A Glimmer of Hope

Today is day 5 of medications. 

I feel the difference this time around. My abdominal area is already feeling ‘tight’ and a bit crampy. I know there is growth already going on in there and I am hopeful that today’s appointment will reveal a positive response to the increased medication. 

Let the blood draws begin!

I look at today’s appointment as “The scary day 5 monitoring appointment”.

In the previous 2 IVF cycles, this is the day that I go in for blood work and an ultrasound and the technician remains quiet. 

A few hours later, I would get a call from my medical team sharing that the doctor is not impressed with the ultrasound results and need to up the dose of medication. For both cycles, this put me back 2+ days of follicle growth, extending the days I was on medication. 

I’m hoping for a different outcome today. 

**

The ladies at the clinic were lovely and I ended up asking for more information about what they were seeing. 

The lady performing the ultrasound shared that she is counting 22 follicles, one that is measuring a bit larger than the rest. 

Way to go little one!

I leave feeling good about the report so far and wait to hear from Nurse Emily. 

**

A headache kicks in. 

It must be the higher medications I’m on. 

I can’t nap. There must be something wrong with me- I’m known to my friends as a Champion Napper. 

The call comes in. Nurse Emily reports that everything looks good. Nothing negative and to remain at the current dose of meds. 

A glimmer of hope. 

A different report then what I’m used to. 

Maybe this round will produce a different outcome. 

I learn that day 5 of my last IVF cycle counted 17 follicles and we all know how that turned out. 

She assured me that I’m on the right track and just to continue progressing as I have. 

No increase in medication, thankfully! 

And there probably won’t be an increase since I’m on the highest dose. 

No wonder my body is already feeling out of sorts. 

I lay down, close my eyes, thank God for the follicles that are growing and pray for the strength to move through today with a positive outlook amidst the pounding tension that grips my forehead.  


Gonal F: 375 IU

Menopur: 225 IU

More waiting makes more planning

I’ve been patiently waiting for my period to come and for the genetic testing report.

The genetic testing report takes about 10-14 days so I have plenty of time to fill with fruitless worry.

In order to calm my mind, I begin to plan out different scenarios of what could be.

Thinking positively, I am assuming the report will come back with a huge green light.

“Why wouldn’t it?” I think “Dr. B thought this blastocyst looked really healthy, even better then when we did our first round and had our sweet daughter”. I’m almost convinced.

Thinking my period would come on Wednesday, I get all prepared and start counting the days to when the FET would take place and what the due date of our baby would be.

Yes, me and my calendar again. Making trouble.

It doesn’t come.

I look to Thursday and move the FET date and due date one day.

It doesn’t come.

I think it must come Friday and move the FET date and due date one more day.

It doesn’t come.

I try to rationalize why it must come of Saturday and move the dates once more.

Each move of the day means another move to the due date for our hopeful baby. With that thought then comes all the others like, what months will I have pregnancy sickness, what months will I feel too swollen to move, what months will I be up all night with a newborn… you get the picture.

Future-tripping. Living in the future and planning, worrying, getting excited over the things that are yet to come and that actually may not ever come.

MYOB USERS – Helping you to keep track of what's due and when | Atticus  Business Accountants

My period still doesn’t come.

I am so frustrated at things I cannot control.
If it would just come so I can start the protocol and meds then it would feel more like a guarantee that we will have a baby.

That’s it! I’m looking for some comfort and assurance that we will have a healthy pregnancy and baby.

I’m looking for some solid ground to stand on when I feel like everything is up in the air.

My period doesn’t come.

I wake up on Sunday, defeated and decide to delete all my potential dates from my calendar.

I surrender to the process and to the timing God has for us.

I even begin to think that God is protecting us from starting the medications because He already knows the outcome of the PGS testing.

I prepare myself for this potential reality.

My period begins to come.

Monday morning, I wake up and I have my period.

Was it the letting go of control or was this just the plan all along.

All that mental energy I spent leading up to this day.

Can I bypass all this next time I’m going through something that has a bug question mark in the middle of it?

Either way, I am thrilled.

I call Conceptions to schedule my outside monitoring baseline monitoring appointment.

Conceptions will do outside monitoring for other IVF clinics in the country. I will go there instead of flying back to Atlanta for the 30-minute appointment.

I have a spring in my step.

We are starting this whole next phase and I can’t wait to get this going and on to the transfer!

Day 4 Post Retrieval

We are back home now.

It is a relief.

I have been attempting to take it easy but life with a toddler and job outside of the home lends to more go-go-go then I would like during this recovery period.

To sleep in my own bed has been a gift.

My body relaxes as the pain continues to throb in my lower abdominal areas.

I feel bloated.

There is not much room down there and much of this reminds me of being pregnant.

The full tension of my insides pressing up against my skin.

My stomach is swollen and my ovaries are not very happy with me.

I get a massage and am grateful for my masseuse who is trained in abdominal massage.

She helps the blood flow and circulation to give my abdomen and ovaries some support.

The pings of sharp pain come only when I move too quickly or when I am resting.

The busy schedule I have this week is helpful.

There is not much time for me to obsess about the little multicell embryos (meaning day 2-5 after fertilization). They are in the cleavage stage, meaning the cells inside the egg are dividing or cleaving but the embryo itself is not growing.  

The first 5 days of an Embryo - Simply Fertility
Days 1-5 of the fertilized egg

When I do think about the multicells, I wonder how they are growing? How many of them are playing nice with each other and multiplying? How many of them are fighting and persevering to continue to do what they want so badly to do? It’s what they are designed for.

I pray for them to be healthy and to be strong. I pray for God to be protecting them as they are so far away from me. I pray that God will guide them and be working in each cell to form as it is supposed to, as He designed each cell to form.

Today these multicell embryos are in the morula stage and tomorrow they will reach the coveted blastocyst.

Tomorrow is day 5 and the multicells will be about 70-100 cells, this is when they have reached blastocyst.

Tomorrow we will receive a call from Nurse Emily.

She will share with us how many of our 7 multicell embryos survived and thrived to day 5 blastocysts.

The wait continues and I am full of excitement.

The Final Push

I just returned from my monitoring appointment and I am waiting to hear if tonight we will trigger the HcG for us to our retrieval in 2 days… or if we will do one more day of medications to give those littler follicles time to grow to maturity.

I am at peace. Whatever your will is, God. I will accept it.

24, 20, 20, 18, 17, 16, 15, 15, 15, 15, 13, 12, 12, 12, 10
12 follicles above 12.5
We had 17 follicles there were 12.5 and above with the first IVF cycle.

——

We just heard from our nurse. One more night of medications to give those smaller ones a little extra time to grow.

We are tired. We just want to go home.

We also know that one more day here could make the difference between a whole other cycle so we are willing to be patient and just be here for the time that is required.

We change our flight (again), I assess our food to make sure we have enough, and we readjust our mind to the inconveniences this change in plan means for us being able to get back home and settle in to our regular days.

Medication:
Cetrotide: .25
Gonal F- 400 IU (use all the remaining pens!)
Medication day 14, cycle day 16

———

I went in for the ultrasound today and it looks like we are ready to trigger!

24, 24, 21, 21, 20, 19, 19, 17, 17, 17, 15, 15, 14, 14, 14, 9

Ovidrel and Trigger Shots for Fertility Treatment

Dual Trigger Instructions at exactly 8pm tonight:
– Leuprolide- 80 units into the belly
– HcG (Chorionic)- 1 ml solution into powder… mix… and inject the mixture into the hip/butt

Tomorrow:
– Morning blood work to confirm my hormone levels are where they need to be
– Take Azithromycin (2 pills) at dinner

The following day:
– Retrieval is scheduled for 8am. I need to arrive there at 7:30am
– The usual pre-surgery instructions: nothing to eat or drink after midnight- brush teeth only
– We will need to get the sperm collect prior to coming in anytime between 5:30am-7am (Good morning to Hubby!)
– After the retrieval, I am expected to be picked up around 9:30 in the office
– Recovery after the retrieval is to rest. It’s expected to feel groggy until meds get out of my system. Common to experience cramping and abdominal pain, Tylenol is recommended.

We will hear how many eggs were fertilized from the physician on the day of the retrieval.

The following day, we will hear from the nurse how many of the eggs were fertilized.

Five days after that, we will learn how many of them made it to day 5 blastocysts and were biopsied. The PGS biopsy results will come back two weeks after the biopsy.  

Expectations = Disappointment

Dr. Bhrama calls. What a lovely voice she has!

This is the first time we have spoken and I find her to be such a delight.

The COVID-19 pandemic has really thrown things off for us to meet in person, so I welcome her call.

We discuss how things have been going this cycle and before I know it, I am having to swallow the biggest upset to date in this process.

We might not have a viable embryo at the end of this cycle.

*Sigh*

Disappointed HD Stock Images | Shutterstock

There are a few things that have tipped her to say this.

  1. My age (approaching 38) is 3 years older than the first cycle
  2. The slow start to the medications. She explained that the first few days of a cycle is the most important because that is when the ‘cohort’ of follicles develops. These are the follicles that will be growing throughout the course of the stim and although more will grow, they will be behind this first cohort. It’s like the cohort is the senior class and the freshmen may be in the same school, but they will never be seniors at the same time as the current senior class. She said that my estrogen was extremely low at the beginning and that if she would have known this, she would have started me with a higher dose of Menopur from the beginning.
  3. The number of follicles we have today is about half from the last time. Our % of blastocysts to eggs retrieved was drastically lower than the average in the first cycle so if we have the same %’s we most likely won’t have an embryo.

My heart drops.

I knew there would be a potential for us to do a 2nd retrieval, but I can’t help but think… I don’t wanna! Like a kid throwing herself on the ground throwing a temper-tantrum.

The upside to doing another cycle is that we would be able to:

  •  start off from the beginning with a higher dose of medication and that would give us the chance for a better follicle growth and count.
  • Meet our new nephew who is due to arrive in 6 weeks from now
  • Be vaccinated from the COVID-19 virus before pregnancy
  • Use the Shared Risk program for how it is designed and feel like the higher price tag was worth it
  • Visit with family another time this year

Dr B also said that my body would be ‘prepped’ for this next cycle because of all the medications I currently have in my system. She said that if we did another stim cycle 1 to 2 months after this current cycle, my body would reap the benefits of it.

Lord, help me remain open to your will and what you are doing for us in the season.

Dr. B also said that she is 75% sure we will trigger tomorrow night… but there is a 25% chance we will go one more day.

*Sigh* oh, Lord, help me release my timing over to you.