The Transfer

Yesterday I told you I got the call from my embryologist in the morning.  I was expecting an email, so my heart dropped, and I did that auto-pilot thing you do when you are expecting devastating news.  Fortunately, the first thing she said was "I'm calling with good news."  My heart resumed beating and she told me that all three of the morulas had made it to the early blast stage.  She expected them to be further along when we got there for our retrieval.  Apparently, the rest of the day, because I was the only transfer that day, she ran around telling everyone employed by the Fertility Center, LLC in Chattanooga that I had made blasts and showed them their picture.  It's part of the reason I love this place.  They are all so amazing and supportive.

BJ and I got to Chat-town a little early and decided to go Christmas shopping at the big mall that is not near as impressive as it was when I was 9.  What can I say?  Once you go KOP (King of Prussia) you don't go back.  As I said, we were Christmas shopping so, of course, we only bought clothes for ourselves.  I got a cute skirt and top in a size smaller than normal.  I believe in Murphy's Law and hope that I cannot wear it for a really long time...well, after a couple of weeks anyway...

It was time to go to the clinic and I was called back for an hour-long massage.  It's included in the IVF package.  So yeah I paid a lot of money for a wonderful massage with a hopefully happy ending.  At least that is the joke BJ and I've been telling each other...hehe...  Then they sent me back to the waiting room. Then they sent me to the lab for my progesterone levels to be checked.  (It's over 40 which is perfect!) Then they sent me back to the waiting room.  What was only like 5 minutes felt like an hour, but finally Susan comes to the door SMILING!  Yes, Susan, was smiling.  Last time, I don't even remember who called me back and then we had the parade of the team doing their death march to tell me, "Umm, your embryos aren't so good."

One of my embryos had become a genuine grade-able blastocyst.  It wasn't a perfect score, but it's in the category of 3AA- which is a high enough grade to consider a single embryo transfer. The three refers to the amount of the blastocyst's expansion, and it just had not had time to take on much fluid.  The first A means that the baby parts were perfect. The second A- refers to the trophectoderm, the part that becomes the placenta.  It wasn't a B, but they were lined up a little loosely.  Susan once again performed assisted hatching on them, and was thrilled to see that it was already starting to hatch itself out the hole she had made. Otherwise it may have been a 4...The other two had made progress, just not quite so much but one was still looking pretty good, so we went ahead and transferred the better of the two still early blasts.  7 other embryos including the early blast were alive and kicking. Two more had become early morulas which is what we had last time.

This is our embryo B in the morning.  It's an "OK"early blast. Its a couple hours behind  embryo A.

This is a Brilliant early blast that is also BJ's and mine. It should look like a rice cake...not bad, huh?

This is Embie B, again 3.5 hours later.  Isn't it neat how fast they grow?  It's still too early to grade but he's making progress and doing fine.

This is Embie A 3.5 hours later and she's a beautiful specimen of a blastocyst.  The outer cells (which are a little bit loose for a A, but an A- nevertheless) will become the placenta.  The cavity part that looks like crinkled paper is going to be the amniotic sack and the little ginger-bread-man looking thing in the low middle is Baby Roberts.  Best moment so far!!!! You can see at the top she's already trying to hatch out which is what you want because that's how they implant in my uterus.

****I do not actually know the sex of these embryos...this is just my silly, sexist conjecture.****  

Dr. Donesky came in with a big smile on his face which has been an unfortunately rare appearance once he starts talking about technical things.  He said this is what we expect.  "We just need one good one and still expect to see some lower quality ones. One is all it takes."  So instead of  bawling crying going into this transfer, I was happy/excited.  So happy and excited that I forgot to ask for water to drink to fill my bladder...OOPS!  I took a quick swig of what I had which wasn't much and tromped down the hall in my shirt, socks, and sheet with BJ in tow.  It all worked out ok as far as my bladder, but one of my ovaries which is still ginormous decided to be a camera hog. (Makes me feel better about aforementioned skirt purchase.)

So, it's a good thing my bladder wasn't full because they had to mash down pretty hard.  I'm pretty sure Dr. D would be very unhappy if I'd had a completely full bladder. For whatever reason the whole transfer process was more difficult this time, but Dr. D finally was happy with everything and the embies were transferred.  The key word is transferred. No one can force an embryo to implant and grow up to make a fetus. I think people sometimes assume that with IVF if you put two in you get two out, or whatever.  But this is a clear case that science can only do so much.  No doctor in the world can make you pregnant, or else I'd have the next available appointment.  After the transfer I had a much easier 30 minute wait before I got up because my bladder was not near as full.  (Remember, ladies, if you ever have to go through an un-pregnant uterine ultrasound, I am living proof that you can cheat it a little bit and be a lot more comfortable.)

So now I've got until Friday around 4pm to be lazy and get up only when absolutely necessary.  As in bathroom trips and eating.  It's a rough few days of trying to not drive myself crazy. Every twinge, and after seeing my ovary I understand why, makes me wonder 'is it happening?'  'Are these implantation cramps?' I keep reminding myself that I'm not an insane person, and that it's not normal to have symptoms this early.  Although I am still on a million hormone supplements, and my ovaries are still acting weird so even if I did, it could simply be residual effects from the stimulation.

It's not all wonderful news, unfortunately.  Susan called me later this afternoon to tell me that none of the rest of my embies could be frozen.  The blast from yesterday did progress a little futher, but the quality wasn't there.  One of the early morulas made it to blast today for a total of 4.  So, no matter what happens, this cycle was 400% better than last.  It was definitely worth trying again.  Susan reiterated that she felt good about the embryos she chose for transfer. One of my online cycle buddies found out she was pregnant this week after having nothing left to freeze out of 23 embryos.  Basically, I've put all my eggs in my one basket. So now it's just praying, hoping, praying, hoping.  And once again, let me take the opportunity to thank everyone!  I would be nowhere without all the love and support I've gotten the past several months. I am forever grateful!

Peace, Love, Prayin' and Hopin'!

Mary Katherine

I believe in miracles. I have to.

"We must try not to sink beneath our anguish...but battle on." JK Rowling

Well, that did not go as planned at all...

I went in for my transfer this morning.  First they took a progesterone level and then took me back to the same prep room they use for the egg retrieval.  No drugs or IV's involved, all I needed was a full bladder (UGH).  It was the normal drill of "disrobe from the waist down and someone will be with you shortly."  This time the someone was supposed to be the embryologist.

A few minutes later, the embryologist, the nurse, and Dr. D came back to the prep/recovery area.  RED FLAG! Susan, the embryologist, told us that our babies were progressing slowly.  There was also some fragmentation.  Out of the 13 embryos remaining the two best looked like they were 4 day morulas instead of 5 day blastocysts.  She did not think any of the 11 remaining would make it to freeze, but she was going to give them an extra day change their fluids and do as much as she could for them.

This is a Day 4 Morula. (image from ivf.net)

These are my precious babies on day 5.  We could really use a miracle, right now. On the right one at about 2 o'clock you can see where Susan performed assisted hatching on the outer layer to help them that much more.  

A Day 5 blastocyst which is where my babies were expected to be. (image from ivf.net)

I tried to be brave and hold it together, but it is really disheartening.  They hugged me and told me not to lose hope, and I haven't, but it still feels like I've been shot through the heart.  I could be losing all 17 of my babies. That is just dreadful to think about.  It is such a strange place to be.  I never expected this and certainly was not prepared for this blow.  Embryo quality did not seem like it was going to be an issue for us.  Our issues were sperm morphology and low hormone levels in myself. Nobody warned us that this could be a real possibility.

It's so bizarre to be in this situation of hope through despair.  I've got to be the best possible mom-to-be to my premature wee ones, but also balance the reality that their odds are diminished.  It's really hard.  I want to scream and cry and have a fit, but I can't.  I want to be elated that I have two of the most beautiful living beings right where they need to be, but I can't.  

Dr. D told us, "It's not what we want to see, but we've seen uglier embryos go on to create some cute babies." I guess he's implying that my embryos are ugly.  I asked him if he'd transferred lower quality embryos and he told me he's done some where he thought the transfer was a complete waste of time and they ended up with twins.  He said not to lose hope.  I haven't, but I'm certainly not in the state of mind that I was hoping to be in for the next 9 days.  Susan also told me that I was a much better incubator than they could recreate in the lab.  So here's hoping.

We signed yet another consent to have both of those transferred and had to be told that the chance of miscarriage, stillborn, and maternal death all increase for multiple pregnancies.  That will just have to be Dr. B's problem if I'm so fortunate.  With a blanket wrapped around my waste and BJ at my side, I followed Dr. D, Susan and the nurse to the operating room.  The procedure was not bad at all.  I barely felt anything but pressure from having a full bladder.  I could see on the ultrasound screen where my two babies were deposited. My progesterone level was great and you could see I had a nice cushy lining for them to snuggle in to if they can hang on for a bit. Hopefully they'll stick around for a while. 

The worst part of the procedure is not being able to pee.  They want you to remain reclining for 20 more minutes.  They rolled me back in to the recovery area on the stretcher and closed the curtain.  That is when BJ and I both broke down for the first time at the same time since this whole process of trying to conceive began. It was an awful 5 minutes, but we realize as potential first time parents, we have a job to do.  I have to take care of the babies I have now and a blubbering jag is not going to help.  

The time creeped by but, eventually, they let me pee.  I got dressed, and BJ drove us home.  I don't think BJ or I said three words to each other in the car.  All you could feel, however, is the strength we have as a couple.  I love BJ so much.  I know we will survive this come what may, I just wish I could give him the family he wants.  

If this cycle doesn't work, Dr. D told us that this did not mean we'd have to use donor eggs or sperm.  If we do have to do another cycle, then, we have every reason to expect things to go well.  He said he would tweak a few things to help ensure my embryos were better quality.  I have no clue what that will involve, but I'm sure it's just more or less medication.

In the meantime we hold vigil for the two babies I've got and their 11 siblings.  Pray that they continue to grow and develop so that some make it to freeze.  I'll take any help anyone has to offer on the prayer side of things.  We've come a long way, but it still feels like we have a bare cliff-face to climb.

Dedicated to my only children.  Mommy and Daddy love you so much!

MK

And the waiting begins...

A person is a person, no matter how small. ~Dr. Seuss

Yesterday, after a nerve-wracking two and a half hours late phone call, I learned that out of our 17 babies, 4 arrested, or quit developing.  So we are down to 13.  I can't say I'm not disappointed, but realistically that is still an amazing amount to work with.  I guess it all depends on your philosophy of when life begins, but when all you've ever had is an embryo, each loss is difficult and leaves us with fewer attempts at a frozen embryo transfer, later.  Again, they only ever expect 30% of embryos to make it to day 5, so anything above 5 and we're beating the odds.

Today, I've tried to rest some more as I've got some beginning of the year, raging sore throat megalo-virus.  I can't talk much to my husband's amusement. I've peed like 18 times today so far (still trying to get rid of all the extra fluid).  I gained 4 of the 8 I lost back the next day and now I'm down 5 for a net of 9 so we're trending in the right direction.  I've tried to get the house ready for Emma Grace's grandmother (my mom) to come doggy-sit since we are headed back to Chat-town. I think I've picked my prescious puppy up so many times today,she is getting sore, but today is possibly the last day that I can pick her up for a while so she's just gonna have to take it!  I also hit the elliptical for one last time for hopefully several weeks...(PLEASE, PLEASE, PLEASE).

I can't say I'm not a little hesitant about the transfer.  My wee ones have a lot of help and support right now, and I'm so scared that I'm going to fail them.  Again, I know I've been extremely compliant and have continued to take all my meds exactly as directed despite a near death experience with a vein and an IM injection (lots of blood, but everyone survived).  There just is not as much control on the implantation side of things. To exacerbate matters, I'm already feeling crampy and pressure in my lower abdomen like before a period starts.  Hopefully it is just the progesterone buffing up my uterus, but it still makes me nervous. I hate to think that there could be something else I could have done to ensure that my babies make it to 4 weeks and then 5, 6, 7....

In 10 days, I will either be the happiest I've ever been in my life, or at the lowest point of my life.  There is no inbetween.  I can't even fathom how I'm supposed to prepare myself if this doesn't work.  How do you get past the feelings of failing at one of life's most basic functions?

Well, it's time to finish packing and begin the next leg of this journey.  All I can do is take it one step at a time.  Give it up to Him and my medical team.  Pray that I'm strong enough to make it through whatever outcome this brings and remember how much I love my husband and how loved I am.

Peace, Love & Survival to day 5,
MK