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 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.

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!

IVF#2: Egg Retrieval Part II

So I laid 21 eggs today! At least, that’s how many the RE collected from me this morning.

The procedure went much better this time around. I pretty much told every nurse and the RE about how quickly I metabolize anaesthetic, and they gave me an extra dose at the beginning of the procedure. I felt my head get heavy, the room started to look blurry, and while I was aware of what was going on at a very superficial level. I didn’t feel any pain, which was really nice.

After the procedure, I recovered in the lounge with apple juice and the snacks that we packed: coconut water and homemade cornbread muffins. Since I had been fasting since 7pm the night before, I was ravenous. I basically stuffed my face as the nurse was trying to explain the discharge items to me. I felt a bit dazed, but then we had a chance to see one of the embryologists, as I wanted to discuss our choice of fertilization method.

We have decided to do 100% ICSI.

They will start the ICSI tonight and then we will get a fertilization report tomorrow.

After that, DW went to grab the car and came to pick me up from the front door of the clinic. I was feeling woozy getting into the car, and started to salivate. In that moment, I knew I was gonna puke, so I opened the door, leaned out, and puked all over the sidewalk in front of the clinic. DW hung onto me by the back of my jacket, and I was so glad my dreads were tied up, because I had four good barfs before I was empty. Goodbye apple juice, coconut water, cornbread muffins, and water!

On our way home, we make two stops. One at Whole Foods because all I could stomach was soup. Another at Walmart to grab some Tylenol for the post-retrieval pain as well as some Gravol because the Dostinex makes me so nauseous.

I’ve spent the rest of the afternoon lounging on the couch, binge watching Broadchurch on Netflix. DW has been taking very good care of me- unlimited fetches, making food, bringing me meds. She also took the dogs out while I vegged on the couch.

The anaesthetic wore off by the time we got home, as I have some pain with moving, but much worse with peeing. I haven’t pooped all day, and I dread having to do it. I finally pooped and while it was moderately painful, I survived. There may have been some whimpers coming from the bathroom.

I have been taking Extra Strength Tylenol every 4 hours, which has taken the edge off and made the pain quite mild. But from what I remember, the OHSS came on with a vengeance a few days after the retrieval, so the worst is yet to come.

Since we had so many eggs retrieved, they’ve already got us booked for a five-day transfer. We transfer on Wednesday! I am hoping and praying that we get a lot of good quality blastocysts over the next couple of days. I’ll post their progress along the way.

Thank you everyone for your kind words and well wishes. I appreciate all of your support. I don’t know how I would have gotten through the past two years without you all.

For now, here’s a picture of two of my cutest girls:

Juno (the big dog) saved Clementine (the little dog) and I from a coyote that was stalking us two days ago. We were walking on a path on the side of a hill, when a coyote cut us off about 30 feet ahead. Juno chased it down the hill and across a valley, probably about 0.75 of a kilometre long. Luckily, she is bigger than the coyotes, so they are afraid of her and run away. It’s one of the major dangers of taking the dogs to this conservation area. There are deer, coyotes, beavers, and other native wildlife. We always try to go during the day time because the coyotes are more active in the evening. I feel so grateful for Juno’s protection, even though she is generally a super suck 99.9% of the time.

Anyhow, fertilization report tomorrow!

IVF#2: After 12 Days of Stims… We Trigger Tonight!

Well here we are, after 12 days of Gonal-F doses ranging from 200IU to 250IU, finally, we trigger tonight!

Yesterday I waited by the phone, self-soothing with spoonfuls of coconut butter (you must try coconut butter- not oil- it is so rich and creamy and delicious. It’s the only food I could really taste yesterday), for a phone call that never came. This morning I went to my monitoring appointment, had more blood drawn (so many holes in my arms now), and went for my daily meditative dildo-wanding.

These are my stats:

As you can see, it was a good call for my RE to have me stim for one more day. A good amount of growth happened, and some of the mid-sized follicles have grown to potential maturation size. The ultrasound technician says that in her experience, the follicles 16mm and greater will probably be mature by egg retrieval. The 15mm ones are iffy, and anything smaller is unlikely to yield a mature egg by egg collection. So right now, we’re looking at 18 or so potentially mature eggs, which is great. Obviously, you never know until egg retrieval, but I love to speculate. TTC had made me a master speculator. I have self-diagnosed a whole shit tonne of things already, most of which has actually been correct.

Anyways, there’s a lot of snow around here, and I’m dying to take the dogs out, but the conservation area doesn’t get plowed, and the snow is knee-height. Juno killed and ate 90% of a raccoon a couple of days ago (we lost her in the conservation park and then found her laying in a mess of fur and blood, so we speculate (see master speculator!) that it must’ve been a small raccoon based on the fur). She has been crapping fur poops, which can’t be fun. I might throw on my gators and go for a jaunt with her. Oh, that dog… Eating things she shouldn’t eat.

Speaking of eating, I have been feeling quite a bit less bloated in the belly lately. I believe that it is due to some changes that I’ve made to my diet:

1. Cut down my carb intake a bit. Because of the amount I was working out before stims, I was eating 40-50g of carbs with each meal (so 4-5 times a day). I’ve cut that down to 20-30g of carbs with each meal, sometimes less, depending on the meal. I always feel a bit better eating less carbs. It’s not a weight loss thing, it’s an overall homeostasis thing.

2. I’m force-feeding myself protein with each meal, even with snacks. I ate a lot of protein before (at least 35g per meal x 4-5 times a day), but feeling like crap doesn’t make you want to cook or eat things that require a knife.

3. I’m consuming a lot more salt than usual. I usually consume very little salt, but thanks to some advice from this lovely blogger at Plan B Chronicles, I’m eating way more salty foods. I’m adding salt to my soups, eating more salty snacks, etc.

4. Metamucil is my friend. I’m taking two scoops of the Orange flavoured powder once a day. DW says it makes her poops “nice and fluffy”, which makes me giggle. I don’t think my poops are ever fluffy, but I’m crapping at least once a day right now, which makes me happy.

Having so many follicles, I’m aware that OHSS is quite likely on the horizon. All of the above mentioned efforts are also to prevent it. Last year’s IVF had 36 growing follicles, 19 of which were mature. I felt super shitty for 6 days after egg retrieval, and then started to feel a lot better. All in all, it took 2 weeks for me to be able to take a dump without crying alone in the bathroom (due to enlarged ovaries). I was bloated and in pain, but didn’t have nausea or troubles breathing like some women do. I definitely had ascites, and got to practice some diagnostic tests that I had learned in professional school.

Lindsey at Awaiting Autumn also mentioned taking Dostinex (Cabergoline) for OHSS, and I’ve sent an email to my primary nurse asking about being prescribed some. This study shows that it doesn’t negatively affect egg maturation, implantation rates, or pregnancy rates.

So yeah, we trigger tonight, and egg retrieval is on Friday, though I’m still waiting for a call from the nurse to find out the exact time for both events.

Last year I said that I’d never do this again (because of the pain and trauma to my insides), and here we are, doing it again. I hope that we finally get some babies out of this.

IVF#2: After 9 Days of Stims

DW and I had a nice date night yesterday. We started off the evening at Whole Foods (always a delight), and then headed to my favourite Thai place. This restaurant is 100% authentic Thai. The women who own it are sisters, and actually purchase most of their spices from Thailand themselves because for some reason, a lot of Thai products aren’t approved for import into Canada. My favourite dishes are their made-from-scratch (and not from a powder) tom yum soup:

And their tilapia keang som, which is a non-coconut milk based curry. It has a base of tamarind paste:

DW tried a new dish, called Pad Ped Pla:

The dishes were served with jasmine rice, and were sooo delicious. We saved some for the next day’s lunch, but by 10pm the same night, we inhaled the leftovers.

After dinner, we hit the movie theatre to watch the new Johnny Depp movie, Mortdecai. We enjoy Depp’s silly humour, and kind of picked this movie without knowing much else about it. However, we were quite pleasantly surprised by how enjoyable it was. Several times I found myself literally laughing out loud. We got home in time for my nighttime Gonal-f injection, and a couple of episodes of the Walking Dead, which we are catching up on on our PVR.

Today, I had monitoring this morning.
Here are today’s stats:

The ultrasound tech was funny today, saying, “uh oh, Dr. ______ isn’t going to like this- so many follicles!”. Ahh such is my life.

She was right. This afternoon one of the nurses called, and I’m supposed to lower my dose of Gonal-f again tonight, down to 200 units.

Monitoring again tomorrow!

Preparing For Embryo Transfer

(Photo from: http://m.inviafertility.com/uncategorized/drvkarande/top-10-interesting-facts-about-ultrasound-guided-embryo-transfer)

Tomorrow is our embryo transfer! So far, DW has been taking estrace everyday (beginning on day 3 of her cycle- dose decreased from 3 pills a day to 2 pills a day on the day of our retrieval). She has also started her prometrium (3 capsules orally per day) and endometrin (3 vaginal suppositories per day). She’s not particularly enjoying the vaginal suppositories, and is making her way through our stock of maxi pads and panty liners. She is being a good sport though, and in addition to the busyness of work and this drug schedule, she is still taking care of my OHSS ass.

Oh yes, still bloated and in pain. If my stats have not improved by tomorrow, I’m going to insist on having an ultrasound to see how bad my ascites is. Two days ago, a chiro friend of mine and I were playing with my belly, doing the fluid wave test for ascites, which we had learned in clinical diagnosis class back in the day. On day 4 today, my weight continues to climb by just under a pound (now a bit over 3 lbs more than on retrieval day) and my circumference remains the same as yesterday. The nurse called yesterday and implied that perhaps I wasn’t resting enough. All of this resting is driving me insane!

But exciting times are upon us my blogosphere friends. We went for sushi yesterday as one last hurrah for DW (who loves sashimi by the way). We called it the Last Supper.She is also shovelling the driveway right now too because a) I’m in too much pain right now, and b) she is on doctor ordered bed rest for two days after tomorrow.

In preparation for our transfer, I did a nice acupuncture treatment on her this morning (she played an iPhone Settlers of Catan game while her Qi did its thang), and I made her this pineapple-rich smoothy:

Mamaetmaman’s Pineapple Smoothy (for good implantation)

1/5 of a pineapple, rind trimmed and chopped but core not removed
2 tbsp coconut cream
1.5 cup coconut milk (the thin beverage kind, not the cooking kind)
1 ripe banana

Throw all ingredients into your blender and blend on high until smoothy no longer has fruit chunks in it. If it jams, add more liquid.

For a refreshing change- pre-freeze your pineapple and banana for an icy consistency .

Pour into a large glass and serve with an umbrella!

For even more fun times, double the recipe and make two drinks- add Malibu Black into the NGP’s glass!

What I’m Doing to Prevent OHSS- Day One

The last 28 hours have been less than fun, given that there are holes in my vagina and ovaries. We have been doing our best to stave off ovarian hyper stimulation syndrome (OHSS), which has felt like a full-time job.

Things that we are doing to prevent OHSS:

– I have been downing coconut water, which is a good electrolyte
– I have been eating salty things like soup
– I made myself a big pot of congee (a savoury Chinese rice porridge), which is salty and very easy on the digestive system
– I am trying to maintain my protein consumption at every meal even though I don’t feel like eating it when I’m not feeling well
– I am not exercising, even though it usually makes me feel better when I’m feeling gross
– I am weighing myself and measuring my abdominal girth daily
– I am doing acupuncture on myself (I have advanced training in this) to prevent ascites
– I am trying to relax and enjoy my 2 days off at home

So far, most of my discomfort has to do with any movements that engage my pelvic floor: getting up/down from sitting/standing, rolling over or changing position on the couch/bed, coughing (still have that damn cold from my MIL!), urinating, defecating, sitting.

This morning, the acetaminophen had worn off and I had major problems trying to pee. I could not bear down, and could only “open the flood gates” and let the natural pressure differential aid in excretion. I sat there for minutes as my urine “drip drip drip drip dripped….”. It was frustrating and sad as DW stood there and stared, feeling helpless and sorry for me.

However, I’m not feeling overly bloated. Just a little maybe. I have read that the bloating gets worse with time, which scares the shit out of me because I was hoping to play hockey on Monday, and am playing in a tournament during the weekend of the 30th.

We’ll see how it goes. Will update more on this as things progress.