Perseverance

Today I had my IVF follow up appointment. Because things have become so complicated, I am debating whether or not I should continue blogging. I am going to stick with it for now, but probably won't be as detailed as I have in the past. There is so much information overflowing my brain that it would be impossible to fit it all into anything short of an entire set of encyclopedias. I highly doubt the average person would understand it all anyway, so I'm saving myself the trouble.

So, here are the basics regarding my failed IVF cycle:

Of 16 retrieved eggs, only 25% fertilized normally with 2PN (pro-nucleate.) The other 75% were ≥ 3PN. In English, this means that more than one sperm fertilized each of those 12 remaining eggs. The many possible causes for this can be described by words that google doesn't even recognize (because I've tried) so I'll spare you. Obviously, this results in an embryo with an abnormal amount of chromosomes. These embryos can develop and result in pregnancy and they often do in a natural setting. Sadly, the pregnancy will inevitably end in miscarriage or loss of the infant shortly after birth. For this reason, they are not considered viable and are not transferred during an IVF cycle.


Of the four oocytes that did fertilize normally, who knows what went wrong there. I thought that we had two morulas, but it turns out that there was only one. One of our transferred embryos had made it to the blastocyst stage. I guess there must have been some sort of misunderstanding there. I'm sure that had I heard anything about a blastocyst, I would have remembered since that was the one word I was longing to hear the most. That being said, it was still a very poor quality blast graded a "DDD."


Apparently, I'm a sort of medical mystery. Nobody understands what the problem is... SUPER! There are the obvious problems, but the underlying causes are baffling. Considering the fact that I am so young (if I hear it one more time I'll scream) and had a great response to the stimulation medications, it doesn't make any sense. My FSH levels are fine, my ovarian reserve is fine. There is one more hormone test (AMH) they can do to check my eggs, but my doctor says he would be very shocked if it came back abnormal due to my excellent response to the injections. I said bring it on anyway, what's one more measly little blood test? I'm continuously surprising everyone with my unexpected outcomes, so why not?

AND THE ANSWER TO THE QUESTION YOU'RE ALL DYING TO ASK...

...........Yes, we are going to go for IVF round #2. We will tweak a couple of things in my protocol (hCG, possibly add ICSI or 50% ICSI) in hopes of a better outcome, but with no definitive reason for this failure we can't do much. I got my full schedule today and I will be on birth control pills for a while. I doubt that I will be as open about this one as I was with the first. It's hard... very, very hard. I want to thank you all for your continued support and prayers through this time of trial in our lives. One day, one way or another I WILL be a mother.

No-

I'm not even sure how to go about writing this so I'm keeping it short and to the point. The IVF has failed - I'm still not pregnant.

Morula Transfer

Yesterday was our embryo transfer. We had hoped by day 5 our embryos would have reached the blastocyst stage, but it turns out that they were all four slow growers. Most embryos are at the morula stage on day 4 and develop into the blastocyst stage by day 5. Two of our embryos had developed into the morula stage by day five. We went ahead and transferred our two healthiest looking morula embabies. My doctor is very surprised that this has happened. Given my age everyone had very high expectations for our embryos.

We let our remaining two embryos continue to grow until today (day 6) in hopes that they might catch up and be able to be cryopreserved for future use. Today, I spoke with our embryologist and found out that one embryo arrested completely at the 8 cell stage which is normally reached by day 3. The other one stalled at the morula stage which should have been reached by day 4. Obviously, that means we have no embryos to freeze for future use. :(

As far as the two we transferred, all we can do is hope for the best. Maybe they just needed their mommy to thrive...? Maybe they're boys and are just going to be slow and stubborn like their daddy...? ;) .........Or maybe this isn't our time either. It's a hard possibility to face, but a very real one at this point. We will continue to pray and hope. I will consider myself pregnant until proven otherwise. As for now, I'm technically pregnant with twins so I am just going to enjoy today and take it as it comes. Below is a picture of our little ones:

Day 3 Embryos

I just received my second embryo report! The embryologist told me that we have three excellent quality embryos at 8-10 cells each. The fourth little one is lagging along a bit with only 5 cells. Overall, this is great news and we're all set for our blastocyst transfer on day 5. The next two days are critical, but we have every reason to be positive and expect a great outcome! :)

Four Embryos

I just received the call from the embryologist. It turns out only 4 of the 16 eggs fertilized normally. This is less than we expected and it came as a bit of a shock. They'll will keep those in the incubator until Saturday (day 3). At that point, they will reevaluate them and call me again. On a positive note, the embryologist feels that because of my age these four embryos have a great chance of dividing normally and thriving. He thinks we still have a pretty good chance of doing a day 5 transfer. All four making it until Monday would be a wonderful outcome but the odds of that happening are low. Please pray for these four little ones to defy mommy already and be healthy and strong.

As for me, tonight I begin my daily progesterone in oil injections ((shivers)) and baby aspirin. I'm feeling very bloated and quite uncomfortable today, but hopefully it will get better and not worse over the course of the weekend. Expect another update Saturday.

Sixteen Eggs

This morning was my egg retrieval! We retrieved a total of 16 eggs! :) :) :) Tomorrow the embryologist is supposed to call with our fertilization report. He should also be able to give us a pretty good idea of whether we will be having a day 3 transfer or a day 5 blastocyst transfer. I'm hoping and praying our embryos are strong enough to make it to the day 5 blastocyst stage because our odds will be excellent if they do.

As far as physically, I feel pretty good. Thankfully, the anesthesia didn't make me sick this time. Honestly, I feel better now than I did before the procedure. The past few of days were pretty uncomfortable with my ovary being so full. I've been told to stay on strict bed rest for at least 24 hours so I'm being a total bum today. Until tomorrow...

Overachiever

YAYYYYYYYYY!!!!!!!!!!!!!! :) :) :) Today I had another ultrasound and more blood work. My E2 levels came back at 2621. My uterine lining is at 12.42mm which is fantastic. My ovary went into overdrive since Saturday and I have about TWENTY follicles on my left ovary! Keep in mind, I only have one good ovary. My right ovary has maybe one or two follicles which is a very poor response. A great response for someone with two great ovaries is 8-16 follicles total. That would be 4-7 or 8 on one ovary. I have TWENTY on ONE ovary!!! I'm definitely feeling it!!! This explains the mega bloat I've been dealing with. My left side feels like the combination of a side stitch and having a really full bladder localized at my ovary. Uncomfortable as it is, this is excellent and very welcomed news. My doctor says since my right ovary is kind of a runt, my left ovary has taken the role of "overachiever" and picked up the slack plus some. Below is an image from my ultrasound that shows some of the follicles. The black round spots in the center of the image are follicles.

I am definitely ready to go. I will do my injection of Ovidrel tonight at 10pm. Ovidrel is just a name brand of the hCG trigger shot. Tomorrow I get a whole day 100% injection and doctor free. A one day break!! WOOHOO! lol. My egg retrieval is scheduled for Wednesday morning at 10am. I have been instructed to take it easy until then. Looks like I'll be spending a lot of time with my couch and remote control. I've got lots of bed rest in my near future. Company is welcome! :)

Straight from my doctor's website:
"During the retrieval, the anesthesiologist administers intravenous medications (pain relievers and sedatives) in order to minimize the discomfort that may occur . The egg retrieval is performed via vaginal ultrasound (similar to the ultrasound used for monitoring your follicles during your stimulation). Once you are comfortable and relaxed, a tip of a thin needle is passed through the top of the vagina and into the cul-de-sac (space behind the uterus). The ovaries are located near the bottom of the cul-de-sac allowing the tip of the aspirating needle to enter the ovarian follicles and aspirate the follicular fluid from them. The egg retrieval takes approximately five to ten minutes. Sometimes there are ovarian cysts that contain no eggs but appear identical to follicles that do contain eggs. Also, follicles of smaller size may not yield eggs. The number of follicles seen with ultrasound, therefore, may not correspond to the number of eggs retrieved. Ultrasound provides only an approximation of the number of oocytes that one can expect to recover."

I will be on to update with all Wednesday's details as soon as I'm feeling up to it.

Ultrasound Day

WOOHOO!! Today I finally got an ultrasound along with my regular labs. It looks like I have 9 great follicles ranging from 13.4 to 18.8! My E2 levels came back at a 1,702 today. I'll continue on with the same dosage until Monday. My next (and hopefully final) appointment for more blood work and another ultrasound will be Monday at 10:00 am. If everything progresses how we expect it to, I should be ready for my hCG trigger shot that evening. This will put me exactly on schedule for my retrieval October 6. PERFECT! :)