Round Two: Egg Retrieval and Embryo Update - EIGHT!

EIGHT.

I received the call early one morning while I was at my desk at work. I wasn't expecting to hear from them yet, and was completely caught off guard. The call itself lasted an entire 43 seconds. I answered, my coordinator told me she had results - pause - then asked if I wanted to year them (in response to my silence). To be perfectly honest I had been dreading the call. Everything had been going so well I was so scared of getting bad news. I didn't want to have any expectations and was perfectly content with the time in between of not knowing.... For once, the waiting was enjoyable, and happy. The thought of results and the reality of it and how much it meant was almost unbearable. So here I am, on the line, waiting for her to speak again in her monotone-giving-nothing-away voice as she goes on to tell me that we have EIGHT healthy unaffected embryos. Some are a very decent high grade, some a little less that high - but all healthy and disease free! She said congratulations, I said "K, thanks!" and hung up! Very rudely and abruptly - but I was just overwhelmed with emotions and needed to just process and soak it up! Also, mind you, I was still at my desk hoping that no one would approach me while on a call and holding back tears. So I paused and sat and processed, exhaled, and fast walked outside to call my husband immediately. Be were both so over-joyed and in such shock. It was torture to not be with him in person to just hold each other over the news.


Out of 16, we have 8. EIGHT! Eight unaffected healthy embryos. Eight CHANCES. Eight opportunities for the dream of growing our families, experiencing life growing within me again, to watch grow day by day as curiosity and learning happens before their eyes. Eight chances at experiencing the full gift of motherhood. Christmas mornings, Easter egg hunts, birthday parties, Disneyland trips, bedtime stories, jammie cuddles, Saturday morning cartoons, spilled milk, sleepless nights, and chaos. Even more so, the chance for not just one, but possibly siblings! The depth of it all! So many of these dreams I thought were slim if not over. This was our last shot. I know we still have the transfer to go through and that it needs to be successful but these chances! We have them. We are this far. They are frozen perfectly in time. What a milestone to achieve. My happiness cannot be obtained. The amount of swelling love I feel from this just brings me to tears. My gratitude is immeasurable. Thank you all for your continued prayers, love and support. Its been a long, long time waiting, but its happening.


Transfer is tentatively set for July. Making babies!

Round Two: Stimulation Injections

The On April 30th we began stimulation shots. This part of the process is designed to help the ovaries to make enough follicles and eggs using mediation. Without stimulating medications, the ovaries make and release only 1 mature egg per cycle. The goal here is to have several follicles grow so multiple eggs can be retrieved at one time. Ive listed the protocol for both rounds to compare.

Round 1 -

Stims Day 1-3 ~ Gonal F 175 & Menopur 75

Stims Day 4-6 ~ Gonal F 100 & Menopur 75

Stims Day 7-8 ~ Gonal F 100, Menopur 75, Cetrotite 0.25mg

Stims Day 9 ~ Trigger Shot Pregnyl

Day 10 ~ No Shots!  Oral Pills Zithromax, and Fluconazole.

Day 11 ~ Retrieval Day! (Retrieved 16 eggs, 11 were mature, 9 fertilized and 7 made it to day 5 blastocyst. Unfortunately only one was normal and nonaffected after PGD/PGS testing and resulted in a BFN after transfer.)

Round 2 -

Stims Day 1-5 ~ Gonal F 125 & Menopur 75

Stims Day 6-8 ~ Gonal F 125, Menopur 75, Cetrotite 0.25mg

Stims Day 9 ~  Gonal F 200, Cetrotite 0.25mg (this was only because I was out of Menopur and my coordinator said this would work the same) 

Stims Day 10 ~ Trigger Shot Ovidrel

Day 11 ~ No Shots!  Oral Pills Zithromax, and Fluconazole.

Day 12 ~ Retrieval Day! (Retrieved 32 Eggs, 22 were mature, 20 fertilized, and 16 made it to day five blastocysts)

Its hard to explain how differently these two rounds of stimming have been. I injected in my legs both times. Iced the injection site first, then Justin administered my shots. Menopur burns regardless, but the actual shots turn into a simple chore and I get a super cute Bandaid as a reward for. The first round I was so nervous and anxious and could not stop researching everything. I was eating well but added more sodium, stopped drinking completely, cut all caffeine and worked out lightly after the first 3 days. This time, it was just different. I was calmer, less anxious and knew what to expect. I had a glass of wine the night before we stated and once during. I had my usual cup of coffee in the morning. Drank ALOT of water. I worked out lightly after three days (that's when you can usually start to feel the bloating and they advise against anything extraneous). I still ate well but added more sodium as directed.

I felt well during the week of stims until around the end I was more and more losing my appetite. After retrieval I immediately gained 5lbs (that day!) and the insane bloating began to set in. It was much more painful this time and still took about a week to heal. My doctor did tell me that its worse depending on the higher number of eggs retrieved, but hey, it was worth it! Im also REALLY glad this part is over.

Now we wait the two weeks to find out how many of the little embies are healthy and unaffected by our disorder. Then the real fun begins!

I am so unbelievably thankful that we had such a successful stim round. I wish I knew who or what to give credit to from a protocol perspective. Im just so thankful that we were so blessed. Im really thankful for those we have in out life that are with us through this journey. Im also really happy and Justin and I are dedicating time to form our own opinions within our faith and God together. I know personally this has made me feel much better. Everything has been happy lately. Im beyond appreciative for everyone's prayers and support. I really really hope and pray that we continue to have happy news to share!

IVF w/PGD Round Two Timeline

February 23, 2016 - Reviewed previously failed IVF Round. No changes to protocol were made except to stim longer in hopes to retrieve more eggs which should raise our odd for creating unaffected embryos. Decided to wait until April cycle to begin birth control for round two.


April 15th 2016 - Received call to begin Estrace and Aygestin. I was out of town and did not expect to begin taking meds until starting with birth control on the 16th. They changed my protocol due to the timing of my cycle and this sped up our process.


April 16th 2016 - Began taking Estrace and Aygestin (Since I was out of town I couldn't start on the 15th, they adjusted my timeline and I was instructed to begin today)


April 19th 2016 - Ordered Stim Medications/Injections from Integrity RX Pharmacy. ($900.00 w/Discounts)


April 28th 2016 - Begin of new cycle.
April 29th 2016 - Baseline Ultrasound and Blood work
April 30th 2016 - Begin Stims - 75 Menopur, 125 Gonal F.
May 3rd 2016 - Ultrasound and Bloodwork
May 5th 2016 - Add Cetrotide in addition to Menopur and Gonal F.
May 8th 2016 - Last day for stims!
May 9th 2016 - Trigger Shot (Ovidrel) at 10pm
May 11th 2016 - Egg Retrieval 10am (Retrieved 32 eggs!)
May 12th 2016 - First Emryo Update (22 mature, 20 fertilized)
May 16th 2016 - Day 5 update (16 embryos made it to day 5 blastocyst and have been frozen and samples have been sent for PGD/PGS Results!)




May 22nd 2016 - New cycle began (Earlier than expected)
May 24th 2016 - Began birth control pills.
May 31st 2016 - First Acupuncture Appointment
June 2nd 2016 - Acupuncture Appointment
June 8th 2016 - Acupuncture Appointment
June 10th 2016 - Acupuncture Appointment
June 12th 2016 - Last Birth Control Pill.
June 14th 2016 - Acupuncture Appointment
June 16th 2016 - New Cycle began
June 16th 2016 - Acupuncture Appointment
June 17th 2016 - Baseline Ultrasound and Blood Work.
June 18th 2016 - Begin Estrace, once a day.
June 22nd 2016 - Blood work and ultrasound at RRFC, Increase Estrace, twice a day, Acupuncture appointment.
June 25th 2016 - Increase Estrace, three times a day, Begin Estrogen Patch, Begin baby aspirin once a day.
June 27th 2016 - Ultrasound and blood work at RRFC
June 28th 2016 - Acupuncture appointment
June 30th 2016 - Continue Estrace, Patch, Asprin, Prenatal, Add Crinone and PIO (Progesterone in Oil injection)
July 2nd 2016 - Added Medrol to the medication list.
July 5th 2016 - Transfer day! Transferred 1 healthy baby boy 5BB blast.
July 18th 2016 - Beta #1: 4.5
July 20th 2016 - Beta #2: 7.5
July 22nd 2016 - Beta #3: 3.


Result of IVF Round Two: Failed. Chemical Pregnancy.

The Plan...

As you know, our journey to starting a family has been a long and very unexpected one. When we tried the first time, it was easy. After the miscarriage it took some time to recover but when the time came and we tried again, within a couple months we were pregnant with Liam. It was scary to be constantly in fear of miscarriage again, but the pregnancy was so happy and blissful. I thought I was through the worst of the worst. Then we lost Liam. Then we learned why. Then after about seven months of healing and researching our options, decided to take a huge leap of faith and try for another child naturally. When that resulted in another miscarriage and another loss from the same genetic disorder as Liam, we were at a new rock bottom. Since then, we started IVF w/PGD and after a very, very long road of that also failing, we again, are at a new rock bottom. Since 2012 my focus has been starting a family. After having and losing Liam in 2014 and experiencing  losing everything thing that we'd wanted for so long, having more children had become my everything. I would wake up and my first thoughts would be all of the loss and emptiness from the last few years. I'd have to regularly talk my self out of that depression every single morning and replace it with all the things I was doing to help us have a child. I would force myself to be positive. Its all I could ever think about. With every other pregnancy announcement, every niece/nephew/cousin's birthday party, every holiday gathering, every party night out all I could think of is what our lives should have been like vs what it actually is and how to just get the happy times back. Everything hurt all the time. I thought I was doing what needed to be done by forcing it, you know "fake it till you make it", but now after its gone on for so long, I'm not sure that's still the best course. I realize now I haven't been happy and I've neglected or half assed a lot of other areas in my life as a result. Its went on for too long.


We had a consult with our Dr at Red Rock Fertility Center to review our failed IVF cycle. She said exactly what we expected her to. I responded better than average to all medications. The average eggs retrieved is typically around 12, we had 16, succeeding in that area too. When we did the transfer my levels were perfect. There was no medical reason found as to why it didn't work. It just simply didn't. Of course they want us to try again, and their only real change to the process is to possibly do the stim shots longer to try and retrieve even more eggs since our disorder is knocking so many of them out. Fortunately, my work had some insurance changes this year, and I'm on a plan that may allow for up to $7,500.00 lifetime maximum to go towards IVF w/PGD. Since they also marked me as having PCOS I should be approved for this coverage, which would help tremendously. The medications, and other procedures will still be a lot. But it may be something we can do. I'm happy to have that kind of assistance at all.


They let me know that we could start the IVF process again immediately depending on my body and my next cycle. After really trying to think about the next best course, we have decided to plan on trying IVF (hopefully) again in April. Ill be able to get a more clear price quote in early April and go from there. I also would just be fooling myself if I thought Id be ready to jump back in to all of this next month with March being a very sensitive month already.

 

So - In this meantime, I will not focus my every thought on what I don't have and want so desperately. I will focus on different things. New goals. New dreams. This is not saying that our others wont come true, I just know I need a break. We have decided to make a few changes to our life now. I truly believe I need to stop numbly going through the motions

of life while waiting for this storm to pass. I feel that I've miserably wasted the last year and a half by doing this. I need to be happy now. I need to embrace the happy things in my life (more) now. So here's the plan.

 

1. I'm focusing on bettering myself.
• I'm a firm believer that you are responsible for your own happiness (yes, even still). Despite everything we've been through, I cannot just sit back and expect to just wake up happy one day pregnancy or no pregnancy. I decided to sign up for a 6 week fitness program at RAW Fitness. Currently we consume "mostly" healthy prepped meals during the work week and eat out/less healthy on weekends paired with working out 4 days a week but I easily find a reason to be upset and leave early or slack off. This program will consist of a very strict meal plan, no alcohol, and 4-5 high intense workouts a week. I already know I'll be grumpy, sore and sober regretting it after the first two days, but I think in the long run I need this type of discipline to make sure I put more effort into it. I'd love to go into a future pregnancy being at a more healthy weigh. Plus after all of the IVF medications causing weight gain and the on and off workout restrictions, I haven't been able to really focus on slimming down as much as I have wanted to, and lets face it, I'm a total stress eater. Being at a confident place body-wise has turned into another thing that I "want but don't have" and there's no reason for it now. I need to suck it up, and get it done. If I can do it, I will feel so unbelievably better about myself. I think that's a great place to start.
2. We are planning a trip.
• This fitness plan will be over right before my birthday. Instead of being depressed at how I'm another year older and should have two happy healthy kids by now, I'm going to celebrate and hopefully with a skinnier bod! I'm not sure when or where but I know that we will figure it out, and have a quick get-a-way to just relax and enjoy each other. Even just some fresh California air or Duck Creek scenery will be so refreshing. Its long overdue.
3. We got a puppy!
• Meet Laila <3 We have wanted another boxer for so long, and were so close to getting one so many times. Each time we would sit down with our "responsible" selves and decide its just too much right now. With this first round of IVF we were planning on having two embryos to transfer (instead of just the one) and having the very real possibility of twins. Two infants, two car seats, two large boxers and a tiny chihuahua?! Our car isn't even big enough for that life! So we again decided against it. Now that things are different, we decided to not wait anymore. We now have a window for this puppy to train without any additional responsibilities while keeping us busy. I know we sound like crazy dog people, but we are! Since everything with Liam, our dogs have just been different too. Its like they can feel the energy in our house is different. Its like they don't understand what happened when mom got all big, then brought home a baby, then never brought him back and smells and objects changed around the house. Having this new little puppy brought so much LIFE and HAPPY into our home again. Cassius has some one to play with (when he's not annoyed with her) and bring the puppy out of him again. I'm so so happy for this little sweet girl.

So, plain and simple right? I'm sure it sounds counter productive to take more on right now, but I really think its exactly what we need. I hope we get the most out of these upcoming months so we can be back to happy and strong when we need it most while trying again. Focusing on the other areas that I've neglected and improving them is something I do have control over and I'm really happy to have a goal that I can actually make happen. I'm excited to have a new addition to our fur baby family. Someone to shake up our routine. I'm happy to have a trip to look forward to that we will enjoy regardless instead of a doctor appointment that consists of either good or bad news. I know Ill still have bad days, but like they say, "Its a bad day, not a bad life". Even though sometimes it can feel the other way around. I want to be happy again. Really happy. I really believe this could be the right path to get back there.


As always, thank you all for your love, support, and understanding <3

IVF Timeline from Beginning to End (Round 1)

I know when I started this process, I wanted to know what type of timeline to expect. It helped me to have a clear idea of how long it would all take. Below is the timeline for our first round of IVF. Our round went perfectly. Nothing was set back or canceled. I responded perfectly to all meds and procedures. Below is our timeframe of our experience with IVF doing a FET (Frozen Embryo Transfer) from the beginning consult, through stims, egg retrieval, transfer and end result.


July 2015 - Scheduled a consultation with Red Rock Fertility. Our Treatment package was $16,000.00 for one round. PGD was $4,500.00. Stim Meds - $2,529.30. Transfer Meds $559.95. Round one total expenses, $23,589.25 plus insurance deductibles, etc.


September 8th 2015 - Our first appointment with Red Rock Fertility. They reviewed our case, discussed pricing and the overall process.
September 17th 2015 - Paid Genesis Genetics, Probe construction and research began.
September 29th 2015 - Diagnostic Testing, Ultrasound & Blood work, Female Exam, Day 3 cycle specific, Semen Analysis, Hormone check.
October 1st 2015 - Sonohysterography
October 4th 2015 - Preop labs.
October 6th 2015 - Surgery (Hysteroscopy) to examine uterine cavity
October  21st 2015 - Follow up Consult and Treatment plan. Began Birth Control Pills.
November 9th 2015 - Ordered Stim Medications/Injections from Integrity RX Pharmacy.
November 25th 2015 - Last birth control pill
December 1st 2015 - Baseline Ultrasound and Blood work, Started Stims (Menopur & Gonal F).
December 4th 2015 - Ultrasound and Blood work, Increased Gonal F.
December 7th 2015 -  Ultrasound and Blood work

December 9th 2015 -  Ultrasound and Blood work, Trigger Shot.

December 11th 2015 - Egg Retrieval - Retrieved 16 eggs, 11 mature, 9 fertilized via ICSI. 7 made it to blast (day 5) and were sent for PGD testing.
December 24th 2015 - Back on birth control pill.
December 30th 2015 - Received the following results for our PGD testing.

1. 1 - Affected GACI Carrier
2. 2 - Affected GACI Carrier
3. 3 - Other Chromosome Abnormalities
4. 4 - Affected GACI Carrier
5. 5 - Unaffected GACI Carrier (5AA Baby girl)
6. 6 - Unknown (Sent to retest and embryo didn't survive thaw)
7. 7 - Affected GACI Carrier

January 8th 2016 - Last birth control pill
January 13th 2016 - Baseline Ultrasound and Blood work.
January 14th 2016 - Began 1 tab Estrace Estrogen and baby aspirin daily.
January 18th 2016 - Ultrasound and Blood work.
January 21st 2016 - Started Estrogen Patch, increase Estrace Estrogen to 2 tabs daily.
January 22nd 2016 - Ultrasound and Blood work.
January 25th 2016 - Ultrasound and Blood work. Began Progesterone in oil injections, and progesterone cream daily.
January 27th 2016 - Begin Medrol (four days) increase Estrace Estrogen to 3 tabs daily.
January 30th 2016 - Transfer Day - Transferred 1 5AA Baby Girl.
Following transfer during the two week wait - Continue Estrace Estrogen 3 tabs , Baby aspirin, Prenatal, Estrogen patch, Progesterone injection and Progesterone cream.
February 3rd 2016 - Hormone check, Progesterone - 39.55, Estradiol - 412.5
February 8th 2016 - Hormone check, Progesterone - 38.17, Estradiol - 344.4
February 12th 2016 - Hormone check, Progesterone - 45.36, Estradiol - 561.4, HCG - 0

 

IVF Round 1 - BFN, Fail.
We plan to meet with out doctor to see if she has any feedback on our cycle. :(


Update
We met with our IVF Dr and she said everything went perfectly and she has no insight as to why our round failed. Looking at my levels, the embryo quality, etc, there's no reason why it shouldn't have been successful.

Egg Retrieval and Embie Update

Well! Our Retrieval Day was on the 11th and went very, very well. I felt fine leading up to and on the day of retrieval. I didn't notice many side effects from the injections other than some minimal bloating, and I was a bit on the emotional side. Luckily not the crazy hormonal side, just the crying a little more randomly and a bit more over the moon happy and positive. It was nice actually. After retrieval I felt fine, I came home and slept most of the day, ate ice cream and watched movies. The following days I experienced more and more swelling. So much swelling, that I looked very very VERY pregnant. I even woke in my sleep one night to use the bathroom and felt that I was in a very real flashback of waking up while carrying Liam in the middle of the night to do the same, trying to roll out of bed, hold my belly and waddle over to the bathroom. Queue random crying.
Originally after the procedure I was told to expect some minor PMS like pains and cramps and if it was anything more to go to the ER, and that I would be good to resume my daily routine the following day. So here I am with completely different pains and immense swelling - panicking but trying to stay calm and tell my self its fine. I call and talk to my nurse & thank God I took it easy for so many days because I was told very, very wrong information from the discharge nurse. My Dr was wondering why I wasn't already in pain and that it was definitely better. She also explained that I was not clear to go back to my normal routine, and the swelling is normal, and was also expected to get worse before it got better. Wow. I was so reassured that what I was feeling was normal! I was so worried that something was wrong and I was at risk for OHSS (Ovarian hyperstimulation syndrome (OHSS) is a medical condition affecting the ovaries of some women who take fertility medication to stimulate egg growth. Most cases are mild, but rarely the condition is severe and can lead to serious illness or worse.). It took 6 days, but I finally felt back to normal and having my swelling going to normal. I am so so so happy that everything went well and that I healed as well and fast as I did.


I am happy to say that we retrieved 16 eggs! 11 of them were mature, and 9 successfully fertilized via ICSI. After 5 days, lucky 7 of them made it to blast. A good explanation of the process of the embryos after retrieval can be found here (https://www.urmc.rochester.edu/ob-gyn/fertility-center/our-services/infertility-treatment/ivf/ivf-step-by-step.aspx) Now they will be tested (PGS and PGD) and frozen until transfer. We are unbelievably happy to have so many make it to this stage.

Now we are waiting for our results to see how many transfer eligible embabies we have. Our transfer should be in January if everything works as planned. Until then, we wait, relax, and enjoy this happy news and place that we are in right now. I remember being disappointed at the timeline of this IVF process because originally I thought I would be transferring in November and December. Now that we are this far in the process, Im glad that I have been able to enjoy the holidays without the stress of worry and pressure of the "two week wait". Im really happy to have this holiday time to be us, remember, honor and miss our Liam, and get a fresh start in the new year.






Everything has been going so well so far. We are unbelievably blessed, happy and thankful. Thank you all for your continued support and love. Happy Holidays!