Monday, August 31, 2015

FET #3: 3dp5dt

Hanging in there in the early early days of the two week wait. If I had to call odds for this cycle, I'm mostly thinking that it's going to be a no go, sometimes 100% convinced that it's already over. Is this based on anything rational? Not really, so please disregard my pessimism.

The fact that I know deep in my heart that Magpie's existence is such a miracle means that I feel that winning the lottery again seems to very unlikely. Add to that that the blasts didn't look as nice to me as they did at Magpie's transfer, and well...hard to feel hopeful here. Perhaps it's even greedy to wish for a second miracle. Although I realize it doesn't deprive anyone else of their turn, sometimes it feels selfish somehow to want for more when I already have so much with the presence of Ms. Magpie.

Fortunately, the outcome doesn't rely at all on how I feel about it!

It's surprising to me that this time I'm having a harder time staying in the "in between" and not knowing place of the 2 week wait. I would have thought that the stakes are so much lower now that we have Magpie, and in a sense, they are. I've got my miracle girl, and an additional child would just be amazing and bonus and more than I ever expected or dared to dream. It would be wonderful for us to have a second child and also a gift to her. She loves people, and she would adore having a sister or brother. I'd love for her to have an ally in life.

Upping the ante, however, is the fact that I turn 44 in a few months and that these are our final three blasts. This has raised the stakes for this cycle more than I ever expected it would. It feels so final. Either this will work and Magpie will have a sibling, or it won't and she'll be an only. There's always the chance that we could pursue a donor sibling, but I don't know that Will would be open to it still and we are well aware of the costs and potential pitfalls having walked down the donor egg path before.

In previous 2 week waits, I have found some pleasure in having some time to imagine the possibility of pregnancy without knowing yes or no. At least so far, I am not enjoying the not knowing. There's no pleasant imagining. It's the old familiar grind of all the meds and dietary restrictions, plus the challenging restriction of not being able to pick up Magpie (no lifting anything over 10 lbs.). And whenever I dare to hope, I tend to tell myself that I must be kidding. Have I seen my history? Crazy girl - this won't work for you! I have to remember though that my history includes Magpie. So it could work. Because in fact, once, in all of our attempts it did, and gloriously.

Still no symptoms really, other than fatigue, some mild shortness of breath, and yesterday some mild uterine cramping. I'm so aware this time that anything I'm feeling could so easily be the progesterone sending screwy signals to my body, that I don't trust anything.

That said, if any of the three blasts are still alive, implantation could occur any time now.

Wow. Oh my gosh. Any time now. For a moment maybe I can hold on to that wonderful possibility. Perhaps there is still life inside of me.

The hope is like a flicker, tenuous and hard to hold on to.


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Saturday, August 29, 2015

1 day post 5d transfer for FET #3: bed rest ongoing

Today is one day post five day transfer (or 1dp5dt). I've been in bed for a day and a half now, and am feeling basically nothing, which is what I would expect. Emotionally I'm a bit all over the place, ranging from hopeful to hopeless to back to hopeful again. Sometimes I'm completely sure that nothing has survived already. Sometimes I'm able to have hope that we could have a positive outcome from this.

I'm also having lots of neurotic thoughts that I'm working hard to quell. Among them:
  • I've sneezed twice and worried it hurt the embryos (seriously? Mo, get a grip!). 
  • I can't remember anyone saying if my lining was triple stripe prior to transfer. What if it wasn't? I know it was 10 mm a week ahead of transfer, but what if it wasn't optimal?
  •  I've had to actively choose not to panic that my estrogen is 2,000 - isn't that too high? Could it hurt implantation potential? I'm on vaginal estrace this time and wondering if the dose is too high or if maybe the levels from the vaginal inserts come back differently from the levels with the vivelle patches. I have a call in about this but won't hear back until Monday.
So I'm trying to be sane over here, with only some success. Normally at home I'm so busy I don't have time to be neurotic. but on bed rest, I have unfortunately lots of time to think too much.

So strange to know this visit was almost certainly our last one to the Denver clinic. Weird to not have more future visits hanging out there after all his time. We brought flowers for our longtime nurse who has overseen all of my cycles and saw our favorite genetics counselor before and after the retrieval. I love the folks at the Denver clinic and especially those two. Both of these wonderful women have really made this years-long journey more manageable and doable on every level. I have fully felt like they are rooting for us. So wonderful to have some people in our corner who've taken such a personal stake in our outcomes.

We are really missing Magpie and have been doing Tango with her (like skype) every night. It is great how verbal she is now and can tell us about what she's done that day. She also always wants to know if we've eaten dinner when we talk - very cute. It seems like she's doing well without us, but we are missing her! At the same time it is nice to just be able to focus on resting and not feel pulled in the multiple directions I usually do.

In terms of symptoms. Not much going on here.

Boobs are not sore. Uterus is "full" feeling. thought I felt a bit of left sided pinching yesterday but who knows what that was.

Implantation wouldn't have occurred yet. I think it is usually 7 to 10 days post ovulation, so in this case, 2-5 days post transfer. Yikes! So scary that we'll know soon one way or the other. Hoping we can eek a pregnancy out of this.

Fingers crossed!


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Friday, August 28, 2015

Transfer complete - with pics!

All went well with the transfer.

My blood results came back well too with progesterone at 24 and estrogen at 2,000 (oh my!)

All three blastocysts survived the thaw 100%. And according to the embryologist, they were all expanded and beginning to hatch!

Here's a pic. We had the embryologist tell us which was which, so I labeled it for you to see.

For comparison, here is the pic from Magpie's transfer. In that case, two survived the thaw 100% and the third 98%, and two of the three had fully expanded. Today's blasts look in much worse shape to me, but then again, I'm no embyologist. Maybe ugly blasts can sometimes go the distance?

And here is the pic from the FET before that, that resulted in a loss at 7 weeks... In that case, All three blasts survived the thaw, with 100% cell survival for two of them and 98% cell survival for the third. One of the three completely re-expanded, and the other two moderately and minimally 

Nothing to do now but wait (and overanalyze...I


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Thursday, August 27, 2015

Flying out today

We fly out later this afternoon so we can be in place and ready for the transfer tomorrow morning (gulp!).

Progesterone level drawn earlier this week came back at 17.81, a good level, so all systems go!

We are leaving Magpie here with her caregiver - it's the longest we've ever left her (the only other time we've ever left her was for the One Day Work Up as a matter of fact). Feeling major pangs to leave her for three nights : (. Hopefully she'll be fine. I felt like it would be psychological torture for her to be holed up in a hotel room with me, but with me on bed rest. So we decided to leave her here. Mommy heartstrings really pulling though. It was tough to kiss her goodbye this morning.

This week, I've cut out all caffeine and even decaf products. And just like with Magpie's FET, I've gone gluten-free (this one is hard for me) on the off chance it might make a difference. Don't know if it will help or not but it feels like I'm giving it my all. My mantra is regret management all the way.

Transfer is 11:15 tomorrow. Wish me luck!


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Tuesday, August 25, 2015

Details on our embryos (why we aren't worried about triplets)

Our three embryos for transfer are: (drum roll):
  • Embryo #11, a Day 7 FISH/Microarray normal 4BB blast
  • Embryo #15, a Day 6 FISH/Microarray normal 3BB blast (my bets are on this one)
  • Embryo #20, a Day 6 FISH/Microarray no result 3BC blast
What does all that mean? I'm about to go all technical on you skip to the bottom if scientific explanations are not your thing.

Day 6 or 7 means the day that the embryo reached the blastocyst stage. Ideally, this would be on Day 5, but Day 6 is ok too. Day 7, not so much. In fact, most clinics don't even culture to this stage.

And then the 3BB or 4BB, etc., is explained in the graphic below. But in shorthand:
1. The number refers to how developed the blast was
2. The first letter represents the quality of the inner cellular mass (which becomes the baby)
3. The second letter describes the quality of the trophoectoderm (which will become the placenta).

So an embryo graded 4AA, 5AA, or 6AA would be most likely to develop into a baby (note, none of ours are AA. In fact none include the letter A at all).

Here is a pictoral explanation:

Finally for the few readers who are super interested, this link will take you to a well explained, detailed explanation of blastocyst grading and multiple super cool photos.

For what it's worth, Magpie developed from one of three euploid blasts: either a Day 6 3AB, a Day 7 4AB, or (more likely) a Day 6 4AA that didn't fertilize on time and had to rescued with an ICSI fertilization the second day (God bless the Denver clinic - most clinics would have just thrown that egg away as non-fertilized). All of those arguably better than any of the three we have left, but it is what it is.

So from what we have for this time:

Embryo #11 is 4BB and so looks fairly good, except for the fact that it didn't go to blast until day 7, which makes it a big outlier and unlikely to implant, according to Dr. Schl. But hey, you never know.

Embryo #15 at 3BB maybe looks like the best bet for this cycle, Day 6, euploid, reasonable quality. Maybe!

Embryo #20 is a 3BC that didn't culture on FISH or microarray so we don't know if it is chromosomally normal. I'm betting it's not and will die off. It's also pretty bad quality for the trophectoderm.

Have any of you out there have a baby from a 3BB or 4BB, or a 3BC or (rarer still) a Day 7 blast? Would love to hear from you if so.

Three more days! I can't believe it.

Fingers crossed.


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Tuesday, August 18, 2015

"You're putting back all 3 embryos?!"

This question has been asked several times with our old reproductive endocrinologist here in NY, my OB-GYN, and the reproductive immunologist.

"You're putting back all three?"


"And they are chromosomally normal?"


"And they are at the blastocyst stage?"


"Are you sure you want to do that?"


And I suppose we may seem crazy, but yes, we want to put back all three. Yes, they are blasts. Yes, they are chromosomally normal.

My reasons are logistical, emotional, and financial.

We have transferred three both previous FETs (perhaps why our Denver RE didn't blink an eye at the request). And out of these 6 chromosomally normal blasts across two frozen embryo transfers, we ended up with lovely Ms. Magpie.

Not twins, not triplets. We got a miscarriage from the first cycle and then Ms. Magpie. So I'm not so worried about the triplet scenario. Our chromosomally normal blasts are clearly not like other people's blasts. I don't know why not, but they aren't.

Because I have stage 3 endometrosis, I had to do two months of depot lupron to gear up for this transfer, and while it wasn't this bad as it has been, I don't want to do it twice. I will also be doing IVIG ahead of the transfer. Costly, and I find the treatment arduous.

There is also the logistical piece of getting out to Colorado, sans Magpie so I can do the transfer and be on bed rest for two days following.

And finally, the emotional piece. As you know, this is tough stuff to go through. It would be nice to know we are either going to be pregnant again, or that we aren't, and not drag this on for many more months.

I don't have any concerns that we will become pregnant with triplets. And even if we *did* get pregnant with three...I've been pregnant EIGHT times and have one miraculous daughter.

Call us crazy, but we're just not that worried about it.

Almost there....transfer is a week from Friday.

This will be interesting, no matter how it turns out.


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