Embryo Transfer Day!

It's a little overwhelming to sit down to write this... so many details that I want to get just right, both for information purposes, and so we'll always remember :-)

On Tuesday (Day 3), we got a call from Natalia at the lab, telling us that we still had 10 growing embryos.  Two of the three that had been behind the day before had caught up, and one of the others was surging ahead. (Ethan and I were really excited about that, but Dr. Skinner told us today that fast, early growth is not as good a sign as it sounded like.)  We each got a massage, then spent a lot of the afternoon on the balcony of our hotel room, talking about baby names and making lists of some names we like.  It's obviously SUPER-early, but it's a lot of fun to dream about! 

Yesterday (Wednesday, Day 4), Natalia called again to tell us that our transfer would be at 1:45 today.  I asked how our embryos were doing, and she explained that there is a lot of changing going on on Day 4, so they don't check on them... leave them alone, let them do their thang :-) We had our favorite cab driver, RC, drive us out to Bathsheba beach.  He gave us a great tour of the island along the way, and we got to see quite a bit that we hadn't managed to see last cycle.  Then we spent a couple of hours on the beach... I hunted sea glass, and actually found quite a bit!  Found my first pieces ever... I'm absolutely hooked on it!  There was this one really pretty piece of white/clear glass, I saw it, and heard a wave rolling in. I reached for it like a flash, just as the wave crashed into my back and washed out the spot where the glass had been.  But it was already safe and sound in my hand... it was such a rush!!  I love it!!!   Finding sea glass gives me an extra little kick of optimism for this cycle, since I have grown attached to the metaphor of the little treasures to our struggle. 

We went to bed fairly late last night, and were just starting to wake up this morning when Natalia called again.  They had already chosen our embryos, and as soon as they have chosen, they like to get them into their mother as quickly as possible, so they moved my transfer up to 11AM!  We called RC and asked him to pick us up earlier, and got ready quickly.  We got to the clinic at about 9:40, and I had 45 minutes of acupuncture to get the blood flowing to my uterus and to relax me.  And y'all... I was relaxed. Walking straight lines was kind of tough. 

We met with Dr. Skinner in her office, and she showed us our official fertilization reports.  We were THRILLED to see that we had two gorgeous embryos - grades 3AA and 3AB.  These were the two they had decided to transfer :-)  Sadly, four of our embryos had "arrested" or stopped growing.  Apparently, when there is a lot of early growth, that is not uncommon.  The remaining four embryos were a little behind, but they are giving them another day to catch up.  If any of them get to the blastocyst stage tomorrow, they will be frozen for a future transfer.  Ethan and I understood this part differently... he thought she said those four are likely to make it, I thought she said it was unlikely.  I guess we'll find out tomorrow!  

Ethan found this great explanation from Oregon Reproductive Medicine of what happens between Days 3 and 5, and why Day 5 transfers are so preferable.  As sad as we are to have lost our four arrested embryos, we know that these are the ones that would have never matured to the point in me to have even started to implant.  By culturing them out to Day 5, we gave them their best chance, and us the best chance of having a living child or two.  

From there, Dr. Skinner walked with us back to the operating theatre, where we met with Emma - the nurse who took care of me before and after my retrieval.  She instructed us to put on awesome blue booties and hats, and had me put on a hospital gown.  When I was done, we all walked back to the little operating room... I got into the usual position and Ethan sat on a stool near my head. The whole actual transfer took just a couple of minutes... we got to watch via ultrasound as Dr. Skinner slipped a catheter into my uterine cavity, measured it, and chose her spot.  Then the lab handed her our embryos through a little window, and we got to see the little "blip" on the screen as the droplet containing our two precious babies landed in my uterus.  Emma printed the picture right at the point, and circled the drop for us :-)  Then, of course, the historian and blogger had to take pics for the baby book ;-)  

I chilled out on my back while Emma went over my post-transfer meds and instructions, then I got up gingerly - so aware of who I was carrying! - and went upstairs for my post-transfer acupuncture.  As we left the clinic, and hugged everyone for the last time for (hopefully) a few years, I had an overwhelming sense of peace and optimism.  I'm really amazed at how calm I am!  It all just feels very right, and very good. 

We fly home in the morning... we can't wait to love on our furry firstborn, hug his grandparents, and settle into our home and routine to wait out the twelve days until I'm allowed to "POAS" (pee on a stick - crude, but effective infertile shorthand, haha)!!

Thank you all so much for the love and support!  Now, as Dr. Skinner said... "It's all up to them."  I hope these little darlings stick around... we're so in love with them already!! 

Very Important Announcement About Announcing!

Ethan and I have given a lot of thought to the questions of how and when we are going to announce a pregnancy, and we've come up with a plan we wanted to share now, ahead of transfer.

To our reckoning, this cycle can end one of three ways: 

1. We can't transfer for some bizarre, unforeseen reason.
2. We transfer and the embryos don't "stick." Also known in fertility blogging world as a "BFN" - a big fat negative pregnancy test. 
3. I get pregnant. (That's fun to type!)

In the case of the first outcome, we would want to share right away, so we can document whatever new plans we make and those decision-making processes. In the case of the second outcome, we would be prone to telling people earlier than in the case of a baby on the way, for the support and again, to be able to document our next steps. If I am pregnant, we would want to wait until I was 6-8 weeks along before putting anything on the blog or other social media, so we could share the news with our close friends and family first. 

But this leaves a conundrum for those who've chosen (and been lucky enough) to share a journey like this with so many people. If my two-week-wait has come and gone, and we haven't said anything, the automatic assumption would be that we are expecting, and being coy about it :-) If someone asks before we're ready to tell, and we say something to brush it off or put it off, it would be the same assumption. 

So our plan is to announce outcome 1 if it happens, as soon as it happens, which would be Thursday. We are not anticipating this at ALL, but we also weren't expecting to not transfer last time, either! For outcomes 2 and 3, we will announce on social media on October 18, when I will hopefully be 6 weeks pregnant, after we've called and visited the people we want to know first. 

Making these plans might make me sound a little full of myself - like the world is waiting with baited breath to hear about the occupant/s of my uterus, I know. But I have my reasons! I'm hoping that having a set announcement date will help us handle the questions we'll probably get, but I also want to give fair warning to any infertility friends who may follow me here, on Facebook, or on Instagram. I know ALL TOO WELL how a pregnancy announcement - even one you're sort of expecting - can feel when you're waiting to make a announcement of your own. This way, anyone who wants to guard against a possible "trigger" can follow up through the end of our trip, and have a couple of weeks to do what they need to do to protect your heart. You won't have to worry about a surprise before that day, and you can avoid my social media presence if you're having a "down" day... pop over when you're feeling strong, I'll still be here! 

Thank you all for all of the prayers for our successful trip, and for loving Ethan, me, and our future kids so much! 

BarBABYdos, Take 2: Baseline and Lining Check Ultrasounds

Last week I had my baseline ultrasound for our FET.  It went smoothly... no cysts, and my lining showed that I was at the very beginning of my cycle, just like it was supposed to.  

Yesterday was a lining check ultrasound, which was the second of three appointments I had made for ultrasounds.  The third was for this coming Thursday, and was dependent on the results of yesterday's.  Happily, when I told Anna how thick my lining was (10.9 mm), she told me to go ahead and cancel that appointment!  In her words, "It doesn't get any better than this!"  Yippee!!!  I took cookies with me to yesterday's appointment, to thank the office staff for taking such good care of me.  All of the extra orders and prescription-writing I've needed from them has really been above and beyond the call of duty!  So they got Almond Joy Chocolate Chip Cookies (from Six Sisters' Stuff) and Quadruple Chocolate Soft Fudgy Pudding Cookies (from Averie Cooks)! 

I am to keep on Lupron for two more days, then switch to having Ethan give me the dreaded Progesterone in oil shots at night.  These will continue through transfer, and I think through my two-week-wait?  I also start Doxycycline and Bromocriptine (aka Bromokryptonite) on Friday, which will also continue through transfer.  :-) 

I spoke with my maternal-fetal medicine specialist (high risk obstetrician)'s office last week, to see when they wanted to see me.  Typically, an RE follows a patient through the first trimester of her pregnancy, then passes her back to her regular ob/gyn, but since my RE is in another country, I needed a slightly altered plan.  They said to see Dr. Altman, my regular ob/gyn, for my betas and the rest of first trimester (or at least through week 8), and that he'd hand me off when he thought it was time.  So, yay for that much of a plan! 

BFC is very much oriented toward positive thinking, and I find myself feeling generally more positive and optimistic as their patient than I used to feel before finding them.  But every once in a while, I catch myself being absolutely CERTAIN that I will be pregnant in just over a week, and it scares me.  I was fairly certain last time, too... what if it doesn't work this time, either?  I know that if I'm certain, and I'm wrong, the pain will be even worse.... I am terrified of having to pick up pieces of a shattered heart again, and honestly can't picture myself finding strength to do this all again after another disappointment.  Please pray for peace and courage for Ethan and me....

BarBABYdos, Take 2: FET So Far (Lupron and BCPs)

While there isn't a whole lot of exciting stuff to report on the FET front right now, I wanted to pop in and just give y'all an idea of what I've been doing to prepare for the end of the month.  

I'd been back on birth control, since right after my IVF cycle  (until this past Wednesday).  It's not always used with an FET, but it helps prevent cysts, and also lets us plan my dates... which is pretty useful when your embryo transfer will take place a few plane rides away :-)  This round of pills went better than some rounds in the past.  I didn't gain any additional weight on it, but it made me a little crankier than usual and I needed to increase my insulin.  

On August 29, I started taking Lupron.  I'd heard about the infamous Lupron headache, but wasn't all that worried about it.  So I gave myself my shot in the morning, subcutaneously in my thigh, like I was instructed to do.  I've never had great luck giving myself shots in the leg, because my legs are fairly muscular and I can't "pinch an inch" of skin/fat on them (not a problem on any other part of my body, haha).  Almost instantly, I had a big knot in my leg, it was hot and red and burned and throbbed, and I was scared!  I fired off an email to Anna and asked if I could try taking them in my hip or the back of my arms (both places I am quite used to putting sub-q needles), in case that might help with the pain.  Her colleague who was answering her emails suggested my lower abdomen (below my belly button), so I decided I'd try that the next morning. 

Within 20 minutes, the knot had peaked, and it was gone in an hour and a half.  But I got nauseated and woozy and wobbly and felt just generally crummy.  I knew I needed to eat something for blood sugar purposes, so I nibbled on some Ritz crackers.  Almost instantly felt better!!  

So the next morning, I ate a little bit of breakfast before I gave myself the Lupron in my belly.  Problems solved!  Just the tiniest little itchy reaction for about 10 minutes, no nausea.  I did end up with a migraine that night, but just the one.  I've taken the rest of my shots just like that, and I've only had low-grade headaches and some drowsiness.  It's definitely messing with my sleep - I wake up several times a night and don't feel rested in the mornings... I tell myself it's good practice for having a newborn ;-)  It's not pleasant, but it's definitely manageable.  

Tomorrow morning, I decrease my Lupron dose, and go for my baseline ultrasound. I also start Estrace and my low-dose aspirin :-) 

BarBABYdos: The Aftermath

 

Ethan and I have been home from Barbados for a couple of weeks now.  He went back to work (and I went back to housewifing) a week ago today... life is mostly transitioning back to normal.

While in the middle of OHSS, we were told that everything would be better when my period started, and we fortunately found this to be very true.  However, the second full day was a bloodbath.  Seriously... terrifying, horrifying, slasher-film stuff!  Emotionally, it was pretty brutal, too.  A large part of that was probably hormones, because my emotions swung wildly and without warning.  But another part was definitely that we had to go buy pads.  I had all but run my supply out with my last pre-IVF period, blissfully thinking that it was perfect timing - I wouldn't have to store them for a whole pregnancy!  It hurt... a lot... to pick a pack up off the shelf at Kroger.  I'm actually lucky I got the kind I wanted, because I could barely bring myself to look at them enough to make sure they were the right ones!  Just grabbed them, tossed them in the cart, and started daydreaming about chocolate chip cookies. ;-)

Leaving Barbados was heart-rending.  I cried like a baby on takeoff, until the island disappeared from sight.  When we landed there, we were so full... of eggs, of hope, of confidence... as we were leaving, I felt so empty of all those same things. Now, we're focusing on our return trip in a couple of months.  There's a little less planning and logistics involved, but still enough to keep us busy and mostly distracted ;-)  

I'm back on BCPs (birth control pills) for our FET cycle, and as usual, they're making my moods swing a little worse than usual.  I haven't noticed weight gain again yet, but it's only been about a week ;-)  I think that week of not being able to hold more than a few bites of food every several hours helped get rid of some of the old BCP weight... not that that is a pleasant/safe/advisable way to diet at ALL, but hey - silver linings. :-)

In other non-fertility news, we're keeping my in-laws' pup, Dixie, for a week.  She is SUCH a funny little critter, so we're having a blast.  It IS an interesting glimpse into life with a baby and a toddler, though... I'm thinking we'll try to space our future FETs out a bit... ;-)

BarBABYdos: Day 7: Egg Retrieval

I woke up as late as I could the morning of my egg retrieval (since I was fasting and tend to get “hangry”), got ready in no time flat, and we called a taxi to take us to the clinic.  I was super-nervous, but I also felt determined.  I had made it this far, all that was left was to take a nice, drug-induced nap while Dr. Skinner retrieved eggs from my hugely swollen ovaries.  Piece of cake!

Once there, we were taken back to curtained pre/post-op area, and I changed into the all-too-familiar, even in a foreign country, surgery garb: a blue gown, blue hair net, and blue mesh booties.  Good thing blue is my favorite color!  Of course, I was also wearing the earrings I’ve worn to every appointment down here… my sperm and egg. 

The theatre nurse, Emma, kept us in stitches while she checked me in and took my vitals.  Dr. Skinner did a quick check of (I’m guessing) my lungs to make sure I was safe to sedate, and told us what to expect as far as how long I’d be in, when Ethan could see me, and how long I’d be in recovery.  

I wasn’t separated from Ethan until I walked from my curtain to the operating room, which I really appreciated.  Lynn was the surgery assistant, and she kept up a pleasant stream of chitchat while she made sure I was comfortable on the table and in the stirrups (the ones that you place your calf in, instead of your heel… love that!).  Dr. Skinner came in and took up the conversation, keeping me smiling and otherwise focused while she slipped an IV into my vein faster and smoother than ANYone EVER has.  Lynn placed an oxygen mask over my face, Dr. Skinner started injecting into the IV, I got a really weird taste in my mouth, coughed a little bit and cracked a joke about it, and the last thing I remember is chuckling with my doctor. 

I cannot stress how different that was from every other surgical experience I have ever had.  I told Ethan I usually feel more like a surface being prepped than a human patient, like the counter a cook wipes down before they start chopping ingredients.  But everyone at BFC from the moment I got there answered questions, joked, encouraged and did whatever else needed done to make me feel absolutely comfortable and valued.  

I woke up a couple of times and remember little bits of each time, just enough to feel like déjà vu when I woke up for real :-) Apparently I told Ethan each time how great Dr. Skinner is!  I guess I also read my texts like they were new each time, too.  When I woke up for real, I was hurting.  Quite a bit.  It felt about as bad as one of my worst cysts popping, and I mostly spoke in whimpers and asked repeatedly when I could have pain medicine.  It came soon enough, and I woke up enough to be able to converse semi-intelligently. 

That’s when Anna came in, which delighted us, because we love us some Anna Hosford!  She incredibly gently explained to us that our transfer would have to be delayed, and gave us enough information to start processing it as a couple.  She came back a little bit later, when we had talked and processed and had some questions articulated, and did one of the things we love her for… she gave us a plan.  She gave us a plan to get through the night, then scheduled an appointment for us the next morning to come up with the rest of the plan.  The compassion for our heartbreak from both Anna and Emma was unbelievable, and I choke up a little thinking about it now, four days later.  

We knew ahead of time that my ovaries were hyperstimulated, and that it had the potential to get worse.  I knew from my time on the internet that cycles were sometimes canceled because of it.  We are so thankful that our cycle was not canceled before retrieval, because while I deal with immense bloating, shooting pains, cramping, nausea, and shortness of breath, I can comfort myself with the fact that we have 23 beautiful, mature eggs frozen at the clinic, waiting for us to return for an FET.  

We have stayed in Barbados for additional monitoring, as ovarian hyperstimulation syndrome (OHSS) can get extremely serious and require draining or even hospitalization in the most severe cases, and we will be returning home when we were originally scheduled.  I have stayed in bed most of the last four days, and am on strong pain killers to deal with the OHSS.  (I am fairly sure my procedure pain was almost gone by the next morning!)  I have had one ultrasound follow-up, and my OHSS is still considered mild, as I do not have much fluid free-floating in my abdomen.  She could find my massive, fluid-filled ovaries almost up to my belly button… they’re definitely not supposed to be up that high!

All things considered, I’m okay.  We are planning a brief return trip to Barbados when my body has had time to heal.  A silver lining is that my body will not have been through such a recent trauma like stimulation and retrieval when our precious embryos are transferred back into me.  

So, this chapter of the BarBABYdos story is ending.  The next one begins in September.  Stay tuned :-) 

BarBABYdos: Day 4: Finalized Schedule

I had my last ultrasound yesterday morning.  All of my follicles are growing right along, and enough of them are big enough that we went ahead and scheduled my last round of meds and my egg retrieval.

Retrieval is Monday, at 9:30 in the morning (please be praying!).  Last night, Ethan gave me my last intramuscular injection (of ELEVEN!  Can we take a moment and give him a round of applause?  He is a champ!) of hMG and FSH, and I gave myself my last shot of Cetrotide.  Tonight, I am to give myself Ovidrel (hCG – “finishes” the ripening eggs) at precisely 9:30 pm, and start taking Bromocriptine orally as well.  I’m super-excited for tonight, because the Ovidrel should be my last shots… hopefully ever, considering how many follicles I have this time.  I’d love to come back to Barbados Fertility Centre for an FET (or a few), get as many kids as these eggs will get us, and never have to stim again.  Stimming stinks!

Yesterday and today, I have been exhausted and achy.  Today, I’ve been nauseated off and on, but I’m not sure all of this is entirely IVF-related.  Travel can be rough on a body, and I’d say we’ve had enough going on to justify a good bit of fatigue ;-)  Our exciting vacation-y plan for the rest of the day is to keep doing what we’ve done all day – nothing.  Tomorrow, we want to go back to the grocery store so we have enough stuff stocked to get us through retrieval recovery, and we need to do laundry.  The hazard of traveling for long periods of time – at some point, you have to do boring grown-up stuff! 

BarBABYdos: Day 3: Follicle Check

I had another ultrasound at Barbados Fertility Centre this morning, checking on my follicles again.  They’re growing, but they’re not done yet.  We’re supposed to do the same injections tonight that we did last night – my FSH and HMG, followed by Cetrotide a little bit later – then go back to the clinic for another ultrasound in the morning.  Anna is expecting that we will do egg retrieval on Monday, but there’s still an outside chance that it could be Sunday.  We’ll know tomorrow!

After my ultrasound today, Ethan had an Indian head and neck massage, which he gave rave reviews!  He sometimes gets those muscular contraction headaches, and the therapist was able to identify some knotted muscles and he thinks she was able to improve them a lot.  Hopefully, that will give him some long-term relief from those headaches!   I had a full acupuncture treatment this time, which was less dramatic than my last one was, but still very nice.  It seemed to have a longer-lasting effect of relaxation this time – my ovaries are still uncomfortable, but I was able to mentally deal with it and enjoy our day pretty well, and I think that has at least something to do with the acupuncture.  The absolutely stunning views and the soothing, rhythmic sound of the waves probably hasn’t hurt, either :-)  

We visited Accra Beach this afternoon.  It’s not far from here, but we took a cab anyway, for the sake of my ovaries and so we could have a little more time to relax there.  Neither of us are BIG beach or water people, but we did really enjoy basking a little, digging our toes into the super-soft sand, and playing around the edges of the water for a while.  We planned to head up to the boardwalk-ish area and shop some of the little vendors’ stalls when we were done and before our taxi driver came back for us, but when we walked back up, the stalls were closed.  So we hoofed it across the street and enjoyed dinner at Chefette, Barbados’s local fast food restaurant.  I have been trying really hard to follow Anna’s suggestion that I avoid refined sugar to prevent the OHSS from getting too painful, but I misbehaved just a little and ate my bun AND an ice cream cone.  Delicious!!