Thursday, August 13, 2015

Just for an instant...

Hello all!

A little update for you, when we last left off I had a beautiful blastocyst transferred and we were amidst the dreaded two week wait to see if it implanted and if I was pregnant or not.

I started out this wait suuuuper cocky. A blast, of COURSE this is it, we have never had one this advanced! I was so cocky I tested at 2dp5dt (2 days past 5 day transfer) in other words, I should seek some sort of psychiatric help...lol. Clearly, it was negative, that poor little nugget didnt even have a chance to check out its surroundings yet! So I tested again at 6dp5dt (6 days past 5 day transfer, also could be called 11 days past ovulation) 2 perfect lines showed up. POSITIVE!! One more faint than the other, as it was so early. Two days later, I took a digital test "Pregnant" showed up on the screen! What a beautiful word! Our family would be growing! A sibling for Colin!

The next day (tuesday) I started bleeding, Thursday was my blood test, still more bleeding, I knew it wasn't good, deep down I hoped it wasn't so. My Beta (blood test) came back at 52, I was pregnant, but juuuuust barely (50 is considered positive). Repeat beta in 2 days - beta 2 came back at 62. The numbers were growing, but not doubling as they should be every 48 hours. People told me "stranger things have happened" I read story after story on "Dr. Google" about low betas. I tried to have hope. But really I was pissed. I knew it was over, why couldn't my body even miscarry correctly?! Two days later beta 3 came back at 6.5. At least I had an answer, I had officially miscarried, or had a "chemical pregnancy". You would think this would be the end to the maddness, nope, my numbers need to be >1 so beta 4 happened 2 days after that it came in at 1.2. For real, so beta number FIVE will be coming. You should see my arms and hands, its not pretty.

People have asked if I'm ok, honestly, I was sad and pissed for a few days, but after having lost Josh and Zoe, this loss, though sad, was sort of put into perspective by my past. I'm just ready to keep going.

#realtalk #pityparty  I'm so friggin over this. Sorry, I will do what I need to do to have a sibling for Colin, but good gracious, can I catch a break ONE time. When we had our transfer I told Bill "this isn't going to work, it was too easy, everything went too smoothly". Man I hate it that I'm always right ;)

So what now?
On the 17th I go in to see my RE for what we in the infertility world call the WTF appointment, as in wtf went wrong and wtf are we going to do about it. This is also when I will have beta #5. We will be signing consent to have a frozen embryo transfer (FET). We have one embryo frozen waiting for us. Here is how this works (the short version) 2 weeks of suppression (so I dont ovulate), blood work and ultrasound, 3 days of progesterone (possibly intermuscular shots in my hip/bottom) then a transfer. All things considered, it's an easy cycle. However we could do all this prep work and show up for transfer and the embryo could have not survived the thaw. In which case we would have nothing to transfer and just wait to move on to another fresh cycle. We will just continue to say our prayers! For now we will call our little snowflake Olaf

Send some love our way, and we will continue to keep you posted <3 
.

Monday, July 27, 2015

PUPO! (Pregnant until proven otherwise)

.
We are PUPO - pregnant until proven otherwise! ^^^ Hello there little baby!! Today this little friend came to stay in my uterus! Say some prayers that he/she is snuggling in tight!!
The expansion grade scale ranges from 1 (least expanded) to 6 (completely hatched).
Grade 1: the fluid-filled cavity takes up less than half the space of the embryo.
Grade 2: the fluid-filled cavity takes up more than half the space of the embryo.
Grade 3: the blastocyst cavity has expanded into the entire volume of the embryo, pressing the trophectoderm cells up tightly against the inside of the zona.
Grade 4: Expanded blastocyst, where the blastocyst has increased beyond the original volume of the embryo and caused the zona pellucida “shell” to become super thin.
Grade 5: Embryo has breached the zona and is hatching out of its shell
Grade 6: Embryo is completely hatched.
So the embryo is given a number grade (1-6), followed by a letter grade for the inner cell mass and then the trophectoderm (A,B or C).
For the inner cell mass:
A: Many cells, tightly packed
B: several cells, loosely packed
C:  very few cells
The trophectoderm grading goes like this:
A: many cells, forming a cohesive layer
B: Few cells, forming a loose layer
C: Very few large cells.
- See more at: http://fertilitylabinsider.com/2011/12/understanding-the-gardner-blastocyst-grading-scale/#sthash.xHvBQGol.dpuf
What you're seeing here is 1. the early beginnings of a baby and 2. More technically - an expanded blastocyst grade BA. Here's a little bit about that that means!



Expanded blastocyst - The fluid filled cavity volume is larger than that of the early embryo and the zona pellucida (outer shell) is thinning.

The ICM grading is as follows:
A ----- Tightly packed, many cells;
B ----- Loosely grouped, several cells;
C ----- Very few cells.

The trophectoderm (the inner shell) grading is as follows:
A ------ Many cells forming a tightly knit epithelium (layer of cells that make up the outer surface of your body);
B ------ Few cells;
C ------ Very few cells forming a loose epithelium.

So what? Welllll that means, basically, that it is in good shape, and a better quality than any of the embryos we have ever had!
We also have one to freeze for sure and maybe 3 more!! holy wow! That has never happened!! Frozen embryos means that if this doesn't take, or we want baby #3, then we don't have to do all the shots and procedures right away.

A little about the procedure - warning if you don't like mild gynecological talk don't read this, though it is a blog about making a baby after all!
I had to arrive an hour early to start drinking water and get checked in. You must have a super full bladder in order to do the procedure, it helps push your uterus down so its more accessible. (Here's the warning part) They brought me into the room to get set up, checked my arm band 2374634 times so I actually had my own embryo implanted then they get you in the stirrups. Now remember I have a TAC (transabdominal cerclage) this is tied at the top of my cervix, because of this my cervix doesn't "rise and fall" like most women. It just stays way way up high, which is fine b/c now it holds in a baby so I'll take that "pitfall".
My RE had to use like 4 different kinds speculums (this sounds like a Harry Potter word) and an extra long catheter to finally reach my cervix. OUCH! He then threaded the catheter through my cervix and into my uterus. The nurse yells "patient ready", embryologist yells "embryo ready" we see it on the screen above our heads and then she runs into the room with another catheter. The embryologist's bonnet was fabric with eggs and sperm on it, amazing. We watch the little white blip that is the embryo float into my uterus.
They took everything out and I went to lay back and settle in for my 15 minutes of laying flat when the nurse told me they don't do that anymore! My how things have changed, they also said I have no restrictions and can pick up Colin any time I want. I will have a blood test later to determine if the embryo "took" (if I am pregnant or not).
Then Bill and I went out for a nice lunch together! (Thanks Mom for watching Colin!)

At this point in the process Bill and I have decided that the blog should go dark for a while. Until we are ready to announce a pregnancy or until we begin another IVF cycle (both will take a while) Until then send some prayers our way!!


Grade 1: the fluid-filled cavity takes up less than half the space of the embryo.
Grade 2: the fluid-filled cavity takes up more than half the space of the embryo.
Grade 3: the blastocyst cavity has expanded into the entire volume of the embryo, pressing the trophectoderm cells up tightly against the inside of the zona.
Grade 4: Expanded blastocyst, where the blastocyst has increased beyond the original volume of the embryo and caused the zona pellucida “shell” to become super thin.
Grade 5: Embryo has breached the zona and is hatching out of its shell
Grade 6: Embryo is completely hatched.
So the embryo is given a number grade (1-6), followed by a letter grade for the inner cell mass and then the trophectoderm (A,B or C).
For the inner cell mass:
A: Many cells, tightly packed
B: several cells, loosely packed
C:  very few cells
The trophectoderm grading goes like this:
A: many cells, forming a cohesive layer
B: Few cells, forming a loose layer
C: Very few large cells.
- See more at: http://fertilitylabinsider.com/2011/12/understanding-the-gardner-blastocyst-grading-scale/#sthash.xHvBQGol.dpuf
Grade 4: Expanded blastocyst, where the blastocyst has increased beyond the original volume of the embryo and caused the zona pellucida “shell” to become super thin.
Grade 5: Embryo has breached the zona and is hatching out of its shell
Grade 6: Embryo is completely hatched.
So the embryo is given a number grade (1-6), followed by a letter grade for the inner cell mass and then the trophectoderm (A,B or C).
For the inner cell mass:
A: Many cells, tightly packed
B: several cells, loosely packed
C:  very few cells
The trophectoderm grading goes like this:
A: many cells, forming a cohesive layer
B: Few cells, forming a loose layer
C: Very few large cells.
- See more at: http://fertilitylabinsider.com/2011/12/understanding-the-gardner-blastocyst-grading-scale/#sthash.t16rla1O.dpuf
Grade 4: Expanded blastocyst, where the blastocyst has increased beyond the original volume of the embryo and caused the zona pellucida “shell” to become super thin.
Grade 5: Embryo has breached the zona and is hatching out of its shell
Grade 6: Embryo is completely hatched.
So the embryo is given a number grade (1-6), followed by a letter grade for the inner cell mass and then the trophectoderm (A,B or C).
For the inner cell mass:
A: Many cells, tightly packed
B: several cells, loosely packed
C:  very few cells
The trophectoderm grading goes like this:
A: many cells, forming a cohesive layer
B: Few cells, forming a loose layer
C: Very few large cells.
- See more at: http://fertilitylabinsider.com/2011/12/understanding-the-gardner-blastocyst-grading-scale/#sthash.t16rla1O.dpuf

Sunday, July 26, 2015

A transfer you say?

So this cycle has been different than any of my previous cycles. On saturday morning, 3 days after my egg retrieval I got the call that they were canceling my transfer and pushing us out to a day 5!
What this means - the longer the embryos can continue growing in the lab, the better chance we have at picking the strongest one. 5 days is the max amount of "lab time".
This is what embryos look like as they grow. Colin was an 8 cell, and Josh & Zoe were 7 and 9 cells.

The embryologist called me today to tell me about my transfer for tomorrow. I asked her about how many we had and their grades. We still have 7 (SEVEN!!!) 
This is how we (we meaning I have no part in this at all...) grade embryos
So the top ABC - this tells about the symmetry of the cells
The next row says 1234, in my practice they use GFP- good fair poor. This talks about the fragmentation or space and "extra" stuff in the embryo.
And of course the higher the cell count, the better.
Got it? Easy Peasy right?? HA
Anyways, lets keep this in mind - Josh and Zoe were 7BF and 9BF, Colin was an 8BF(one of the 8BFs in this cycle didnt make it).
We currently have 2 10BGs (AHHH) and 5 8/9CFs. One of the BGs will be transferred tomorrow at 12:15!
Say a little prayer for us that transfer goes smoothly!!
Tomorrow I will show you our little "embie" and I will explain the transfer procedure. I feel I have bombarded you with enough info for one post!

Oh and because some people have been asking, we will being doing a SET (Single Embryo Transfer). The doctor is too worried for me to carry twins again (even tho the TAC can handle it) but really the end all be all is the fact that insurance will only approve the transfer of one embryo graded better than an 8bf in patients under 35. So unless I want to pay for IVF (which I don't) then one it is.

Thursday, July 23, 2015

Fert report!

I always want to sing "creature report, creature report cre-ture re-port!" but with "fert"

ANNNNYwayyyys
Out of the 15 eggs they retrieved 14 of them were mature and 8 of them fertilized.
So to break that down even further, ICSI (intra cytoplasmic sperm injection) is done to fertilize our eggs. The embryologist took a single sperm and injected it into a single egg 8 of them managed to successfully fertilize and begin to grow.


On transfer day they will pick the embryo with the most cells and the best letter grade. If it's below an 8BF then they will allow us to transfer two. 

So we will watch and wait, the embryologist will call me tomorrow and tell me how many cells each egg is and we will probably transfer on Saturday.

end of super short post!

Wednesday, July 22, 2015

Buck buck buckkkkk

Today was egg laying day!!!
Or retrieval if you want to be all technical

We left bright an early so we could beat the traffic! When we got there they of course took my vitals. My BP was so outrageous number like 146/96 or something (needless to say I was petrified). The nurse was amazing, as they usually are, and she promised we would take our time and do the IV right.
She wrapped my arms in warm blankets and then took about 15 minutes to feel all possible places to put the IV. I appreciate her taking the time and not just jumping on what she "thought" might work. She decided to try for my hand but promised to not force the plastic cath if it wouldn't go. She got it!!! She got it on the first try and the least painful IV I have ever had!

Yes, I took a picture! Its a big deal!!! We waited a little while until the person ahead of my was out of the OR. It was finally my turn, I walked in and sat on the OR table, scooted down and they strapped my legs in the stirrups. They strapped my arms in and started to administer the meds to make me go to sleep.

I came into the recovery room with O2 still on, first time for that. Bill was there, I didnt talk to him so I didn't say silly things. First thing I did say when I finally felt more coherent : "How many did we get?"
My good nurse laughed at me and said we got (drumrollllll)

15 eggs!!! WOOOO
Tomorrow they will call and give me the "fert report" and then I will have a transfer friday, saturday, or monday (it will probably be saturday) Until then, we wait!

Thanks for all the prayers!!

Monday, July 20, 2015

Pulling the trigger



Today was another day of monitoring. So here we see my two ovaries almost touching each other (they aren't really suppose to do that in real life) and in the middle, the shadowy ball is my uterus. Fun huh? The ultrasound tech said she wasn't sure what they were going to do with me since I had a batch of follies in the 18ish mm range and then a bunch in the 15-16mm range (we need 19-22mm). I finally got the call today at 4pm, as I was beginning to freak out about being forgotten about...
Turns out they wanted me to trigger!!! WOOOOO!!! So what a trigger shot does, is it tells the body to release the eggs, basically I take HCG to make me ovulate. I HAD to take it at 8:30 on the dot, 36 hours later (wednesday 8:30am) I need to be in the OR to have my retrieval  


Here is my trigger shot!

I have to draw up 1cc of diluent and mix it with the powdered HCG with that giantass needle you see there. Then I get to unscrew said godzilla needle and put on the little subq one. Way easier! However this time the needle caps wouldn't come off and I was afraid of yanking them and stabbing my finger so I ended up bending one of the little subq needles, good thing they send 2!

So if you happen to take a moment on wednesday morning, just send a little prayer my way for an easy surgery. Also that they can get the IV set on the first shot, without blowing out multiple veins and me having a crying hysterical moment when they cant do it but keep trying. Honestly, getting an IV is the worst part of this whole entire process. Needles in my belly all day erry day is no big deal its blood work and stupid IVs that are the big problem.

Until next time!



Saturday, July 18, 2015

Do you want to see my follies??

If you sang that title to the tune of "Do you want to build a snowman", then you win.

So here they are so far!





It appears that I have around 18 follies all in the 12-14mm range (goal is 19-22mm). We are trucking right along! I'm def starting to really feel the fact that my ovaries have literally 17x the amount of things in them on any normal month.

This med I am taking - Ganarelix
See that large yellow sicker on it? If you cant read it, it says "May cause headache". Yeah, as in perpetual headache that sleeping wont touch. Caffeine is a no go, and I am suppose to stay away from pain killers as much as I can.
The nurse said I might be ready for a trigger on Monday, which would make my retrieval on Wednesday morning. Monday morning I have more BW and US, that will tell me our next course of action.