Tuesday, July 28, 2009

BFN

No surprises. Just relaxing at home this evening with some wine and chocolate.

I'll be going straight into another minimal stim cycle with the arrival of AF later this week. DP has a business trip to the East Coast next month so we should be able to combine our trips and hang out together for a bit longer than usual.

Sunday, July 26, 2009

9dp3dt - Last HPT in the house

I used the last First Response in the house this morning and this time I made sure to look at a clock while I waited. I gave it a full 10 minutes, and there was nothing.

At this stage of the game, even if it develops something like a gray shadow later in the day after sitting out, it doesn't matter. The lines should have color by now if it is going to be anything viable.

As I have said before, I would rather have a straight up BFN than a low beta that is slow to rise and ends in a chemical (or worse). There is always an exception I guess, but after about a dozen or so failed cycles that have blank sticks at 9dp3dt, and the positive ones that had dark lines by now, I'm not expecting a different outcome.

It is early Sunday morning and a nice day ahead for plenty of distracting activities. I think I have more of a tendency to mope around if it is a weekday.

Beta is only 2 days away, so just a little bit more with the messy progesterone supps and their multitude of pregnancy-like side effects. It has actually been kind of interesting with the evaporation lines, or maybe annoying is a better word...

Saturday, July 25, 2009

8dp3dt - Evaporation Line

This morning's HPT was completely blank after several minutes.

But then I tested later in the day and a very faint gray line came up in about 2 minutes. Even now at several hours later there is still no color to it, so I am calling it an evaporation line. Not sure if it is visible in the photo:



The confusing thing is, when I now look at this morning's stick it also has this very faint gray ghost line.

Not sure what to make of it all as I didn't think FRERs had evaps, but as long as there is no color to it I can't get excited, only curious!

Friday, July 24, 2009

Evening results

Answer HPT was much lighter, any normal person would say there wasn't a line.

But Accuclear still had a faint line, about the same as earlier in the day.

Things should be clearer tomorrow!

7dp3dt - fun with trigger



Hmm... the faint lines never seem to show up well in a photo. I'm not crazy, despite the apparent blankness of the top stick, in real life there is a faint line that doesn't need squinting to see even at arms length. The Accuclear one does seem to be a bit more photogenic.

The line is about the same faintness as yesterday, so inconclusive. Believe me, I have been staring hard trying to figure out if it is a tiny bit darker today or not, but I really can't tell. Today is usually the day when either the trigger is fading out or a real line is fading in. I'll have to do another test this evening!

Thursday, July 23, 2009

6dp3dt, baseline HPT

This probably isn't going to show up well in a tiny photo, but trust me, there is a 2nd line. The trigger is still there as usual. For some reason the top half of the lines are darker than than the bottom half, but in real life the test line is very faint but definitely there. It started showing up within about a minute. All this is typical for me so far for 6dp3dt.



What happens in the coming days will tell the story.

I popped into Target today to stock up on more HPTs, was shocked that they were nearly out, the shelves were almost bare! Prices for First Response at Target can't be beat... around $12 for a 3 pack, and the 2 pack is even cheaper per stick but they were completely out.

Tuesday, July 21, 2009

4dp3dt - 1 week down, 1 to go

The first week always goes by fast. I mean, by transfer it is already 3 days down, that's almost half a week right there. Embie is now 1 week old. If it is still alive, it should be about ready to implant.

I flew home the day after transfer, which I realize is a bit controversial as the clinics like to prescribe bed rest. Until I see a study that says bed rest after IVF transfer has any benefit at all, I won't be doing it. Well, apart from sleeping off the valium for a few hours right after the transfer. All the studies I've seen show that bedrest after transfer has either no benefit or has lower pregnancy rates. One of those studies is Does bedrest after embryo transfer cause a worse outcome in in vitro fertilization?, and there are lots of others that are similar if you Google around a bit.

Although I don't do bed rest, I do take it easy. Very easy. I'm not exactly a bundle of energy while on the progesterone, so that part isn't hard to do.

The progesterone is kicking my butt! I am on 400mg suppositories twice a day, as well as a 200mg oral prometrium. So far it is all the usual side effects, which for me are:
  • sleepy sleepy sleepy! I just want to go lay down for a nap all the time.

  • hungry, but its a toss up between napping and eating when it comes to doing something about it

  • sore boobs. I go "ow!" when I get a hug from DP and I need to sleep in a sports bra.

  • vivid dreams. These start as soon as I start progesterone and they are pretty out there... nothing disturbing thank goodness, just whimsical and always entertaining. I wake up impressed with my imagination.

  • having to get up and pee 2-3 times a night.

  • crampiness! Just like a whopper of an AF is about to start.

  • indigestion

Oh, I went and had my 3dp3dt bloods drawn yesterday:

E2 - 228, Progesterone >40.

I chose not to do the ultrasound as it is so expensive here, and I really don't see the benefit... they can tell from the bloods whether the meds needs to be adjusted. In my case, they said that it looked fine and no adjustments were necessary.

Friday, July 17, 2009

A 5 cell for transfer

Well the good news is that I remembered to bring my socks today, which was just as well because the transfer room was even colder than the retrieval room!

But then things got a tad disappointing with the news that the embryo was only at 5 cells today, when it was 4 yesterday.

I mentioned on the Over 40 board that Check did a study which showed that for a single embryo transfer, a 6-8 cell embryo has a whopping 6 times greater chance of implanting than a 5 cell one, and that is in a woman with high FSH and less than or equal to 3 antral follicles, a criteria I fit quite nicely into. You can read about that study here.

Of course, a small, reduced chance is still a chance, which is more than I have with no IVF at all. If I didn't have tubal issues I would be going down the natural path but this is the only chance I have.

Here is the 5 cell embie. I have to say though, it is one of the better 5 cell ones when I compare it to others that I have had in past cycles... the last 5 cell I had was over a year ago. The embryologist said it had 5% fragmentation, although I think it looks like it has a bit more than that in the picture:

Wednesday, July 15, 2009

Fertilization call

This is the most feared step of the IVF process for me. Beta day can also be pretty bad, but at least I can prepare beforehand because I am an avid POASer. The fertilization call is a complete unknown, and with only one egg, the whole cycle can come to a grinding halt right here.

My DP refuses to take the call, every single cycle. I had to step into the shower this morning and left him the phone, but he said that if it rings he'll just bring it to me in the shower! He says his fear is that if the news is bad, he'll just say ok and hang up... and I'll be upset because he didn't ask a bunch of questions to get as much information as possible! He's right though, I'd want to know if the egg looked unusual, or if it fertilized abnormally or just didn't fertilize at all.

The phone rang mercifully early this morning. Yes, the egg did fertilize! I let out a "yay!" on the phone! Oh the relief!

They will call again tomorrow with another update, and if all is well, it will be a 3 day transfer on Friday.

I've googled and found that the fertilization rates with ICSI are around 60-75%, depending on the clinic. We have been very lucky, we have had quite a few single egg cycles and so far the lone egg has always fertilized. I wonder if it is because it is the egg that the body has chosen for that month anyway, so it stands a better chance of being a good one?

I took DP to the airport this morning, and am glad I don't have to organise my own flight home today... the cycle is still alive!

Tuesday, July 14, 2009

Retrieval day

No nerves this morning, it is going to be either 1 egg or 0, and I think I am prepared for either scenario.

I have also asked that my hydrosalpinx be drained during the procedure. The tube has been ligated so there is no danger of fluid seeping back into the uterus, but the hydro has been getting big and is starting to cause discomfort. They used to drain it routinely at my previous clinic, but it has been over a year since the last time it was done.

At least if it turns out that there is no egg, the procedure wouldn't have been a total waste of time.

I got to the clinic and had the routine scan before the retrieval. They don't use gel on the ultrasound wand before retrieval, so that makes it a bit uncomfortable. Follicle is still there at 20 and the lining is 10 TL.

We fill out the consents and get the paperwork out of the way, fork over $550 for anesthesia, and then I get taken back to the change room. At this point I realise I forgot to bring some socks! Yeah, I had a camera with me but forgot the socks. Oh well. So all I had were the thin paper booties:



I have realized that there isn't much to take a photo of at a fertility clinic. Everyone wants privacy and it is hard to get a pic of anything without people in it, so I am reduced to taking a pic of my feet!

The procedure went well, and I'm very happy to announce that they got the egg! One big hurdle down, but another even bigger one tomorrow for the fertilization call. I hope this egg makes it! We are using ICSI but still, the odds of fertilization are far from 100%.

Monday, July 13, 2009

Better news on the E2

Just a quick one today... went for bloods again, Cooper likes to check on the level of hcg the day after trigger to make sure it got absorbed appropriately.

The E2 was much more reassuring today, up to 446! Not bad for a single! I'm now wondering if there was an error with the results from a few days ago... E2 went from 180 to 173 to 446. Weird.

Here are the results for the day after trigger:
hcg: 377
FSH: 19
E2: 446
LH: 2

Good to see the LH nice and low, hope this means ovulation will hold off long enough for retrieval.

Sunday, July 12, 2009

Triggering tonight

The scan yesterday showed the follicle at 17, so today it should be around 19 which has been the typical trigger size for me.

The bloods yesterday were concerning though. The E2 dropped from 180 to 173. It isn't from the addition of Cetrotide either, as I have been on it for a few days already, and a slight drop or plateau usually happens after the first day.

The LH is still low so there is no danger of surging, and progesterone is still at 1.

I did some research on a dropping E2 before trigger, and the articles that I found all indicated that it adversely affects IVF outcomes. Some even went as far as recommending that the cycle be canceled. Ugh.

I did however, find some anecdotal success stories. One person said that their E2 was dropping so they bumped up the stims and it turned out to be a successful cycle.

Well, they did increase my stims to 225. I suspect this whole dropping E2 thing falls into the same category of canceling if there are less than 4 follicles. Or like the triple line pattern of the uterus. Desirable, but not necessary for a successful outcome.

So staying up late for the trigger tonight, with retrieval planned for Tuesday morning.

Another wildlife in New Jersey pic... there are bunnies everywhere, and they aren't like bunnies found on the West Coast. I have only seen jackrabbits in California, they are tall with huge ears. The ones here are much cuter and have these little snow white cotton tails (although I couldn't get a shot with the tail), I thought these existed only in cartoons!

Friday, July 10, 2009

CD10 update

My follicle is 15mm now, up from 13 two days ago. As for bloods:

FSH: 14
E2: 180
LH: <1

That LH really got slammed down by the Cetrotide, which is good I suppose, no chance for a surge anytime soon. I have some leftover Menopur so I might add that in the mix tonight again, as Menopur has LH in it. Although with minimal stims, it doesn't really make much difference whether I use just FSH, or a mix of FSH and LH. I'm just working through my leftover meds, I have a bunch expiring soon so I am trying to use them all up.

So I'm guessing a Sunday trigger right now, with a Tuesday retrieval. DP is flying up tonight, even though he's holding a refundable ticket and he could change it to Sunday or Monday, he decided to come up anway. I'm excited to see him! For once he has some down time before retrieval, usually he arrives late at night and has to get up early for ER the very next morning. This time he has a chance to relax a bit before he is called up to duty.

Now for today's wildlife in NJ pic. There are heaps of geese everywhere, often in large groups by the side of the highway, especially if there is any body of water around (even damp grass counts). They don't seem to be shy at all!

Wednesday, July 8, 2009

CD8 and another 1 follie cycle

Had a day free from monitoring yesterday, and look what I found while driving around:


A brand new Nordstrom at the Cherry Hill Mall!

I had to stop and check it out. There was some stuff on sale and it was fun browsing, but most things were out of my budget. The mall has been undergoing a remodel since last year, and it is looking pretty nice now. It is a great place to wander around when the heat and humidity get too high.

Although I am supposed to be getting some work done in the hotel room, I find I never seem to get as much done as I expect. You'd think that there would be fewer distractions, but somehow I manage to find some.

Went in for monitoring again today, and the scan showed just one follie at 13. For those of you who are new to my blog, I'm not kidding when I say I'm a poor responder!

There are a few others still stuck around 5, that haven't grown at all despite stims. This is pretty typical for me, happens with high stims too. I guess we are really scraping the bottom of the barrel here in terms of finding any eggs to ripen. That's ok, as long as there is at least 1 follicle developing, I'm game to give it a go!

Bloods were encouraging for my lone follie:

FSH: 14
E2: 105
LH: 2
Prog: 0.9

Lining is 9mm.

Since my follie is at 13, I'll be starting Cetrotide tonight along with the stims. From past experience, I don't expect the smaller ones to catch up at this point (especially since they haven't changed since the previous scan). The Cetrotide will hold off any chance of an early surge starting before trigger.

Next check is on Friday. My follies often accelerate in growth once they reach the teens so I expect to trigger either Friday or Saturday night. I got DP a cheap refundable ticket for Friday, so he'll be here to hang out with me over the weekend.

Monday, July 6, 2009

Started another cycle!

It has been a while since my last blog entry, but sometimes a mental break from TTC is needed, and having a mental break means no blogging about it!

I am back in NJ again for another cycle. Here is a pic of the clinic, the high FSH mecca! Nothing fancy to look at, but there sure have been alot of miracle babies because of this place.


The main purpose of this visit is for a consult, but being in a cycle that actually has a rising E2 (albeit slowly) is a bonus. I hope it keeps going and doesn't stall out, I want to make it to retrieval this time.

Amongst other things, I wanted to talk with the doctor about how estinyl affects my cycles, and how I seem to end up being canceled due to an E2 stuck below 10 when on estinyl. It just shuts my ovaries down. So we agreed that the new plan is if my FSH comes back high, we won't use estinyl to bring it down first, we'll just wait and see what my body does on its own. I'm pretty sure that I'll eventually start growing a follie without meds, and then at that point we can start stims if needed.

This cycle I clocked in with a CD2 FSH of 5, and estradiol 37.

Today at CD6, FSH has already jumped to 13 (haven't taken any stims yet) and estradiol rose slightly to 50.

There is one follicle under 10mm, and a couple little ones under 5mm. We're doing another minimal stim cycle, and today I'll start adding 150iu of stims. This is the latest I have ever started stims. I haven't had all that much luck starting stims earlier, so I don't mind trying a later start this time. Plus any day that I am not stimming saves quite a bit of money, those meds are pretty expensive!

Next scan and blood draw on Wednesday.