Coculture procedure

I had the endometrial coculture biopsy today.

I realized last night that I was a bit nervous about it, having visions of the two unanesthetized D&Cs I went through after miscarriages 1 and 2, which were - really - rather hellish. Any procedure description that includes the words "gentle scraping" using a currette now makes me wince. From these prior experiences, I know there is not a thing gentle about it.

There was really nothing to the biopsy procedure today, though. It hurt a decent amount for the few seconds during the actual suctioning - maybe 30 seconds?- as my RE was getting his little snip of the lining. And then it was over. That was it.

The nurse held up the container to me afterward to have me check my name, but I didn't hear that part and instead marvelled at the little pink tissue bits floating in the saline. I even said, "Yup, that looks like a part of my uterine lining!" (I have to admit, I thought it was a little odd she needed me to confirm the contents.) She repeated dryly, "Your name, just look at the tag - is this your name?" Oops. Yeah.

I read some of the research on co-culture, and the process to clean and separate and then seed the cells into the dish sounds pretty cumbersome. No wonder more centers don't offer it. I'm grateful my clinic does and I am hopeful it will help.

I certainly like the idea of my own cells with their growth factors and helper cells surrounding the embryos and hopefully nourishing them as they grow and divide.

Stims start on day 2 of my cycle, probably next Tuesday or so.

IVF #4, here we come! Fingers crossed that this coculture makes the difference.

Mo

A womb away from home: co-culture

I went in today to get my blood drawn for the endometrial co-culture. The RE's office had said to be prepared for it being a lot of blood, and boy, they were not kidding. You know those huge syringes they use to draw your blood the day before retrieval? (At least at my clinic they use these). They filled FIVE of those. I don't have a blood or needle phobia, but geez, if you did, this would be brutal. As it was, I felt a bit woozy.

For those not familiar with endometrial co-culture, the basic idea is that next week my RE will take a tissue sample from my endometrial lining and then culture it in the lab (I believe in this vat of blood I just contributed).

Later, after I go through stimulation and egg retrieval, they will grow the embryos in this cultured tissue, sort of a womb away from home for the little ones. The idea is that the living tissue can remove toxins and introduce growth factors that will encourage better quality embryos than I would otherwise have. We shall see.

It felt weird to be back at my NYC RE's office after our second opinion last week. Like my head is still spinning. Do I believe my great NYC RE who thinks we have a really good chance? Do I believe the CCRM doc who thinks that we do not? More than ever before, I felt like I was going through the motions. Often in the past, even sitting in the RE's waiting room, I have had this sense of hope, of progress toward having a family. Today, I felt, well...woozy. And like I was just showing up.

Hopefully just showing up and doing what I am supposed to medically for this cycle will be enough to give it its best chance. It's just so odd to be going into it thinking that it will almost certainly fail. Maybe this is normal after three tanked IVFs? I don't know. I just never thought we would be at this stage with no baby in sight.

Mo

Cycle delayed

We heard from the RE's office today that they are booked solid this month for endometrial co-culture biopsy slots. Ugh. We were told to call on day 1 of my next cycle to "see if we can get on the list for next month."

The bottom line is we will be delayed a month in starting IVF #4.

I took this harder than I thought I would. I didn't realize how much I was clinging to the hope of cycling again soon to help cushion the blow of my disappointment over our last failed cycle.

Adding to it all, I have been having hot flashes since Dec. 26th. Several times a night. Which is screwing with my sleep quality and filling me with doom and gloom thoughts of perimenopause. The fact that Thursday is my 37th birthday is NOT helping (Fear is that 37 + history of chemotherapy = the end of the egg supply).

Anybody else ever have hot flashes after IVF? I've had them on Lupron - but I'm not on any drugs now. Every time I have a hot flash, I panic a little that this is it. The beginning of the end of my fertility (not that I was so fertile before, but you know).

Holding on to sanity by a thread over here. Words of wisdom very welcomed.

Mo

The consult...a look back, plus a plan

So you saw our questions in the last post. Now we have some answers. Thank you for all of your ideas about what to ask - both those left as comments and those privately emailed. Will and I appreciated all of your thoughts.

The RE's main point was that we shouldn't lose hope. He feels our prognosis is still very good. That we had bad luck with the chromosomal abnormality and miscarriage our first cycle ("That could have happened to anyone"). And that we can't read too much into the failure of cycle #2 because we only cultured three embryos (freezing six others at 2pn stage) and only transferred one.

He still thinks we can succeed with our own eggs (and even said he would not allow us to use a donor at this point if we wanted to, which we don't). Surprisingly, he felt the embryo quality throughout the three cycles has been fairly good. (Could have knocked me over with a feather with that statement. I was like "Really??!")

He continued to say that PGD would do more harm than good and that CGH is still too experimental (he said he thinks that the technology is still years away). He said they don't do micro-dose lupron except in the case of poor responders ("and you're not a poor responder," which was nice to hear). He seemed so-so about assisted hatching (but I think we'll ask for it anyway).

In terms of what's next, he said we should probably do endometrial co-culture and he's changing our protocol, removing lupron, upping the dosages of the meds a bit, and adding Ganrilex and menopur.

We are on the cancellation list to try to get in to do a co-culture biopsy in late January. I'm going to stay on progesterone through Friday to delay my cycle starting (who thought I would ever agree to extra PIO shots?!). If we're able to get the endometrial biopsy done in late Jan, we'll be on to cycle again in late Jan/early Feb.

So it looks like we're on to (gulp) IVF #4.

I can't believe we have to cycle again. But since we do, it feels so so much better to have a plan.

By the way, it is freakin' COLD in NYC today. Like Minnesota cold. Those of you who live in northern climes (Canadians, I am talking to you), I applaud you. I don't know how you do it.

Thank you again for all of your encouragments, stories, suggestions on blogs to read, and medical advice. I never realized how interactive blogging can be. Your thoughts and comments have been an enormous help.

We are past the solstice. There is a bit more light today than yesterday. Hoping for brighter, warmer days ahead.

Mo