IVF Diary Vol III: 14-16 Apr 16

April 16, 2016April 16, 201637 Comments

Medication(s) administered and dosage(s). Transfer Day!!!! PM Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2.

The past few days Chris has been giving me my progesterone in oil injections because I have been too sore to turn around and attempt to give one to myself in the behind! Last night I prepped the medication as per usual, I iced my backside, then usually I go lie on the bed face down ready for Chris to inject, but this time I decided to secretly attempt to inject it myself! I stood with my side facing the bathroom mirror (which I didn’t actually use in the end). I held the needle like a dart, but it’s very difficult to get a true dart like action when doing this to myself! There was no hesitating this time (I must have tried this about 10 times last cycle). Rather than ‘dart’ it in, I placed the needle on my skin and pushed a little – it didn’t break the skin! I couldn’t feel it because I had iced the area anyway, so I pushed harder. You definitely have to push that thing in a whole lot harder than you might think!!! Anyway, it went in and I started to inject the oil. Chris walked into the bathroom as I was doing this and for a second ignored me…then realised what I was doing, I hadn’t told him I was going to do it!!! He was super impressed!! After I took the needle out I realised that there was quite a lot of blood with this one – typical!!! I hadn’t got the gauze ready. I felt a little dizzy, but not too bad. I put my heat pad on the injection site as usual and gave Chris a high five! Can I give a high five to all my lovely supporters who have cheered me on with this injection!!! You helped me do it! Thank you so much!!!

Medical procedures undertaken. 5 Day Embryo Transfer!!!!! I was very nervous that we would arrive and the procedure would be cancelled because I was still feeling the OHSS symptoms. We arrived at 0700AM at the clinic and we were second in line – there were only two of us patients in the OR today. Learning my lesson from previous transfers I did not drink anything when I woke up and ensured my bladder was as empty as it could be by the time I arrived at the clinic. I started sipping my water about 40 mins before they took me in. They recommend drinking 24oz, but seriously my bladder can barely hold 12oz and with the OHSS the past few days I have only been able to drink about 8oz at the most before needing to pee. Once I was in the OR the doctor told us we had two beautiful embryos to transfer today and one potential to freeze. Once I was in the stirrups, the doctor placed the speculum and the other doctor used the transabdominal ultrasound on my tummy. OH MY GOODNESS it hurt! And this time not from a full bladder! The Doctor exclaimed ‘Oh yes, you do have super enlarged ovaries!’ I just laughed out loud because I could tell him that without the ultrasound. Anyway, the canula tube that the embryos would be transferred by was inserted into my uterus and we were ready to go! The embryologist checked my identity, and went back into his lab and showed us the embryos on the TV screen, confirming they were ours – one of the blastocysts had started to hatch since he took the photo earlier in the morning (a new thing the clinic does!!!! Very cool because before Chris would snap a pic of the TV screen with his phone!). At this point I was crying because of the pain from the ultrasound!!! We watched the embryos on the ultrasound screen ‘arrive’ into my uterus 🙂 We had the same doctor do our transfer for our Positive result last year…not that this should make a difference…but….this is a good sign!!!!!

Any results? The two embryos we transferred were graded 3BB and 3CB (Here is a useful link to find out more about blastocyst grading). There is one blastocyst that might make it to the freezer (FINGERS CROSSED!!! This would be amazing so it can join our other frozen embryo!!!) Sadly the other 7 embryos are highly unlikely to make it to the freezer 😦

The one on the right is the 3BB the one on the left is the 3CB – we haven’t decided on a name for them yet!

What are my symptoms? Still suffering with OHSS, but the important thing is that it is not getting worse. Now we have to hope that it doesn’t get worse if I get pregnant (OHSS can either appear or get worse as hCG levels increases once you actually get pregnant)…so we are still on the watch. I am really getting bored of not being able to do anything other than a gentle walk – and that is a short distance gentle walk too 😦

How do I feel today? I was feeling really anxious last night about today’s transfer and I did not sleep well at all. I had awful nightmares about the Brussels attacks too. I woke up from them and couldn’t stop thinking about it for about an hour or so before I fell back asleep. Today I am feeling relieved that we had at least two to transfer and all those emotions came bubbling up in the form of tears as we left the clinic – a true mix of happy, scared and pained feelings!

BUT I am PUPO! (Pregnant Until Proven Otherwise) and for that I am truly grateful. We will be over the moon if this one blastocyst also makes it to the freezer.

What’s next? The two week wait…..eeeeeeek!!! To pee or not to pee (on a stick)…..that is the question!!!!

The Final Countdown!!!

*Notes. I take First Response Reproductive Health multi vitamin gummies (pre-natal), 5mg Melatonin at bed time and CoQ10 200mg gummies daily. NSTR = Nothing Significant To Report.

Average number of blastocysts per IVF cycle

February 21, 201624 Comments

It’s a really simple question – what is the average number of blastocysts per IVF cycle? After our failed IVF cycle I posted a status update in my local resolve support group’s facebook page, I explained what had happened with our cycle: 14 eggs retrieved, 11 mature, 11 fertilised, 2x 5 Day blastocysts transferred (5BB & 5CC) on Day 5, 9 still alive on day 5, but 0 were of sufficient quality for cryopreservation. Some ladies commented how they had similar results with 0 embryos making it to the freezer, and one lady posed the very good question how common is it to have 0 make it to the freezer? Perhaps it is more common than we think? So it got me thinking…at no point has my doctor said what a typical number of eggs, embryos or blastocysts she would expect out of a cycle for us – the only stats we were ever told was all about our likelihood of a successful pregnancy from 1 cycle of IVF, and ultimately, a live birth. And of course, that is the only statistic we only really care about, right? This holds true, until you get a Big Fat Negative (BFN), then the other statistics start to matter and grind at you.

So I looked into it, and asked google – what is the average number of blastocysts per IVF cycle? But I couldn’t find an easy answer, or at least one that I held great confidence in. I’m the kind of person who needs to see the supporting evidence, and not just some seemingly arbitrary numbers some random person has posted on a website. But although I didn’t find any national statistics per se, what I did find, made me feel a whole lot better about our last cycle.

The statistics that the Pacific Fertility Center in Canada are claiming are [1]:

11 – Average number of eggs retrieved

9 – Average number of mature eggs

7 – Average number of eggs that fertilise (approximately 80%)

7 – Average number of fertilised eggs that will form embryos (98%)

7 – Average number of embryos on Day 3 of culture

3.5 – Average number of blastocycts on Day 5/6 (50% of good quality day 3 embryos make it to blastocyst)

It was not clear if this was their clinic’s statistics or where the source of this data came from. So my confidence is not high in it, I don’t know over how many cycles or patients this average is calculated. But at least it gives you a flavour of what numbers to expect. Note, it does not mention average number of blastocysts making it to cryopreservation!

Another clinic, Advanced Fertility Center of Chicago, provides a nice pretty chart of their own statistics, broken down by age for the period of 2003-2005. First of all my first alarm bell is that is over 10 years old now! Has anything changed in Assisted Reproductive Technologies in the last 10 years? Hmmmmm. Anyway, here it is….

Advanced Fertility Center of Chicago’s average number of eggs, mature eggs, fertilised eggs, 8 cell embryos and Day 5 blasts [2]

Their numbers are slightly lower than the Canadian clinic’s…but there could be many reasons for this because, again, there is no clue as to how many cycles/patients this average is calculated over. This clinic does publish their statistic of how many blastocysts make it to cryopreservation. And here is the money shot statistic people!!!!

Advanced Fertility Center of Chicago’s average number of blastocysts frozen per cycle in 2010-2011 [3]

Just look at how low these numbers are! An average of 1.7 for women younger than 35 years old. And this statistic is a little bit more up to date than the ones above – this was for cycles from 2010-2011.

So what is the point of this post? The point is that we didn’t have any blastocysts that made it to cryopreservation, but we did have 2 blasts that were transferred and 1 that could have been frozen, but they decided it might not survive the thaw. For our first cycle we had one blast make it to the freezer. The point is, we had high expectations for more to make it to the freezer, when in actual fact the reality is, we were better than average to have so many good Day 3 embryos and we were typically average with transferring 2 on Day 5. Yes, IVF cycle 2 was a failure, but we were pretty average with our second cycle!!! This doesn’t mean we are less likely to succeed with cycle 3, rather the odds ARE in our favour.

Happy dance Dani!!!

stay the path

[1] Source: http://www.pacificfertility.ca/our-resources/guide-to-ivf-lab-results/

[2] Source: http://www.advancedfertility.com/ivf.htm

[3] Source: http://www.advancedfertility.com/cryo.htm

IVF Diary Vol II: 29-30 Jan 16

January 30, 201626 Comments

Medication(s) administered and dosage(s). Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2. Remember I was taking baby steps with self injecting the progesterone? Well, I have not progressed any further, in fact I probably regressed. I am really struggling to pull back the needle to check for blood and keeping the needle still, then I freak out when the needle is moving around in my butt!!! I have yet to take the plunge with putting the needle in myself. I am feeling pretty miserable with my lack of progress. I’m not going to give up, but I’m feeling frustrated at myself.

Medical procedures undertaken. 5 Day Embryo Transfer! Our transfer was scheduled for 7AM on Saturday, so we were up super early again. I learned my lesson from last time around. No tea before the procedure. Usually I am a real grump without my morning cup of tea, but as tea is a diuretic I decided to avoid it this time. I also didn’t drink anything until I arrived at the clinic. For our first IVF cycle, in addition to tea, I also drank 3/4 of the recommended water to take 30 minutes before the procedure (24oz) and I was painfully busting to go to the toilet. So, now knowing my bladder size a bit better, I decided to drink just a third of the 24oz recommended water (and no tea). I was a little nervous it wouldn’t be enough, but the ultrasound clearly showed my uterus (Dr also commented on the severity of my retroverted uterus as if it was a surprise!).

As I got onto the table ready for the transfer procedure the Doctor gave us a run down on the status of our 11 embryos. This time, she showed us the report (last time the Dr just told us we had 2 eight cell embies). We had not been given an update since the fertilisation report so I was very nervous!!! Amazingly, all 11 embryos were still alive. We had three blastocysts, graded 5BB, 5BB and 5CC. The other 8 embryos were still only 9-5 cells. They were going to wait one more day to see if they would catch up. When I said ‘so this means we will have at least one to freeze?’, she didn’t seem particularly confident that we would have any. But I will remain hopeful that the rest will catch up!! We were transferring the best two blastocysts we had, and I am happy with that!

We have named our embies Petrie and Spike…can you guess why we ended up naming them this?

Introducing Petrie & Spike – our Day 5 Embryos – now on board! (We think that weird stickie looking thing is a scratch on the petri dish – that or I will be giving birth to some stick man)

The Dr prepared me for the procedure, she washed out my ‘baby house’ as she called it, then practiced inserting the catheter, everything went smoothly! Then the embryologist came to confirm my identity, he went back to the embryology lab to show on the TV screen in our room our name on the petri dish and then a zoomed in picture of our embryos. Then he came back in the room with our embryos ready to be transferred. The Dr quickly did the transfer as we watched on the ultrasound monitor the liquid with the embryos in it go up into my uterus. Chris later described it looking like a ‘shooting star’. I thought that was a lovely way to describe this! I was wheeled back to the recovery room and I had to lie down for one hour before they would let me either pee or leave!!!

What are my symptoms? I think the estrogen and progesterone are starting to kick in and I had a good old cry last night. It wasn’t helped by my failure to do my own progesterone injection.

How do I feel today? I was pretty relaxed with the whole procedure today and I am feeling positive still. Woohoo!

Any results? I am thinking of doing a home pregnancy test everyday from 7 days past the 5 day transfer – last time I tested the day before the beta. But this time I am thinking of testing simply in the name of science. I don’t know why, I’ll have a think about this – I’ve got a while anyway! 2 Week Wait here we come!!!

What’s next? Beta HcG test will be 13 days from now :-s

Weight. NSTR.

Waist. The Dr showed me my squished uterus today from my stimulated ovaries – there were some pretty big follicles still in there. I am not surprised I am still bloated as I am. The Dr told me to keep up the drinking to help flush them out.

Boobs. Definitely growing.

~~Hours of Sunshine 🙂~~ Deleted from my diary…what’s the point? The one sunny day at a weekend – I am on enforced bed rest!!!

*Notes. I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily. NSTR = Nothing Significant To Report.

IVF round 2 – December/January 2016

October 28, 2015October 28, 20156 Comments

We met for our follow-up appointment with our doctor yesterday. There were no surprises. Which is a good thing! So the plan of attack is a fresh round of IVF…get a couple more embryos frozen:

Schedule a Hysterosalpingogram (HSG – if you would like a refresher what this procedure entails, check out my post from last time here) – I will do this as soon as I start my period (who knows when that will be!!!). It is very unlikely that my fallopian tubes will be blocked, but she wants to be sure. Fair enough. However, I am NOT looking forward to this test. Last time I was completely naive to the potential pain ahead for this particular procedure, now that I know exactly how much it can hurt I’m a wee bit nervous!
Plan to start Birth Control Pills to regulate my cycle in December with an egg retrieval date for early January 16. There is a period of 3 weeks that the embryology lab is closed over the Christmas period. Seriously – how unlucky am I?? Last time my cycle was delayed because the embryology lab was being refurbished. Oh well – I guess everyone needs a holiday.

There is a potential chance we could start Birth Control Pills in November, and do a retrieval before Christmas, but I think it will be close to my 3 month period of ‘no baby making’ because of the methotrexate shot I had affecting fetus development. I have been researching this, and I would be willing to go ahead a week or two earlier because doctors are overly cautious with this 3 month time stamp. As long as I keep taking my folic acid I should have no problems. However, this is something to be discussed once we have a better idea of a) when my period is likely to be and b) assuming my HSG test is all clear!!!

There will be no change to my protocol, perhaps a slight increase in some of the medication dosages to mature more of my eggs. As a reminder from our first round we had 9 eggs retrieved, 6 of these eggs were mature, 4 of these eggs were successfully fertilised by ICSI, 2 good 8 cell embryos were transferred on day 3, and 1 of the 2 embryos made it to Day 5 blastocyst and was frozen. Our doctor mentioned that she would consider waiting to Day 5 for the transfer this time around, especially as our frozen one is Day 5 – she wants them to be the same. We like this plan!

This gives me some time to concentrate on work for a little while, get my body healthy and start growing some strong eggs! What is amazing is what the horrrorscopes says for me next week…

I was already planning on going back on my sugar free, healthy diet next week! Freaky! Sooooo….which old friend should I Skype on Sunday next week and wants to reveal a long-held secret to me??!!!?!