Hope hurts

Beta was negative.

And I really thought I was pregnant (after feeling very pessimistic earlier in the 2ww). I had cramps on Monday, and then twinges here and there all week. I've been dreaming every night. All symptoms I had with the two BFPs, and so I convinced myself that maybe this did work.

But no.

$20,000 down the drain.

This was the one part of the process that I had some faith in my body about -- two previous transfers = two previous pregnancies. Now, the embryos weren't normal, but my body did what it was supposed to. This feels like a betrayal - I put a known good embryo back in there, and my body didn't keep it safe.

At least we proved we can create a normal embryo.

And logically, I know there was about a 30% chance of a live birth with a good embryo, so the statistics are not on my side. But I had such a good track record with implantation...

I go off meds tonight, and schedule the WTF appointment tomorrow, although there's not much to discuss. We'll do another cycle or two this way, with the PGD, before considering other options.

And I turn 36 in May. And I won't have a baby this year. It hurts.

Girl power

Home resting after transfer.

It turned out that the normal embryo was also in the best shape - grade II early blastocyst. The next best embryo was also a Grade II early blastocyst but had one monosomy. There's about a 5% chance it's actually normal with two markers that were too close together to distinguish. The third embryo was a Grade II morula but had two monosomies, which gives it only a 1% chance of being normal. (Grade I and Grade II embryos have the same chance of live birth.)

We transferred the first two. All three were female, so that wasn't a factor (we would have chosen to transfer one of each if we'd had the choice).

He estimates 30% chance for the normal one (based purely on age (almost 36) and the Grade II characteristics) and like I said 5% for the other. I feel more optimistic than this would suggest, since I've gotten BFPs from both prior transfers. But we'll see - at least we know we can make normal embryos!

Transfer was a little more involved only because he had to switch to a more curved catheter.

And I gave myself the giggles when they radioed that the embryos were on the way and I called out "embryos walking!". Hee! I had to not look at the ultrasound screen cuz all the juggling kept me laughing.

Since it's a Day 5 transfer, implantation could be as soon as tomorrow night. I'll go out to acupuncture tomorrow but will otherwise be at home.

Betas at 10 and 12 days post transfer.

Thanks for all your support! And I'm so thrilled that Lady Pumpkin and Jen had transfers today as well, and CGD got a fabulous fertilization report!

Relief

Transfer is on for tomorrow at 11am!

I got the call from my RE today with the results of the PGD. All three embryos are still in the running -- one came back normal (on the 9 chromosomes they test), and two are 'swing' embryos, which means they only saw one marker but there could be two that are just close together.

We're currently planning on transferring 2. If the swing embryo only has one marker for some chromosomes, it'll either fail to implant, or disappear as a chemical pregnancy by 5 weeks, and according to my RE wouldn't risk the normal embryo. If it's actually a normal embryo, then we have slightly elevated chances of having twins (since both embryos would be normal, and twin probabilities are based on unscreened embryos, so some are abnormal).

My husband would prefer twins, although he admits that's an emotional response. This week, Dr. Sher had a great post about deciding how many embryos to transfer, which I sent to my husband and he found very useful and informative.

I'm ok with the idea of twins but would still prefer to have one at a time, given the risks and costs of a multiple birth. That said, I'm EXTREMELY interested in having at least one baby, hence the two.

We're relieved to have at least one good embryo, and maybe more. I was steeling myself all day for the (not unlikely) possibility of having nothing to transfer.

Phew. And just in time, I have a bunch of Netflix discs coming in the mail tomorrow for my bed rest.

Please send good thoughts to my friend Jen at This is Personal - after a rough day, she's waiting to see if any of her four embryos make it to a transfer tomorrow.

And please also send good thoughts to Lady Pumpkin who's waiting for her PGD results for a hopeful transfer tomorrow.

Three

Quick update -- got an update from our clinic. Our laggard embryo didn't make it, but our three from yesterday are still growing. And it turns out we did have 7 eggs -- 3 mature, 4 immature (one of which matured overnight and became the laggard -- we've never had success with those late-maturing eggs, tho...)

Next update should be Wednesday -- afternoon call to tell me transfer time for Thursday (since we won't know yet if we have something to transfer) and then evening call from my doctor with the genetic screening results. Of course we could get a call before then if we lose all the embryos, but hopefully that won't happen.

Feeling less sore today but still swollen and squishy.

Sending good wishes and #hope over to Jen at This is Personal - her transfer is Wednesday!

Three maybe four

This afternoon I commented to my husband that based on 7 eggs, we'd end up with 3-4 embryos.

In fact, based on 6 eggs (not sure where the 7th went -- I guess there wasn't one in there after all?), we currently have 3 normally fertilized embryos, and one laggard where the egg matured overnight and was fertilized today. We'll find out tomorrow if that one fertilized normally.

This is our best result so far from an IVF cycle. Small numbers compared to lots of people, but good for us. Incidentally, I'm considerably more sore post retrieval this time and have no idea how you people with 20+ follicles handle it.

One bonus of having a laggard is that we'll get daily updates as long as it's in the running. Here's what the week looks like:

Saturday - retrieval
Sunday - Day 1 report for regular embryos
Monday - Day 1 report for laggard embryo (Day 2 for regular embryos)
Tuesday - Day 3 report for regular embryos (Day 2 for laggard embryo)
Wednesday - Day 3 report for laggard embryo (Day 4 for regular embryos)
Thursday - PGD results for regular embryos (Day 4 for laggard embryo) and transfer of any good ones if laggard doesn't make it
Friday - PGD result for laggard embryo and transfer of any good embryos

So from Day 3 transfers in previous cycles, we could end up with a Day 6 transfer if we get lucky enough to have that laggard in the running.

Although we may not end up with anything to transfer. But so far so good!

Thanks for all the well wishes. I had 128 visitors to my blog today prior to writing this post - whoa!

Lucky seven

Back home from retrieval.

Amazingly, out of 8 follicles we got 7 eggs. We won't know until tomorrow how many are mature. (And my RE noted that if any are immature and mature overnight, we could end up with a Day 6 transfer instead of Day 5.)

My NK and TH1:TH2 came back completely normal, so no Intralipid today. If we transfer and get a BFP, then my next Intralipid will happen then. Lovenox starts back up tonight and progesterone (in ethyl oleate) starts Monday.

Retrieval was smooth. Had an anesthesiologist I like (I've had 3 different ones), IV was easy, no nausea. Slept a little longer than usual post retrieval, but otherwise very normal and easy. They all know I have to be flat for IV going in and out, so we have our routine down.

Thanks for your well wishes, everyone!

Retrieval Saturday

I should have posted yesterday but never got around to it...

Ultrasound yesterday morning (Thursday) showed that we're definitely ready to go. Largest follicle was 19mm, then 18mm, 15m, 13mm, 12mm, and 3 around 9-10mm. So 8 total, with 5 that are good possibilities. Lining was great at 11.7 (it's always good -- the one thing I don't have to worry about).

Estradiol was up to 1189, LH slightly up to 7.0 and progesterone low at 0.3. I triggered last night at 9pm and have enjoyed a shot-free day today.

(In unrelated news, I actually had an unplanned shot yesterday. I had LASIK in January and an eyelash grew back ingrown. My LASIK followup was yesterday and I asked my doctor to deal with the eyelash. This involved a numbing injection to my *eyelid*. Eek! Tiny needle -- 30 gauge. I bet he doesn't have many patients who understand how small that is...)

I had a meltdown last night... Scared that I'm going to spend this whole year trying to use my own eggs, and then have to move on to donor eggs. If I knew today I'd have to use donor eggs, I could reconcile to that, but I can't know that. Urg.

I wasn't feeling swollen yesterday but today I have been very tender. The Lovenox started Tuesday and that's causing more bruising, of course. So I had a low-key day, mostly puttering around the house.

I'm not particularly optimistic that we'll get to transfer anything next Thursday. So many milestones:
-how many eggs retrieved
-how many mature
-how many fertilize
-how many make it to Day 3
-how many make it to Day 5 (we've only done Day 3 transfers in the past, so I have no benchmark for this)
-how many pass the PGD screening. (Seems like too many hurdles for 5-8 follicles...)

It would be awfully great if we had a good embryo to put back in! And if this one isn't it, then this fast cycle means we'll be able to do the next one sooner.

We'll wake up early tomorrow -- have to be at the clinic at 8am for a 9am retrieval. No word on my NK and TH1:TH2 results so I don't know yet if I'm having an Intralipid infusion tomorrow.

Sending good thoughts to lady pumpkin who is also having her retrieval tomorrow morning.

Whoa Nelly

(If you're following along with IVF #4, you may be interested in following some of my cycle sisters as well that I listed in my last blog post.)

CD 7 today, based on my clinic counting first day of stims as CD 2. Went in this morning for ultrasound and bloodwork (serious bloodwork - NK, TH1:TH2, estradiol, prolactin, progesterone, LH = 7 vials).

Now, normally I'm a long stim girl -- my retrievals have been on days 14-16 for my previous three IVF cycles.

Not this time. My right ovary has 5 follicles -- the biggest is 15mm! Quick, get some Ganirelix in her! They actually loaned me a Ganirelix so I could take one this morning at the clinic, and when I go back in on Thursday I'll give them one of mine.

So right ovary has a 15mm, a 13mm, an 11mm, a 10mm and a 9mm. The left ovary has two follicles, the larger of which is about 9mm.

Apparently the extra long estrogen priming meant they were really juiced up. Not fabulous, since there's a pretty big spread between the biggest and the largest, but that's what we have to work with.

On one hand, I'm disappointed, because in October we got 6 eggs from 7 follicles, and half were mature. It's likely we'll probably get 4 and 2 will be mature. And then with PGD, we may end up with zero. But, we knew going in that we're likely to have to do a couple of retrievals before getting a good embryo to transfer. And retrieval happening sooner means the next one can happen a little sooner too, should we not get any good embryos this time around.

Silver lining -- this will be the first cycle where I haven't had to order additional meds! At $800/Gonal F pen (for 2 days worth of meds) that's handy.

The hormone bloodwork came back this afternoon and my estrogen is at 714, prolactin/progesterone/LH were all properly low. In October, my estrogen was at 848 on CD 11 and 1137 on the day of trigger (CD13), so I'm way ahead.

Next monitoring is Thursday, and he expects that I'll trigger Thursday night for a Saturday retrieval. The NK results should come back Thursday and the TH1:TH2 will come back Friday. Since my Intralipid was last Thursday I suspect he'll only have me do one with retrieval if my levels are still elevated (last time he did one even though they were normal, but it had been a few weeks since the Intralipid and he wanted to be proactive.)

In unrelated news, I had lunch with a friend who confided that she recently had to terminate a pregnancy at 20 weeks due to an incompatibility-with-life diagnosis. The CVS showed no problems so it was a complete surprise. Heartsick for her...

Yay for Injections

I emailed my clinic again on Friday as I knew I'd need another estrace prescription called in, and was wondering if I needed to do Ganirelix again, and they told me to get estradiol/progesterone checked on Saturday and then they'd figure out what I needed to do.

Bloodwork showed high estradiol (expected because of the estrace) and very low progesterone. So when they emailed me back on Tuesday they told me to come in on Wednesday for an ultrasound and more bloodwork.

The ultrasound showed a great lining (9.5, lol) and quiet ovaries full of resting follicles. For once, my RE was enthusiastic about my ovaries. He thinks I didn't ovulate, and so just got an extra long estrogen priming protocol. Since things look good, he told me to start stims today (Thursday)!

What a relief -- I was imagining horrible scenarios like having to redo an estrogen priming cycle, and thus being put off for two months. So glad I get to start sticking myself with a needle now instead.

I also went in today for an Intralipid infusion (the first one without my husband there -- happy to report it went smoothly). Next Tuesday is my first monitoring appointment, and a giant blooddraw for hormone levels and immunology -- so it'll be something like 7-9 vials of blood. Ew.

Same protocol as last time -- 225 IU of Gonal F and 75 IU of Menopur, morning and night.

Happy to be doing this cycle with some cycle sisters:

cgd at Adventures in Infertility Land

Jen at This is More Personal

Madame Pumpkin at Planting a Pumpkin Patch

Tillien at a nuttier life

Lori at Love, Life & Infertility

Let There Be Sims at Wishing for the Gift of Life

Kittygirltx at Mission to Baby

Rebecca at Trying Not To Scream

Bobbi at The Johnson's Journey

Roccie at Roccie Road

Anyone else starting a cycle around now let me know and I'll add you to the list. :)