Our one frozen embryo

October 1, 2016October 1, 20169 Comments

Earlier this week at dinner Chris and I were talking and the topic of ‘we haven’t talked about timings for #2 baby yet’ came up. I talked about the minimum suggested time between giving birth and getting pregnant again according to doctors is after 12 months. I am not sure I would want to get pregnant sooner than that anyway! And so I said to Chris,

“well we can get ready for a frozen embryo transfer with our one left in the freezer after a year”.

Chris then said, “But I would like to try and conceive naturally first before doing a transfer”.

I paused, looked at him for a moment and just burst into tears.

I couldn’t explain to him exactly why I was crying, but I had a gazillion emotions running through me at that moment. It was difficult to process, but here are some of the things running around in my head before I could even get a word out between the tears….

A reminder that we were not able to conceive naturally in the first place.
It’s so so so unfair.
But what about our embryo in the freezer? How can we leave that behind?
I would LOVE to conceive naturally and believe that our infertility can be resolved and that pregnancy ‘resets’ my hormones (somehow).
We haven’t got to take home #1 yet, I can’t imagine #2!
Aghhhhhh this stuff is just scary to think about right now.
HORMONES HORMONES RAGING HORMONES can’t stop crying, why can i not stop crying???!!!

So Chris consoled me and asked me to talk to him. Once I gave my nose a good old blow, I started thinking all these things out loud. We had a long talk about it all, our thoughts, opinions and differences. But for me the most important thing I wanted to explore was the fact that we have one embryo in the freezer still. I was unsure what I felt about that, and how we should be involving that into our decision making. It lead to some general questions about the existence of life and ethics. Our journey to conceive and the stages we have faced along the way. We talked about attachment to our embryos and changes over time.

Every month I receive a bill of $60 from my fertility clinic for embryo storage costs. A monthly reminder of what we are lucky to have. This little embryo was frozen from our first IVF cycle and is the only embryo out of our three IVF cycles that made it to the freezer. So our frozen embryo is now over a year old already.

Each of the subsequent IVF cycles after our first I have often questioned the logic of pursing another round of IVF when we have one embryo ready to go. But it was all about an assessment of risk. Risk that we would prepare for a Frozen Embryo Transfer (FET) for our one and only embryo not to survive the thaw and have nothing. So the idea was to get at least another one to the freezer so we could de-risk the chances of preparing for a FET and not having anything to transfer. It was all about numbers. But the longer I think about it and further we got into IVF, our embryo is not just a number. It’s a life we created. Although many argue it’s not really a life as some people consider a life to be. It’s kind of mind boggling, and I wish I could articulate it in words.

So part of my response to Chris was my wrapped up with my convoluted feelings about our frozen embryo. Maybe it’s guilt or maybe I’m thinking why the hell are we paying $60 a month if we don’t plan on using it!

It’s complicated and we have lots of time to decide what to do if we decide to try for #2 baby. But I don’t ever forget about our frozen embryo, it’s existence and it’s strength to survive out of all our others 23 embryos (not including Rocky of course!). May be it’s a future brother or sister for Rocky. May be it will never survive the thaw. But it’s definitely not forgotten about.

Our two little 8 cell embryos – AKA HuckleBERRY and HuckleBERINA (because they look like raspberries)

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.

IVF Diary vol III: 10 -14 Apr 16

April 14, 2016April 14, 201612 Comments

Medication(s) administered and dosage(s). Wait and Hope Phase Day 3 (i.e. the bit between Egg Retrieval and Transfer!). PM Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2.

Medical procedures undertaken. Egg retrieval – I wrote about it in a separate post here. Basically the procedure went well, but I was in pain immediately waking up from the anesthetic. I had Ovarian Hyper Stimulation Syndrome (OHSS) by the time I got to the day of Egg retrieval, so the pain was to be expected (according to the doctor – I was oblivious).

Any results? 17 Eggs retrieved, 12 of these were mature, and 10 of those fertilised. The clinic’s protocol is that if you get 7 or more fertilised eggs then they aim for a Day 5 transfer.

So when I woke up from the egg retrieval, the doctor tried to explain to me the symptoms of OHSS and that I need to watch out for certain potentially dangerous symptoms – such as shallow breathing and vomiting. Apparently she explained all of this to Chris in a whole lot more detail whilst I will still recovering, which was a good thing, because my exact recollection of her words were shadowed by the pain I was having in my abdomen!!!

I put together a nice little chart showing how for this cycle my estradiol levels sky rocketed in comparison to my previous cycles and what we got out of them. Remember, we are trying for quality not quantity!!!

estradiol results.jpg

What are my symptoms? The day of my egg retrieval surgery (Monday) and the day after (Tuesday) I was practically in bed for most of it, or sedentary on the sofa. I was suffering with gas (farts and burps galore!), pain in my abdomen particularly above my belly button and below my lungs. The pain killers really weren’t helping much with the pain, they just caused constipation, so I gave up on them. I could barely eat a plate of food. I ate small portions of soup and bread, I tried to eat salad, but that filled me up after a few bites and made me feel nauseous. I couldn’t even drink much water/gatorade my tummy felt like it was about to puke all the time. Wednesday I braved work because I had to get up and move around. Mentally I was fine, but the lower half of my body was not playing ball. So I left work after lunch to work from my bed instead because all I needed was to lie down propped up. Lying down completely flat and sitting upright/standing weren’t particularly comfortable, but hunching over a bit was OK. I went to bed last night swearing that if I was not better in the morning I would be calling the clinic for an ultrasound. Well despite a crappy nights sleep, I did feel a bit better once I got up. So I weighed myself and measured my waist. No change – but I was still almost 8 inches wider round the waist and 5lbs over my normal weight. I wasn’t getting worse – just not any better, I decided not to call for an ultrasound.

This morning we both waited until 0800 before getting on with our lives because this was the time that the clinic would have called if we were to go in for a Day 3 Transfer, just in case some of our embryos weren’t surviving. But they didn’t call, and we breathed a sigh of relief. Although we know from our last cycle, that this doesn’t mean we have good quality embryos waiting for us on Day 5. So without any updates on their progress until the day of our transfer, all we can do is hope they keep growing strong.

How do I feel today? I was feeling really down yesterday about my OHSS symptoms and frustrated with my body. I am not a good ill person. I was pretty grumpy at Chris too. On Tuesday I decided to enlist the help of my friends and gave this status update on facebook:

“Please send us a happy thought for us as I tuck myself up with a hot water bottle, drinking fluids and electrolytes and eating salty food as I try to ward off the symptoms of ovarian Hyper stimulation syndrome so that we can transfer our embryos this week!!! Anything to make us smile would be greatly appreciated! Post your favourite funnies below! (Although not too funny because my tummy hurts!!!)”

In the spirit of National Infertility Awareness Week‘s theme #StartAsking….I decided to ask for help from our friends to help us get through this rough patch! I am glad I did 🙂 I received many funnies…and gave me a smiley warm feeling inside that my friends were thinking of us. They say laughter is the best medicine!

Also, if I am honest with myself I am nervous that we have one less embryo than from IVF cycle 2….but I must remind myself QUALITY not QUANTITY is important!!!!

What’s next? Our Embryo transfer is scheduled for 0700 Saturday morning!!! Yikes!! I can’t wait to be PUPO – Pregnant Until Proven Otherwise 🙂 Oh and I need to do this progesterone in oil injection on my own. *GULP* my mountain, my nemesis :-s

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.

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 Diary Vol II: 26-28 Jan 16

January 28, 20169 Comments

Medication(s) administered and dosage(s). Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2. I am taking baby steps in learning how to inject the progesterone myself. Last night I held the needle and hovered it above my skin but cried, well sobbed… and begged Chris to do it. I realised that I had never actually watched this huge needle go in before because I have always been lying down on the bed face down. So the first step was watching it break the skin. He checked for blood, then I took over from Chris and injected the oil so I know what it feels like and I took the needle out. There are definitely some challenges with injecting yourself and reaching round at the right angle – fortunately I am pretty flexible (thanks yoga!). We will do the same again whilst I build my confidence up! baby steps….!!

Medical procedures undertaken. Nil

What are my symptoms? My recovery from the Egg Retrieval surgery has been incredible! Compared with last time when I was practically crippled with pain and constipation I am in a way better place. The runny/dribbly/itchy nose and continuous sneezing has started to wear off. I treated the symptoms with nose saline spray (with aloe) and antihistamines. I was only constipated for about 1.5 days, and for someone who poos 3-5 times a day this wasn’t insignificant! But again, it was no where near as bad as last time when it was 3 days. I don’t sleep well when taking the progesterone injections or the estrogen patches, I’m not sure which is the culprit. I suspect it’s the progesterone because I remember being like that when I was only taking the progesterone suppositories for the IUIs. I woke up very early this morning with some sharp tummy pains, the kind you get from being very hungry. OK enough whinging, really, I am in a good place!

How do I feel today? I guess technically we are in the 2 Week Wait. I’m getting nervous that I am too positive now!!! Although last night I had a dream that I had to knit my embryos, and I dropped the last stitch, which meant I dropped an embryo on the floor and I had everyone looking for it!!! Don’t pscyho-analyse me too hard ;-p I went back to work on Wednesday and people were surprised to see me in good health because I had originally booked the whole week off as sick leave based on my experience last time. But it wasn’t needed!

Any results? Out of the 14 eggs that were retrieved, 11 of them were mature. Out of the 11 mature eggs all 11 fertilised successfully! This means an automatic go to Day 5 Transfer space!!! Our clinic doesn’t provide updates on the embryo progress unless things are going badly. We haven’t heard from the clinic and today is Day 3, so we are assuming things are all good. Our next update on how many made it to blastocyst will be on Saturday morning when we go in for our Transfer! It’s really strange because I know so many other clinics offer daily updates, but I’ve come to the conclusion that ignorance is bliss.

What’s next? Day 5 transfer is scheduled for 7AM this Saturday :-s who needs a lie-in when you can make a baby the good old test tube way!

Weight. Aghhhhh. I can’t even….

Waist. Seriously bloated and look pregnant.

Boobs. Getting bigger by the day – someone is happy about this! Not my bra, that’s for sure ;-p

Hours of Sunshine 🙂 The sun has been hiding. I think that the whole sun thing has no bearing on my fertility considering the amount of sun I got in August last year when we went through IVF the first time!

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

How to get the most out of your doctor

August 23, 2015August 23, 201512 Comments

It took me about 24hrs after it was confirmed that I am pregnant to realise I do not know how to be pregnant. This might seem very weird considering we have been talking about this moment for more than two years now. Once we started trying to conceive I just of buried my head in the sand. I didn’t want to jinx our chances by buying a book about it, and I started to avoid all pregnancy related websites and apps after 6 months of failing to succeed in our quest to make a baby. I know the basics, like smoking is a big no-no, drugs are dangerous, avoid raw meat and reduce caffeine, but really, that is the limits of my knowledge. So yesterday we went to the book store and bought two books on pregnancy. One was the standard text book “Great expectations: Your all in one resource for pregnancy”, and the second was “Expecting Better”, beautifully demonstrated in this picture by Sushi:

Sushi, my book keeper

This second book interested me because I have always wondered whether Japanese women stop eating sushi, or French women stop eating brie when they are pregnant. Really? I don’t think so. I hope that this book will enlighten me to what the conventional wisdom really means. But when I started reading the first chapter I didn’t need to go much further with it to be completely satisfied with my purchase. Why? Well the author, Emily Oster, is not so different from me, she was not happy with what her doctor was telling her. I realised that my experience with my fertility clinic’s doctors and the feeling I had that there was a poor lack of communication. All of this was because I was not asking the right questions. I didn’t know I needed to ask them. And this is silly because all along I had the key questions in the back of my mind…I use them everyday at work!!!

In my job I help leaders make decisions every day…I do this by presenting the evidence, the facts – for and against a decision – I do some analysis on the data that supports the decision, I try to be unbiased and objective in my analysis, and then I present a recommendation to the leader on the best course of action. The leader doesn’t always go with my recommendation, but I have presented them with the facts and figures to make their own mind up. Sometimes I feel a bit hurt, but then I remember, I am not the one taking the risk. So when it comes to our healthcare and doctors, WE are the decision makers. We need to be presented with the arguments for and against, and be told what the supporting evidence is. WE are unique in many different ways and the decisions we make will be unique, blanket guidelines are not always appropriate for everyone.

I think a good example of this is when we were told we should do ‘ICSI’ because of our unexplained infertility. We didn’t ask the questions: What are the pros of ICSI? What are the cons of ICSI? What are the improved success rates with people like us? (i.e. what’s the supporting evidence/data?) We were not armed to make a decision, we just went with what the doctor said, and in the back of my mind I felt like I had not been given a chance to make a decision. I did actually do a lot of this research myself, but it would have been better if my doctor would have told me – after all I am not the medical professional, I just have the fortunate ability to interpret statistics from studies and experiments. So although I was finally happy with the decision to do ICSI after my research, something inside me was niggling about our doctor’s communication.

Another example is when it came to our embryo transfer. We were told that it is the standard practice at the clinic to transfer 2 embryos on day 3, unless there were over 6 fertilised embryos then maybe we would be a candidate for waiting to Day 5 to transfer 2 blastocysts. We did not ask the questions: what are the pros of us waiting to Day 5? What are the cons of us waiting to Day 5? What are our personal chance of success with 4 fertilised embryos compared to if we had had 6? (i.e. what’s the supporting evidence/data?). Again, I did a lot of this research myself.

I could go on with other opportunities throughout our infertility treatment where I could have asked these three simple questions that would have revealed the knowledge I needed to feel like I was in control of making a decision. We rely on doctors to make the decisions for us…and most of the time I am happy with that fact, but there were times that I felt like we should hold that responsibility for a decision. When it comes to my pregnancy I want to be able to ask these questions to my doctors and nurses so I can take the responsibility for making some of the big decisions such as prenatal testing or birthing plans.

Emily Oster suggests reading the book “Our medical mind: How to decide what is right for you” by Jerome Groopman and Pamela Hartzband. I think I might try it, and I’ll let you know how it goes. Has anyone read this one?

In the meantime my friends, next time you are in a consult with your doctor, remember these three simple questions to help you make the best decision, for you, and get the most out of your doctor….