Transfer day

Thank you all so much for your good thoughts and well-wishes. They mean more than we can say.

Transfer complete, but not without a few hair-raising moments. First we received a call from the nurse yesterday that the transfer might be cancelled because I potentially misunderstood (still unclear to me) and took the first dose of progesterone a few hours early. Dr. Schl. ended up saying a few hours makes no difference, but it was a real panic situation for about 30 minutes that basically ended up seeming like needless drama from the nurse. That imaginary crisis averted, all systems were again go.

This morning, we were scheduled to arrive at the clinic at 11AM but received a call at 7:30AM to "put on my pants and just get there asap" - apparently all of Dr. Schl's transfers got moved up this morning by several hours. So we hightailed it over there and I had acupuncture and then the standard 10 mg of valium they give to relax you. Mmmmm.

They thawed three CCS and FISH chromosomally normal embryos:

Embryo #5 from June - a 6BA

Embryo #14 from June - a 4BB

and Embryo #6 from March - a 6BB

All survived, 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 (but the third one was thawed last in our race to the new transfer time this morning, and so may catch up). The lack of re-expansion on the two (see pic below) scares the bejeezus out of me, but I'm trying to just accept it and hope for the best. Not sure how critical it is. Any of you know?

After spending much time post-transfer trying to pee in a bedpan (boy that was difficult!) and getting a second round of acupuncture, I'm back at hotel and on bed rest until Sunday - planning to snooze a lot after very little sleep last night (nerves) and watch multiple episodes of Mad Men for entertainment. Love that show. Will is as usual being a champ and helping me do everything I need. Such a good husband!

I'm not feeling too hopeful, more just terrified, which is maybe what hope looks and feels like at this stage of the game? Talisman necklace clutched tightly in hand, prayers on my lips. Hoping to find a zen place to settle my mind in soon, but so far somewhat failing.

Here are the Mo and Will threesome below, if you're curious.

Any thoughts on the lack/slowness of re-expansion and what it portends? Any of you btdt with vitrified blasts and had a good or not-good outcome?

More to come soon...

Mo

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Countdown to transfer

We leave tomorrow for Denver. All is in order for a Friday transfer. Gulp. I have been so slammed at work that I haven't been able to update the blog, or do much of anything (haven't packed for that matter - need to get to it right after this).

Estrogen and progesterone are in good shape (E2 = 655, P4 = 11.82 at last check). Lining is triple-striped and was 8.6 mm at last check (late last week).

I have been doing acupuncture two to three times a week for the past few weeks. Trying to reverse this blood flow problem to my uterus.

I started an anti-inflammatory cocktail today of prednisone, claritin, and pepcid that Denver is using with women with recurrent miscarriage. I have been on aspirin and medrol and estrogen patches and oral estrogen as well as progesterone suppositories for days.

We decided to throw Lovenox into the mix, even though Dr. Schl. thought it was probably unnecessary (the reproductive immunologist we saw last fall recommended it). I was really scared to take this after the things I've read on the Internet, worried the shot would be very painful. It is so no big deal, which is a relief.

All systems are go and we are approaching lift off.

I spent almost 30 minutes on the phone today with the head embryologist in Denver, trying to determine what embryos we will be transferring. After much soul searching and discussion between Will and me over the past couple of weeks - as well as today's long talk with the embryologist - we will be transferring two day 6s and a day 7. It is very scary to transfer three, but even scarier to imagine not getting pregnant at all. Because two of the three we are planning to transfer have already hatched and might not survive the thaw, we have backup embryos in line if needed (geesh, I hope not needed, but better to be safe than sorry).

It feels surreal to be on the cusp of the transfer. I can't believe we've finally arrived at this point. Honestly, it doesn't feel real in any way - I feel pretty detached about it. Maybe it will start to sink in soon?

A wonderful blog friend sent me a necklace that she wore during her successful cycle and that was passed to her from yet another blogger who wore it during her successful cycle. What an honor. What a beautiful thing. I will be wearing it Friday, hoping to catch a whiff of all the good luck this talisman has to offer. How incredible that through the words on our screens, we reach each other, touch each other, and connect across all the distance in the world. Amazing. I am so grateful. Just touched to my core.

And oh, God, maybe, could this maybe work?

Mo

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Schoolie says

So...we talked to Dr. Schl. in Denver finally. Boy, he is one cool cucumber. It was an interesting talk, but somewhat surprising to us. We expected major optimism from him (EIGHT NORMAL BLASTS!) but well...

He certainly wasn't pessimistic, but was not as hopeful as we thought he would be.

He said he thinks we should try this transfer and that if it doesn't work, we should consider a gestational carrier (Whoa!), because while all this time everyone has thought we have an egg issue, now that we have a number of chromosomally normal blasts, it appears we may have a uterine issue behind our failures as well (14 transferred embryos resulted in only two pregnancies, and of our five losses, two were not tested and so may or may not have been due to aneuploidy)...

Dr. Schl's warning about my uterus was more than a bit of a surprise to us, although maybe it shouldn't have been (we've wondered about my uterus ourselves). He's funny too the way he talks - he advised that we would want to consider a "proven uterus" should this cycle fail.

In terms of the "how many" question, Dr. Schl. said he thought that we should definitely transfer two normal blasts and that it would not be unreasonable to transfer three normal blasts (two "typically developing" normals and one of the day seven blasts). He said that transferring three could result in triplets, but he estimated our chances of a singleton pregnancy are 50% if we transfer three. (Of course, he's making up that number but it gives us a sense of what he's thinking). Denver normally has a 71% pregnancy rate with two normal blasts transferred, so he's thinking our chances are significantly less than typical. But hey, 50% is nothing to sneeze at, either.

Anybody else have Denver tell them they can transfer three normal blasts? Don't think I've heard of that before, that I can recall...

Apparently the embryologist will pick which embryos to transfer. Fine by us. So that's the lowdown. There's some kind of protocol they've used with women with recurrent miscarriage that is supposed to reduce inflammation, so I will be going on that once I get the specifics. In the meantime acupuncture is continuing 2-3xs/week and I'm off all caffeine.

We have many thoughts over in the Mo and Will household about our recent Dr. Schl. chat. Honestly, we don't know what we are going to do regarding the transfer. At the moment we are thinking we will transfer at least two. Three is a terrifying prospect, but then again, the idea of not getting pregnant (and being told not to try again with my uterus) is also terrifying.

More to come.

Mo

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Your embryos are frozen - why would ever transfer more than one?

It's getting to be decision time.

Here we are - in the fortunate - can't-even-believe-we-could-be-so-lucky - position of having eight chromsomally normal frozen embryos. Four that developed typically and on time.

And now we are faced with the question of how many to put back when we go to transfer.

A few people have asked us, Since they are frozen, why would you even consider putting back more than one? Why not just do a single embryo transfer? You've got eight, after all, and a singleton pregnancy is lower risk than a twin pregnancy.

These are good questions. Tough questions.

Of course our hope, and our goal, is to have a healthy baby. We are balancing our deep desire for a good and safe outcome with a reality that may be harder to understand, but I'll give it a try anyway.

Folks, we are seriously running out of stamina. The past seven IVFs and our five losses have taken us to the mat. All the treatments and surgeries over the last three-plus years, including the most recent two months of depot lupron, have taken a deep toll on us individually and as a couple.

To put it starkly, I don't think we have eight tries left in us emotionally. That's just the facts at this point. If we don't succeed fairly soon, I think we may be packing it in. Chromosomally normal embryos or not. There is also the practical matter that having already spent two weeks "vacationing" in Colorado this year, I don't have enough time off left for eight separate tries either, but that seems like a more surface explanation.

These may not be the best reasons to put back more than one embryo, but it's as honest as I can be.

This may seem weird to say, but after everything that has happened, and despite our genetic results, I can't imagine getting pregnant. And I can't even come close to imagining staying pregnant.

Would I be happy with one baby? Definitely. Happy with twins? Yes - although the idea is a bit daunting. Do I realize that a twin pregnancy is a higher risk pregnancy? Yes, I do.

We'll talk to Dr. Schl. soon. We'll get his thoughts on what our odds are, given our history and situation. We will tell him our thoughts. And then we'll go from there.

Promise to keep you posted.

Mo

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How I have missed thee

So sorry to be silent for so long. I've been reading your blogs, cheering you on quietly, not commenting very much at all. I have had my head down and have been just slogging through the depot lupron...one foot in front of the other. I don't recommend it to anyone, but those days are behind us.

Hard to believe it, but we have actually started a calendar for our embryo transfer, which is currently scheduled for Oct. 8. My depot lupron days are finally over and I am on to birth control (ha!) and daily injectable lupron, which will be followed by vivelle patches. Oh, yes! Estrogen! How I have missed thee! Let me count the ways!

Also I will start twice weekly electro-acupuncture momentarily to try to increase blood flow to my uterus. As of now, all caffeine has been stopped.

The idea that we will be trekking back to Colorado - and for a transfer no less! - still seems vague and distant, although I realize (somewhat dimly, it appears) that in less than a month we will be back in Denver. Wow. Huh. When did that happen?!

Also, next week we will speak to Dr. Schl. about how many embryos and which ones to put back. We vote for as many as he'll agree to. Maybe two normals + a day 7? We'll see what he has to say.

Thanks for hanging in there with us...here's hoping the other side of the mountain is approaching.

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