Day 6 embryo report

Nine. Nine. Beautiful, beautiful nine fucking frozen embryos.

Two made the grade yesterday at 7 am or so; one more joined them at 10:30 am, so that's three frozen on day 5. An additional six joined on Day 6.

Day 6 have been sometimes found to be less likely to implant than are day 5; a 2001 study found a 50% reduction (from 60% to 30%) -- but a much larger 2006 study found almost no difference (32% vs 28%).  The fact that the 2001 5-day blast group had a pregnancy rate of 60% makes me think that their population must have been a bit unusual, anyway -- I don't know of anywhere that can claim a 60% pregnancy rate, unless all their participants were 20!

Anyway, even the worst represents a good solid pregnancy rate, and did I mention six of them fomg.

And -- I might need them. I freaked myself out yesterday by reading a lot about Asherman's Syndrome, and it sucks. Makes it harder to get pregnant, and makes miscarriage a lot more likely; one source reports a miscarriage rate of 45%. Just what I need, huh? But it's also easy to find stories of women with Asherman's who have three or four miscarriages and then a live birth. If I have the balls to keep rolling the dice, there's a decent chance I'll eventually win.

Basically, if I go ahead here, I have to be prepared that it may take a few false starts. I have to figure out how to not go completely mental the way I did with the other two miscarriages. I have to figure out how to stay sane. I probably have to stay out of the forums where people assume that a positive pregnancy test means a baby.

This all sounds grim, and I was pretty damn down last night when I thought I had two embryos, or just one try. But now that I have 9, which could well be four tries, I'm feeling much more hopeful.

I think I am tough enough for this. I think I can do this. It helps to know that I can stop any time. Her Indoors is more than okay with keeping our family the way it is -- frankly, she's indulging me on this endeavor. There will be zero pressure on me to keep going. If it's too much, I can pause or walk away. It's not like my family sucks the way it is, you know? Yes, the wordless longing of my heart is for one more. Yes, I feel like there's still someone missing. But really, I could be wrong. I've been wrong before. Maybe our family's the way it's supposed to be. I have to try, though.

For the historical record, our family roster now consists of:

Hatching blasts:
2 - AA Good
2 - BB Fair

Expanding blasts:
2 - AA Good
2 - AB Fair
1 - BB Fair


FWIW, I'm not particularly hung up on embryo quality. Have I mentioned that a little 2BB blastocyst (different rating system, but prob equivalent to the BB Fair) turned into our entirely acceptable son? And I have seen many perfect embryos come to naught. Anecdotal, yeah, but it's anecdotes that make up my story, so.

In conclusion, beautiful, beautiful nine!

Day 5 embryo report

2 expanded blast (will be frozen)
7 early blasts, 6 fair, one poor
2 morulas
1 9+ cells
3 no change, on probation
2 no change, discarded

The early blasts and possibly the morulas are still in the game for Day 6. But at least we've got two safely in the freezer.

It's not what I'd fantasized about (I imagined my nurse's voice saying "all 9 were beautiful and we froze them!"), but it's far better than I'd feared (i.e., nothing to freeze, a big waste of a cycle).


*chews nails*

Day 4 embryo report

We have:

9 morulas (morulae?)
1 "9+ cells"
2 8 cells
1 7 cells
1 3 cell
1 2 cell
1 eager-beaver early blastocyst (the nurse thought this was a good thing, so maybe I'm wrong? but my research says too fast, man)
1 no change for one day, on probation
1 no change for two days, discarded

So, the wee ones are still dividin' like champs. Now is the time I'm super grateful for being at Big Shiny Fertility Factory, with their Big Shiny Excellent Embryology Lab. Although I loved Dr. Stewart's Discount IVF Shack, I just can't be confident in their lab. And from here on in, it's all down to the lab (and the embryos, of course).

We'll see how this batch turns out, but I've thought a bit about the "ugly duckling" stage that my embryos went through last cycle, when they slowed down mightily between D3 and D5.  I've since learned that a lot of labs aren't particularly good at blastocyst culture. Blastocysts have different needs than embryos, and between days 3 and 5 the labs have to make a lot of adjustments, I dunno, give them different food, plump up their tiny pillows, something, stuff, do I look like an embryologist?  It's also an awkward and trying time chromosomally, so it could very well be that my embryos weren't/aren't good at making the transition... but a different lab may help.

So! 9 morulas, full speed ahead!

Day 3 embryo report

Our brood is still doing well. They like to see them between 6-8 cells on Day 3.

8 cell: 4
7 cell: 4
6 cell: 2
5 cell: 2
4 cell: 2
morula: 1
arrested: 3

All of them were rated "good"; not sure exactly what that means in terms of fragmentation, but I'm okay with that.

I was puzzled at the D3 morula; that's a whole day ahead in development. I'm guessing it's the eager little bugger who was 5 cells yesterday. Too-fast development is also a sign of a problem, so I've put it at the bottom. Because really, when you work that quickly, you're gonna make some mistakes.

 So 10 of the flock are in appropriate range, and a further 4 are not far out of range. Goooooooo little ones!

Day 2 embryo report

My little flock is doing well! They're supposed to be between 2 and 4 cells on the second day. Currently the breakdown is:

5 cell: 1
4 cell: 13
2 cell: 3
1 cell: 1

I feel protective of that poor little 1-cell. Can't help but think of the very-mediocre 2BB embryo that turned into our perfectly-splendid small son.

This practice calls every single day with an embryo update, which I really, really appreciate. I'm also trying to remember that, last time, my embryos were gorgeous through Day 3, went through an ugly duckling stage from days 4-5, and then bloomed out beautifully on Day 6 (including the one in my uterus).

It's nice to be sharing good news. <3

Holy moly!

My retrieval was yesterday. I haven't posted much because, well, I was kind of dejected.

By stim day 9, my E2 was up to 1400. By day 11, it was up to 2600. I was told that a dozen or so follicles were chugging along. I triggered the night of day 11, making for a ten-day stim period, precisely the same as my first and third IVFs.

By Thursday, Retrieval Day, I was feeling... tender. As in oh-god-I-never-noticed-that-speed-bump-was-quite-so-bumpy tender. I thought maybe this boded well, but I am nothing if not a rugged pessimist.

Retrieval went fine. Cab was eight minutes late, which reduced me to a rage-filled mess, but we got there fine, everything was fine, there was fineness.  As usual, I took the anesthesia flawlessly and woke up in a high good humor. I'm just super lucky in that whatever chemical pathways those drugs are supposed to tread are clearly wide open in my body; I go down like a sack of taters, and wake up like a sack of giggly taters.

I woke up, and eventually my doctor came by to say that he'd retrieved 27.

Whaaaa ---

My peak E2, the morning after trigger, was 3100. The most follicles I'd be told about was 13 or 14. My doctor had decided to switch from the Lupron trigger to the regular hCG trigger, airily saying "there aren't that many follicles, you'll be fine."

Where the hell were all of them hiding, is what I want to know?

It seems I may owe an apology to Dr. Stewart. For my third IVF, he counted 14 follicles and ended up retrieving 23 eggs. I attributed this mismatch to his rather ancient ultrasound equipment. But the ultrasound at Big Shiny Fertility Factor does everything but insert the wand itself. I'm going to have to form some theory that my ovaries are just coy little beasties, and sometimes they don't like to show their eggs until they absolutely have to.

When I heard "27 eggs" I immediately tamped down my expectations by reasoning that, with the E2 so low, most of them couldn't be mature.

Well.  Of the 27 eggs, 24 were mature, and 18 of them fertilized.

This is, in technical terms, awesome.

 So why was the E2 so low? Who knows. This cycle I took an antagonist, which various sources hint can lower estrogen levels and/or make estrogen tests less reliable. All I know is that a lousy cycle, my worst ever, suddenly turned into my best cycle in terms of mature eggs, and my second-best cycle in terms of fertilization (on IVF #1, I had one more).

I'm on OHSS watch, but I don't feel too bad -- tender and swollen, but taking it easy and sipping electrolyte drinks. Finally getting around to watching Legend of Korra (I was/am a huge A:TLA fan). Right now just being quiet, grateful, and wishing my best to the 18 little clumps of cells in a laboratory fifteen minutes down the road.

Day 7: when I'm up, I'm up

Okay, this is one thing that is true about me in general and really, really true of me-on-hormones: my mood is not whatyou'dcall stable. I'm a leaf on the wind. If the news is good, I'm up. If it's not, it's the end of the world. My emotional lability is less than my toddler's, but not a lot less.

But right now, I'm up. Because:

Doctor was downright cheerful about my progress. This morning, at follicle check:

Doc: Why so glum?

Me: I'm not happy about how things are going.

Doc: Why? Things are going well!

Me: My E2's so low.

Doc: It tripled between the first and second check, what more do you want?

Me: ...

Doc: *fishing around with ultrasound wand in my pelvic girdle* Follicles are looking good, very good. All is well.

Me: Patient is high-strung, okay?

He found 12-13 measurable follicles, which is a nice improvement from the last check. Full speed ahead, divert all power to my ovaries¹.

Also, I like my new fertility pharmacy. I'd been using The Apothecary Shoppe, mostly because they had the word Apothecary in their name. One of my ambitions in life is to own an antique oak apothecary chest, so yeah,  The Apothecary Shoppe. Made me think that my Follistim was being hand-crafted by a kindle old herbalist.

But they annoyed me mightily the last two cycles, by

1. Compounding a readily-available ready-made medicine (medrol) simply because they didn't have the ready-made version in stock. This cost me three times what it would have if they'd simply notified me so I could order it from another pharmacy. It was only an extra $26, but damn, it pissed me off. They tried to pull the same thing again next cycle, but I told them in no uncertain terms that no, thanks, I'd fill it locally.
2. Charging me for shipping when my order fell just below the minimum. Come on, boys. I have bought over twenty five thousand dollars' worth of medication from you. Make a goddamned exception.

Anyway, my new pharmacy is Mandell's, and I like them a lot. Everything's arrived perfectly, but mostly I'm charmed that the last two times I've placed orders with them, the person on the other end of the phone has said, warmly and sincerely, "Good luck!" It's almost like they know what kind of medication they're selling, and why, and want it to work. Anyway, it's sweet, and they also included a little bag of Hershey's Kisses in my top-up order of Menopur and Follistim ($7000 sans insurance, dear G-d, yes I'm very very grateful and I'm never quitting my job).

So... Mandell's, yeah. Recommended!

blah blah babble babble when I'm up I'm up when I'm down I'm down when I'm only halfway up I'm going to be either up or down in five minute, anyway

 ¹Two nerd references in one post, go me.