Nov 23, 2011

betas

I have been the lousiest updater since I got a positive pregnancy test last week. The news so far, though, has actually been really good! I went in for my first beta on Sunday (11dp5dt) and it was 308. My second beta on Tuesday (13dp5dt) was 849. So it would seem that I am undoubtedly pregnant and that things are progressing as they should for now. It is weird to be blogging about pregnancy. Honestly, it makes me a little uncomfortable hence the lack of updates. We will have our first ultrasound late next week, but we are done with betas, so until then I am in a no-data zone. Taking a step back, trusting in my body - wow, that part is really hard. For now I am so grateful to be here, in this place, I just hope I never wake up from this dream.

Nov 15, 2011

two lines

I will cut right to the chase - I POAS this morning (6dp5dt) and I saw two lines. Holy crap. I was such a crying, blubbering mess I think Y thought someone had died. When I finally managed to successfully communicate to him why I was hysterical, he was so confused that it wasn't bad news! Can't believe one year ago today I was in the hospital miscarrying and today I saw this unbelievable thing. It feels totally other-worldly. My E2 is very low so I started estrogen pills today...I hope the E2 won't be a big problem. Beta isn't until Sunday. We still have an incredibly long way to go, but I am in shock to have made it to here.

Please send good vibes to my dear cycle buddy & friend T that she will get some great news over the next few days.

Nov 14, 2011

one year ago today

The ultrasound one year ago today: Broken. Didn't think one year later we would still be empty-handed. I suppose there are nicer things to reminisce about during the 2ww...

Nov 12, 2011

an absence of something

I have just been waiting...waiting to feel something, anything, a twinge or a cramp or some slight indication that our embryos are still with me. As usual, nothing. I think that maybe those little embryos just got tired of cell division or whatever it is that usually happens to them. I know anything is still possible - still, the one time I was pregnant, I had so much cramping with implantation, I find it very hard to believe that I won't feel anything at all if something is trying to implant. I have been so sad this weekend. I feel like I already know the answer. I hope so badly that for once, I will be wrong.

Nov 9, 2011

2 blasts on board

Just a quick update to say that we had two blastocysts to transfer today. They weren't amazing quality, but still, I'll take it! There is a 3rd embryo that was a morula today that may be frozen tomorrow based on whether it has continued to progress and how it looks. I am so happy and relieved we had something to transfer. I was quite anxious that we might end up with nothing.

Today was really beautiful outside - a clear, cloudless blue sky and a crisp chill in the air that made me nostalgic for New England fall days. "What a beautiful day to become pregnant," my acupuncturist said. I hope, hope, hope.

Nov 7, 2011

embryo update :(

I just got a call from Dr. T. He said that this morning (day 3) two of our embryos were looking good at 8 cells, 5 were 'okay' or fair at 6 cells with some fragmentation, and 1 had arrested. He wanted to update me in case I wanted to see whether they could squeeze me in for a day 3 transfer today, especially since 2 embryos are clearly looking better than the rest right now. He did say that he felt the outcome of the cycle would be the same regardless of when we transfer (or if we transfer - meaning that if there is nothing on day 5, it probably wouldn't have resulted in a positive cycle anyway had it been transferred on day 3), but he wanted me to be prepared for the possibility of having nothing to transfer if we press on to blastocyst and he knew that would be very disappointing.

I thought about it, and I guess I feel that if we truly trust in the assumption that what doesn't survive in the lab won't survive in my uterus, it makes sense in my mind to still press on to day 5. The reason being that if the outcome of this cycle will be the same no matter what, I think I would rather start another fresh cycle in a few weeks and have the opportunity to create new embryos than transfer frozen embryos that wouldn't have made it to blastocyst anyway.

I also feel like the disappointment of having nothing to transfer would not be greater than the disappointment of a failed cycle, though I am sure if this happens I will feel regret for not having transferred the 2 higher quality embryos and given them a chance when there was the option…tough choices. Y said he will go along with whatever I decide, so we are pressing on to day 5 for better or worse. I am starting to get the sinking feeling that there is more IVF in our very near future.

Nov 6, 2011

retrieval and fertilization report

First thing Friday morning we went in for our retrieval. The experience at the small private hospital was much more pleasant than the experience at the large university hospital. No waiting around forever...it was amazing! We got there at 7:30am and got to leave by 9:30 (it's true we were really pushing it - Y HATES waiting around hospitals which is ironic given his profession and also his place of employment...he was ready to take out my IV himself). For comparison, at my previous clinic I got there at 8am for retrieval and wasn't able to leave until 3pm, mostly because it took hours for a doctor to come and sign off on my chart.

I also had a much, much easier time recovering from the retrieval this time around which also made it a much more positive experience and as I mentioned previously, my friend T (who was the one who actually recommended my current RE) had retrieval immediately after me, so it was really great to have a comrade in all of this (as I have said to her, I like to imagine our embryos hanging out in the incubator together becoming friendly in their pre-life :) ).

This time around we got 10 eggs, which is two less than last time. It is about what we were expecting. I had 13 follies at my last monitoring appointment, but of those 13, four were still just barely measurable, so it would seem that one of those little guys was able to catch up and the other three weren't. I do think I had a slightly smoother stimulation this time than during my last fresh cycle. Last night we found out the 8 fertilized, and as of today, we still have 8 embryos. Last fresh cycle we also had 8 embryos, but coming from 12 eggs, so this was a higher fertilization rate. Like last time, we did a split-batch of 1/2 ICSI 1/2 regular IVF. I am still not sure what proportion of eggs fertilized via ICSI vs. natural fertilization, but I will be interested to know.

The decision of whether to try to grow the embryos to blastocyst or not was much more agonizing than I thought. Dr. T. basically left it up to us to decide. He did suggest the possibility of transferring 1 embryo on day 3 and then attempting to grow the rest to blastocyst with the option of transferring another embryo on day 5. I guess the idea is that this would be a sort of insurance policy if none of the remaining embryos made it to blast. Another consideration is that the lab is apparently not super adept at freezing and thawing blastocysts, even with vitrification, so by attempting to do a day 5 transfer, we might be limiting our possibilities with pursuing frozen transfers from this cycle.

I guess the thing that nags at me most is that all the doctors agree that the reason we are probably not getting pregnant is due to a very high proportion of genetically incompetent embryos, even if they morphologically look nice on day 3. If this is true, it seems to me that our most efficient strategy is probably to eliminate as many abnormal embryos as possible and not even bother transferring them and growing to blastocyst gives us a better selection device than we have had in the past to accomplish this (ultimately, CGH testing would probably be the best selection device, but it's not really an option for us here in Israel right now).

Soooo....in the end we decided to try to grow the embryos to blastocyst. I just know I need to be emotionally prepared to lose all of our embies and/or pursue another fresh cycle in a few weeks if it doesn't work. I still must say I am feeling better about this cycle than our previous ones and I am quite happy we switched clinics and grateful for our RE, who allows us to be much more involved in the process than our previous clinic.

Nov 3, 2011

retrieval tomorrow

Tomorrow I go in for my ER bright & early. I am really a bundle of nerves - so many what-ifs running through my brain as usual. I started off this cycle so optimistic. I was really making a conscious effort to stay as positive and calm as possible. I am still trying, but as the cycle unfolds and I have more & more information available, it becomes so hard!

I know in every cycle previously I constantly adjusted and managed my expectations as the cycle progressed, and this has been a splendid defense mechanism to prevent me from ever being surprised or caught off-guard by a negative beta, but on the other hand, I really would like to be able to keep up some positive energy and I just want so, so badly for this to be the time things are different.

We are in a new Jewish calendar year, we are at a new clinic with a new doctor - I have just been so ready for a change of luck. My pragmatic side realizes that just feeling ready for a change in luck or any sense of entitlement that I really *deserve* this for all of the crap I have been through, doesn't really make it any more likely to happen; I mean if this was about what is fair, I like to believe I would have had a screaming baby in my arms quite some time ago. But please G-d, still, can't this time be different?

The truth is that even with the tweaks in my protocol, this cycle is eerily reminiscent of my last fresh cycle, right down to the E2 that initially rises nicely but then stalls such that my E2 and my follicle growth become somewhat inconsistent with each other and right down to the 2 dominant follicles (I often wonder if these 2 big guys are sequestering all of the drugs for themselves and not playing nice with their friendly ovarian compatriots? :) ). In a way it is humbling how even with changes to my protocol, it seems my body is just going to do what it's going to do despite our best efforts to steer it a little differently.

I don't mean to be all gloom and doom - I still did get a respectable number of eggs last time (though this time it seems like there may be less), but it is so difficult for me not to let all those familiar doubts come rushing back in. My friend T will also be doing ER with me tomorrow morning - companionship that I feel very lucky for. I really hope next time I write I will have some good news to report!