Cent Cinquante Neuf

All-day pregnancy sickness has kicked me in the ass this week. I’m basically doing the bare minimum in terms of daily tasks (feed self, feed dogs, bathroom tasks), and then trying to sleep away the nausea in between. When I am awake, I feel like I’ve got the worst hangover of my life- nausea, headache, flu-like symptoms. My food aversions are terrible too- all foods are grossing me out. I had a bottle of Diclectin (Diclegis) leftover from last pregnancy, and finally decided that it was time to take it. I started it last night, and so far, it hasn’t kicked in yet (heard it can take several days to work) and makes me feel super groggy. I’ve never responded well to Unisom or Benedryl as a sleep aid- it keeps me drowsy but unable to sleep, contrary to what many other people experience (Diclectin as a wonderful sleep aid). 

This morning I dry heaved several times because I didn’t get my oatmeal in my tummy fast enough. However, I was able to finish an entire lunch and had a snack this afternoon. That’s progress!

So today was my viability ultrasound. 

And I have good news….

We have a heartbeat!

Dumplin’ is measuring 6 weeks 6 days (a little short of the 7 weeks 3 days that is based on my IVF dates), and has a heartbeat of 159!

There was also another empty sac measuring 0.6cmx0.4cmx0.3cm that could either be a subchorionic hemorrhage or a second gestational sac. Judging by the shape of it (sphere-like vs. crescent-like), RIP Dumplin’s Vanishing Twin.

So I’m not sure if we’ve graduated from the fertility clinic, but given the congratulations!, random loot bag they gave me, plus the requisition for my OB or midwife to sign off on (for me to do a 12 week screening ultrasound there), I’m guessing we did!



Loot bag (with a post-it note that says ” For OB patients only”)

What was inside the loot bag.

So yeah! They want me to start tapering off my prednisone in two weeks, but after consulting with some other RPL friends as well as investigating other protocols for NK cytokine activity, I’ve decided to go rogue and start tapering at 15 weeks instead. 

The progesterones and Fragmin they want me to stop abruptly at 12 weeks.

The aspirin I continue until 32 weeks. 

The synthroid I will continue as per my endocrinologist’s recommendations.

This week I will have my last intralipid infusion as well.

We are very happy to have viability. Given our losses, it’s difficult to be as bright-eyed and bushy tailed about it, as we know anything can happen. But we are taking it day by day, and are grateful that this little soul chose us.

And of course, we celebrated with some awesome authentic Chinese food for lunch! 



Tomorrow, we meet with our midwives for the first time! 

Thank you everyone for keeping us in your thoughts. Please continue to, as the next five weeks will be difficult as well. 


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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: Day 1 Fertilization Report

So remember my post about fertilizing our eggs via conventional IVF vs. ICSI? Well last year, we had 19 mature eggs, and opted for 1/3 IVF and 2/3 ICSI. Last year we had 14 fertilize.

Today I got a call that out of our 21 eggs collected, 13 were mature, and all 13 fertilized via ICSI.

Now I’m a little upset that only 13 of the 21 were mature. I was hoping for more. However, I am so glad that I posted my dilemma about IVF vs. ICSI, and that with your support and sharing of experiences, DW and I decided to go all ICSI.

I am also glad that I spoke to the embryologist yesterday, and asked her how they select when eggs get IVF’d and which ones get ICSI’d. Apparently, they can only do ICSI on mature eggs, but immature eggs can be fertilized via IVF. So if you choose to do a “split” of ICSI and IVF, they choose the mature ones first for the numbers you’ve designated for ICSI, and the remaining (including immature eggs) are used for IVF. So if you choose to do a split, you may have a greater yield of fertilization because they can utilize those immature eggs, which are still capable of fertilizing. However, if you choose to do all ICSI, you can’t use those immature eggs at all.

OHSS update:

Weight: same as yesterday
Circumference at umbilicus: same as yesterday

I have been in progressively more pain as time passes since the retrieval. I have been popping extra strength Tylenol every four hours, which works, but wears off after about three hours. I woke up in the middle of the night with searing abdominal pain (meds wore off), and had to pee, which hurt like hell. I have been asked by the clinic to track my liquid intake and output, which has been very difficult for me. We have a measuring cup in the bathroom for that, and I always forget at the time I start to pee. Plus, the perfectionist part of me hates not having a very accurate system for measuring liquid from things like vegetables. I also dislike how I’m measuring my intake in millilitres, and my output in cups. I know it’s a simple conversion, but it still bugs me.

Things that hurt: walking (a bit), rolling over in bed, changing position, twisting, putting on pants, putting on socks.

Things that really hurt: coughing, sneezing, peeing, pooping.

So far, it just feels like my ovaries are inflamed from having holes poked in them. However, thankfully, my belly isn’t more distended than on retrieval day. From what I remember though, the OHSS didn’t really show until a couple of days after the retrieval.

Anyways, more salty snacks and soup for me!

To ICSI or Not to ICSI?

During IVF#1, we went in blind, not knowing what the outcome would be for fertilization. The embryologist recommended we fertilize 2/3 of our eggs using ICSI and 1/3 via conventional IVF.

For those of you who aren’t familiar with these terms, conventional IVF is when they place the eggs and sperm together in the Petri dish and let fertilization happen on its own.
This allows the stronger sperm to fertilize, and the normal eggs to be fertilized.

ICSI, which stands for intracytoplasmic sperm injection is when the embryologist selects which sperm he/she deems to be the “the best”, and then manually injects that single sperm into the egg to fertilize it. There is a different kind of selection here, as it is based purely on the embryologist’s observations of morphology and motility. Less natural selection here, as the race to the egg and process of penetrating the zona pellucida (shell of the egg) is bypassed. Potentially, crappy sperm and crappy egg can fertilize and be fertilized by ICSI, however, if you suffer from fertilization failure (hard to penetrate eggs or sperm that can’t dissolve the shell) ICSI can make a positive difference.

These were our results from last year’s IVF:

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Now, the grades of these embryos were all very good, except for one which was fair. The “best looking” embryos were ICSI fertilized. We don’t know which ones were chromosomally normal, but know that the pregnancy (and subsequent miscarriage) in July/August/September was of a chromosomally normal female embryo.

Since egg retrieval is coming up next week, we have to decide how we want to fertilize our eggs. I want last year’s IVF to be a learning opportunity. The embryologist thinks we could do all conventional IVF since we did have fertilization occur properly this way. Conventional IVF also allows natural selection of normal eggs and normal sperm as well. Overall live birth outcomes are the same whether you do IVF or ICSI, even if IVF yields less embryos.

This compares the use of ICSI over Conventional IVF in several different causes of infertility, and finds that ICSI is only beneficial in cases of male factor infertility.

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Right now we’re leaning toward 100% IVF, but our RE thinks we should still do some ICSI, without giving a real reason. He says it depends on our numbers on retrieval day. We are not naive to the fact that doing ICSI means they can charge $1250 more.

And then there’s this, which seems to say that there’s little to no risk from doing ICSI, so why not do it.

Another factor is that we are not using the same anonymous sperm donor as last IVF, so it is unknown how well this sperm will fertilize our new batch of eggs. But seeing as how our sperm is coming from a sperm bank, we can assume the motility counts are decent.

I would love your feedback and experience as we make this decision.

Fertilization Report

So as you know, I elected for 7 ova to be fertilized the old fashioned IVF way:

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(Photo from: http://m.123rf.com/photo-23226463_ovum-and-spermatozoon-fertilization.html)

And 12 ova to be fertilized via ICSI:

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(Photo from: http://www.sisuhospital.org/icsi.php)

The embryologist called this morning to inform me of our fertilization results:

Of the 7 ova to be fertilized via IVF:
4 fertilized
2 were abnormal
1 had 2 sperm fertilize it –> abnormal

Of the 14 ova to be fertilized via ICSI:
10 fertilized
2 were immature
2 did not fertilize

So in total, we have 14 zygotes!