Thursday, October 25, 2012

Beta

4 weeks 6 days

Three days ago I had my first blood test (called a beta test) to confirm this pregnancy!

I was so excited to get that phone call from the clinic to tell me that I am in fact officially pregnant.

The beta level on Monday was 489.7.  This is an excellent number, not too high, not too low.  A low number (below 100) would be worrisome as that could mean the pregnancy wasn't viable or not progressing.  A really high number (over 1500) could be evidence of twins or it could also be evidence of an ectopic pregnancy (pregnancy in the fallopian tube).  Yes, even with IVF it is possible to still have an ectopic pregnancy, although it is rare. The nurse asked me to come back in on Wednesday for a second test to make sure the beta levels are rising appropriately. Ideally, beta levels will double in 48 hours.

Yesterday I went in for a 2nd test. The results were 899.  The test was taken exactly 48 hours after the first one, but it didn't quite double.  They were looking for results closer to 1000 (489.7 x 2 = 979.4). 

It may not be anything to worry about, but I am.  According to what I've read and from what other people have experienced it could be nothing, everyone is a little different and every one's levels increase at different rates.  I was only off by 80.4, but I just don't know what to think.

I'm going in again tomorrow morning for another test. I've been trying to keep busy and occupied last night and today so I don't worry too much about tomorrow. 

The good news is that my symptoms have continued to increase.  I've never been so excited to feel like crap!  The morning (all day) sickness is starting, and I'm completely exhausted all the time.  I attended a training workshop today and fell asleep during the presentation and again in the car on the way back (no I wasn't driving!!) and then had a nap for about an hour once I got home. 

Now I'm off to bed.

Wish me luck tomorrow.

Tuesday, October 16, 2012

More Pink

9dp3dt

A little more pink entered my life at 4:15 this morning.

After yesterdays breakdown after seeing pink I had a similar one after seeing this pink:


Once I realized that second line was appearing I woke D up and made him look at it.  He was really worried when I shook him awake and he realized what time it was.  He kept asking if I was ok, is something wrong?  I just kept repeating, everything is fine, I just need you to come look at something.

When we got tot he bathroom I shoved the pee stick in his face and asked "what do you see?"

"Pregnant"

Once I had him convinced that a line of any shade, no matter how light, is a positive we had a big hug and a little cry in the bathroom.  He asked "so what does this mean, you're a little bit pregnant?"

No dear, there is no such thing as a little bit pregnant, there is pregnant or not.  That is all.

I think I will keep taking tests every morning to make sure I'm not just in some kind of dream.  It's all very surreal!

We have not told any of our family yet.  I want to do that in person and D wants to wait until after we get the official blood test from the FC on Monday.  I'm not sure that is going to work out as his parents are going on a  big trip starting Tuesday.  So either we tell them this weekend, or not till they get back in November.

I'm on call this week so I'm not supposed to leave town, but I think I can make this exception to leave town to tell my parents that after 2 years, 9 months, 2 days, 2 surgeries, 33 cycles, 4 rounds of Femara, 2 failed IUI's, 72 injections, hundreds of blood draws and internal ultrasounds, I am FINALLY pregnant.

Monday, October 15, 2012

Spotting

7dp3dt

Today I am 7 days past (7dp) my 3 day transfer (3dt) or 10dpo (days past ovulation). I swore that I wouldn't test until Wednesday but this morning I broke down and tested.

BFN

Not surprising as its still early. Many people don't get a BFP until 14dpo so there is still a chance. Or at least that's what I told my self this morning and what I truly believed until I got home from work.

When I went to the bathroom after work, there it was, plain as day... Pink.

Pink, right there on the toilet paper.

Now, this can mean one of two things;
1- AF is coming
2- AF is not coming

Confused?

Me too.

Normally, without any drugs, I have an LP (days between O and AF) of between 12-13 days. This would mean I would normally expect AF on Wednesday of this week.  And normally, I spot for 1-2 days prior to AF. So if I "expect" AF on Wednesday then I spotting today would be normal.

But this is not a normal cycle. This is a cycle on steroids. Ok not steroids literally...  The progesterone supplements that I'm on now have the potential to lengthen my LP so who knows when I can actually "expect" AF.

So if this is not AF spotting then what is it?

Implantation spotting is the other option. Implantation spotting occurs when the embryos implant into the uterine walls, this sometimes creates a little blood that eventually makes its way out. This usually happens around 7-8dpo or in my case 4-5dp3dt; 7dp3dt is a little late for implantation spotting but not unheard of.

What is my spotting today?  I don't know and there is no way of knowing other than to wait it out.

I'm not feeling very positive right now. To me, the timing if the spotting is more indicative of AF. I feel it's too late for implantation spotting.

When I came out of the bathroom I was bawling, D immediately knew that something had happened and let me cry into his shoulder for a while. I swear I heard him choke back a sob or two as well.
We are heart broken, but still hold that sliver of hope that this could still work out.

Although I don't see how.

Monday, October 8, 2012

Transfer Day

Today was transfer day!!

Sometime I still can't believe we made it here.  It's surreal.

This morning D and I drove down to the FC for our day 3 transfer.  When we arrived, we were taken back to the same prep/recovery area that I was in for the retrieval on Friday.  We were the only transfer this morning so it was pretty quiet in that area.  At our retrieval, there was one other couple back there with us but I don't know what stage they were at... maybe they were doing their transfer that day?  Either that or they didn't make it to day 3 or they have amazing embryos and went to day 5!  I really hope for them it's the latter.

Anyway, it was quiet... 

After I changed, we were brought into the same procedure room as Friday and the nurse checked to make sure my bladder was full enough.  It probably could have been a little fuller as they were still having some trouble getting a good picture of my uterus because of my enlarged ovaries.  A few minutes later, the RE came in.  This is an RE that I'd never met before.  He explained the procedure to me and what would be happening step by step.  He then had a conversation with the Lab tech and the nurse to confirm identities and an embryo information and generally make sure that everything is food to go.

In the procedure room there is a window, almost like a take-out window with shutters that connects to the lab.  During the ER,  the contents of each of my follicles were passed through this window and the lab techs confirmed the presence of an egg.  This time, the lab loaded 2 of our embryos into a catheter and handed the catheter to the RE.  The catheter was wrapped inside a paper package with my name on it and I was asked to confirm that it was in fact my name.

It was.

Phew!

Next my legs were put up into stirrups and the procedure began.  First a warmed speculum was inserted.  Side note: why don't all doctors warm speculum's???  They are always freezing! Anyway, it was nice that is was warm...  Then, the RE and the nurse worked together to track the insertion of the catheter through my cervix and into my uterus.

D and I were both able to see the ultrasound screen which was really cool!  They stopped a couple times to take some measurements, and when he found a nice cozy spot in my uterus he stopped and gently pushed the embryos from the catheter to nestle in my uterine lining. 

It was THE most AMAZING thing to see.  I wish I had taken a picture.  No, you can't actually see the embryos, they are still microscopic at this point, but they put them between 2 air bubbles and you can see the bubbles.  As the bubbles were released from the end of the catheter, they shone so brightly on the screen, like sparks of light!

Sparks of life!

D and I watched those little sparks for as long as they were on the screen before the nurse took instrument off my belly.  The catheter was removed and handed back to the lab where they inspected it under microscope to ensure the embryos are no longer there.  When we got the all clear from the lab (literally, they called out "All clear"), I was released from my stirrups and allowed to get dressed and go home.

While I was changing, the nurse brought out a copy of our Embryo Transfer Record.  Today we transferred two 8 cell / grade 4 embryos.  That is the highest day 3 quality you can have.  We are very hopeful that this will work.  The remaining 8 will be frozen for future use.

For freezing:
1@ 8 cell / grade 4
2@ 8 cell / grade 3
1@ 10 cell / grade 4 - this one is slightly over developed for day 3, that's why this wasn't used today.
1@ 9 cell / grade 3
1@ 7 cell / grade 3
1@ 5 cell / grade 4
1@ 12 cell / grade 3

I really hope we don't have to use these.  At least not anytime soon...  maybe to give this little one a sibling?

Today, I'm just thankful to keep my little sparks safe and happy in my tummy.

Happy Thanksgiving!

Yesterday's Report (Fertilization Report #2)

I realized this morning that I didn't update with yesterdays lab report.  I looked forward to that call so much yesterday morning.  I got up early and made coffee and sat watching the phone with my fingers crossed.  Luckily they called really early again so I didn't have to wait long.  All 10 made it through the night again!  The nurse who called didn't have a detailed report but said that they are of mixed quality. She put me on hold and talked with the lab techs and they said I'd be transferring on day 3 (today).  Apparently I didn't have enough high quality embryos to qualify for a day 5 transfer.

There is a significant increase in success rates when transferring on day 5 rather than on day 3.  In our IVF teaching the statistics they quoted were 60% success rate on day 3 transfers and 80% on day 5 transfers. 

So you might ask why do anything other than day 5?? 

The reason day 5 transfers are so much more successful is because they were already strong enough to make it to day 5 outside of their natural environment.  Not many embryos are that strong, and there is a risk that you could lose all embryos before getting to day 5 and have none to transfer.

Embryos flourish in their natural environment - the womb, so if they are not doing so great int he lab, it's better to get them back in their natural environment as soon as possible.  Before day 3, the embryos have not developed enough to properly judge which ones are developing better than the others which is why they wait until the 3rd day so they can choose the best to transfer back.

Originally I was hoping that I'd be able to do a day 5 transfer so that I'd be confident in that 80%.  It would also mean that I had a bunch of amazing looking embryos; so many that I could afford to take the risk.  But that's not the case.  Mixed quality meant that of the 10 I had, some were really good and some were only ok.  If I pushed for a day 5 transfer, I could be risking losing all of them.  I'd rather have them safe in my belly were I could nurture them and keep them safe instead of in a lab.

Generally with a day 3 transfer, they transfer 2 embryos to increase chances of success.  With day 5, the will only do 1 except in extenuating circumstances; eg. over 40.  Transferring more than 1 embryo on day 5 does not increase the chance of success, only the chance of twins.

D and I had a discussion last night and both agreed that the risk of twins was acceptable on a day 3 transfer and would transfer two if that's what the RE recommends.

I'll be back later with a transfer day post!

Saturday, October 6, 2012

Fertilization Report #1

This morning D and I were woken up by an amazing phone call!  The FC called before 9am this morning to give me my fertilization report.  Of the 12 eggs retrieved, all of them were mature.  This is important because only mature eggs will continue to develop and that's why the FC will only ICSI mature eggs.

ICSI (Intracytoplasmic Sperm Injection) is where they select 1 of D's sperm by microscope and inject it into one of my eggs.  Because all of mine were mature, were all fertilized by ICSI. 

It is normal for some of the embryos to stop developing at some point in this process.  After all, they are out of their natural environment... Anyway, one little guy didn't make it through the night, but 11 did and that's amazing!

If the FC is going to call before 9am tomorrow morning, I'm going to have to get to bed early tonight!

Now that the "fun" injections are over I'm entering a whole new era of fun in the form of progesterone suppositories!!  Sound exciting?  They're awesome.

Not so much.

Definitely better than injections, but still...  I'm not looking forward to the wonderful side effects these are going to give me because they will mirror all early pregnancy signs - just to screw with me. 

I'll be back tomorrow with another update/

Friday, October 5, 2012

Retrieval

CD16~18

Yesterday was a really busy day getting everything at work ready for me to take a week and a day off.  Work is busy right now so that was a little difficult.  Earlier this week I had to go to my boss and move my vacation from Wednesday to Friday.  He looked at me a little funny so I explained that I was having a procedure and it kept getting pushed back.  He agreed to move my vacation but said "I'm rather to change things around for people who are going on vacation, not staying in a hospital... that's not a fun time off"  Then yesterday when I handed in my time sheet (it was due today) he came back to me and said "now you have me confused... I thought you said this was for medical reasons, why are you using vacation days??"  So I had to explain that yes, it was for medical reasons, it's two procedures a few days apart but I wanted to make sure I had plenty of time around each day to relax so I'm using vacation.  What I didn't tell him is that I didn't want to have to get a Dr.'s note in order to get that much time off.  The note would have had the name of the FC on the letterhead and that would have given me away.

Last night before bed I took an Ativan to help me sleep.  I was surprised that it also took a bunch of the pain/uncomfortableness away that I was feeling in my tummy as well it was nice.  It wore off about 4 am and I woke up when the pains came back. Boo.

We got to the clinic around 8:00 am and since we were a little early we went for a drive to get some ginger ale and Gatorade for afterward before going to wait in the waiting room.  We were only waiting for a few minutes until the nurse came to get us.  She brought with her a brown paper bag containing an empty bottle for D to leave his sample in and directed him to the collection room and I was brought back to a different area to get changed.

I put on two hospital gowns; one forward and one backward so that I was completely covered and I was allowed to keep my socks (Yay! - my feet are always cold so I was happy I could keep my socks).  Just as I was getting set up for my IV, D was brought back to me.  The IV went in without a hitch and they started the saline.  A few min later they took me to the washroom before going to the procedure room.

Once in the procedure room, they set my legs up in stirrups.  She kept asking if I was comfortable... no I'm not comfortable!  My legs are twisting out at odd angles and you have a direct view of my vag! But I have no pain so I consider that as 'comfortable' as I'm going to get.  They then gave me two different drugs in my IV line and that's when things start to get blurry.

I could still feel most of the needle sticks as they were poking around my ovaries and even through the drugs they gave me, it still hurt and I turned into a big ball of wimp and started crying.  Part of it was that it hurt, but the other part was just the emotional aspect of it.  They upped my drugs part way through, but the procedure was so quick that they didn't really take into effect until after it was over so by then I could hardly get up off the table and I was sleeping in the recovery room instead of getting ready to go.

We got home around11:30 and I've been sleeping on and off ever since.  At one point I attempted to text my friends to let them know I was fine and the results but I was so out of it couldn't figure out how to send the text!  It was hours later after I woke up from a nap that I thought it was strange that none of them had texted back and I went looking for the text in my sent items and it wasn't there!  It took another 20 min or so to figure it out!

Overall, today was a success and they retrieved 12 eggs. - A perfect number!

I will get a phone call tomorrow to let me know how many of those 12 are mature and now many fertilized.  Fingers crossed we don't loose too many over night.

Wednesday, October 3, 2012

Trigger Day

OK, A quick summary of the last 3 days.  I went to the clinic every morning and this is what my number were:

Monday October 1, 2012
Right: 13,12,11,11,5@10,3@9 = 12
Left: 11,9 = 2
Total = 14
E2 (Estrogen) = 9,192

Tuesday October 2, 2012
Right: 16,15,15,14,14,12,12,4@11 = 11
Left: 13,12,12,10 = 4
Total = 15
E2 = 13,435

Wednesday October 3, 2012
Right: 21,18,17,16,16,15,15,14,14,12,11 = 11
Left: 18,17,15,14,14,14,12,11,10 = 9
Total = 20
E2 = unknown

If you remember from Saturday my numbers were:
Right: 14, 13, 12, 11, 10, 10
Left: 12, 10, 10
So when I went in on Monday and none of the follicles were any bigger I was a bit worried.  I was concerned that not only had they not grown, they appeared to have shrunk.  Yes there was more of them, but I still needed them to get bigger.

When I met with the RE Monday morning he thought he might have to increase my Puregon dose since nothing had grown.  But when the nurse called me in the afternoon, they lowered it instead!  I was shocked, but apparently an E2 level of over 9000 is really high at that stage.

Tuesday morning I felt better when I saw that there was some growth and my E2 level didn't raise too much so I was left at the the same dose for another day.  Before he had the results of my E2 test the RE mentioned that we were walking a fine line between encouraging growth and risking cancellation because of a high risk of OHSS.

This morning I was really happy when I saw significant growth over yesterday.  The RE said two things could happen depending on my E2 levels today: One, I continue stimming for one more day to try to get a few of the smaller ones (under 15) a little bigger; or two, trigger today.  It turns out that my E2 levels were high (although I don't know the number) so I am triggering today!

The trigger shot is designed to  time ovulation for between 36 and 39 hours after the shot is administered so timing is critical.  I must take the shot at exactly 9:00 pm tonight and my egg retrieval is booked for Friday morning at 9:00am.

I happy, scared, excited, terrified...

The other good news is that tomorrow is needle free!  49 needles down, 1 to go!