My IVF Journey

For our 6^th wedding anniversary, my husband and I gave ourselves the riskiest and most expensive gift to date: IVF. After 2.5 years of infertility and two miscarriages, we decided to make the jump to IVF with ICSI (aka sperm injection) and PGS (aka preimplantation genetic screening).  We both had fears going into IVF. Mine was mostly about the financial impacts and significant time necessary for all the appointments. My husband was worried about putting my health at risk and also concerned about the cost.  We are lucky. I was able to change my employer provided health insurance to a plan that covers 50% of IVF and we have the financial means to pay for the remainder. Additionally, we have access to fantastic Reproductive Endocrinologists (RE) locally and a flexible work situation to cover all the appts.

After completing all the required pre-IVF requirements (consents, injection class, blood work, financial), the day actually arrived when all my IVF medication was delivered. I remember thinking “Wow, this is actually going to happen!”.  The amount of medication is overwhelming but I was not intimidated. I had paid attention in the injection class and done my research. I was confident I understood the process and the medication schedule. I reminded myself that I would take this one shot at a time.

During my previous IUI’s, I had already learned how to administer an injection to myself. That didn’t scare me. I did not need my husband to perform the injections for me. I could do it on my own. In fact, I was really excited to start IVF. The possibility of IVF working and becoming pregnant with a healthy baby was enough to get me through. I was also intrigued by the science behind PGS. I found it amazing that technology has evolved to the point of freezing and unfreezing embryos without damage and performing an ity bity biopsy to examine the DNA!

Friday, 2/13/15

Stimulation Day 1

Tonight is my first night of IVF medications. It’s hard to believe everything finally got worked out with insurance coverage, medication shipping, pre-IVF blood work and appts. I feel so lucky to be able to have an opportunity to try IVF. We have the funding and access to great doctors. Not all couples get the chance to try IVF.

In 30 mins after a hot bath, I will administer my first 2 injections. I am not scared. I am excited. I have all my medication organized and ready to go. I am strong and I can handle these injections on my own. I am excited for the possibilities. I feel hopeful IVF will lead to a health pregnancy.

I can do this.

Saturday, 2/14/15

Our 6^th Wedding Anniversary

We traded an expensive anniversary trip/gift for dinner and a movie with friends. It was a fun, low key evening.

Monday, 2/16/15

Stimulation Day 4

Right Ovary = 16

Left Ovary = 12

Today I had my first monitoring appt. The appt was quick – easy blood draw today. The RE office called me back this afternoon and instructed me to stay the course with the current medication dosage I am on. I am taking that as I am responding appropriately to the medication. Next appt is on Wednesday.

I am doing well with the nightly injections. I have a routine down. I take out the chilled Gonal-F and let it warm up. Then prep the room temperature Menopur injection. I put an ice pack on the injection site for 10 min to numb. That helps with the pain – although the injections do not cause much pain.

I view IVF as a gift. Not all couples get the opportunity to try IVF – it is expensive, time consuming and emotional. We stared IVF the day before our 6^th wedding anniversary and I consider IVF our most expensive anniversary gift of all time! And if it works, the best anniversary gift ever!!

I told a good friend that we are doing IVF. She asked a lot of good questions. She recently read an article about the PGS and asked if we are doing that. We are. I was hoping she would be hopeful and excited, however by the end of the conversation she was questioning when we would stop trying to conceive if IVF doesn’t work. She doesn’t want us to wait around forever before deciding on adoption. I think she means well but I am hopeful IVF will work and I’m not ready to start worrying about what we will do if it doesn’t. There is no reason to worry yet. I’d rather stay hopeful.

Wednesday, 2/18/15

Stimulation Day 6

Another monitoring appt today. 20 follies all together. They haven’t grown much. RE is expecting growth by Friday appt.

Friday, 2/20/15

Stimulation Day 8

11 + 8 follies with an additional 4 or 5 that the nurse measured. They are starting to grow big. The RE is happy with my progress. The nurse called this afternoon and is having me change up the medication to add Centrotide – which prevents ovulation from occuring naturally. I created myself a medication calendar in excel to keep track and check off the medications each day.

Today I am feeling some discomfort in my ovary area. I can feel things are growing. I don’t actually feel bloated yet but I can feel an abnormal sensation. I am thinking just another few days before egg retrieval sometime next week. IVF patients stimulate for 8 - 14 days. An egg retrieval surgery next week is really bad timing for work because I have a lot going on but I will make it happen.

Friday, 2/27/15

1 day post Egg Retrieval

A lot has happened. Yesterday was my egg retrieval. We traveled an hour to Rockville MD in snow for the procedure. Luckily, we arrived on time. My husband provided his sample and I was prepped in the OR waiting area with an IV. My least favorite part of visiting any OR room is an IV.

I went into the procedure thinking it would be no different than the other 4 times I had been in an OR for fertility issues either a D&C or Hysteroscopy. I was wrong. I came out of the procedure and was in pain immediately. The nurse gave me two doses of morphine to calm the pain and a vicodine pain pill after I ate some crackers. The pain was manageable after that. At least I wasn’t feeling nauseous from the anesthesia, which I had experienced in the past.

The OR tech told me they retrieved 20 eggs which is a great number to start with. She told me on average they usually get 8 – 12 and my own research online indicated that 15 is a good number. So I was happy with 20 eggs.

When I finally got home I was surprised at how much pain I was still in. I decided to take another pain pill and go to sleep. I had a hard time simply sitting up because my ovaries were swollen, sore and inflamed.  Originally, I had planned to go into work the day after the egg retrieval, however, I woke up this morning with a lot of discomfort. Going to the bathroom nearly made me throw up and pass out this afternoon!

I am feeling a bit better now. My husband stayed home with me and has been waiting on me hand and foot.

I got a call from my RE this afternoon. He reported that out of the 20 eggs retrieved, 17 of them were mature and out of the 17 mature eggs, 16 of them successfully fertilized. That is a great place to start!  I will get a report every day until they embryos are frozen on day 5. I expect the number of growing embryos to reduce each day because only the healthiest and strongest will survive.

At this point, I am waiting on my period to arrive on her own to start a new cycle for the frozen embryo transfer.

Summary Fertilization report for day 1!

20 eggs retrieved

17 of those eggs were mature (only mature eggs can fertilize)

16 eggs have successfully fertilized!

Saturday, 2/28/2015

Fertilization report day 2!

The fertilized eggs are starting to grow and multiply cells. So now they grade them on how many cells the embryos have. All 16 of my embryos are still growing today. Below is the break down:

5 embryos at 5 cells

9 embryos at 4 cells

2 embryos at 3 cells

The doctor says this is great.

Sunday, 3/1/2015

Fertilization report day 3!

They said all the embryos are still growing. 8 of them have grown to the “compacting” phase, which means they have so many cells, the doctor’s no longer attempt to count them. These are really strong. 6 more are in the phase just before that so they look really strong as well. 2 of them are starting to slow at growing so those may not be healthy enough.

The doctor says I have 14 strong embryos now and that is a really great number. So much so that we may have to spend more $$ on the lab tests because there are so many. The lab has a flat rate for up to 8 embryos then you pay for each one after that. It is going to add up. But we talked about it and we want to biopsy as many strong ones as possible because we have no idea how many of them may be unhealthy. 

No report tomorrow.

Monday, 3/2/2015

4 days after egg retrieval

Period started

Tuesday, 3/3/2015

Update for day 5 – Biopsy Time!

Today 3 of the embryos were ready for biopsy and freezing. They all are really good quality. The doctor said they are keeping an eye on 6 more embryos to see if they can be biopsy’ed and frozen tomorrow.

Day 5 embryo biopsy

Both my husband and I were disappointed with the drastically dropped number of embryos. The doctor assured me this is normal and the 3 frozen today are something to celebrate.

I found this article on my doctor’s website that really helped explain this part of the IVF process and the natural selection that occurs at this stage. Specifically, the paragraph "Are there benefits of blastocyst transfer with IVF?”

Wednesday, 3/4/2015

Update for day 6 - the final embryo update!

Good news today. The doctor called and they biopsy’ed and froze an additional 5 embryos! So we have a total of 8 - all of which had the biopsies sent to the lab for chromosome testing. We are really happy with the total of 8 embryos. Our fingers are crossed that most of the embryos have normal chromosomes.

Tomorrow night I start birth control pills for 21 days. After which I will be on medication (Del estrogen and Progesterone in Oil) for 2.5 weeks to prepare my uterus for the transfer. The medication will build up my uterus lining to the appropriate size for a 6 day old embryo. They sort of match up your uterus to the age of the embryo somehow. 

Unfortunately, the RE office could not schedule my embryo transfer until April 14th - but that’s not so bad. That will get us past an out-of-town wedding on March 21, a few pre-wedding events in March and the wedding I am maid-of-honor in on April 11th. 

Anyway, here are some more articles to read about the biopsy part. There has been some bad publicity on genetic testing for embryo’s. My RE office responded to the negative news with this article, which I found interesting. Additionally, here is the website for the lab doing the genetic tests. We are doing PGS - Preimplantation Genetic Screening. We should get the results back late next week I hope. 

That is all for a while. I welcome the chance to relax for a month.

Tuesday, March 24, 2015

Genetic Results and Next Steps

Last week, we received information regarding the genetic tests on our 8 embryos.  Bottom line: Out of 8 seemingly good embryos, we have only 1 viable, healthy one. The RE said 5 embryos were genetically abnormal, 2 were inconclusive and 1 is genetically normal. The RE is planning to thaw, re-biopsy, refreeze, then retest 1 of the 2 inconclusive embryos because it is high quality. The other inconclusive is not strong enough to make it through the thaw and refreeze.

I asked about the 5 abnormal embryos and learned that each one had a different genetic defect.  One was missing a chromosome while another had an extra one – there was no consistency. Both my husband and I have already been through genetic testing and our results are normal so the high rate of genetic abnormalities in our embryos is really confusing to me.  My RE said it is not normal to have only 1 out of 8 be normal and this explains a lot about my history with miscarriage. The doctor explained that abnormalities occur at the time of fertilization and he sees these types of abnormalities with other couples who have had losses. Unfortunately, the doctors cannot explain it. I am thankful to know why I’ve had my losses – even though, I can’t fix it.

I asked my RE if I should avoid ever trying to conceive on my own again. While he did not say no, he did say I would have up to an 80% loss rate in his opinion. That information made both my husband and I stop and I think. An 80% loss rate?! Considering the health risks associated with miscarriage – the gamble may not be worth it. We have spent the last few days letting that information sink in.

I do want to end this post on a positive note. I do have something to look forward to. One healthy little embaby. My husband reminded me that our normal little embaby is the closest we have ever been to a successful pregnancy. I know the Frozen Embryo Transfer (FET) is not guaranteed to work, but I am hopeful. My RE said with one genetically normal embryo, the pregnancy rate is about 70%. Today I received the medication to prepare my body for the FET. I also scheduled a few extra acupuncture appts to help with relaxation and blood flow. My baseline appt is on March 27^th and if all is well, I will start the medication that evening.

The FET of our healthy embaby is scheduled for April 14, 2015.

Fingers crossed for our embaby!

Tuesday, April 14, 2015

Frozen Embryo Transfer

Today was the day! We had a successful embryo thaw and transfer! I am really excited.  Despite the rain, we arrived at the surgical center early. We stopped by Cheeburger Cheeburger for a quick bite. Then headed over to the doctor’s office.

After validating our IDs, I prepped for the embryo transfer. My husband stood next to the exam table and held my hand.

The doctor came in and told me the embryo thawed successfully – which was great news. He explained the procedure to me and I signed some paperwork. There was a screen on the wall that showed the view from the embryologist microscope. After they flashed my name on the screen, I saw our little embryo hanging out all alone.  Then the focus switched to the ultrasound machine, the doctors inserted the catheter through my cervix to my uterus. We were able to see the catheter on the screen.  Next, the embryologist came in with our embryo loaded into a tube, which was inserted through the catheter into my uterus. We could see the tube come out the end of the catheter. The doctor said “transfer”, then the embryologist said “transfer” and our embryo was pushed into my uterus with a poof of air. We were able to watch the whole event via ultrasound. We saw the “poof” happen. Afterwards, the embryologist checked the tube via microscope to ensure the embryo was successfully transferred.

And that was it!  I am PUPO – Pregnant Until Proven Otherwise.  The nurse came in afterwards, gave us instructions and a super zoomed in photo of our embryo.

A selfie with our embryo!

I am officially in the 2 week wait until my pregnancy test.

Friday, April 24, 2015

Pregnancy Test

Today I had my blood drawn for a pregnancy test. This afternoon we found out that I am still pregnant and my beta level is 232!!!

We are so excited and happy! I'm still working on wrapping my head around the fact that I am pregnant. It is hard to believe because this journey started back in Jan/Feb time frame and now we are in April. We have been through so much - so many shots, procedures, worry and $$$.

I know we still have a long way to go from here. Everyday I will continue to remind myself that today I am pregnant and I love my baby.

   

Monday, May 11, 2015

1st Ultrasound

This past weekend was scary. I woke up Saturday morning with bleeding and light cramping. It freaked me out. After a call to the emergency phone line of the RE office, they told me to monitoring things and go to an ER of the bleeding increases. It didn't take long for the bleeding to slow down. I still was freaked out so I went to an urgent care facility. They were not able to do a ultrasound - which is what I wanted. However, they did do another beta test. My beta was 55,000, which is perfect for how far along I am. After a basic physical, they released me. By that point the bleeding had stopped and the cramping subsided. The next day was mothers day and I really wanted to have a normal day. So I didn't seek additional check-ups because I had no more bleeding or cramps. 

Today at 6 weeks, 4 days along we had our first ultrasound. I was hopeful but worried due to the bleeding I experienced. To my disbelief, our little Popsicle was alive and well with a heart beat of 116 (I think). Popsicle was measuring on schedule and looked great. We were overjoyed! This was the first "normal" ultrasound I had ever had. We are so very thankful!

1st Ultrasound

Thursday, April 14, 2016

I Year Ago Today

I can't believe it has been a year since our IVF embryo transfer and the day I became pregnant with our precious daughter, Cora. How far we have come! Tonight I am thankful...for rubbing vicks vapor rub on my daughter before bed to calm a cough, for being able to bond with my daughter through nursing, for having to prepare my daughters daycare bottles and I am thankful to wake up every morning to my beautiful little girl.

 

Cora at 5 months old