5 Weeks and Counting

Today I am exactly 5 weeks pregnant.  Even though we can't be certain what the final number of babies will be, I've been living life as if I'm pregnant with multiples.  That means increasing my vitamin intake significantly.  I take a cocktail of about 15 pills everyday including multiple prenatal vitamins, fish oil, folic acid, magnesium, and probiotics.  In addition to that I'm still supplementing progesterone  and estrogen throughout the first trimester.  I still feel every bit the infertility patient because of it.

My diet is also baby-centric.  I'm eating almost all organic now (which is, admittedly, tough on the pocket book).  I try really hard to get enough iron and calcium in my diet and am putting a heavy focus on protein.  I am also going to acupuncture once a week, and may increase to twice a week if multiples are confirmed.  I tried to enroll in prenatal yoga, but they prefer that you wait until the end of your first trimester before beginning.  I am still doing regular Yoga, but I've switched from Power to Restorative classes and I'm also keeping the Pilates reformer classes going.  My Pilates instructor is really good about helping me modify for pregnancy and I really like that.

So far, everybody is surprised that I haven't already gotten morning sickness because all of my hormone levels are so sky-high.  I hope that it is related to everything that I'm doing with vitamins, diet, acupuncture, and exercise and that I can keep it manageable, if not avoid it entirely.  I know that multiple pregnancies can be very difficult, and I am hoping that I get to be the exception to that rather than the rule.

As far as symptoms I am experiencing, I still have a crazy strong sense of smell and it's getting more pronounced every day.  Ryan came home from skiing yesterday, and I gave him a big hug and almost choked on the smell of sweat.  I'm a little nervous about going to volunteer at the Humane Society today because of all of the smells.  Hopefully it's not too bad.  I am also starting to notice the fatigue.  I get tired more quickly than normal.  When I went in for the ultrasound, Dr. Magarelli came in and specifically told me not to try to power through it.  He said, "I know your type, and you have to trust me on this.  You won't be able to do as much as you are used to doing."  So far, those are the only symptoms I'm having.  I'm sure more are on the way.

I'm glad to have had the first several days of my pregnancy off from work so I could establish a routine.      I've also had a chance to do a lot of reading and studying which puts me at ease.  I like to feel in control, and being educated about what is going on inside my body helps me to do that.  I know that I'm probably going overboard, but when you've worked this hard to get pregnant, you don't want to leave anything to chance.  As an infertility patient, it's hard not to view pregnancy as a series of hurdles.  Positive pregnancy test, confirmation of implantation, heartbeat, first trimester, etc.  I am making an effort to just enjoy it when I can.  I just wish that part came more naturally.

Nothing Definitive

I was thinking that I would go in today and they would be like, "There are definitely X babies in there."  It wasn't quite so cut and dry.  We went into the ultrasound room, I disrobed, and then they began the ultrasound.  The nurse technician was able to find where all three embryos had implanted.  That is the reason that my beta number was so high.  Don't get excited yet, that doesn't necessarily mean triplets.

Basically, one of the embryos looks ideal, one is average, and one is several days behind in development.  With her 15 years of experience, the nurse thought it was unlikely that the third embryo would make it much further.  The fact of the matter is that you can't really consider it a success until you see a heartbeat.  That happens at about 7 weeks gestation. Today I am 4 weeks and 5 days, so 2 weeks and 2 days to go.

I have another ultrasound scheduled for next Thursday.  That will give us a better idea of whether or not that third embryo is simply behind the other two in development, or if it has stopped growing entirely. The good news is that none of them have shown signs of splitting, so we are looking at a maximum of three.

So, I guess we're not picking out nursery furniture yet.  All we know right now is that we are having equal to or less than three babies.  It's funny how when you're sitting there, looking at the ultrasound, you become emotionally invested in the babies that are inside of you.  Ryan and I have talked at length about the fact that we would be most happy with twins.  But, as I sat there, looking at the struggling embryo, I wanted so badly for it to thrive.  Here I am, scared to death we're going to lose this poor embryo, and having triplets is not even something that we wanted.  It's still not something we want, but I can't help pulling for the underdog.

Here I am, only 4 weeks and 5 days pregnant--at this point a lot of women don't even realize they are expecting--and I am getting emotionally attached to these black dots on a screen.  I know it's not just the dots, it's what they represent.  A chance for a family.  A chance for a legacy with children and grandchildren and great-grandchildren.  It's a really big deal.  So, what we need now is some rest and some focused prayer.  May we be blessed with the exact number of children we were meant to have.

These are our strongest two.  The third is underneath them and we couldn't get a good picture.  

What?!?

Today was the date of our first blood test to check my levels of HCG (Human Chorionic Gonadotropin).  It is basically a growth hormone produced during pregnancy and it is measured with something called a "beta number."  The higher the beta number, the more HCG you have floating around in your system.

I went in this morning for the blood draw on base.  The base laboratory called the on-call nurse at Dr. Magarelli's office and she called me around noon with the results.  The conversation went something like this:

Cecilia:  Congratulations!  You're definitely pregnant!
Me:  That's fantastic, do you know what the beta number is?
Cecilia:  Of course, we always get the number.
Me:  What is it?
Cecilia:  3,100
Me:  Isn't that really high?
Cecilia:  Well, it's not too high.  We'd like to schedule an early ultrasound for you on Friday.
Me:  Like, this Friday?  Two days from now?
Cecilia:  Yes.
Me:  Isn't that very early for the ultrasound?
Cecilia:  We thought getting you in as soon as possible was a good idea.  Is Friday at 10:00 alright?

So, just in case you need a frame of reference, at this stage after an embryo transfer a beta number of 3,100 is stupid high.  On the up side, we will know on Friday how many babies we have in there.  On the down side, they have me genuinely worried about how many munchkins we might be having.  The most shocking thing they could say to us on Friday is, "Looks like you have ONE healthy baby in there."

Today, I called my best friend Jenny to tell her that I was freaking out about how many babies I might have in my belly.  Worst case scenario, if all three split, we could end up with sextuplets.  You know what she said?  "I hope you have so many that you get your own show on TLC."  Thank you for the support, Jenny.

Wandering Mind on Christmas Eve

Ever since I found out we were expecting, I've been a little bit nervous that it's not going to last.  This is especially true because I'm so early in the pregnancy.  Just 4 weeks and 1 day to be exact.  There's a reason that people are advised not to tell others until the end of the first trimester.  Not to mention, I'm so early that I don't even feel pregnant yet.  I get the occasional twinge, and I have a wicked sense of smell, but that's it.  Usually morning sickness and whatnot doesn't come on until about the sixth week.

This morning I woke up and took a home pregnancy test just to make sure that I was still pregnant.  Here are the results:

So, not only was the test positive, but the pregnancy line was actually darker than the control.  There's no doubt about it, I'm still pregnant.  On Wednesday and Friday, I go in for blood tests, so I'll get that much more reassurance about the fact that we're going to have a baby.

One of my first impulses when I found out I was pregnant was to begin getting ready for our baby (or babies).  The problem with trying to get ready is that I have no idea how many I'm getting ready for.  I don't know whether I'll be able to use the stroller my brother let me borrow, or if I'll need a double or triple stroller.  How many cribs will we need?  We don't even know which bedroom to start preparing.  Will we be able to use the smaller one or will we have to use the larger one to have enough space?

Being the bargain shopper that I am, I have to hold off on all of the goodies until we have an exact number.  Then, after I collect the basics, I'll have to hold off again until we find out what flavors they are.  There is so much waiting involved; it's tough.  For now, I'm just researching as much as I can.  I've almost finished "What to Expect When You're Expecting", and then I'll be into reading "Eating Well When You're Expecting."  I've subscribed to "Fit Pregnancy" magazine, let my Pilates instructor know to help me modify my routine, and after the holidays, I'm going to sign up for Prenatal Yoga.

I think my biggest fear with twins or triplets is not at all related to managing them after they are born.  I'm a pretty organized gal and I rarely get stressed out or upset; I was practically designed for this type of challenge. Not to mention, my husband is amazing. My biggest fear is that I won't carry them to term and then I'll have to see my sweet angels in incubators in the NICU.  That terrifies me.  I recently had a close friend have a baby at 31 weeks (who is thankfully a healthy, thriving little boy), but hearing about her journey made me think, "I don't know if I could do what she did."  I know that having multiples puts you at a much higher risk for preterm labor, and, to me, that is the most frightening part. Anyway, we don't even know if that will be an issue, so I'm kind of putting the proverbial cart before the horse.

Merry Christmas and God bless.

The End of the World (As We Know It)

To be honest, I was a little irritated that my test results were going to be pushed back for the holidays.  I thought I might take a home pregnancy test, but then I decided that I would abuse my power as a healthcare professional and have a coworker order an early blood test for me today (a big thank you to Dr. Pack!)

This morning after I saw my first patient, I rushed to the hospital to have my blood drawn.  As soon as I got back to the clinic, I began compulsively checking for the lab results on the base medical system.  Exactly 1 hour and 8 minutes after I had my blood drawn the results changed from pending to completed.

I took a deep breath and hit enter.  The next thing I saw was the word POSITIVE in all capital letters.  I jumped up out of my chair and started clapping.  I ran down the hall and started calling my family.  Shortly thereafter, I went into the ladies locker room and cried tears of joy.  The rest of the day was really lovely.  Nothing could bring me down.

The high hasn't worn off yet.  I am still so happy I can hardly stand it.  After all of the needles, pills, and heartbreak, we are finally expecting a baby (or three).  I know there is still a long road ahead and a lot of hurdles to jump, but that doesn't make the excitement any less.

So what's next for the Manning's?  We have two blood tests coming up on Wednesday the 26th and Friday the 28th.  They are going to tell us our "beta numbers" which is a measure of HCG (Human Chorionic Gonadotropins) in the body.  What we are hoping is that those numbers at least double over a 48 hour period.  That is an indicator of a viable pregnancy.  After that, we will have our first ultrasound around January 9th or 10th and we will find out then how many babies are in there.

For now, I'm going to go hang out with my Baby Daddy and then read "What to Expect When You're Expecting" until I fall asleep.  Goodnight to all and may your holidays be as wonderful as ours will most certainly be.  Thank you so much for the thoughts and prayers, it made all of the difference.

The Waiting Game

I don't know how to describe the wait other than to say that it has become excruciating.  It has been five days since the embryo transfer and I am still nine days away from knowing what is happening with my body.  At this point last time, I was breaking my heart daily with negative home pregnancy tests.  I believe I started testing at three days after the transfer when I saw that one of the girls on the forum I was following got her positive result that early.

The problem with home pregnancy tests is that once you open that floodgate, it's hard to stop yourself from taking them over and over again.  I don't think I can promise that I won't succumb to the temptation to use one, but not having any in the house sure is helping.  Tonight after my shower, I intentionally put on pajamas and left my hair wet to keep myself from running to the store.  A little crazy town?  Maybe.  But it worked.  

Enjoying bed rest.  New Jimmy Choo's came in the mail and I was so excited I wore them in bed!

I've definitely been feeling more symptoms than I did last time, but that could always be attributed to medication or to a very active imagination.  Here's what I've noticed so far.  On Saturday night, I stood up from the couch and it felt like I had done about a thousand crunches.  I hadn't worked out since Monday, so I'm pretty sure it wasn't residual soreness from that.  The past couple of days, mostly today, I've been noticing a slight cramping.  I would describe it (for the ladies who know what I'm talking about), as the period cramps you feel that signal you that more painful cramps are on the way.  Nothing has been painful or even uncomfortable, just noticeable.  Also, I've had a seriously heightened sense of smell.  Today, a lady came into my office to use the microwave.  Guess what she was heating up?  A hard boiled egg.  First of all, who does that?  Secondly, I had to leave my own office to escape the stench.  I couldn't handle it.  

I realize that these symptoms could very well be the result of medication side effects and magical thinking, but they sure do feel real to me.  I think the only good thing about not knowing, is that I get to enjoy thinking I'm pregnant for just a little bit longer, no matter what the outcome is.  

The current Manning children.  

The future Manning children.  Love them already.  

Possibly Pregnant

Right now, I am two days past the embryo transfer.  Those of you who I haven't spoken to already are probably wondering how it went.  The short answer is that it went very well.  On Wednesday, we arrived at the office right on time (which, for those of you that know Ryan and I, you know that is a huge success in and of itself).  The office wasn't very busy and it seemed like only my favorite nurses and techs were there.

We were taken back quickly and changed into our operating room garb.  I did a little dancing and singing to Britney Spears "Toxic" and took some Valium.  Shortly after, Dr. Magarelli came in to discuss how the embryo thaw went and to help us make a decision on how many embryos to transfer back in.  As you may know, we had four embryos remaining after our last transfer.  All four of them thawed, but one was not showing signs of continued growth, so it was not a viable option for transfer.  That left us with three Grade B embryos.  Dr. Magarelli said, "If you're alright with it, I'd like to transfer all three."

Next thing I know, we were signing on the dotted line and being directed back to the operatory for the procedure.  Everything went really smoothly.  It was much less crowded this time around, which was good.  Before the procedure, my bladder has to be completely full because a full bladder helps push things around so they can put the embryos back where they want them to be.  Probably the worst torture in the world for me is needing to go to the bathroom and having to hold it.  Just ask my brother; I was miserable on long car trips as a child and he used to torment me relentlessly about my delicate bladder.  When the procedure is over, they ask you to lay there for 15 minutes before getting up.  Last time, I tried to grin and bear it and was absolutely miserable until they brought me a bed pan.  This time, I asked for the bed pan right away then drifted off to sleep.

After we changed and they wheeled me out to the car in a wheelchair, we headed over to the acupuncturist for a treatment.  For some reason, they gave me two Valium this time instead of one.  I was one relaxed little girl.  At the acupuncturist's office, they gave me some hot packs around my neck and feet and I dozed off before they even finished putting in the needles.  Going from the acupuncturist to home is a long sleepy blur followed by a four hour Valium nap.  At around 7:00 that night, I began to become a little more lucid and decided to check my phone and the internet.  Guess what?  Internet was down.

I guess God truly does work in mysterious ways.  The internet can be a very insidious thing, and last time around, it truly aided in driving me insane.  I googled symptoms and shopped for baby things, and researched parenting methodologies.  This time, that wasn't even an option.  From the time I got home until now, I've spent time reading, watching some Disney movies, and journaling.  It's really been a lovely couple of days of bed rest.  Now, I'm at a coffee shop borrowing the internet and relaxing outside of the house a little bit.  Don't worry, I'm not having any caffeine.  In a few minutes, I will be off to get a little acupuncture, then wrapping and scrapbooking for the rest of the afternoon and weekend.

I am very content right now with the little Manning triplets floating around inside me.  I don't even have any of those blasted pregnancy tests in the house.  We are scheduled for a blood test on December 26th.  What a lovely Boxing Day gift!  As far as transferring three embryos instead of two, I supposed that we just have to trust that God won't give us more than we can handle.  Will check back again soon with pictures when we get our internet going again at the house.  Hoping that your holiday season is lovely.

12/12/12

Today is the day!  For some reason, 12/12/12 is feeling very lucky to me right now. This cycle feels absolutely nothing like last time around.  I suppose that's a good thing, because last time it didn't work.

I spent last night lounging in the bathtub, drinking a glass of red wine (presumably my last one for several months), and reading the November issue of Vogue.  This is in absolute stark contrast to last time when I was running around trying to make the house perfect for bed-rest and absolutely studying everything "baby" I could find.  I think I may have driven myself a little nutso.

In the time between transfers, I really have been focusing on myself and my relationship with my husband.  I've been eating healthy and working out a lot.  I've even gotten into Pilates reformer classes that I absolutely love.  After all of the nasty hormones and depressed eating of the last cycle, it's nice to see my body finally changing back to what it was before.  I'm not gonna lie, I'll be a little disappointed to see the belly start growing after all of this work, but if I keep on the healthy track I am hoping I will be able to bounce back at the end.  I've also been journaling, praying, and reading.  These are all things that help soothe my soul and make me feel really good.

This time I am going to do bed rest a little differently.  Focusing on being pregnant and thinking about babies the whole time was maddening.  I am still planning to spend today and tomorrow on bed rest, but my entertainment is going to be a little bit different.  I have a manual to go through for my new iPhone and another Disney biography (I've already read a couple) to devour.  After that, I am going to spend the next couple of days on modified bed rest in my happy corner.  Can't wait!

My room!  Cozy and clean!  Ready for bed rest.

Entertainment for the two days.  iPad, iPod, computer, books, and journal. 

My happy place!  Every 11-year-old girl's dream.  Don't plan on growing up.  Ever.

Can't wait to catch up on some scrapbooking! 

On Saturday night, Ryan and I got all dressed up and went out on a date.  We talked and laughed and had a wonderful time.  There was a moment, when I was sitting across from him and he was smiling his big, beautiful smile and I thought, "I am the luckiest girl in the world."  I can't wait for this next chapter to begin.  The transfer officially happens at 1:30 today.  That's 3:30 Eastern time for the followers in KY.  If you find a moment, and your heart leads you there, say a little prayer for the Manning family.  We would really appreciate it.

3 Days Left

Geez, oh Pete!  This transfer has really snuck up on me.  Only three days left until it happens and I've been so wrapped up in Christmas that I haven't even had much time to think about it.  It's hard to believe, after being so obsessed last time, that I would even be capable of being this nonchalant about the whole thing.

Since my last post, I've had two doctor's appointments with blood work and ultrasounds.  They both went swimmingly.  I would have blogged about it, but I didn't think "everything is normal" was really worth writing home about.  My estrogen levels have been sufficiently high this time around (that was the big scare last frozen embryo transfer), my uterine lining is trilaminar (it has three distinct layers) and it is nice and thick (a good bed for embryos to snuggle into).

Also, as promised, I made acupuncture appointments for the day before and the day of the transfer.  It's kind of the bear minimum, but I dislike acupuncture so much that I thought it was probably the appropriate regimen for me.  At least I'm getting back in there.

So far, everything has been very easy and it's all going according to plan.  The biggest concern at this point is how well our embryos will thaw, and that's completely out of our control.  I think that having survived a failed cycle, I am much better at managing my expectations.  I have seen failure, so I'm not as naive.  I think the way to describe how I'm feeling is cautiously optimistic.

At this point, if it doesn't work for us, I am ready to call it quits.  However, I don't think Ryan is quite there yet.  He wants to keep going until we have used all of our embryos, at least.  I'm beginning to think that this whole thing is effecting him more than it is me.  My husband is a very competitive, hard-working person and he has never met a challenge he couldn't surmount with a little bit of perseverance.  He seems so certain that this cycle is going to be a success, that I worry about how broken his heart will be if it is not.  I think that seeing him hurting will be the hardest part of a failure at this point.  I pray that we don't have to go through that.

Shots Again...Bleh

Yesterday was the kickoff appointment for the next frozen embryo transfer.  They did blood work, took a urine sample, and completed another ultrasound.  All of the blood work came out perfectly, the urine sample indicated that I was not currently pregnant (surprise!), and the ultrasound showed that my uterine lining was ideal and I am completely healed from the Ovarian Hyperstimulation Syndrome (OHSS) that I had back in August.

When I went in for the last frozen embryo transfer, the OHSS symptoms were mostly resolved, but not completely.  I still had some small cysts in my ovaries.  Actually, they weren't "technically" cysts because they were still small, but they were still not normal.  I do wonder if my body was not ready for the transfer last time around.  If that was the case, then this time, we should have a much better chance for success.  

Tonight I began the estrogen shots.  The good news is that I only have to do these shots once a week.  The other good news is that the dosage is really small so it doesn't hurt as much.  The bad news is, it's a gigantic needle in the bum and it still isn't fun.  I also started taking Doxycycline today to prepare for the procedure.  I've been taking Folic Acid, Fish Oil, and a Prenatal Vitamin for a while, so I'm continuing with those.

It's nice to have support from Isis.  She makes it a little easier.

As far as acupuncture goes, I still haven't gotten back in the saddle.  I have been meaning to, but I dread it so much.  I will probably only get in a couple of treatments before my procedure.  I know it's supposed to help somehow, but I wonder how helpful it can be when I get anxiety even thinking about it.  I will call and set up some appointments tomorrow.  Promise.

Oh yeah, we have an official date for our next transfer!  Wednesday, December 12th.  Mark your calendars and say a little prayer if you find a minute.  We need all the help we can get.

Round Three...and We're Off!

More needles this time around.  Sad.

Today is the official beginning of IVF cycle number three.  Since they are timing this round with my natural menstrual cycle, the start of my period wasn't just the start of my period.  It marked the next round of medical intervention as well as the confirmation that we still can't make it happen naturally.  

On Wednesday, I go into the doctor's office for baseline blood work and to receive the calendar with the official date for the embryo transfer.  It will likely be the week of December 10th.  We have four embryos left and they are all of lesser quality than the two that we used during the last transfer.  That makes me nervous.  Hopefully, a more positive state of mind and overall better health will outweigh this sad fact.  

Honestly, I'm a little disappointed that our break from the Reproductive Endocrinologist has come to an end.  I was enjoying the freedom from thinking about all of this stuff.  After spending three months thinking of nothing but having a baby, the two months off was incredibly refreshing.  The good news is, we only have a month to go before we know whether or not this is going to be our road to baby.  Here's praying.   

Balance

This last month, I have worked really hard at healing after our first IVF failure.  I've spent many hours engrossed in deep journaling; putting my thoughts on paper has always helped me to sort things out.  I've spent time appreciating my husband and working to make our already strong bond stronger.  I've put a heavy focus on bringing fitness back into my life and have been reaping the rewards.  And I have found solace in prayer that I have not experienced in a very long time.  Finally, I feel content with everything that has happened and everything that is yet to come.  

Yesterday, I spent the morning shopping for gifts for babies that have recently come into our lives or who are about to enter this world.  In the afternoon, I attended a lovely baby shower for a former co-worker and realized that I felt absolutely no jealousy, only joy.  I cannot say that I would have felt this way at any other time over the past year.  Emotionally, I am in a place that I have wanted to be in for a very long time.  

Perhaps, the reason that God put me through everything that I have experienced thus far is so that I could get to this place.  I no longer spend my time obsessing oveer the one part of my life that is missing.  Instead, I am enjoying all of the blessings that I already have.  I am excited about our December embryo transfer.  I am certainly hopeful, but I have learned that making it the singular focus of my life is not only completely draining, it is also emotional sabotage.  I need more balance.  

I would say, if I am going to do one major thing different this time around, it would be that I am not going to obsess over the transfer as if it is the only thing going on in my life.  Last time, I read books, participated in forums, shopped for my future baby, and, in general, let every other aspect of my life slide.  This time, I will continue to pray, but also keep in mind the importance of maintaining my physical and emotional health as well as my relationships.  In my opinion, it is extremely important for a mother and father to be balanced in order to raise a balanced child.  Balance is my goal this cycle.    

Ryan's pumpkin carving project.  Niko and Isis helped.

Pumpkin carving success!!

Napping after all of the hard work we did watching Ryan carve a pumpkin.

Here We Go Again

It's been almost a month since we learned that our first embryo transfer was not successful.  After some time spent in mourning and a much needed break from medication, I called to schedule the obligatory "What happened?" appointment.  We went to that appointment this afternoon and sat down with Dr. Magarelli to discuss the last cycle.

Unfortunately, as I had suspected, there were no good answers.  It was just one of those things.  I hate that.  I wish we could simply pin point what went wrong and fix it before moving on.  Sadly, these things are not that easy.

The good news is that we have mapped out a plan for moving forward.  We are changing a couple of things from last time.  First of all, after the estrogen debacle that almost cancelled the transfer last time, we are switching from estrogen patches to injections.  Bleh.  But, I clearly didn't respond well to the patches last time, so I totally understand and agree with the change.  Also, at my request, they are going to follow my natural menstrual cycle instead of manipulating it with birth control.  Last time, I ended up having an 11 day cycle before the transfer and I feel like that really threw off my clock.  I've always had a pretty regular 28 day cycle and felt really out of whack when it changed so significantly.

As far as a schedule, we are planning to do the embryo transfer in mid-December.  That gives me about six weeks for  acupuncture and detoxing all of the caffeine and alcohol I introduced into my system last month.  Here we go again.

The Results

This morning I went in to have my blood drawn in order to find out whether or not the past three months and several thousands of dollars had yielded us the results we had been praying for.  After an excruciating 6 1/2 hours, I finally received the call.  It was Dr. Magarelli himself and he began the conversation with a deep sigh.  At that moment, I knew what he was going to say.

"Well, it didn't work out this time.  You're not pregnant."  At first, I felt my whole body go numb.  Then a lump began to grow in the back of my throat as I attempted to end the conversation without letting my voice quaver too much.  I immediately called Ryan, and as I told him the news I couldn't contain the tears any longer.  I only had a couple of minutes before I had to see my next patient, so I wrapped it up quickly and headed back to my office to see if my patient had arrived.

Unfortunately, he was already seated for a two hour procedure that I wasn't even sure if I was capable of doing.  I ran to the restroom, wiped off the smeared mascara, wet my face and headed back to the treatment room to finish my day.  Before I walked in, I put on my mask and glasses to cover the red skin and puffy eyes.  The whole two hours, I struggled to choke down the rock in the back of my throat and keep the tears away.

At the end of the day, I changed clothes and made my way to my car.  I kept my eyes down and took the long way so I wouldn't have to salute anyone.  As soon as the car door closed, I broke.  I spent the next five minutes doubled over in the driver's seat with my face buried in my hands.  When I finally regained my composure, I drove home in silence with tears streaming down my face.  It was hours before I could even call my parents and let them know the news. So, please, do not take offense if you are close to me and I didn't call you today to let you know.  I just wasn't able.

So where do we go from here?  Quite frankly, I'm not sure.  I definitely am not up for another transfer yet.  I need a break.  I need to gain a little bit of normalcy before I jump in again.  We have four more embryos waiting for us.  Maybe one of those was meant to be our little one.  I suppose we'll see.  In the mean time, I plan to spend a lot more time on myself and my marriage.  I need to remember the family that I do have instead of dwelling over the one piece that's missing.  I'm fortunate enough to have parents that care, a brother that cares, in-laws that care, and nieces and nephews to adore.  I have amazing friends who support and love me no matter what happens.  I really am a very lucky girl.

Night Before the Pregnancy Test

It's been a couple of days since I took a home pregnancy test.  I just couldn't bear to see anymore negatives.  I wouldn't say that I have completely lost my hope, but I would say that I'm managing my expectations.  According to the www.nyufertilitycenter.org, on day nine after a five day embryo transfer, levels of HCG should be detectable.  For me, they were not.  At this point, if I were to have a positive blood test tomorrow, I would fall into the realm of being the exception rather than the rule.  To an extent, I have already grieved for this cycle.  

I have spent more time the past few days working out what Plan B will be than I have being excited about the prospect of potentially being pregnant.  In a lot of ways, this feels safer to me.  If the test comes back negative, I will feel comforted by having a plan in place.  If the test comes back positive, then I can happily toss my plan to the side and I still have nine months to prepare for the next adventure.

If my blood work yields a negative result, I am going to take a couple of months off before going back for another transfer.  This emotional roller coaster has been exhausting and I need to get off of it.  The most important task for the next couple of months is to focus on myself.  I started off about 10 pounds heavier than I wanted to be, then, with all of the hormones and the ban on exercising, I gained another twelve.  Now I'm 22 pounds heavier than I want to be and I hardly recognize myself when I look in the mirror.  My most beautiful clothing doesn't fit me anymore, and as a lover of clothing and fashion, this really breaks my heart.  I will spend the next few months unmedicated and working with a trainer at the gym.

I can't wait to get myself back, not just physically, but emotionally too.  All of the hormones I took completely messed with my emotional stability.  Not to mention, the whole process put so much stress on me that I was singularly focused on having a baby and forgot about many of the other things that are important to me.  I'm excited about the prospect of stepping back and refocusing.  No matter what happens tomorrow, we will create a happy ending.

8 Days After the Transfer

I haven't been writing on the blog because if I actually wrote how I felt each day, then everyone would think I was completely schizophrenic.  One day, I'm so certain that I'm pregnant that I'm picking out cribs and downloading relaxing music to play in the nursery.  The next day, I'm devastated, crying in the shower and devising Plan B.  If I were to post every thought that I had, I am sure that when I finally had a baby someone would come and take it away.

Today I am officially 8 days past a 5 day transfer.  I used to find some solace in an online forum filled with other women who were going through Frozen Embryo Transfers during the month of September.  Yes, the forums really do get that specific.  I was certainly surprised.  Anyhow, after the transfers, many of the women started taking home pregnancy tests.  As early as 4 days after their transfers, these women were getting that second pink line.  The majority of the ladies who did transfers the day after I did have already gotten positive results.

I took my very own home pregnancy test this morning.  It was the most sensitive test on the market.  I got a big fatty fat negative.  I can't help feeling completely discouraged and heartbroken.  The official blood test is on Monday,  but I feel pretty certain that I have my answer.  I know there is still a glimmer of hope, but I don't want to bank on it.  Only a handful of women get a positive blood test with a negative home pregnancy test this late in the game.

If, in fact, I turn out not to be pregnant, here is a list of things to never, ever say to me.
Keep in mind I have already heard all of these in one way or another:

1)  Just relax and maybe it will happen naturally.
2)  Enjoy the freedom of life without kids.
3)  There's always next time (unless you're willing to pay for it next time, then you can say it).
4)  Maybe you weren't meant to have children.
5)  My personal favorite:  You can always just adopt.

Pregnant Until Proven Otherwise

It is the day after my embryo transfer and I am in sitting in my bedroom watching Aladdin and trying to enjoy my time on bed rest.  On the nightstand next to me, I have some beautiful flowers sent by my mother-in-law and the picture of our embryos propped up against it.  Every time I look over, I imagine that they are snuggling in and making a home for the next nine months.

Yesterday was an exciting day in the Manning household.  We spent the morning preparing for the time I would spend on bed rest and took the dogs for a walk.  At 11:00 we headed to the Reproductive Endocrinologist's office for the procedure.  The first order of business upon arrival was our discussion with the doctor about the number of embryos to transfer.  We found out that both of the embryos that they attempted to thaw, thawed successfully and no cells were lost.  This was fantastic news.  After a short discussion, we decided to transfer both of the embryos.

After consents were signed, Ryan and I both got suited up and waited for the procedure to begin.

Waiting to go back into the treatment room.

Throughout this process, there have been multiple students and interns involved in my case.  For the procedure, they all wanted to come back, so I had quite the audience.  Including Ryan and myself, there were nine people crammed into the tiny procedure room.  It was nice to have so much support from the staff at Dr. Magarelli's office.  If a medical procedure can be fun, then I guess we all had a good time and a lot of laughs preparing for the procedure.  I have to say that I wasn't even the slightest bit nervous.  There was so much positivity in the room, I couldn't help but to feel good about it.

The transfer itself went off without a hitch.  It was as smooth as it could possibly be.  After it was all over, the whole staff yelled together, "Let's have a baby!"  and it made me cry happy tears.  Ryan was handed a picture of our two embryos, and we looked at it together while I laid down recovering from the procedure.  Honestly, the procedure itself was not very difficult.  We watched on an ultrasound as the doctor placed the embryos and there was very little discomfort.

So now I just sit and wait hoping that these embryos snuggle into place while I rest in bed.  I find myself analyzing every small stir in my body.  Every stomach gurgle or twinge makes me wonder if the  embryos are cuddling in.  I like to imagine that is exactly what is happening.  The worst part about this phase of IVF is waiting for a definitive answer.  I am scheduled on October 1st for my first blood test to determine whether or not I'm pregnant.  It will be a couple of weeks after that before I know how many implanted.

In the meantime, I greatly appreciate all the support, prayers, and thoughts that so many of you are sending our way.  Ryan and I are truly blessed to have such wonderful people in our lives.  We will do our best to keep everyone updated.

Transfer Day!

Today is the big day!  I am massaged and acupunctured and ready for the day.  We're going into our Frozen Embryo Transfer (FET) with a lot of optimism and prayer.  At 12:15 Mountain Time (that's 2:15 for the followers in KY), we will be transferring our embryos back  into my uterus and waiting for them to snuggle into the cushy uterine lining that I have been trying to create with medication for the last 2 months.  We won't know until we arrive how many have thawed and how many we are going to transfer back in.

We have 6 totsicles waiting for us at the doctor's office. They are frozen in groups of two.  The embryologist will begin by unfreezing the two highest quality embryos.  If both survive, Ryan and I are hoping to transfer both.  Each individual embryo has about a 40% chance of implanting.  When you transfer two, you have an 80% chance of getting pregnant and about a 30% chance of ending up with fraternal twins (at least for our age and health).  In about 1% of cases, the embryos split causing identical twins.  That means, in a very very small percentage of cases, people who transfer two end up with two sets of identical twins or quadruplets.  My Reproductive Endocrinologist has been practicing since 1992 and has had this happen three times total.  Please pray that we are not number four.

I honestly don't have a preference about whether we have twins or just one baby, there are pros and cons to both.  My only hope is that we don't have more than two, as this greatly increases the risk to both the babies and to me.  I just want to have a healthy pregnancy and a baby who is a combination of myself and my wonderful husband.

Throughout this process, Ryan has proven himself to be the single most thoughtful, empathetic, and kind person that I have ever met.  He is far more amazing than I even thought he might be the day that I married him.  I am so fortunate to have someone like him in my life, and the world would be truly blessed to have a child of his in it.  I hope that our child takes after their father in every way possible.  I know, without a shadow of a doubt, that he will be a phenomenal dad.

After the procedure today, I will go in for one more acupuncture appointment then head home for three days of bed rest.  I have spent the past couple of days setting up the room for optimum entertainment.  I've filled it with books, movies, and I'll have my computer, iPad and phone on the ready for all of my electronic needs.  I am hoping to catch up with friends, download music, read, and update Pinterest while I'm down.  Here are some pictures of the lovely oasis that I've set up for myself.  Hopefully I will manage to stay entertained.

My cozy bed and nightstand full of goodies.

Collection of pregnancy books, but I've already read all but two.

The last year or so of Vogue, one new book (Room), one library book (From Conception to Birth), a few favorites from my collection, my journal, and an iPad for downloading books and updating Facebook and Pinterest.  

Transfer Moved...Again

I last wrote on Monday after an appointment where everything was right on track.  My estrogen level was at 230 and apparently climbing.  Their goal is for estrogen to reach 300 prior to beginning supplementation with progesterone.  On Friday I went in for another ultrasound a blood work to check the lining and make sure I had reached that 300 mark.  After the ultrasound, they said that my uterine lining looked like it belonged in a textbook.  That made me feel really confident about going into the transfer next week.  After this confidence builder, I was completely blindsided when they called Friday afternoon to let me know that not only had my estrogen level not reached 300, but it had actually dropped to 214.

I was devastated.  If my estrogen level didn't rise, I might have to wait until next month to try again.  They asked if I could come back on Saturday morning to see if it had risen, but they made it sound like this was a little bit of a long shot.  That evening, I let my acupuncturist know what had happened and she did a treatment to help stimulate estrogen production.  I also added a fifth estrogen patch to see if I could get the levels to go up.

Saturday morning, I went in and had my blood drawn.  It was a tough morning of waiting for the results.  Needless to say, I had a one track mind.  At 11:30 the nurse called to let me know that not only had my levels risen above 300, but they wanted to move the transfer up a day!  What amazing news!  After all of this waiting and postponing, I was actually going to get to do something ahead of schedule.

I was elated for the rest of the afternoon.  That evening, Ryan and I went out with the Murphy's for sushi and indoor skydiving.  We were both celebrating our 3rd anniversary and having one last night of risky fun before I find myself expecting.  Only three more days!

Waiting in our skydiving suits with Ryan Murphy and my husband Ryan.

Flying high!

So happy!  Pictures complements of Carrie Murphy.

 

10 Days Until Transfer!

As I sit here, I am sipping on what will hopefully be one of my last pumpkin ales until next fall.  While I am sad about the sacrifice of the delicious pumpkin beverage, I think the trade off will most certainly be worth it.  While I'm thinking about it, could someone ship me some spiced apple wine from Huber's?  That is something I will most certainly miss this holiday season.

If you can't tell, I'm feeling very confident at the moment.  I had a very good check up at the doctor today.  They did blood work and an ultrasound.  Right now my estrogen level is 230 (and increasing, poor Ryan), and my uterine lining is about 7.9 mm.  They will want it to be between 12 and 16 mm by the transfer next Thursday so the embryos can snuggle in, but I am well on my way.

Today I am 10 days away from my transfer and I am starting to get excited again.  Finally.  I was beginning to wonder if I would this time around.  I think my biggest problem now is getting it off my mind.  Right now, I am not able to see patients at work due to some hoop jumping, red tape, and incompetent people in the credentials office at the Air Force Academy.  That means that I spend all day at work just sitting there reading or surfing the internet.  (I apologize to all of you whose tax dollars are supporting such nonsense).  I am so bored that I can't help but to obsess about the process.

On Sunday, I spend three hours volunteering at the Humane Society, and it was the best three hours that I've had in a very long time.  I was so busy, that I didn't think about IVF even one time.  It was like freedom.  I can only hope that I am able to see patients at work soon so I can stay busy and not think about everything so much.

On Friday, I went in for my first pre-transfer acupuncture appointment.  I have to admit that it was much more relaxing than the pre-retrieval appointments.  I actually fell asleep for almost the entire treatment.  While I was sleeping, I had a dream that made me wake up with happy tears in my eyes just before the treatment ended.  It was a brief dream, but I dreamed that I was riding the Dumbo ride at Disneyland, and I looked back and saw Ryan in a yellow Dumbo behind me laughing with a little brown-haired boy.  I looked to my left and noticed that I was sitting next to a little brown-eyed, brown-haired girl dressed like princess Belle and she was smiling.  I woke up feeling like I had seen a glimpse of a possible future for Ryan and I with children.  It made me so happy.

I don't believe that I saw the actual future, but it was an idea of a family and it made me feel whole.  I hope that this process leads to a family for Ryan and me.  We want this more than anything.  I want this to be our time.

One of my all-time favorite pics of Ryan with two of our nieces and one of our nephews. 

Here We Go!

Went in yesterday for my baseline blood work and ultrasound.  Everything is as it should be.  My hormone levels are all normal and my uterine lining is nice and thin.  Last night, I began the estrogen patches.  They are clear patches that about 1 x 1 and 1/2 inches in dimension.  Apparently, they don't like sweat very much.  This morning when I was working out, it got a little loose around the edges.  I change them every 48 hours, so I may only have to break a good sweat once every other day if I'm going to keep them in place.

I think the worst part about them is that the glue globs up around the edges and attracts dirt and yuck.  It  makes me feel like a gross person.  Right now I'm only wearing one, but by the time it is all said and done, I will be wearing four at a time.  Don't worry, if it looks ridiculous enough, I will take a picture and post it.

Also, today I got the calendar for this cycle.  According to the schedule, the transfer is September 20th and the first pregnancy test is scheduled for October 1st.  At this point, I suppose I am cautiously optimistic.  I have no reason to believe that things won't go well, but I didn't last time at this point either.  I will just have to take the next 15 days one at a time until the transfer happens.  Round two, here we come!

Baby Pics

A lot has happened since my last post.  On Friday, I had a doctor's appointment to do an ultrasound and check for fluid in my ovaries.  It's all cleared up!  That means I'm on pace to do a Frozen Embryo Transfer (FET) on Thursday, September 20th.  I'm really glad that I get to move forward, but the appointment was a little bittersweet because according to the original calendar that I got for my IVF cycle, Friday was the day I was supposed to find out whether or not I was pregnant.  I had a good cry on Friday afternoon, then picked myself up and decided to focus on my list of "Fun Things Before Pregnancy."

Friday evening was nice and cool, so Ryan and I went to our gym, wallowed in the outdoor hot tub and had some good conversation.  It was a really perfect night and we got to check a little something off the list. Sunday, Ryan and I watched the UK vs UofL football game and enjoyed a win for our favorite team before our guests arrived from Boulder, CO.  Jim and Christina arrived in the early evening and we immediately headed out to Edelweiss to enjoy some German cuisine and, of course, some delicious German beer.  I also tried Brie for the first time which is both delicious and something you're not supposed to have when you're pregnant.  We ended the night with some Apples to Apples then got some rest before our big day today.

Bright and early this morning we headed out to Triple B Ranch to do some horseback riding and enjoyed a leisurely ride in pretty much perfect weather with absolutely gorgeous scenery.  If my Camelpak hadn't been leaking on my back the entire ride, it would have been perfect.  After that we headed out to lunch in Manitou Springs where the less than stellar waitress broke a glass of cream on Ryan's lap causing him to have to change his clothes, then paid for his meal. The Manning's just couldn't seem to keep dry today.  Finally, we made a stop at Garden of the Gods to take in it's sheer beauty and awesomeness.  It was pretty much a perfect Colorado Springs day.  

So, to recap, this weekend I got in a hot tub, drank German beer, ate Brie, and rode horses.  A very fun non-pregnant weekend.  This week I get back on track preparing for my FET.  Tomorrow I go in for baseline blood work and ultrasound and begin my medication for this cycle.  I saved the best news for last, though.  On Saturday, I went to the mail box and inside it was the embryology report and right there in the center of it was pictures of our embryos!!!  Our first baby pictures!  More likely than not, one of these six blobs is going to be our future child.  How crazy is that?

Looking Forward

I've received all of the medication for the Frozen Embryo Transfer.  This is going to be so much easier on my body than all of the medication leading up to the egg retrieval.  Not a single shot.  A lot of the medication I'm taking now, the doctor is recommending that I continue taking throughout the pregnancy.  Fish Oil (for baby brain development), Folic Acid (to prevent neural tube defects), Prenatal Vitamin (makes sure I have the right mix of vitamins in my system), Synthroid (to keep my hormones regulated throughout), and Singulair (because allergies in Colorado are miserable).

The rest of the medications are meant specifically to get my body ready for the embryo transfer.  Estrogen patches (to help make my uterine lining nice and cushy), Aspirin (to increase blood flow prior to the procedure), Doxycycline (to prevent infection from the procedure) and birth control (to get my hormones on track before everything begins).

I have been taking the birth control for a few days and Friday is supposed to be my last dose.  On Friday, I have an ultrasound to make sure that I am completely healed after Ovarian Hyperstimulation Syndrome.  The last ultrasound found that I no longer had fluid in my abdomen, but I still had three small sacs of fluid in my ovaries.  They want to make sure that those are gone before going ahead with the embryo transfer.  If they are gone, then I will be done with birth control on Friday and gearing up for an embryo transfer on Thursday, September 20th.  If they are still there, they are going to keep me on birth control for a few more days, recheck, and then do the transfer on Wednesday, September 26th.

In the weeks leading up to the transfer, I am going to start acupuncture again.  I am also going to do all that I can to decrease stress and increase positivity.  I've decided that this month, I am going to try to do the fun things you're not supposed to do while you're pregnant.  Not everything, though.  I'm not going to light up a cigarette, snort cocaine, or bungee jump (looked into it--too expensive), but I've made a list of some of the things I'm going to try to fit in.   Here it is.  Feel free to let me know if you think of more.  It's already going to be a busy month, but I will try to do as much as I can.

Fun things to do BEFORE pregnancy:
1)  Jump on a trampoline
2)  Get in a sauna or hot tub
3)  Sky diving (it's indoor, but I will still count it)
4)  Horseback Riding
5)  Eat Sushi
6)  Ride Roller Coasters
7)  Clean the litter box (Ryan will love that)
8)  Drink alcohol (not a lot, but I will be down to zero when I'm pregnant)

This weekend, our friends Jim and Christina are coming into town and we're going to do some horseback riding near Garden of the Gods.  Also, I'm going to head over to the Mason's house to hit up their trampoline.  Finally, I'll head over to the gym and soak in the outdoor hot tub on a night that's cool.  Next weekend, we'll cash in some free amusement park tickets we have and get on some roller coasters.  Finally, our anniversary weekend, we're going to go to Denver for some sushi and indoor skydiving.  All of these fun activities will be punctuated with the occasional adult beverage and litter box scooping.  I'm very much looking forward to September.  Hopefully, all the fun will keep my mind off the waiting game and my spirits high.

Dealing with Sadness

I write each of my blog posts sitting in a glider in the corner of the bedroom that we set up as a baby's room when we moved into this home over a year ago.  We thought for certain we would have news of joy very soon after we arrived in Colorado.  Now, this room is a standing reminder of the missing piece in our lives.  I have been having trouble dragging myself to the computer to write over the past week.  Tonight, I just decided to sit down and write whatever thoughts came into my head.

If everything had gone according to plan with our first IVF cycle, we would have been finding out whether or not we were expecting a child this Friday.  It is strange to think that only two short weeks ago, I was filled with so much hope and happiness about the whole process.  Since the transfer was cancelled, so many things have brought me sadness.  I have had to avoid Facebook, because each time I log on I am bombarded with baby pictures, birth announcements, pregnancy bump updates and stories about children.  I used to be so extremely happy for everyone, but now I can hardly keep tears away.

It makes me feel so guilty that I am so wrapped up in my own sorrow that I can't even feel joy for others.  I have never been this way.  I have always been a supporter and a lover of other people; in the past, I considered this one of my best qualities.  I don't even feel like myself these days because I have lost that.

As we proceed with the Frozen Embryo Transfer, I feel emotionally empty.  I am afraid to be hopeful.  After everything that we have been through so far, all that has happened is that I have had to recover from an illness, I have an empty bank account, no vacation days left at work, and I am 10 pounds heavier.  We haven't even had a chance at creating a family yet.  I don't think I have ever hurt so much in my entire life.

Two days ago, I started birth control to regulate my hormones in preparation for the next phase of IVF.  The good news is, that prior to the Frozen Embryo Transfer, there are no shots.  The only goal this month is to create an environment that is perfect for growing a baby.  This means that I will be taking medication to help create an ideal uterine lining for the embryos to implant into.  This also means that I am going to have to figure out how to get my emotions under control.  I need to find a way to get rid of all of the negative thoughts and surround myself with positivity over the coming weeks.

One thing that made me very happy this past week was shopping for a gift for my nephew's 6th birthday.  I am sad that being away from Kentucky is causing me to miss so many milestones for my nieces and nephews, but when I go back it will make being with them that much more special.

The picture we sent with our nephew's gift.  

Embryo Update

Over the past few days, I've been receiving daily phone calls about the progress of our embryos.  Each day, I waited on pins and needles for the report and, even though I knew they couldn't all have stayed near perfect, I was still extremely disappointed whenever I heard one was struggling.

After investing so much in the egg development, I found myself extremely emotionally attached to the growing embryos.  I would cheer for them, pray for them, and each time we lost one my heart would break a little.  Unfortunately, as is the nature of this sort of thing, time showed clearly which were strong, which were weak, and which were irreparably flawed.

When the growth period ended and the dust finally settled, we were left with only 6 embryos that were of high enough quality to freeze.  Of those, 2 were Grade A blastocysts, 3 were Grade B blastocysts, and one was still in the morula stage.  When the cells become blastocysts, they have two distinct cell types that become baby and placenta.  Grade A blastocysts are the best that you can transfer.

Day 5 Morula

Day 5 Blastocyst

A study conducted by the Advanced Fertility Center of Chicago found that in women under age 35 who had blastocysts transferred, 69.4% resulted in a live birth for each embryo transferred.  These statistics are very encouraging to me.  Now that we have only six embryos, we need this to work.  We don't have a lot of chances.  Because we are going to try transferring two embryos, that will leave us with only three chances total to get a baby of our own.  After all the expense and the heartache that goes into this process, I'm not up for repeating the whole thing again.  As far as we're concerned, if these transfers don't work, we will have to make the decision between adopting a child or having our family be complete as it is.

I have to admit that after beginning with so many eggs that I suffered from OHSS, to end up with only 6 embryos is extremely disheartening.  I feel like I've been through so much and I've been given such positive feedback that I genuinely expected better results.  It also hammers in the notion that if it is this difficult for us to make a baby with assisted reproductive technology, our chances of having a baby without it are likely as grim as they told us.  That is a difficult fact to accept.

During today's phone call, they told me that the transfer would be scheduled for September 26th.  That seems such a far distance away.  It would be nice to know now what the next step for us would be; whether heartfelt discussion or preparing for our new love.  I'm pretty sure with all of this, the waiting is the hardest part.

Excellent Embryos

As I sit here writing this post, our future child (or children) is sitting in a petri dish across town dividing like crazy.  On Tuesday, the doctor was able to remove 19 eggs from my ovaries.  Of these, 18 were mature and one was overly mature (too old to fertilize).  The embryologist fertilized the 18 good eggs using a process called Intracytoplasmic Sperm Injection (ICSI).  Traditional IVF put several sperm in a petri dish with each egg and let them fertilize at will.  For ICSI, they hand pick individual sperm, remove the tails, and directly inject them into the egg.  This is ideal in circumstances when the sperm is not very strong.  At our clinic, they do it for every single patient because it is more predictable.

Beginning with 18 eggs, only 11 fertilized normally.  Unfortunately, this is a testimony to the overall quality of the sperm used.  However, today, all 11 of the 11 that fertilized are not just alive, but thriving.    Dr. Magarelli informed us at our appointment this morning that 6 of the embyos are Grade A and 5 were Grade B.  He said, and I quote, "You really couldn't have hoped for better."  

The grading system works as follows:

Grade A:  Even, equally sized spherical cells with no cellular fragmentation that are viable.

Grade B:  Embryos have uneven or irregularly shaped blastomeres, less than 10% fragmentation and are viable.

Grade C:  Embryos have up to 25% fragmentation, may be viable.

Grade D:  Embryos have 25-50% fragmentation, may be viable.

Grade E:  Embryos are considered non-viable with lysed, contracted, or dark blastomeres.

When it comes to embryo transfer, both Grade A and B are transferred with a high rate of success.  Grade C may be transferred, but has a much lower rate of success.  Grade D and Grade E are not typically used for transfer.  So, basically, we have 11 excellent embryos.  Yay!  My biggest concern with doing a Frozen Embryo Transfer (FET) was that we wouldn't have any embryos that were high enough quality to freeze.  So far, it looks like that is not going to be the case.  They will continue to watch the embryos divide until Sunday, then freeze all of the remaining ones that are viable.  By day five, ideally they will be blastocysts and will be ready to implant into the uterine wall.  Here is a little diagram of what they should look like over their five day development with the first picture being day 0 (egg retrieval day):

They did an ultrasound at today's appointment and found that I still have some fluid in my abdomen from the Ovarian Hyperstimulation Syndrome (OHSS).  When Dr. Magarelli walked in he said, "I really wish you felt terrible so you'd believe me when I tell you that it's not safe to proceed.  You probably think I'm just being overly cautious because you feel so good."  He's right.  It's hard to understand why I can't just move on when I feel good.  But, at least with the ultrasound I could see the fluid that wasn't supposed to be there.  

They told me that I should recover completely by the time my next menstrual cycle begins.  Also, they told me that they would be able to do the FET at the end of September!  That's only a month or so away.  I know that my doctor is trying to protect my well-being, and I appreciate that.  However, it is a little unnerving to tack a month onto the process and to shell out more money for the FET.  I feel good about things after today, though.  I was starting to feel my little flame of hope flickering out, and now it's back.  We may get to have a child of our own after all.  

Cancelled.

Yesterday morning, I went into the doctor for my egg retrieval procedure.  I was so relieved to have the eggs taken out and some of the bloating and discomfort relieved.  When we arrived, they took my vital signs and placed the most painful IV ever into the back of my left hand.  The nurse who ran the IV was on her 2nd day.  Yay!  Love feeling like a guinea pig.  As she placed the IV needle, blood got absolutely everywhere.  I thought Ryan was going to pass out as he watched.  Honestly, I'm not sure how I held still as it was going in.  Today, there is a huge bruise on the back side of my hand and I believe it is the most painful side effect I have remaining from the surgery.

After they placed the IV, I was given Doxycycline which stung like crazy as it was going through the skin.  Finally, the nurse anesthetist came in to talk to me a little about the procedure.  He asked what was wrong and I told him that the medication was stinging, so he adjusted a few valves to dilute it and I could no longer feel it going in.  Where was he five minutes before?  Goodness.  Anyhow, we talked just a little about the anesthesia, then he went back to the treatment room to get ready for the procedure.

The last person to make an appearance was the embryologist.  She came to discuss her part of the procedure.  After the eggs are removed, it is her job to fertilize them and keep the embryos safe while they grow and divide.  She proceeded to tell me that because my estrogen levels were so high (8200), they would likely have to freeze all of the embryos at the five day mark.  What?  ALL of the embryos?  I told her that this was the first time I was informed about this.  She seemed a little confused about that, like she had expected me to know already.  As far as I knew, everything was going along swimmingly and I was going to have the embryos transferred back in on Friday or Sunday.  Not so much.  

After that, I moved down the hallway to the treatment room with a heavy heart, trying to push back tears the whole way.  I was then sedated and the eggs were removed.  As I was waking from the anesthesia, I heard Dr. Magarelli say something about fluid, lining, and freezing.  That's when I knew for sure that any hope of getting pregnant this month was lost.  

Turns out, I have mild Ovarian Hyperstimulation Syndrome (OHSS) which is when the estrogen levels in the body are very high and it causes fluids to leak from the ovaries into the abdominal cavity.  This also effects the quality of the uterine lining, making it a less than ideal place for an embryo to implant.  Not to mention, OHSS is exacerbated by a pregnancy and if you get pregnant, you can end up hospitalized as a result.  

They were able to retrieve 19 eggs, but we don't know yet how many were mature and how many fertilized.  That sounds like a good number, but they have to be extremely high quality in order to be frozen as embryos and survive the thaw at the other side.  If you do a fresh cycle, you have the option of putting in average quality embryos and having them be successful.  Frozen Embryo Transfer (FET) takes away this option.  The good news is, if you have embryos that are tough enough to make it to FET, your chances of success are very high.  But now, there's no room for error.  We have to pray hard that the embryos grow strong and make it to the freezer.  

So where does this leave things for Ryan and I?  At this point, I just have to recover from the soreness of the egg retrieval, continue taking the Lupron shot (so much for being done with injections), and drink tons of fluid to help keep OHSS from rearing it's ugly head.  At this point, I am fortunate that I do not really have any symptoms.  However, now I have to wait until I complete two natural menstrual cycles before we can attempt the Frozen Embryo Transfer.  So, we're looking at October.  That's assuming we have quality embryos to proceed with.  

This afternoon I will get a fertilization report that lets us know how many eggs were mature and how many fertilized.  Tomorrow, I go in for a follow-up appointment to make sure that I am recovering appropriately from the procedure and to discuss our next moves.  Needless to say, I am super nervous about this afternoon's phone call from the embryologist.  Just hoping for good news.  

Egg Retrieval Day

In a couple of hours, I leave for the egg retrieval.  Today they will put me under IV sedation, place a catheter with a small needle on the end into my ovaries and remove all of the eggs from each follicle that I have been taking medication to grow for the past few weeks.  Each follicle that I've developed should have one egg in it.  At last count (on Saturday), I had 23-25 follicles total.  In theory, that means that they would retrieve that many eggs.  However, not all of the eggs will be fully mature and usable for the IVF process.  In fact, some may have matured too much to be usable for fertilization.

After the procedure today, I will be told the number of eggs that they were able to get, but not the quality.  They won't know that until they get them into the embryology lab.  Also, they will fertilize the eggs today with my husband's sperm to create embryos.  Tomorrow, we will find out what the quality of the eggs was and how many fertilized.  Then, we wait and watch them to see which develop the best and, after three or five days, they will put them back in.

There has been a lot of "hurry up and wait" in this process.  I've been pushing through the medication and injections now for weeks in preparation for the egg retrieval.  Now that it's here, I'm extremely nervous about it.  On top of general nervousness for undergoing a surgical procedure, I worry that the results won't be exactly what we wanted.  We could get bad news at any juncture.  We could end up with very few eggs, we could get lots of eggs, but very few of them be mature, we could get good quality eggs and have very few or none fertilize, they may not grow healthy and strong after they are fertilized, they may decide not to implant after they are put back inside me, and, probably most heartbreaking of all, everything could go right and then a miscarriage could happen in the future.  I'm not trying to be a negative Nancy, but I'd be a liar if I didn't admit that these concerns are going through my head.

At this point, I would say that I am cautiously optimistic.  So far, almost everything has gone according to plan.  I've done everything that I am supposed to do and have responded very well to the medications.  Also, in our circumstance, the infertility appears to be male factor rather than female.  This also gives us a good prognosis for the procedure.  All we can do at this point is wait and pray.

I am a firm believer in the "everything happens for a reason" philosophy.  If this doesn't work for us, there is a reason for that.  Maybe it wasn't our time and we will have our own child in the future, or maybe there is another child out there in the world that is meant to be ours.  We will know what the reason is in time.  But I do know some of the reasons why we are going through this process.  Since we've opened up about our situation, we have learned of so many others that are struggling with infertility.  We have been able to be sounding boards and guides for those people and it is a blessing that we have been able to fill those roles.

Another thing that this process has allowed us to do is to be firm on our decision to have a family together.  This is more for me than Ryan; he always wanted children.  In fact, when I first met him he told me he wanted four and I almost broke it off on the spot.  For many years, I was convinced that I wanted my career and my freedom over a family of my own.  I wasn't interested in marriage unless I could find someone who, without a shadow of a doubt, was exactly who I wanted to marry.  I dated many kind, wonderful people and did not want to marry them, so I assumed for a long time I wouldn't even get married.  Then I met Ryan and everything changed.  Not only did I find myself wanting to make a life with him, but, eventually, I wanted nothing more than to raise a family with him.

I assumed that creating a family would be the easy fun part.  Not so much.  But, as we fight for a family of our own, I realize how important it has become to me.  I am solid in my resolve.  This is very good for me. I know that if a child had been thrust upon me, I would have had trouble accepting it as what I really wanted out of life.  Now I know that it is what I want, and when we have a family, it will be so much sweeter.