I LOVE DR. CLINICDIRECTOR
Honestly, love is the right word, not like not even heart. The transfer yesterday was exceptionally smooth......Incredibly easy.
Yes, I used easy and transfer in the same sentence.
Let me back up, I got to the clinic yesterday 30 minutes before my scheduled transfer time. My bladder was already full. I make it uncomfortably full for transfers because it straightens out the cervix a little and is the only control I have over not being sent home without embryo's inside me.
Dr. ClinicDirector was not there yet. This was not surprising, it was his day at the hospital today, he had agreed to come in on his lunch break to do my transfer. He was very accommodating throughout. They showed me into the recovery room to change and meet with the embryologist. We learned that out of our 12 embryo's, 9 had made it to day 5. 4 were blastocysts and 5 were morula's. The embryologist explained that all 5 morula's had compacted and the only thing separating them from the blastocysts were that they had not expanded yet. I was elated with the results but surprised by the way they got there. You see, Lisa, my little 10 cell over-achiever, had arrested at 10 cells. An 8 cell, graded 1 had arrested at early morula stage and a 6 cell also graded 1 had arrested at 6 cells. The 5 cell had become a compacted morula and the 6 cell that was graded 4 had become a full out blast.
By this time Dr. ClinicDirector had arrived, right on time and came to see me. "I know you have had bad transfers Krista, he said, but I want you to know this is not going to be one of them, so I need you to really relax when you get in there". Ok I said. Of course in my head I was thinking, sure buddy, you are pretty confident for a man who doesn't know the revenge my cervix takes on cocky doctors.
So we do the speculum, we do the cervix cleaning, and we do the catheter. And honest to God I did not know the catheter was in. I was still waiting for him to try the catheter when he called for the embryologist to bring the two beautiful blasts we had chosen. What!!! Are you in I say?
Yes.
Well as I sat there absolutely fucking stunned, cause like Dude, he hadn't told me he was putting the catheter in and I really had no fucking idea.
Hmmm... Unfortunately the good doc ran into some problems and I see the needle looking thingy that carries the embryo's being brought back to the lab by the embryologist. What's going on I ask, I ran into something he says. Usually once we get to the opening of the cervix like that it is easy from there but I am running into something and this catheter is too soft to get through.
OHHH..... I don't like the sounds of that.
Embryologist, he yells, bring me an instrument (I wish I could tell you the name of the instrument but despite googling I cannot find it, it sounded like occlemeter). I have flashbacks of very bad day 3 transfer from IVF # 1, of being sent home without any embryo's and with mild contractions. I start to panic. Is that a metal rod I ask.
No Krista it is not a metal rod. It is a stiffening device. It will make it easier for me to get in but I don't want you to panic, this is NOT going to hurt, I want you to be relaxed again. Do you need to take a minute?
God no, I really need to pee. He responds with "please wait until I am out of the way"
Then he proceeds to start with the stiffening device. I am waiting, waiting waiting to feel a pinch, a cramp, a pain..... or worse
he seems to be taking his own sweet time putting in this new device and I am beginning to get concerned that I won't be able to hold my bladder much longer when suddenly I hear
Are we well past the opening?
Ultrasound tech: yes and turns the screen for us both to see
OMG there is the catheter a 1/4 way into the uterus and honest to god I did not feel a frigging thing, again.
So in come the blasts, we wait to hear the embryologist say that the now empty tube is "all clear" and everything is out and the whole thing is over. Took perhaps 20 minutes.
Good doc then looks at me and says now missy, I am going to show you on the screen exactly what happened. He shows me the corkscrews in my cervix that were a lot easier to navigate because of the weight of the bladder and he shows me that the opening to the uterus is slightly lower than the cervix up to that point, like all of a sudden it bends downhill. And then he shows me where the blasts had landed.
Rick later tells me that while I was waiting, thinking the good doc had not started with the "stiffening device" he actually put it in, ran into something, withdrew it and bent the end a little in the shape he thought it was needed and then slid it back in there.
Dr. ClinicDirector has been renamed to Good Doc. And I love him.
And there are currently two blasts inside my uterus who have to decide if they want to lie down and take a nap on the nice cushy pillows. But... they cannot complain that the road was too rocky and they are beat up and tired. They cannot say that the uterus is trying to kick them out (because I didn't have even a cramp). At this point it is all up to them.
Update:
Embryologist just called, 3 of the morula's made it to blast. 5 blasts have been frozen.
Tuesday, October 03, 2006
Saturday, September 30, 2006
Last Update before Transfer
All 12 embryo's are still dividing.
We have 10 that are between 6 -9 cells (majority at 8 cells)
1 that is 10 cells
1 that is 5 cells
11 are still graded 1 or 2 for fragmentation
little guy that is graded 4 for fragmentation is still going and is at 6 cells.
Thalia is right, the embryologist told me today that they will not be calling me tomorrow. He said that on day 4 embryo's look ugly. They all look ugly. They have started to compact but haven't made it to blast stage and they don't take them out.
Now that he, and Thalia, say it I remember it from last time. I remember being so scared that in that day they would all die and when I got in for my day 5 transfer nothing would be left. We all know that didn't happen and this time I feel more at ease with that. I know there will be some blasts on Monday.
I am pulling for the little 10 cell. It is graded 1 for fragmentation. Rick says that it is Lisa and the 5 cell is Bart and the rest are Maggie's. I guess you have to be a Simpson's fan to get that.
I am guessing we will have at least 6 or 7 blasts on Monday but we will just have to wait and see.
Things that are different from last cycle:
1. There were less overall follicles
2. My E2 level was less
3. I have not attempted and failed a day 3 transfer and had my girlie parts traumatized
4. I know that a positive beta will be the 1st in a series of uncertain events and does not guarantee a baby
Altogether I am feeling much more "positive" than the last couple of weeks. Not hopeful exactly. Not negative either but more like I am looking from afar with interest. Like my spirit is floating above me, watching. She wants the best outcome, but somewhat detached and realistic, she knows that nothing is guaranteed and it could go either way.
I will probably not post after transfer on Monday. I know that there is not a single shred of evidence that says that resting after transfer makes any difference. I know that there is in fact some very credible research right now that says pregnancy rates are exactly the same regardless of what people do after transfer. Nonetheless, I intend to come home Monday morning to a bed clad with clean flannel sheets. To a good book and some bad tv. I intend to stay there and be pampered all day. Not because it makes any difference scientifically but because it will make a world of difference to me emotionally.
I will update you all on Tuesday.
We have 10 that are between 6 -9 cells (majority at 8 cells)
1 that is 10 cells
1 that is 5 cells
11 are still graded 1 or 2 for fragmentation
little guy that is graded 4 for fragmentation is still going and is at 6 cells.
Thalia is right, the embryologist told me today that they will not be calling me tomorrow. He said that on day 4 embryo's look ugly. They all look ugly. They have started to compact but haven't made it to blast stage and they don't take them out.
Now that he, and Thalia, say it I remember it from last time. I remember being so scared that in that day they would all die and when I got in for my day 5 transfer nothing would be left. We all know that didn't happen and this time I feel more at ease with that. I know there will be some blasts on Monday.
I am pulling for the little 10 cell. It is graded 1 for fragmentation. Rick says that it is Lisa and the 5 cell is Bart and the rest are Maggie's. I guess you have to be a Simpson's fan to get that.
I am guessing we will have at least 6 or 7 blasts on Monday but we will just have to wait and see.
Things that are different from last cycle:
1. There were less overall follicles
2. My E2 level was less
3. I have not attempted and failed a day 3 transfer and had my girlie parts traumatized
4. I know that a positive beta will be the 1st in a series of uncertain events and does not guarantee a baby
Altogether I am feeling much more "positive" than the last couple of weeks. Not hopeful exactly. Not negative either but more like I am looking from afar with interest. Like my spirit is floating above me, watching. She wants the best outcome, but somewhat detached and realistic, she knows that nothing is guaranteed and it could go either way.
I will probably not post after transfer on Monday. I know that there is not a single shred of evidence that says that resting after transfer makes any difference. I know that there is in fact some very credible research right now that says pregnancy rates are exactly the same regardless of what people do after transfer. Nonetheless, I intend to come home Monday morning to a bed clad with clean flannel sheets. To a good book and some bad tv. I intend to stay there and be pampered all day. Not because it makes any difference scientifically but because it will make a world of difference to me emotionally.
I will update you all on Tuesday.
Friday, September 29, 2006
STatus Update
Day 2 post retrieval and the embroyologist reports:
12 of the fertlized eggs are developing normally.
11 are between 2-4 cells and 1 is 5 cells
11 of the 12 are graded either 1 or 2 for fragmentation (although he said mostly 1)
1 of the 12, a four cell, is graded 4 and probably won't make it
Based on these observations they are tentatively recomending a day 5 transfer. He will call me tomorrow morning and if something drastic has occurred they will schedule a late morning transfer, but otherwise, we will wait until Monday.
He will continue to update me daily on their status.
I, of course, am nervous. Although I know a day 5 transfer is good, and that it is good that we have such seemingly strong embryo's, I can't help but feel a bit of deja vu. During my last IVF we had 14 "great embryo's" on day 3. And 9 excellent blasts on day 5. And we all know how that turned out.
Part of me wanted to do a day 3 transfer just so we don't have to deal with the risk that none of them make it to day 5. The other part of me laughed and said "Bitch pulease" nothing that has ever been put into your uterus has lived, these potential lives are better off in the lab.
When are they going to learn to grow the fetus in the lab for the full 9 months? Then I might have a good chance of having children.
12 of the fertlized eggs are developing normally.
11 are between 2-4 cells and 1 is 5 cells
11 of the 12 are graded either 1 or 2 for fragmentation (although he said mostly 1)
1 of the 12, a four cell, is graded 4 and probably won't make it
Based on these observations they are tentatively recomending a day 5 transfer. He will call me tomorrow morning and if something drastic has occurred they will schedule a late morning transfer, but otherwise, we will wait until Monday.
He will continue to update me daily on their status.
I, of course, am nervous. Although I know a day 5 transfer is good, and that it is good that we have such seemingly strong embryo's, I can't help but feel a bit of deja vu. During my last IVF we had 14 "great embryo's" on day 3. And 9 excellent blasts on day 5. And we all know how that turned out.
Part of me wanted to do a day 3 transfer just so we don't have to deal with the risk that none of them make it to day 5. The other part of me laughed and said "Bitch pulease" nothing that has ever been put into your uterus has lived, these potential lives are better off in the lab.
When are they going to learn to grow the fetus in the lab for the full 9 months? Then I might have a good chance of having children.
Thursday, September 28, 2006
Retrieval and Fertilization
So the retrieval was yesterday morning.
It was ok. Apparently there is some scar tissue or maybe endo around my right ovary. That made the retrieval on the right side a little more difficult. I'm not even going to go there right now because I have asked two different doctors( at two different clinics) about a laproscopy and both have said there is no reason to do one, no indication it would tell us anything.
Anyway Dr. ClinicDirector was fabulous. I loved him and he would warn me when he was encountering the scar tissue (that made him have to jab hard to get through) and finally said to the nurse, let's give her some more pain med. No reason for her to have to feel this.
Ahhh... lovely pain meds. And that was that, the scar tissue was on my right side which also happened to be the first side he did. I got the extra dose of pain meds after the third jab and everything after that was a blur. I thought we were only there about 10 minutes but Rick assures me it was almost 30.
As I was being helped out of the room, I asked how many we got. They told me 18. Even in my foggy state I thought that had to be a mistake. The wanding showed there were only 7/8 really mature and even if all the 1.6's made it, that would have only be 14. At any rate, I wasn't in the condition to argue and I fell asleep in the recovery chair. When I woke up and was getting ready to leave I asked again. The Nurse said 18!
Well, I spent most of yesterday trying to understand how they got 18. I figured that everything over 14 was probably immature.
Embryologist called this morning with fertilization reports.
Out of the 18 egg's, 3 were immature, 2 fertilized improperly and 12 fertilized normally. 1 is apparently hard to read. Embryologist thinks that maybe it was fertilizing as he got in this morning, although that would be late fertilization.
So, we have 12 (maybe 13) fertilized. He will call tomorrow with status update.
I am feeling much better today. Still very bloated and a little sore but nothing abnormal.
It was ok. Apparently there is some scar tissue or maybe endo around my right ovary. That made the retrieval on the right side a little more difficult. I'm not even going to go there right now because I have asked two different doctors( at two different clinics) about a laproscopy and both have said there is no reason to do one, no indication it would tell us anything.
Anyway Dr. ClinicDirector was fabulous. I loved him and he would warn me when he was encountering the scar tissue (that made him have to jab hard to get through) and finally said to the nurse, let's give her some more pain med. No reason for her to have to feel this.
Ahhh... lovely pain meds. And that was that, the scar tissue was on my right side which also happened to be the first side he did. I got the extra dose of pain meds after the third jab and everything after that was a blur. I thought we were only there about 10 minutes but Rick assures me it was almost 30.
As I was being helped out of the room, I asked how many we got. They told me 18. Even in my foggy state I thought that had to be a mistake. The wanding showed there were only 7/8 really mature and even if all the 1.6's made it, that would have only be 14. At any rate, I wasn't in the condition to argue and I fell asleep in the recovery chair. When I woke up and was getting ready to leave I asked again. The Nurse said 18!
Well, I spent most of yesterday trying to understand how they got 18. I figured that everything over 14 was probably immature.
Embryologist called this morning with fertilization reports.
Out of the 18 egg's, 3 were immature, 2 fertilized improperly and 12 fertilized normally. 1 is apparently hard to read. Embryologist thinks that maybe it was fertilizing as he got in this morning, although that would be late fertilization.
So, we have 12 (maybe 13) fertilized. He will call tomorrow with status update.
I am feeling much better today. Still very bloated and a little sore but nothing abnormal.
Monday, September 25, 2006
Oh... and I was worried about my estradiol being too high. (UPDATED)
So today's wanding showed that the follicles did not grow much yesterday. Instead of being between 1.5 and 2.0 they were between 1.6 and 2.0. If we trigger and they do not grow between now and retrieval the 1.6's may not be mature and I would end up with about 7 retrieved.
But, given that my follicles did not grow, they are concerned by estradiol may pleateau. Did you get that! They are concerned that my estradiol may not go up today.
Apparently, if the E2 plateaus at this point it may be a sign that everything will start dropping and the follicles will shrink. I have never, ever heard of this.
They are concerned enough that if my E2 has not risen from yesterday they are going to trigger me tonight despite the fact that there preference would be that I stim for one more day.
I won't know until I get the bloodwork results this afternoon. At this point, retrieval could be Wednesday or Thursday.
I am trying not to stress, 7 follicles sounds like a very low number to me (remember I had 19 last time) but I am trying to remind myself that I came into this with a quality not quanity attitude and I wanted a much lower follicle count.
Update:
Just heard from my nurse. My E2 stayed the same and so I will trigger tonight and retrieval will be 9:00 am on Wednesday morning. Dr. ClinicDirector has agreed to do both my retrieval and my transfer, even if I have to transfer on day 3 which is Saturday. There were at least 6 follicles today that were 1.6. I am going to hope and pray that some of them grow by .2 in the next40+ hours so that they will be mature. Estrogen level topped out at 8,011 ( 2182 as measured in US) which is at least 4000 less than last time.
But, given that my follicles did not grow, they are concerned by estradiol may pleateau. Did you get that! They are concerned that my estradiol may not go up today.
Apparently, if the E2 plateaus at this point it may be a sign that everything will start dropping and the follicles will shrink. I have never, ever heard of this.
They are concerned enough that if my E2 has not risen from yesterday they are going to trigger me tonight despite the fact that there preference would be that I stim for one more day.
I won't know until I get the bloodwork results this afternoon. At this point, retrieval could be Wednesday or Thursday.
I am trying not to stress, 7 follicles sounds like a very low number to me (remember I had 19 last time) but I am trying to remind myself that I came into this with a quality not quanity attitude and I wanted a much lower follicle count.
Update:
Just heard from my nurse. My E2 stayed the same and so I will trigger tonight and retrieval will be 9:00 am on Wednesday morning. Dr. ClinicDirector has agreed to do both my retrieval and my transfer, even if I have to transfer on day 3 which is Saturday. There were at least 6 follicles today that were 1.6. I am going to hope and pray that some of them grow by .2 in the next40+ hours so that they will be mature. Estrogen level topped out at 8,011 ( 2182 as measured in US) which is at least 4000 less than last time.
Sunday, September 24, 2006
One More Day
So yesterday's estrogen was 6181.
Today's follie scan showed that we are almost ready to trigger. I had 8 follicles on the right side between 1.5 and 2.0 and 6 on the left side between 1.5 and 2.0. The overall count didn't change from yesterday.
The nurse predicts that tonight will be my last stim shot and then I will be prepped for trigger tomorrow.
For some reason my lining went from .95 to .88. Nurse didn't seem concerned about it, said that they look for .8 and greater so I am fine. I am concerned though, why would it go down?
Today's follie scan showed that we are almost ready to trigger. I had 8 follicles on the right side between 1.5 and 2.0 and 6 on the left side between 1.5 and 2.0. The overall count didn't change from yesterday.
The nurse predicts that tonight will be my last stim shot and then I will be prepped for trigger tomorrow.
For some reason my lining went from .95 to .88. Nurse didn't seem concerned about it, said that they look for .8 and greater so I am fine. I am concerned though, why would it go down?
Last time on trigger day my E2 was 12,300.00 so we should be well short of that even if it is highter than I would like. I would really, really like tomorrow's estrogen to be 7500 or less.
Dr Replacement. is recomending another blast transfer (assuming we get that far again). That will give me 6 days for my estrogen to fall before transfer. He says if I start showing any signs of hyperstimulation they will recomend freezing and waiting for a frozen transfer but otherwise his recomendation is to do a fresh transfer even if E2 is higher than we would have liked. As he pointed out, it's not likely an either or scenario. If we assume that things will go along the same route as last time, we can assume that I will be able to do a fresh blast transfer and a couple frozen blast transfers. Given the success rates of fresh vs. frozen he doesn't think I should cancel a fresh transfer unless I am having symptoms of actually OHSS.
I am keeping my fingers crossed and drinking lots of Gat*orade.
Saturday, September 23, 2006
Cycle Day 10
Today I had 28 follicles. 14 on each side. The right side mostly ranges from 1.4 to 1.7 but there is one at 1.8. The left side ranges from 1.7 to 1.0. I think there are probably 8 or 9 that will be retrieved on the right but probably only 4 or 5 that will be retrieved on the left.
Estrogen yesterday was 4,405. Not sure what today's was but given the increase in follicles I would imagine it jumped again. We will find out tomorrow morning.
I was read the "gat*orade" riot act today. Same as last time, drink at least 1 litre a day. Gat*orade or V*8 juice (apparently equal in sodium) but I hate V*8 juice so I will stick with Gat*orade.
I am not sure how I am feeling. I had really wanted to not produce so many follicles this time. But we didn't increase the dose, and actually reduced it considerable as soon as things started to vamp up. Maybe my body just really doesn't want to cooperate. Maybe I will have to accept that.
My guess is that they will try to get those 1.4's to 1.8 before triggering. Given that they usually grow by .2 a day, I would guess 2 more days of stimming before trigger.
Estrogen yesterday was 4,405. Not sure what today's was but given the increase in follicles I would imagine it jumped again. We will find out tomorrow morning.
I was read the "gat*orade" riot act today. Same as last time, drink at least 1 litre a day. Gat*orade or V*8 juice (apparently equal in sodium) but I hate V*8 juice so I will stick with Gat*orade.
I am not sure how I am feeling. I had really wanted to not produce so many follicles this time. But we didn't increase the dose, and actually reduced it considerable as soon as things started to vamp up. Maybe my body just really doesn't want to cooperate. Maybe I will have to accept that.
My guess is that they will try to get those 1.4's to 1.8 before triggering. Given that they usually grow by .2 a day, I would guess 2 more days of stimming before trigger.
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