Not much hope now

Today I am 8dp5dt. I have my beta tomorrow morning. I have been taking pee tests since Sunday afternoon. Last one was an hour ago. They've all been negative. I was pretty upset about it yesterday. But I've accepted it today. Even though we had poor embryos on day 5, I still had hope that something would stick and give us a sibling for our son. Now it doesn't look like that will happen. 

So next steps will be to actually get my beta results. Should be late afternoon when I'll get the call. Hopefully I won't cry so I can make an appointment right away for a follow up meeting with our RE. Then we'll call a couple other places for 2nd opinions. Even if we stay at the same place in the end, we'll still probably get some advice or things to try for next time. I know already that I'll add acupuncture back in next time but there might be other things. 

But we'll have to wait for my hubby to get a new job and for my insurance to roll over in January before we start another cycle. In the meantime, more preparation.  More dwelling on whether or not we'll be able to grow our family. Whatever will be will be I guess. If a cycle next year doesn't work though, I think we'll be done. And that is just scary. Perhaps we will consider adoption but I just don't know about that. Biggest thing will be guilt that we can't give our son a sibling.  Tons of people only have 1 child these days but IMO nothing is better than having a sibling who you have an unspoken understanding with. A sibling is a friend and confidant for life. And when your parents drive you nuts and start going batty, they will be there to laugh with you. I'm probably being overly dramatic. But it's a gift I want to give our son and I might not be able to. 

First things first though. Gotta get the beta done. Will post with those results tomorrow. 

3dp5dt

Not much to report today. I took a hpt this afternoon and it was bfn. So that means my trigger is gone:). Now when I poas on Sunday or Monday if I get a positive, I will be sure that it is positive and not just leftover hcg from my trigger. So that's good!  Other than that, nothing else is new. 

2dp5dt update

I got a call this morning that our compacting embryo did not make it. This was not a surprise. But I still felt a twinge of sadness. I feel like maybe we should've transferred it just so it could be where it's supposed to be and not die in an incubator - but it doesn't matter now. And it didn't really "die". It just stopped developing. I have to keep reminding myself that these embryos are not babies yet. They are packets or clusters of cells that could turn in to a baby. But they have not reached that stage yet. Not until they at least implant in to the uterine wall and I get my BFP. If I think of them as babies now, I will get too emotionally invested. So I did fine with the news. Like I said, it was no surprise. An embryo not even at the morula stage on day 5 is not a strong embryo. 

So all attention is now back on the 2 that we transferred on Monday. Hopefully at least one is still thriving and is about to or has implanted.  I will test to see if my trigger is still present tomorrow evening. Tomorrow will be 10 days post trigger. Hopefully it's gone. I will definitely need to poas earlier than my beta next Wednesday because I just found out that I need to be in a meeting from 2-5 that day. Ugh!  That's right within the window that they'd be calling. Plus today I was also in a meeting when they called about the embryo. Instead of leaving a message they made me call them back. So when I get outta this meeting at 5 next week, the clinic will be already closed and if they haven't left a message with the results, I won't be able to call back until Thursday!  I'll just have to ask them to call my hubby I guess if they don't reach me. I MUST have the news that day!  HPTs are somewhat reliable but not like beta tests.  Plus if it's a bfn, I will want definitive results ASAP so I can have closure and start thinking about next time. 

As far as symptons, nothing really of course.  I am only 2dp5dt. Some things I am feeling are cramping, general soreness in my belly, ovarian aches, it sorta feels like I've been doing crunches - belly is just sore. I am VERY bloated too. I stepped on the scale thinking that I musta gained 5-10 lbs in the last couple weeks. Nope - lost 3 lbs!  Lol. So anyway, not much else to report. I'll post again once I know my trigger is gone!

PUPO take 3...

Well.....I'm PUPO (pregnant until proven otherwise)!  We had our transfer yesterday morning.  They transferred 1 blast and 1 morula.  The only other embryo remaining was a compacting embryo.  All the others stopped developing.  This is normal for a large drop-off from the initial fertilization number to day 5.  Only about 30% of embryos make it to blast stage.  However with this statistic in mind, our blast rate was a dismal 10%.  For our last cycle we were close to that 30%.  Also, the quality of the 1 blast that we did have was only a 2cc.  The explanation for this grade can be found here: http://www.advancedfertility.com/blastocystimages.htm

Below is a table from that site:

Expansion grade	Blastocyst development and stage status
1	Blastocoel cavity less than half the volume of the embryo
2	Blastocoel cavity more than half the volume of the embryo
3	Full blastocyst, cavity completely filling the embryo
4	Expanded blastocyst, cavity larger than the embryo, with thinning of the shell
5	Hatching out of the shell
6	Hatched out of the shell

ICM grade	Inner cell mass quality
A	Many cells, tightly packed
B	Several cells, loosely grouped
C	Very few cells

TE grade	Trophectoderm quality
A	Many cells, forming a cohesive layer
B	Few cells, forming a loose epithelium
C	Very few large cells

My grade of a 2cc means the blast cavity is at an intermediate stage.  At my clinic, they actually use 4 grades instead of 3 - A, B, C, & D - for the inner cell mass and trophectoderm.  So my 'cc' grade is really somewhere between the b and c grades shown above - the technical description they have is as follows:

• A is the same as Gardner's A 
• B is "not quite A, but still quite good" 
• C is "not quite B, but not bad" 
• D is for very few cells

So, this blast is a "not bad" intermediate blast.  I hear so many stories of beautiful blasts never forming babies and of ugly embryos making twins so there's really not much stock to be placed in the blast grading system.  Also, I learned that my son was likely a 3cc blast - not much better than a 2cc.  We got a picture of the embryos that were transferred.  Comparing the 2cc embryo with the 3cc embryo, they really look similar.  Really my disappointment stems from not having more than 1 blast to transfer.  If an embryo gets to the blast stage, this is a large milestone and means they are really strong.  But I only had 1 blast plus 2 others that were not there yet.  I guess I should be happy that at least we had 1 blast.  An embryo is at the morula stage typically on day 4 or early day 5 right before the embryo becomes a blast - so perhaps it would have been a blast in a couple hours.  The 3rd embryo that we have - a compacting embryo - is what we transferred the very first ivf cycle.  This embryo is very slow.  I don't have much hope for it.  They said that we could transfer it with the blast and morula but obviously the doc could not rule out triplets which did not appease my hubby.  So they are holding this embryo to see what it does today and will call me tomorrow with it's status.  If it has continued developing, they will freeze it.

Yesterday was my transfer.  The important commitment that I thought my hubby was going to have last Friday was actually yesterday.  So he could not attend.  The doc called him via phone to get his consent and discuss our embryos though.  I had the transfer, then went back to my parents house and hung out until after dinner.  Then I drove back home.  I could not lift my son and did not have my hubby to help me so I wanted to put him in the carseat and have him fall asleep with the intent of not stopping until we got home.  The plan worked.  My mom put him in his seat and within 45 minutes he was sleeping.  When we got home, hubby came out and took him to bed.

I'm having mixed emotions today.  I am 1dp5dt.  Of course I do not have symptoms.  Occasional cramping and uterine tightness - but all can be associated with the transfer procedure and with the progesterone shots that I've started doing again (oh joy!).  Trying to avoid google but that is really an exercise in futility.  Of course I'm going to google success stories with a 2cc blast.  It's just inevitable and I might as well accept it.  I will probably pee on a stick (POAS) sometime before my beta next Wednesday.  But I need to "test out my trigger" first.  This time I triggered with the full 10,000 units of HCG whereas last time I did a lupron trigger.  The pregnancy tests detect the HCG hormone and since it has only been 7 days since my trigger shot, I should still have HCG in my system.  Sure enough, I POASed and had a 2nd line this morning.  So my trigger is still there.  It should be gone by 10 days so on Thursday evening I will test again.  I'm thinking I might POAS for real Monday (assuming I'm able to test out by trigger by then - for some women, the trigger sticks around longer than this).

For now, I'm trying to focus on the positive - at least that's what I KNOW I should do; whether I am able to do it is another story...haha.  Thinking about what went wrong this time is not really something I should dwell on yet.  We will cross that bridge if we get there.  Still have a plan B though that would involve meeting with doc for a cycle review and then maybe trying again in the spring.  This however would be contingent on hubby getting a job.  Similar to last time, we have to pay quite a bit out of pocket as the whole cycle is not covered by my insurance.  This time it will cost about $5000 after all is said and done.  Some of this we have already in savings and in our HSA account and we are putting the balance on a 0% interest credit card that needs to be paid off by 3/2017.  If we have to do another cycle, that will be another $5k to add to our expenses and so we will really need to have a definitive 2nd income to support that.  But again, we will cross that bridge if we have to.  Until then, HAPPY THOUGHTS!!

Recap of this past week

Ok, so I have neglected this blog in the past week.  I have already gone thru transfer so this post will focus on last stim days, triggering, and ER.  Next post will be about ET.

So I went in for monitoring last Monday.  I had good growth but didn't seem to be there yet.  My monster cyst on my left ovary was a whopping 5cm.  HUGE!  On the ultrasound image, that was all that could be seen in some views.  Yet, my left side was still producing more follies than my right!  Anyway, after that appointment I was concerned that I'd have to order more follistim.  As I said in my previous post, I was already at my $5k max for meds so everything beyond that point was out of pocket.  By 4pm I still hadn't received instructions so I called my doctor cuz I wanted to be sure I would be able to have enough time to get my med order in to the pharmacy.  Instead of ordering more meds though the nurse told me that doc wanted me to trigger that evening!  I was going to trigger with the full 10,000 units of HCG.  No lupron.  So that meant my E2 level was fine and no risk of OHSS.  Luckily I didn't have to do an intramuscular shot of HCG either.  My clinic just does it subcutaneous.  That shot still HURT though!  Anyway, my nurse told me that based on my follicle sizes we could expect to get 2-8 eggs.  Only 2-8???  Ugh.  So I was sort of bummed about that.  Orders were orders though.

My instructions were to go home immediately and administer my last shot of follistim.  Then at 8:30 CST, inject the HCG.  So I scurried home, took my last stim shot, and prepared my HCG shot.  HCG is actually in powder form that is activated when sterile water is added.  The medication expires quickly so you have to do this the day of trigger shot - the pharmacy cannot do it for you.  Its relatively simple though.  You can also draw up the HCG beforehand and have the syringe ready to go in the fridge so you aren't fumbling around with mixing etc when you need to take the trigger.  The shot needs to be taken at the precise moment that the doctor specifies.  If you don't, you could ovulate early or late and loose your precious eggies.  So after my last stim shot, I prepared and drew up the HCG.  Then at 9:30 EST (had to factor the time zone difference) I took my shot.  Like I said, that thing hurt.  It burned and left a welt that lasted for days.  In fact, 8 days later I think I still have it.  Otherwise, shot went well.

Tuesday I didn't have to do any shots.  We left for Chicago that afternoon.  Our ER was Wednesday at 7am.  My dad watched our son while we were up there.  My son was good and he had a blast with "Opa":)  Everything went very well during the procedure too.  My hubby submitted his sample, they got my eggs, and I was sore but didn't feel too terrible the rest of the day.  Hubby got some nice footage of me when I was waking up from anesthesia:(  I was just out of it.  LOL.  Didn't say anything too embarrassing - just kept saying "I'm confused..."  After the procedure, the nurse said the doc would come in to discuss the results and then we could leave.  Seriously 1 hour later the doc comes in.  Grrrr.  I got over it quickly though when he said that we got 13 eggs!  13??  The nurse said to expect 2-8.  Lol!  The doc said the eggs looked good too and the embryologists would perform ICSI using my hubbies sperm later that day.  We would receive official maturity and fertilization results the next day.  They would decide if we would do a 3 day or 5 day transfer based on those results.  We were thrilled with that number of eggs.  That was the same number of eggs that we had last time.  So far so good!

After the procedure, my hubby and I went back to my parents house and I rested the rest of the day.  The next day we went home.  During the drive home I got our results.  I was minutes away from calling them cuz it was nearly 4pm CST and that is when they close.  So I was starting to get anxious.  Anyway, the embryologist called and told us that all 13 eggs were mature and 10 fertilized normally!!  WHOOHOOO!!!  Last time, only 8 of the eggs were mature.  All 8 fertilized normally, but still - this time we have 2 more than last time.  I was excited with this news!  They also said that they were going to definitively schedule us for a day 5 transfer.  Unfortunately that meant that they were not going to review our embies on day 3.  They said the less they take them out to look at them, the better.  Embies don't like the change in environment.  So that was that!  We were to wait for a call on Sunday when they would call to schedule the appointment for Monday.

Day 9 of stims update

So I had a post all typed up last night but it never posted. Now I can't find it:/. So I have to re type. Lol. 

Today is day 9 of stims. Things are going well so far. I started monitoring last Tuesday and was monitored twice more after that on Thursday and Saturday. I go in again tomorrow morning. Things are moving slower than last time. Last time I triggered on day 9. I seem to have plenty of follicles but they are just growing slower. At my last check I had 19 follicles, the largest 3 at 13mm. 8 others b/n 10 and 13mm. The rest are smaller. I also have a huge 3cm cyst on my left ovary. The doc isn't concerned about it but its taking up a lot of space. Ironically, my left side has the most follies.  I've already gone thru twice of what I stimmed on last time and have ordered more drugs twice. I'm over my limit of $5k for ivf drugs:( The other day I had to fork over $1200 for my refill. Ugh. I really hope I trigger Monday or Tuesday. Otherwise, I'll have to order more drugs. Plus I just wanna get this over with. 

My emotional state has been in a word unknown. Up until Friday I was working on a tough deadline for work. So I did not have time to think about anything else. Now that that is over though, I can't really say how I'm feeling. I think I'm afraid to get excited or really think about anything right now. My stimming has been slightly worrisome but each time the nurse says I'm doing good. I have to remember that last time I was "rambunctious" and they had me at lower doses in order to reign me in. It's just very interesting that only 3 years later I am going so much slower. Oh well. 

The fact that I'm going slow is annoying schedule-wise. ER is looking like it could be Wednesday thru Friday.  It depends on how I look tomorrow. If I've had a lot of growth, maybe I'll trigger tomorrow for a Wednesday ER. But if things are still uncertain I'll have to order more drugs and ER might be Thursday or Friday. My husband has something here on Friday morning that he cannot reschedule so that will be VERY annoying. 

Then after ER we will have more uncertainty in terms of when transfer will be. It will be either a 3-day or 5-day transfer. It will be a 3-day transfer if we have a small number of embies. If we have a lot that still look good, it will be a 5-day transfer. We won't know this until the morning of day-3.  So it would be nice if day-3 falls on a weekend so I don't have to skip work at the last minute. We basically have to have our bags packed cuz we'll have to leave right after we get that call if we end up doing a day-3. At first we were wanting to do PGS (where they screen the embies for genetic issues like downs, trisomy, etc) but we cannot do it anymore because the embryologist who does the biopsies will be at a conference when our embryos reach day-5. So we were given the choice of either moving forward without PGS or postponing until the next cycle. Work wise that would not have been good for me as I have more deadlines mid-November. Plus at the time, we thought my unemployed husband was going to have a job in November and thus would have a hard time getting the time off. So we decided to just move forward. Well my deadlines were shifted around and hubby didn't get the job he was close to getting so looks like he will still be unemployed in November. Anyway, we coulda put it off I guess is my point - then we could've done PGS. But another reason for moving forward in October was purely superstitious as my first unsuccessful ivf occurred in November 2012. Argh. Can't change it now. 

So as usual all the uncertainty is starting to get to me. Plus I'm hormonal and hubby still has a mess upstairs. I've been a grump all week with my deadline too but yesterday we had an argument centered around me being fed up with the mess and his inactivity. So today he's cleaning it up. In the meantime, I'm gonna pull some weeds, maybe go on a bike ride to the playground with my son and enjoy this lovely October weather!  I'm gonna try to leave the rest of this stuff up to God. Worst case, we luckily have some of hubbies sperm on ice at the clinic so if the ER ends up being Friday and he can't be there, we won't be totally screwed.  I'll post an update after I talk to the nurses tomorrow!

...And we're off!!

We have officially started!  My baseline was Thursday and shots started tonight. Baseline went well. I have 16 follicles now. I had 11 at my last AFC check. So, happy with that. I did have a cyst on my left ovary. But I guess they aren't too concerned with it because I'm taking 375iu of follistim and 8 units of low dose HCG until Tuesday when I start getting monitored.  This dose is nearly 2 times the dose I was taking 3 years ago. So it'll be interesting to see what happens. I guess they are being aggressive right out of the gate. Also slightly worried about side effects but we'll just have to wait and see. Next week will be so busy at work too. Plus my husband decided to tear apart our 2nd floor in order to do some painting. An entire can of paint spilled on to the carpet in the process. So he had to replace the carpet with laminate flooring in one of the bedrooms. Ugh. So there's crap everywhere. With work and the state of the house, conditions are less than ideal for my serenity.

Well, I'm exhausted. So more later.