Embryo Transfer #6: Welcome Home Mochi

Two days ago, on a beautiful Friday morning, DW and I headed to the fertility clinic for her single blastocyst transfer. She’s been on a long list of meds for this cycle, in the hopes that it will combat whatever has been causing her recurrent miscarriages, and maximize little Mochi’s chances of a successful implantation and growth:

Since day 15 of her cycle, she’s been on: 

– 4mg Estrace 

– 3 x 100mg Endometrin (suppositories), 300mg Prometrium (orally)

– 20 mg prednisone

– 5000IU Fragmin injections

– 25 mcg + 6.25 mcg Synthroid

– 1800 mg Omega 3 Fish Oils (3:2 of EPA:DHA)

– 400IU vitamin E

– 300 mg vitamin B6

– 4000IU vitamin D

– 100mg zinc

– Pregvit Folic 5 multivitamin

The clinic was running really late that day, as they seemed to have the RE (who is an OB) booked with OB-GYN patients in addition to his regular fertility patients. DW’s transfer didn’t happen until about 1.5 hours after she was scheduled. But as usual, the transfer went smoothly, with no pain or discomfort at all (she has a very friendly cervix, as opposed to my angry s-shaped cervix). 

 Little Mochi in DW’s uterus:  
Now, in case you’re not familiar with the deliciousness that are Mochi, they are a Japanese dessert made of an outer sweet glutinous rice layer, and then usually a flavoured filling. DW loves Mochi, particularly the Taro flavour.

Many flavours of Mochi:   
(Above image from:  http://blog.wagashi-net.de/category/wagashi-sweets/mochi-wagashi/)

After our transfer, we headed to one of our favourite Korean restaurants for lunch. For the past couple of days, we’ve been chilling at home, trying to get DW not to do chores or yard work. It’s hard for her, since she’s such a busy body! 

Tonight, we’re heading to the cottage for a week of lakeside relaxation. See ya when we get back on Friday! 

Fingers, toes, and your dog’s pads crossed for good news in a week! Please keep us and Little Mochi in your thoughts and prayers. Thank you friends!

Now That’s a Big Dumplin’! And DW’s Transfer Date!

  
(Photo from: http://www.boozyburbs.com/2012/10/18/brand-new-mandu-factory-northvale-nj/)

Today we went downtown for our 28 week biophysical profile ultrasound at Mt. Sinai. I’m only 27 weeks 5 days, but close enough. Not everyone has this ultrasound, but after our scary NT scare at 12 weeks (thank goodness everything turned out okay), we get all sorts of fun precautionary appointments. Seriously though, we love the extra opportunities to see Dumplin’, and what he’s up to in there. The reassurance that all is good is also very nice. And like I’ve mentioned before, the peeps over at Mt. Sinai are da bomb and might be getting an Edible Arrangement from us. 

The ultrasound itself was actually really short in duration. Previous ultrasounds at 14 weeks and 18 weeks were about 45 minutes, we saw lots of stuff, and were given a pretty good commentary by the ultrasound tech. Today however, it was 8 minutes, and the guy doing it barely said two words. I guess he’s not a morning person? 

Pro Tip: Bring a hand mirror to your ultrasound appointments- so you can watch and see baby as they’re doing the scan! This is what we’ve been doing.

We got to see Dumplin’s positioning- he is already head down, right by my cervix, which is 3.4 cm right now. His face is looking at the left side of my back, and his legs are tucked near my far right ribs. Which is exactly the position that I predicted! When I feel movement, it’s usually strong kicks near my right ribs, and punches near the bottom of my left belly. Sometimes I feel both at the same time. I also rarely feel what feels like bubbles or popcorn popping near my cervix. I’m guessing that that might be hiccups?

Anyway the specialist said that at this point, there’s less space so Dumplin’ is unlikely to change position. So I’m really happy that he’s already setting himself up in a good birth position.

Functionally, he scored an 8/8 on his Biophysical tests- amniotic fluid, fetal movement, fetal tone, fetal breathing. Mommies are very happy about this!

The blood pressure in his umbilical artery is perfect, and my placental integrity is a grade 1 (best).

Size-wise, little Dumplin’ ain’t so little. His head is measuring 30 weeks, his legs are measuring 29 weeks, and overall, he’s measuring 1 week and 1 day ahead. He weighs 1260 grams = 2lbs 13oz, which puts him at the 80th percentile for his gestational age. 

I’m sorry if I’m boasting too much. We’re just so relieved that all is good with our little man. Ultrasounds have been kind of traumatic for us after all of the fertility treatments, sad miscarriages, and horrific NT scans. To have a “perfectly normal” scan is something to be celebrated!

So yeah, that’s one big Dumplin’!

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In other news, DW’s started her daily regime of 27 pills (13 different drugs/vitamins) + 1 injection, and FRIDAY IS TRANSFER DAY!!! We are nervous and excited about it, and I’ve been giving her “spa” treatments everyday- massages and acupuncture on alternating days. We are begging the universe for some good vibes.

Pregnancy update to follow in a few days… 

Embryo Transfer #6: Frustrations

So DW is on cycle day 9 today of her FET cycle. So far, she’s had blood work and ultrasounds done during her previous cycle, and during this treatment cycle on day 3, and her next will be on day 12 (Friday). We have been with this clinic since 2012, and it really hasn’t been feasible for us to change clinics because of all the monitoring that needs to be done before work. This clinic has 4 locations, which makes them fairly convenient for us, since we work in two different cities. However, our relationship with them isn’t without significant frustration…. 

I’ve had time to cool off about it, so I will just casually list off the ridiculousness and incompetences that we’ve had to deal with:

1. Nonsense: When DW went in for her monitoring last cycle, they kept insisting that I had to come in to update my bloodwork since she hadn’t been active for almost a year. I suspect that this must be protocol for heterosexual couples, but we’re a same-sex couple, and my blood work has nothing to do with DW’s FET or the status of our embryos. Plus, the nurses know who I am (I mean, 3 years, 4IUI’s, 2IVF’s, 5 transfers, and 50 grand later, they better know who we are!), so logically, why do they need my blood? We argued with them for a while, and all they said was that they needed updated bloodwork because the embryos came from me (still doesn’t make sense!). Anyways, we just keep ignoring their requests because I ain’t getting poked to satisfy their stupidity and inability to critically think.

2. Inconsistencies: So on her last cycle and during this cycle, DW had elevated prolactin on her both of her day 3 blood draws. They told her that anything over 30 (don’t remember the units) was elevated and then made her repeat her prolactin bloodwork the next day while fasting (in fact her day 3s were also done fasting coincidentally), and her repeat levels were normal (29) for her monitoring cycle and 39 for her treatment cycle. They then said that the normal range was 40 or less, and that her prolactin values were fine. WTF? How did the normal range change from 30 to 40? This nurse has made major mistakes in the past and I’ve argued incessantly with her but it just makes her even more unwilling to check her facts. Also, I know that high prolactin can affect implantation, and have read that other RE’s consider normal as 25 or less, and ladies with anything higher are put on bromocriptine or Dostinex to bring it down before transfer. Sadly, there’s nothing we can do about this because this nurse is not very open to other opinions and the RE is very uninvolved in checking levels it seems. 

3. Incompetences: so my endocrinologist (who is awesome, and I trust very much) says that TSH should be less than 2 preconception, and when I was trying to get pregnant, she vigilantly had my blood TSH, T3 and T4 levels checked monthly to keep me under 2. Last cycle, DW’s TSH was 3.8, and the damn fertility clinic seemed to think this was fine. I argued with them about it, and apparently my RE seems to believe that a TSH under 4 is acceptable. I’m so upset about this because for our 4IUI’s with me, my TSH was around 3.9 and my endocrinologist (looking back at old bloodwork print offs that I demanded from the fertility clinic) thought it was unacceptably high. I’m frustrated that the fertility clinic doesn’t seem to prioritize optimal hormonal levels, but instead is just happy with us trying under suboptimal conditions, wasting sperm, wasting embryos, wasting time and money. I feel so strongly about this that after her day 3 bloodwork last cycle, we “unofficially” started DW on 25mcg of Synthroid from my stash. In one month, that brought her TSH down from 3.8 to 2.8, so we added another 12.5mcg daily = 27.5 mcg daily to hopefully bring it down a touch more. Frustratingly, the fertility clinic only checks her TSH once in a cycle, so we have to just keep our fingers crossed that her levels are hovering around 2 or less. I’m also a big stressed because I’m still taking Synthroid and my stash of pills isn’t large enough to be supplying both of us until my next refill is eligible. But my priority is giving her body enough thyroid hormone to support a pregnancy. It just sucks to have to be so clandestine about it. We’re also doing the same thing with her and prednisone. 

I know I’m a bit over analytical about all of this baby-making, but DW has suffered 2 miscarriages of 4 of our best day 5 blastocysts. Despite their “investigations” the clinic has not been able to identify any reason for her losses. They have demonstrated inconsistencies, incompetencies, and don’t seem to critically think about our unique circumstances, but rather treat everyone with the same “cookie cutter” approach. Changing clinics at this point is pointless, since most clinics around here function very similarly (what’s the incentive in improving when you’ve got a 3-6 month wait list of patients?). So basically, our approach is to just go ahead with the transfer, hoping that by lowering her TSH her prolactin might balance out too, and that the autoimmune meds help deal with the unexplained RPL. As I mentioned before, this is DW’s last go at it. She took a year off after her last loss to be ready to face this juncture again. We hope that it works, because I can’t even imagine the heartbreak if it doesn’t. 

If you have any experience with prolactin or TSH levels, I’d love to hear from you. 

As usual, your support is invaluable to us. 

IVF#2: 10DP5DT: Beta HCG

Just a quickie right now to fill y’all in. We drove to the clinic in a near snowstorm this morning, but we had the awesomeness of each other’s company, and good tunes. I fell asleep in the car on the way home, and have been on the edge of a nap ever since.

Finally, a few minutes ago, we got the call. I know that in this process there are many permutations of “the call”- “the call” to let you know you’ve been cleared to start a cycle, to tell you it’s time to trigger, to tell you when you will be egg collecting or embryo transferring, to tell you how many embryos survived to day ____. But today’s call is the one that has had me glued to my phone. Good thing we don’t live in the 80’s or at a time without call waiting.

So here we are, 10 days post embryo transfer, and my beta HCG level is….

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Thank you for your continued support, especially those of you who are also waiting for “the call” that brings good news- at whatever stage you are at. I know how hard it can be. These are exciting yet scary times for us, as you can probably imagine. But right now, in this moment, I am PREGNANT.

IVF#2: Halfway Through the Ten Day Wait (5DP5DT)

Well, it’s been 5 days since our blastocyst transfer, and really, I don’t have much to report symptom-wise.

I haven’t had any cramps or dizziness like last BFP. I’m not out of breath, or overly tired. I’m peeing my usual 1-2x per night. I am eating like normal again, and there are no signs of OHSS.

All I have noticed is that I’m having trouble regulating my temperature. I’m either freezing cold, or hot like a furnace. Sometimes, my torso feels a couple of degrees hotter than my feet, which can’t seem to get and stay warm.

That’s it.

Being 5DP5DT, I am getting worried. By 7DP5DT, countdowntopregnancy.com says that you are more likely than not to get a true positive if you POAS.

After my retrieval, I only suffered mild OHSS (or not at all). I felt back to normal pretty much the day before my transfer, and better each day since then. I am really grateful that I did not get OHSS despite my high estrogen levels and 30-something growing follicles. In fact, I am shocked. Part of it I’m sure is thanks to the Dostinex that they put me on, and I also believe that my high sodium and high protein diet for a few days before and after retrieval helped too. I have been secretly hoping for some OHSS to reappear, as a way of tipping me off that we may be getting a BFP, but so far, I feel fine.

This TWW started off really low stress, and I’ve been lucky enough to have my wife at home this weekend for three days (Family Day Holiday in Ontario, Canada). I finally got back to hiking in the snow with her and the dogs on Saturday (Valentine’s Day), and have been trying to keep fun music on in the background at home because it keeps my mood light. I am happy to report that I have busted into fabulously fun, but totally embarrassing dance parties daily in our living room. Juno the dog watches me and barks when my dance moves get a little too funky. I also devoured Gillian Flynn’s Sharp Objects, which I have found to be her most twisted book of her three best sellers. I really enjoyed it though, and am on some female author murder mystery kick right now.

My anxiety has stayed relatively low since the transfer, until today. Somehow, being at this halfway point, an obsession with POAS has set in. I have been googling and Instagram searching days by #DP5DT, and I’m driving myself mad. I didn’t mention this last month, but in January, my anxiety seemed to peak again, and I decided that I couldn’t cope without some pharmaceutical intervention. I was super close to starting the Cipralex that had been calling my name since I filled the prescription, but wanted to wait until I felt safe and pregnant. A work friend reached out to me last month, complaining about how terrible of a time she is having at our school (she was also transferred there at the same time as me), and how she basically feels bullied by everyone except one or two other teachers. Hearing her share her unhappy experiences triggered some of my PTSD from September, where I had visions of crying in the staff washroom between teaching classes, wiping blood off the toilet seat as I was miscarrying, inserting my Endometrin suppositories so deep that my cervix ached because I was so desperate for the bleeding to stop. I remember talking to my vice principal about how a student physically threatened me, only to have him wave it off as “his bark is bigger than his bite”. I felt unsafe in that school, and unfortunately, I don’t feel any better about returning right now than I did when I miscarried. My leave is up at the end of this month, and I’m terrified to go back there. As of today, I’m back to having daytime anxiety fixations about it, and because I don’t want to start the Cipralex yet, I have really no way to cope. I have an appointment with my therapist this Wednesday, and plan to see my family doctor either this week or next week, because I can feel the anxiety ramping up again. When it comes, I feel debilitated. I do illogical things, like peel the skin and cuticles off of my fingers, layer by layer, until they bleed. I become absentminded, and unable to multitask. My fixations start during the day, as daydreams, and as they get worse, they consume more and more of my day until they start to prevent me from sleeping. Once I stop sleeping, I stop eating. I dwell deeper and deeper until I am unable to even maintain a conversation with my wife because I’m consumed by my anxiety. I’m not there yet, but my anxiety at the stage where it is starting to take up more real estate, and I am scared.

So yeah. Anyways…

I have decided to POAS on Thursday, which will be 8DP5DT, and happens to be DW’s birthday. This could be the best birthday present ever, or send us both off on a shitty tone for the rest of the day.

Anyways, please send me some hope and positivity. I can tell that I’m on the verge of sliding into an anxiety pit soon, with work and the uncertainty of whether I am pregnant or not. Thank you all for your support. I’m sorry to have to bring my anxiety back into the mix, but it’s a big part of my struggle right now.

IVF#2: Embryo Transfer

The sun was shining this morning as I woke up to my beautiful wife. Lazy mornings with her are my favourite. She is an early riser, but stays in bed and reads the news until I wake up.

The pace of the morning was very relaxed. It was a nice contrast to the stress and anxiety that I felt all day yesterday. DW came home last night after a long day at school, as she volunteers to open the workout gym for the kids for a couple of hours. She hadn’t even changed out of her work clothes before I was sitting on the carpet, bawling my eyes out.

The stress of two plus years of actively TTC, four failed IUIs, four failed embryo transfers, three miscarriages, and one last IVF which was proving to be less fruitful than the first IVF finally broke me. DW shared how she feels lost in all of it too. Together, sitting in the middle of the floor, dogs licking the tears off of our faces, we both admitted that we’ve reached our limits. Infertility has sucked too much happiness and enjoyment out of our lives.

After that session with my wife, I felt tremendously better. We decided that whatever happens to our embryos on day 5, happens, and that we will be okay. We will roll with it. DW also said though, that she has a good feeling about our transfer tomorrow.

Fast forward to today.

I started the morning with awesome dog cuddles.

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I wore a lavender dress with black tights and my Tretorn boots.

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I was way more relaxed for embryo transfer today than any other transfer, which was ironic because today’s was a fresh transfer and all of my other ones have been frozen ones. What I mean is, I just had my vagina stabbed multiple times just five days ago, laying on the same table! Whether it was the awesome songs playing on our drive to the clinic (Uptown Funk, Riptide), the sun shining outside, or the fact that we’ve been through so many transfers now that it has become like a routine, I felt super chill. I was chatty and joking around all the nurses, I didn’t cry when the phlebotomy nurse spent several minutes rooting around in my arms trying to find a vein, and I wasn’t rushing around or impatient.

The transfer itself went great too- I practiced some deep breathing during the insertion of the catheter, and took a moment to welcome the embryos into my body before they were transferred. There was no pain or cramping, unlike all of my other transfers.

We transferred these two beauties:

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Here they are in my uterus:

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Our beta isn’t until Feb 21st. I hope we get some good news. Now to keep my mind occupied until then…..

Thank you all for your continued support. Each and every single one of your likes and comments means a lot to us. I feel so much gratitude right now.

IVF#2: Embryo Development Day 4

Last year, this is where the major short listing happened, as we went from 11 embryos on day three to 8 embryos on day four.

Yesterday, I informed you that all fertilized embryos were still alive and kickin’. However, their grades weren’t all the same:
6 graded good
5 graded average
2 graded poor

I figured that we would probably have one or two less than last IVF make it to the day four compacted morula stage.

But I was wrong.

And I’m about to cry.

Of the 11 day three (good and average graded) embryos from yesterday….

FOUR were compacting.

How the hell did we go from 11 to 4?
Last year we went from 11 to 8!

I have made so many changes to try to produce better quality eggs (no evidence that my egg quality was a problem even) this time around, like:
– supplements
– minimal exercise
– more sleep
– Chinese herbs
– no coffee
– less sugar
– more fat

So WTF?????!

The embryologist said, “Hopefully, we will have 1 or 2 to transfer tomorrow.”

Last year we had SEVEN blastocysts.

She said that the remaining embryos are still alive, and could just be slow growers. Some could become day 6 blastocysts. There are a couple that have a lot of fragmentation, so they are unlikely to progress further even though they are still alive. She didn’t really seem to want to carry on talking to me, or giving me details like she had in previous phone calls.

I guess no one likes to be the bearer of bad news.

Please please please universe, help all four of my morulas keep growing and thriving so that they can come home where they belong. Send love to the embryos who have fallen behind so that they too, have a fighting chance.

Friends, please send me hope, peace, and positivity, as I can feel my anxiety spiralling out of control already. I don’t want to relive the hell that was IVF#1. This is my chance to restore hope in the things out of my control. Thank you.

PS- my OHSS has gotten a bit worse again. There’s no pain now, but my weight is up 2lbs, my circumference up 2cm, and I drank more than I peed out yesterday.

IVF#2: Embryo Development Day 3

So last year, we had 14 fertilized embryos on day 1, 11 of which survived to day 3.

Today, I got an update that all of our embryos are at the appropriate 6-8 cell stage, with one embryo having 10 cells already. Normal for day three is anywhere from 4-10 cells, ideally 8 cells by the end of the day, so we’re good there.

Now, of the entire batch of embryos:
6 are grade 2 (good quality, minimal fragmentation)
5 are grade 3 (average quality, moderate fragmentation)
2 are grade 3-4 (poor quality, a lot of fragmentation)

Judging by the total count of embryos here (13), I’m guessing that the single slow grower from yesterday caught up to the group.

The grading made me a bit nervous though, as I wonder why I don’t have any perfect grade 1 embryos. Is the grade 1 embryo just super rare? Is my egg quality not great, or is the grade 1 embryo a mythical creature like the unicorn?

Everything that I have read says that both the grade 2 and 3 embryos have good implantation potential. And a greater indicator of making it to the blastocyst stage is the embryo making the expected number of cells for its developmental day.

OHSS Watch:

Weight: down 1 pound
Umbilicus circumference: down 1 cm

I got out of bed today, and had minimal problems dressing myself (yesterday, DW had to help me put on my pants and socks- which was actually quite enjoyable). Peeing and pooping still hurt, but changing positions is accompanied by only mild pain now. My ovaries are still sore on palpation, but more like a sore muscle than active inflammation. The bloating is still there, much worse at night, but sleeping and peeing lots overnight seems to bring me back to a less bloated baseline.

DW and I started watching this show called “Transparent”, which has been really fantastic. It’s about a Jewish Patriarch who comes out as transgender to her family of quirky adult children. It’s got this really interesting tone to it. A humorous backdrop, with really deeply somber and tender moments. I’m loving it, and have to try hard to savour each episode rather than binge watch it.

Tonight though, is the Bachelor, and while I object to the whole premise of the show, I can’t seem to look away. Why is there always so much crying?

PS- embryo transfer is happening in T-minus 48 hours!!

IVF#2: Embryo Development Day 2

(Image from: http://www.advancedfertility.com/4cell.htm )
On day 2 of development, embryos should have 4 cells. The grading of them depends on the level of fragmentation.

Of our 13 fertilized embryos:
7 have 4-5 cells, and are graded as good
5 have 4-5 cells, and are graded as average
1 has 2 cells, but is still alive and could catch up

I asked the embryologist to give us daily updates, which they don’t normally do. I am so grateful that she is doing this for us, and appreciate the time she takes to answer our questions.

OHSS watch:
Weight: up 0.2 of a pound
Waist measurement: up 1 cm

How I’m feeling: Ovaries are still sore, especially with movement, peeing and pooping. The Dostinex is still making me super nauseous despite taking it at night and with food. DW made me a great breakfast in bed: GF grilled cheese and soft boiled eggs, with a side of Gravol.

Today, I start all of my embryo transfer meds:
– prednisone 10mg
– endometrin (progesterone suppositories)- 100mg x 3 times a day
– prometrium (progesterone orally)- 300m at bedtime
– Fragmin injections

*TMI Warning*
Shoving the Endometrin in my vagina was a real treat this morning (not!). My vagina is clearly still in the early stages of healing after all the egg retrieval punctures. I couldn’t get the suppository more than two inches inside, because everything was clenched and hurt.

I’m a little worried about the Prednisone, because last time (failed FET) it caused major comfort food cravings, as well as water retention. This time, I’m trying to stave off OHSS, and the last thing I need is to crave bad food and retain water. However, a nice therapeutic effect of the prednisone is that it made my digestive issues go away. Honestly, my usual IBS and Celiac issues seem to go away when I’m on the Prednisone, which is wonderful.

FET#4: Protocol

There are a lot of meds involved in our FET this round, and I thought that I’d like to document it, both for myself, but also to help anyone else who is also going through this. The days refer to cycle day, and non-medical supplementation is in brackets (Chinese Medicine herbs).

Days 3-16: Estrace 6mg daily

Days 3+: ASA 81mg daily

Day 13: Intralipids

Day 17+:
7:30am: Prednisone 10mg, Estrace 2mg, Pink PregVit, 100mg Endometrin, (1000IU Vitamin D, Yuan Support Formula- 4 tablets)
3:30pm: Endometrin 100mg, (Yuan Support Formula)
Dinner time: ASA 81mg, Blue PregVit Folic 5
11:30pm: 5000IU Fragmin, 2mg Estrace, 300mg Prometrium, 100mg Endometrin, levothyroxine 25mcg, (omega 3 fish oils, Yuan Support Formula)

Day 21: Frozen Embryo Transfer

Day 31: HCG beta test

Day 33: Repeat HCG beta test

Sometime after Day 33: Intralipids

Tips:

– Set time alarms on your phone so that you take your meds at the proper times.

– But a pill schedule case like this to organize yourself:

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– inject the Fragmin super slowly

– protect your underpants from leaky Endometrin using long and wide, but super thin panty liners. Better yet- make your own cloth ones, they are so much more comfortable

– clean your lady parts after Endometrin messes, or else it seems to burn down there

I just started the huge combo of meds today, and let me tell you, the Fragmin burns like a B$&@H! I was perfectly fine with the Lupron, Follistim, and Ovidrel injects during my stimulation phase, but this needle would not break the skin without significant force, and while I plunged very very slowly, the medication itself causes a strong burning sensation. I had DW hold my fat roll for me because I needed two hands to steadily depress the plunger, and it felt like she was pinching me as tightly as she could with fingernails (she wasn’t- that’s just what the Fragmin felt like going in). Anyway, I will find a way to make it work, as it needs to be done daily, but right now it is a not-so-distant unpleasant memory. Some advice: have someone else inject it for you, inject the drug very slowly, stop and catch your breath after the burning feeling, inject some more, and so on.

We also keep a stash of homemade organic tea tree and witch hazel wet naps by the toilet to help me “wipe up” any nasty Endometrin leakage (vaginal suppository). I am back to wearing large Cadillac-sized panty liners again too (so as to not ruin my underwear), so the wipes help to prevent some of the chaffing I experienced last pregnancy.