Aug 25, 2011

FET #2: craziness ensues!

First off, I have been pretty horrible commenting this ICLW (and actually in general over the past few weeks). For someone reason, reading blogs lately has been stressing me out a little, so I apologize. I hope I will be back in full blog commenting gear soon.

Here is the craziness I shared with my message board buddies earlier today:

Yesterday was our 2nd FET. I was told to arrive at 10:30 am. When I arrived, the nurse told me that there were many transfers today and to expect a long wait. I figured I must be last on the list, because I noticed that they were having both the women who came in before me and the women who came in after me change into gowns but not me.

Around noon, Y decided to speak with the nurses and as usual, he got more information than me. They told him that it wasn't that I was last on the list, but that they were putting my transfer on hold because the thawing had been problematic and the lab was waiting for the doctor to make a call on whether we would proceed or not.

According to the fertilization report, we had 2 frozen embryos remaining in a straw together: a 5-cell BC grade and an 8-cell B grade (my clinic uses an A-D scheme to rate fragmentation, with A being the best). My RE had told me not to expect much from the 5BC, it was not such a good embryo and would be likely to not survive thawing.

Anyhow, the RE doing the transfers comes out and tells us that our embryos were initially a 9-cell BC grade and an 8-cell B grade and that after thawing, the 8B only had one surviving cell and wasn't viable (this was supposedly our good embryo) and that the 9BC had 7 surviving cells and was viable to transfer.

Objectively, none of this information added up at all to the original information we had about these embryos: a 5-cell BC and an 8-cell B were supposed to be in a straw together but it turns out that it was actually a 9BC and 8B and that now they are 7BC and 1B? It just didn't make very much sense and I guess that is why the lab was waiting for the RE to make the final call about whether to proceed with the transfer of the one remaining mystery embryo. I saw in marker on the updated report print-out where someone had crossed out "5 BC" and written "9 BC."

The RE told us that it's possible that the 5 BC just "grew a lot" (almost 2x?) in the time between the final grading report and being frozen. This explanation really doesn't make much sense biologically, and all of our other embryos remained the same in cell number, so it doesn't seem that a lot of time elapsed between the final grading and the freeze.

We went ahead and transferred the one remaining mystery embryo at the RE's urging but I am still so confused. In other news, I got a horrible migraine yesterday after the transfer and spent the night vomiting (sorry for the TMI). It seems like there are 3 possibilities here:

1) They got confused between the 5 BC and 8B in the same straw - it makes a lot more sense that the 5 BC wouldn't survive and only 1 cell would remain viable and that the 8B would remain viable but lose 1 cell, making it a 7-cell embryo. I think this is the most attractive and reassuring explanation, even though it's not the one they were offering us.

2) The 5BC miraculously almost doubled in cell number between the final grading and the freezing although during that same time period, every other embryo remained the same in cell number.

3) The 2 embryos in the straw didn't resemble the original embryos we froze because they weren't our embryos (this is the most horrifying explanation but also the most unlikely). I know this is probably almost impossible but the thought crossed both Y's mind and my mind independently.

Thank goodness we have our long-awaited appointment next week with the new RE. I am ready to run, not walk to a new clinic. I am curious, in this situation, what would you guys have done? Would you have still gone ahead with the transfer? I like to believe I would have at least asked to speak to the embryologist and the lab directly and see what they have to say, but in the pressure of the moment, when everyone was trying to work quickly and there were still several women waiting behind us, I guess it was hard to press for more info or reassurance.

Aug 18, 2011

quiet

I know I have been pretty quiet lately. Not a whole lot going on. I went in for my lining check on Monday and my lining was 9.2, which is great. I am now just about in the middle of my cycle and I had noticed over the past few days that I was getting pretty severe cramping after running, like bad menstrual cramps. Sure enough, when I went running on Tuesday, not only did I get really bad cramps but I also started bleeding bright red, like I'm in the middle of my period. Luckily, it became just spotting by the next day. I called the clinic and spoke to one of the nurses who accused me of skipping estrogen pills (absolutely not the case) and told me to just come in next week for my next lining check as originally planned.

Hopefully bright red bleeding and cramping is common and not a problem while on estrogen for a FET, otherwise I might be in trouble. Since the nurse seemed unconcerned, Y said I should be unconcerned, too, but I don't know - it just seems...odd. I guess it's probably just breakthrough bleeding or something.

Dr. Google made me a little anxious (haha, when doesn't it?) because apparently cramping/bleeding after running is quite common in endometriosis because running can irritate endometrial implants and cause them to bleed. I also remembered that when I was younger and running competitively, I would have bright red bleeding and cramping after running at totally random times of my cycle, but I never really gave it much thought other than thinking it was a little weird. I didn't run yesterday, so it will be an experiment to see what happens after my run tonight, I guess.

In other uneventful news, my 2nd opinion appointment got cancelled, so I guess that's not right on the horizon anymore. I am meeting with the new acupuncturist on Sunday. I really hope she can help me at least feel a little bit more positive and relaxed. I am trying to think of new ways to distract myself from IF, so I am looking into signing up for an evening painting class at the local art museum this fall. I used to love to paint and I think it might help me to get back in touch with my creative/artistic side.

Also, after heavily procrastinating on signing up for any road races (due to my inexplicable and illogical belief that I could at any point become pregnant), I signed up for a 10K at the beginning of November, so I am pretty excited for that and hoping that cycling won't interfere (realistically, assuming this FET doesn't work and with our trip and the holidays coming up in Israel, I don't think we'd be doing another fresh cycle until November and I am okay with that).

Aug 7, 2011

moving on to FET #2

Today I went in for my clinic appointment. We have two frozen embryos left in a single straw at this point - a 5-cell BC grade and an 8-cell B grade. I saw the youngest RE in the practice today and I must say that I found his no bullshit responses refreshing.

He basically said what I thought all along - that the 5-cell BC is basically junk and while it is technically possible to get pregnant from an embryo of that grade since the classification schemes we have now are imperfect predictors of an embryo's potential, it would be very usual. Since all of my embryos lost cells last time in the freezing/thawing process, it is very possible the 5-cell embryo will lose too many cells in the thaw to remain viable anyway.

However, the 8-cell B grade embryo is a good embryo and if it thaws well, it has a chance just like any good day 3 embryo. We are going to clean out the freezer and do another medicated FET this month.

I also asked whether the fact that all of my embryos lost cells last time during the thaw was in any way a reflection of the quality or competence of the embryos and he said that it is really a technical issue with the lab and not any embryo-specific problem. I guess that was reassuring in some sense, but it also reaffirmed my feeling that our current clinic is not so up to par in its lab.

I have an appointment in 2 weeks with another RE for a second opinion as we contemplate moving clinics for our next fresh cycle if this FET doesn't pan out. I guess I have mixed feelings about this - I am used to the way things work at my current clinic and I feel a certain sense of loyalty to them. It is also by far the most convenient option for me and I feel like I have a good relationship with the nurses.

On the other hand, I have been at the same clinic for 13 months now with no viable pregnancy (ironically despite what everyone keeps assuring me is an amazing prognosis), I have serious doubts about the practices and quality of the lab, and the institutional attitude is just not so proactive.

It is maddening constantly wondering whether I have just been really unlucky with the last 5 embryos transferred (but do indeed have a great prognosis) or whether there is something major going on that just hasn't been uncovered. Of course, the truth of my situation could certainly lie somewhere in between those 2 possibilities but I have a little trouble sometimes with the many shades of gray:) I also oftentimes wonder whether during many of those IUIs, we also had eggs that fertilized and became embryos but never implanted.

AF arrived full-force late this afternoon so tomorrow it's back to the clinic for baseline and assuming all is clear, back to little blue pills and estrogen headaches...yum.

Lastly, thank you so, so much for all of the support over the past week. Your comments mean so much to me and truly brighten my day when I am feeling down.

Aug 4, 2011

beta is zero

My beta wasn't originally scheduled until Sunday, but the nurses had mercy on me and I was able to go in today (11dp3dt) so that my misery of not officially knowing wouldn't be prolonged over the weekend. I got the call around 3pm with the news I already knew:( I am not sure exactly what is next for us.

Aug 3, 2011

10dp3dt=BFN

It looks like this is how FET#1 is going to go down...I keep thinking of those 3 embryos and wondering what happened to them.

Aug 1, 2011

getting ready to write this round off...

I'm sorry I've been so lousy about writing the past week. I am just feeling very down and woe-is-me. I am quite certain none of the 3 embryos took. I had my progesterone check yesterday (7dp3dt) and my progesterone was lower than it's been during previous cycles, so it would seem to me that clearly there isn't anything going on in there making endogenous progesterone. Aside from the estrogen headaches, I have been completely symptomless, no cramping, no twinges, nada.

I just wish we had some insight into why my body doesn't get pregnant so that there could be something for us to fix. I feel like IVF isn't really fixing anything, it's just improving the odds by allowing us to produce many more eggs and also embryos in a given period of time than we could ever generate naturally. I just feel so broken and fundamentally not like a real woman.