14dp3dt: Thought of the day

If today were two years ago and we had conceived naturally, I would be blissfully unaware that my hCG levels were precariously low and slow. I wouldn't see a doctor for at least another four weeks. And the home pregnancy tests would assure me that everything is okay. That bliss is one of the many things that infertility steals from us. But for now, I'll try to enjoy this: I am pregnant!

13dp3dt: Living on the edge

More borderline news today: my hCG (the pregnancy hormone) level was 112. It needed to be >107 to be viable. But >150 would have been better. hCG should double every 48-72 hours in early pregnancy. We're at 65 hours, high but okay. These embryos have been pokey throughout this process -- I was slow to suppress, the follicles were slow to grow, the embryos were slow to grow. But each step has eventually been successful. So we might yet catch up!

It's frustrating, as I was really ready for some solidly good news today. I'd been really optimistic that the hCG level was going to be between 150 and 200. But we'll continue to live on the edge of uncertainty for a while longer. They want me to come in again next Monday, which is actually a pretty full day. So I'll either go in Friday or Tuesday.

10dp3dt: The results ...

are at best inconclusive.

My HCG level was higher than I anticipated, but definitely borderline. Mostly I'm feeling relieved that it's not as bad as I'd expected. But I would have liked to know for sure! I'll have a repeat on Monday, where we'll look for the number to have more than doubled (hopefully tripled).

If you care about the numbers, HCG was 52. The clinic wants to see >50. Average for 13dpo is 62.

UPDATED: 9dp3dt: Deja vu all over again

UPDATED: We ran into our RE at the Bart Ehrman lecture tonight. Okay, we invited him. (And by the way, I heart Ehrman.) But anyway, he was very stern and told me not to give up hope. More tomorrow.

We had 24 hours of excitement after a very faint positive pregnancy test yesterday morning! But today the test was fainter and was accompanied by other, pretty conclusive, signs that the cycle was a bust. We're sad and disappointed, since we'd let ourselves get pretty excited yesterday. But we're ready to try again. I'll still go to the clinic tomorrow for a blood test. I am certain it will confirm that this is another chemical pregnancy (positive pregnancy test, but embryo stops developing before it can be detected on an ultrasound), just like last March. We'll wait a month, then start IVF#2. Thanks for all your love and encouragement through this process. We'll keep you posted!

5dp3dt: For Leo

We are celebrating here Chez Blangsdau. The bill isn't perfect (infertility coverage, anyone?) but it means that my friend Leo True-Frost will not be inhibited by lifetime caps, pre-existing condition exclusions, or chronic condition limitations. And that's a great thing.

4dp3dt: Laughter

The last embryo didn't make it to freeze, but that's pretty normal, so we're okay with it. We had a visit to the clinic this morning to check my progesterone level, which is fine. (B is apparently doing an excellent job of giving me a shot in the a** every night.) Dr. R came out from an exam room when he heard my "unmistakable laugh."

It reminds me of the video some of my students shot of me last week for the annual mock-the-professors show this week: "Professor Bangs, why is your laugh so loud? I mean, really, we can hear it all the way in the pit." Because it brings you joy, Jeff, because it brings you joy.

Halfway through the two-week-wait from retrieval to test; six days to go.

2dp3dt: Early blast

I just got a call from the clinic, which has been keeping an eye on our two remaining embryos. One stopped growing, but the other is hanging on and is in the early blastocyst stage (just about on track for day 5). Since the embryos they transferred back were of higher quality, and I quote, "there's every reason to think" one or more of those have continued to progress in their natural environment. The last embryo at the clinic isn't well enough along to freeze, but they'll check it again tomorrow to be sure.

Wee, bright flicker of hope -- eight days to go.

1dp3dt (1 day past 3-day transfer): What I've learned so far

Bed rest is not for wimps. After 24 hours, not only am I bored to tears (not that I'm doing the schoolwork on my to-do list, which would keep me busy and occupied), my muscles and joints (especially my hips) are already feeling the atrophy. Props to the mamas who do this for months on end to ensure healthy baybees.

I've also had loads of time to consult with Dr. Google.

Word on the interwebs, including from some MDs, is that three-day transfers at clinics (like ours) that normally do five-day transfers are nothing more than a face-saving/ass-covering maneuver. They'd rather the embies die inside the mama than in the lab. That way it's "our" fault, not their fault. According to these sources, the line (which we were fed yesterday morning) that the natural environment is better is, in fact, a bunch of bunk. Embryos that will thrive will thrive anywhere. I hate to think of our wonderful doc, whom we adore, lying to us like that. But whatevs, either these embryos will make it or they won't. And it is kind of nice to be PUPO (pregnant until proven otherwise) for a few days!

On the other hand, the internetz are full of stories of successful day three transfers of 7-cell embies. And so despite my neverending pragmatism, I can't resist that wee, bright spark of hope that keeps returning.

Nine days to go.

Day 3 transfer: Embryos on board

This morning brought mixed news: fragmentation was minimal (5-15%, when what they want to see is less than 20%) but growth had slowed considerably. They should have doubled overnight, to 8-10 cells. But we had only 5, 6, and 7 cell embryos this morning. So they decided to do the day 3 transfer, figuring that being in their natural environment might perk them up. We also transferred three, instead of the clinic's usual two, because of their size. There's about a 35% chance of pregnancy, about 5% of triplets (compared to a 60+% chance of pregnancy if the embryos had made it to a day 5 transfer).

Nevertheless, the embryologist and the doctor were very optimistic. Dr. R. assured me that he was not just being "rah rah cheerleader." But he did answer my questions about a second cycle, if this one fails, instead of just telling me to go home and think positively! That made me happy; I always cope better with a plan B.

But in the meantime, I will think positively. I'm at home in bed/on the couch for two days, being waited on hand and foot. Then ten days until the pregnancy test.

2dpo: Good news and bad news

The good news is that we still have five growing embryos, and they're growing at a good rate:
2 5-cells
2 4-cells
1 3-cell
(The goal is 2-4 cells on day 2, so we have two that are even a little ahead.)

The bad news is that they're not very pretty. And we only want a cute baby.

The report from the embryologist this morning is that there is too much asymmetry (cells are different sizes) and too much fragmentation (portions of individual cells have broken off and are fragments are floating around inside the cell). If that trend continues, we'll transfer tomorrow instead of day 5.

Rates of pregnancy with a day 3 transfer are somewhat lower; with asymmetric and/or fragmented cells, much lower. So I'm definitely feeling a bit discouraged today. But I'm hanging in.

1dpo: Fertilization report

We're celebrating! We have six embryos this morning, an exceptionally good fertilization rate. The one egg that didn't fertilize actually didn't survive retrieval. So we had a 100% fertilization rate, truly unheard of! Since we've had a confirmed embryo only once before (the miscarriage last spring), we are jumping for joy. We might get to be parents! The lab will call tomorrow with a report on how they're growing. We'll likely lose some before the week is out, but this is a terrific start.

Retrieval Day

Dr. R got seven eggs this morning. I'm trying not to be too disappointed in the number. We only need one, we only need one. But everything went smoothly. The anesthesia was no big deal, and I recovered so quickly they released me early. Mom, Dad, and B were all in the recovery room. And my new friend M stopped by to say hi after her own appointment with Dr. R. We'll get a call in the morning with the fertilization report.

Cool or creepy?

We're leaving for the airport shortly to pick up my parents, who will be joining us on this big adventure this weekend. I realized yesterday that, if this cycle works, my parents will be with us at the moment their grandchild is conceived. And thanks to the miracle of modern medicine, neither Brent nor I will be present for that conception.

Final follie check; Mood = Trigger happy

We're a go! The follicles showed amazing growth over night, and Dr. R. definitely thinks we're looking at 8-10 eggs. I'm so excited I could jump out of my skin. Dr. R says if I'm anxious now, just wait until I'm full term. Brent's work starts tonight; he injects me with the trigger shot at 10 p.m. And then retrieval is 9 a.m. Saturday. We'll be back with an update in the afternoon.

Follie check #5; Mood = Getting excited!

Is this pregnant brain? I'm always a little forgettery, but I'm losing my train of thought in the middle of a sentence and am unable to get it back! If the meds are doing this, what would actual pregnancy do?

I had another good appointment this morning. There were 13 follicles, 8 that look big enough to contain eggs (though there's no guarantee). Although the biggest has reached 18mm, the doctor is going to put off retrieval one more day in the hope of getting a few more mature. So I have on more night of stimulation, then we'll "trigger" ovulation tomorrow night, with retrieval on Saturday morning. My folks will be here for the weekend, so I'll have lots of people holding my hand.

After a rough weekend (fortunately the Bl@ckberry survived!), my zen is back. And I'm feeling pretty good.

Follie check #4; Mood = Relieved

We're up to 10 or 11 follies this morning. They're still poking along, so I'll continue on the high-doses for two more days and return to the doctor on Wednesday. But both nurses said to me, "Slow and steady wins the race." I asked specifically, "They won't be overripe if we stim for more than two weeks?" And I was assured that slower was better than faster. It means our schedule remains in the air. The retrieval is likely pushed back again, maybe to Sunday, give or take a day or two. I'll probably start daily monitoring with my Wednesday appointment. I'm anxious to get there; but I'm more than willing to wait if it means more eggs and, hopefully, more embryos.

In other news, it appears I'm still employed for another year. Big sighs of relief all around.

Follie check #3; Mood = A wee bit frustrated

The good news is that there were nine visible follicles this morning -- that's more like it! But the biggest has only grown about 2mm, where 4mm would be expected. It's possible that the biggest is really a cyst, not a follicle. If that's the case, then the rest are growing at an appropriate rate. If it's a follicle, then it's being very sloooooow. Dr. R. keeps reminding me that the human body is unpredictable! The upshot is that retrieval has been pushed back a day or two to the end of next week. I go back on Monday for another check.

Follie check #2; Mood = Better

The good news is that the follicles are growing at an appropriate pace (about 2mm a day), and the biggest one on the left is now 12mm. So we're looking at a Tuesday or Wednesday retrieval next week. The less-good news is that there were still only six or seven visible. So we're probably looking at low numbers of eggs. I'm bummed, since we'll likely lose some at each step of the process. After some aren't mature and some don't fertilize and some don't grow, we may be lucky just to get two to transfer. But I'm handling the news, and life in general, better today. I'm physically exhausted and looking forward to retrieval and spring break and transfer so I can sleep for days and days! But my mood is brighter, which is nice. I stay on the high-dose of my evening med for two more nights, then back to the doc on Saturday morning.

Follie check #1; Mood = Blue

At this morning's ultrasound, I had four follicles on the left and two on the right. The largest follie is 7.2mm. Six is definitely fewer than I would have liked. The average number of eggs retrieved at my age is 12. But since mature follies are 17-18mm, we've got a long way to go. And Dr. R. was adamant that I not be discouraged; more follies could appear. My morning shot is discontinued, though my evening shot will be doubled over the next two days. Since this is the one that is now causing me giant, angry, red, itchy welts, more discomfort is in store. We go back on Thursday morning for another check.

Fortunately, B will be going with me on Thursday, as in the last week, I've had a reduced ability to cope with anything. Minor challenges have either put me on the edge of tears or filled me with dread. I finally figured out this morning that it's all these drugs (plus, you know, the fear that this is not going to work). I'm a little slow on the uptake.