Frozen Embryos

I used to joke that I had embryos all over the state. We have 5 here locally in Syracuse with Dr. K and then we have 2 that are currently residing in Manhattan at Dr. B's clinic. 

When we first started with Dr. K we bought a package IVF deal. For $7500 we purchased 3 fresh IVF cycles with unlimited frozen cycles. We signed a contract that all of these cycles had to be completed within a certain timeframe. 

After our second fresh cycle with Dr. K resulted in my third early miscarriage I met with one of the doctors. He told me I just needed to keep trying and that it was a numbers game. He didn't think my history warranted recurrent pregnant loss testing despite me practically begging for it. He was willing to treat me as if I had problems without actually testing for them (using intralipids, lovenox. etc). That didn't sit well with me so that's when we first scheduled a consult with Dr. B. At that point I had completed 2 of the 3 cycles we had paid for. 

Dr. B had different ideas for medications, protocols, etc for me. The thing was, I didn't want to jump in to that with a cycle already paid for. So, I got Dr. B to manage my last cycle with Dr. K. We did a freeze all since I used a Lupron trigger. We froze 7 embryos. The next month we transferred 2. Although I had faint positives on tests my HCG came back at below 5, so negative. At that point I was exhausted and so discouraged with treatments. I wrote Dr. B an email and he told me I needed to give it one more try before I decided the treatment didn't work. 

We thought about it for a while. Since I had transferred 12 embryos with that clinic without a take-home baby we decided if we were going to give it one more try we were going to go all in. We decided to do our last cycle with Dr. B at his clinic. I got pregnant with twins and we froze 2 embryos. 

Last year around this time I got a bill to continue to store our 5 embryos here in Syracuse. I called to speak with an embryologist because we were supposed to pay $600. I thought about keeping half of them so we didn't have to pay the full amount. When I spoke with them they told me they could put them all into one spot and only charge us $300. So, we paid it. 

The thing is, another year has passed. We once again got our $300 bill and W said, "I just can't picture paying it." 

If we decided to try for more children we would definitely use our 2 embryos in Manhattan first. As much as I'm not thinking any of those 5 embryos could be my future child/children, I hate the idea of just giving up on them. I went through so much to get them. I don't think I'd be comfortable donating them to another couple. Although it's not set in stone, both W and I have said we wouldn't want to go through another fresh cycle. 

So, we have to make some decisions soon. I'm hoping that W will agree to continue to pay to store our 5 little frosties here in Syracuse but we will see. I'll likely just put it off until they send me a final notice like last year. 

I know it's not a bad problem to have, but it really is difficult to make these decisions. 

Transfer-iversary

This weekend marks one year that we transferred our perfect embryos. Highlights from that day included: seeing those perfect embryos on the screen and having a hard time believing they were ours, taking Valium and walking around Manhattan, soup dumplings for takeout on our way out of the city, and the full moon that accompanied our long drive home. 

I can't believe that a year ago my little girls were starting to grow inside me. I'm so grateful we gave it one last try and that embryos #18 and 19 turned out to be my perfect girls. I'm so lucky to have them and to be their mommy. I often catch myself saying "mommy's coming" or "mommy's here" to them and just can't believe I'm someone's mommy. I'm a mommy to 2 amazing little people! 

Ultrasound

Our ultrasound was Monday morning at 9:45. We headed down to NYC on Saturday evening and planned to spend all of Sunday in the city. Our friend's still have their empty (minus a bed) apartment in Queens that they gave us the keys to again. It's so nice having a free and empty place to stay right in the city. 

Empire State Plaza lit up for President's Day Saturday night

We slept in Sunday morning and took our time before we headed into Manhattan. We took the subway in (after an extra little ride and some confusion) and first went to Central Park. We saw all of the horse drawn carriages and looked out at the park for a bit. We were pretty hungry at that point so headed to look for some lunch. 

We stopped at an Italian restaurant and got some amazing soup and pizza. When we were totally full we went to FAO Schwarz. We spent quite a bit of time browsing around and had a great time. We picked out and bought a really neat NYC children's book. 

Giant Twizzlers at FAO Schwarz

Our next destination was then Grand Central Station but along the way I wasn't feeling great so we stopped at St. Bart's to take a little rest. We sat and relaxed in the quiet for a bit and then both lit a candle. 

In Grand Central there was a couple taking wedding photos so we watched them for a bit and then got a smoothie and sat a little longer. We admired the beautiful building, looked for a unique gift shop that was recommended and closed, and did some great people watching.

 From Grand Central we then headed to Broadway/Times Square to look for discounted show tickets. The line was really short and we bought tickets for an Off-Broadway show for that evening. We went into a couple of gift shops and bought an I Love NY onesie we've wanted to buy for a while. We also got a little outfit that had New York taxi cabs all over it. 

Since I knew I would need my Lovenox shot during the time the show would be going on, and we had some time before the show, we went back to the apartment to grab it. It was absolutely freezing out so we warmed up at the apartment for a short time. We grabbed some amazingly delicious and fast dinner at a Tibetan/Nepalese restaurant. We rushed to get to the show and really enjoyed it. It was a super small theatre and there were two actors in the whole show. I decided next time I want to see something bigger and on Broadway, but we still had a great time. 

Without a nap at all yesterday and with our busy day I fell asleep shortly after returning to the apartment. 

I woke up this morning feeling terrified and so nervous for everything. I made the mistake of looking last week at my blog to read about my symptoms and the way I felt when I had a missed miscarriage two years ago. I found out the day we found there was no heartbeat was the same date of my appointment today (Feb 18th). Finding this out made me even more terrified. 

I could hardly eat anything but forced myself to take some bites of cereal. We gave ourselves plenty of time and arrived super early. We sat in the car a bit and then decided to head in about 15 minutes before my scheduled appointment. The office was super packed and I knew we would be waiting a while. We waited nervously for about an hour before being called in. 

Once called in the nurse asked me how I was feeling and I told her I was really nervous. I asked if they would be doing blood work and she said as long as everything went well they wouldn't. She told me Dr. Br.averman would be doing the ultrasound. 

We waited another 10 minutes or so before he came in. When he asked me how I was I told him I was terrified. I said he didn't doubt it and got right down to business. He told us he may not say anything initially and that we shouldn't be alarmed if it happened.

 "Wandy" went in and within a few second W and I both saw two little sacs. Pretty quickly he confirmed what we thought and said that there were two sacs. He then zoomed in on them and said there were yolk sacs. A few seconds more and he detected one, and then two little heartbeats. He pointed them out and then tried to turn on the sound to hear them. He said because I was breathing so heavy (being so nervous) that we might not hear them or get a measure. We did not hear them and he said it was likely they had just started beating. From there he looked at my ovaries and then looked at the doppler blood flow to my uterus. He took a while doing this and I had definitely calmed down a bit at that point. Once he was done with that he went back and looked at the heartbeats again. He congratulated us and said something about this being their first appearance together. 

You can't see much, but there's definitely two! One only looks smaller because of the angle. 

He pointed out something about the wave of the blood flow and said he wanted to keep an eye on it. I think it had something to do with the way the blood flow reverberated or something. He wanted us to come back in two weeks, but said everything looks great and that we shouldn't be concerned about the blood flow thing. He said usually it resolves itself and thats why he wants to look again in two weeks.

W and I are so excited and scared. It really doesn't seem real at all and we are waiting for it all to sink in. Two little heartbeats!! It's so hard to believe that this may be happening. 

Good News!

I emailed Dr. Br.averman to get the update today on things. He responded very quickly with some great news. He first said that with the use of In Vitro Maturation (IVM) they were able to mature and fertilize two more eggs. This brought us up to 10 fertilized eggs out of the 12 that were retrieved. 

Of the 8 that fertilized, 5 were at 4 cells and graded A. 2 others were 4 cells and graded B, and then there was 1 that was 3 celled and graded D. The one that was graded D he said they were going to perform embryo plasty on tomorrow. I'm not exactly sure what this is, but I think it is defragmentation. The definition of the word plasty is: to repair, restore, or replace. I'm guessing they are going to alter it in some way to try to help the quality. 

The other 2 eggs that had fertilized were at the 2PN (two pro-nucleate) stage and he said he would have their grades tomorrow. 

Dr. B said based on this information we would do a 5 day transfer on Saturday. He told me to email him again tomorrow for more information. 

I'm still not feeling great. I was able to work a half day today before I became super uncomfortable and headed home to the couch. It's not easy to work sitting on the floor with little ones when your abdomen is uncomfortable. I think I did a bit too much bending and reaching and needed some time to rest. I napped for a few hours and woke up feeling better. I'm hoping I can work a full day tomorrow. 

I'm so happy to hear the news that more eggs fertilized and that we have a good handful of embryos growing away. Hoping for more great news tomorrow.

On another note, Amber from Old Lady and No Baby got the devastating news today that her little one "Bob" no longer had a heartbeat today. Please stop by her blog and send her some love during this tough time. My heart is breaking for her. No one deserves to go through something like that, especially without the love and support of others. 

The Dark Clouds are Parting

Things are looking up. The dark clouds that were hanging around us last week seem to be moving aside and allowing for some bright light. We are feeling happier, smiling more, and moving on from the sadness. It took a lot longer this time, but it also changed some of our perspectives on things.

The orientation at the adoption agency Tuesday night really helped. We drove about two hours west and arrived early. It was a good thing we did because finding the office was incredibly confusing. I guess they had just moved so it wasn't marked as their office and we spent almost 25 minutes looking for the place, driving up and down the road. The orientation itself was informative and helped to explain the whole process really well. They had a bunch of sample profiles to look at and it was nice to see what people share about themselves. The agency also had a family come in with their four month old son to share their experience. They had waited thirteen months to be matched, but their little guy was adorable. The process sounds difficult and expensive, but totally worth it. I'm sure it's incredibly hard to wait for "the call." It seems to different from doing treatments.

After the orientation we went for dinner. The food was horrible but we laughed and had a good time. We had some great conversations in the car during our two hour ride home. It was fun to talk about and we both felt so positive.

We aren't jumping up and down to start registering with them. I thought it would be a good idea to speak to an adoption attorney first to get some reviews of this agency and possible other options before moving forward. If we do choose this agency they believe in open adoptions. When I first asked W about it we were on the fence. The more we thought about it the more it seemed fine. W said, "It's just another person we get to brag to about our kid." I thought that was funny.

When I looked up local adoption attorneys yesterday I found a good family friend of my MiL and FiL listed. W called him today and he said although he does deal with some adoptions, he had a good friend who primarily does them. He gave us his number and W left a message yesterday afternoon.

In other news Aunt Flo finally decided to show her face a full eight days after stopping my meds. It was the longest I have ever waited and I was honestly started to get concerned. I emailed the nurse at Dr. B's office on Wednesday and by Thursday morning things had started. I also got a call from Dr. B's office saying they had an appointment available for the 27th. I called back and we are scheduled for 2:30. We are planning to take Thursday and Friday off from work and spend some time in NYC. He isn't doing office visits in the city anymore (Hurricaine Sandy maybe?), but it's so close and a great excuse to spend some time in the city. I'm pretty sure the tree will still be up in Rockefeller center so I'm pretty excited to see that. W has two cousins that live in the city, I have one, and his aunt and uncle live in northern NJ. I'm sure we can find someone to stay with.

I have to call my local clinic to schedule a baseline appointment before starting birth control pills. I'm a little nervous about it because they always ask what kind of cycle I will be doing. I know they won't like the idea of me going somewhere else, but I think it's time to move on from them. 

It's somewhat alarming how much cheaper my current clinic's prices are. It has to be for some reason, right? I can't believe it's just because the RE who owns it has a good heart. We were able to buy three cycles for a little over $7,000. That included ICSI, assisted hatching, anesthesia, and all frozen cycles involved. It didn't include meds and monitoring. Doesn't that seems bit too cheap? My first IVF cycle was at a publicly funded state university clinic. They still charged us about $6,000 for the cycle we did there. 

 I'm sure my current clinic is a great clinic if you are a straightforward case and the one-size-fits-all approach works. Unfortunately, I'm not that person. I would have loved nothing more than for our first cycle to work with them. Three fresh cycles (one with a freeze all) and three frozen cycles later it still didn't worked. I shouldn't feel bad going somewhere else, we need to do what is best for us. At this point though I'm still not completely convinced what is best is doing a cycle with Dr. B. It may just be pursuing adoption, but I think I'd like some closure on treatments. The thing about that is as long as we have five frozen embyros, we won't have closure. I'd really like to make a decision by the end of the year so that if we pay for another cycle we can deduct it on our taxes. With all of our medical expenses this year it would help us to get some of it back. The prices at Dr. B's office certainly aren't as cheap as where I am now. 

None of this is easy, but now we have some plans in place. We are hoping to speak with a lawyer soon and at least register with an agency. We will meet with Dr. B and make a plan moving forward with him most likely. It's been a bumpy ride, but hopefully there will be fewer potholes in the future. Either that, or I should buckle up and hang on tight.

Moving Forward

Estsy: MeganMatsuoka

Maybe it's because we invested so much more into this cycle, but this negative has been one of the hardest hits in a long time. W and I are definitely still really sad about it. There are times each day where I find my eyes welling up with tears thinking about it. We're taking care of ourselves and allowing ourselves to be sad. 

I have exchanged a bunch of emails with Dr. Br.averman since Friday. He generally responds quickly, but I can tell isn't comfortable answering all of my questions. I understand that. I really should sit down with him and pay him for his time. I just needed some immediate answers to feel better. 

When I asked what the biggest factors are in determining FET success he said, "I looked over your records. I think your treatment for the HLA issues is complete. We need to look at both embryo quality and other issues such as your uterine lining at the time of the transfer." When I explained to him that my lining was almost 9 mm a week before the transfer and that I've done both a sonohysterogram and endometrial biopsy recently, all signs pointed to our embryos.

His words: "I agree, most likely a quality issue." I don't find that hard to believe since we have transferred a lot of embryos without success. What frustrates me the most is that we don't have an answer to why our embryos aren't great quality. The last time I met with my local RE he told me my eggs look fine and the sperm is great. The first clinic we went to for only one IVF cycle told me the outer shell of my embryos was hard to penetrate. When we did ICSI on half and allowed the other half to fertilize naturally, only one fertilized naturally. They also triggered me too soon so I'm not sure if my eggs were immature and that was part of it. The clinic I currently go to where we have done three cycles is the one that told me my eggs look fine.

 Our embyros also get decent grades each time and we always have some left to freeze. They make it to day five and we've gotten really high graded embryos in the past. Those were the ones that resulted in chemical pregnancies. 

We've only ever had success with fresh transfers. I'm not sure if it's the lab, vitrification process, or our embyros that result in no implantation with frozen cycles. 

I know this is a bit of a moot point, but my HCG came back at 0.8. In the past with each negative HCG it measured <0.5. I've gotten that result at least five times between baseline appointments and negative cycles. I'm wondering if this slight elevation means a little something did happen. I wish I had tested earlier. Not that it matters though. When I test before the beta I wish I hadn't. When I don't test I wish I did. The grass is always greener. 

The morning after our negative result W hugged me as I cried and said I didn't think it would ever work for us. I thought it was time to move forward with adoption. We talked about how we knew we could love any baby but how it's hard to mourn the loss of our own. I wasn't sure how much more heartbreak I could take. We've talked about adoption a lot in the past. Originally we had talked about having two children and then adopting one. My mom, dad, brother, brother in law, and two of my cousins are all adopted. It's something we're totally comfortable with. 

I looked online and called around a bit on Friday and found a local-ish agency that happens to have an orientation this coming Tuesday night. W and I are planning to attend despite the drive. I've also signed up to receive registration packets from a few other agencies. It's incredibly overwhelming knowing which agency to pick so that's why I've requested information from a few. I think we will start moving forward with adoption. I'm looking forward to learning more on Tuesday night. For those who have adopted, how did you choose an agency?

When I first emailed Dr. B and discussed my frustration with the process he said, "You certainly have to try one more time with treatment to be sure that this won't work." Enter doubt. When we talked about it we realized we didn't give Dr. B a full chance. We used our own clinic and had him make the decisions. When we first met with him he told us that he can't control the lab or speak for the lab at our particular clinic. That may be part of the equation. I'm not putting everything on that but it's certainly something to think about. We went through the process of getting all of the blood work done with him and we found out some new information. From there, we've haven't given it much of a shot. It's just so hard to continue doing treatments with the stress of the costs and emotional tolls it all takes. I know we don't have to do another cycle just because Dr. B recommends it but I never want to look back and feel like we should have tried harder. 

When I called Dr. B's office last week to try to book a follow-up/WTF appointment I was told there's nothing available until the second week in January. I emailed him and told him this and he said he'll get me an appointment sooner. 

So, I'll wait to hear when I can follow-up with Dr. B. I have a list of questions started and we'll determine then whether we are going to do another cycle. There is no huge rush to use our frozen embryos, they're not going anywhere. We will attend the orientation on Tuesday and find out more about adoption. I may call and talk with the embryologist at our local clinic and try to find out more information regarding our embryos, my eggs, and W's swimmers. It will help to be armed with that information going into the appointment with Dr. B.  

We're still picking up the pieces and feeling really sad about this most recent cycle. We are taking time to mourn this loss and trying to determine whether we want to continue with treatments or not. Either way, I know we are going to be parents, and awesome parents at that. Our child (wherever he or she is) is so wanted.

Another Negative

There's not a whole lot to say. I was surprised we didn't get a positive this time. I really, really thought this was going to be the one. I feel lost. I don't know what to do moving forward. 

W and I tested the morning of my beta. I was so surprised a second line didn't pop up. We are so disappointed. Yet again. 

We have five frozen embryos left. I'm not sure whether we will use Br.averman for this next cycle. He definitely used a different protocol but I'm not sure it made much of a difference. The biggest differences were Lupron, antibiotics, and Neupogen. He wants me to get a few tests repeated as the nurse said it may help explain why we got a negative. I don't think anyone ever knows why it doesn't work. I just doesn't. 

I'm so tired of this. I just want a baby. 

As I've realized already, life goes on. Even when you feel like you are standing still you look around and realize nothing else is.

 I will be okay and so will W, but it doesn't make it suck any less. 

Transferred

Everything went great today. The two embryos they picked survived the thaw just fine and we still have five embryos in storage.

We arrived on time to a crazy packed waiting room. I guess that's what happens the Monday after a holiday weekend. We waited about a half hour and then W gave up waiting and went to use the bathroom. As soon as he left the room the nurse called my name. He must have heard because he came right back.

The nurse schedued my beta for December 5'th and then left the room to get my Dr. K. I saw there was the picture of our embryos on the counter so W and I checked it out while we waited.

I changed into the sexy hospital gown and relaxed in the bed as the Valium kicked in. The transfer beds at my clinic don't have stirrups and are more like massage tables so it was pretty easy to relax there. We laughed as the ultrasound screen was a freeze frame of someone else's uterus. 

Finally Dr. K came in the room. Everything was quick and easy. Once he was finished he shook both of our hands and left. I stayed laying down for about 15 minutes and then headed over for some free acupuncture.

I haven't seen my acupuncturist in a while since I felt like it was a lot of money to spend and it didn't seem to be making a huge difference. After placing the needles he stayed to chat quite a bit. He asked if I had named our embryos yet and I said I hadn't. He told me I should name at least one of them after him. Then he left and I relaxed and eventually fell asleep. I had slept horribly last night so didn't have much trouble falling asleep. 

When I went to leave I saw it was snowing and beautiful outside. As we drove closer to our house there was no longer snow and I was a bit disappointed. W had to go to work so I watched the movie Elf, ate some lunch, and then fell asleep for a bit on the couch to a comedian on Netflix.

All in all, it was a very relaxing and perfect day. I'm SO hoping at least one of those little embryos decide to stick around. Either way, it's completely out of my hands at this point. I'm glad to have something to do tomorrow as I'm returning to work after five days off. I'm a little concerned it's going to be a huge shock after all of my recent relaxing. 

Tomorrow I have yoga and book club. I'm sad that I won't be able to hang out late due to having to do my PIO and Delestrogen shots around 9, but also my need for sleep. I haven't decided whether I will go back to acupuncture on Wednesday, but we will see. That was what he recommended to assist with implantation. 

 I'm keeping my fingers crossed, my stress levels lows, and trying to stay as happy as possible this next week. It shouldn't be too hard with the way W has been treating me. I'm so lucky to have him!

Oh, and here are the little guys we transferred today. I didn't ask about grades or anything so I'm blissfully ignorant.

What's Going On

The weekend always goes by too fast. How did we get to Sunday night already?

Last week went by fairly quickly. I worked a lot more than I have been working for the past few weeks and was exhausted by Friday night. I felt like such a bum Friday night when I napped while W did two loads of laundry, bathed the dogs, did all the dishes, and started dinner. Whoops!

Last Tuesday night I got together with my friend after yoga and we went out for Thai food. Of course we talked a bunch and had fun so I ended up getting home pretty late. 

Staying out late on Tuesday night made my Wednesday 6:45 appointment feel extra early. My lining measured at 7.78 and my estradiol levels were 746. We scheduled my transfer for the 26th at 10:15. We haven't made a final decision about how many embryos to transfer, but I think it will be two. I emailed Dr. Br.averman to get his opinion and it seemed to be two. He said he rarely recommends three unless the embryos quality is poor, the woman is over forty, or there have been repeated failures. We only fit into one of those categories and I'm not ready to fly through our best embryos. He also told me about the blood work he plans to repeat at my beta. Unfortunately, they were mostly tests that were only done at the out of network lab and are they were super pricey the first time around. I am going to email him to find out more about this. I don't understand the purpose of repeating these tests if my levels were within normal limits the first time. I guess to see how I responded to the new meds?

On Thursday W and I went to a vinyasa yoga class with my mom and then we went out for Indian food after. The class went much better than the previous Sunday. I felt strong and got a great workout. That one instructor is amazing. 

I had a nice friend-filled weekend. I saw my friend T on Saturday and we got lunch, walked around the mall, shopped a little bit, and got pedicures. I'm pretty excited about my new pajama pants and the festive dog collars I bough. T is due with her little boy in eight weeks! I can't wait to meet him. Her baby shower is coming up on December 8th so I really need to finish the binding on the quilt I made and then get it machine quilted by someone. The binding is intimidating me a bit which is why I haven't done it yet. I watched a little video on You Tube this weekend but still am not sure about it. I better get sure about it soon. 

Today we went to yoga and then hung out with our friends C, J, and their little girl E after. The yoga class had a sub instructor and I didn't love it. It wasn't very dynamic or fast moving. Little E wasn't feeling well and was being super sweet and snuggly. It made me want a little one that much more. We made plans with them to go cut down Christmas trees the first weekend in December like we did two years ago. 

I've feeling really hopeful and positive about our transfer. I am excited for it to be here and know the next week should fly by with Thanksgiving. I'm still bruising quite a bit. On Friday I ended up with a dark purple bruise that is bigger than a quarter. It's super attractive, trust me. I also bled for a long time when they took my blood. The Lovenox is definitely working. 

I'm really looking forward to the short work week and seeing all my family on Thursday. Then we have our transfer in eight days! It feels like it's taken a long time to get this close. Let's hope this is it!

IVF #4 CD 16- Fertilization Report

So I got the call this morning from my clinic. Of our 23 eggs they were able to ICSI 19 of them. Of those 19, 13 fertilized (68%). I'm elated that we have 13 lucky little embryos growing. I know that more could still fertilize because it happened last time, so we will see. 

They told me I won't hear again about them unless I want to call. They will freeze the embryos on day 5/6 and I can call if I want to get more information from the embryologist at that time. 

I'm feeling much better today than I was last night. I didn't sleep great because I was super uncomfortable. I weighed myself before bed and was up 4 pounds from the clinic. I can't say my scale is the same as theirs, but my stomach was definitely distended. I weighed myself again this morning and was down 3 pounds. I feel much better. The lupron trigger shot is amazing in comparison!! I can't believe how much better I feel this time around. I almost feel like I could have gone to work today, but I'm glad to be home relaxing and taking it easy.

I'm glad we have the next few weeks to relax and not worry about anything IVF related. I can get my body back to normal and start feeling better before we transfer any embryos. 

Keep growing little ones! I have such a good feeling about this cycle.

Follow-Up Chat/WTF Appointment

My appointment didn't go exactly as I had hoped, but it was pretty good overall. My plan was to let my RE (Dr. Greene) tell me what he thought before asking any questions. Well, he came into the room, introduced himself (even though I've met him 3 times already), and immediately asked me what questions I had. 

So first I asked why he thought I was having chemical pregnancies. He said that he thought it was likely genetic. He explained that at the point that we transfer the embryos they have only made simple determinations as to what type of cells they are going to be (placenta, fetus, etc.) but it's not very complicated. The cells are multiplying and dividing, but not getting too detailed. He made an analogy to a book. It is as if the embryo copied all of the chapter titles of the book, but didn't yet get any words. He said that as things progress the embryo needs to make more complicated divisions and the cells determine exactly what everything will be (liver, brain, blood vessels, etc.) This is where there appears to be a problem. 

He didn't recommend donor eggs, donor sperm, or PGD at this time. He recommended we just keep trying. This I found somewhat frustrating. It's not that I want to do any of these things, but I wish we had more concrete answers. 

His recommendation was to do the FET before moving on to another fresh cycle. He said the quality isn't great for the ones we have, but it is best to focus on this as our next step. When the embryos were frozen both were graded 4CC. 

He then said grading is just a beauty contest. It's not that he doesn't give the embryologists credit for the amazing job they do, but he and the other doctors at the practice don't care as much about the grade. He said it probably means more to me than it does to him. Dr. G told me a story about a woman who had only 1 embryo to transfer that the embryologists graded as so poor they didn't even recommend transferring. This woman got pregnant and her son now speaks 3 languages and plays 2 instruments. He said even though our embryos didn't get a great grade on their report card there's no reason to believe they can't turn out to be perfect babies. The grading plays no part on what the child ends up as, it's just a simple way of judging them when they are at such an early stage. Once they implant there is no reason to believe they will be inferior or imperfect. 

He also said he did a study which compared embryos with PGD. He said often the best looking ones were the ones that were the most abnormal. His theory was that the ones that don't look as great could have had a simple problem during division and they already corrected themselves, giving them a less than perfect appearance. 

Dr .G didn't seem to think the coasting had much of an effect on my eggs. He said the HCG trigger is what is responsible for the final maturation and not the other meds. He did say that one option is to do a staggered cycle. This is when you don't coast at all but you freeze all embryos and transfer them in a subsequent cycle. 

He didn't see any problems with egg quality, sperm quality, or embryo quality. This is pretty good because I was worried about my eggs and embryos. My last clinic told me that all of our embryos were slow to develop. He said this wasn't the case with my past 2 cycles. He compared it to puberty. Just because people go through it at slightly different times doesn't mean either are better or worse off. 

I asked about my thyroid since my levels vary a bit. Since they are always (more or less) within the normal range he didn't think any further testing was necessary. He said TSH levels can affect a person's ability to get pregnant, but don't typically unless they are grossly abnormal. 

I asked about doing a panel for RPL but he said it wasn't going to change anything we are doing. It is just more testing and more money, but it won't change our current protocol. He was skeptical about Lovenox, but said the other doctor in the clinic highly believed in it. He said there weren't any specific studies to prove it is effective. He seemed to be on board with intralipids and Metformin to help reduce miscarriage rates. 

I really wanted a plan for our next IVF, but he was more focused on the upcoming FET. He said he could sit down and look specifically at my past cycles and make a new plan, but he didn't feel like we should focus on that yet. He said I could email him any time and I plan to (if necessary) about this rather than booking another appointment if our FET doesn't work.

The dialogue part of the appointment was pretty short and a nurse popped her head into a room at one point and I heard something about someone being ready for an HSG. He pretty much wrapped things up and said to stay positive and focus on our next FET rather than trying to plan for our next IVF. 

I then asked if I was going to get an ultrasound. He said I could if I wanted one. I explained that I was wondering if this cycle was ovulatory or not and wanted to get a prescription for progesterone if it wasn't. 

They brought me into another room and I waited a bit. I'm guessing he did the HSG in that time. Then he came in and did the ultrasound. First was my lining. It was a bit thin for me at 7.5. He then went to my right ovary (the one with a tube) and there was a great looking follicle which measured about 17 mm. On my left ovary (the one without a tube) there was another one which was larger and a little bigger than 20. I asked about a natural FET and he asked when my HCG came back negative. I think how recent that was paired with my thin lining made him say it wouldn't be a good cycle to do it. He said I should pick up ovulation tests and start using them. He then said we should definitely try on our own this month.

To find out I was actually ovulating was pretty great. There are some perks to going to a fertility clinic, such as getting a peak inside even when you are not actively cycling. In total, W and I only tried on our own 3 months. One was the first month before we saw a RE, and 2 cycles were post D&C so I don't even know if they were ovulatory. Sometimes I wonder if we could do this on our own, but it's hard to have faith in my body at this point. Dr. Greene did say that often women get pregnant in the cycles immediately following an IVF cycle. This is because the eggs are exposed to a more favorable environment preceding final maturation and ovulation. I would certainly take a natural pregnancy at this point!

I know this post is thorough and I may have bored the crap out of you, but I wanted to document and remember as much from the appointment as possible. I'm a seeker of information and always try to understand as much of this process as I can. 

I've been peeing on OPK's for a few days now. Since I have so many and they are cheap, there is no concern with using more than 1 per day. This afternoon the line was darker than it has been and there has been an abundance of EWCM. I'm hoping I get a positive soon and I will keep you posted. 

IVF #3 Beta Results

I mentioned earlier my fear of another chemical pregnancy. I'm pretty sure my fear is becoming a reality. My beta HCG levels came back at 19.5 today. Yeah, that's less than half of what it was last chemical pregnancy at this point (43). I'm not alluding myself at all. I'll return on Tuesday (closed Monday for the holiday) and have my blood drawn again, but I may stop my meds before then. I bought some FRER tests and I'm going to watch the progression in the next few days. I used a FRER and a cheapy test this afternoon. On the cheapy test today the second line really wasn't any darker than it was 2 days ago. 

I did find out we have 2 frozen embryos and I booked a follow-up appointment with Dr. Greene for June 8th, so we have a backup plan for now. Honestly though, I don't think FET's work for me. It's just part of the contract we are in that we have to use them before moving on to another fresh cycle. 

Speaking of fresh cycles, we only have one more paid for. I feel like we need to change something. What we are doing does not seem to be working.

I'm going to ask about PGD. I know it's expensive, but so are repeated rounds of IVF. I feel like it was stupid to expect a different result with the same (more or less) protocol for IVF #2 and #3. 

I wish I had better news to share today and I hate the disappointment of another (likely) failed IVF cycle. This process is starting to become really disheartening. 

Nada

That's how many of the frozen embryos we transferred implanted. I had the formality of my beta today to tell me what I already knew. The nurse said, "Hey, you never know" when I told her I knew it was negative. When she left the room W also said that is also the slogan for the lottery.

 I started testing the day before we left for vacation and nothing ever appeared. I used Wondfo and bought 3 FRER tests. I only used one of those at 7dp5dt and that's when I knew it was over. The consolation prize? An amazing vacation in Mexico. We ate, drank, swam, relaxed, read, ziplined, snokeled, rappelled, sunned ourselves, and enjoyed each other and the surroundings. I think every 2ww should end either with a positive pregnancy test or a relaxing vacation. Add that to my bill!

Our resort was amazing and adults only so I didn't have any great (or not so great) families to watch and feel jealous about. No cute babies or screaming children, so it was pretty great. I read 2 1/2 of the 3 Hunger Games books and can't wait to see the movie. 

At my appointment this morning I asked about another IVF cycle. We can start as soon as AF shows by taking BCP's. Oh joy! They gave me a free pack of pills and told me to call on CD 1. We discussed the Lupron and Antagonist protocols and the NP gave me a few good reasons why the Antagonist wouldn't be a good idea. 

First, my estradiol levels peaked at 7672 last cycle. Since I wasn't on any antagonist we were able to pull that out of the "back pocket" to make my levels drops way down. Also, they retrieved 28 eggs. With no suppression the NP said my response could be scary, especially with polycystic ovaries. We will switch from Menopur to Luveris this cycle and use a much lower dose. She said I may stim for more days but hopefully we will keep my estradiol levels a bit lower and more under control. 

How do I feel about doing it again? Eh, whatever it takes, right? I'm not excited to go through the egg retrieval process again, but it will be ok. I don't think waiting or taking any time off helps me. In fact, it just reminds me of the negative experience with all the waiting with RE #1. 

BTW, we transferred all 4 of our frozen embryos. I'm not sure what their grades were, how many cells survived, etc. We decided to thaw all 4 thinking they wouldn't all make it. I wanted to transfer 3 this time but when we were told all 4 survived, my RE and I agreed to put them all back. Part of the decision making process is that with the package deal we bought in order to move on to another fresh cycle you have to use up all of the frozen ones first. I wanted to transfer 3, so it didn't make sense to keep just one frozen. I'm pretty bummed that none of my 4 blastocysts implanted. I guess it wasn't the right time or the right embryos. That's all I can really say about it. No use feeling badly. 

Onward and upward. 

5DP5DT and Hanging in There

I haven't updated since the morning of my transfer. The transfer itself went fine. Dr. K (aka Dr. Gere) did it this time rather than Dr. Greene. Dr. K is my actual doctor, but this was only the second time I've seen him in this process. He didn't really want to tell me the grades of the embryos when I asked and gave me a speech (about 2 feet away from my face) about how it doesn't really matter. He is a very touchy-feely, oozing with positivity kind of guy. He said how he has seen both good and bad embryos turn out to be perfectly healthy babies. All of the embryos we chose to thaw survived so we transfered them. 

Dr. K just went about his business and didn't really explain the process as he was doing it. He didn't tell me when he was going to put the embryos in and I noticed more cramping this time. It could have been the lack of knowing what was going on, or the technique, but it was pretty minor cramping. He wished us luck and left the room. 

I went to acupuncture after and took a nice nap. I followed up two days later with another session to "help with implantation." 

The first few days I made the joke that I didn't have a uterus, that way I wouldn't be able to tell what was going on. I didn't over think it much and continued on. After my post about symptoms being B.S I kept repeating that to myself. At this point I'm pretty close to insane. 

Tomorrow morning bright and early we leave for vacation. I am so excited to get out of town and relax for 6 days. I'm also excited for a week off from work. I will be bringing some HPT's with me since the waiting last time almost killed me. The anticipation and anxiety just weren't worth it. And, this time I will have my beta 2 days later since I am out of town. I won't be posting over vacation so I guess I will just leave you in suspense for the next week. 

If it works, that will be awesome and amazing. I'm not holding my breath since the embryos really didn't look as good as last time. They were much more bloby and I'm sure they weren't as high of a grade. I know the grade doesn't mean everything, but they were also frozen. I'm trying to convince myself that if they made it to day 5 and then survived freezing and thawing, they must be somewhat strong. 

If this is a bust we have 2 more fresh IVF cycles already paid for. I'm hoping we don't have to do that, but at this point it's not as overwhelming and intimidating. I have almost all of the meds necessary and know mostly what to expect. 

Wish me luck. If not, I will drink some delicious frozen beverages, I promise. 

IVF #2 CD 20 Transfer Info and 1dp5dt

I didn't update at all yesterday about the transfer. But, it went fantastic! We really couldn't have asked for any better. 

When we arrived at the clinic I took my Valium as instructed. We were called back shortly after which made me nervous since I wasn't feeling it at all. They brought us into the newly expanded part of the clinic. It was absolutely beautiful. We walked past the embryology lab which was fish-bowl style. There were lots of people working away.

When they brought us into the room it felt more like a spa room than a transfer room. Super comfortable bed, no stirrups, low lighting, music, and calming colors. The nurse came in and explained everything that was going to happen. She asked if I had a preference for the doctor and I said I didn't care. She had a print out of our embryos and she started counting. Where did she stop? 17!! Of course not all of them were at the same stage, but all were still going, which completely shocked and amazed both W and me. 

Then the doctor came in. It was the same one who did my retrieval and I really liked him. W actually remarked when he first came into the room to explain the retrieval procedure my heart rate dropped dramatically by the time he left. 

Dr. Greene told me we had 4 blastocysts and that he recommended transferring 1 or 2. He said he would need a lot of coaxing for 3 since the quality was so good. We talked about the odds. Transferring 2 meant greater odds for twins, but it also upped the success rate from transferring 1. Transferring 3 made the triplet rate a little scary for both of us and didn't change the overall success rate.  

He showed me the best blastocysts and I then asked about the grading. He opened a door which led directly to the embryology lab and called the embryologist in. She told me of the 4 we had, 2 were 4AA and 2 were 4BB. There were a bunch more that were close and they were going to monitor them to see whether they turned to blast. Her recommendation was to transfer the 2 4AA's and freeze the 4BB's. Done deal.

Dr. Greene first did a trial transfer and then the actual transfer. When he was doing the trial transfer he turned the screen towards me and moved the catheter so I could see what I was looking at. He then said, "That's me, waving hello." We all laughed awkwardly at that one. 

W was there holding my hand the entire time and it was over quickly. No cramping, no discomfort, totally smooth. Dr. G counted down, "3, 2, 1" when he put them in, but I couldn't see anything different on the screen. I wasn't sure exactly where to look. 

I scooted up the bed and relaxed for the next 20 minutes or so. We got a picture of the ones we transferred and I've been transfixed by them since. Maybe I'm biased, but I can't believe how perfect and beautiful they are. 

After the 20 minutes the nurse returned and said I could get dressed. We walked about 30 seconds down the hall and were at acupuncture. I definitely fell asleep there and felt super relaxed. We went home and spent the rest of the day lounging around and watching comedies. 

Today I went back to work since I've missed so much. It was a light day and I tried not to pick up any of the kids or be too physical with them. When I woke up this morning I felt really anxious, but was able to listen to Circle + Bloom, and that really helped. 

Unfortunately, W texted me around 11 saying the stomach bug had hit him. This evening was spent laying low and relaxing again. I feel terrible that he got it too since it's no fun. I hope he feels better soon. 

Tomorrow I have acupuncture scheduled for 3:30. We bought tickets to the SU Georgetown game, but I'm not so sure we will be going. It's harder to be distracted and positive when your hubby is so sick. I'm trying my best though. 

I'm thinking positive and grateful thoughts and really hoping this is it. Oh yeah, and here are my amazingly beautiful future babies:

Our 2 4AA blastocysts

Our joke is that the one on the left looks more like me since it's rounder and I have a rounder face and features. Very creatively, it is nicknamed "round". The one of the right looks more like W since he has a more narrow face and more pointy feature. That one is called "pointy". So hopefully "round" and "pointy" are getting comfy cozy as I type. 

Embabies on board

Our transfer was at 9:30 this morning. Although I had trouble falling asleep and proceeded to have crazy dreams, I still woke up feeling rested. When we got there our embryos were up on the computer screen so I took a quick look. Four appeared fine and one no longer even looked like an embryo, more just like an egg. Dr.S appeared shortly after and began getting set up. They wanted to bring me into the transfer room at 9:15 but my bladder wasn't very full and I wasn't feeling the Valium. I've read too much about people being incredibly uncomfortable due to an over-full bladder, so I guess I didn't drink enough.

They gave me some time to drink more water and then we talked about the embryos. Of the four that survived two looked really good and two had yet to cleave or divide. I guess they were still viable, but hadn't shown any new growth. So...? We put them all back. I think it was the best choice because I would hate to think the two slackers could get tossed. 

Looking and feeling loopy, W has no excuse

It took a bit of time to get my uterus in full view on ultrasound, but once they did we were ready. They put the embryos in and then checked the catheter to make sure they were out. 

When they brought me back out to the original room to lie down I was super loopy. I was cracking myself and W up with my actions and comments. I had a bit of gauze and was using it as a pirate's patch. 

After a half hour I sent W to pick up the car and planned to walk out and meet him. When Dr. S saw me waiting by myself he offered to walk me out. He walked me out to my car and even opened my car door for me. 

My beta HCG test will be in 14 days, which is a bit of a long wait if you ask me. I am planning to test before then, but definitely not too early, I promise. I might even just test the day of so we can get the news together and at home. Dr. S told the nurse he would be the one to call me with the results. 

I spent the day lounging on the couch watching movies and shows: 30 Minutes or Less (ehhh, even though it had some of my favorites), 27 Dresses (always a good one), Parks and Recreation, The Office, and now America's Funniest Home Videos. No serious or sad stuff around here. Tomorrow I have to do an evaluation at 9:00 but plan to take the rest of the day off. W has been great today, doing everything for me and being super helpful. I will miss him tomorrow.

I will be thinking positive and hopeful thoughts for my embabies on board. How is it possible to have so much love for a little bundle of cells?

Hello again disappointment

The nurse called today and said we will not be able to do the FET this cycle. My RE wants me to come in for another ultrasound when I stop bleeding. He wants to be sure the fluid is gone. I guess if I were to start the estrogen and start building up my lining it could mask the fluid. If the fluid is still there he wants to do a biopsy.

The ultrasound tech is on vacation next week and I don't have an appointment until August 8th.

 I am frustrated to say the least.

Now the debate is whether to wait another 7+ weeks to do the FET (my cycles unmedicated are about 35 days), or whether to start another fresh IVF. I was willing to do the FET this cycle because it would give me closure on our cycle. I didn't have a ton of hope in the fact that the embryos that were frozen were as follows: 1 6-celled embryo graded 4+, 3 4-celled embryos graded 4, and one fertilized egg that hadn't started to divide. It was always very clear they were slow to develop.

So I'm working on a pro's and con's list of IVF and FET.

FET

Pros:

The only cost is the meds (estrogen)

It may work and we could get pregnant for the cost of one IVF cycle

It gives me closure on our cycle and allows me to say we completed an IVF cycle

Cons:

The chances of success aren't great

Our embryos are not as many cells as they should be for day 3 embryos

We have to wait 7+ weeks

The best embryo may not survive the thaw and we would be left with only 4-celled embryos to transfer

IVF

Pros: Doing one cycle prior lets us know that we need to ICSI all eggs and may result in more embryos

We could be transferring fresh embryos in about 7 weeks

The chances of success are higher

We have all the meds we need

We can start this cycle (I think)

Cons:

$$$$

Our embryos could be slow to develop again

Fluid could return since we didn't know what caused it

I really can't make any decisions until the ultrasound to know whether the fluid is gone. Today W and I had a conversation about where to go from here, how much disappointment this has all been, how far we are willing to go with fertility treatments, and how this will all (hopefully) be worth it. Needless to say, the disappointment continues.

IVF #1 CD 16 (cancelled transfer)

Today absolutely sucked. I don't understand why my body won't cooperate and things always go wrong. I am so incredibly bummed and spent much of the afternoon crying/napping in bed. I had to keep myself together for hours since I was with my MIL, so literally the second I walked in the door I started bawling. 

We arrived on time for the transfer and although my RE was a little late, he got there and we were able to look at the embryos and make a decision as to how many/which ones we were going to transfer. We picked the best 3 (one was 6 cells, and 2 were 4 celled and all were rated 4/5.) I had taken my Valium and was plenty relaxed. 

We got into the transfer room and they got me all gowned up and covered in sterile sheets. They then called the ultrasound technician to come in. She got the abdominal probe ready and puts it over my abdomen. Immediately she says, "What that?" She and my RE decided they need a better look with the vaginal probe and my RE puts it in. Like I said before, he is NOT gentle with it. He zooms in and they all agree it looks like an early gestational sac. They then called the other RE from the practice, the embryologist, and another nurse into the room. They were all amazed by what they saw and decided I need to take a pregnancy urine test and go upstairs to the higher resolution ultrasound machine to get a better picture/idea as to what was going on. 

The urine test is negative. 

The ultrasound reveals 3 areas of fluid in my uterus and they draw my blood for another pregnancy test. The ultrasound technician is able to get a measurement on the one round spot in my uterus and it measures ~4w4d. 

I talk to my RE again and he says he will get the results of the blood pregnancy test and that I should come back in 2 hours so we can talk about it. My MIL and I went and got lunch and returned a little after 3. They made the decision to freeze all embryos since there wasn't a great chance for success with something in my uterus of unknown origin. 

The HCG results were 43. This is likely residual from the trigger, especially since it would be impossible to see an early gestational sac with such a low HCG level. My RE said he will treat it for the weekend as if it were a pregnancy, but it is highly unlikely. I am supposed to continue the progesterone and return Monday for another HCG. Regardless, this number is far too low for what it should be if I were pregnant. 

All in all, we froze the embryos and he wants to keep me on progesterone (probably pill form after Monday's results) in order to be sure I have a good bleed after and get rid of everything in my uterus. We will plan to do a FET next cycle. 

I can't believe I didn't even get to the transfer. I am SO disappointed in my body and am starting to wonder whether this is ever going to happen for us. My RE said I have not followed any of the textbooks and he will take my case to a panel of doctors next week to discuss it.

Today seriously sucked and I am so bummed. I know that freezing and not transferring was the best decision and none of the other doctors consulted said they had ever seen this happen. There wasn't any fluid there Sunday. I just wish my body wouldn't repeatedly fail me.