We Have Embryo's...

I woke up this morning feeling only slightly better than yesterday. Which isn't saying much. My retrieval was scheduled at 11am, but Dr. 3 was running behind. They had arranged my procedure to be the last of the morning because I had the most follicles of their patients also scheduled for the day. 17-18 that they could see. They wheeled me back to the  - what is that? an OR? - Whatever the name, it was a little surreal, let's just say that. I proceeded to lay on the table in the padded stirrups for what felt like an eternity while the nurse babbled on about my husbands chosen profession. In reality it was only about 25 minutes, and I was long gone within about a minute and a half of Dr. 3 gracing us with his presence. Afterward they managed to wake me up just before transferring me from the table to a gurney and I could hear the doctor telling me it had taken less than 20 minutes and that I'd done very well. I remember asking how many eggs they got, but he said he wasn't sure yet. Still, I persisted "lots?"... "Did you get lots of eggs?" And I'm pretty sure I remember them laughing at me.


The next thing I knew I woke up crying in recovery and asking the nurse for Brian. She gave me a heating pad for my abdomen and shot of a pain killer in my IV.  I remember several people asking me why I was crying, and to tell you the truth I'm not sure I could narrow it down to one specific thing. I felt relieved that this part was over. I felt grateful to see my husband standing over me with concern. But I also felt violated by the fact that I even had to go to these lengths to achieve such a common human experience. Parenthood. And suddenly none of what I was doing there made any sense.  How do blood draws, and stabbing myself in the stomach repeatedly with fine gauge needles, and procedures that require general anesthetic, and lab technicians, and petrie dishes... how does all this lead to motherhood? It felt so unnatural. Unfair.


But maybe that was just the pain talking. Because my mood quickly elevated from there. They gave me a box of apple juice, and propped me up so that I could feel a little more normal. Shortly after that I felt decent enough to change back in to non-assless clothes, and before we knew it Dr. 3 came in to sit down with us. First he reviewed the follow up "NK Assay" blood panel they had taken earlier in the week. Great news: The Humira and Dexamethasone had done their jobs and all of my levels were normal. This meant that I wouldn't be required to do the ($700 per session) Intralipid infusion until after a positive pregnancy test. The plan they initially set for me required one at the retrieval, one after the transfer and then every few weeks after positive betas. Whew, deep breath. Then he told us they got 19 eggs. Nineteen... We were  thrilled. 


I spent the rest of the day in bed with my new best friend Mr. Heating Pad. Seriously, if you have a retrieval pending be sure to pick one of these bad boys up. Brian took great care of me, getting up and down, going back and forth with my every whim. Dr. 3 told us that we'd likely get a call by "lunch-time" today with our fertilization report, but they tortured us until a little after 1pm. Out of the 19 retrieved, 11 were mature, and 9 fertilized normally. That's an 82% fertilization rate. Which is pretty good. Which is why I feel like a total asshole for being a bit disappointed that we didn't have more mature eggs. But such is the life of a PCOS gal. We can produce quantity, but not always quality. Intellectually I know that nine embryo's is good.  And I will keep telling myself that. NINE IS GOOD. But my poor little infertile heart wanted more. More mature, more to choose from, more to freeze. I know we're lucky to have this many and to have even gotten this far, so I'm going to end it on that. Nine is good, and we're lucky.


I won't hear anymore about the status of our embies until Thursday, when we go in for our transfer.  Please keep our little ones in your thoughts until then. Thanks again for all of your support.

November ICLW!

Each time I participate in ICLW I try to come up with some new-fangled concept for and intro. And today is no different! With that, I give you: Contributing factors in an Infertility Bloggers Life; via Bullet Point. Autobiographical.

1. An outlet of some sort became necessary approximately six months after we officially started trying, and my lovely husband couldn't understand why I cried alone in the bathroom every 31 days.
2. At that point I was still fairly certain that I'd see a positive pee stick in the very near future and shortly thereafter commence writing a wildly self-indulgent, and more than likely whiny pregnant-lady-type-blog.
3. Lingering only slightly in denial, we didn't have any testing done until after 14 months of trying.
4. A week before Christmas, 2008 we found out we had Severe Male Factor, and were instructed to go directly to a Reproductive Endocrinologist.
5. Before even seeing an RE, we promptly decided not to have children at all.
6. That resolution only lasted about two weeks.
7. Fast forward to now, and we are gearing up for our very first IVF cycle in January/February, though I'll likely be starting BCP's towards the end of December.
8. In an effort to circumvent my crying over MUCH spilled milk, you can read about my sordid past here. It gets down to the nitty gritty of exactly what happened from the time we were diagnosed, to the beginning of what would be a break in TTC, and ART for pretty much all of 2010.
9. The new RE we're seeing (referred to here as Dr.3) ran an obscenely comprehensive blood panel on me and it came back positive for MTHFR (two mutations of the A1298C gene, with a borderline homosteine level), Elevated TH1, TH2 and Natural Killer Cells. Awesomeness. Oh, and also Ovulatory PCOS - different than Classic PCOS - cause ya know - I'm an over achiever... Okay, not really.
10. None of the aforementioned diagnoses were ever found by my previous RE(s) because they don't believe in Immunological Disorders. Or paying close attention to Antra Follicle counts evidently, because the OPCOS is as clear as day on a baseline u/s, and should have been determined easily based on the knowledge of my 30+ day cycle.
11. I'm over the misdiagnosis - CLEARLY.
12. I know you have 742 other blogs to read and comment on, so I'll keep it brief and end it here; welcome you to my blog and thank you in advance for your comment, then tell you I look forward to reading all of your blogs as well. Oh, and if you're going to be cycling with IVF close to when I am, be sure to say so in your comment - I'd love to stalk you and compare Lupron induced rants notes!

Taking The Long Way

Hey kids, sorry for all the drama on my last post. I sort of forgot what it was like to have no control over my life whatsoever. Ahhh infertility, you haphazard bastard- I kind of missed you.

Okay, not really...

So my appointment wasn't all bad. Except for the part after I'd gotten home and realized that I had shaved one leg twice, and the other not at all. That must have given Dr.3 a great impression. ("She'll probably Follistim her eye out", I'm picturing him telling the nurse) And I know I did one leg twice, because I switched razor blades on the second round... In case the first explanation didn't quantify my incompetence enough for you.

I digress.

The ultrasound. Right. So I made Brian go with me. To a baseline ultrasound. At first I wasn't going to ask him to come, but then I realized that this was the first appointment meeting our new RE (whom I've named Dr.3) and I really wanted him there. And truthfully having him with me gives me a sense of calm. It's like having someone to sit with on the first day of school, ya know? Anyway, the ultrasound was pretty standard, he pointed out my uterus and the lining, my femoral (right?) artery pulsing, then went on to each ovary and the follicle counts. It was at this point that he casually mentioned the OPCOS, in the same demeanor I'd imagine he'd have if he was telling me I had green eyes. I realize that this is common place for him, and essentially good news, but all I could think about is how TWO other RE's who'd seen my charts and gave me ultrasounds had never seen this, but Dr.3 nailed it over the phone. Meanwhile the vein in my forehead began pulsing and I could barely construct a sentence. He finished up, and told me about the Metformin, while I nodded likely with my mouth open, and he sent us on our way.



I will say that I have not thus far, noticed any side effects from the Metformin. I've heard from two IRL friends that it can be pretty nasty so I was a bit apprehensive about starting it, but I'm grateful to say it's been fine. Except that I can't really drink alcohol with it. Not that I was a big drinker before, but Dr. Google says the use of alcohol with this medication can disrupt the normal functions of my kidney and liver... Not quite the same as putting up with the runs.


Having now had a few days to cool down, I am a little more grateful for the diagnosis and the fact that it's potentially a good thing. Dr. 3 wants to put me on a Long Lupron Protocol, though I'm very familiar with most aspects of IVF, the medication protocol is my weak spot. Have any of you done the Long Lupron protocol? So far I've read it's typically very successful for first timers but of course I've come across a few horror stories about over suppression. What say you veterans?

Something That Could Have Been Brought To My Attention YESTERDAY

Or two fucking years ago, before we spent six months and thousands of dollars on DIUI's that were NEVER GOING TO FUCKING WORK.

I have Ovulatory Polycystic Ovarian Syndrome. Different than "Classic" PCOS.

(Thank you Meg, for the link.)

Yeah, I've never heard of it either.

Maybe I would have, had I been diagnosed TWO FUCKING YEARS AGO. Because then I would have known that one of the symptoms of OPCOS is an elevated blood sugar level which can hinder implantation - KIND OF A BIG FUCKING FACTOR don'tcha think?!?!

So yesterday I had my CD3 Antra Follicle count. Our new RE (I need to come up with a name for him) wanted to see my ovaries in an "unchallenged state", meaning before there was a dominant follicle present. He quickly counted eight resting follicles on my left, and 12 on my right. FYI, the average for most women is about 10-12 total between the two ovaries. I have 20.

He mentioned something about this on the phone consult Saturday, but honestly I didn't have any idea what he was talking about, because I knew I didn't have any of the "Classic" Polycystic symptoms. But evidently he saw it coming because I have a 30 day cycle, which is a indicative of women with OPCOS. The only good thing about this is that it means I am likely to yield a higher reserve of follicles on a low dose of stims.

He wants me to start on Metformin asap. He says it will essentially make me "more fertile". And thanks to the link Meg sent me, I now know that is because the Metformin will regulate my insulin levels therefore bypass any implantation problems. He also said he will keep me on it until I am 12 weeks along, because it can also decrease the risk of miscarriage for someone like me.

I know I should be happy about the fact that it's finally been diagnosed, and our RE just kept reassuring me that it's actually a good thing because it means I'll be a better than average responder. But just having found out - I'm pretty hung up on the fact that this wasn't caught sooner. It kills me to think about how much time and money was wasted, but most importantly how the failed cycles caused such an epic amount of unnecessary heartache. Really the time and money was one thing, but the depression that followed not only comprimised my marriage but has forever changed who I am as a person.

Oh and now I have to sit with what else could come back from the rest of my blood tests. And all TWENTY-FOUR vials that they took!!!! It was twenty three, but the lab called later yesterday afternoon to tell me they had forgotten one. GAH. And fuck, what if the insurance deception doesn't work?!?!

Commence Meltdown.
(Number One)