Let's Play a Game...

I've been a downer lately - chalk it up to the looooooong wait for microarray results and the crashing hormones after ER with no ET. Today is 16 days post biopsy so another 4 weeks to go. Ugh.

Anyway, I thought it would be fun to play a little game, totally made up and thought up in my mind and probably a reflection of how unstable I feel these days. So if the rules don't make sense, put it down to the hormones okay?

So here's the game. When I am cycling or trying to get pregnant the old fashioned way (by doing the BD ladies...yes, rumour has it that some people actually do get pregnant by doing the BD), I get all superstitious. If someone helps me along the way, I am so grateful that I often think to myself "I'm going to name my kid after you"! Last cycle, before I left for Denver, I actually qualified for local radio contest to win a trip for 2 for Breakfast in Barbados. You know, the contests where they qualify the first 5 callers starting with the 25th caller for the draw the next morning...I was caller 30 so I finally qualified after years and years of trying (hmmm...years and years of trying...why does that sound familiar??). Anyway, I didn't win the trip, but the act of actually qualifying for the draw was so exciting and I thought to myself, "I'm going to name my kid after you [the radio DJ] because this is an indication of more good things to come right?!".

As I have said before, I am so grateful for all of the wonderful people I have met in Blogland and for the outlet this gives me to express all of my emotions. In honour of my gratitude, let's all pretend that we're going to name our kids with the help of the blogger "word verification" (the sometimes real, sometimes made up nonsensical letters they randomly put together to fool the spam software out there) that needs to be typed in before you can submit a comment :).

You get 3 tries to get a word you like and then you have to answer the following questions:

1. What did blogger name your kid?
2. Is it a boy's or girl's name?
3. What does it mean (make it up if you have to - extra points for being creative!! extra extra points if you can tie it back to IF and TTC!!) and how do you say it (make this up too if it's a funny looking word!)?

Good luck to you all and I hope Blogger word verification is kind to all of us!

***********************************

I posted on someone else's blog this AM and I'm going to use that verification word as an example:
1. What did blogger name your kid? CYLOWNH
2. Is it a boy's or girl's name? Girl
3. What does it mean and how do you say it? It's pronounced with a soft "c" at the beginning so it sounds like the "s" in the word "soft". SIGH-LONE. It means "force to be reckoned with" as its origins are from the word "cyclone"!

Possible Combinations

It has been 15 days since the biopsy.

Two weeks and one day.

At least four more weeks to go. [Insert loud scream here]

I was okay at first, keeping myself busy settling back into life at home and getting us back into our daily routine but I found myself very emotional this past weekend and I wonder if it's because I know at the back of my mind that I'm anxious about what results we may get.

I've considered all of the possibilities too.

Possibility #1: two normals! Yippeee!! Yay!! Awesome! This is the best outcome we could hope for and in this case, we would transfer back both and take our 85% chance of success. This one was the no brainer.

Possibility #2: two abnormals. Boo hissy boo. This would be the worst outcome and I will be pretty devestated if this is what comes back to us. I don't know what we would do if this was the case. We could try to scrape together the $$ for another cycle but then that would mean living our lives on hold for even longer since we would be in the cycling holding pattern.

Possiblity #3: one normal, one no result. This is still pretty good too IMO. We would know we have at least one normal so that's a 65% chance which is much higher than the 25% chance Dr. Sch initially gave us. Who knows with the no result embryo too...could be fine too so this option is pretty good too.

Possibility #4: two no results. Talk about a shades of grey option but the possibility exists that this may happen so I've been chewing on this one. My DH and I have talked about doing another banking cycle in the hope of getting one normal in the bunch if something like this happens. But then again, we need some more $$ to do this choice and this puts us back into a cycling holding pattern.

I've also been trying to decide whether to take on a short term contract to earn some $$ to pay for another cycle just in case we want to do this or whether to just hang in until we get the results. I have my name out there with two head hunters but with the economy the way that it is, I've heard nasty rumours that most job postings are fake so they can still get the candidates to come in but then they don't really have any real jobs. I figure if something works out than great but if it doesn't, maybe I should sit it out until I hear back about the test results. See how we've come full circle? Everything comes back to waiting for the test results.

Four more weeks to go...

Forgiveness

First of all, I wanted to thank all of you who shared your own experiences with me in my last post about talking to people IRL about IF and why I shouldn't feel as though I have to justify why I am at home. By the number and length of all of your responses, it seems that I did hit a nerve and from a purely selfish point of view, it made me feel a lot better...not that you've all suffered the same kind of pointless and hurtful things in your life...it's the knowledge that I am not alone in what I struggle with. It's always nice to have people who understand you and get it so thanks everyone for taking the time to respond with so many heartfelt posts.

Secondly, I am still catching up on things I was remiss in doing while I was away in Denver. I wanted to metion and give a shout out to Mamasoon, who I had the great pleasure of meeting in Denver just before my ER. We met at Park Meadows Mall and just sat and talked for a few hours. It was so nice to meet up with another CCRM IVFer and I so admired her strength and determination, even though her cycle was not going as she had hoped. Hugs girl - I'm thinking about you.

Thirdly, Momsoon nominated me for the Sisterhood award which was so cool and I haven't yet thanked her for it. Since I'm weeks behind with this one and I saw it go around the blogs already, if you haven't already been nominated, consider yourself nominated by me. Thank you Momsoon for the nomination - I am truly honoured and touched.

Now onto the subject of today's post - forgiveness. I found myself thinking about this more since my last post and thinking that I had to find a way to forgive others and, more importantly, I needed to find a way to forgive myself. But what does the actual act of forgiveness really mean? When you say that you have forgiven someone, does it mean that you no longer feel any anger or hurt that was caused by their actions? But then how do you stop feeling that anger or hurt that is now associated with that person/action? Are your emotions somehow turned off? Is forgiveness a mindset, a change in your thought processes?

Let's take an example. I have been trying to forgive my sister for her insensitivity that she has continually shown to us throughout our struggles. At first, I did tell her what was going on...I was brutally honest about how it was to suffer through all the testing, even describing to her how awful it was to do a medicated IUI cycle (early morning doctors appointments, dildo cams, daily blood work, etc. etc. We hadn't yet made it to IVF). We also talked at length about the emotional side of IF and how it made me feel, how isolating it is and how depressed I was about it. She nodded, said that she understood, but then when it came time for her to announce her own news, she suffered instant amnesia and told us (IMHO) in the worst and most hurtful way possible. What bothers me too is that she outright lied to me about starting to try to have a family. I agree that it is nobody's business when you start to try and have a family, but if you're going to ask me that question and expect an honest answer, than that means that the same question is fair game for you then. Needless to say, a few short months later after she lied to me, our faces screamed our shock when she handed us a photo frame with the words "insert a photo of your new niece/nephew here on [date]" in it at a family dinner a few short months later. We were completely unprepared. We went numb. Since then, I have completely been unable to open up to her about anything that has been going on and it is a subject that I refuse to talk about with her.

Back to forgiveness - how do I forgive her? I want to...I have tried to...but I find that the old wounds open up every time we scurry around the topics of pregnancy & babies. I tell myself that she wouldn't deliberately hurt me and that she didn't know how insensitive she was being. I remind myself that she is only expressing her own excitement and wouldn't I be excited too if I had news like that? All of these reasons seem logical & rational and it is very much in my head...but my heart continues to hurt. Does the act of forgiveness mean then that your head tells your heart logical and rational reasons why the hurt was not deliberate and then does your head keep reminding the heart until the heart listens?

Yes, I could always confront those that have hurt me but I can only control my actions and my response and forgivness is something I have chosen to do. It doesn't matter whether they think they are right or wrong...if I have decided that I want to forgive, it is something I need to do, not anyone else. However, what bothers me is that there is usually not a lot of remorse or acknowledgement that any hurt has been caused and there are a lot of repeat offenders out there. That tells me that they just don't get it and often, it tells me that they just don't care to get it. I've discovered a lot about who my real friends are and who are the acquaintances in my life. Does this suggest though, that the act of forgiveness involves the other person who caused the hurt to show remorse? But then is that still forgiving or has that morphed into forgetting? Does the act of forgiving inherently involve forgetting as well?

Lots of questions. No easy answers.

Than there is the issue of how to forgive myself. There is not a day that goes by when I don't feel a lot of shame and embarassment (especially when I get asked "what do you do all day at home??") that my body is not able to do the one most basic thing that nature intended. All the parts seem to be there...but they're not working right and they're not working together. Can you imagine if Eve (of the biblical Adam and Eve) wasn't able to have children? If I were Eve, and the future of mankind rested on my ability to reproduce, we would all be in BIG trouble. The Bible would have been a very short book indeed. But I am not Eve and it seems that, however reluctantly, I am walking down the road of IF and I am struggling to find the forgiveness I need to give to myself. How do I forgive myself for failing at one of the most important things in my life?

It's an easy thing to say "I forgive myself" or "I forgive you" but in practice, it is a hard thing to do. I generally do not hold grudges and I think I am a pretty forgiving person but IF has made it so much harder to be that person. So in the meantime my head continues to remind my heart and maybe, one day, my heart will listen again.

Nothing To Show For It

Today I'm down. Pull up a chair if you want - Crazy is about to start her rant...

Yesterday I had lunch with an old coworker of mine. For those of you just joining me, I haven't work since November 2007 when I quit my job so I could focus on pursuing treatment full time. It is now March 2009 and I have nothing to show for it...at least not externally and nothing I certainly care to talk about with most people IRL. When I gave my notice, everyone was asking me why I was going and my answers were along the lines of:

"I've been working too many hours and this has been seriously affecting my marriage [which it was] so I'm going to take some time off and maybe look for something in the new year" or I'm thinking about making a career change and maybe going back to school".

In my head, I was secretly thinking about all of the doctors appointments I needed to schedule, trying to get into a new clinic without too much of a delay, copies of medical files I needed to get, looking for a new acupuncturist that I'm not afraid of, trying to find a way to get to all of these appointments. You get the picture. I was doing anything but sitting at home, eating bon bons and picking my nose. Of course, none of this truth crossed my lips. I just quietly resigned and went on my merry way. I'm sure some people suspected the real reason why I was quitting but I never confirmed anything - it's no one else's business and I don't care to air out my personal laundry for the company to gossip about.

Fast forward to yesterday - after lunch I ran into two other co-workers of mine and they were asking me with genuine curiosity about what I've been doing since I left the company...to which I don't really have a good answer for. And it's not only them - the longer I go since leaving my job, the more everyone wonders about what it is that I do every day. My sister asks me constantly what I do during the day as does my Mom, my in laws, my friends who don't know what's been going on. Even my parents' friends ask me when I run into them. I am tired of having to justify why I'm at home right now, as if I don't have a right to be here without a brood of children under foot. Believe me, I would rather be chasing after a small child than spending my time chasing doctors and appointments all over the continent.
I also hate the "quick check" - you know what I mean. The quick glance down to your belly area to see if you're showing. Maybe I'm super sensitive but I catch EVERYONE doing it, usually right after they ask me what I've been doing or have been up to these days. God help me on the days that I have a little muffin top going on above my jeans.

I said above that we have nothing to show externally for the past 6 years we've been trying to start our family but man, the scars that run inside run pretty deep. Some days my scars feel as wide and as deep as the Grand Canyon and I wonder how I will ever feel whole again. My fellow blogger DAVs talked about having invisible children in her post and that made so much sense to me, for our invisible children cannot be seen by those around me that continually ask me what I do during the day. If they could see them, they would certainly stop asking me wouldn't they? Another fellow blogger, Kris, talked about at what point does life begin and how disregarding all of the eggs retreived and fertilized along with any chemical pregnancies or m/c would be the same as disregarding everything we go through as couples experiencing IF. She's so right.

What frustrates me as well is the need that I feel to justify our decisions to everyone else. Maybe I'm ashamed that I've had the luxury of being at home without a small child to care for that makes it acceptable in society's eyes not to work outside of the home.

It has crossed my mind to just tell everyone the truth about what it is that we have been going through...but I can't bear the thought of the pity that would accompany such an admission. My past experiences have also not been good with coming clean and some of the greatest hurts have been inflicted by those around me that I've dared to share our plight with. I've even been dumped or frozen out from some groups - like from the first group of former friends that I told about our IF. The lunch where I told them was the last lunch we ever shared together...in fact, I never heard from any of them ever again. They all went on to have children and never called me again. Didn't they know that my admission was a plea for support? Instead, all I got was the stone cold wall of silence in exchange for baring my soul. If it was hard for them to hear about it, couldn't they imagine how hard it was to live? It's MY life you know...they only had to listen about it for a short hour or two and yet that proved too uncomfortable.

Better to know now is what I've told myself. You don't need "friends" like that. You don't need to suffer more hurts like that. So instead, I keep this all to myself and just answer probing queries about what it is that I do every day at home with vague replies like "I'm studying" or "I'm going back to school soon". Call me crazy, but it seems easier that way. What have your experiences been like with telling other people about your IF? Have you been pleasantly/unpleasantly surprised by the responses of others?

Day 6 Fertilization Report

We just heard from the lab and the news isn't great but we're not out of the running yet. I just wish we were dealing with larger numbers since we were doing such a good job of defying the odds - I had hoped that trend would continue.

We're down to two blasts that are pretty good quality and two that are really poor quality. Normally, they wouldn't have even biopsied the two poor quality blasts but they only did so at our request. The embryologist said that they haven't seen the poor quality ones turning into babies and that they usually don't freeze or thaw well. However, we still wanted them biopsied and again, you must be your own advocate as I have told everyone and anyone over and over again that no matter what, we want everything and anything biopsied, arrested or not. We just want answers and I want as much information that I can lay my hands on because this is it for us.

Of the three early blasts from yesterday, one was graded a 5BB and the other one was graded 2/3. To understand what this means, I am quoting from Linda's Day 5 post from November since she explained it so well:

"The blast development status (expansion - hatching stage) is indicated by the number in the front. The number ranges from 1 to 6, with 1 being the lowest and 6 being the highest quality.

1 = Blastocoel cavity less than half the volume of the embryo.
2 = Blastocoel cavity greater than than half the volume of the embryo.
3 = Full blast, cavity completely filling the embryo.
4 = Expanded blast, cavity larger than the embryo with thinning of the shell.
5 = Hatching out of the shell.
6 = Hatched out of the shell.

The first letter is the grade of the inner cell mass (the cells that will become the fetus). The letters range from A to C, with A being the highest and C being the lowest quality.

A = Many cells, tightly packed.
B = Several cells, loosely grouped.
C = Very few cells.

The second letter is the grade of the trophectoderm (future placenta cells). Again, the letters range from A to C, highest to lowest quality.

A = Many cells, forming a cohesive layer.
B = Few cells, forming a loose epithelium.
C = Very few large cells. "

Thank you Linda!

Really, you're looking for embryos that are graded 5AA so a 5BB is a pretty good quality embryo but not the best. The one graded 2/3 is the earliest blastocyst stage and they can't grade the inner cell mass or the trophectoderm cells (hence no letters after that grade) at this point. They biopsied it anyway because they felt that if they waited any longer, it may have hatched out of its shell. They don't like to perform biopsies on hatched embryos but she did say that the cells of the 2/3 looked good and healthy so we're hoping that this one will be okay.

Of the three early blasts from yesterday, two are the ones I just talked about and the third one has turned into a poor blast. The grade she gave it was a 4CB...ouch. The final blast biopsied was one of the morulas from yesterday and I believe that the grade given to that one was a 2/3 again but she said that this one didn't look very good. Everything else has arrested but she said that they would continue to culture them for one more day just in case the improbable happened but that it was unlikely that anything else would come along at this point.

In total, 4 blasts were biopsied, two being pretty good quality and two being very poor quality. I always knew that the attrition rates were high and we went from 8 fertilized in total down to 2 real contenders but it is pretty stark when you look at it. My mind is telling me that we only need one and if the probabilities hold true, one of the two of those will be normal so there is our singleton...but my heart is demanding retribution for the long, long road we have travelled to get to this point. Shouldn't IVF results be positively correlated with the length of the journey and the suffering that ensued along the way?

I think the embryologist I spoke with told me that they would call us one more time tomorrow with the final count but I don't think that anything will change between today and tomorrow.

I'm not sure how to feel...excited to have the two or sad for the others that were lost along the way. I don't mean to sound ungrateful for the two that we do have...I just feel conflicted at the moment. I think that I need some time to digest this information. I have maintained that I didn't want to do a transfer for the sake of doing a transfer and I would rather know than go through the pain of another m/c...but part of me, naive me, still managed to plant the seeds of belief and hope, secretly thinking that the statistics were wrong somehow.

If both of the two embies come back normal, we have an 85% chance of success if we transfer both. If one of the two embies come back normal, the success rate drops to 65% because we would only be transferring one. Still, these odds are better than what we would have had given a fresh transfer so I need to hang onto that. So I guess we settle in now for the 6 week wait for microarray results.

Day 5 Report

I spoke with John, the head of the embryology lab today as I had asked them to call us with any news or results since waiting until Day 6 without any news would be excruciating.

The short version - nothing was biopsied today.

The long version - there are three early blasts that they can't yet biopsy but that will likely make it to biopsy. From my understanding of the biopsy procedure, they actually made a small hole in the zona pellicuda on day 3. When the embryo grows to the blastocyst on day 5, the biopsy is done on trophectoderm cells that protrude out of that little hole. They don't perform the biopsy until there are cells protruding out of that little hole. In addition to the 3 early blasts, there are two embryos that are at the morula stage, the stage right before blastocyst. John said that those embryos are still doing what they should be doing so those 5 are still in the running (the three early blasts and the two morulas). The two eggs that were ICSI'd on day 2 plus one from the original 6 that fertilized don't look that great but they are still continuing to culture them and will check and see what they look like tomorrow. John said that he was hopeful for 2-3 making it to biopsy but we have put our order in to the powers that be for all 5 to make it to blast biopsy. Please, oh please!!!!

Of course, each day brings new things to worry about so I'm worried that since there was nothing to biopsy, that's not a good sign. After all, they don't call it day 5 biopsy for nothing! Is the fact that they haven't developed out to that stage mean that they aren't as strong or that they aren't going to make it?? Has anyone had their embies take longer than 5 days to go to blast? Logical me is quick to remind myself that CCRM did tell us during the genetic counselling session that sometimes it can take up to 6 days to develop to blast so it is normal but I do wonder...

Come on kids! Keep growing! Go to blast!! Hang in there!!

WE REALLY WANT YOU IN OUR LIVES...

Day 3 Fertilization Report

I'm back at home now and settling back in. As I put my long johns and extra layers on this morning, I thought longingly of the warmer weather in Denver but at least the sun is shining here in Toronto! It's amazing how you can come and go and nothing seems to have changed yet everything is different somehow. I've been pretty tired since getting home which I attribute to the 2 hour time difference and the additional hour we lost to daylight savings time this past weekend but I'm adjusting so everything is fine.

Technically, today is day 4 post ER so we did get our day 3 fert report yesterday but late in the day. I basically spent the day sitting by the phone, waiting for it to ring which was pretty nerve wracking. To bring everyone up to date, the two eggs which matured overnight after ER were ICSI'd on day 2 and both fertilized!! That brings our final count up to 11 eggs retrieved of which 10 were mature (!!!) and 8 fertilized (!!!). This is definitely the best cycle ever for us and I know I'm not blowing anyone out of the water in terms of absolute numbers but we are pretty thrilled to have done so well given our past history.

At this point, embryos should be between 6-10 cells with 8 being the perfect number. CCRM begins grading their embryos on day 3 and I asked the embryologist to go through and give me the grades for each of our embryos. In short, the day 3 embryos at CCRM are graded using the following chart, 4 being the best and 1 being the worst:

4 : 0% fragmentation
4- : less than 10% fragmentation
3+ : less than 20% fragmentation
3 : less than 30% fragmentation
3- : less than 40% fragmentation
2+ : less than 50% fragmentation
2 : less than 60% fragmentation
2- : less than 70% fragmentation
1+ : less than 80% fragmentation
1 : less than 90% fragmentation
1- : 100% fragmentation

Our embryos were as follows:

Embryo 1: 8 cell grade 4 & compacting (this one is the most advanced of the bunch)
Embryo 2: 8 cell grade 4
Embryo 3: 8 cell grade 4
Embryo 4: 8 cell grade 4-
Embryo 5: 8 cell grade 4-
Embryo 6: 7 cell grade 4
Embryo 7 (from day 2 ICSI): 8 cell grade 3
Embryo 8 (from day 2 ICSI): 6 cell grade 2+

We are pretty impressed with the lab so far because at this point in all of our other cycles, we had a ton of eggs either a) not fertilize or b) arrested already. So far, we've been lucky enough to only lose 1 egg due to immaturity, and 2 other eggs failed to fertilize. In comparison, my last cycle we had 7 immature eggs out of 10 eggs retrieved! To my knowledge, nothing is arresting at the moment; however, the embryologist that I spoke with did tell me that they do expect to lose 1/3 to 1/2 of all embryos going to day 5 so it is unlikely that all of ours will make it to the blastocyst stage. We will continue to hope and hang onto positive thoughts.

The embryologist also told us that the next time that they will be checking on our embryos will be tomorrow (Saturday). Any embryos that have progressed far enough will be biopsied with any remaining embryos biopsied on day 6 (Sunday). After the biopsy, they will be vitrified (flash frozen). Since it is the weekend, they may not be able to call us tomorrow but they will definitely call us by Sunday to give us the final report post biopsy. For once, I want to beat the odds and have all of our embryos make it to blast and biopsy. I can always hope can't I?

My DH has been cracking jokes since ER and asking me whether our kids will have U.S. citizenship since they were conceived in the beautiful state of Colorado! We also lovingly refer to them as "our American children" :). It's wonderful to think that right now, at this very moment, there are 8 little embryos in this world that are made up of half of me and half of my DH.

For now, we're back to reality...DH has returned to work and I am sorting through all of our travel expenses, paying bills and getting our tax return ready. I hope our good luck will continue to hold.

One final note - I wanted to say a very warm thank you to everyone who have posted comments on my blog and given me such wonderful words of support and encouragement throughout this cycle. You have touched me and at no point did I ever feel alone. You guys are the best!!

Retrieval and Fertilization Report

Hey everyone - I'm sorry I haven't been able to blog until now but yesterday was kind of rough for me as I was sore and in more pain than I have been in the past so I was just lying around, trying not to move about too much. I didn't think I needed any pain meds until afternoon when the pain meds from the surgery wore off and I sent my DH out to find me some Tylenol.

I went in at 10am for retrieval and the first question out of my mouth after I woke up afterwards was "How many did they get?". Initially, Dr. Surrey said that they got about 7 which was a pretty good number for us but it got even better when the embryologist who came to talk to us told us the number retrieved was actually 11 after they went through the follicular fluid!!! Eleven!!! That is a record number for us!!!

Then, the waiting began for the fert report. We have gotten 10 eggs retrieved before but it was a dismal fert report afterwards so we were cautiously optimistic, but nervous all the same. Were we going to drop from our high of 11 eggs retrieved to a dismal number? So, we have been sitting by the phone all morning here, trying to keep the phone free for that all important call from the lab. That finally came at around 11:20am.

Well, of the 11 they retrieved, 8 (!!!) were mature and they ICSI'd all of them and that gave us 6 fertilized eggs!!!!!!! I was pretty happy about that and in my excitement, forgot to ask her what about the other 3 immature eggs of the original 11. So, had to call them back and then wait for the return call from the lab and she called back and said that of the 3 that were immature, 2 matured overnight and they will ICSI the add'l 2 today!!!!!!!!!

We're so happy!!!!

So, of the 11 retrieved, a total of 10 were mature and right now we have 6 fertilized with a potential for 2 more.

Yippee!!

Of course, now the nail biting begins to see how many make it to day 3 and ultimately to day 5 but it seems that we are off to a good start :). Tomorrow, the lab said that they would call us to let us know if any of the 2 that matured overnight fertilized. Right now though, we are riding high on the news to date. Go CCRM!

Tomorrow is ER!

I triggered last night. My estrogen had shot up to over 3300 which bodes well for some mature follies right? The general rule of thumb is that each mature follie will generate about 200 units of estrogen so if we do the math, we should have more than we've ever had in the past. DH is betting on 16...I'm being more conservative and betting on 12 but we shall see. They still only measured about 9 follies >10mm so I'm hoping that they missed some and there are some lurking in the back that they can't see. Otherwise, maybe some of the smaller ones will give up some of their eggs?? I sure didn't miss the IM shots and that trigger shot brought back memories of doing those all cycle long since my doctor in Canada preferred IM shots over subcuntaneous shots. Today was a wonderful injection free day so I truly enjoyed it!

I'm nervous...I am getting to the point where I don't care if they just retrieve 9 eggs if they're ALL mature and if they ALL fertilize :). Only time will tell.

Thank you everyone for all of your thoughts and comments and all of the support you have given to me through this cycle. It is so nice to know that I have my own little cheering squad who are thinking good thoughts for me. I have had the pleasure of meeting up with some of the women from IVFC and am hoping to meet up with MamaSoon from blog world on Tuesday. These gatherings are so wonderful and I feel really lucky to have found all of you.

I probably won't blog again until Tuesday and hopefully will have some great news from the fert report. Everyone cross your fingers please!!

Twas the Night before...

I am 99% sure that tomorrow is trigger day. One more day of shots, one more date with the dildo cam, one more day of b/w and that is it for me. We're done. What a sprint this has been to the finish line. For those of you who are detailed oriented, here are my numbers from today's u/s and b/w:

Left Ovary
This cycle: 19mm, 15.7mm, 14.1mm
Last cycle in Canada: 17mm, 10mm

Right Ovary
This cycle: 22mm, 18.4mm, 15.8mm, 15mm, 13.6mm, 11.7mm
Last cycle in Canada: 21mm, 20mm, 19mm, 17mm, 15mm, 14mm, 14mm, 13mm

E2= 2199
P4=1.3
LH=1.9

It is very interesting to note that in my last cycle in Canada, my doses at this point (day 10 of stims) was a whopping 750 units/day whereas yesterday, they dropped my dose down to 300 units and today raised it back up to 450 units. I don't see much of a difference in the results so again, more proof that what they say about amounts >450 not yielding better results is holding true for me.

My original calendar had down that I was supposed to trigger tonight but I've been told that it will most likely be tomorrow. I have been repeating and repeating myself over and over again to anyone who will listen that I have had a history of immature eggs and because of my insistance, Dr. S (not Dr. Sch) has pulled me over one more day to see if we can improve on the maturity of my eggs retrieved. Under normal circumstances, he would have triggered me tonight. It just goes to show you that you MUST be your own advocate in this whole thing and if you have a clinical history of something, make sure they know it when they are evaluating your case as it may make a difference to the decisions they make about how to approach your file. My nurse also told me that they may also give me a bigger dose of the trigger shot (HCG) in an attempt to help this issue and mature more eggs. Usually, the dosage is 10,000 units but they may give me more. We shall see what happens tomorrow.

Today we also had our meeting with the genetic counsellor and it was a really educational meeting. We are down to down Microarray testing to check for aneuploidy in our embryos since there are no genetic mutations that we have been diagnosed with that we may possibly pass along. In non-IVF speak, checking aneuploidy means that they will confirm that all 23 pairs of chromosomes are present and that there is no more and no less genetic material. Since we have had a history of not producing that many embryos, we really had to make a decision whether or not we were going to try and push our embryos to make it to day 5 when they will do the biopsy for microarray testing. Embryos must make it to day 5 post retrieval in order to have enough cells to biopsy and the attrition rate is about 50% from day 1 post retrieval to day 5 post retrieval. We were really wrestling with this because we have never tried to push our embryos to day 5 given that we have had, at most, just 3 on day 3 post retrieval. The risk is that we can end up with nothing to biopsy on day 5 and then we would have nothing - nothing to transfer and no answers either. However, the genetic counsellor that we spoke with told us that in these rare instances when this happens (i.e. nothing to biopsy and send for testing), as long as the embryos made it to day 4 post retrieval, they can still do a biopsy and send it out for testing, just to get some answers back for us. Just because the embryos don't make it to day 5 post retrieval doesn't automatically mean that it was abnormal. Also, if this happens, they will refund us $4,000 of the fee for Microarray. The head embryologist said that I am still young and that in his experience, he usually sees embryos from people like me making it to the blastocyst stage on day 5. In the event that we have only 1 or two embryos make it to day 5, we have also requested that they biopsy and test any and all other embryos that may have arrested on day 4 or day 5. We're after answers here and it sounds like they can give us those answers. If they all come back abnormal, than that's my answer whether I like it or not. I also said to my DH that I just would rather not go through again all the pain and anguish of transferring in one or two (if that's all we had left) and then miscarrying later. I would rather find out they are all abnormal and transfer none than not find out and then getting pregnant only to miscarry a few weeks later. Once was enough times for me.

So, hopefully trigger tomorrow with retrieval on Monday. Let the games begin!

Report From The Front Lines (3rd u/s)

It has been 8 days of stims and things are continuing to chug along. I think I'm doing marginally better than how I did back in Canada but it's hard to say and my DH keeps saying that we are here also for the lab, the impact of which we will not see until after ER. So, for those of you numbers and detail oriented people, here are my stats from today with comparatives:

Left Ovary:
This cycle: 18mm, 12mm, 9mm. 5.6mm
Last cycle (cancelled): 18mm 8.5mm 7.5mm, 7mm
Last cycle in Canada: 13mm, 7mm

Right Ovary:
This cycle: 17.5mm, 15mm, 12.3mm, 12mm, 11.1mm, 10.5mm, 5mm
Last cycle (cancelled): 17.3mm, 13.5mm, 10mm, 9mm
Last cycle in Canada: 17mm, 15mm, 15mm, 13mm, 11mm, 11mm, 8mm, 8mm

It's very interesting that my last cycle in Canada had me on whopper stims of 600 units/day and I seem to be doing about the same, which supports what CCRM told me - that amounts >450 units/day are not proven to be beneficial. I think the whopper stims fried my eggs last time so I am hoping that this time, we will have better quality. They're estimating that we'll get between 6-8 eggs this cycle and I really hope that they're all mature and they all fertilize. Cross your fingers!!

I had lunch yesterday with Mangymutt and Mom2beASAP from IVFC yesterday and what a fun time that was! We met at around 11:30am and didn't leave the restaurant until 5pm when they politely told us they were starting dinner service!! The time just flew by and it was great to sit and chat with both of them and trade experiences.

I have also been chatting with the plebotomist that has been drawing my blood every day at CCRM and she has been telling me the funniest stories! She told me today that the fainters mostly tend to be the men (haha - but not my DH...he was a real trooper and didn't blink at all with all the vials of blood they've taken from him) and that she really has to baby them (i.e. fully recline the chair, give them juice, etc) and that it can take up to 40 minutes to draw 2 vials of blood! One poor guy was so nervous he soaked through his whole t-shirt in his anxiety over having blood drawn! Yesterday, we were talking about the colour of blood and if there are various shades she sees (mine was dark red, well oxidized she told me). She she said that sometimes, the blood serum that is spun out can vary if the person has high cholesterol. Blood serum s/b a yellowish colour, kind of like the colour of a custard but when someone has high cholesterol, that turns the blood serum white - ewwww! Interesting things you can learn chatting with the people at CCRM.

As for Dr. Sch, I have yet to even see him walking the hallways of CCRM. My ER is estimated to be on Sunday or Monday so I don't even know if I will meet him this time. If anyone else is potentially doing ER this weekend, Dr. Surry is the one who will be doing it.

That's it for now - will update with hormone levels later. I'm down for daily monitoring now so we're really into the crunch time now.

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Update:
My hormone levels came back today and E2 has continued to rise while P4 and LH have stayed the same. I was worried about potential breakthrough ovulation b/c I have had a lot of CM the last few days (sorry - TMI I know) but my nurse said that it would be very, very unusual to have breakthrough ovulation while on Cetrotide. I was worried because I know you can have breakthrough ovulation on BCP and Lupron so I wanted to make sure that this couldn't happen on Cetrotide.

So, today's hormones are:
E2=847
P4=0.4
LH=1.3

Second Ultrasound

So I have been stimming for 6 days (including today) and went in for my second u/s this AM and things are looking good! In comparison to my other cycles where I was on whopper stims (600 units a day), things are going slower but that is a good thing since I've noticed that all the follies coming along are hovering around the same size. In past cycles, I've had huge disparities between the biggest and the smallest follies ranging from 15mm to 6mm and this time, largest follie is 13mm and smallest one measured is 9mm so they're nice and close in size.


So here are the results from today's u/s:


This Cycle:
Left Ovary: 13mm, 9mm, 9mm
Right Ovary: 12mm, 10mm, 10mm, 9mm, 9mm

Last Cycle (cancelled due to cyst):
Left Ovary: 16.4mm, 5.7mm, 5.2mm
Right Ovary: 11.8mm, 10.2mm, 7mm, 4.7mm

Last Cycle in Canada:
Left Ovary: 11mm, 6mm
Right Ovary: 15mm, 12mm, 12mm, 11mm, 11mm, 9mm, 7mm, 7mm, 7mm

In hindsight, it seems now that we definitely made the right decision to cancel the cycle in November as the results are already much better than what we had then. The u/s tech was still saying that it was early and there were some small ones she didn't bother measuring so they could come along. So, it looks like there are 8 good follies coming along at this point. Yay!

At this point, I'm not sure if I will have to go back in for another check tomorrow b/c they may let me ride until Wednesday. We shall see what my E2 and P4 numbers come back at later on today. Other than that, I've been enjoying the wonderful weather in Denver, the bright blue skies and sunshine. I've been able to meet up with some of the girls that I've been chatting with on IVFC and just relaxing, giving my body the rest it needs to keep growing follies!

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Update - I didn't get my hormone levels today since I wasn't at the hotel when the call came through but they are starting me on Cetrotide today which means that my LH must have started to surge. It is CD8 today and I usually have my LH surge on CD11. I also saw some CM today so everything lines up with the beginnings of an LH surge. I am a little concerned that the Cetrotide will slow things down a bit but we'll have to see. I'm not going in tomorrow but will be back in on Wednesday for another check.