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.