Saturday, March 5, 2011

To My Future Children

A song came on the radio when I started my last post, that made me feel like it should be dedicated from me to my five embies, as my future children (and made me cry-or maybe that was the progesterone I'm on). It's an 80's song called "The Promise", by When in Rome. Of course it wasn't written for this purpose-It's a romantic love song, but it strikes a chord in me right now. Here are the lyrics, and the music video:

If you need a friend,
don't look to a stranger,
You know in the end,
I'll always be there.

And when you're in doubt,
and when you're in danger,
Take a look all around,
and I'll be there.

I'm sorry, but I'm just thinking of the right words to say. (I promise)
I know they don't sound the way I planned them to be. (I promise)
But if you wait around a while, I'll make you fall for me,
I promise, I promise you I will.

When your day is through,
and so is your temper,
You know what to do,
I'm gonna always be there.

Sometimes if I shout,
it's not what's intended.
These words just come out,
with no gripe to bear.

I'm sorry, but I'm just thinking of the right words to say. (I promise)
I know they don't sound the way I planned them to be. (I promise)
But if you wait around a while, I'll make you fall for me,
I promise, I promise you...

I'm sorry, but I'm just thinking of the right words to say. (I promise)
I know they don't sound the way I planned them to be. (I promise)
And if I had to walk the world, that make you fall for me,
I promise you, I promise you I will.
I gotta tell ya, I need to tell ya, I gotta tell ya, I gotta tell yaaaa ...

I'm sorry, but I'm just thinking of the right words to say. (I promise)
I know they don't sound the way I planned them to be. (I promise)
But if you wait around a while, I'll make you fall for me,
I promise you, I promise you...

I'm sorry, but I'm just thinking of the right words to say. (I promise)
I know they don't sound the way I planned them to be. (I promise)
And if I have to walk the world to make you fall for me,
I promise you, I promise you I will ...
I will...
I will...
I will...

The IVF Experience: Egg Retrieval through Day 3

We last left off at the HCG "trigger" injection. I used to think the sole purpose of the HCG was to make you ovulate, so I wondered what it's use was in an IVF cycle, when they don't want you to ovulate before they retrieve the eggs. It turns out it also tells your eggs to switch from 46 to 23 chromosomes-an important step if you want room for the 23 chromosomes a sperm will add!

Thirty-five hours after triggering, I had my egg retrieval (ER). This entailed not eating or drinking anything-not even water-from 5 in the morning until my retrieval just after noon. The water was absolutely the toughest part of that! At the clinic, I filled out more forms, changed into a hospital gown, hairnet, and booties. I was allowed to keep my bra and socks on, so I wore my special silly socks to help keep my spirits up and my feet warm!  Besides, other than your hoohah, your feet and calves are what your surgery team ends up seeing most of the time, and you want them in a good mood!

Nurse "Sweet" was my prep and recovery nurse, and first she tried to put the catheter in my hand for the IV. It didn't go so well. So, the anesthesiologist, Dr. "Silent" took care of it, hooked me up, then walked me into the OR. As I'm climbing onto the table and swinging my knees up over the stirrups, I'm already feeling like I've had a couple drinks, and frankly, I don't even remember laying down, that sedation worked so fast! I do remember asking my main IVF Nurse, Nurse "Mellow" if she liked my socks! She said yes, they're great!

Next thing I knew, I was feeling awesome and back on my original gurney, and I just really wanted to keep sleeping, but Nurse Sweet insisted I had to wake up! I vaguely remember telling her and maybe someone else in the room they they all did a great job, that it was awesome, that they were awesome and I loved them all, and that I would bake them zucchini bread. I was probably quite entertaining, but hopefully welcome comic relief after the cranky patient I overheard before me.

While I was asleep, here's what my team was supposedly doing: The RE takes a long needle, and using a speculum and an ultrasound machine, inserts it into the vagina, through the vaginal wall, and into each mature follicle in each ovary. Dr. Analytical said he retrieved 19 eggs, so that would be 19 follicles. Fun, eh?

After a brief recovery period, I was sent home with painkillers and instructions to take it easy, not immerse myself in water, lift more than 10 lbs, have sex, or get my heart rate over 120 for two weeks, among other things. Pre-op was at 11:45, ER at about 12:45, and I was home at 3:30.

The next afternoon, Nurse Mellow called to give me the fertilization report. Out of 19 eggs, I only had 8 that were mature. This was a big drop to start this process with, and I was horribly disappointed, not to mention still in physical pain. Only five had fertilized, with a sixth runt that was a possibility. This made me cry. Looking forward, I knew we still had to get to Day 3, then through genetic screening, and to Day 5, for transfer or freezing. Then, of course, there's my history of pregnancy loss. All those hurdles seem awfully daunting with 5, maybe 6 embryos. (Not to mention-only 8 out of 19 were mature?! No wonder we're infertile!)

Today we got our Day 3 report, and while number 6 didn't make it, the other 5 did! We have another one falling a little behind, but still ok. Ideally, they want 6 or more cells on Day 3, and when Nurse Mellow called me this morning, she said number five only had 5 cells. However, three of my embies were already up to 7, and one of them even had 8 cells! This is blessed news!

So, we still have five embies growing like the little stubborn warriors we know they are. Please continue to send them your prayers, good vibes, and well-wishes. As their mother, I know they can feel the love, as do the Wacky Wicketeer and I.

Friday, March 4, 2011

The IVF Experience: Through Trigger

Here's where I start to give you the details about what this IVF cycle entails. At the moment, I'm frankly a little buzzed on a prescription painkiller my RE gave me after egg retrieval, so please, bear with me!

The first part of preparing for IVF is down-regulating. Particularly with PCOS, the woman's hormones need to be under control prior to starting stimulation. To accomplish this, Dr. Analytical had me go on birth control pills (BCPs) in December. On a Wednesday in mid-February, I started daily injections of Lupron, which does a lot of things, but mostly suppresses estrogen production. Thus, side effects are like a mini-menopause: hot flashes, fatigue, headaches, etcetera. At the same time as the Lupron, I started taking Dexamethasone, to help suppress my immune system. The next Monday, I stopped BCPs, and Aunt Flo officially began my cycle that Wednesday.

I had to get my estrogen level tested the next day to make sure that I was properly suppressed, which I was, with estradiol at 25. So I was on course to start stim injections the following week, which included Follistim and Luveris.

You might be noticing that there are a lot of injections involved. Most women either do these themselves, or have their husband or partner do them. However, the Wacky Wicketeer has a tendency to faint at the sight of needles, and while he nonetheless offered to try, I decided that I did not want a passed-out husband on my hands while going through this. The idea of doing them myself totally stressed me out, but I'm fortunate enough to have a Stepmom that is a nurse! So, she was kind enough to arrange twice-daily injections with me.

After a week of stims, I had my monitoring appointment, which included an ultrasound and another estradiol test. My estradiol was 3500, my uterine lining was 9.5, and I had 21 follicles ranging from 12 to 21 mm, with most of them in the 15 to 18 mm range. Dr. Analytical said I responded perfectly to the stims, that it looked great, and we should stop stims, trigger, and schedule egg retrieval for Wednesday - 2 days ahead of schedule!
So we did.

We had to administer the trigger injection - Human Chorionic Gonadotropin (HCG), a.k.a. the pregnancy hormone - at 1:45 in the morning! So, Stepmom stayed overnight, and we got up in the middle of the night to get it done.

Next up, the scary part: Egg Retrieval!

Thursday, March 3, 2011

How we got to IVF & Current Status

Last year, after going through two miscarriages at about 8 weeks, I had a bazillion tests done to see what could be wrong. We found nothing. No uterine factors, no immunology issues, no clotting factors, no infection. The Wacky Wicketeer and I were both karyotyped after the first miscarriage, which showed that we, ourselves, had no major chromosome defect that might be contributing to the loss. My general practitioner did find that I had a severe vitamin D deficiency. However, my Reproductive Endocrinologists (REs) would not attribute my losses to this factor. (Despite the fact that there are recent studies coming out showing a possible relationship between uterine lining and vitamin D.) Go here for more information on causes of Recurrent Pregnancy Loss (RPL):

We were very disappointed in the attention and lack of customer service we were receiving at our first clinic. So, we went to a new one last fall.

Our new RE, Dr. "Analytical", diagnosed me with a mild form of Polycystic Ovarian Syndrome (PCOS). You can learn more about PCOS here: PCOS is a syndrome, thus it occurs on a spectrum. At my end of the spectrum, I still ovulate regularly, but my eggs are immature and/or poor quality.

Dr. Analytical has a theory that, between poor-quality eggs caused by PCOS, and abnormal sperm, as exemplified by the Wacky Wicketeer's abnormal sperm morphology, we end up with a non-viable embryo on the rare occasions that sperm actually fertilizes egg. This then results in a pregnancy loss.

Dr. Analytical has explained to us that our best chance at having a biological child is through In Vitro Fertilization (IVF) with Intra-cytoplasmic Sperm Injection (ICSI) and genetic screening. In this way, we are the most likely to become pregnant with a viable embryo.

So, here we are. We decided to do IVF with ICSI and genetic screening, and are now in the midst of treatment. It is a trying process, and we are attempting to approach it with grace, with respect for our marriage, and with love for the embryos conceived in the process. I'll explain more of the details in another post, but for now, know that we have five, maybe six, embryos in their first home at the clinic, each fighting to grow. Please send them, and us, your prayers, hope, love, luck, and well-wishes. Thanks in advance, and lots of babydust to those looking for it!