quickly and was easily put back into her pack and play. Lucy, on the other hand, didn't go back to sleep until close to 4 am. We tried giving her Tylenol because I knew she was cutting a big molar, but that didn't seem to help. We tried putting her back into the pack and play multiple times and she would just cry. You can't really let your kid cry in a hotel room.   

The hotel had a free breakfast so we went down in the morning. There we met a couple that said they were pregnant with twin girls. When they asked us if we had any other children we said no and then asked them the same question. They said they had three others...triplet boys! Can you imagine?!

I was so nervous I barely ate. We put the girls down and left around 9:20 for my 9:45 appointment. When I checked in they gave me a cup for a urine sample. I tried my best but was only able to give them a super small amount of urine. There wasn't anyone in the waiting room and they called us back fairly quickly. The nurse was one I remembered from last time. She took my blood pressure and it was surprisingly good despite how nervous I felt. She left the room and we waited for Dr. B. 

He came in after a few minutes. He again said that if he didn't say anything right away it didn't mean anything, he just wanted to get a good look first.  

We saw a beautiful little baby that measured 6w6d and on par with when I thought I ovulated. My due date is 10/3/15. We heard an amazing heartbeat at 141 beats per minute. I asked Dr. B to check which ovary I ovulated from and he joked it was so I could tell my child when they someday ask. Sure enough, it was the one without a tube. When I said that he said the tubes actually lie overlapping on each other. I guess I didn't realize how close in proximity they were. 

He checked the doppler blood flow and it was pretty uncomfortable. He made more jokes as he seems to do and said the blood flow to my uterus was slightly constricted but that the blood flow from my uterus to the baby was great. He didn't think there was any need to change any of the medications at this time. He asked about the immune panel and I said it was pending. I asked about Neupogen and told him it was denied by my insurance. He said once the insurance company denies it there's no point in appealing it. I asked about donated meds and he said he would check if there were any. He then asked,"See you again next week?" I then reminded him that we lived almost 5 hours away, so he said he wanted me to get another ultrasound next week locally. He said he'd like to see me again around 10 weeks and we said we'd be able to make that work. 

I then asked him if he allowed children in the office. He said he didn't have any problems with it but knew the infertility patients sometimes complained about it. He liked to see it as what could be for those patients and said it would be great if we brought the girls in for some pictures. 

When I went to check out the nurse said my urine sample was going to be enough and that I didn't need to try again. I asked her about Neupogen and she said she'd check. It took her a little while but she came back with 4 vials! I was so happy and grateful as they are each $360 OOP and one of them lasts about 3 1/2 days. 

Since the appointment was so quick I texted my mom to see if the girls were sleeping. We didn't hear back from her so we went to a plaza nearby the office we've been to before. We went into a few stores and grabbed me a coffee before heading back to the room. 

The girls woke up when we got back and we packed everything up. We headed back to Dr. B's office for them to see the girls. There was another child and another couple waiting in the room. The other child was around the same age and we were talking some with the mom. I could tell the other couple wasn't pleased to see all the kids in the office. After a bit Dr. B came out and we got some pics of the four of us with him and then passed the girls off. They immediately started crying (as I suspected they would) and we got some funny pics. Dr. B was a good sport to smile while holding two crying babies. He told them, "Last time I saw you two you were just circles." I guess they didn't think he was too funny. 

From there we headed into Manhattan. My mom fed the girls snacks as we drove. We parked in a garage about 7 blocks from a restaurant and Children's museum I had scoped out. We walked to the restaurant and had an amazing lunch of dosas. The girls ate them and also loved trying something new. We were both impressed when Clara was gladly eating chicken curry. 

We then walked around the corner to the Children's Museum of Manhattan. This museum was a bit pricey as we had to also pay for the girls (most museums around here don't charge for children their age). It was so worth it though! The girls had such a great time. They were both walking all over the place and loved all the slides everywhere. Every time we moved on from one thing to the next they were sad. It was 5 floors that were all so much fun! There was a lot for kids their age and they had a ton of fun playing and watching the other kids. We stayed for a few hours and then headed out from there. It being their nap time we expected them to sleep for quite a while. 

Lucy had other plans. The ride home wasn't fun with her even with the DVD players we bought. They helped some, but she was teething and exhausted, so didn't want to be in her carseat. I ended up in the backseat with them for most of the ride home. We stopped at a rest area for dinner (soup dumplings that we had picked up in the city before heading out) but unfortunately there weren't any tables there apart from the ones outdoors and buried under a least a foot of snow. We improvised and made it work on a bench and then let the girls walk around and tire themselves out. 

For the rest of the trip Lucy mostly slept but would wake up crying about every 15-20 minutes. It wasn't a fun 3 remaining hours to say the least. With traffic and stops our ride home took 7 hours. Luckily both girls went down in their cribs and slept the rest of the night once we got home. 

I'm feeling so much better about things having seen and heard that little heartbeat. It's so amazing to think there's another little baby growing inside me. Next week I'll probably end up at the local fertility clinic for my ultrasound unless I'm able to get in at my ob's office. I'm hoping things continue to go well and stay uneventful. 

2013 in Review

I started this post last year, I swear. I've been trying to find the time to turn it into a photo bomb post (like most of my posts these days) and I think I can finally publish it. 

By far, 2013 was the best year in a long time. January came with lots of trips to NYC for our ivf cycle with a successful transfer on the full moon of Jan 21st. 

In early February we found out we were expecting not only one, but TWO babies! I was so surprised and shocked that I didn't successfully wrap my brain around the concept of twins for a few months. 

March and April brought my changing and growing body as well as fears about my pregnancy. I had my first official ob appointment We got to Skype with my mom in Costa Rica to tell her the exciting news. I also told my work and families I was pregnant. Apparently I wasn't hiding it as well as I thought. 

In May we found out we were going to be having 2 girls. It was one of the best and most exciting days of my life. Prior to the appointment we said we were going to wait to find out what we were having. Big surprise, I couldn't wait. 

In June we celebrated reaching viability at a cousin's wedding in NJ and I started to get really big and uncomfortable. 

July was hot and exhausting with work, but I survived until about the first week of August before getting pulled out. In a weeks time we celebrated my 30th birthday with the purchase of a fancy camera, I stopped working, and W found out he was going to need to find a new job. It was a bit scary at times, but W quickly lined up a new job. 

The summer was spent being lazy and large. I did a lot of crafting for the girls (quilts, mobiles, dresses, etc) and napping. Life with leisurely and relaxing. 

On labor day my sister came for a visit. We celebrated W's birthday and debated going to the state fair. 

On September 3rd I was heading to the fabric store with the dogs when I got into a car accident. Immediately things changed as my water broke and I was rushed to the hospital. 3 hours later my beautiful girls were born and rushed to the NICU. 

The next 18 days were spent primarily at the hospital. I lived out of a suitcase at my in-laws house and spent as much of my waking time possible visiting my girls. 

On the 21st of September, exactly 9 months after our full moon transfer the girls came home. 

W was home with me until Halloween, and most of October and November were a blur of feeding babies every 3 hours around the clock. We had some outings, but mainly stayed home. 

December brought our first out of town weekend and our first Christmas with the girls. And now another year has ended. It's amazing to me how much changed in my life this year and how fulfilled I feel now. 

So now I'll use my usual template for new years. 

1. What did you do in 2013 that you'd never done before?

Became a mommy 

Sewed clothing

Started a new carreer and quit my old one (for now)

Became an aunt to my nephew Benny

Regained some confidence in my body

2. Did you keep your resolution's, and will you make more for this year?

I kept some abs wasn't so successfully with others. I helped W in the kitchen like I said for a few weeks. Getting hugely pregnant didn't help but it's also a convenient excuse for me. 

I continued with my yoga practice and attended a prenatal yoga class for a majority of my pregnancy. I loved going and even met a new friend. I'm hoping to get back into doing yoga again soon. 

3. Did anyone close to you give birth? 

This was a big year for babies. My sister had my nephew in February and 3 of my close friends had babies. 

4. Did anyone close to you die?

My sweet grandma passed away in July at the ripe age of 94. She was so positive and such a wonderful person. I miss her and wish she was able to meet the girls. 

5. What countries did you visit? None! We spent a lot of money and vacation time on our ivf cycle in January that brought us our girls. Totally worth it but I miss the beach!

6. What would you like to have in 2014 that you lacked in 2013? 

A beach vacation. Please??!!

7. What dates from 2013 will be etched upon your memory, and why?

January 21st-full moon transfer of our embryos 

February 8th- found out we were pregnant with TWINS!

February 23rd- my nephew's birthday 

May 8th- found out we were going to have 2 girls. 

August 3rd- celebrated my 30th birthday

September 3rd- the birthday of my girls 

September 9th- The day I first held my girls together. 

September 21st- the day we brought the girls home from the NICU

October 10th- our 4th wedding anniversary 

October 15th- the due date for the girls 

8. What was your biggest achievement of the year?

 Growing and giving birth to 2 perfect little girls. I also view breastfeeding them as a huge achievement. Having these positive experiences with my body has given me renewed confidence that I definitely lacked the past few years. 

9. What was your biggest failure?

Not having the birth experience I wanted. Due to the accident I needed an emergency cesarean section. This was done under general anesthesia because I was on blood thinners. This meant I didn't get to hear my girls cry for the first time and W wasn't able to be in the room. Also, their prematurity felt like a bit of a failure. Avoiding the NICU would have been ideal. 

10. Did you suffer illness or injury?

No, we were very lucky. I had a pretty uneventful twin pregnancy that was only complicated by gestational diabetes. Even that was easily controlled through my diet. 

11. What was the best thing you bought?

The ivf cycle that got us our girls and broke the bank, a new car (Mazda CX9), and lots of fun stuff for decorating and putting together the nursery. 

12. Where did most of your money go?

Expensive ivf cycle in NYC, nursery, mortgage, new car, savings

13. What did you get really excited about?

This is getting a little redundant but obviously my girls. The most exciting days were finding out they were both girls, holding them at the same time for the first time, and bringing them home. Since then, every little milestone is exciting; sleeping through the night, smiles, rolling over, giggles, etc.

14. What songs will always remind you of 2013?

For like the third year in a row I'm going to say Mumford and Sons but also the songs Mercy and Sweet by Dave Matthews Band. I also played the song Home by Edward Sharpe & the Magnetic Zeroes to my belly while I was pregnant and play it for the girls now. I love the chorus, "Home, let me come home. Home is whenever I'm with you." 

15. Compared to this time last year, are you:

Happier or sadder? Immeasurably happier!

Thinner or fatter? Much thinner. Thank you breastfeeding!

Richer or poorer? Poorer! I'm not working much at all these days. Financially things have changed but I'm beyond grateful that I get to be home with my girls every day. 

16. What do you wish you'd done more of?

Relaxing and lying around before the girls got here, living in the moment, trusting myself, and traveling to see my sister and nephew. 

17. What do you wish you had done less of?

Worrying about every little detail. 

18. How did you spend Christmas?

Christmas eve we went to the in-laws, Christmas morning we slept in until 10 and then went to my moms. We managed to get out of dinner on Christmas and stayed home in our jannies. For new years we went to dinner at my in-laws and had lobster and risotto. After we went home and both fell asleep on the couch before midnight. Having infant twins is so glamorous!

19. What was your favorite tv program?

Breaking bad, the new girl, Generation Cryo, and I watched a lot of a really crappy show called Dr 90210 on Netflix when I got pulled out of work. 

20. What were you favorite books of the year?

Ummm Babywise? Maybe the Baby Nane Wizard, Love You Forever, Raising Twins? I need to get back into reading for myself and enjoyment. I don't have the time yet, but maybe someday. 

21. What were your favorite films of the year? 

The Hunger Games is the best I can come up with. 

22. What did you do on your birthday and how old were you?

I turned 30 this year which was a huge milestone. That same week I hit 30 weeks in my pregnancy. We were supposed to have dinner at my moms but she cancelled as she wasn't up for it. We went to the mall to look at cameras, went out to lunch, and then W's parents hosted dinner instead. My MiL made a nice cheese dessert as I had my GD test the next morning. 

23. What's one thing that would have made your year immeasurably more satisfying?
Carrying my girls full term but oh well. 

24. What kept you sane?
W, my sister, and all my great friends who had been through infertility and pregnancy, especially Tamara.

25. Tell us valuable lessons you learned in 2013:
My body is better able to do things I doubted it could do.
Pregnancy is everything it's cracked up to be and I feel so grateful I got to experience it.
Trust your gut and pursue everything you think is necessary to accomplish your goals. Find a doctor who you trust and believe in.
 I should trust things will be okay.
I have zero control over things I like to try to control.

This year was so amazing and I feel so grateful to have found Dr. Braverman. I can't believe I had 2 little girls this year. I can't wait to see what this year has in store for us.

8 Weeks

I'm almost through week 8. I oscillate between feeling really positive and confident about things to worrying a whole bunch. Early in the week we watched the first episode of the Walking Dead. That night I had a horrible dream that the babies died. I also dreamt I was chasing my cat around the supermarket because he got free from a bag I was carrying him in. I have a lot of crazy dreams, but this was one of the worst. I woke up feeling horrible and scared. When I told my sister about my dream she said she had bad dreams when she was pregnant and watched that show. We won't be watching it again any time soon. 

I finally made a decision about an OB and made an appointment this week. When I saw Dr. Br.averman on Monday he said he wanted me to be seen this week or next. I was so overwhelmed by the decision of who to choose I put it off until later in the week. 

I first started with the hospital I knew I wanted to deliver at. I chose that one because they have the highest level NICU. I really hope we don't need it, but it's good to have "in my back pocket" as my general physician said. I got recommendations from 2 friends and my general physician about who to use. Then I called and made an appointment. They didn't have anything this week so I made an appointment for next Thursday afternoon. They offered me one Tuesday morning, but the afternoon is much better so that W can be there. I'm really nervous about the idea of not getting and ultrasound. I have no idea whether I will not not, but I'm not sure I can go too much longer without one. It's so easy to get spoiled with weekly ultrasounds. 

After my bad dream this week I decided I wanted to buy a doppler. I ordered one online and am hoping it comes this week. I really hope it doesn't cause me more stress since I bought it for reassurance. I realize it doesn't always pick up a heartbeat, so I promise I'll try not to stress if that happens.

This week the babies are the size of raspberries or about 3/4 of an inch. The fingers and toes are still webbed but starting to differentiate. Upper lips, the tip of little noses, ears, and eyelids are developing. The babies even have distinguished wrists and elbows that they can flex.  

My belly is definitely getting bigger. I still don't think it's noticeable to anyone else, but it feels more firm and has a different shape. I'm still fitting into my jeans but joked the dryer really shrunk my one pair this week. I put them on one morning and had to really stretch them out before they felt comfortable. I may not be putting them in the dryer again. I'm sure it's the dryer's fault, not the fact that I'm getting any bigger, right?

My symptoms are about the same. The nausea fluctuates from day to day and hour to hour. I'm still exhausted and love my sleep and naps.

The meat aversion has improved slightly and I had meat at 2 different meals this week. One was a soup that had chicken in it and I had a few bites with the chicken and then last night I ate corned beef. I know it's not great a great choice, but it's a once a year occasion. I've noticed anything with nitrates in it seems to give me headaches so that wasn't so much fun last night. 

I'm still getting up a few times a night to pee although I tend to resist and then not sleep as well. The bathroom really isn't that far and I try to keep my eyes closed as I pee so that I can fall back asleep easily. 

I've had some heartburn this week and eating Tums seem to help a bunch. 

My ovaries still feel huge and are really painful if I move fast or suddenly. Last night I rotated in bed and was in so much pain on both sides. 

My back has also started hurting a little bit this week and I'm not sure why. Good thing my hubby is a physical therapist. He said he was going to look into some exercises for me. I also want to start doing prenatal yoga but there isn't any place that close and the only one I found offers it on Thursday evening. Not sure how well that will work. W and I talked about ordering a DVD. We took the dogs for a walk today since it was so beautiful. I have honestly been too scared to do anything but am realizing it's really important to at least walk as much as possible.

I haven't really had any cravings. Every time I open the fridge and see pickles though they look absolutely delicious. It's the only thing that looks good all the time (even in the early morning). I don't think that's really anything new though. Just typing this makes me want to eat one. It just seems so cliche. 

I don't have a ton of patience these days. I feel badly as I work with young children and really should be more patient, but I'm struggling lately. I also don't have a ton of patience with W but he's pretty understanding. He appreciates that I recognize it and apologize after.

I'm still on Metformin 2000 mg/day, Neupogen 35 units each evening, Lovenox 40 mg in the morning and evening, 3 estrogen patches every other day, 2 cc's progesterone in oil every night, baby aspirin and Foltanx in the morning, and a prenatal vitamin. Last time I asked Dr. Br.averman he said just to continue everything. Not sure when I will stop them but I'm nervous just thinking about it.  

Last night we stopped at the mall and looked at a few baby things. We haven't bought anything other than the onesie and outfit in NYC but it was kinda fun to look at things and start thinking. W and I both woke up this morning and talked about dreams we both had where we were lost. I think it pretty much sums up how we are both feeling. The twin thing is sinking in more and more and I'm starting to get excited and feel attached to them. I've been really guarded this whole time but I feel myself letting my guard down more and more. I just hope things continue to go well. 

Follow Up With Dr. B

Thursday was our follow-up appointment with Dr. Br.averman. Our appointment was at 2:30 in the afternoon and we had planned to both work on Wednesday and head down after to stay with my cousin in NYC. Well, they had predicted about 9 inches of snow so we ended up leaving early to avoid it. We got into Manhattan around four and my cousin wasn't going to be free until quite a bit later. We parked our car and walked around Ti.mes Sq.uare, Br.oadway, and Ro.ckefeller Cen.ter. The weather was pretty awful and within a short amount of time we were ready to head back to the car. We were both soaked and cold. 

From there we decided to do the driving tour of Manhattan. We saw the Empire State Building, the Freedom Tower, 5th Avenue, and Greenwich Village. It was so much better from the warmth of the car. W only triggered one episode of road rage from another driver, so, all in all it was successful and much more enjoyable. 

We met up with my cousin and her husband and had dinner delivered to his Muay Thai boxing gym in Manhattan. They were doing some maintenance since they were closed for the holidays. After a bit we headed back to Queens to their apartment. 

W and I slept on their fold out couch which wasn't the most comfortable, but was most definitely free. We woke on Thursday morning, showered, got some breakfast, and hung out for a bit before we headed to Long Island for our appointment. I had my list of questions and was ready to meet with Dr. B. 

We didn't wait long to see him and there weren't many people in the office. It was such a different feel from my current RE's office where you wonder if there is going to be enough seats for everyone. One woman came out and was talking with the receptionist. Then Dr. B came out and gave her a big hug and chatted with her for a bit. I'm pretty sure she was pregnant, although I tried not to eavesdrop. 

When we headed back to Dr. B's office he greeted us warmly and mentioned something about how much easier this appointment was than the last one. He first asked how many frozen embyros we had left. When I told him five he started to make a plan for that. Then I told him we were more interested in doing a fresh cycle at his clinic than using those frozen embryos right now. 

He thinks our past failures are more linked to the lab than either eggs or sperm. I can't deny the success rates are really low at my current clinic for fresh cycles. Their frozen success rates are abysmal. That's not to say it doesn't work for some people. I know lots of people who got pregnant there. I just don't appear to be an easy case. 

Dr. B thinks we should do a similar protocol to last time with a Lupron trigger, so that means no Lupron to suppress. I've been on birth control pills for around two weeks now so will stop that soon. At that time we will start stims. I haven't received a calendar yet, but I have an idea of what it will look like. We will use Gonal-F and Menopur and I'm also guessing Ganirelix. In addition, we will increase the Neupogen dose a bit. We will wait until the day before the transfer to add in the Neupogen since I guess it has been linked to higher estradiol levels when added sooner. We don't need any help in that department. 

I asked about doing an endometrial biopsy again and he said studies aren't conclusive enough to do it at this point so it's probably not worth it. I asked about repeating the HSG since I've only ever had that done once and he said he sees too many false positives with it and that it's not a great test. The best way to look at everything is with a lap surgery which I have had, twice. I asked about PIO vs. Crinone and he said that at least initially he prefers to use PIO. I asked whether our chemical pregnancies were likely the result of chromosomal abnormalities or the HLA matching. He said it could be a combination of both and that it's hard to know. 

I asked at what point implantation is reduced with high estradiol levels and he said around 4000. He agreed to aim for a fresh transfer and said that, "maybe there's something there" since I've only ever had implantation with fresh cycles. 

He was super positive and said we will have a baby. Even if it's not a guarantee, it was really nice to hear. He even said that if we aren't successful this cycle (frozen embryos included) that he will give us another cycle for free. He's not going to leave us hanging. 

He said his lab is able to mature eggs and that if it means triggering me a day sooner to keep my estradiol a little lower, it's not a big deal. At that point we would likely have some mature eggs so it would just mean some would have to undergo in-vitro maturation.

 Once our conversation appeared to be at a near end I asked if I was going to get an ultrasound. He said yes and called his tech down. 

We went into the ultrasound room and started. The tech didn't say much but I knew a doppler blood flow portion would be performed. The ultrasound took a really long time as she was super thorough. I had no idea what she was looking for with the doppler so I lost interest quickly. When she finished she told me not to get dressed and to wait for Dr. B to come in the room.

When he came back he told me a number of things, all new to me. He told me I had a fibroid that was about an inch. It was making my uterine cavity appear curved. I asked whether this was something that grew slowly and he said it had likely been there for a while. This pissed me off a bit that I had never been told about it at all. I'm wondering if my current clinic ever even saw it. He said he wanted to perform a hysteroscopy to take a look at it to be sure it wasn't in my uterus. If it was we were looking at surgery to remove it. He joked that he could do it that day but that the machine wasn't sterilized so he could give me a half off deal on it. I asked whether it could be done the following day and he said fine. 

He then told me I had reduced blood flow to both sides of my uterus. He recommended I use Viagra vaginally to help with blood flow as well as Vitamin E daily. In addition, he said they would double my dosage of Lovenox next cycle to twice a day. Hopefully this will all help with the blood flow issue. I'm really glad I went and had this done because it obviously gave us new information and changed our treatment a bit. When the tech was performing the doppler portion I asked her why more clinics don't do it. She said it's because they likely don't understand the importance. 

We returned the next morning for the hysteroscopy. We waited a bit in the procedure room this time but when Dr. B came in he joked about reading the cliff notes for how to perform the procedure. When I asked the previous day whether I would be conscious for the procedure he said I would but he would not. The hysteropscopy itself was short and showed the fibroid wasn't going to interfere in any way so that was really great news. From there he turned to W and said he was sorry he didn't find his watch in there. 

I talked with his nurse for a bit and we talked about meds for this upcoming cycle, my calendar, and supplements Dr. B recommended. These were: Omega 3 Fish oil 2x's/day, Vitamin C 1000-2000 mg/day, Vitamin D 4000 units/day, Pycnogenol 100 mg/day, Vitamin E 500 mg/day, and Vitamin B complex. In addition, she gave me a sample of something called Preg.nitude which contains Folic acid and Myo-inositol and instructed me to take in twice a day. They also wrote me a script for Mentanx which is to help with the MTHFR. The nurse also said Dr. B is going to want to see me around day eight of my stims to perform the ultrasound and take a look for himself. This is going to make things a lot more complicated and I don't think W will join me for that appointment. We will see at what time it falls and see who I can rope into coming with me. 

All in all, I'm really glad we went. Talking with someone face-to-face is so much better than over the phone. We regained some confidence and feel positive moving forward with Dr. B. We also received some new information that changes things a bit. I'm not holding my breath that IVF #5 (holy crap) is going to be the one, but it's nice to have some hope again that it may work out in the end. 

Freeze Report

I was so nervous to call. I dreaded it. When my friend texted me to get the report and I told her I was too scared, she encouraged me strongly to call. 

I feel more invested in this cycle than previous ones. That's part of why I was so nervous. 

I finally called around 12:30 and spoke with a nurse. She was able to tell me that we have a lucky 7 embryos frozen. I asked for their report cards and she said she would have to get an embryologist to call me back. 

A little while later my phone rang. This is what I found out.

On day five they froze three embryos. Of those we had a 5AC, 4BC, and a 3BC. 

On day six they froze four embryos. They were a 4AC, 4BC, 4BC, and 4CC.

She also said they were watching four more to see if they would be able to freeze them on day seven. I didn't realize that was a possibility. 

When AF showed up on Tuesday I emailed Dr. Br.averman. He suggested I schedule a baseline appointment and we didn't talk a whole lot about instructions beyond that. He wanted to know how many embryos we had before we talked next steps. That's one thing I've figured out about him. He likes to take things one step at a time. I'm always trying to look to the next step, so find this somewhat frustrating. It's forcing me to live more in the moment than plan ahead. We had exchanged a few emails about different protocols but he didn't specifically say what to do for me. 

My baseline appointment was this morning. My ovaries were still pretty big and "angry" as the NP put it, but my lining was thin. Both ovaries had some left over cysts but she didn't seem too concerned about it. She asked what the plan was, and not knowing, I just went with the flow. She came back with instructions and my next appointment scheduled. 

When I asked her to fax the results from today's appointment she stopped and stared at me for a second or two before saying, "If that's what you want." Seriously?

I emailed the nurse at Dr. B's office and asked if Dr. B was going to give me a calendar. Well, come to find out he wants me to do something entirely different. The theme of this IVF cycle all along? Different is better!! I guess I'll have to contact the NP and tell her of the change of plans. 

To those of you who have done FET's, what was your protocol? 

All I know right now is this one involves 2 weeks of birth control pills before anything else. I'm pretty sure it also adds Lupron, Progesterone, and Estrace at some point. It's amazing how many months I have spent on the pill while we have been trying to get pregnant. My clinic was happy to have me take Estrace 3x's/day until I started progesterone. Pretty simple. Things are going to get complicated again. 

I forgot to tell this story sooner. The day before my retrieval I had to go for blood work to be sure the lupron trigger worked. I made the appointment for a bit later in the day and ended up having some cancellations for the time after. I called a friend and my MIL to see if either of them wanted to have lunch with me, but was unsuccessful. So then I called my FIL and he gladly agreed. He was so patient and a fantastic listener as I jabbered on about the newest news with us TTC wise. When I told him I had a procedure the next day he asked me, "Are things coming out or going in?" That's one way to put it!

New and Confusing Information

Yesterday was my follow-up with Dr. Br.averman. Of course the office was running behind so we waited for over an hour past our appointment before they called. 

At first Dr. B said everything was essentially normal. But I could hear him flipping through pages and pages of paperwork. Then he got to the HLA (Human Leukocyte Antigen) matching portion of the testing.

Here is information I found on HLA matching from Dr. B's website in order to explain it and be more clear:

"A fundamental part of HLA function is the presence of MHC molecules on all cells in the body. While there must be great similarity between these HLA genes with the donor and recipient during a transplant, this does not hold true when considering an embryo. There are reasons an embryo must have significant differences than the mother in order for a pregnancy to be successful and not result in miscarriage. Evolution has resulted in significant variation in the shape and sizes of MHC molecules (It is the MHC molecules that pick up virus and bacteria and present it to the immune system for eradication). The variation of the MCH molecules prevents a virus or bacteria from mutating and then evading the immune system in every person they infect, preventing an entire population form getting wiped out during an outbreak. Nature has a reason therefore to try and reject an embryo in couples with similar HLA genes as this would eliminate the ability to diversify.

Other HLA molecules on the embryo's surface, however, play an important role in beginning the process of immune tolerance. One theory is that a difference between the HLA genes of the mother and the embryo is important as it draws the immune system to the site of implantation due to the detection of something foreign. From here, the embryo begins to interact with the maternal immune system to turn off its attacking aspects and use it to its own advantage. Advantages include mild inflammation that can assist with implantation as well as the production of antibodies to protect the fetus."

 So, apparently W and I have a lot of matches. He said anything over 5 was considered significant. We have 6 that we know of for now. The test wasn't complete and the DQ Alpha portion of it was missing. This means there are another possible 2 matches that we will find out about once we complete the testing.

The HLA system is located on chromosome 6. As Dr. B said, this is the chromosome that "polices the immune system". If things are too similar, then the immune system attacks the embryo. He thought this was a possible reason for the way things have turned out in the past.

He also said that I had a PAI 1 4G gene mutation which is consistent with PCOS. I also have 1 copy of Factor V and 1 copy of MTHFR. All of these create a cumulative effect relating to blood clotting. He said this can be easily remedied with the use of Lovenox.

As far as the HLA matching goes, I guess his plan of action is to use Neupogen. This is a drug that is administered as a shot like anything else in a IVF cycle. The way that it works is it puts the immune system to rest in order to shield the embryo from the immune system. It's a drug commonly used during chemotherapy and is experimental for use in IVF cycles. Dr. B said he's had a lot of success using it for this type of problem. 

He said we don't need IVF and that IUI's would be an option. For now we will do IVF since we already have a cycle paid for. In the future, we could have him manage the immune portion and do IUI's. They are covered by my insurance so it's definitely something to consider if need be. It's that whole missing a tube thing that deters me. 

We talked about this upcoming IVF cycle. At first I could tell he didn't want to manage it due to the logistics. He was trying to back out of it but I put more pressure on him and he said he would keep to his word. I know its complicated and difficult, but I can't keep doing the same exact thing that my clinic has me doing. It's not working!

We talked about a the protocol again and meds. We will start on Gonal-F at a higher dose and then step it down shortly after. The reason to do this is that the higher dose recruits more eggs to begin with and then once they start growing they don't need as high of a dose. We may or may not add LH depending on my levels and his preference was Menopur over Luveris. After a few days we will add in Ganirelix and will trigger with Lupron. The plan for now is to freeze all embryos. It is likely my estrogen will get super high again and it's not a favorable environment for embryos. Also, the hormone management is extremely difficult with a Lupron trigger and I guess it would be easier to wait. I'm not thrilled about this option, but it's OK. I'm happy to try something different. 

So the plan for now is I need to get doctor's orders to my current office to get a sono before coming off birth control pills. I'm waiting for them to send this over so I can schedule my appointment. Then I will get a scan. As long as everything looks good I will stop bcp's and we will start this cycle. I should get a protocol written out from Dr. B and get assigned to a nurse soon.

So the biggest question is, how am I feeling about all of this information? I'm SO HAPPY I trusted my gut and pursued another opinion. I'm glad I found Dr. B and that we went through with all of the immune testing. I definitely had my doubts about whether it would all be worth it. I now 100% believe it was! Just doing what CNY told me "keep trying, it's a numbers game" was not going to work for me. There is something bigger going on. 

I'm kinda sad to find out to the hubs and I are apparently just too compatible. At least we know that if we ever need an organ transplant we don't need to go far. I'm hopeful for changes and armed with a whole bunch of new knowledge, ready to move forward and get this show on the road!