Tuesday, August 30, 2022

IVF Cycle 5 (Catching Up Installment 3 of 3)

So much time has passed since my last update that I had to go back and read my last post to know where I left off and what I said. I left off at the egg retrieval on June 21, where we retrieved four eggs. Writing this all now seems a bit anti-climatic compared to building up through blog posts with each update, but I'll try to keep it interesting.

Early on June 22, the morning after the egg retrieval, the embryologist called to let us know that all four of our retrieved eggs were mature and had fertilized. This was, of course, the best possible scenario, so we were thrilled to get the update. They reminded us that our next update would be after day 6 (June 27), so I expected an update on the morning of June 28. 

On the afternoon of June 27, the embryologist called with an update. Fortunately, I did not have time to remember that the call was coming early; otherwise, I might have started spiraling and assuming everything stopped growing. Instead, she had a very happy update: three of our embryos were graded highly and had been biopsied and frozen. The fourth embryo had arrested (stopped growing), so three was the final update. I try not to put too much weight on embryo grades, but it was nice to hear the good news.

The next stage was to wait for the genetic testing results to come back.  The wait on this part is between one and two weeks, so I was not exactly sure when we would have news. As a refresher, the rule of thumb is that less than half of embryos sent for testing come back normal. In the three cycles where we froze and tested embryos, we'd gone 0/1, 2/3, and 0/1, for an overall of 2/5.

It turns out the correct answer was July 6. My RE's assistant called to let us know that all three embryos tested normal. My response?

"Holy shit."

Then I quickly regrouped and tried to be professional.

"Well that was really unlikely, but it was definitely what we hoped for." 

In the meantime, I had started my next menstrual cycle, so I had already called my RE's office to initiate a transfer cycle. We scheduled the transfer for August 18. As with other IVF things, the first step was to take birth control pills. We later added Lupron shots, and sometime after that, Richard got COVID, and I got COVID five days after that (despite my best effort). Fortunately, the COVID situation only set us back five days instead of requiring us to cancel the cycle. I stayed on the Lupron for five extra days. Next, we added estrogen patches and tablets, stopped the Lupron, and added PIO. Thankfully, our nurse gave us a printed schedule that made it easier to track everything. 

We transferred the embryo last Tuesday (August 23). Our RE said the embryo looked great, and he was excited about the expansion. I did a bogus job preparing my bladder for the transfer. This was a rookie mistake; I should have started drinking sooner. I ended up with a full belly and mostly empty bladder, but fortunately, it wasn't so empty that they had to backfill my bladder. I do not fully understand what backfilling a bladder entails, and I don't think I want to know. What I do know is that I am glad that didn't have to happen. Here's our hopeful future child!

After the excitement of the FET, Richard took me to McDonald's, then I took the rest of the day off work to relax (read: nap) and stay cozy. Rumor has it that embryos like a cozy environment, and since this one is genetically related to me, there could be nothing better than a day of McDonald's, naps, and warm blankets. I took the next few days completely off of exercising but started power walking (30 minutes) on Friday. I'm ready to run, but I'm more ready to have a healthy pregnancy, so I'm holding off. 

Our first beta (blood draw) is Friday morning, and we are hopeful for better news than ever before. The third time is the charm, as they say (though that was wrong for our third retrieval cycle, so who truly knows?)

Something that made today great: One of my dissertation participants e-mailed me to let me know he read my dissertation and was impressed! 

Time I woke up: 8:45 am

Tuesday, August 9, 2022

IVF Cycle 5 (Catching Up Installment 2 of 3)

 I was surprised to check my blog and see that my last post was just over a month ago. More than ever, the weeks are flying by. I feel like I have not caught my breath in months...whew.

I left off at the end of May, which was when we heard back from the ERA that I was prereceptive and needed additional progesterone before transferring a frozen embryo. Since we used one of our euploid embryos in the October 2021 FET, we were left with one euploid embryo in the freezer, so we wanted to go for another egg retrieval first. Despite our luck thus far, we still hope for multiple children. Also, it might take more than one to achieve even one live birth. 

Since we'd been in the IVF game for a while, we had to redo a bunch of paperwork and consent forms, which felt weird and like pouring salt in the wounds, but we did not have to rewatch the videos about how IVF works. The cycle began with birth control, as all of the others have thus far. I started the stim shots on June 8, and our protocol was a little different this time. In the past, we did Lupron (10 units) and Follistim (250) in the morning and Lupron (10 units), Follistim (125), and Menopur (150) in the evening. For this cycle, we dropped Lupron entirely and did Follistim (300) and Menopur (150) in the evening for the shots. In addition, I took 100 mg of Clomid and 10 mg of Provera in pill form.

Our monitoring appointments went like this:

  • June 13 (Day 6 of stims): 2 follicles - 11 mm on the left; 12 mm on the right
  • June 15 (Day 8 of stims): 4 follicles - 14 mm, 10 mm, and 10mm on the left; 17 mm on the right
  • June 17 (Day 10 of stims): 5 follicles - 16 mm, 17 mm, and 18 mm on the left; 12 mm and 20 mm on the right
The June 17 monitoring appointment was a tough one. My clinic closes at noon on Friday, so Friday mornings have usually been hectic when we go. A typical appointment involves bloodwork, an ultrasound, and chatting with the nurse. We waited for what felt like a while after my ultrasound, then our RE called us in. (Remember, it's usually not a good thing when the doctor talks to us instead of the nurse.) Based solely on the last year and three months, we knew our number of follicles was not stellar, but there was not much we can do about that except continue to try. 

Our RE was probably the second saddest we'd ever seen him (second only to when he saw the empty sac on the ultrasound on January 10) and said we were looking at retrieving three or four follicles. Timing the trigger shot properly would be critical to maximizing the retrieval results; he used the metaphor of threading a needle, which sounds pretty precise. I do not remember his exact words that followed in this conversation, but I'm pretty sure he said something about being stubborn and grabbing the bull by the horns...which is a pretty accurate description of my decision-making when it comes to [in]fertility. (Richard tends to use the "roll the dice" metaphor when talking about taking chances with IVF.) I think our RE also tossed out the word "recalcitrant" too, but I'm less certain about how closely I fit that one. Once he had a chance to review my bloodwork, we would decide how many more days I would continue the stims and when we would do the trigger shot.

I asked our RE if we would try again if this retrieval didn't go well, and he had a discouraged look on his face but gave me a semi-vague answer about reviewing all of the information and having a conversation about how to move forward. In my last post, I mentioned feeling like one of those inflatable clowns getting punched in the face, but this conversation left me feeling like I'd been punctured. Totally deflated.

Richard and I probably went to Whataburger on the way home from the appointment. When the nurse called later, she instructed us to continue the stim shots through the weekend and do the trigger shot on Sunday night for retrieval on Tuesday morning.

We spent the weekend in Ruston for Father's Day/my birthday (and had to come back to Baton Rouge a little early on Sunday night because I didn't bring enough Menopur...), but we finished the stims and trigger shots as planned. I went into the retrieval feeling halfway "well, hopefully this will work out" and halfway "well, this is probably going to suck." I said yes to a little extra medication to take the edge off. Then when our RE came to check on us, I even asked him if he was going to break up with us. He seemed a little surprised by the question and initially dodged the question by asking why I was asking. I told him he looked sad at our appointment on Friday, and he said he wasn't going to break up with us, but I might put him in an early grave. Fair enough; I sometimes wonder if all of this is taking years off of my life too.

Shortly after confirming that we weren't about to get doctor dumped, they rolled me back for the retrieval. We succeeded at threading the needle; our RE was able to retrieve four eggs. We were happy with that since it was the bigger end of the range our RE gave us.

Hopefully it won't take me a month to write the next update...but that will be the final installment including next steps. Ahh!

Something that made today great: I cleaned out my office at LSU!