2nd Beta Test

Today I had my second lab test at 7:30am and then headed off to work.  I was definitely more nervous today then on Monday.  I was so scared that my hCG level wouldn't double, or worse, would decrease.  Just had to keep thinking positive thoughts!  Around 1:30pm, the nurse called and told me that my Beta hCG test came back at 1800 (mIU/ml)!  Holy Cow!  She said that I needed to come in for an ultrasound, so we scheduled that for next Tuesday.  Hopefully, she'll be able to see how many embryos we have!  She wants me to continue with the baby aspirin and the progesterone.  I only have a few days worth of progesterone remaining, so she had to order some more for me. 

Wow!  What a wonderful Thanksgiving this be!  We have so much to be thankful for!  I hope you all have a Happy Thanksgiving!  Travel safe and I'll update you on Tuesday with the results of the ultrasound!  

1st Beta Test

What a day it has been!  I had my lab test at 7:30am and then headed off to work.  It was the longest morning ever as I waited for that one important phone call from the nurse.  Around 11:30am, the phone rang and it became one of the most unforgettable moments on this journey.  My first Beta hCG test came back at 700 (mIU/ml)!  Usually, for single baby pregnancies, normal hCG levels are 5 to 430 at 4 weeks.  Since my level is so high, it is highly likely that we will have twins!!

Weeks of pregnancy after last menstrual period	Days after conception	Approximate hCG levels for single baby pregnancy (mIU/ml)
Week 3	7	0 to 5
Week 4	14 (next period due)	5 to 430
Week 5	21	180 to 7400
Week 6	28	1,100 to 56,500
Weeks 7 to 8	35 to 42	7,600 to 230,000
Weeks 9 to 12	49 to 70	25,300 to 290,000
Weeks 13 to 16	77 to 100	14,000 to 243,000
Weeks 17 to 24		4,000 to 165,000
Weeks 25 to birth of baby		3,200 to 90,000
4 to 6 weeks after birth		Less than 5

The nurse told me that she wanted to retest in 48 hours (Wednesday morning), as my level should roughly double.  I got off the phone with her and just started crying tears of joy!  I was so overwhelmed and happy to hear this news.  Immediately, I called Jared to share the results with him.  He was excited as well, although I think he was also in shock.  After talking to him, I called my parents, then other family members and friends.  I don't even know how many times I broke down in tears today!  It was such an emotional day that I ended up leaving work early so I could relax and let everything sink in. 

If we do end up with twins, the expected due date is July 12, 2014.  Otherwise, it would be August 3, 2014.  I just can't thank everyone enough for their thoughts and prayers!  It's been quite the journey to get here and I'm blessed to be able to share it with you.  We are so excited to enter this next chapter on the road to parenthood. 

9DP5DT - 9 Days Past a 5 Day Transfer

Friday night I had terrible cramps and woke up feeling very depressed.  I just knew that this cycle didn't work.  Jared told me to stay positive but I was preparing for the worst.  Even though I swore I wouldn't test early, I decided to go to Walgreens and pick up a HPT - First Response.  I immediately went home to test and was floored when I saw this:

 

After almost two years of trying, I finally was able to see what  a positive result looked like!  I couldn't believe my eyes!  And I just knew it couldn't be a false positive, since the HCG from the trigger shot was already out of my system.  I immediately called Jared to share the news and he was just as excited -- although he told me to not get overly excited and wait until we get the official word from the lab on Monday.  That was easier said than done!  I couldn't stop smiling!

I then woke up this morning to test again to make sure I didn't have a faulty test, and again it was positive!  OMG!  I'm completely overjoyed!  Granted, I still need the blood test to confirm tomorrow, and then again on Wednesday.  And yes, we still have a long road ahead of us, since IVF pregnancies can be higher risk for miscarriage, but just having a positive test shows how far we have come!  I'm not sure when they will be able to tell if both embryos implanted but I'll be happy regardless!

I appreciate the love and support we have gotten from all of our family and friends.  Just to listen to me when I needed someone to talk to meant so much.  The simple call, text, or email meant more than you know and kept our spirits and hope alive.  I really never thought we'd see this day and here we are. 

5DP5DT - 5 Days Past a 5 Day Transfer

Well, I'm officially at the half way point between my transfer and my blood test to confirm if this worked.  Talk about a stressful few days.  I've had days where I 'feel' like I'm pregnant (sore boobs, tired) and other days, I feel just fine.  If I'm pregnant, the implantation is complete and tomorrow I should be able to get a positive result on a HPT (Home Pregnancy Test).  Since the start of this process, I swore I wouldn't use a HPT because I didn't want a false positive due to the trigger shot, but I'm so anxious right now that I just want to know.     

5-Day Transfer

Days Past Transfer (DPT)	Embryo Development
One	The blastocyst begins to hatch out of its shell
Two	The blastocyst continues to hatch out of its shell and begins to attach itself to the uterus
Three	The blastocyst attaches deeper into the uterine lining, beginning implantation
Four	Implantation continues
Five	Implantation is complete, cells that will eventually become the placenta and fetus have begun to develop
Six	Human chorionic gonadotropin (hCG) starts to enter the blood stream
Seven	Fetal development continues and hCG continues to be secreted
Eight	Fetal development continues and hCG continues to be secreted
Nine	Levels of hCG are now high enough to detect a pregnancy

 

Embryo Transfer

Yesterday was not only my birthday, but more importantly, it was the day of the embryo transfer.  I drank lots of water as we drove up to Columbia to ensure I had a full bladder as instructed.  Upon arrival, we stopped by the pharmacy to pick up my prescription for Valium and took one of the pills.   The nurse then took us back to get ready for the embryo transfer and gave us the most recent stats on our embryos.

1 was an Expanded Blastocyst Grade 1
2 were Blastocysts Grade 1
2 were early Blastocysts Grade 1
1 was a Morula Grade 1
1 was a 10-cell embryo Grade 1
2 fell apart and arrested to develop

The embryologist and the doctor recommend we transfer two embryos - the Expanded Blastocyst and one of the other Blastocysts.  They were going to freeze the other Blastocyst, the early Blastocysts and the Morula.  They decided to discard the 10-cell embryo since it was so far behind at this point.  The nurse gave us a photo of the two embryos that they were going to transfer -- our first future baby pictures!

Once we signed a form stating we agreed on the number to be transfered and frozen, they wheeled me into another room.  It was actually the same room where the retrieval took place.  Jared sat by my side as the doctor got everything set up.   The doctor reminded us that he only has 20 seconds to get the embryos from the lab to the uterus.  When he was ready, he called for the embryologist.  The embryologist came in, confirmed our names, and gave the doctor our embryos.  The doctor then quickly inserted them into the catheteter and into my uterus.  Jared was able to see a little speck on the ultrasound.  It was really exciting and overwhelming!  We were thrilled to be at this point. 

 

I was then wheeled back into the original room where I rested for 30 minutes.  This really surprised me -- reading other blogs, it seemed like most patients were kept at the doctor's office for up to two hours!  I was scared to get up this soon.  Not to mention, we had an 1.5 hour drive back to St. Louis.  She said I would be fine, just needed to be on bedrest for the next 48 hours.  I had to trust that she knew what she was doing.  She also wanted me to empty my bladder as well.  I was super paranoid -- I didn't want to lose these embryos!!  She laughed and said I had nothing to worry about. 

 

I laid down in the front seat of the car during the ride back and then spent the remainder of the day sleeping in bed.  That Valium really knocked me out.  Today, I plan on resting on the couch.  Being on bedrest is definitely not fun -- Jared has been a big help though!  Can't wait till I can start moving around again.  The nurse gave me an order to get a pregnancy blood test done on 11/25.  If it comes back positive, she'll want a retest on 11/27.  So now we have a 9 day wait....better than a two week wait though!  Gosh, we really hope this works...so much anxiety and stress right now.  We will be devasted if neither embryo takes.   

   

 

 

Day 3 After Retrieval

Today was another FANTASTIC day!  Remember back on Sunday, when Dr. Wilshire said they were able to retrieve 11 total eggs?  And then on Monday, they informed me that only 9 fertilized?  Well, today we got news that we have 9 perfect embryos!!  I was shocked and confused that we went went from six to nine!?  The nurse said they kept the eggs that didn't fertilize to see what would happen and then ended up getting fertilized!  She also said that she misspoke when she told me that three had arrested to develop yesterday -- they were just completely undeveloped at that point. So it sounds like of the 11 eggs retrieved, only two have arrested to develop.

So at 72 hours, the embryos should have 8 cells.  Here are today's results:

4 embryos have 8 cells and are Grade 1

1 embryo has 10 cells and is Grade 1

2 embryo have 6 cells and are Grade 1

1 embryo has 4 cells and is Grade 1
1 embryo has 2 cells and is Grade 1

I couldn't be happier!  What a great looking team!  Yes, we got some slower ones, but they are developing beautifully!  The embryos will be left alone the rest of today and tomorrow. 

My transfer is scheduled for noon on Friday.  I have to arrive at 11:30 with a full bladder and they will give me valium at this time as well.  Additionally, they will give me the final stats of the remaining embryos and they will choose the top two to be transfered back into my uterus.  The others will be frozen for a future transfer.  I will stay laying down at the office for two hours before they release me.  I plan on bringing a book and some cards to entertain ourselves.  Too bad, we don't have a tablet....hmm, I should put that on my Christmas list!  Then I get to spend the rest of my birthday and the following 48 hours on bedrest.  Not sure what that all entails at this point -- can I shower, can I lay on the couch?  I am just simply thrilled right now at how well things are going.  And the support!!  It has been tremendous!  Just being able to share these little details with you really keep my spirits up.  Hopefully soon we'll all get to meet Baby Williams!      

Day 2 After Egg Retrieval

After stressing out all day, waiting for the phone to ring, I got the call I was waiting for!  Dr. Wilshire's office does a 3 point scale from1 to 3, with 1 being the best.  As I stated yesterday, at 48 hours, the embryos should have about 4 cells.  Here are our results:

 

3 embryos have 4 cells and are Grade 1

1 embryo has 5 cells and is Grade 1

1 embryo has 6 cells and is Grade 1

1 embryo has 3 cells and is Grade 1

 

So 6 perfect embryos!!!  YAY!  I'm SOO excited!  Unfortunately, the other three embryos arrested to develop. Because so many embryos were considered perfect today, my embryo transfer will definitely be on Friday.  The nurse will call me to tomorrow to let me know how they are doing.  Now we just have to hope that they continue to grow and develop normally and that we don't lose any more along the way. 

 

Day After Retrieval

Today I got the anticipated call from our nurse. She said that out of the 11 eggs, 10 were usable  and 9 successfully fertilized!!  This was so exciting to hear and really brightened my day!  Tomorrow, she'll call me and give me the grade of each embryo and will let me know when the embryo transfer will be. 
 
Basically, each embryo is graded as A, B, C, or D ("A" being the best and "D" being the worst).  What determines the grade is the cell number, regularity, and fragmentation.  Embryos should be at 2 to 4 cells at 48 hours after egg retrieval and preferably about 6 to 10 cells by 72 hours.  It is generally best if the size of the individual cells are similar in size.  A Grade A embryo is one which has equal sized cells in it (Blastomeres). Fragmentation, is a process where portions of the embryo's cells have broken off and are now separate from the nucleated portion of the cell.  A Grade A embryo is the one which has no fragmentation or less than 10% fragmentation. A Grade C embryo, however, does not mean that the baby will be abnormal. It just means that the chances of implantation are reduced, as compared with a Grade A embryo. Below are some examples of the different Grades. 

GRADE A :

10-Cell Grade A embryo

1. Regular Blastomeres.
2. No Fragmentation.

GRADE B :

10-Cell Grade B embryo

1. Regular Blastomeres.
2. > 10 % Fragmentation.

GRADE C :

8-Cell Grade C embryo

1. Irregular Blastomeres.
2. > 10 % Fragmentation.

GRADE D :

8-Cell Grade D embryo

1. Irregular Blastomeres.
2. > 20 % Fragmentation.

The number of good embryos will determine if we do a Day 3 (Wednesday) or Day 5 (Friday) transfer. Below is a table that compares the transfers.

Egg Retrieval Day!

Before I get into the events of this morning, let me catch up from Friday night...

So Friday night, Jared and I went to play poker at a friend's house.  We had to bring a bag with the trigger shot since we wouldn't be home at 10pm to take it.  We both set an alarm on our phones to not be late!  Jared's alarm was set earlier than mine so that he could get everything all set up in the bathroom and then I joined him a few minutes later.  This medicine was a little more difficult to mix than the others, but the added stress of meeting a deadline probably didn't help either.  We were ready to go at 10:01pm.  The 1.5in needle surprisingly wasn't too bad, probably because I had so much adrenaline and excitement for the retrieval.  However, the injection site has been sore since!   But, I'll gladly take the soreness since this was the last injection!  I just kept hoping and praying that we did the injection in the right spot and everything would be okay for the retrieval.

We woke up today at 5:15am to get ready to make the trip to Columbia.  We arrived right at 7:30 and the nurse took us back so I could get ready for surgery.  The anesthesiologist came in and asked a few questions as well.  I then said goodbye to Jared and they took me to another room, where they started the IV.  Twenty minutes later, the surgery was over and  I was waking up with Jared at my side.  The only pain I was experiencing was moderate to severe cramping, which was expected, so the nurse gave me some Tylenol.  Dr. Wilshire then came in to give us our egg count...only 11 eggs were retrieved.  9 were matured and 2 were expected to be mature within 24 hours.  I was devastated and began to cry.  All these shots and all the pain and tears for 11 eggs?!   He was pleased with this number though, as he aims for 10-15 eggs, but I wanted more.  Luck is never on our side and I know that not all 11 will fertilize - in fact, roughly 70% will fertilize, and even fewer will be considered normal by day 5.   I was so disappointed....

The nurse  then went over all of the post-op directions with us.  I start the Progesterone suppositories tonight.  Tomorrow they will call me to give the exact number of eggs that fertilized and on Tuesday, they will let me know how the embryos are doing -- if only a few look normal, they will want to do the transfer on Wednesday.  However, if several look normal, they will let them continue to grow and we'll do the transfer on Friday.   I'm hoping for a Friday transfer! 

Injections: Days 10 and 11

Day 10:

Today we had to do the shot of Follistem.  And just like last time, it was pretty easy and painless.

Day 11:

This morning, we had to do Ganirelix again so I had to deal with a sore thigh for a few hours.  I then drove out to Columbia for blood work and an ultrasound.  About 3-4 of my follicles were at 19mm and the others (about 11-12) were at 17mm.  My Estrogen came back at 1800!    And then I received the news I have been waiting for: 

TONIGHT I CAN DO THE TRIGGER SHOT!!

Never have I been so excited for one of the worse injections!!  After enduring almost two weeks of shots, I couldn't be happier to hear this.   So at precisely 10pm, Jared has to give me the HCG (Pregnyl) shot in the butt (sounds glamorous, I know!).  This is the most critical part of the IVF process.  This shot has to be right at this time...any earlier or later, and my egg retrieval will not be a success. 

 

Tomorrow morning, I start another antibiotic to be taken twice daily and tomorrow night, I have to douche (again, sounds so attractive!).  Sunday morning at 8am is my scheduled egg retrieval!!  I cannot wait!  I hope Jared has good numbers as well, otherwise we have the frozen samples as backup.  Let's hope all the eggs get fertilized.

 

Injections: Day 9

Today I had another appointment in Columbia for an ultrasound and blood work.  I was hoping the nurse would tell me that I was done with the meds and that I could take the HCG trigger shot tonight for preparation for the egg retrieval on Friday.  

Well, that didn't go as planned.  The ultrasound showed 14 eggs and all were about 16mm in size.  She wants them to get to be about 18 mm.  My Estrogen level came back over 1000, which she said was fantastic .  She wants me to the Ganirelix tonight as well as Follistem, which is another FSH drug.  Tomorrow, she said to just take the Follistem and then on Friday, to take Ganirelix in the morning and then come back for a final ultrasound.  As of now, it looks like Sunday will be my egg retrieval.

Ugh!  I totally wasn't expecting to do anymore shots!  Jared had to keep reminding me about the end goal so I wouldn't lose focus.  So after some complaining on my part, we did the two injections.  Follistem wasn't bad at all.  We did that one in the belly and Ganirelix in my thigh.

Two more days of shots!  I can do this!!  I'm just so tired of these meds and I'm tired of being tired!  And on top of feeling super drowsy lately, I have a constant feeling of being 'full' due to the swollen ovaries, resulting in me having little to no appetite. 

Sunday can't come soon enough...

Injections: Day 8

This morning I took the Ganirelix injection in my thigh.  Just like last time, the shot itself didn't hurt, but about 30 minutes later, my leg was throbbing in pain.  It was sore during most of the morning at work as well.  All day I was super tired.  These shots are wearing me out and making me so sleepy.  Not only that, I'm getting so much more emotional and sensitive due to the high level of estrogen.

I wasn't looking forward to coming home tonight since I knew that awful Menopur shot would be waiting for me.  I just kept thinking to myself that if the retrieval is Friday, that this may be the last injection before the trigger shot.  We decided to try my thigh to see if that would be less painful.  While it was slightly less painful, this shot still burned like hell!  Menopur is by far the worst injection I've had to take in regards to level of pain.  I just want to be done with these shots already!! 

Injections: Day 7

I went up to Columbia today with Jared for an ultrasound and blood work.  Jared had to provide another sample to combine with the first sample that he gave last week.  His motility went from 8% - 12%, and his count increased to two million motile. 

During my ultrasound, the nurse saw 10 follicles in my right ovary and 4 in my left. All are about 12-15mm in size, which is right where they should be.  My estradiol level was 343, which is in range as well.  So tonight, she wanted me to take 300 IU of Menopur, which is similar to Bravelle in that they both contain FSH, but Menopur also contains LH (Luteinizing Hormone).  That shot STUNG!!  I'm sick of these shots already and all the pain and tears that go along with them.  Just gotta remember that I'm almost done!!

Tomorrow morning, I am supposed to take the Ganirelix again to prevent ovulation.  This one shouldn't be too bad.  And then tomorrow night, I'm to take 300 IU of Menopur again....definitely dreading this one!

I go back to Columbia on Wednesday to check my follicles (size and number) as well as my Estradiol level.  The nurse said I should be prepared to have my egg retrieval done on Friday or Saturday!  Yippee! 

Injections: Days 5 and 6

Day 5:
   
Last night we did left arm again.  My arm was sore due to the amount of injections in the same area, but the shot itself, didn't brother me.  We are officially at the halfway mark for injections!!  Whoo-hoo!  

Day 6: 

Tonight was the first night of two injections:  the Bravelle shot and the Ganirelix shot.  We did the left arm for the Bravelle shot and the left thigh for the Ganirelix.  The thigh wasn't bad at all -- just felt the prick of the needle and that was it!   But about 30 minutes after the Ganirelix shot, my thigh became very sore - almost like a stinging sensation.  Not sure if it is due to the location or the injection.  
My only other symptoms are still my sore ovaries and bloated belly.  I've been tired lately and have had a few headaches, but I'm not sure if either are due to the meds or stress.

Tomorrow, it's back to Columbia for another ultrasound and blood work.  Let's pray for more eggs!  Hopefully by the end of this week I will be done with these crazy injections and will have my egg retrieval!

Injections: Days 3 and 4

Day 3:
   
Last night we decided to try the right arm since the left arm was pretty painless.  Well, Jared must have hit a muscle or something, because that injection stung!!  Thank God it only last for a couple minutes.  

Day 4: 
    
Today I drove out to Columbia for my second ultrasound and blood work.  The nurse saw about 10 follicles in my right ovary and about 5 in my left.  She said that was good and that more will develop as we continue this process.  I wanted to see like 20 follicles, but she told me not to worry.  Right now, she just wanted to make sure that all the follicles were growing and were all roughly the same size. They were all about 1-2 mm in size, which is great!  I told her that my belly was slightly tender to the touch.  She laughed, said it was normal, and told me that by Monday, I won't even want to tough it...LOL.   

My Estradiol level was 127 today, which was in the normal range, so she said to continue the 300 IU of Bravelle for tonight, tomorrow, and Sunday.  But on Sunday,  she also wants me to take the Ganirelix Acetate 250 mcg prefilled syringe so that I don't ovulate prematurely.  This injection, like Bravelle, is a SubQ injection, so hopefully it's not too bad.

Tonight's injection was a breeze!!  Jared did such a good job! We went back to the left arm, around the same area that we did it last time.  I applied ice for about 2 minutes prior and felt nothing!!  It was the first time that I was actually smiling after the shot, rather than wiping away tears!!