Out of my cave

Wow hasn't it been forever since my last blog entry? Yes, I retreated into my pregnancy cave... I am sorry I left everyone hanging about me, and I apologize to all my due date buddies that I abandoned. Everything felt so surreal being pregnant and this pregnancy hasn't been easy on me at all. So what has happened since my last entry?

Well, I had some spotting during the early days of the pregnancy and I was also told that baby's heartbeat was slow. Everything turned out ok in the many, many scans that I had following that one. I guess I totally went into denial about being pregnant because I was so afraid I would lose my baby. Thank goodness the spotting never returned... but... a boatload of other pregnancy symptoms did.

So basically from week 6 to... week 16... I was spending my days (and nights) in the bathroom hugging the toilet. I guess I'm one of those women that gets bad morning sickness and also gets it, I'm guessing, for 9 months. Yes, I am still throwing up once in a while. Midwife put me on Diclectin and I was on up to 8 pills a day and I was still feeling iffy. Thank goodness it has somewhat subsided and I am only on 2 pills(sometimes zero, if I feel ok) a day now, and throwing up only occasionally.

My NT scan went beautifully and the anatomy scan too. And... we are having a.... boy!! We are naming him Nathan and we truly believe that he is god's gift to us.

I won't go on and complain about all my pains and aches. Let's just say that there are a lot of symptoms of pregnancy that I didn't know existed! (For example, sneezing my head off every 5 seconds while trying to hang on to my va-j-j so the baby doesn't fall out and I don't pee myself... ok I know the baby won't really fall out but it feels like it sometimes...)

So... I am hanging on at 26 weeks, happy that I am at the viability stage and almost at the 28 week mark. This has been an incredible journey and I am so thankful that even though it is tough, I got to experience it.

Early ultrasounds - A love/hate relationship

I've been trying to stay positive since my last beta. The 2 weeks plus wait for the first ultrasound was unbearable. The ultrasound was suppose to be scheduled for 7 weeks and 1 day (12/14) but I started spotting and even found a few clots on 6 weeks and 3 days, so I called my clinic and asked for an early ultrasound.

Looking back, I think the spotting was actually not really that big of a deal. It was mostly brown and mostly only when I wiped. But of course, I overreacted and really freaked out when I saw a few black blobs that looked like clots. They were just on the tissue and maybe smaller than a pea. Again, I think I really overreacted and had ZERO sleep that night. Of course, the terrible nausea and vomiting didn't help. By the way, I've been sick all day and vomiting 1-3 times a day now! I feel like I'm not allowed to complain, but I really feel terrible.

Anyway, I had the ultrasound and more blood work. We saw one little bean measuring right on track at 6 weeks 4 days with a heart rate of 111. My beta was over 60,000 and progesterone was super high at 180.

I was initially happy... until the doctor said that 111 was kind of slow for the heartbeat. She said they like to see it above 120 at this point and I should come back in a week to see how things are. Sigh...

I played Dr. Google when I got home (of course) and read a lot of varying information. Some say between 90-110 for week 6-7, some say above 120, some say above 100. So what does this all mean??? I even read a study that said a heartbeat of 111 at 6.3-7 weeks is considered borderline and is associated with a 17% of miscarriage. Yikes...

I thought I can finally breath after all this worrying. I vowed to try to be normal again after seeing a heartbeat but I never saw this coming... I should have waited until I was 7 weeks! Seeing the lovely flicker of my baby's heart was precious but I'm so afraid that this will all go downhill...

I guess I asked for it right? ugh...

*whisper* The P word... sshhh

Can I say it now? I don't know! We've told close family members but has yet to mention anything to friends. Maybe I'm a little ahead of myself, should I focus on a good second beta before getting too excited? Or should I go google "best strollers" and make a list of baby items I want to buy? Oops, wait, I already did the latter... Funny thing is my husband actually said to me, it's Black Friday, maybe we should buy "necessities" that we will need later while they are on sale. Then he said, or maybe we can start researching and get them on Boxing Day. What!! He's too cute.

I figured "normal people" get excited as soon as they see that second line, don't they? Why can't I? Is it going to make things any easier if the worst happens if I don't get excited? Probably not... So hey, why not take advantage of my huge bloated belly and pretend I'm 20 weeks along (I kid you not!) and go browse Babies R Us?

It's so hard to open up about this "p" word! Everyone in my family seems to think this is it for me. They even have talks of twins. *oh my* I hope it all goes smoothly. I don't think I've ever been so happy yet scared in my whole life. I am just so grateful for everything, there are no words to describe.

Early Beta - 9dp5dt

Forgive the ever so creative title of this post. I am in disbelieve and shock right now! I've been getting some very uncomfortable bloating and nausea, so I emailed my nurse and she asked me to go in for an early beta. I spent almost all of yesterday googling "beta 9dp5dt" and failed to come up with a number that I would be happy with. I figured that I would only be happy with a number above 100 but it's not possible since my HPTs were coming up so faint before. I decided that I would make my peace with it if my number came back at above 50 and not freak out. Well, the wait for the phone call was long and I was going out of my mind! Here's what my FRER looked like about 6 hours before my test:

(I woke up and was wide awake at 2am and took a test.)

So... my beta @ 9dp5dt is.... *drum roll* 145!! WOW! I never thought the day would come that I'd be celebrating a high beta. I am so grateful and I hope the viability ultrasound will be alright and the rest of the pregnancy will be smooth.

Wait... I think I was getting ahead of myself... I hope my second beta will be great as well :p

PS - They cut out my estrogen and decreased my progesterone pills. Apparently, my E2 is above 10,000 and progesterone above 100. Now I only have to do the progesterone pills twice a day! Yay!

6dp6dt - BFP... I think?

This is going to sound so strange!
I peed on today's stick wrong and initially, it had no line and no dark space going across the window like you usually get... I think I didn't get enough urine on it... So I waited a few minutes and there it is! The second line! This is what it looked like about 5 minutes after the test: (today's test is the one not yet labelled...)

So I figured, ok so even though I may not have gotten enough urine on it, it probably worked? After all, it shouldn't register a positive when there is no hcg in the pee...

After about 2 hours, the test looked like this:

It got so dark!! But I'm only 6dp5dt. Twins maybe? Or faulty test? Either way... I hate myself for not peeing on a stick right! LOL...

I've called the midwife as I want in but I know the waiting list is crazy! I hope everything will be alright. 8 days until beta... I can't believe my clinic makes us wait so long.. ARGH!!

Glimpse of hope - 5dp5dt?

Ok... I have to say that I officially HATE the dollar store tests now... Never again... I thought I'd test out my trigger(especially because I had 2 shots of Ovidrel) so if I get 2 lines, I will know it's a real BFP. Being cheap, I opted for the dollar store tests and I tested negative 3dp5dt and 4dp5dt.

So today is 5dp5dt and I thought I'd break out the good stuff and used a First Response. Well, behold!!!  2 lines!! Faint second line but definitely there, no question. I started crying and showed it to my husband who wonderfully pointed out that I should test with the dollar store one and if there is a line on that test, then he will officially believe I am pregnant. So I had some pee left and tested again with the cheapie... and... no line! (Well, maybe a ghost line but I wasn't entirely convinced that it was there...)

So what is it? Real BFP on the FRER or trigger shot still in the system picked up by the FRER but not the cheapie? Oh the torture!!! I want to be happy but I can't cause I don't really entirely believe it... I'm 12 days past my trigger shot today but I had 2 shots so has it left my system? Don't know...

*Frustrated groan*

4dp5dt - BFN

Yes, I was super positive this cycle and yes, it's still early... but sigh... these BFNs hurt... I was hoping my luck would last and that I would be one of those lucky girls that would test positive really early so I can start celebrating... but of course... it's me! Nothing that good ever happens to me. The cycle probably just looked really good so that my BFN can be just the more disappointing. That sounds more like something that would happen to me. I'm just allowing myself to be really negative for a moment...

Back to being positive... Well, I used a cheap dollar store (Pro care brand) test and maybe it's just not that sensitive! (it says sensitivity of 25 but can you really trust something for a dollar?) So I will start using my FRERs tomorrow. (Maybe tonight... lol)

Say what? Are those really MY eggs?

I want to finish writing about my cycle now that I have started my dreaded 2ww. I hope that anyone who reads this post will be motivated to try new protocol(s) because as you will see, a new protocol (and little tweaks) made a HUGE difference in this cycle. Not even considering the result of this cycle, I am a lot more hopeful than I was after finishing my last 2 cycles.

This will be a long post, so here's the short version:
- Stimmed for 10 days with trigger on CD11 with 8 expected eggs to be retrieved
- 8 eggs collected, 6 mature, 4 fertilized. (I was worried at this point but wait it gets better...)
- Day 3: A wonderful 9 cell embryo, 3 wonderful 7-8 cell embryos, all graded 1-2 (with 1 being the best)
- Decided to take them to day 5
- Day 5: (Yes I was a nervous wreck that day) transferred 2 wonderful looking blasts!
- Day 6: Froze 1 blast! (WHAT? A snow baby... me?)

What a difference this protocol has made. I am eternally grateful to my doctor and the nursing team that took care of me. I started this cycle thinking I had CRAP eggs (even though I am 28) because of my 2 failed cycles. They weren't just failed cycles, out of 16 eggs retrieved in 2 cycles, I only had ONE, ONE tiny little day 3 embryo to put back in total that ended in miscarrage. You see why I was concerned. If you read my cycle#2 posts, you also know that I had ZERO fertilization that time. I feel so blessed even though the ultimate goal is to have a BFP, but this is just looking so much better. I hope that everyone who are having difficulty with egg quality can read this and know that protocol DOES make a difference!

The details:
In short, my CD8-11 numbers looked better by the day, with new follicles joining the group and steady E2 rising. This time around, I stimulated for a total of 10 days with trigger shot on day 11. On CD10, it was a tough call to give me another night of stims. I was concerned as I had the biggest follicle at 23mm, 4 in the range of 17-20mm, and 4 that were between 14-16mm. My RE was wonderful and even gave me call to ease my fear of over-mature eggs and told me that it was not an easy decision but he looked at my previous cycles and he feels an extra day would give me the best chance.

Anyway, on CD11, I had one large follicle at 24mm, 6 between 17-22mm and 4 that were either 15 or 16mm. The nurse said to expect to get around 8 eggs, as the biggest one would probably be too large, and ones that are between 15-16mm have a 50% chance of containing an egg.

Well, ER day came around and SHE WAS RIGHT ON! I had 8 eggs collected, and I was happy about that. The procedure was very pain-free UNTIL the doctor got to my left side... my god... But I would do it again in a heartbeat! (I hope I won't have to though)

We waited and waited for the calls the days after ER. With each day, good news came. I was initially concerned about only have 4 eggs fertilized. But knowing they were of good quality eased my mind a little. (What am I talking about, it didn't ease my mind at all. I was a WRECK!) Day 5 came around and I went into the clinic without knowing if I had any embryos to transfer. I had waited 45 mins in the waiting room for the nurse to give me a progesterone injection. The waiting had me thinking that something was wrong, but as soon as I saw the nurse, she told me that nothing has been cancelled for me as of yet, what a relief! Still, I was prepared for the worst. I was prepared to transfer one horrible looking embryo and the news that all other 3 had arrested. (And the PIO injections... YYEEEEOCH!! I'm still hurting)

The transfer was smooth (although I was BURSTING with my extremely full bladder) and my RE was so great.

So you all are probably wondering... What did we do differently this cycle? Well, here's a list:

Things done differently before my cycle:
1. Took TCM herbal teas (or they are more like mud soups if you ask me...)
2. Ate an avocado a day
3. Increased the amount of fruits I ate, especially blueberries
4. Increased my fibre intake

Things done differently during my cycle:
1. Took low dose birth control pills (Aleese) for a month.
2. Decreased the dosage of my stims(FSH) from 400iu to 200iu
3. Used GonalF instead of Puregon and Luveris instead of Repronex. Also Cetrotide instead of Orgalutran.
4. Started injections 7 days after I stopped my BCP, which was about day 3-4 of my period, instead of starting them on day 2.
5. Took a low dose thyroid medication staring with injections.
6. Delayed the start of the antagonist (Cetrotide). Started on day 6 instead of day 5, and started with 1/4 dose on day 6 and continued with 1/2 dose until trigger. (I was on full dose the previous 2 times)
7. Had an extra dose (300iu) of GonalF with my trigger shot.
8. Took a double dose of trigger instead of full dose the first cycle, and half a dose on the total failure that is cycle#2.
9. Had a progesterone in oil injection the day of transfer, right before transfer.

That pretty much sums it all. Pretty drastic differences if you ask me.

Today is 1dp5dt and I'm already itching to POAS... I've been nauseous, crampy, and super tired... all wonderful side effects of progesterone. It's hard not to be positive this cycle since it has been the best cycle for me yet. I know it could still turn out to be a BFN, but in the mean time, I'm going to celebrate and think I am pregnant.

CD6/7 Update

CD6
I started quarter dose Cetrotide in the morning. My LH went from 3 to 5 today so I was told to use half dose of cetrotide tomorrow. Being a control freak, of course I googled what normal LH levels are and I think it's not called a surge until >20, so I think I'll stop thinking about that.
Follicles: Happy report today! The big one still grew. It is now at 16. But I now have 5 little guys, 3 at 11, and 2 at 10! It's a little depressing to think that I got so excited over 5 measly follicles, but this may be the max amount my body will ever make!
E2: 3200

CD7
Can you say growth spurt? I don't know how it happened, but my follicles are now measured: 19mm, 16, 14, 14, 14, and 10. Unfortunately still the same 6, so I probably won't be expecting any more to pop up. But how did one grow from 11mm to 16mm in one night? That's a bit crazy. This is only CD7 and in the past, I wasn't even close to the 15mm mark. I had maybe 1 at 12mm or 13mm at this stage. I seem to be stimming fast this time. I stimmed for 11-12 days in the past. Is this a good thing? It's weird how a different protocol can change things. I'm not sure what to think... Having maybe only 4 or 5 to work with is making me super nervous...
E2: 4200

One day at a time, I guess... Let's hope I survive another ultrasound tomorrow...

The stress of cycling...

I never imagined that this cycle would be so stressful. With 2 cycles behind me, I thought I've seen the worst. I never had trouble during the stimming phase even though things moved along slowly. After all this, I thought the nervousness and hair-pulling won't start until after the retrieval.

But IVF has thrown me a new kind of worry. Despite everything looking so great before the start of my cycle with the excellent AFC and cyst gone, I seemed to have developed a lead follicle. My old clinic didn't have me go in for monitoring until CD5, but this time, I am being monitored daily from CD4.

CD4
So at my first scan, I had one dominant follicle already at 14mm. (What 14? CD4?) Yup... Weird! The only other measurable follicle was at 10. However, I seem to have lots of little ones, a total of 14 little ones they tell me. My estrogen is at 1182, which means that something is growing... hopefully...

CD5
Lead follicle grew to 15! Ick! Two follicles beside that one: one at 10 and one at 9. The count of smaller follicles grew by 1 to 15. I have no idea of their size. I am starting to freak out. My estrogen is at 2226 today, which the nurse seemed to be happy with. She also reassured me that it does look like some follicles will be popping up soon. I will also be starting the antagonist, Cetrotide, quarter dose, tomorrow morning to prevent ovulation.


Comparing with my previous 2 cycles:
My previous first scans were on CD5. In the first cycle, I had 1 follicle at 9mm and that was it. The second cycle, I had nothing on CD5! Things didn't really start to come in until CD9! So technically, I'm seeing more follicles this cycle than I've ever seen before.

I don't know why I'm so bothered by this dominant follicle crap. I was never worried about the risk of cancelling in the first 2 cycles when things looked worst. Maybe it's just the stress of the cycle being the third one. Maybe I just want this too badly. I'm trying to act like I'd be ok with another cancellation or no transfer... but it's hard. I wish I can just turn off my brain for a week and be like a robot.

More bloodwork and ultrasound for the week to come...!

Here goes again... #3

I can't believe this is all happening again! 

It felt like I have been preparing for this cycle FOREVER. The BCPs took forever to finish, and the week between my last BCP and first injection felt like a whole year. All in all, I am happy that this is finally happening again, but of course I am nervous about what's around the corner.

My baseline report was fair. OFC actually never did a baseline for me so this is the first cycle out of 3 that I am getting this info.

AFC: 13 (10 on right, 3 on left) 

E2: 210

Lining is right where it's suppose to be at this point

I have only gotten my AFC counted once, and that number was 8. Needless to say, I am happy with 13. But I am still scared that this is setting me up for a big disappointment. My E2 level is quite high. At this point, 200 and below would be acceptable and I am just over that line. I was given the go ahead to start, so I guess I will *try* not to freak out too much until my next appointment.

Here's what's going on with me today: second day of injections, topped with bloating and a side of weird twinges here and there. Warning: Emotional stability not guaranteed.

Uncertainty and sleepless nights

After a long 5 months, my IVF journey #3 will be coming up very soon. I'm not sure how I feel about this.

I've now met with 2 different doctors not at Ottawa Fertility for a second and third opinion. I had my AMH tested twice, 14.7 pmol/L and 16 pmol/L. Both times at the lower end of normal, but amazing for someone who has such extensive endo and it is still considered normal. So I DO have lots of eggs left... I guess this is somewhat of a comfort. DH's sperm is normal, fragmentation at 22%, which is fair. So basically, all these tests point that everything should have been perfect and does not explain whatsoever why my embryos don't fertilize/grow. Of the 2 cycles I did, I had retrieved a total of 16 eggs of which only 3 fertilized and 1 transferred on day 3. Horrible for a 27 year old. What's going on?

After meeting with Dr. Arthur and Mount Sinai and Dr. Hannam at Hannam Fertility Clinic, I've decided to cycle again with Dr. Hannam. He was so great at looking at my file thoroughly and both DH and I just loved him. We discussed lowering doses and doing a completely new protocol. With lowered doses, we're really hoping to get better quality eggs. I just hope I respond to the stimulation. Expecting to call in CD1 this week. Our treatment plan will be:

PROTOCOL: OCP - controlled Antagonist Cycle Down Regulation: Alesse x 3-7 weeks with endometrial biopsy
Starting Dose: Gonal f 200 once a day with Luveris 75 Add: Lthyroxine 50mcg/day until preg test
Cycle LH Inhibitor: Cetrotide 62.5 to 125 mcg/d
Ovulation Trigger: Ovidrel/HCG x2 sources with 450 IU push prn. Fleet enema prn
Retrieval Day: Standard anaesthesia protocol: fentanyl, midazolam, xylocaine & atropine PRN.
Add serum TSH, T4
Post-Retrieval Day: Prometrium 200mg PV TID with Estrace 2mg PV BID
Male Instructions: 2-4 days of abstinence before expected day of retrieval
LABORATORY INSTRUCTIONS (Lifequest) Fertilization of Eggs: ICSI with fresh sperm SPINDLE VIEW please Assisted Hatching: Yes
Extra Testing: None Plan to Transfer: two embryos on Day 3 or 5 TRANSFER INSTRUCTIONS Pre-Transfer Day: Routine Care
Transfer Day: Full-bladder ultrasound guided embryo transfer. PIO 50mg IM x 1 dose 1 hour prior to transfer
Post Transfer: Serum estrogen, progesterone

My chances seem grim. I'm not sure how I feel about this next cycle. Not sure what I should expect. Maybe I should expect yet another zero fertilization, because that's the worst that could happen. This cycle just may tell us once and for all, if we should even continue down this path. I've been losing a lot of sleep.

New clinic, new doctor, new protocol, new hope? But the shadow of my last two cycles still haunt me.