41 - Transfer- August 24th, 2008

Here they are - the two embryos that are hopefully hanging on tight in my uterus as I type!

Today went very smooth - we were so pleased with our embryo quality report -

1 - 8 cell - A+, no fragmentation (one of the two pictured above)
2 - 8 cell - A, less than 5% fragmentation
1 - 9 cell - A, less than 5% fragmentation
1 - 10 cell - A, less than 5% fragmentation (one of the two pictured above)
1 - 5 cell - B-C grade, not sure about the fragmentation

The doctor said that the 3 eggs that matured and fertilized a day later didn't look as good, but he said that based on the above numbers we could end up with between 2-3 to freeze...that would be a bonus. We are just so pleased we had good quality ones to transfer today.

So, now's the 48 hour bed rest stint...I still a little sleepy from the valium, so I will post more details about the transfer tomorrow.

40 - Fertilization Report - August 23rd, 2008

So I guess 6 of the 14 eggs were mature at the time of retrieval. They ICSI'd all 6 that day (August 21st) and all 6 fertilized normally. Then by Friday morning (August 22nd) 4 more eggs had matured and they ICSI'd those as well. We just got the report this morning that 3 of those 4 eggs fertilized normally - a total of 9 fertilized eggs. I thought they would have graded the first 6 today, but they said they won't grade them until Day 3 (tomorrow). They also said that the 3 they fertilized a day later won't probably be ready to be considered for the fresh transfer, so they will keep watching them for possible freezing.

We will be doing a Day 3 transfer tomorrow at 10:15AM. We will show up at 8:30AM because I have elected to do the acupuncture treatment. So they do that first, then the transfer, then another round of acupuncture, then home for 48 hours of strict bed rest. We will head back to Michigan on Tuesday morning, arriving home Wednesday afternoon.

I started the progesterone suppositories today - not a big deal. The nurse said that the applicator gets the progesterone high enough that you don't have to lay down for 15 minutes or anything afterwords.

The hubby and I are just doing laundry, cleaning the rooms we've been using at the friend's house we've been staying at, and preparing for the 2 days of bed rest and our Tuesday departure.

39 - Retrieval - August 21st, 2008

The above picture is a result of my husband screwing around while I was waiting for the anesthesiologist to come in before retrieval. He took it on his iphone. I told him to send it to some of my closest friends and title it "Christina on vacation in Colorado". We have a similar picture of me laying on the table waiting for the ultrasound on our one day work-up at CCRM. I think my husband takes unflattering pictures of me on his iphone as a form of stress relief during this process. Ah well, better than hitting the bottle or doing drugs, I guess :-). My form of stress relief at this wait time was holding my breath in an attempt to see how low I could get my heart rate - of course, I was hooked up to all the monitors. We were both being completely silly, and I've discovered that "silly" is a good way to be at various times throughout this process.

The retrieval went great. No problems. No bleeding. No cramping. No nausea. I have never had any kind of surgery before, so I asked the anesthesiologist if she could give me some extra anti-nausea meds just in case. She was happy to comply. I probably would have been okay without the extra, but I just didn't want to have the additional stress of worrying about being nauseated. Last time I had looked at the clock before they rolled me into the operating room was 12:21PM...when I opened my eyes in recovery, it was 1:08PM. The nurse was right there and asked about my pain. I told her "no pain" and she brought me some crackers and ginger ale. I was starving and thirsty because the last time I ate/drank was 8PM the previous night. Then the nurse we had been working with since the beginning of this journey at CCRM stopped by to give me a hug and see how we were doing. I love her - she is such an angel. Then I moved to a reclining chair and the embryologist came up to discuss the results. 14 eggs. We were pleased. And it looked like my husband did a good job as well :-). There is a chance we may not have to do ICSI, or maybe only half ICSI.

The nurse explained that I should drink plenty of fluids and eat a lot of salt the rest of the day to prevent hyperstimulation. No problem - I love salt and had actually been avoiding salty food since prior to the stim process. So on the way home we stopped by the store to pick up cheetos (I've been craving them - today was a great excuse). When I first got home from retrieval, I watched a little tv and had some lunch and made a few phone calls. Then I took a two hour nap. When I woke up from the nap was the first time I felt any pain...but two max strength Tylenol took care of it. Then the hubby and I went out to dinner.

No more shots! I've decided to do the suppositories 3Xday of progesterone instead of the shots. Those will start tomorrow. 9 days from today, I will also start estrogen patches. For the next few days I will also be on tetracycline, medrol, and
baby aspirin.

So today is the big fertilization phone call. They said they would probably call before noon (denver time).

38 - Trigger shot complete/summary - August 20th, 2008

So the trigger shot is complete. It did not hurt at all, but I did numb the area a little with some ice. The trigger shot is HCG which will induce ovulation. Today we just go in for blood work in a hour or so - they want to make sure that we injected the HCG correctly. No more shots or drugs for today.

Summary of our cycle so far:

49 sub q shots total (lupron, menopur, gonal) + 1 HCG im shot
Started the lurpon/dexamethasone on 07/28/08
Started the stim drugs on 08/09/08 - 2 amps menopur, 150 gonal, 5 lupron

6 stim check ultrasounds:
STIM DAY 4 - 08/12/08 - baseline, eggs are small, E2 (estradiol) was low - 121
up stims to 2 amps menopur, 300 gonal, 5 Lurpon,
STIM DAY 6 - 08/14/08 - eggs are small, about 4-5 maturing, E2 - 433
stims still 2 amps menopur, 300 gonal, 5 lurpon
STIM DAY 8 - 08/16/08 - better, still about 5-6 maturing, E2 - 866
stims still 2 amps menopur, 300 gonal, 5 lurpon
STIM DAY 9 - 08/17/08 - still about 5-6 maturing + some slow growers, E2 - 1794
reduced stims to 2 amps menopur, 150 gonal, 5 lurpon
STIM DAY 10 - 08/18/08 - about 7-8 close to mature + some slow growers, E2 - 2096
stims still reduced to 2 amps menopur, 150 gonal, 5 lurpon
STIM DAY 11 - 08/19/08 - about 13 close to mature!, E2 - 2899
stims reduced to 2 amps menopur, 5 lurpon, no gonal

TRIGGER SHOT: 08/20/08 at 1AM
RETRIEVAL: Scheduled for 08/21/08 at 12PM (Denver)

I know I say this over and over, but it has been so wonderful being away from home for this process. There is no obligations - no house to clean, no lawn to care for, etc.. We have been spending our days reading, eating, watching movies, and watching the mountains and wildlife. I wonder if this contributes to the reason why CCRM has good success rates. They do have a large number of out-of-area patients and when those patients come here, while they do have the normal stress of the cycle, they don't have any of the obligations they would have at home. Can't recommend this place enough.

I probably won't post tomorrow, but I will post on Friday about the retrieval.

37 - Trigger Night - August 19th, 2008

The above pic is my stomach on day 11 of the stimulation drugs...are they sure I'm not pregnant yet :-)?

So we got the word this afternoon that we can go ahead and give the trigger shot tonight...or rather at 1AM tomorrow morning (Wednesday morning). The timing is very critical. The hubby is going to give it to me, which will be the first shot I haven't given myself since this whole process has started. It is an IM shot. Our retrieval is scheduled for 12PM (Denver time) on Thursday.

Today was a good day - the ultrasound looked great...quite a few more mature follicles than yesterday. It looked like the possibility of 13 mature eggs at the time of retrieval. And my estrogen was 2866 which seems like a good number given the number of mature follicles.

CCRM is amazing. We were frustrated that we had to wait an additional day for the trigger shot, but it looks like that additional day may have gotten us several more eggs. They are brilliant, and I am so happy with our decision to be here.

I'm going to catch some zzzz's before the shot...good night.

36 - Mile 18 - August 18th, 2008

Back in 1999 I ran the Marine Corp Marathon in Washington, D.C.. Miles 1-12 felt great...lots of excitement. Miles 12-17 started to get a little tougher, but were still manageable. Then mile 18 came - the mile when I felt completely torn between two worlds - the knowledge that this, too, would soon end and I would feel completely elated at such an accomplishment and the fear that I was actually going to die before I crossed the finish line. We are at mile 18 in this ivf process.

We just got the news that they want us to do yet another night of stimulation medication. We were really hoping that they would give us the go ahead for the trigger shot tonight, which would mean a Wednesday retrieval. Now the earliest day for retrieval will be Thursday. My estradiol only rose to 2093 from 1794 yesterday - nothing to be concerned about, but I think that number allows for a few more days of egg growth without running the risk of hyperstimulation (which can be dangerous).

So tomorrow look for a post unfortunately titled "Sixth Ultrasound and Blood Work".

Tonight we are going out for Mexican with the woman we are staying with...for some reason I can't remember the last time I've looked so forward to Mexican food - must be the hormones :-).

35 - Dreams of med dosages - August 18th, 2008

The above picture is taken on the deck of the house we are staying at while in Colorado...humming birds everywhere.

Last night was a true example of how invasive the whole ivf process really is...I spent a majority of the night (so it felt) dreaming of various med dosage situations. In one dream, the clinic called and said that because my estradiol was so high, they needed to but me on different meds for another 5 days. So then, in my dream, I was spending a ton of time online learning everything I could about the new meds and finding out what being on meds for an additional 5 days did to the success statistics. This is just one example of several med dosage dreams I had last night...time to officially stay off the internet, you think?

Had my 5th ultrasound and blood work (and hopefully last before trigger/retrieval) this morning. The lab tech who drew my blood told me an inspiring story. Her daughter did ivf through ccrm. They got 19 eggs from her, but by day 5 after fertilization, all but 1 egg died. They implanted that one egg and she is now due in about 3 weeks...

I will post again this afternoon when we find out if tonight will be trigger night.