Saturday, January 3, 2009

The nitty gritty

The details of our cycles and pregnancies:

IVF # 1 (NYC): September '07, age 35
Long Lupron Protocol
300 Follistim, 5 units Lupron
22 eggs retrieved, 20 mature, 14 fertilized
2 blasts transferred on day 5 (3BB, 1BB), nothing to freeze
BFP!
Betas double appropriately
Fetus measures on track
HB: 140, 151
Missed miscarriage at 8 wks, 4 days.
Cytogenetics: female with trisomy 21 and monosomy x

IVF #2 (NYC): February '08, age 36
Long Lupron Protocol
225 Follistim, 5 units Lupron
11 eggs retrieved, 10 mature, 9 fertilize with ICSI
For personal reasons freeze 6 at 2pn, culture 3, transfer one at day 3.
BFN
(When 6 are thawed three years later, none survive in culture)

Natural Pregnancy: March '08, age 36
Betas double appropriately (223, then 425, then 831)
Missed miscarriage discovered at 7 weeks.
Cytogenetics: Lab loses sample

Natural Pregnancy: May '08, age 36
Beta fails to rise appropriately
Natural miscarriage
Cytogenetics: male with trisomy 16

IVF #3 (NYC): November '08, age 36
Long Lupron Protocol
225 Follistim, 5 units Lupron
12 eggs retrieved, 10 mature, 8 fertilize without ICSI
three embryos transferred at day 3 (8, 7, 6 cells, moderate fragmentation)
BFN

IVF #4 (NYC): February '09, age 37
Antagonist Protocol with endometrial co-culture
Day 2 FSH = 6.8, E2 = 32.7, LH = 5.47
200 Follistim, 75 Menopur
15 eggs retrieved, 14 mature, 11 fertilize without ICSI
five embryos transferred at day 3 after co-culturing (9, 9, 8, 8, 8 cells, minimal fragmentation)
BFN

IVF #5 (NYC): May '09, age 37
Antagonist Protocol with endometrial co-culture
Day 2 FSH = 7.0, E2 = 30, LH = 7.5
200 Follistim, 75 Menopur
Trigger one day early (Day 9)
6 eggs retrieved, 4 mature, 3 fertilized without ICSI
Three embryos transferred at day 3 after co-culturing (9, 8, 7 cells, grade 1 and grade 2)
BFP
HCG levels: 9dp3dt: 23; 11dp3dt: 48; 13dp3dt: 36; 15dp3dt: 17
Chemical pregnancy

Natural Pregnancy: June '09, age 37
Beta #1 (15 dpo): 188!, estrogen 271, progesterone 39
Beta #2 (17 dpo): 585!, estrogen 301, progesterone 36.45
Beta #3 (19 dpo): 2,413
Beta #4 (21 dpo): 3,159
Beta #5 (23 dpo): 5,221
5 wk u/s: gestational sac, yolk sac
7 wk u/s: baby w/ heart rate of 167 bpm! Measuring 7 wks 4 days.
8 wk u/s: baby w/ heart rate of 185 bpm! Measuring 8 wks 1 day.
9 wk u/s: no heartbeat (8/6/09). D&C performed.
69XXX - triploidy

IVF #6 (Denver): March '10, age 38
Microdose Lupron Protocol
Day 3 FSH = 5.5, E2 = 33.2, AMH = 1.4
300 gonal-f, 150 menopur, 20 ml lupron every 12 hours
.33 Saizen, .5 dexamethasone
19 eggs retrieved, 14 mature, 16 fertilize with ICSI (13 immediately, 3 more after in vitro maturation with Day 2 ICSI)
7 blastocysts [6BB (Day 7 blast), 4AB (Day 7 blast), 2 x 4BB, 4AA (from Day 2 ICSI), 3BB, 3AB]
Freeze all
Sample sent for sex chromosome FISH testing and microarray to test all chromosomes
Results indicate three normal blastocysts!!!

IVF #7 (Denver): June '10, age 38
(For two months ahead took inositol, coenzyme q10, and melatonin to improve egg quality)
Microdose Lupron Protocol
300 gonal-f, 150 menopur, 20 ml lupron every 12 hours
.33 Saizen, .5 dexamethasone
25 eggs retrieved, 22 mature, 18 fertilize with ICSI
Freeze all
Sample sent for sex chromosome FISH testing and microarray to test all chromosomes
Results indicate five normal blastocysts!!!

FET #1 (Denver): October '10, age 38
Medicated cycle
Took Depot Lupron for two months prior to cycle to improve endometrium/reduce endometriosis
One month of twice weekly electro-acupuncture to improve blood flow to uterus
Transferred 3 FISH and microarray confirmed chromosomally normal blastocysts
(Embryo #5 - 06/10: Day 6 6BA, Embryo #14 - 06/10: Day 6 4BB, and Embryo #6 - 03/10: Day 7 6BB)
BFP
Start 40mg lovenox, 10mg prednisone, 40mg pepcid, 10mg claritin, baby aspirin, and intralipids for potential immune issues
Beta #1 (9dp5dt) = 26.8, estrogen = 526, progesterone = 4.87
Beta #2 (11dp5dt) = 56.0, progesterone = 28
Beta #3 (13dp5dt) = 145.5, progesterone = 33
Beta #4 (17dp5dt) = 690, progesterone = 22
Beta #5 (20dp5dt) = 1702, progesterone = 11, estrogen 543
5w5d u/s: gestational sac and yolk sac
6w2d u/s: larger sac + fetal pole?
Beta #6 (31dp5dt) = 12,691, P4 = 23.12
7w3d u/s: no heartbeat, debris in gestational sac. D&C performed.
Cytogenetics: 46XY. Chromosomally normal male baby


FET #2 (Denver): February '12, age 40
Medicated cycle
Took Depot Lupron for two months prior to cycle to improve endometrium/reduce endometriosis
One month of twice weekly electro-acupuncture to improve blood flow to uterus
One IVIG treatment 10 days before transfer to reduce NK cell activity
Took 40mg lovenox, 10mg prednisone, 40mg pepcid, 10mg claritin, and baby aspirin for any immune issues
Transferred 3 FISH and microarray confirmed chromosomally normal blastocysts
(Embryo #3 - 03/10: in vitro matured Day 7 4AA, Embryo #5 - 03/10: Day 7 4AB, and Embryo #21 - 06/10: Day 6 3AB)
BFP
Beta #1 (7dp5dt) = 69.3, estrogen = 442, progesterone = 34.3
Beta #2 (9dp5dt, 4w0d) = 155, estrogen = pending, progesterone = 31.16
Beta #3 (11dp5dt, 4w2d) = 445, estrogen = pending, progesterone = 38.68
Beta #4 (15dp5dt, 4w6d) = 3,032, progesterone = 28.2
Beta #5 (18dp5dt, 5w2d) = 7,681, estrogen = 844, progesterone =11.5
Beta #6 (20dp5dt, 5w4d) = 12,362, estrogen = 1,185, progesterone = 70.7
Beta #7 (25dp5dt, 6w2d) = 45,785, estrogen = 616, progesterone = 32.82
Beta #8 (28dp5dt, 6w5d) = 65,543, estrogen = 683, progesterone = 53.15
6w5d u/s shows hb = 127bpm, baby measuring at 7.1 wks
7w5d u/s shows hb = 154bpm, baby measuring at 7.6 weeks 
Beta #9 (36dp5dt, 7w6d) = 140,934, estrogen = 732, progesterone = 39.4
Beta #10 = (42dp5dt, 8w5d) = 182, 833, estrogen = 1,169, progesterone = 57
blood work at 10 weeks, 3 days = estrogen = 852, progesterone = 28.13
blood work at 11 weeks, 2 days = estrogen = 1,116, progesterone = 35.44
Pregnancy continues with partial placenta previa, which resolves
Gestational diabetes develops at 28 weeks but is controlled through diet and overnight insulin
****Baby girl born at 39 weeks, 1 day!!! - via c-section after failed induction****


10 comments:

Lisa said...

Good lord Mo - you have been through so much - here is hoping that this cycle is your first and last in '09.

Nikki said...

Mo - I'm sorry for all your losses! You've been through so much!

Are you considering PGD / CGH this time around? I'm wondering because it does seem like a couple of your miscarriages have been possibly because of the chromosome issues, right?

Good luck with everything!

m said...

Dear Mo, I am saying it today: 2009 is going to be our year.

I can feel it.

Bean said...

I've got everything crossed that IVF #4 is the one that works and that 2009 is a great year for you and Will! Just curious -- what's embryo co-culture?

Emily said...

Staggering to write it all out like that...I am so very sorry. HUGS.

Here's to #4!!!

musicmakermomma said...

Sending good thoughts your way - hoping this is the one!

Ms Heathen said...

Sounds like you've really been through the mill. I'm so sorry for all your losses, and hope that this cycle may be the one for you.

linda said...

Holy crap you've been through hell!! I am so sorry your path has been so heartbreaking!! :-(

One thing that I see in your cycle is that you've not done 5 day transfers save for your first IVF and that one worked (and then ended in miscarriage due to aneuploidy).

Have you considered resveratrol and pycnogenol? (Sorry if you are already taking these supplements). My RE things that they are good for stabilizing the meiosis process.

Lgirl said...

Oh boy, I wish you two good luck. We are family of two professionals, although 5 years after writing a dissertation.
I wonder why your RE does not suggest you to do PGD, which is fits your case perfectly, age after 37, chromosomal abnormalities and multiple miscarriages.
I had 3 missed miscarriages, 2 out of 3 checked for chromosomes, all were normal. Still RE suggested us to do PGD. So far one IVF cycle ended up as biochemical pregnancy. We will start cycle 2 soon. I hope for good

Anonymous said...

Just reading you for the first time... Do you read tertia's blog "so close"? She also had 7 ivfs and has three children now (had mutiple miscarriages- quads, twins twice and a few singles...) anyways google it if you're interested. She runs an egg donor program in South Africa and recently received an award from Resolve organization in New York for her work.

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