October 2016 - 1 year RE-aversary + Next Steps

September was our 1 year RE-aversary.  It was a little over a year ago that we walked into our Reproductive Endocrinologist's office.  We were nervous, worried about what we might find out, but most of all frustrated with our lack of success in 20 months of trying to get pregnant.  It felt good to take a more direct approach, but it was also terrifying and the science was a little overwhelming.

I wonder if Hallmark makes a card for that?

"To our favorite Reproductive Endocrinologist... 

Happy RE-aversary!  

Thanks for not giving up on us like my ovaries are trying to do!  

You're really EGGstra special!"

I bet they do.

Serious note to self: send Dr. S and his wonderful nurses a card saying thank you for not giving up on us...

Although, we did actually already celebrate with about a dozen vials of blood for updating all my blood tests.  That was a fun surprise that I probably should have seen coming.  Flash back to how intimidating that was a year ago, and how all I could think a year later was, "at least I get to chat with Lori the blood tech for a while longer!"

Now, 1 pregnancy, 1 miscarriage, and 4 rounds of egg retrieval later, here we are on October 6.  It's 36-ish hours after getting wonderful (and surprisingly early) news of a normal genetic profile for the Lone Ranger (our one frozen blastocyst from round 4 that took 7 agonizingly LONG days to grow).  That makes for 2 embryos on ice.  One from January, which did not get genetically tested due to bad paperwork, and one from October, genetically NORMAL (hooray!), for a total of 2.

Dr. S called to congratulate us on #2 yesterday.  After expressing mutual relief and excitement, noting the irony of the slow-growing embryo and the super-fast genetic testing turnaround time.  He then gave us a choice for our next steps.

1. We could move on to embryo transfer...sprint toward the IVF finish line!  Chances are pretty decent that we could get pregnant with the two embryos we now have.  Transfer of a normal embryo have a 50-60% chance of resulting in pregnancy.  We don't know if #1 is normal, but #2 is.  #1 has been our fastest and strongest grower so far.  A record (for us) 10 cells counted in the Day 3 report.  
2. If we have the emotional energy remaining, possibly recharged a bit from the success of #2, we could try for another retrieval round and (hopefully) bank up one or two more frozen embryos. This would increase our chances of having more than one child, which has been our goal since we first discussed about having kids nearly 15 years ago.  

Option 1 is very tempting.  This has been a very long and emotional road.  Moving to the next step would be hugely encouraging.  Up to now, the finish line has been a dot on the horizon.  One where you squint and ask, "Can we even get there from here?  If so, then how?  Are we even on the right road?  WTF, where's my GPS?"

Option 1 has one principle con.  Embryo #1.  Here's how this could all go down:

• Dr. S puts me on the path to embryo transfer.  This involves several days (weeks?) of progesterone oil injections (intramuscular shots in the gluteus muscle).  These are (as an IVF friend's 11 year old son eloquently described it), "an actual pain in the ass."
• These injections would help convince my body that it needs to grow a nice, healthy uterine lining that embryos love.  Once it's ready, my transfer procedure will be scheduled, and 24 hours before the procedure, the lab will defrost and take a sample of embryo #1.  They will send the sample off for a 24-hr turnaround genetic test.  
• Michael and I will walk into the downtown surgical center ready for the transfer procedure and get the results of the genetic test.  
• If the result is good, we will implant embryo #1.  If not, we will wait an hour while they defrost embryo #2 and implant it instead, which we know is normal.
• There is a chance that in 1 day, we go through both of our embryos and only have a 50-60% chance of successfully getting pregnant.
• In this case, if we are lucky enough to get pregnant with embryo #2, and lucky enough to have a successful pregnancy with embryo #2, we are likely out of luck for any other children with my genetics...18-24 months down the road, my ovaries will probably not make any more eggs, or at least not enough to make IVF a reasonable prospect.
• Option 1 starts to sound like a bit of a gamble.
• Sure.  Embryo #1 might be perfectly normal.  It might get us pregnant and give us a baby on the very first try, leaving us with the Lone Ranger for a 50% shot at baby #2.  This is the best case scenario, and it's pretty good, actually.

We thought hard about this option, but it didn't take us long to decide.  We are going with Option 2 and will try another retrieval round.  The estrogen priming gave us some good, even follicle growth in round 4, and maybe we can even improve on those results.  If a round 5 can get us one or two more, we would be making the most of the time we have now with my ovaries being somewhat responsive, and it could make 2 children a much better possibility for us.  

We can be tough.  I can do this again physically, and emotionally, it's amazing what some positive results can do...  I was actually sobbing to Michael on Sunday night that I didn't think I had it in me do it again if round 4 turned out with 0...in that moment, feeling that way, the guilt was immense.  Today, a mere 4 days later, I'm signing up to board the rollercoaster again.  ~6 more weeks of motivation, just like that.  

Thank you, Lone Ranger.  We hope to get to meet you face-to-face someday.

October 2016 - IVF #4, Believe it or not...

Yesterday morning, I set up an appointment with a counselor who specializes in helping couples going through fertility challenges to get some extra help understanding and working through big emotional challenges and decisions faced on the IVF journey.  Quite frankly, this round has been one of the hardest emotionally, and it will only get harder if this round were to fail...

I struggled with whether or not to post about this.  I know it can be controversial / taboo to discuss seeing a therapist, though many, many people do.  Michael and I have talked about seeking that extra help at a few different points this year, but have never pulled the trigger.  Mainly, the support needed is for me.  Helping me work through the emotional toll and try not to let it drag me down too far.  Michael has borne the brunt of that support so far and very successfully helped me bounce back to a more positive view of the path.  The decisions are just getting harder, and the continued disappointment is hard on both of us.  We are still a great team, and even more so now...this process hasn't broken anything in our relationship, thank God.  It's more about being sure we are making the best decisions we possibly can, considering all the angles, and navigating the stress, heartache, and disappointment in a healthy and positive way.

But this is really not the point of this post, nor the reason for it's title...

While I was on the phone with the counselor, Michelle called. 9:38am.  My heart stopped as I saw the call-waiting, and I knew I couldn't switch over.  I went into a panic:

"This is way too soon to know anything, right?  This must be awful news.  Something must have gone wrong...  Is it possible they lost the sample in the mail?  Did it arrive damaged or unusable?  The embryo is frozen now, they can't re-test it if there's something wrong with the sample.  Oh please, God, don't let this be more bad news."

I hung up with the counselor, appointment set for next Wednesday.  Maybe I should have asked her policy on emergency sessions for extra-bad news?

The voicemail from Michelle simply asked me to call her.  My ears pricked for any indication of the nature of the situation, but I couldn't tell from her tone of voice if it was good or bad news...she is infuriatingly even keeled.  Understandably so, I suppose, given the stress level of her audience...

Before retrieval, we had dubbed the follicles "The Fabulous Five"...then it was the "Fantastic Four" eggs, and the "Three Amigos" were our growing embryos.  This last one, we have been calling "The Lone Ranger".  So what does this call mean for our little Lone Ranger?

I sucked in a deep breath and called her back.  My fingers fumbled, dialing the wrong extension.  Redial.  She answered!  She is on the phone so much, I usually miss her and get her voicemail, then we play tag, but this time she answered.

Michelle:  "Genesis (the genetic testing company) received your embryo sample and because they didn't have many queued up for testing, they were able to process it very quickly."

Me:  "Ok..."  holding my breath...heart pounding in my ears.  Am I ready to know?  I thought I'd have more time!  This is happening too quickly!  I'm not ready for it to be over!

Michelle:  "Kelly, It's good news..."

Me:  "Wait, what?"  I swore I didn't hear that correctly.  I plugged my opposite ear to be sure.

Michelle:  "It's GOOD news...your embryo is normal.  It's normal."

Me:  "It is?"

Michelle:  "Yes."

Me:  "Oh my God!  Wow...wow. Thank you!!!  Thank you thank you thank you."  Tears poured down my face, and I sobbed (loudly) on the phone.  I didn't care...  I was so happy, I couldn't stand it. We were so afraid...7 days, it didn't look good.  The odds were against this, but IT WORKED!!

Me:  "Finally some good news!"

Michelle:  "Hahaha! Yes, I know, it's long overdue.  I couldn't wait to tell you."

Michelle:  "Do you want to know the sex?"

Me:  ::sniff, sniff::  "Yes! Well...  Yes, we want to know."

She told me.  Now we know.  Isn't science amazing?!

Our little embryo that took it's freaking time getting to blastocyst stage made it.  Who would have thought the results would come in far earlier than planned and be NORMAL?!  Michelle and our doctor have both said we are overdue for good news, and indeed they were right.  We are so thankful to finally have some.

I know you are thinking, ok "NOW WHAT?!"  I will post on that soon.  We have some choices to make, but for now:

October 2016 - IVF #4, Day 5, 6, & 7

This weekend was a little tough.  Saturday morning was the end of 5 full days of embryo growth.  Most competent / normal embryos make it to blastocyst stage by this point.  Well, not my embryos.  They see it fit to torture us for longer, drawing out the anxiety for at least a day or two more.

Saturday, after Michael and I spent a beautiful morning Racing for the Cure in downtown Houston, Michelle called.   She told us that none of the embryos had made it to blastocyst stage yet, but that they are still progressing.  They are (again, as in Round 2 and 3) classified as "stage = other"...not morula or blastocyst, but hopefully something in between the two.  Michelle then offered to check with the lab again on Sunday morning and give us a call then, something she is in no way committed to do, since Sunday is usually her only day off from making these calls.  Surely the embryos would figure themselves out by tomorrow...

Sunday.  She calls at 9:10am...earlier than usual..."Shit, WTF does that mean?!" I say to Michael as I put her on speakerphone.  She explained that she went into the office, but now she was leaving and the lab hadn't finished checking the embryos yet.  She would head home, log back on, and give me a call in a couple hours when she would likely get the update.  She didn't want us hanging on a thread all morning...she is really a saint.  I tell her thank you (two of three ways) before hanging up and taking a deep breath.

Sunday (end of Day 6), 10:20am, she calls again.  Report says embryos are STILL not there yet, but they have not yet degraded.  One is looking better than the other two, which haven't changed too much since Saturday (end of Day 5).  They are going to give them ONE MORE DAY, and she will call us on Monday morning.  She encouraged us to hang in there, and we said thank you again and again that she would take the time to let us know what was going on.

So Sunday morning we knew that the forecast for Monday was looking more like Zero with a chance of One.  Both of our blastocysts so far (round 1 - untested, and round 3 - genetically failed) made it to blast stage after 6 days.  The ONLY embryo we have had go to a 7th day promptly degraded in the 7th day (embryo 2 from round 3).  Taking this long is NOT a good sign.  Last night, it was really hard to sleep...you might argue I would have slept better if Michelle had just NOT called and waited until Monday morning to give us the update.  You might have been right, but sometimes it feels like ANY news is better than no news...

So Monday morning, I couldn't bring myself to go into work.  At work, I would be sitting in an open area or glassed conference room when I got the call, and I was pretty sure I was going to burst into tears no matter which way it went.  Michael stayed with me.  We were strung out on this waiting game together, and both of us needed to be together for this one.

We logged on to our work computers early and worked from home, keeping as busy as possible until the time Michelle called (11:29am).  Two of the embryos degraded and were discarded, but ONE MADE IT!  It was the same one that was 8-cells on day 3.  The lab sampled it for genetic testing and froze it for (hopefully) future use.  The sample will be sent off today, and Michelle will call us when the genetic test results by mid-next week.

Relief poured over us.  It wasn't zero.  Thank GOD it wasn't zero.  We knew without being told that it was more likely that something is genetically wrong with a blastocyst that took 7 days to form.  For now, that mattered less than the fact that we cleared this hurdle and there's still hope (even if it's small) that we could clear the next one.  As I expected, I cried for about 5 minutes.  Much of the tension and anxiety of the last month of round 4 was loosening briefly.

As you may have deduced by now, the bonus prize for achieving this success is...drumroll...MORE WAITING!  Hooray!  We haven't had enough of that yet!  Please, sir, may I have another?  I think I look so much cuter with my hair mostly pulled out...it's the new fall look, I swear, I saw it on PINTEREST!!  Ok, so I was feeling like I was extremely happy and mildly losing my mind at the same time.  This is a game (like so many in life) where success at each step means more waiting and anxiety for the next success or bad news.

I'm actually really, extremely, hands-shankingly thankful to have a chance at the next step with this little one.  I'm sad for the two that didn't make it, but that's just the way all this goes.  So far we've retrieved 15 eggs and only 3 have made it this far.  20%.  At least that's better than the batting average of most National League pitchers, right?