Wednesday, October 7, 2015

One Year Anniversary of our Embryo Transfer

Today is the ONE YEAR ANNIVERSARY of our EMBRYO TRANSFER that resulted in our beautiful baby boy on June 18, 2015.  Many do not understand the journey, so I thought I would post a quick rundown of our infertility journey. It is long, but its condensed as much as possible. I hope that it helps "outsiders" understand the long and painful process and also helps anyone going through it to stay strong. Feel free to ask questions if you'd like.
 
I never had cycles really growing up. I got my first period at 16 and had maybe 4 before going on BCPs to regulate it and help with cystic acne. I stayed on BCPs for many years even after getting married in 2006. After we had been married for about 5 years, we felt it was time to start a family. I knew it was probable that I would have trouble getting pregnant, but we had to start somewhere.

09/2011- No more birth control & let's see if I cycles
11/2011- 1st cycle I had on my own without drugs to induce it... since I was 18 (10 years ago!)

2011-2012- I did not have anymore cycles that were not drug induced. Bloodwork was done for me and DH, Semen Analysis was done for DH...all fine. All bloodwork looked normal. It did not show any signs of PCOS.

06/2013- HSG test showed one blocked tube, one open tube. Dye is pushed through a cervical catheter through your ovaries and spills into your uterus. The left side of my body felt like I was having cramps combined with fire. Yes, it felt like a raging fire was ablaze in my left side lady parts. And the HSG pics showed the contrast dye flowing through. The right side...nothing. Blocked. The dye wouldn't go in. Because I had one open tube though, my OB put me on Clomid to hopefully stimulate cycles.

08/2013- Clomid 50mg: O'd late, BFN
09/2013- Clomid 100mg: O'd even later, BFN
10/2013- Clomid 50mg: O'd late, BFN
11/2013- Clomid 50mg: O'd late, BFN
12/2013- Clomid 50mg: O'd really late, BFN
02/2014- Clomid 50mg: O'd late, BFN. That was it. No more clomid. We are put on the fertility doctors 4 month waiting list after an initial consultation....so we begin to pursue adoption.

03/2014- We choose an agency and begin doing our home study packet. Then this happened...

03/31/2014- I went for my personal interview with the social worker. DH and I have to each do one separately for an adoption home study. So I go....and all weekend I had read books and stuff on adopting and parenting and discipline...and I was ready. Then I get there and we're talking and some of the financial information we'd been given before doesn't match up with what she's saying now. It's not a huge deal...it's not a deal breaker....and it's chump change really....but something in me says I need to call DH. So I call DH and explain the situation. He says he feels uneasy with the social worker at this time....and that we need to pray this out. Well, in my heart thats what I felt too....that something just wasn't right....that God had put this roadblock there on purpose. So I canceled the interview, paid her for her time thus far, and went back to work dejected. I felt like this was supposed to be us moving forward.....but it wasn't....and God made that clear. So now we just gotta pray for His guidance. His billboards for our family, if you will. Billboards....I need God-written Billboards. 

04/01/2014- God works things out. Always. To HIS glory. For HIS good. Sometimes we don't understand the whys? and sometimes He lets us. So after yesterdays derailing of the adoption process, we prayed to God asking for billboards...signs of where our family was supposed to head next. Neither of us received answers right away, but we both had peace. DH randomly told me to call the RE and see if anyone had canceled and if we could be worked in. Well, I had already called once to be put on a waiting list to get back in for another consultation as soon as possible, so I totally didn't wanna bug these people. Well, I get in the car and call my mom....my normal morning routine...and mom can only talk for 5 minutes of my 25 minute drive to work. After I hang up with her I get this thought....call the RE....and the thought doesn't go away....so I call..... and guess what??? They said can you be here at 3pm? 3pm today?!?! 

This consultation I have all kinds of bloodwork and so does DH. I have a vaginal ultrasound that reveals 50+ follicles on my ovaries...so even though my bloodwork didn't show PCOS my ovaries look classic PCOS "like a string of pearls."
 
So after lots and lots of discussion with the RE, he said he believes that I am at extremely high risk for hyperstimulation with any kind of assisted reproductive treatment. Various reasons, but mainly because I am young, skinny, and have millions of eggs.....so for those reasons he would not consider Intrauterine Insemination (IUI) for us. He said in his professional opinion we have 2 options:

#1- Hysteroscopy and Laparoscopy followed by 3 months of Letrozole with timed intercourse
 Basically, the hysteroscopy and laparoscopy would be to look for any kind of uterine abnormalities and fix them. The Letrozole works basically like Clomid. After explaining this option, he said that while this was an option that it needed to be seriously considered before undertaking as Laparoscopy is definitely surgery....and no surgery should be taken lightly. He also said if you choose this option, I feel that I will be seeing you back here in 3 months because you're still not pregnant. He explained that my HSG and that fact that one tube was blocked really made him uneasy. He also said that for me taking an ovarian stimulating drug like Clomid or Letrozole can be dangerous because I produce so many eggs already....and then if we were to get pregnant from them I was at a super high risk of multiples. He said twins are fine, but upwards from that is risks that he doesn't like to take....and he said with the amount of eggs I'd be producing I could end up with greater than twins....so he thought this option was probably a waste of time and money, but it was an option.

#2- SHG and IVF with only frozen transfers
The SHG would be done to get a better look at my uterus since the HSG wasn't a successful glimpse at it. Then if all was well there, then we would proceed with IVF. He said I am at such a high risk for hyperstimulation that he would not do a fresh transfer on me. He said it's rare that he sees someone with such a high risk (every nurse in his place keeps commenting on how many eggs I have). This option he said is best for me because (A) It would bypass my possibly blocked tubes and (B) Less risk overall because they would remove my developed eggs before I ovulated and then return one or two of them after my ovaries calmed back down. He said IVF is overall the safest option for me and probably our best bet of having a biological child.

We're supposed to call back to start option #1 or option #2....and either way I'll need to take something to start a new cycle to get either option going. So we got a lot to pray about.
 
After much prayer, we both feel a peace proceeding forward with option #2 of SHG and IVF. (After having the SHG we learn that was our best option since my good tube wasn't good anymore.)
 
Tuesday, April 29: Start Birth Control (Apri) I ended up being allergic to this BCP! It caused me to have cystitis like symptoms at all times. It was terrible!
 
Tuesday, May 6: SHG since by HSG in 2013 was inconclusive. The SHG finds that I have fibroids and I had scarring on what used to be my open tube, so a surgery called a myomectomy was scheduled. The fibroid had grown there in less than a year which means that I should probably be on BCPs when I'm not working on my fertility. My fertility doctor decided I could proceed with the planned IVF schedule immediately after the surgery.
 
Saturday, May 17: End Birth Control (Apri) Thank goodness! Hopefully no permanent damage done since I was allergic to this!
 
Tuesday, May 20: Trial Transfer & Injection Training- They practiced the actual embryo transfer on my uterus to make sure it was feasible. Afterwards, I learned to inject a million different needles into my body. I was nervous, but had to become a pro really quick.
 
Wednesday, May 21: Baseline Ultrasound- This would prove that my ovaries did not have any cysts or follicles and that the lining of my uterus was thin...as both should be at the beginning of a cycle.
 
Thursday, May 22: Hysteroscopy with Myomectomy- My fertility doctor was able to cut out the fibroid successfully with little damage to my uterus. He also cleaned out my uterus so that I would have the best possible chances for a pregnancy. Here's a picture he took:
Two days after surgery I began injecting myself with ovarian stimulation drugs to produce lots of quality eggs. Heres a pic of some of my meds:


 
Sat, May 24: Stim Day 1: AM- 75 iu Menopur & PM- 200iu Gonal-F
Sun, May 25: Stim Day 2: AM- 75 iu Menopur & PM- 200iu Gonal-F
Mon, May 26: Stim Day 3: AM- 75 iu Menopur & PM- 200iu Gonal-F
Tues, May 27: Stim Day 4: AM- 75 iu Menopur, go in for bloodwork, & PM- 200iu Gonal-F
Wed, May 28: Stim Day 5: AM- 37.5iu Menopur & PM- 200iu Gonal-F
 
Thurs, May 29: Stim Day 6: AM- 37.5iu Menopur & go in for blood work and an ultrasound. Take Ganirelix ASAP & continue PM-200iu Gonal-F. Here's pics from the ultrasound:
2 Views of My Right Ovary Covered in Follicles

More Views of My Right Ovary Covered in Follicles...and they are measuring one

Views of My Left Ovary Covered in Follicles...and they are measuring one

2  More Views of My Left Ovary Covered in Follicles...and they are measuring one

Here's the summary of the 10 she measured....that was all their system would record
After the ultrasound, I returned to work. A few hours later I received a call from the nurse that I needed to take a Ganielix shot immediately to keep from ovulating....so weird since previously I never ovulated! Sooooo I had to leave work to go get the shot.

Fri, May 30: Stim Day 7: AM- 37.5iu Menopur & Prefilled Ganirelix & PM- 200iu Gonal-F

Sat, May 31: Stim Day 8: AM- 37.5iu Menopur & Prefilled Ganirelix & go in for blood work and ultrasound & continue PM-200iu Gonal-F.
Here's a summary of the follicles that were measured. You can compare to the last summary and see they grew .5-.6 in 48 hours! They warned me that because of the large amount of big follicles I had, I would probably have a lot of fluid retention. They said to drink Gatorade/powerade and eat tons of protein. 

Sun, June 1: Stim Day 9: AM- 37.5iu Menopur & Prefilled Ganirelix & go in for blood work & Lupron Trigger @ exactly 8:15pm. That would be the last shot for a little while.
 
Mon, June 2: Bloodwork and Valium...no eating/drinking after midnight. At this point my ovaries feel like softballs under my skin. You can see how swollen my ovaries had made me...little did I know it was about to get way worse.
 

Tues, June 3: Egg Retrieval @ 8:15am. They would put me under general anesthesia and go through the walls of my vagina to my ovaries and basically suction out each follicle. I had 60 follicles aspirated that day.  Here's some pre-surgery pics:
 

Wed, June 4: Begin Prometrium. Egg update: Out of the 60 follicles aspirated, only 40 had viable eggs. Out of those 40 only 21 eggs were mature enough. This was a terrible maturation rate, so I'm assuming PCOS was hard on my eggs too. BUT, we had a high fertilization rate!!! Because of the 21 matured eggs, sperm had fertilized 20 of them!! God is soooooo good!! We had embryos! Some people do all this and get NO embryos! Now Dustin had something called Testicular Torsion as a child and although he had been tested a ton of times, the doc recommended my eggs undergo ICSI for a better fertilization rate. That seems like that was true since all but one fertilized. With ICSI (pronounced ick-say) the sperm collected and washed. Then only the strongest sperm are injected into the egg. Also, here's what my one day post surgery ovaries and belly looked like:
I had gained 3 lbs of water weight over night and couldn't walk on my own. The doc gave me pain meds and I have definitely been taking them. They told me to quit drinking water also and don't eat anything except protein. If I go over 5 lbs of fluid retention they want me to check into the hospital.
 
Thurs, June 5: Embryo update: We currently have 13 Grade A or B+ that are already 4-5 cells each AND 7 Grade B!!! Yay! So all 20 are growing. The embryologist said that they will not have another update for us until Monday morning. This is because they want to minimize the times they take them out of the incubator.  Monday morning, though, they will know how many made it to the blastocyst stage and froze. Our REs office uses vitrification for freezing, so they estimate the most blastocysts will freeze....and they generally only freeze blastocysts.
 
And I went up to 7lbs of water weight, so if it doesn't go down in the morning, I guess I'm headed in. Here's a pic of this cruel trick. I look 6 months pregnant.
 
Mon, June 9: Final embryo update- The embryologist called to tell me very excitedly "Mrs Sarah it's good news for you!"  TEN, as in 1-0, MADE IT TO THE BLASTOCYST STAGE AND FROZE!!!  Praise God from whom ALL blessings flow! I am so overwhelmed with happiness right now. Ten viable little chances! Thank you Lord for taking care of them and please continue to watch over them.
 
Now normally, 5 days after egg retrieval you would have an embryo transfer. However, because of the surgery I had and the fact that I had SO MUCH water retention, I would not be able to complete the cycle with a transfer to try for a baby. I knew all this going in, but it was still hard to go through all this without even a chance. I was mentally and emotionally spent....not to even mention financially. We had to take a vacay for a few days for me to clear my head or I may have had a nervous breakdown. The doctor wanted me to use BCPs to force two more cycles before we could try. 
 
Fri, June 13: End Prometrium
Sun, June 15: Start Birth Control (Azurette)
Sat, July 5: Last Birth Control (Azurette)
Tues, July 8: Started Menstrual Cycle
Thurs, July 10: Begin Birth Control (Azurette)
Sat, July 19: End Birth Control (Azurette)
Tues, July 22: Started Menstrual Cycle (I didn't realize this would happen.)

Thurs, July 24: Bloodwork & start Lupron 5 units in the PM- I had to start giving myself shots again to simulate a full cycle and prepare my endometrium lining. Continue this until I'm told to stop.
Fri, July 25: Start 2 mg Estrogen tablets vaginally twice daily. Continue this until I'm told to stop.
Possible transfer is the week of August 11th.
 


Thurs, Aug 7: Bloodwork & Ultrasound: lining at a 7, so transfer is postponed until the next week. I continue on with Lupron shots and estrogen tablets.

Fri, Aug 15: Bloodwork & Ultrasound, lining is still at a 7, so add extra 2mg of Estrogen daily
Sun, Aug 17: Bloodwork & Ultrasound, lining still at 7, Fluid in Uterus, & Estrogen Dropping. This happened all on DH's birthday. I was soooo distraught by all this I even forgot it was his birthday. My doctor didn't make this decision as he wasn't the one on call, but another doc called to tell me to end Lupron and the vaginal Estrogen. He was CANCELLING my transfer. That I would need to set up again and maybe try a different protocol. I LOST it. I cried my head off.


Also I began going to a miscarriage and infertility support group. We're reading Baby Hunger by Beth Forbus. This weeks chapters were on Elizabeth and Zacharias. They didnt get pregnant right away...nor pregnant in their youth. The book says

 
"He knows that child. He knew us, he had plans for us. If He has holy appointments laid out for our lives long before the first cells ever begin to divide, don't you think He knows exactly when our lives on earth should begin?
What if we had the authority to grant pregnancy whenever we wanted it? We might miss out on the plan of God appointed to each person before they are even born. There could be no greater tragedy."
 
This just stuck out to me so much. I mean if I was in control, I would ruin that child's life before it ever even happened on earth! Of course, I don't want that for my child. Of course, I want God's perfect timing. But just the mere fact that if I was in control, I would choose pregnancy, and therefore I would ruin their earthly life....and if I've ruined their earthly life then I could've affect their eternal life also. Wow. That's an amazing responsibility to decide when to create a life! I do not want that responsibility. I WANT God to make those decisions!

Sun, Aug 17: Begin Provera
Tues, Aug 26: End Provera

 
Wed, Aug 27: Started Mentsrual Cycle
Fri, Aug 29: Start Birth Control (Azurette)
Sat, Sept 13: End Birth Control (Azurette)


Wed, Sept 17: Bloodwork. Blood work showed I was healthy again!! And ready to try to set up again! Here's all the new meds for setting up for a transfer.
Thurs, Sept 18: Begin 5 units of Lupron Daily in the PM daily until told to stop!
Fri, Sept 19: Apply 2 Vivelle Estrogen .1 patches- rather than the estrogen tablets my doc put patches used for hormone replacement therapy in my protocol. They were expensive, but what isn't in infertility!
Mon, Sept 22: Apply 2 Vivelle Estrogen .1 patches We decided to add to the protocol and go on a cruise to keep my stress level at a minimum. This meant all the patches and shots had to be done onboard!
Wed, Sept 24: Apply 2 Vivelle Estrogen .1 patches
Fri, Sept 26: Apply 6 Vivelle Estrogen .1 patches
Sun, Sept 28: Apply 6 Vivelle Estrogen .1 patches.
Tues, Sept 30: Apply 8 Vivelle Estrogen .1 patches. This is what 8 patches and shots looked like. You can see how irritated my skin was and the little and big bruises I had everywhere.
Thurs, Oct 2: Bloodwork & Ultrasound, lining at a 8.44!!! THANK YOU LORD! Here's a picture of the ultrasound showing my beautiful lining!
Thurs, Oct 2: Apply 4 Vivelle Estrogen Patches, take Doxycycline, continue 5 units of Lupron shots, and add .75ml Progesterone in Ethyl Oleate intramuscular shot (gasp!)

Friday, Oct 3 AM: take Doxycycline and take 3 Prednisone
Friday, Oct 3 PM:  take Doxycycline, 5 units of Lupron shots,& .75ml Progesterone in Ethyl Oleate
Sat, Oct 4 AM: take Doxycycline and take 3 Prednisone
Sat, Oct 4 PM:  take Doxycycline, 5 units of Lupron shots,& .75ml Progesterone in Ethyl Oleate
Sun, Oct 5 AM: take Doxycycline and take 3 Prednisone
Sun, Oct 5 PM:  take Doxycycline, 5 units of Lupron shots,& .75ml Progesterone in Ethyl Oleate
Mon, Oct 6 AM: take Doxycycline and take 3 Prednisone
Mon, Oct 6 PM:  take Doxycycline, 5 units of Lupron shots,& .75ml Progesterone in Ethyl Oleate
 
Tue, Oct 7: Transfer Day!!
Our embryos were frozen in pairs, and we did not want to waste one...so we were prepared to put back 1 or 2. Well, when the day came, the embryologist thawed a straw with a pair in it. He said both embryos started growing and hatching again, and were perfect quality....so by the time I got to the surgery center he had already refrozen one. Thank you God for taking that decision out of our hands and off our minds! He gave us a picture of our 5 day old embryo prior to transferring it to my uterus.
 

DH is allowed to go into the surgery room with me. I am not put to sleep for this.
The doctor actually talked us through the procedure and we watch it on the ultrasound monitor. He actually let DH video the screen.
 
Afterwards I had to lay flat with my uterus tilted for an hour...and then use the restroom there....and then go home and rest for several days. My fertility doctor tells me it's up to God. I begin the longest wait of my life.
 
 
Sun, Oct 12: I just know. I feel it. I know God has performed a miracle within me. I took a test. Two lines! I took tons more...I had a blood test. And we of course continued praying for the little life within me.
 
We had no clue whether it was one little life or two or three. We had no clue whether the little life or lives would be boy or girl. The only thing we knew is that we loved the little already.
 
One day, I will continue the story...
 

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