Let There Be Embryos!

Just got the call and I swear I have been a raging bitch all day.  Fertilization report day is a NIGHTMARE!

Of the 19 retrieved, 12 were mature and healthy looking, and 8 fertilized with ICSI!  So we have 8 embies as of now.  That's three more than I had post retrieval last time! 

Let's hope they stick around and divide their little hearts out!!!!  We might have some to freeze!!!

Anxiety

We have a saying in our office.  It's kind of tongue in cheek and kind of true.  "Leave 'em where Jesus flung 'em."  Sometimes we see kid who has such a complicated lot in life, that any intervention on our part would make it even more complicated.  When we hit the wall with a situation that is just beyond us, we say "poor kid's done been flung."  Sounds callus now that I'm tying it out, but it's really not meant that way.  Sometimes I wonder if J and I have been flung and we just don't know it yet.


Tonight, we start Gonal-F injections for IVF deux.  The days leading up to some point yesterday were filled with so much hope.  Since last go around, I've had a lap to have endo removed, a hysteroscopy where they removed some "irregular lining," a month of doxycycline, and we're adding in ICSI.  "How can this not work?" we were asking ourselves.

At some point yesterday it hit us.  What if it still doesn't work?  What if we've been though all of this and we still have crappy fertilization?  What then?  It could happen.  There are certainly no guarantees.  All of the sudden, we're feeling really anxious.  We feel like we're heading down a rabbit hole and the wonderland on the other side will be either awesome or awful.  If we get a good fert rate, but I still don't get pregnant, I'd feel good giving it another go. If we still get a shitty fert rate, I'll probably like I've done gotten flung.

I'm not ready to face that reality yet.  As much as I talk with J and my family about how okay I would be without a biological child, I'm not ready to face the thought of giving up on my body.

Please let this work.

Jiminy Christmas

My RE called last night for an impromptu WTF.  I certainly don't mind the phone call vs office visit scenario.  He's kind of socially awkward and seems to do better on the phone.  Also, I'm down with the lack of copay for these phone calls.

He was so kind.  He genuinely seemed very surprised by our poor fertilization and negative beta.  He said we would definitely do ICSI, but that there was no guarantee that it would fix things for us.  He wants to do an endometrial biopsy, which seems to be pretty standard after a failed IVF, so while I'm certainly  not psyched about it, I will sign up for more cervical suction cups and catheters.

Then he started talking about the endo issue.  About 10 years ago, I had symptoms that led my then Gyno to suspect endometriosis. She put me on the pill and there I sat.  Truth be told, I had symptoms long before that, but I also had an asshat for an Gyno when I was young and naive who said "Yup, periods hurt."  He was a dude.  Surprised?  Anyway, they have never seen any evidence of endo on my ovaries, so they assumed that if it were endo, it couldn't be severe.  He said that there is a chance that I could have severe endo that just isn't on my ovaries, and while it would be rare, it could affect egg quality and fertilization rates.  He didn't come out and say it, but I think the fact that we had a few fertilize, ended up with a couple of embryos, and I didn't get pregnant leads him to think this is an egg issue and not some subtle sperm issue.

So he wants to do one of two things.  Either assume I have endo and put me on Lupron for 2 1/2 months or do a lap.  I was down for the lap right then and there.  For one thing, I need to know.  For another, I ain't takin' something as evil as Lupron without knowing if I really need it or not.  For a third, I have a big history of early onset osteoporosis in my family that includes my mother.  I do NOT need to encourage that shit and I certainly don't need to shrink for the love of all that is good and holy.  No Sally Field meds to be added to my cocktail, thank you very much.

He didn't want me to make any decisions yet.  He wanted us to sit on it for a bit and then come in and talk to him about all the pros and cons.  He's never seemed very psyched about the thought of a lap and hasn't come out and said why.  Before it was just that he thought IVF would circumvent the issue, but he doesn't have that to fall back on anymore.  He said any surgery was a big deal and the Lupron is a big deal too.  I send babies off to surgery on a daily basis so maybe that's why I'm a little desensitized to the whole surgery thing, I don't know.  He kept talking about how emotional this all is and that we just had a big blow.  While I appreciate the sentiment, all I kept thinking was that it was one of a million other nasty blows and we just want to keep chugging along.  He recommended seeing their therapist and I thought that was a good idea.  Lord knows I'm as anxious as all get out these days. 

The RE kept repeating, "The biggest predictor of outcome is age and you have that on your side."  I wanted to yell, "FOR HOW LONG!?"  I turned 34 a month ago.  The magic number will be here before I know it.  Every time we make a decision, another cycle goes by before we can act on it and another month is lost.

I just hate wasting time.  I feel like there will be an end to all of this at some point and I want to get there.  Whether that's end comes with a baby or not... I just want to know what's on the other side.  I want to stop hurting.  I want to see my husband enjoy 24 whole hours of happiness.  I want my life to revolve around something else.

If you've gotten this far, I appreciate it and apologize for your eye strain.  Got any advice?  To Lap or to Lup?

Negative

I just got the call that the test was negative.  Stop all meds and wait for my period.  I went ahead and POAS on Saturday, and I'm glad I did.  It helped soften the blow today.  It's strange.  I'm sad for the little embabies and so is J.  I know they were a tiny bunch of cells and I don't see them as people, but I do see them as living things that we created and now they're gone.  They didn't even have a chance to become people.

Part of me falls into the trap of "not meant to be."  I know that J and I would make good parents, but would we make a healthy baby?  If we can't get our sperm and eggs to play well together, is it wise to force it?  Are we tempting fate?  I know plenty of people have had crummy fertilization and have gone on to have healthy babies after ICSI, but we all know how it is when that little voice in your head starts talking to you.  And talking to you...  And talking to you...

I'm going to have some wine, and probably some ice cream, and try to buck it up tomorrow.

Transfer Day

It was a weird morning.

My cell went off before my alarm, and when I looked at the screen I saw it was the clinic.  My heart lept into my throat, thinking they were calling to tell us that no embryos survived and that we shouldn't come in.  I answered, and instead it was the RE on call, who would be doing our transfer, asking us to come in early because he had somewhere to get to.  Whew!  So we brushed our teeth and off we went.

We went straight back and I had some acupuncture.  This was my first time with the needles and all that jazz and I've gotta be honest, I wasn't a fan.  Don't get me wrong, I'm well aware of the fact that I suck at relaxing, but I had an impossible time quieting my mind.  She had headphones on me with this new age music going and all I could think was "Has it been 30 minutes yet?  Has it been 30 minutes yet?  Has it been 30 minutes yet?"

The doctor came in, we'll call him Dr. Huggie, to explain that two of the fertilized eggs didn't divide at all.  He put his hand on my leg and squeezed.  It was kind of creepy.  He looked me in the eye and said very directly, "Three have made it, which means that the other two have died."  I didn't really know how to respond to that, so I said, "Okay."  So then he offered us the option of transferring all three or freezing one.  No thanks on the three!  Did you not notice that I'm under 5 feet?  What if all three took!  Good Lord!  He thought two was a wise decision, but I guess he had to offer it.  I asked if the third was still of decent quality and he said, "Oh sure!  But if we do end up doing future cycles, you'll want to use it as a store to add to." 

They took us back to the procedure room, and I didn't even have to drink anything to get a full bladder.  I'm just that awesome with my mini-bladder.  Our embies were on the screen and it was really cool to see!  I knew that they weren't as fantastic looking as I've seen on the internets.  Not as bad as the bad examples, but certainly not the textbook examples I've seen.  I asked about the grading, since all we knew was that there was a 7 cell and a 6 cell.  Dr. Huggie was very evasive.  He just said, "Oh, she does that in the lab, but I don't even pay any attention to it.  They're fine.  Some perfect embryos don't result in a pregnancy and some ugly embryos turn into some really beautiful kids."  Ummmm, okay? 

So we did the transfer, ultrasound guided so we got to see them being "launched."  He gave me a hug (Swear.  I've just met this man.) and told us he'd pray for us.  This IS the south, so that's not all that creepy.  I thought it was nice.

We went back to the holding area and I had the second half of the acupuncture.  This time I opted against the music and she let J stay in the room.  The sound of the AC was way better than that music.  J closed his eyes and I closed mine and it was much more relaxing.  I still don't think I'd do it again, though.

And now, we wait!  I'm the most pregnant I've ever been.  I know a 6 cell and a 7 cell aren't the best, and they aren't gorgeous, but they're what we've got.  My beta should be on Mother's Day.  I'm hoping they reschedule that.  Yowza.  Here are the kids!

Oh, and PS: PIO shots aren't as bad as the internets will make you believe.  I think they are way harder on my husband than they are on me.

Now That I Have My Wits About Me...

I think I was just so anxious yesterday, and so chock full of estrogen, that I over reacted a bit to the fertilization report.  I have five freaking embryos!  That's so great!  Some women are not that lucky.  Yes, it wasn't the outcome I was hoping for, yes, a 19% fert rate blows, but at least we ended up with some hope in the end!  Now we know what's up with us and if we have to try again, we have a game plan.  But all isn't lost!  The clinic likes to leave the embies as they are and not disturb them, so we won't know the status of yesterday's 5-pack until we go in tomorrow morning.  All we need is one little booger (as my mother has dubbed them) to make it.

Thanks for all of the supportive comments.  I have not lost my mind yet!

A New Kind of "Unexplained"

When I have bad news to relay to a patient's family, I sit on it.  All day long it languishes on my "to-call" list until the last minute.  Apparently, REs do the same thing.

We wanted to avoid ICSI unless we really had to and there was no reason to believe we needed it.  I didn't like the increase in abnormalities (albeit very small) and if we could do one thing naturally in this process I wanted to do it.  So we had a semen profile where they went over J's sample with a fine toothed comb for any known issues that would result in a need for ICSI.  He passed with flying colors and we opted not to do ICSI.

All 26 eggs were mature, but only 5 fertilized.  He said there was no reason for it and just something that happens for some couples.  My eggs looked great and the sperm was perfect.  They were all still alive and kicking this morning, but for whatever reason, they just didn't fertilize.  The 5 embryos we do have looked good today, so we're still hopeful, but there probably won't be anything to freeze.  We're going to do a three day transfer on Sunday.

I asked if this was the reason for our infertility and he said that it most likely was.  He said that for that reason alone, having the answers, he thinks we made the right decision to not to ICSI.  I agree wholeheartedly.  And I know, we should be so happy to have 5.  Some people don't get that far, but I'm still in tears.

I spent years of heartbreak and soul searching to find my J.  I hate the feeling that no matter how much we love each other, our gametes don't really like each other much at all.