Monday, April 27, 2009

Spring Plantings

I'm a beginner gardener with more of a brown thumb than a green one but I'm slowly learning how to grow a beautiful garden. In addition to some flowers, we like to plant tomatoes and it has to be one of the easiest vegetables to grow. Believe me, if *I* can grow them, they aren't that hard to take care of!

This year, for a change, I am playing around with a bunch of heirloom tomato seeds. I planted 7 different varieties in many different colours and as they sprouted this past week, I kept drawing paralells between growing the seedlings and our journey with IF and IVF.

In this first photo, there are actually 3 plants that sprouted. There's the big one on the left at 10 o'clock, the tiny little one on the right at 2 o'clock, and believe it or not, there is a small one poking up through the soil in between the two at 12 o'clock. The first thing that I noticed was that although I had planted them at the same time, some took longer to germinate than others. I have no doubt that these seedlings will all grow to be healthy, producing tomato plants, it just took longer for some seeds to settle in and sprout. This reminded me of my 2/3 embryo that was biopsied on day 6. I've been concerned that it was developmentally slower and therefore less viable than other embryos since most would normally be a full blastocyst by day 5. However, like my little seedlings, sometimes it takes just a little longer to get to the same stage.

In this next picture, there are three seeds that have sprouted in the pot at the front but you'll notice that the one in the back right hand side looks like it is wearing a little helmet. That's because the seed pod is still attached and is preventing the leaves from opening up. I've seen the leaves on some of my other seedlings shrivel up and die when they weren't able to successfully separate from the seed pod. However, if I remove the stuck pods, they will continue to grow and become strong tomato plants. This reminded me of the assisted hatching that the embryologist performed on our embryos. Sometimes they just need a little help to get going and sometimes they won't even be able to make it without a little help.

In this next photo, there are three plants here and I know you can't really see well from the photo, but the plants at the 11 and 2 o'clock positions each have one leaf that has turned yellow in colour. It is interesting to note that these two were the first to sprout and are the tallest ones of the bunch. I'm not sure if they will be okay because of the withering leaves. The last little on at the bottom in the 5 o'clock position sprouted last but is the healthiest one with two perfect, dark green leaves. This reminded me of our results from the microarray testing - our best looking embryo was abnormal and never would have turned into a baby. On the flip side, one of our lousiest looking embryos was normal and hopefully, that one will survive the thaw and implant and become a beautiful little baby. Looks don't always matter.

Finally, there is one variety that I planted where all three sprouted at the same time and they are all healthy looking and all three are growing at the same rate. Sometimes, you just get some real strong ones that take off and do everything that you expect them to do the first time. You just never know which one you're going to get. Of course, you hope for this best case scenario but even with my little seedlings, only one variety out of seven turned out to be so strong. This reminded me of how some people seem to not have any trouble, that everything they "plant" seems to take without any apparent effort at all. But that is not our story...we're more like one of the other pots but with a little coaxing and some extra attention, those pots did okay too.

Wednesday, April 22, 2009

Preparing for a FET

We have finally decided.

Afer much debate and a written pro and con list, we have decided to do a FET with my next AF in May. The discussion went on for days, we went around and around in circles, we weighed all of our options and we always seemed to end up at the same answer - FET. Thank you to the many people who gave us such helpful support and advice and we did ponder everything very carefully before deciding. It may not be the most obvious choice but let me explain our rationale and how we came to this conclusion.

My first knee jerk reaction was to cycle again and bank as many as possible to give the FET the best shot possible. However, in thinking back over my long IF history, when I've done back to back cycles in the past, my results get worse with each progressive cycle. I know that CCRM doesn't believe that you need to rest at all between cycles, but being the poor/average responder that I am, every little thing seems to matter. If this was the option that we pursued, than the logical answer would be to wait a little while longer to cycle. How long would we wait? Probably a few more months...long enough for us to do a FET now. Besides, if we waited to cycle again, doing a FET now would still be considered a resting period for my ovaries. Full circle back to FET.

If we pushed to cycle again first, we considered the possibility that we could get more and better graded embryos. When time came to do the FET, we would likely bypass the 2 embryos we have on ice now (a 2/3 and a really iffy 4CB) in favour of the higher quality embryos. That would mean that the ones we have now would remain vitrified for a longer period of time if we get a BFP. Vitrification is such a new freezing technique, there isn't a lot of information out there about the effects of vitrification on embryos stored for the long term. Given how fragile everyone keeps telling me my eggs are, it may not be the best thing to keep our two totsicles vitrified on a long-term basis. The best thing would be to do a transfer sooner rather than later. Full circle back to doing a FET now.

We also considered that if we cycled again, I could end up with nothing and still be in the same place with the same two totsicles. A bird in the hand is worth two in the bush or so the saying goes. We always knew that pushing out to day 5 blast would be a big risk for us and that possibility is the reality that we can't ignore when we cycle again. To mitigate this risk and to improve our odds, I would want to continue working with my TCM doctor with the hopes of improving my response. I have seen some positive changes since beginning to work with her and it has only been about 2.5 months so if we waited to cycle, it would give her a longer period of time to get my body back into balance (whatever that is!). While we wait, might as well do the ET and see what happens. Full circle back to ET.

No matter how we looked at it, it just seemed to us that all signs were pointing to waiting to cycle and doing the ET now. It feels like the right decision for us regarding these two embryos. We felt that we needed to give them a chance but have left it open that if things don't work out, we will cycle one last time at CCRM. I know, I know - I've said that before but I still feel that this is the year that the ART portion of our IF journey will be brought to a close. The only reason why we are even considering doing one more cycle at CCRM is because of the size of our tax refund.

My calendar has been tentatively set to start with my next AF expected on May 18th. If I started with my April AF, ET would have been during the June shut down and would have been put on more and longer meds to get me past that time. Given my body's dislike for meds, that didn't seem like the right choice. With my May AF, ET is pushed back just 2 weeks and is estimated right now to be June 26th.

The knots in my shoulders and neck have gone away now that we've made our decision. No more chest pain either. Onwards...that is the only way we can go at this point. Now I have a date, a timeline, a schedule to follow. We have carefully planned our next step. Let us now take that step forward boldly.

Thursday, April 16, 2009

Things That Make You Go "Huh"

Two things that happened to me today that made me pause a little.

First - had a dream about a friend of mine showing up pregnant one day with a cute little bowling ball bump. Saw her today and she is, you guessed it, pregnant although not showing. The showing part was completely in my dream.

Second - I've been having terrible shoulder and chest pains and my TCM doctor told me today that the shoulders in traditional Chinese medicine represent the gall bladder meridians and the gall bladder governs decision making! Huh - so I'm all conflicted about what to do - cycle, don't cycle, FET - and it is totally and completely being reflected by my body. My chi is low and my shoulder pain indicates that I am pretty conflicted about this decision we have to make. Interesting...

No decision here yet although my DH is leaning towards doing the FET now and seeing what happens and then dealing with the result then. Me - still sitting on the fence about it. I'm not getting any younger and if we have to try again, I would rather do the cycle now and increase our chances for the FET. But it always comes down to money. Ironic that our mortage needs to be renegotiated by June 1st and if we needed more $$, now is the time to get it. If I increase the mortgage, I feel like I am dooming the FET to failure since I have put contingency plan in place. If I don't increase the mortage, I am essentially putting all of my eggs in one basket (haha - pun intended!). I still don't know what I want to do.

Anyone have a good psychic I can consult with?

Monday, April 13, 2009

Decision Time

I'm having a hard time writing this post because my thoughts and emotions are all jumbled up and I feel scattered at the moment. I just got off the phone with Dr. Schoolcraft and he gave us a lot to think about. Although I had a bunch of questions written down to ask him, I still felt unprepared and of course, had a new question for him as soon as I got off the phone. That never seems to change! The high I carried with me through the weekend has now evapourated into the cold, stark reality of what we're facing.

The first thing we discussed was what the results indicated and if it could explain our past failures. My take on it was "isn't it great that I produce normal embryos?" and his take on it was more along the lines of "this confirms our poor egg quality theory". That's Dr. Sch - he always tells it like it is. I'm still digesting that tidbit of information...I've always been in denial that our IF was my issue, wanting to believe that it was more unexplained, but now it seems that CCRM is confirming what the doctors here have been telling me all along. That's a very bitter $30k pill for me to swallow.

How is this indicative of poor egg quality? Well, we've never had anything go to blast before and on day 3 of our CCRM cycle, it appeared that I was having (in his words) a perfect cycle, meaning that we had 6 embryos that were all 8 cells. The high attrition rate from day 3 to day 5 when we dropped from 6 embryos down to just two viable ones confirms for Dr. Sch that the poor egg quality is reflected by the poor embryo quality and the high number that arrested. In the past, we always did day 3 transfers so we never knew that we had such a high attrition rate between day 3 and day 5. I should have asked him about the 4CB poor quality blast that was normal - how come it was normal yet such poor quality? I suspect he would have said that quality and viability are not always directly correlated with the right number of chromosomes and make reference to my poor egg quality again. Again, should have asked him, but didn't think of the question until I hung up.

Interestingly enough, he was also in a bit of disbelief at my estimate of the success rates (65% for 1 normal transferred; 85% for 2 normals transferred). He was asking me where I had heard those numbers and I told him that it was from the genetic counselling session and based solely on my age. He was quick to correct my estimate and decreased it to a 40% chance if we transferred one normal embryo, taking into account my past history. He thought though that we could get as high as a 70% chance if we transferred two normals.

Dr. Sch also confirmed for me that the 4CB embryo is not normally one that they would have biopsied and he doesn't have a lot of past experience with the thawing of such poorly graded embryos. He doesn't know if it will make it through the thaw (the embryologist seemed to think that there was a good chance that it would not) but if it did, he would be okay transferring that one as well. However, he said again that this was a poor quality blast and that, in his opinion, we only have the one real contender here. Ouch.

As an aside, I asked him if the grading of the embryo could change from the time it was thawed to the time of transfer and he said that the freezing and thawing of embryos does not change embryo grading. What they were graded before the freeze is the grade that they are at thaw. They will tell us however, what percentage of the cells made it through the thaw but that's it. I was also wondering if we would be able to get a better idea of the grade of the inner cell mass and the trophectoderm cells of the normal 2/3 embryo after thawing and he said that the time between thawing and transfer is about an hour so there is not enough time for the blast to develop any further in culture.

So, it is decision time and I do not know what we're going to do. Part of me thinks that we should go down and hope for the best, that both will survive the thaw so we have two to transfer. The other part of me wants to cycle again in hopes of getting one or two more to transfer and therefore increase our chances as high as possible. I've even had the thought cross my mind to cycle again up here since it is cheaper and ask my doctor to follow CCRM's protocol but then I think about CCRM's top notch lab, which becomes even more important given the fragile nature of my eggs. Another option would be to try and treat this through TCM only because, after all, this is the only school of thought that believes that there is no such thing as poor egg quality.

In the end, lots to think about. Which way will we go? Don't know yet.

Friday, April 10, 2009

The Wait is OVER - Microarray Results 3w5d Post Biopsy!!!!!

Yes, you read right - I got "the call" from CCRM today that they received our microarray results in what I think is record time - 3 weeks and 5 days post day 6 biopsy!! My nurse called me today and the funny thing was that I just spoke with her yesterday about our FET protocol and thought she was calling back with my tentative calendar. She shocked me when she told me that she had microarray results for me. We haven't yet spoken with Dr. Schoolcraft who is supposed to call us to talk about the results in more detail but just knowing what the results were was big and my nurse knew I was dying to know and called me as soon as she got them!!! Thanks Dawn!!

Yes I know - stop blabbing on and give out the results. There were:


I am so cautiously happy and for the first time in a long time, I felt the beginnings of real hope spring from within the depths of my heart. I had almost forgotten how that felt, to feel again that the possibility exists for us, that we, K & J can become parents. Right before she told me, I had a moment of intense fear - was it good? Bad? But then I had to know and I cried when she told me that we had 2 normals!!!

Onto the nitty gritty for those of you who like details like me. As you all know, we had 4 biopsied and vitrified and they were graded with microarray results as follows:

Embryo 1: 5BB, our best graded embryo by far - ABNORMAL

Embryo 2: 2/3, early blast - NORMAL

Embryo 3: 4CB, poor blast - NORMAL

Embryo 4: 2, early blast and also marked as poor quality by lab - ABNORMAL

Here's where the shades of grey come in. I think that they only biopsied Embryo #3, the 4CB one, because we asked them to. I distinctly remember asking the embryologist about this one and Embryo #4 and she told me that they were pretty poor quality and they normally wouldn't have even biopsied them. It is my understanding that they only did so at our request. She cautioned me that those two embryos would likely not make it through the thawing process. I am afraid that means that even though there are two normals, only one is a real contender. Don't get me wrong - I am extremely grateful to have the one and that has more than doubled our chances of success that Dr. Schoolcraft gave us (he estimated for us a 25% chance during our phone consult with him - transferring 1 microarray normal embryo gives us a 65% chance). However, the question remains, is there one or two real contenders here?

I can scarcely believe two almost seems too good to be true. Remember that it's me we're talking about here - the poor responder with 5 failed IVFs under her belt. Can it really be two normals for us? I'll have to discuss with Dr. Schoolcraft when he calls.

There are so few high moments along this journey so I'm going to bask in the knowledge of 2 normals for the time being. We really couldn't have asked for a better outcome and we are truly grateful.


Thursday, April 9, 2009

My Body is Trying to Tell Me Something...

I feel fine most days and I don't think that I am stressing about the microarray results but I think my body is trying to tell me differently. This week started off with me getting a huge crink in my neck. I've gotten them before but haven't in a long time but it is a sure sign that I am stressed. My shoulders are really tense and I have knots right along my shoulder blades. My acupuncturist helped to get rid of the crink in my neck but then since the crink couldn't be there, it shifted places...over to my chest.

Now before everyone freaks out, I have had chest pains before and they were definitely stress related. I've had EKG's several times and there is nothing wrong with my heart. I also know these are stress related chest pains because I can actually feel the muscles knotted in my chest and when I press on them, like you would press on a knot in your back, it hurts. So, stress related and nothing else. My TCM doctor also said that the point that hurt was what they call a "spirit point" and that meant that my spirit was low. How to fix? No idea. She did stick a needle in it and now, I am happy to report that the pain is gone. Gotta love the TCM thought process...does it hurt? Than let's stick a needle in it!

I actually had a dream last night about getting our results and the funny thing was that it indirectly involved Sue as she is also currently awaiting her results (although from CGH not microarray). It wasn't a stressful dream, but the fact that I dreamed about it makes me think that this whole wait is weighing heavily on my mind, if only in my subconscious at this point. In my dream, I received an envelope through the mail and I just knew it was results from CGH/microarray. However, somehow I knew, as you only can "know" in dreams, that the results didn't belong to me - they were Sue's and there was a mix up and they sent her results to me by accident. I wanted to open the envelope, even though the results weren't mine (talk about being nosy!) because in my dream, I was convinced that Sue's results were a predictor for my own. I knew that opening up Sue's results was wrong but I wanted to know and not know all at the same time. The dream ended with me still conflicted about opening up the envelope. Weird eh?

We're fast approaching the 4 week wait mark and I called my nurse today to talk about the FET calendar since I want to squeeze the transfer in before the June shut down at CCRM. We'll see what she says and maybe once I have a timeline in place, it will get me moving on other things that I have been procrastinating about.


Update - spoke with my nurse and the shut down for ET is from May 30th to June 7th (1 week). I think it's longer for ER and she didn't tell me what the shut down was for ER but I suspect it's an additional week, although which week (i.e. the one before or the one after the shut down for ET) I don't know.

Wednesday, April 8, 2009


Ahhh snow. Here is a photo of my backyard from this morning with everything blanketed in a fresh layer of snow...notice the hopeful looking BBQ on the left!

As promised, here are some photos of my Easter hatchlings that I was working on today. They turned out to be decent looking but boy are they SWEET...or maybe they taste that way because of my recent attempt to eliminate sugar from my diet!

My ingredients:
1 box of cake mix, 1 can of frosting & eggs (oil and milk not shown)

Lots of sprinkles, dragees, candy corn, dots & candy coated mini chocolates from which I will create my beaks, eyes, feet and ears!

Assorted sprinkes that I used - hearts & stars with some barnyard animals thrown in but not used - I was trying to figure out what I could use for feet but the hearts worked just fine turned upside down.

This was the first time I've ever played with melting candy coating chips and it was fun although some of the colours were very bright - like the pepto bismol pink ones on the left. I had to temper that colour with the white chips on the right but it still ended up being fairly pink!

See what I mean? BRIGHT PINK!

This is what the cake balls look like after the cake has been baked, crumbed and mixed with the can of frosting - I cheated and used my KitchenAid mixer but I tend to use it for everything I can. Love that thing! Of course, there is one of my trusty cookie scoops which made portioning out the cake balls pretty easy.

Drumroll please....introducing a very pink bunny...

...and my first chickie...

...and my second chickie with different eyes...

...and another wascally wabbit...

...and an egg.

They all look a little stunned b/c I couldn't find one of those edible markers to draw on a few more features but I thought they looked pretty good for a first attempt! I packaged them all up in little sucker bags except that a lot of them didn't fit on account of their large behinds. I was lamenting to my DH that all my bunnies and chicks had big butts but then he wispered to me that "some people like that"!!

And just in case you weren't sick of photos yet, here is a close up of some bunnies...

Here's a close up of the chicks and eggs.

There you have it - my attempt at cake balls/cake pops! I hope the kids like them! I'm excited to give them to my nieces and nephews, pump them full of sugar and then send them all home to their parents (snicker snicker). After all, what are Aunts for?

Monday, April 6, 2009

It's snowing

Yes, spring has officially arrived yet we are in the grips of a snowfall here. It's overcast, sky is grey and it was snowing big huge flakes this morning and has since turned into sleet that hits your face like hard little ice pellets except wet enough to stick. Needless to say, my walk with Daisy this morning was short and sweet rather than our usual jaunt through the forest and around the parks in the neighbourhood. There were some pretty confused robins hopping around, leaving these cute little "-->-" tracks in the snow. Hopefully this terrible weather won't last.

It is now officially the half way point of our microarray wait. I just read on Sue's blog that CGH is taking about 8 weeks since the lab is helping to set up another clinic with CGH testing. I don't know if microarray is done by the same place but if it is, we're in for another 2 more weeks on top of the 6 weeks we were originally told.

What to do in the meantime? I haven't recommitted myself to any plan yet in terms of diet, exercise and meditation so I guess I should be figuring that out soon. It's hard though since I need so much privacy to do many of these things like meditation and my castor oil hot packs and we always seem to have a steady stream of house guests. I can always go into my room and close the door when I need privacy but I'm not comfortable since there is the possibility that I will be interrupted.

Easter is next weekend and I have a lot of family in town and a lot of family events going on. I'm going to make some of the chick & bunny cake pops following the instructions from the Bakerella site so that will be fun. If they turn out, I will post some pictures here. It will be a first for me as I have never made any cake balls like Ashley has. I tried making a Tart Tatin for the very first time this weekend and it didn't quite turn out as I thought it would (tasted good - looked terrible since the caramel was very watery). Nothing like runny caramel to teach me to use the type of apples as is specified in the recipe!! My DH is a master BBQer and we had our inaugural BBQ of the season yesterday - he smoked 2 racks of back ribs and it was SO GOOD. The meat was tender and perfectly seasoned, falling off the bone. He only put a dry rub on it too and omitted the sauce since most BBQ sauces contain tons of sugar and I am trying not to eat sugar these days (the tart was my one treat this week!). I'm a convert to dry rubbed ribs now they were that good!

I sure hope it stops snowing soon...