Depot Lupron, Day 14

This week, my Depot Lupron side effects seemed milder. Perhaps last week, my body was adjusting to the medication, resulting in some more severe side effects.

* Headaches–Ibuprofen + caffeine has been really effective for the headaches I have experienced this week, but overall they seemed to be much fewer and farther between. Thank goodness!!!

* Breakthrough bleeding–I had some light spotting on Tuesday evening, but that was it. Hopefully last week was just my body getting rid of the last part of my lining, and I’ll see no more spotting/bleeding until after this treatment.

* Hot flashes, Mood, Energy, and Libido–I honestly haven’t noticed anything different yet in any of these categories. It’s still pretty early to be feeling the full effects of the medications, so we’ll see how the next week goes.

Thirteen days stand between me and Depot Lupron injection #2. I already called in the refill, and it will be delivered on 11/10, three days before my second injection on 11/13. So far, so good!

Moving On Up

We were able to speed up our FET calendar by four days–not much, but better than nothing! The new calendar has me taking 12 BCPs instead of 19, so the FET date just moved up a bit. She wrote in an extra two days of four patches on 1/9 because otherwise the FET date would have fallen on the weekend (and CCRM only does FETs Mon-Fri). I think she forgot to change our beta date to reflect the new timeline, but our beta should occur on January 26, I believe. Eleven weeks and two days to go!

Twelve Weeks Away

Yesterday I e-mailed our nurse at CCRM and inquired about whether there is any way to speed up our FET timeline slightly, by taking less BCPs or something. I know, I am crazy, but even moving it up by a week would make a huge difference for me psychologically. Why do I need to take 19 BCPs AND inject more lupron for suppression when I’ll just be coming out of two months of menopause thanks to Depot Lupron? I’m guessing she will roll her eyes when she reads my message, but I had to ask. But as it stands today, our FET is exactly 12 weeks away, and I start BCPs exactly six weeks from today (on my birthday!). Twelve Fridays from now, we should be in Denver, preparing to see our little embryos for the first time.

We are actually feeling hope and optimism, which is very new for us. We are glass-half-full kind of people, but not when it comes to this battle. We’ve recently instituted middle-of-the-week date night, because we both agree that we should soak up date nights together before our world is rocked by diapers and bedtimes. This is really the first time that we’ve acknowledged that an actual baby might result from this transfer. Wow, what a feeling.

Last weekend was a little rough for me emotionally. We attended a wedding with my DH’s family. Inevitably, there was plenty of discussion about my SIL’s pregnancy. The baby was kicking up a storm, and everyone was excited that they’ve chosen her name. Additionally, my BIL had felt her kick for the first time that day. The pastor that I previously mentioned in my cringeworthy post last month was also a wedding guest, and he congratulated my father-in-law on his impending granddaughter. My FIL thanked the pastor and gripped my shoulder and then gently said, “Now we’re just waiting for “Auntie Em” and “Auntie Em’s Hubby” to catch up.” My eyes uncontrollably welled up with tears, and I had to walk away. If only he knew how hard we are trying to catch up, and what we will have gone through when we (hopefully) do announce our own pregnancy next year. We will probably share some details about this process next year, but right now they have no clue that we’ve even been to Denver. The secretiveness is our choice, and we feel it’s the right one for us, but once in a while I wish they knew just how hard we’re working to win this war.

I did slip up a bit a few weeks ago, when my BIL innocently tried to thrust ultrasound pictures of their daughter in my face. This was right after we returned from Denver, and they had attended the gender reveal ultrasound while we were gone and wanted to share the detailed pictures of our new niece. When he tried to hand me the pictures, I abruptly excused myself and announced that I had to use the restroom. I just couldn’t look at those pictures right at that moment, but I’m sure it was so obvious. I stood in the bathroom for a minute, flushed the stool, regained control, and rejoined the family. But I feel terrible for not handling this better because they are so nice and deserve every ounce of happiness. Ugh. I’m trying, that’s all I can say. I cried all the way home, again. My poor hubby.

The day after the wedding, I met my MIL and non-pregnant-SIL at a restaurant for lunch and baby shower planning session #1. I’m choosing to participate in the planning because I simply don’t want to ostracize myself from the family or cause anyone to resent me. I sometimes feel on the bubble of the family anyway, since I was the last member to join and my DH doesn’t want to visit his parents as often as his siblings do. My coping strategy for the shower is actually to be absolutely as involved as possible, which sounds kind of ironic. The way this strategy plays out in my head, I will simply be too busy dealing with the details to dwell on my own infertility. I volunteered for SO many duties–penning the invitations, preparing all kinds of food, making the diaper cake, etc. I think being as busy as possible during the actual event will make it easier for me to handle. And hopefully, the effort I’ll be putting into this shower will help me to seem supportive, despite the few public displays of pain that I’ve shown since their announcement.

Tonight we are going to dinner with the family again, and tomorrow I’m heading to my hometown to visit friends and then the hubby and I are attending two Halloween parties in the evening. Sunday we’ll be handing out candy to trick-or-treaters. Last year at this time, I felt like we were so very far away from achieving our goal. And this year, I can actually see the light at the end of the tunnel, even if it is 12 weeks away. We’re over the hump, and that is a good feeling.

To Acu or Not to Acu

I’ve been debating whether to go through some acupuncture while preparing for our frozen embryo transfer. I’ve never had a single acupuncture session, but I’m planning to add sessions immediately before and after our ET at CCRM. I would like to attend at least one acupuncture session locally so that I will know what to expect at CCRM in January.

At our ODWU, the doppler indicated that blood flow to my uterus was perfect. CCRM didn’t say anything to us about including acupuncture in our protocol, but I assume the REs think it’s helpful since they allow a third-party company to provide acupuncture services immediately preceding and following the embryo transfer. Therefore, I’m considering it to improve our odds for success.

I was thinking about starting acupuncture around the same time that I will start preparing for our FET (December 10th), which would mean about six weeks of acupuncture. I contacted a local well-known infertility acupuncturist for information about pricing, only to find out that she is on sabbatical through the fall and winter. I’m going to continue researching to see if there is another recommended acupuncturist in my area.

My husband’s opinion differs greatly from mine on this topic. He feels it’s a crock and a waste of money, while I feel that we should do anything possible to enhance our chances for success. I need you, my wonderful online friends, to help me decide whether acupuncture will be worth the time and extra expense.

So my questions to you are: How much money should I expect to spend per session? For how many weeks should I consider seeing an acupuncturist? Does the acupuncturist need to specialize in infertility (thanks Pie :)), or will a general acupuncturist know what to do? Do you think it helped you manage your stress leading up to the FET? How many sessions per week did you attend?

I would love to hear from you! Please comment or email me at ccrmjourney@hotmail.com.

Trisomy 2

The genetic counselor at CCRM recently told us that our lone abnormal blast (Embryo #3) had Trisomy 2. An extra copy of the second chromosome was found during PCR testing.

Chromosome #2 is the second-largest chromosome in the genetic code and contains 8% of the entire DNA in cells. The CCRM genetic counselor said that this embryo would likely never have survived implantation. Trisomy 2 mosaicism appears to be the outcome if the embryo does implant, and I wouldn’t recommend researching it. You will see some pretty terrible results and images.

This embryo was graded as a 6AB, one of the highest-rated blasts. I’m guessing it would have been chosen third in line for transfer, behind our 5AA and 6AA. I am very thankful we elected to add CCS testing!

Depot Lupron, Day Seven

Today is Day 7 of Depot Lupron (or Lupron Depot, seems to be interchangeable). Every week, I will post about the symptoms I’m feeling in hopes that it will help future DL patients know what to expect (although their side effects may vary).

This week I have been dealing with:

* Breakthrough bleeding–This started four days after the injection and was heavier than spotting but lighter than a full-blown AF. It lasted one full day and then very briefly the next day. It was accompanied by feelings of crampiness, but nowhere nearly as painful as when AF is really here.

* On-and-off pounding headaches–This has been my worst symptom so far. The headache comes and goes, but it almost always makes my head pound. On Thursday night, I was awake half the night because the pounding behind my right eye prevented me from sleeping. I took extra-strength Tylenol and finally felt some relief. My nurse suggested taking four 200mg Ibuprofen with a little caffeine, and I’m free to treat the headaches with this combo until I start BCPs. Alcohol (like a glass of wine) seems to exacerbate the headaches, so I have totally cut myself off from even one drink. Hopefully the next time I enjoy an alcoholic beverage, we’ll be a family of three or four!

Only 20 days until my second Depot Lupron injection!

Surprise Call from Dr. Surrey

Earlier this week, I was leaving work when my cell phone lit up. I was surprised to see CCRM on my Caller ID and even more surprised that the caller was Dr. Surrey. My first thought was that they mistakenly gave us the wrong CCS results! : ) But actually, he was calling to give me our results, not realizing that I had already received a phone call last week. I was happy that he called so I could get his perspective on our chances for pregnancy.

He seemed very impressed at the number of normals that resulted from our six blasts. Apparently, he only expected 30-40% to be normal. I’m not sure if he was basing this prediction off general statistics or his personal thoughts about our cycle. He also seemed very impressed by our grading. Apparently, our best CCS normal blast is the 5AA (which he called “a perfect Day 5 blast”) and our second-best blast is the 6AA (which he called “a perfect Day 6 blast”). He did mention that the 6AA has hatched out of its shell before vitrification, so it will be more delicate during the thawing process. Hopefully it will survive!

He asked whether we had decided how many embryos to transfer (one or two), and I asked him about our chances of twins based on the grades of our embryos. He said if we transfer one embryo, we have a 60% chance of that one embryo implanting. If we transfer two, we have an 80% chance of at least one sticking. The current twin pregnancy rate with two CCS normal embryos hovers around 40%.

I told him that although we aren’t seeking twins, we are leaning more towards transferring two simply for the increased odds of a pregnancy. If both embryos stick, we’re going to have a temporary freak-out, but we would rather have two children than no children after this FET. Dr. Surrey agreed with our decision and asked me to just tell our nurse if our plans change. We will transfer the 5AA (Embryo #15) and 6AA (Embryo #20). As long as there is at least one heartbeat at that first u/s, we will be absolutely overjoyed.

Then he asked if we had received an FET date. I told him 1/21/11 and he said jokingly, “Okay, I’ll try to be there for that.” I guess even though you may not see your doctor at all during your IVF cycle at CCRM, they do try their best to perform your embryo transfer. If he is there, then great, but if not, then no big deal. Any of the doctors there can handle it, I’m sure!

We discussed the dates of the depot lupron injections and the lead-up to the FET, and with that, our conversation concluded. He seemed very optimistic for us!

While in Colorado: Outlets at Castle Rock

One day while in Denver, we headed to the Outlets at Castle Rock for some retail therapy.

We were so busy shopping, we forgot to take many pictures!

I took a photo of the store directory, but I wasn’t able to capture both the store directory and the map. Hopefully you can click to zoom in. Otherwise, I’m sure you can find this information online anyway.

Some things we purchased were:

* A new watch and sunglasses at the Fossil outlet
* Socks at the Adidas outlet
* A new wok at the Calphalon outlet
* A dutch oven at The Kitchen Store outlet

If you are in need of some retail therapy while in Colorado, I would recommend this place!

Another Breakthrough

Today it’s been four days since my first Depot Lupron injection, and I am bleeding. I intend to provide weekly updates on the side effects I’m feeling, and this breakthrough bleeding is the first. It’s not as light as spotting, but not super-heavy, and it started around noon while I was out walking in a park. I have felt a little crampy today, but I was surprised to see more than spotting.

My CCRM nurse had said that although the Depot Lupron shot can be injected anytime between CD 1-7, injecting this medication between CD 1-3 would give me the best chance to avoid breakthrough bleeding. I did receive the injection on CD 3, but apparently I fell on the wrong side of the statistics. I can’t friggin pay AF to show up when I need her to, but give me some menopause-inducing medicine and the bleeding starts immediately! Oh, the irony. : )

I guess this means the medicine is doing something in there! I’ve had lingering headaches all week too–not sure if that’s caused by the recent sharp change in weather or if it could be the result of the Depot Lupron. None of this is unbearable by any means, but I just want to report it for those who will be going through the Depot Lupron treatment in the future. Pack your protection, ladies! : )

And those of you out there who have been through the DL treatment: did you experience breakthrough bleeding?

While in Colorado: Garden of the Gods

We were so impressed by our first visit to the Garden of the Gods, we decided to revisit while in Colorado a few weeks ago. It is just such a gorgeous and serene place, so natural and picturesque, and I feel a great sense of peace there.

A nice paved walking path leads visitors all around the breathtaking rock formations.

Some skilled rock climbers were scaling the rocks while we watched.

It seems kind of like a magical place.

FET Calendar

Our CCRM nurse sent us a Frozen Embryo Transfer (FET) calendar a few days ago that details how the rest of this process will unfold (click to enlarge below). It’s wonderful to know what to expect, since this will be our first FET.

My birthday present to myself in December will be starting a pack of BCPs. : ) And my Christmas present to myself will be jabbing myself with lupron beginning on Christmas Eve. And lastly, around New Year’s Eve I’ll be celebrating my first AF in 60 days which, I’m assuming, will be terrible given her two-month absence. It’s funny how the dates on our calendar occur on holidays, but I guess that’s what we get for scheduling all of this around Christmas.

Our actual embryo transfer is scheduled for Friday, January 21, 2011. What’s ironic about that day is that if IVF #1 had worked, our EDD was January 20, 2010. So we’re kind of coming full circle by having the FET occur on January 21 next year. If this FET date sticks, our first beta will occur on January 30, and our first ultrasound would occur right around Valentine’s Day. This will either be the happiest or saddest Valentine’s Day of our lives.

Only twenty-five days stand between me and my second Depot Lupron injection. And thirteen weeks and three days until our FET! Our weekends are pretty filled up through December, so I’m optimistic that the time will pass pretty quickly even though right now January 21 seems so very far away.

While in Colorado: Manitou Springs

In April, I wrote a post about the places we visited while in the Denver area for our one-day work-up. Last month, we revisited Historic Manitou Springs, which is located at the base of Pike’s Peak.

It was lunchtime and we were starving, so we sat on the porch and enjoyed some food at PJ’s Continental Bistro. The hubby ordered pierogies, and I ordered a wrap.

After lunch, we walked along the sidewalk, next to some springs… (I don’t recommend you taste-test the spring water… yuck!)

And ended up back in the penny arcade area that we enjoyed so much in April.

There are a lot of fun, old games here…

(My fate landed on Fish Peddler.) : )

Our bellies were too full for ice cream at Josh & John’s (plus we had just enjoyed the cake & shake at d. Bar Desserts the previous day), so we skipped dessert this trip. We did walk up and down the main drag, exploring the stores, before heading back to our car and revisiting the Garden of the Gods. More on that on Wednesday!

First Depot Lupron Injection, Check

This morning I went to my local RE’s office for my first of two Depot Lupron injections. Everything went smoothly, except that I waited in a tiny room for 30 minutes before they gave me the shot (they treat me like a second-class patient, presumably because I’m not cycling there). This injection can be given anytime between Cycle Days 1-7, but administering the injection between CD 1-3 helps reduce the chances of breakthrough bleeding. Today is CD 3 for me, so hopefully I won’t have to deal with any unwanted spotting. I’ll have enough to deal with considering this medication causes menopausal symptoms like hot flashes, headaches, mood swings, achy muscles, and fatigue. It also repairs beta 3 integrins in the uterine lining (the proteins that create the “sticky stuff” needed for implantation), so hopefully all the yucky side effects will be worth it. Thirty days from now, I’ll have the second injection administered, and then I can start prepping for the embryo transfer 30 days later.

I figure I’ll post weekly about how the Depot Lupron is making me feel. From what I’ve read of others’ accounts, it’ll be at least a couple of weeks before I feel anything.

Tomorrow is our second wedding anniversary, and we feel like we have plenty to celebrate this year. We still have a few months to go before this process is over, but we finally feel like we’re over the hump. Thanks to CCRM’s amazing lab, we have five CCS normal embryos frozen in a lab in Colorado, and hopefully one or two of them will become our first child(ren) in 2011!

Our CCS Results Are Already In!!!

Wow, this has been one exciting day in my world, and one of the happiest days of my life. I awoke this morning with a terrible headache–like, the kind where it hurts even to move your eyeballs from side to side. At lunchtime, I realized AF had started, so I guess my headache was hormone-related. Since today is CD 1, I needed to set up the Depot Lupron stuff. I spent an hour coordinating shipment of the first injection, so I’ll be going to my local RE’s office to receive the injection on Sunday morning. Hot flashes, here I come! That was Exciting Development #1!

Then came Exciting Development #2. My wonderful CCRM nurse called to discuss faxing orders for the injection to my local RE’s office. She asked if I had received the CCS results yet, and I told her we were expecting to wait another week. As it turns out, the results were already available, and she was so excited to tell me!

5/6 embryos are chromosomally NORMAL!!!!!

Wow, I am still beaming 30 minutes later. Sixteen months ago, we were sitting in our local RE’s office, crying as we sat in an u/s room, listening to someone else’s baby’s heartbeat in the next room while we waited for the u/s that would confirm our chemical pregnancy. Fifteen months ago, the same RE advised us to consider a donor egg cycle because she felt I possessed no chromosomally normal eggs and it would be the fastest way “from point A to point B.” And today, here we sit, with these amazing results that FAR EXCEEDED our wildest expectations. 

We are SO thankful that we turned to CCRM for help. It was a pain in the butt to sit in limbo for over a year while we threw as much money into savings each paycheck as we could in order to cycle there. From our perspective, CCRM was worth every penny!

Embryo #1: Fertilized abnormally
Embryo #2: Made it to early blast stage, but wasn’t good enough quality to grade or biopsy
Embryo #3: Day 6 blast, Graded 6AB; very expanded and already hatching  ((ABNORMAL))
Embryo #4: Didn’t develop after fertilization
Embryo #5: Day 6 blast, Graded 6BA; looks very similar to Embryo #3  ((NORMAL))
Embryo #6: Didn’t develop after fertilization
Embryo #7: Fertilized abnormally
Embryo #8: Did not pass the cleavage stage
Embryo #9: Did not pass the cleavage stage
Embryo #10: Degenerate and poor quality
Embryo #11: Did not pass the cleavage stage
Embryo #12: Did not pass the cleavage stage
Embryo #13: Day 6 blast, Graded 6BA; expanded and hatching  ((NORMAL))
Embryo #14: Did not pass the cleavage stage
Embryo #15: Day 5 blast, Graded 5AA; hatching  ((NORMAL))
Embryo #16: Did not pass the cleavage stage
Embryo #17: Did not pass the cleavage stage
Embryo #18: Did not pass the cleavage stage
Embryo #19: Poor quality
Embryo #20: Day 6 blast, Graded 6AA  ((NORMAL))
Embryo #21: Day 6 blast, Graded 5BA  ((NORMAL))
Embryo #22: Did not pass the cleavage stage

Feedback from Fertility Lab Insider

Earlier this year, I found the blog Fertility Lab Insider. Carole Wegner, PhD writes blog entries covering some of the ins and outs of infertility and IVF labs. Having a great interest in all things medical, I feel like her posts have given me a porthole into what happens in an IVF laboratory. Check it out, if you haven’t already!

I’ve been curiously searching the Internet for information about embryos with a grading of “6” and have found very little. The CCRM embryologist told me that the designation means the embryos are very expanded and already hatched or hatching at the time of vitrification. I was so dazed by the results, I failed to ask her whether this is actually a good thing, or if hatching too early can have a detrimental effect on embryos. Mo left me a comment (very much appreciated), explaining that occasionally embryos with a grade of “6” don’t make it through the thaw, but otherwise I couldn’t find much info online. Searching for success stories didn’t lead me to many results. So I reached out to Carole and asked about her experience with blastocysts that have hatched in the lab. I posted her response below. I thought perhaps others searching for similar information in the future might find it helpful.

(Posted with Carole’s permission):

The “6s” designation is a new one for me (maybe CRRM specific scoring?) but if it means hatching blastocyst  on day 5, then the good news is that your embryos are progressive and not stalling out. Hatching is the process whereby the embryo shrugs off the zona pellucida like a coat it doesn’t need anymore. It must hatch in order to implant so hatching is a good thing.  To biopsy the embryo, an opening is made in the zona pellucida  to pull out the sample cell(s) and this opening can sometimes hasten hatching. (Making a hole in the zona was used before biopsy existed as a technique to “assist hatching’ of day 3 embryos.)

The shell is handy when they are being picked up in the catheter or other handling tools, but not absolutely necessary to their survival at this point.  It just means that they need extra special care in handling until they are placed in your uterus. (CRRM has some of the best, if not the best pregnancy rates in the country (as per CDC rates) so they have certainly encountered and had to handle hatched embryos before with success– that is also good news!)  We have had pregnancies from embryos that hatched in the lab before we could get them back to Mom so be happy at this point and don’t rule them out. I don’t have any statistics but it certainly wasn’t the end of the road if they hatched in the lab.

I know this waiting time is so hard but be cheered by all the hurdles your embryos have jumped over already- fertilization- early cleavage- biopsy- development to blastocyst and now hatching. They are on target so far.

Wishing you a positive beta and a healthy baby!!!

Carole

The Next Two-Week Waits

It’s been a few days since my last post… I think I’m kind of coming down from the “high” that came with traveling to Denver, stimming, retrieving all those eggs, and then waiting for the day 6 report. I still can’t quite believe that we ended up with such good results! Although we were very much hoping for at least five blasts to biopsy, we never dreamed that they would receive such high grading. Not bad for two people who were told 18 months ago locally that we should move on to a DE cycle! : ) There’s no doubt in my mind that the expertise of CCRM’s lab, as well as a carefully chosen protocol selected by Dr. Surrey, played a huge part in our success up to this point.

So now, we’re in two different two-week waits, the most significant of which is for the report that will indicate if any of our six blasts are chromosomally normal. A technique called “polymerase chain reaction” (PCR) is used by CCRM’s lab to determine how many copies of each chromosome is found for the embryo. This technique has been perfected by CCRM’s lab personnel during the past several years, but has only recently become their primary method for testing embryos. A “normal” embryo has two copies of each chromosome–one inherited from the mother, and one inherited from the father. When an embryo has more or less than two copies of a certain chromosome, then a miscarriage or serious illness may occur. If you choose to have your embryos undergo CCS testing, then CCRM only transfers chromosomally normal embryos, or embryos for which testing showed “no result” (meaning the testing was inconclusive but also did not indicate chromosomal abnormalities). If an embryo is reported as “no result,” the patient can have it retested or choose for or against transferring it. This information was all explained to us during our genetic consult.

Recently, the wait from the Day 6 report until the “normals” report had only been taking about two weeks. However, the embryologist let me know that the results may take a little longer currently because of the demand for this technology. I’m still counting down the days as if it’s a two-week wait, because once we hit the two-week mark, the news may arrive at any time. Eleven days to go!

I’m honestly much calmer with this wait than I was with our day 6 report. Perhaps I’ll become more nervous as the days pass, but psychologically, I felt the day 6 report was the biggest hurdle we would face during this process. I knew my body was capable of making lots of eggs, but I wasn’t sure we could make blasts, especially any of good quality. It is definitely possible that all six of our blasts could be chromosomally abnormal, but I finally feel the teeniest bit optimistic. And that feels pretty good!

The other two-week wait I’m going through currently is the wait for my lovely AF. I was told that I could expect her about two weeks after the egg retrieval. Once she does show up, I will have my first of two Depot Lupron injections at my local RE’s office. The second injection will be scheduled for 30 days after the first. This medicine will put my body into menopause for 60 days (read: hot flashes), and in the process it will work its magic on my uterine lining so that I will have the sticky proteins needed for implantation. Lack of these proteins (beta 3 integrins) is sometimes associated with moderate to severe endometriosis. So even though I didn’t have the endometrial biopsy to test for the sticky proteins due to a mix-up, Dr. Surrey decided to take a “better safe than sorry” approach because of my history and encouraged us to do the Depot Lupron treatment anyway. I don’t have insurance coverage for this medication, and it is expensive–$754.99 per injection. Yuck! But if it works, it will be worth it a million times over!

No AF yet, but that’s okay. I’m perfectly content to be free of injections, bleeding, and hormonal side effects for the time being! : )

I am a Believer (Day 6 Results)

I am so shocked and thrilled to be able to write that we have SIX biospied blasts for genetic testing. Five embryos were biopsied today, and one was biopsied yesterday. And, even better, they are all great quality! All of the doubts I had going into today were baseless, and I have no doubt that the amazing lab at CCRM made a huge difference for us.

Here is a brief explanation of how CCRM grades embryos. A more technical explanation can be found here. First the staff assigns a number from 1-6 to indicate the expansion of the embryo. A rating of “1” means the embryo is hardly expanded at all, and a rating of “6” means the embryo is very expanded and even hatching. Second, they assign an alphabetic letter grading the cells that will later become the baby. Third, they assign an alphabetic letter grading the cells that will later become the placenta. For both cell masses, the grades may range from A-C. The best rating is “A,” but there are plenty of success stories even with embryos graded “C.”

Out of the 22 eggs that were mature and ICSI’d on Day 1 (boldfaced are the biopsied blasts):

Embryo #1: Fertilized abnormally
Embryo #2: Made it to early blast stage, but wasn’t good enough quality to grade or biopsy
Embryo #3: Graded 6AB; very expanded and already hatching
Embryo #4: Didn’t develop after fertilization
Embryo #5: Graded 6BA; looks very similar to Embryo #3
Embryo #6: Didn’t develop after fertilization
Embryo #7: Fertilized abnormally
Embryo #8: Did not pass the cleavage stage
Embryo #9: Did not pass the cleavage stage
Embryo #10: Degenerate and poor quality
Embryo #11: Did not pass the cleavage stage
Embryo #12: Did not pass the cleavage stage
Embryo #13: Graded 6BA; expanded and hatching
Embryo #14: Did not pass the cleavage stage
Embryo #15: (This embryo was biopsied yesterday) Graded 5AA; hatching
Embryo #16: Did not pass the cleavage stage
Embryo #17: Did not pass the cleavage stage
Embryo #18: Did not pass the cleavage stage
Embryo #19: Poor quality
Embryo #20: Graded 6AA
Embryo #21: Graded 5BA
Embryo #22: Did not pass the cleavage stage

We are thrilled!!! To experienced IVFers: one of my friends wrote that a grade of “6” means that the shell is too thin. Do you have any idea whether this is true? The lab told me they are great quality, so I’m not worrying to much, but Dr. Google isn’t telling me anything. I might request one more call from embryology to set my mind at ease.

Not all of these embryos are going to be chromosomally normal. We are hoping for half, which would be three. The embryologist said it might take a little longer than two weeks. And now we wait again. But for now, we are still in this game, and the lab exceeded our expectations by a mile!

The Sun’ll Come Out Tomorrow

Less than 24 hours until Saturday, the day of our Day 6 report. I can’t remember the last time I was so nervous about anything. I feel sick to my stomach. I can only imagine how stressed I’m going to feel in a couple of weeks when our CCS results are in! My heart pounds just thinking about it!

I’ve been giving myself pep talks since Wednesday’s day-long freakout. Everything will be fine. It’s out of my control. We did the best we could. The embryos are in the best possible hands. We aren’t out of the game yet. Keep busy. Think positively. On and on, these thoughts race through my mind like white noise, and I use them to cover up the lingering doubts and worries that force their way through.

Tomorrow is the third hurdle in this race, and I just hope the results come relatively early in the day so I won’t look at my phone five million times. Every time my phone lit up yesterday to signal a call, my heart dropped into my stomach, morbidly thinking it was the lab calling to tell me that everything arrested. Unfortunately, I’ve done the same thing so far today, even despite the pep talks. Why can’t I just relax, have faith, and trust?!

My prayer is for at least five blasts to test, but based on my past history, I expect more like three or four (if even that many). Statistically, 50% of the blasts are abnormal, so I just pray for 2-3 normals. If not, I will honestly need a counselor of some type, because I don’t know how I will rebound from the devastation. I don’t even want to go there yet in my mind, but I can’t help it. I’m one of those people that has to have a plan for any possible outcome.

I am not that straight A student from school who insisted that he or she was going to flunk a math test, and then ended up with 102%. I know that we are fortunate to have youth on our side during this battle–we are only 28. I know that we were lucky to start with 19 embryos on Monday. I know that we were even luckier to still have 10 good-looking embryos on Wednesday. I know that we look great on paper, with awesome test results and plenty of follicles. But I do have reason for my fears. My former RE coldly informed me that I have zero chromosomally normal eggs. Even Dr. Surrey himself agreed that if blood flow to my ovaries was cut off during my laparotomy in 2007, my eggs may have sustained damaged, and no test can prove or disprove this. During IVF #1, we had 13 great-looking embryos until Day 4, when 11 died for seemingly no reason (which is what led our RE to her assumption). We actually baffled the embryologist, and he let me know that our embryos were severely fragmented and abnormal-looking for a couple our age. All of these reasons are why we turned to CCRM and their undeniably stellar lab, and all I can do is pray that they will make a difference for us, like they have for so many other women whose stories to which I have clung.

My brain is my worst enemy right now, and the only thing I can do is continue with the white noise and stay busy! I will update tomorrow when we get the news, good or bad. If you could spare a prayer or a positive thought for my DH and me (and my heart and blood pressure lol), I would very much appreciate it! : )

SIL Update

While we were in Denver, exploring the downtown area, my pregnant sister-in-law and brother-in-law were at a local OB’s office, finding out the gender of their baby. It’s a Girl. The family is overjoyed, but I simply cannot find it in my heart to feel that way. Being over the hump of our long delay and actively cycling made this news a little more bearable for me, but it’s still difficult. Will the pain ever dissipate?

12.5 weeks until her baby shower. I must find some better coping ability before then so I don’t burst into tears or something!

Day 3 Report

The embryology lab at CCRM typically doesn’t call with a Day 3 report (at least for patients adding CCS to their protocol), but I decided to call this morning and ask if it was possible to receive an update today. I was fretting about fragmentation since this seemed to be the biggest problem with our embryos last year. The receptionist sent a message to the embryology lab, asking them to call me when possible.

About an hour later, I received the call. Out of the 19 embryos currently in culture, 10 are looking good. All 10 have a rating of at least 3 (on a scale of 1-4 with 4 being the best), have at least six cells, and have little to no fragmentation. Four of the remaining nine embryos are a little slower and could possibly still catch up, and the other five are not likely to make it. Four of the 10 good-looking embryos currently have a rating of 4-, which is really good. Still, this report is a little below average for their lab, based on our age.

The embryologist said that typically, half of the good-looking embryos on Day 3 make it to blast and are able to be biopsied. Because of our youth, it’s possible we could see slightly better results. So maybe five or so will be biopsied. Worst-case scenario, they could all arrest, or a few could make it and then be abnormal. I guess for whatever reason, even though I can make lots of eggs, they just don’t fare well, even in the world’s best embryology lab. It’s pretty disheartening.

I’m glad I got the report, but I definitely wish the news would have been better. I know that ten is still good, but now I find myself pretty afraid of what Saturday’s phone call will bring due to last year’s huge dropoff on Day 4. Please let us just have five to test. Two to three chromosomally normal embryos is all we can ask for.

Egg Retrieval Experience

While preparing to cycle at CCRM, I read plenty of blogs that described the professionalism of the surgical staff. As a result, I went in there with high expectations, and I was not disappointed! Although no surgery is fun, I was impressed with how smoothly everything went and how professional the staff was. In the following account, you’ll see that it’s the little things they do that make this experience so much better.

The day before the egg retrieval, I received a call from the anesthesiologist. He asked if we had any questions and reminded me not to eat or drink anything after midnight. I’ve had a lot of surgeries, and I’ve never received a call from the anesthesiologist before. It’s the little things, you see!

We had instructions to arrive at CCRM at 8:45 a.m., exactly one hour before the scheduled procedure. The nurse instructed us to park in the garage located underneath the clinic. We pulled up to a little black box, talked to a receptionist, and the garage door opened. Our car was the only one in the garage at that time. Just inside the entrance, there was an elevator. We pressed 2 and were whisked right up the second level, arriving in the lobby of the surgical area. The staff had already been notified of our arrival.

The hubby got to sit with me the whole time before surgery. A nurse (Terri) showed me to a room and gave me blankets that had obviously just come out of the dryer. Again, it’s the little things! I changed into a gown and those dumb blue booties and hat, and rested in the bed underneath the warm blankets. Terri came back in the room with a hot towel that she wrapped around my hand and forearm. Then she injected me with numbing medicine before starting my IV. I honestly didn’t feel anything, but she said the IV is the worst part of the process for most people.

Once the IV was in, I was ready for surgery. The hubby and I joked nervously until about 9:30, when Dr. Minjarez came in to introduce herself. She is SO nice! Our friends in real life have spoken very highly of her, and she seemed to recognize their names when we told her. After she left, we felt very at ease with what was to come.

At exactly 9:45, the anesthesiologist came in and quickly administered the “happy cocktail” that relaxed me as I was wheeled to the operating room. My DH took a seat back in the lobby of the surgical area, and provided his “contribution” in an upstairs andrology area while I was put under. The egg retrieval lasted only about 20 minutes, and then I was wheeled to the recovery room.

When I awoke, a neat contraption was blowing warm air on me underneath my blankets. Again, it’s the little things! (I desperately want one of those things for my own personal use!) Before I even knew it, Terri had ushered my DH to my bedside as I gradually became less groggy. I was in a little pain, so I was given some medicine through my IV. For some reason, I had a terribly upset stomach, but a little more pain medicine helped with that. The hubby helped me to get dressed and sit in a chair next to the bed. When I got out of bed, there was a huge mess left behind that I was initially horrified might be blood, but it was actually Betadine! Terri gave me a plate of crackers and my choice of beverage (water), and I rested in the chair and ate a few crackers while I became more alert.

After a little bit, a woman from embryology arrived to tell us how many eggs were retrieved. She also talked to us about what to expect the rest of the week–the fertilization call would come the next day, and then we wouldn’t hear anything else until Day 6. At that point, they’ll let us know how many blasts were biopsied for CCS testing.

When I was ready, Terri removed the IV, and I was free to get up. Before we left, I had to use the restroom. Ouch, did that burn!!! By the end of the day, though, the burning sensation had gone away. A little spotting is normal, and I only experienced it for one day. Terri took me in a wheelchair in the elevator to the garage and dropped me off right at the passenger door.

CCRM’s policy is that you should recuperate in Denver for 24 hours before traveling home, but we left Denver immediately. I wouldn’t necessarily advise this if you’re driving, since bumps in the road didn’t feel great, but I was ready to get home. They just want you to be near the clinic if there are complications, so they recommend staying one more night in Denver. I took Tylenol for pain the day of surgery, and I’ve felt a little better every day since then.

Keep the Good News Coming (Fert Report)

Dr. John (CCRM embryologist) called this morning. Out of the 24 eggs retrieved yesterday, 22 were mature, and 19 fertilized with ICSI. That’s an 86% fertilization rate, which is a little above average for their lab. We are happy!!!!!!! This feels like the second hurdle cleared.

However, for us, the most critical hurdle is yet to come. Last year we had a great number of eggs retrieved (16), a great number of mature follicles (14), and a pretty good number of embryos (13) initially thanks to a great fertilization rate (93%). We were very optimistic that we would have not only two awesome blasts to transfer, but also a few to freeze. Then on Day 4, something terrible happened in the local lab, and all but two embryos arrested. By Day 5, we had only one okay-looking blast and one okay-looking morula remaining. And the result was a biochemical pregnancy. Our local RE determined that I possess no chromosomally normal eggs. The embryologist was totally befuddled and didn’t have any suggestions. So without any obvious ideas to improve our odds for the next attempt, we instead went to the Big Guns. Now is the time when CCRM’s lab will hopefully show us what they’re made of! They obviously can’t make blasts out of crappy eggs, but our hope is that this slower protocol and more reputable lab will make all the difference for us. If not, we agree that we’ve done everything we can.

The embryologist from yesterday said that we’ll probably hear the next report on Saturday, which would be Day 6. At that time, they’ll let us know how many embryos were biopsied for CCS testing. The genetic counselor told us that statistically, half of the embryos that fertilize in the lab become blasts, and half of those blasts test “normal.” If our embryos follow suit, we may have 4-5 normals left at the end of this. If I really do have terrible egg quality, then we may only have a couple. Our hope is that we have at least 2-3 normal embryos at the end of this process. Anything less would be terribly disappointing, and anything more will leave us totally ecstatic. This is going to be a long week!

Today I’m feeling sore, like I did a million sit-ups yesterday. We’re working on unpacking, doing loads of laundry, grocery shopping, giving our dogs some attention, and putting our house back in order. We just traveled to the airport to pick up my car after a six-day stay in the parking lot. Tomorrow I’ll recap yesterday’s retrieval for those of you who haven’t gone through an ER at CCRM yet. And as the week progresses, I’ll post some pictures from sighteseeing during our last few days in Denver!

Home and Happy With the Day’s Events

Wow, what a long day it was, but we are back in the Land of Oz. Two little terriers were very happy to see us when we walked through the door, and we are overwhelmingly glad to be home. Twenty-four eggs are currently being watched in a lab, the results of today’s egg retrieval. Dr. Minjarez was awesome. We are obviously thrilled with the number, but we’re still feeling cautious while waiting for tomorrow’s fertilization report. For now, today’s results feel like the first hurdle cleared.

More tomorrow! I am pooped, sore, and my attention is being demanded by our hyperactive four-legged friends. Thank you all for thinking of me and checking on me today!

The Day Before “The Day”

We went to CCRM this morning for one last blood draw. The phlebotomist had to stick me twice, because my veins are getting tired. They are testing my HCG level (to make sure the trigger shot absorbed correctly), progesterone, and estradiol. Assuming I receive a call today from the nurse, I don’t plan to ask about my estradiol level. I feel a little anxious about the 4010 level yesterday (although I’ll feel okay about it if a decent number of mature eggs are retrieved tomorrow). I’m feeling considerable pressure in my ovarian region, even more so than yesterday. It doesn’t hurt or anything, but just feels uncomfortable.

Dr. Minjarez will be performing the egg retrieval. I haven’t met her yet, but she was my IRL friend’s doctor, and is a wonderful doctor by all accounts. Even though CCRM’s policy is that we should stay in Denver for one day after retrieval, we are leaving for home right after the retrieval. We probably won’t arrive at our house until 10pm or so, but I will make sure to post about the day’s results after we get home. Thank you so much for checking this blog and supporting us along this journey! It has truly made us feel less alone during this process.

We’re off to Rocky Mountain National Park. Stay tuned for pictures of the past few days–time is getting away from me a bit!

The 10:45 Trigger Shot

We got the call about an hour ago… we’re triggering tonight at 10:45 p.m. Interestingly, Dr. Surrey only wants me to inject part of the HCG injection instead of the whole 10,000 units. (I found out later that this decision was based on the fact that my estradiol level was pretty high, and Dr. Surrey was worried about hyperstimulation. Just FYI.) My egg retrieval is scheduled for 9:45 a.m. on Sunday morning. I shouldn’t have, but I asked for my estradiol level today. It is 4010. O-m-g, that seems kinda high to me. That is quite a bit higher than my level last year; however, the difference is that 1) it seems that more eggs are brewing, and 2) Dr. Surrey has kept me on a relatively low dose of stims so that the level has increased slow and steady. Hopefully these two factors will make a huge difference in terms of egg quality. Now I wish I wouldn’t have asked for today’s estradiol level!

We went to the Outlets at Castle Rock today and bought some neat stuff–a wok at the Calphalon store, a dutch oven at a different kitchen store, a new Fossil watch for me at the Fossil outlet, some new Adidas socks for dogwalking, and a few other things. Then we walked around Manitou Springs at the base of Pike’s Peak, which is something we did in April during our ODWU stay. We also walked around the Garden of the Gods and took a bunch of pictures. I am pooped, so pictures will have to wait! We’re going to our favorite Denver Thai food restaurant tonight, A Taste of Thailand. It is a hole-in-the-wall across from the Swedish Medical Center, but it’s soooo good!

Tomorrow I have to go back to CCRM for bloodwork, and then we’re heading to Rocky Mountain National Park for the day. It’s going to be yet another gorgeous day, so I”m sure it will be absolutely beautiful there. It’s our last real day in Denver (at least until we return in January for the transfer), so we plan to really enjoy it!

Possible Trigger Tonight!

It looks like we may end up triggering tonight instead of tomorrow as scheduled! I didn’t get the measurements of all of the follicles, but my nurse told me they expect to retrieve 21-25 eggs. She said on average, 75% of the retrieved eggs are mature. We’ll see if these statistics hold true for us!

We’ll get the official instructions later. I injected one vial of Menopur today, but the nurse thinks I’ll skip Follistim tonight. I will update when we get home from a full day of sightseeing!

The Fountain and Downtown Denver

Today I’m heading back to CCRM for another ultrasound, blood draw, and our IVF cycle review.

(This is the famous fountain in the lobby at CCRM.)

Yesterday we had a fun day. After spending our morning at CCRM, we ate a quick lunch and then headed downtown. We had reservations to tour the Denver Mint. They are VERY strict about security there, and I wasn’t able to take in my camera, so I have no pictures. Darn! It was neat though. The Denver Mint only makes coins, and the tour includes an overhead view of three of the rooms where coins are stamped.

Afterwards, we drove by the Capitol building…

And headed to our dessert destination, d Bar Desserts. We love The Food Network (this restaurant is owned by Keegan Gerhard, a judge from Food Network Challenge, and his wife), and I’m a chocolaholic, so we had to make time in our schedule for their “Cake and Shake.”

Yep, it was amazing if you like chocolate. The space itself is small, but the interior is very pretty and modern…

We LOVED this mid-day dessert rendezvous. We normally don’t even eat dessert at restaurants, so this was a rare treat. The cake was SO rich, we each brought at least half of the slice home. You can choose between a chocolate or vanilla shake or malt. Yum!

Last night we took Cassie’s suggestion and went to 3 Margaritas for dinner. We went to the Littleton location on County Line Road, and we really enjoyed both the food and the 5-mile drive west toward the mountains. It was a day of great food!!!

Today after we finish up at CCRM, we’re heading back to the Garden of the Gods and Manitou Springs. We went to both places when we were in Denver for our ODWU in April, and we loved it. I will be sure to take plenty of pictures of both to share. We’re also planning to explore the Outlets at Castle Rock, which is something we haven’t done before. The weather here has been beautiful, so it should be a nice day!