Transfer Day - Take Two

The journey to FET #2 has been filled with more anxiety and nerves than I would have liked. After going through a failed transfer it is hard to get my hopes up and to be excited and try to enjoy the moment.

I have been taking Estrace for a couple of weeks now and Progesterone In Oil (PIO) injections for 5 days in prep for this transfer. For the most part the process has been the same however I have felt a lot more emotional this time, likely from all of the hormones.

Today was the day for transfer number two! As I lay here on bedrest I still am in awe of the entire process. Months of appointments, procedures, and testing lead up to this day and then it is over in a flash as the actual transfer only takes about 5 minutes!

I started the day out pretty anxious. Didn't have much of an appetite, felt like puking, and I was on the brink of an anxiety attack as we headed to the hospital. I kept having to swallow back tears and kept telling myself to just breathe. It is in His hands and I need to have faith and trust in my doctor and her team. This will all be okay.

After a lot of thought and in talking with the doctor Josh and I decided to transfer 2 embryos this time. Transferring 2 doesn't necessarily guarantee a pregnancy, however it increases the chance of a singleton pregnancy to 65-70% and overall increases the chance of multiples to 25%. These are all odds we thought a lot about and felt in our hearts was the best decision for us.

The clinic called about an hour before I was supposed to arrive at the hospital and let us know that Embryo #1 thawed out great and was ready for transfer. Embryo #2 however was struggling post thaw and needed a little more time. They wanted to give it another hour to perk up like it was supposed to and if it didn't quite get there we'd decide then whether we wanted to thaw a different embryo out so we could continue on with a 2-embryo transfer.

We arrived at the hospital, did all of the intake paperwork and tests, and waited for a bit before my doctor came in to chat with me. She said that embryo #2 was starting to degenerate and wouldn't make it so we talked about thawing out another. I strongly felt like doing 2 was the best decision and she agreed that was the right thing to do. So transfer was delayed by about 15 minutes [with a full bladder it begins to feel like a long time!]. 30 minutes later she came back and said Embryo #3 thawed well and is also ready to transfer!

As said above, the actual transfer took about 5 minutes. They drew up both embryos into a catheter, inserted them into the uterus and got the final okay that they both were placed where they needed to be! I was required to rest for 45 minutes before being discharged and then we headed back to the hotel. I had a wonderful 3 hour nap and am continuing to try to relax and stay calm.

I am so thankful that my anxiety has lessened as the day has progressed. I attribute a lot of that to the Valium that I had to take this morning but I also know that the moment has passed and there is little that I can do to control the situation. It is all out of my hands.

Thanks for all the prayers and positive thoughts up to this point. I know that we have so much support and we are very, very thankful. I continue to ask for prayers that these embryos continue to be strong and continue to develop, for my body to stay relaxed, for my uterus to be receptive for implantation, for my anxiety to keep at bay, and for a good amount of patience as we wait for the blood test to see if this finally worked!

Top Left: Embryo #2 that didn't quite make it after the thaw

Top Right & Middle: Embryo #1 right after thaw and then right before transfer

Bottom Right: Embryo #3 that was thawed and transferred right away

Our First FET

Words don't come easy when the news you dreamt of sharing turns into news that breaks your heart.

The month of October has been full of complex emotions for Josh and I. At the beginning on the month we quietly began our protocol to prepare for our first frozen embryo transfer (FET). Lots of pills, an ultrasound, and several progesterone injections later, we got to hold a picture of our beautifully thawed little embaby and amazingly got to watch as our RE gently transferred it to its new home.

We left the clinic in awe. We had hope, we were optimistic, and we were overjoyed that maybe it was finally our turn to become the parents that we've been painstakingly trying to become.

Day 1, 2, 3, and 4 post transfer passed slowly and both Josh and I were thankful for the distraction of our jobs and ordinary life. Hope and optimism prevailed. Medications and routines continued as if this little embryo implanted into its new home comfortablly.

As the next days moved forward and home pregnancy tests continued to be negative, nerves, doubts, and disappointment slowly creeped in. At first I laughed... of course they are negative, it is still far too early... but then why are some of the ladies in my support group already getting positives? I still shrugged it off... mine will come.

But then on day 6 the reality of the 50% chance that this little embryo may not have made it became clear in my mind. I hid my fear at first, but my husband knows me well and knew I wasn't okay. I cried. I shared my doubts. We talked about our optimism turning into doubt and we moved forward.

Day 7... negative again. Deep down I knew.

Day 8 was my Beta, (blood HCG test). My home test was again negative and even though I knew it would be negative, once I got home I prayed fervently, through tears, that there was some hope of a miracle.

Exactly 1 hour later my phone rang and my heart skipped a beat. Dr. Oakes' office. I took a deep breath and said hello. It was Dr. Oakes herself. Immediately the tears streamed down my face. I knew. She asked how I was and I lied. I said okay.

She told me she was floored. Completely stunned. My test was negative and our embryo failed to implant. Her words only partly stuck with me as I was trying to compose myself enough to comment. She said that typically she doesn't say very much during transfer because she doesn't want to give any sense of false hope because transfers DO fail. But she told me that our embryo just looked perfect. It thawed beautifully, transferred very well, and she fully expected it to be a success. She reiterated to me the fact that approximately 40% of embryos are chromosomally or genetically abnormal. She feels that, in her words, "We just didn't choose the right one".

I couldn't think of any words to say. No questions to ask. My tender heart was broken. She went on to say that she feels our protocol was perfect and that we are welcome to transfer again next cycle, or wait it out until we are ready. She invited Josh and/or I to call her and ask any questions or voice any concerns at any time and she would make the time to talk to us about what is next.

I thanked her, she told me, "Today is a bad day, take care of yourself". I hung up and just stared forward. Now what? I made my way to the couch and after sitting down I let out the biggest, ugliest sob that I'd been holding in for days. I had never felt so alone in my life. My husband was at work and I felt like I was literally going to fall apart. I didn't expect the news to devastate me in that moment quite like it did. I cried and after composing myself just enough, I called Josh. News I didn't want to deliver over the phone, but I had no other choice. He didn't answer and so I sat there with tears streaming down my face.

Eventually I picked myself back up and started distracting myself with laundry and by getting ready for work. Then Josh called and I dreaded talking to him. I wanted nothing more than for him to rush home and be with me. Even more-so I didn't want him to be alone. I knew how I felt and it crushed my heart to think that he may feel the same way yet be surrounded by his students unable to process the news.

I answered and stuttered to tell him. We didn't exchange many words, but I know that we could both tell by each others voices that we were heartbroken. It killed me that I couldn't come home that night so that we could be together. I hated to know we would both be alone. I cried the entire way to work and as I got closer put on a mask that hid the devastation I was feeling in my heart. Work was the best distraction.

We've been doing better since Tuesday when we found out, but our hearts still hurt. We continue to grieve for our little embryo, we grieve for all of the time lost, the time taken off of work, we grieve for the money we spent, we grieve for the seemingly perfect timeline that could have been, we grieve knowing that we could have been 4 weeks along, we grieve for the future that we thought we had started. We just grieve.

I find myself doing mostly okay, but I have moments of sadness and I've had quite a few moments of being angry and bitter that this didn't work out. I've been talking to another women who had the same timeline for her FET that we did. Her's also did not work and she has been a wonderful resource for me as we both struggle to understand the why's and as we try to figure out what to do next.

Keeping this transfer journey quiet was good in theory but we realize how lonely it has made us feel after we found out that it did not work. It's made me realize how much I appreciate the support and how thankful I am of the support of family and friends as we take each step. It's hard to know when to share and where to draw the line because all of this is so incredibly emotional and personal. But again, we are constantly made aware of how amazing our support system is.

I am so thankful to walk this path with my husband. While work has kept us apart, he's been the only person I've really wanted to be around as no one knows this journey better than him. I'm thankful for the weekend to spend some quality time together to focus on us and to continue to move forward.

Josh and I have had a couple of opportunities to talk about what our next steps are going to be. The conversations have been good but the decisions to make are so difficult and must come so quickly. We will be going through with another FET before the end of this year the question we must quickly face is when. We also have the difficult decision of how many embryos to transfer, as she has given us the option of 1 or 2. We appreciate many thoughts and prayers of guidance for us. For us to know in our hearts the answers to the decisions that we face.

The journey is not over for us, we've just hit another step in the process that we will overcome. The end result is becoming even sweeter and so much more special for us. It's an end result that we absolutely cannot wait for.

How Many to Transfer?

Throughout this process a super common question that both Josh and I have been asked is

"How many are you going to transfer?!"

I thought I'd do a quick post to address this as there are so many misconceptions about how the entire IVF process works and how transfer works. After we tell friends that we have 9 frozen embryos we have to giggle because it is surprising the number of people who think that they get transferred all at the same time! They ask us if we will end up like Octomom or something! I am relieved to say that it is pretty rare to transfer more than 2, SOMETIMES 3 embryos at a time.

Each of the embryos are frozen separately and therefore they are able to be thawed individually. The goal of my RE, and most REs out there, is to give the patient the best chance of a live birth with few to no complications. With that being said, most women have the best chance with only transferring one, sometimes 2 depending on the reason for the infertility.

In our case, it was recommended for us to only transfer one embryo unless we were dead set on two. Josh and I both thought about doing two, and we thought about the possibility of twins. It could be a lot of fun, and you get two for the price of one! BUT we decided that we wanted to do what our RE said was going to give us the best chance at a successful transfer and pregnancy. So far all of the steps that we have taken to get where we are have went according to plan and so hopefully one will do it!

I have learned that just because you transfer multiple embryos it does NOT increase the success rate of the transfer, instead it just increases the chance of multiples. Furthermore the more embryos that you transfer the greater the chance of complications throughout your pregnancy if they all implant successfully.

The thought of carrying twins scares me, especially because of my health history. I don't really want to carry two babies in my belly at one time anyway! Ha! And the thought of actually raising twins in the beginning is also really scary... first time parents responsible for TWO lives. You also have double the cost of everything all at one time and that within itself is intimidating!

So with all of that being said, we decided to only transfer one embryo. If, for some reason, this little embaby doesn't make it, it may be recommended to transfer two, but we will always go with the doctors recommendation of what will be best for us! If we are ever blessed with twins, we would be scared but absolutely overjoyed at the opportunity!

Our little Embryos

Life since egg retrieval has been much better than expected! It has definitely been filled with a lot of suspense as we have waited for each call, but recovery wise it has been so good!

I have heard horror stories of recovery post retrieval so I tried to expect and prepare for the worse. The day of the retrieval I had some cramping and discomfort but I didn't have to take any medication for it other than what they gave me at the hospital before I was discharged. I woke up Saturday feeling pretty well and we drove the 4 hours home. By the time I got home I was fairly uncomfortable from the bumps and sitting up for so long. Sunday I took it fairly easy and by Monday I returned to work. I was probably feeling about 90% on Monday and by Tuesday I was feeling 100%!

Saturday I woke up so early and couldn't go back to sleep. I'm sure a lot of that was in anticipation of the phone call from the clinic telling us how many of my eggs were mature and how many fertilized. She called close to 11:00 and told us that out of the 13 eggs that were retrieved, 12 were mature, and 11 (!!!) fertilized!! Both Josh and I were so happy. That is such a great number to start with and gives us really good odds for having enough embryos to work with at the end!

She told me that they would call back on day 5 to let us know how many embryos made it to the blastocyst stage to be able to be frozen for a transfer later on.

Today is Wednesday and I got the call! We have at least EIGHT little 5-day embabies in the freezer waiting for us! 8 is an incredible number and so many more than I could have asked for and more than I dreamed of having. I am over the moon happy and excited! We have 3 embryos that they put back in the incubator for one more day. They have a 50/50 chance to make it to freeze, so we could potentially have as many as 11 embryos waiting for us.... Tomorrow will tell!

A Bakers Dozen

We made it! It has been a rough couple of days but we made it to egg retrieval day! Wednesday after my panic attack I felt much better after chatting with the nurse and her easing my mind that everything was looking good for retrieval on Friday. I went to my sister-in-law's house, took a nice nap and woke up SUPER congested. Great! My husband is finally feeling human again after a respiratory infection had him miserable this last week. Seems to be that we swapped bugs!! So by Wednesday night I was feeling fairly awful and I'm pretty sure I had another low grade fever. We had to stay up until 11PM to do my Trigger shot of Lupron.

I was so nervous about Josh giving me the injection! Do you see a pattern of how much I like to be in control of my situations?! I had him practice on a tomato and we watched a couple of YouTube videos of IM injections. Here are a few pics my sister-in-law snapped of us learning:

I do have to give hubby props - he did so good! He told me exactly what he was doing the entire time which really helped me relax. I honestly didn't really even feel it other than the poke at the beginning! Piece of cake! 

I woke up on Thursday absolutely miserable again. I had some pretty bad nausea all night and woke up with major nausea, headache and feeling like my head might explode from the pressure. I took a hot shower and hubby was kind enough to get up and drive me to the clinic for repeat labs yesterday morning. Got to the clinic and was able to talk with the nurse a little bit. She assured me that, minus the head cold, the nausea was pretty normal to be experiencing at this stage. Suggested I rest and load up on water!

Went back to the house and slept for a bit and got the call back that the trigger shot worked, labs looked good, and we were for sure on for Friday retrieval! 

So fast forward to this morning.... We made some babies with a lot of love and even more science!

The nurse that I had was fabulous - definitely above and beyond what I expect from a nurse when I'm in a pretty uncomfortable situation and a little bit nervous. Thanks, Bernice!!

Retrieval went well, she said my follicles were difficult to get into, but other than that it went according to plan. We retrieved 13 eggs which is a great number to start out with! I was a little disappointed as I really thought we would get more considering that I started out with about 20 follicles... but I keep reminding myself that in the end it is quality over quantity. I will be extremely happy if we get at least 5 embabies to freeze. A couple of babies plus a couple of extra embryos should we need them due to implantations failures (God forbid). 

 

After retrieval we quickly stopped by Walmart to get a heating pad, some drinks, and a cozy blanket for me to wrap up with. I took a nap this afternoon to let the pain medication wear off and I've been relaxing and drinking fluids! I'm feeling pretty good, just some cramping and an achy feeling that is pretty constant, but the heat is helping significantly and honestly I can't say that it is that bad!

Tomorrow morning we will get the an update with how many eggs were fertilized via ICSI which is a standard procedure at our clinic. My fingers and toes are crossed that we get most if not all to fertilize Then we will hear back by the end of next week on how many made it to blastocysts to freeze! I don't know if I'll be able to handle myself with the wait, but then again... IVF is full of waiting!!

Trigger Day!

This last week has simultaneously zoomed by and lasted forever. I have had a ton of back and forth trips to Lincoln in the evenings for an early morning drive to Omaha for monitoring appointments. To be honest, I can't really even tell you what day it is today with any kind of certainty!

I knew that this was going to require a lot of my personal time, but I honestly didn't think that my life was going to completely revolve around medications, injections, lab work, ultrasounds and the works. I know that if I lived in Omaha life could continue on as normal as possible, but having to drive to Omaha really limits how much I am able to work and be home. I'm incredibly thankful that I have been able to take off this whole week to focus on growing and maturing some eggs! It has also been really nice to have a full week off of work. It is definitely not how I would prefer to spend it as I'd much rather be vacationing in the mountains or taking another trip to Utah, but since we had to cancel our vacation this summer to save for IVF, mentally I really needed this break. I hope that I am able to regroup and come back to work refreshed enough to start digging through the piles and getting everything caught up so that we can do this again come transfer time!

So a huge shout-out to all of my employees for stepping up and maintaining the lab while I'm gone. Thanks for allowing me the break to start my family and to not feel like I have to stress out about not being there. I owe you guys!!

Since the last time I wrote I have had a couple repeat scans. Monday's went pretty well. I had about 5 follicles that were ready but roughly 15 that were still young and needed to mature so my doctor felt like it'd be best to continue my stims and add in an additional injection to prevent ovulation of the big follicles and to allow the other follicles to catch up.

So I drove back to McCook on Monday after my appointment and spent all day on Tuesday catching up on the dishes piled high in my kitchen, sweeping the piles of dog hair away, and getting some laundry caught up. This not being home thing has really caught up to me! I overdid it a little bit so I was relieved to be able to sit and relax on the drive back to Lincoln Tuesday night.

I had another scan this morning and it just really caught me off guard. I think the clinic had quite a bit going on and so the wait was pretty long to go back even though I got there earlier than usual. That didn't exactly help my anxiety :) For some reason I was more nervous than I have been, probably because this is the scan that tells us if we can proceed!! With all of my past scans my doctor has done them. I've been able to ask questions during and she takes the time to explain the results of the scan with me and what they mean. It's really helped my anxiety and has allowed me to feel comfortable and not really sweat it. But today a different lady came in to do my scan. Totally fine, but her body language was a little harsh and she never introduced herself to me. I'm going to be honest, I have NO IDEA who she was! My best guess is an assistant of my doctor? She said hello to me, asked me if I had my lupron, and then at the end told me they'd meet me outside. That was literally all she said to me. SOO that raised my anxiety a bit and just made me really uneasy.

I did get to see Dr. Oakes briefly after the scan. She told me that things looked good and that we are good to trigger tonight! For those of you not savvy in IVF speak, this means that at a very specific time tonight, exactly 36 hours before egg retrieval, I will do an injection that will trigger the final maturation process of the eggs and allow them to release at the correct time on Friday when we officially have the egg retrieval. Tomorrow morning I will go in for labs one more time to make sure that the trigger actually worked like it was supposed to and if everything looks good FRIDAY IS THE DAY!

After I got out to my car I started getting nervous and a little panicky. By the time I got out on the highway I started getting tears in my eyes. I decided that I probably needed to find a place to park so I found a parking lot and pulled over. By the time I got into the parking lot I started having a nice panic attack. Great. The fear of the unknown started creeping up and just completely overwhelmed me (and of course the extra hormones soaring through my body didn't help). All of these What-If situations keep playing around in my head. I think part of that is because I didn't know exactly what the scan showed other than the follicles that were measured, and to me they still seemed a little small.

What if the trigger injection doesn't work?

What if my eggs don't mature enough?

What if we are triggering too early?

What if. What if. What if. 

[A huge thanks to my sister for responding to me super quick when I sent her a message that said, "I need someone to TALK ME DOWN." She's always been good about responding right away and just listening to me when I need to verbally work things out.]

It is so hard to just let go and trust the process. I DO trust my doctor. She has done this countless times and is excellent in what she does. She knows more than I do... she knows more than google does. This is why she has a degree and does what she does. I have to be okay and know that she is doing everything as it is should be. Everything is going to be okay and even if it's not, it is NOT the end of the world, just another bump in the road. If it doesn't work out, it is just another piece of the puzzle of why we can't conceive.

What if = Fear
Even if = Faith

So as I'm sobbing in my car in the parking lot of Scooters, I told myself that if I want my morning coffee I needed to stop it, pull myself together, and stop thinking like this. I reminded myself of when I freaked out 2 Friday's ago when I thought we were going to have a cancelled cycle how how it all worked out and I spent the weekend emotionally exhausted for nothing.

So I am currently just waiting to hear back from my clinic about the timing of my trigger shot tonight and am anxiously waiting my husband to arrive tonight. I have been so thankful for all of the support that we have gotten. But I'm tired of doing this all alone, physically alone... with no one by my side. I've gotten along okay, but am beginning to feel quite nervous as I am back to not really knowing what to expect with retrieval on Friday. Going to try to distract myself today with a movie at the theater and I am going to try to accomplish some more on my new crochet project later this afternoon until my niece and nephew get home from school! That's a super good perk of staying in Lincoln, I've gotten to see a lot of my sister-in-law and those two munchkins. Lifts my spirits up!

Looking "Eggcellent"

Whew! What a bumpy ride I've had so far!!

On Monday I started the Follistim and by Tuesday night I was miserably sick with a low grade fever, chills, sweats, and the works. I felt like I had the flu which really concerned me. I wasn't sure if being sick could affect the process or if I was having some horrible reaction to the medication. I was reading the package insert of the meds and a "serious side effect" of flu-like symptoms was listed with the recommendation to call your doctor immediately. Great. 

So I got on the phone and they got me in touch with the on call fertility doctor at the clinic. She reassured me that it was probably a huge coincidence and that I probably just caught something going around. What horrible timing! So all of Tuesday night and Wednesday morning I was feeling like death, but by Wednesday evening I was feeling like an entirely different person! Whatever I had it ravaged my body very quickly and left quickly as well. 

Other than that, I have been doing really well! Day's 1-3 I haven't had any symptoms at all from the medication. Today is day 4 and I can definitely feel my ovaries when I bend left or right and I've been getting some minor cramping and twinges from them as well. It hasn't been a big deal and to be honest, it is kind of a relief to actually feel something because I know that the medication is working. 

Today I had my first monitoring appointment. Things are looking great! I've got 8-10 follicles on each ovary ranging from about 10-13mm each which is an excellent number to begin with! I have a couple of bigger follicles and a few smaller ones as well, but they might not amount to anything, only time will tell! My doctor was very pleased with how I'm progressing. My Estrogen level is fairly high and so she changed my "Trigger" medication that will trigger the eggs to release when we need them to for the retrieval. For those of you IVF-savvy it was changed from an HCG trigger to a Lupron only trigger which should reduce my risk of OHSS.

Each follicle should house one egg... so we are looking at an estimated egg count of around 20 as of right now. Not all of those eggs will be mature, not all will fertilize, and not all will make it to the important blastocyst stage that they need to to freeze. So just because we get 20 eggs doesn't mean that we will have 20 embryos to work with... only time can tell. But my RE reassures me that it is a great number to work with. :) 

I go back for another ultrasound and more labwork on Monday and we will go from there! Hopefully the follicles continue to grow at a steady pace. We are looking at an estimated retrieval on Wednesday or Thursday... it continues to get SO REAL!