Hope needed

3 weekends ago, the doctor transferred 2 viable embryos on a day 3 transfer. Out of 7 follicles, 4 embryos resulted after ICSI. I was a complete mess around the time of retrieval, worrying the same bleeding complication would happen again but thankfully, I was alright. When hubby and I received the call about the 4 embryos, we were tickled pink to hear there were that many. I was definitely surprised going into retrieval thinking there would only be 4 follicles.

Then the 2 week wait came and passed and I finally had my beta test last Wednesday which was negative. To date, I have not experienced a positive beta, not even a low one. So after meeting on Friday with our RE, hubby and I are left to think about another IVF cycle, this time with a low dose protocol. My doc even wants to remove the estrogen patch and if necessary add birth control pills if my FSH is high. The high dose I was on may have affected egg quality. Of course this was indeed a blow to myself, sitting in that office chair feeling pretty helpless about my reproductive state.

My husband and I were really hoping this cycle would be our last one because after 3 cycles, the financial burden is no longer something we can ignore. For us, each IVF cycle costs us around $15K. This is because our insurance does not cover advanced reproductive services such as IVF in addition to the high deductible before any coverage begins. You hear people talk about being house poor, well, I don’t want to be infertility poor. For those contemplating IVF, financing is a huge stressor for many. Now, cost is a bigger part of the equation.

So where are we at? Well besides AF hitting me like a tornado, I’ve been feeling the usual high and low every time one gets the negative beta news. Funny how it doesn’t matter how many times you’ve experienced the news, you still go through the same emotional rollercoaster ride. And as always, I always feel a level of self-hatred as if I had a role in placing myself here. My husband of course, reminds me of how much he loves me and that I shouldn’t blame myself for anything.

For the most part, we still feel as if there is hope for us, however my RE reminds us that if the next cycle, possibly 2, doesn’t result in even a low beta that we should start contemplating egg donation.

Today, I am ordering my meds just so I have them and start on Day 2 again (next month starts a new deductible. Gulp.) Who knows, maybe the lower dose protocol will produce better quality eggs. The co-culture didn’t add much to the cycle so my RE doesn’t want co-culture next cycle.

In the meantime, I will be on the lookout for the baby stork. I seriously could use some hope over here.

 

IVF Co-Culture – Scheduling and Basic Info

 

I wanted to write a post about (IVF) Co-culture to help those who have been recommended it and need some basic information. When my doctor first recommended the procedure to me I couldn’t find much info online or in the forums. My post references the info I obtained by scheduling a co-culture  biopsy date at New York Hospital Weill Cornell’s  Infertility Center, the Ronald Perelman and Claudia Cohen Center for Reproductive Medicine. Please keep in mind, this info is basic and specific to this center. The protocols at your center may be different so always discuss your concerns and questions with your RE or your infertility nurse.

 

Just to give you a quick review, since Fall 2010, we have been through 5 IUIs and 2 IVF cycles, all without success. The 1st IVF in 2012 resulted in 8 eggs, 6 fertilized (without ICSI), 3 transferred, none frozen. 2nd IVF resulted in 2 eggs, 1 fertilized,  1 transferred (I did have some empty follicles!@#$$%^!!!!).

Protocol in 2nd IVF was different with the addition of Clomid before stimming and delaying trigger until the follicles were larger and more mature. The embryo quality in the 2nd IVF was of poorer quality which brings us to the Co-culture recommendation. For the next IVF, the plan is to add co-culture and go back to a protocol similar to the 1st without Clomid since it did not help.

 

Here’s what I learned:

  • Not many centers perform this procedure
  • Co-culture involves biopsying the uterine lining to harvest the endometrial cells. The cells are prepared and grown in a dish for about a week then frozen. They are thawed close to retrieval time. The embryos are placed on the cells the day after retrieval. The idea is the cells help the development of the embryos and hopefully improve quality.
  • Biopsies are performed Tuesdays and Thursdays only
  • Biopsies are performed in the luteal phase  5-12 days after your LH surge
  • LH surge must be monitored with an ovulation kit, cycle where co-culture biopsy is scheduled, you CANNOT try to conceive on your own
  • Blood has to be drawn prior to biopsy and again during the stimming cycle before HCG (in an IVF cycle)
  • All cervical culures must be complete and not beyond 1 calendar year of biopsy date
  • It is possible to have co-culture biopsy and go straight into an IVF cycle
  • The charge for co-culture is $1000 US payable when you start the IVF cycle
  • There is also a doctors fee
  • Biopsy is performed without any anesthesia. It is recommended I take Ibuprofen 400-600mg an hour prior to the procedure.
  • They say I can return to work after the biopsy and moderate cramping can occur

 

Since I haven’t had the actual biopsy yet, I can’t say describe what it feels like so I’ll add that in another post afterwards.

Ever since the complication in December, I get so anxious when I have to go back to the hospital! Wish me luck!

 

 

 

 

My Other Journey – Living More Green (Something more fun than Infertility!)

Ever since we started our infertility roller coaster, I have been working hard on this (other) goal of becoming healthier. Not only have I focused on my weight, the foods I eat and mindset, I have also been mindful of the products I use. I have read when women prepare to start a family; many of them make lifestyle changes. Perhaps on some level, this has happened to you. I have read women stop drinking caffeinated coffee or switch to decaff. Some quit habits such as smoking, drinking or doing drugs. Others start exercising and eating better. Personally, I did switch to decaf coffee, started exercising and eating better. I also decided to change things up by switching the chemical laden products I used to simpler, more natural products and that’s what I share with you in this post.

I recently picked up a book by Dr. Alan Greene called RAISING BABY GREEN. I haven’t read the entire book yet but have read through the chapters important to me. One thing I like about the book is it’s divided into specific chapters so I can read what I want. So far Chapter 1 speaks volumes to me. I have never been a fan of artificial ingredients like sweeteners or artificial colorings and have been more of a naturalist at heart but this chapter really enlightened me. It’s titled, The Womb, and hits home the effects of the environment on a mother and baby. I wanted to share some startling points for me:

  • The umbilical cord study (study by Environmental Working Group which tested the umbilical cord blood of 10 babies born in US hospitals for industrial chemicals. The results are scary; over 200 chemicals were identified).
  • How buying organic foods has much positive impact: on our drinking water, milk (think growth hormones and antibiotics), fruits and vegetables, on our soils and lands, the treatment of agricultural animals, hormones used in livestock and how many billion barrels of oil are imported annually.
  • How something simple like switching the regular foods your children eat to organic versions can reduce or eliminate the breakdown products of pesticides found in their urine.

I SO don’t want any of these or any other chemicals in my body or my families’. So in the past year, I already decided (probably like many of you) to get my body into prime baby making (and baby keeping) shape. I started researching chemicals and what their potential harmful effects are and decided to simplify and de-toxify my life as much as possible. So far, these are the items I’ve switched out, but it’s still a work in progress.

     BPA

To avoid this estrogen mimicking chemical, whatever I use that comes from a can, I have either purchased it in a BPA FREE can or buy it in dried version (e.g. beans). I personally use Eden’s Organic Cannellini White Kidney Beans. Instead of paying US$2.99/ can at the outside grocer, I can pay US$1.86 online (which is a huge difference).

I’ve also changed food containers from plastic to glass. Dr. Greene in his book advises to minimize eating and drinking from plastics with the recycling numbers 3, 6 or 7 because harmful chemicals can leach out. He says to opt for symbols 1, 2, 4 or 5. Even better is if you carry your food or water in stainless steel or glass containers. I carry my water in my SIGG Hello Kitty Aluminum bottle! (The lining is BPA free and it’s way cute!).

     Chemical exposure

To lessen the amount of chemicals exposed to my skin, I looked at the products I use and did Spring cleaning.

  • I replaced my (favorite) Bath and Body Works anti-bacterial hand soaps (filled with Triclosan) with Dr. Bronner’s Castile liquid soap. I use it to clean the dishes, bathroom sink, tub and toilet (added with baking soda and a little dilution). It’s a pretty versatile soap.  The best part is I scent the hand soap with a few drops of Lavender essential oil and I am in heaven (I just love Lavender!).

Chemicals just have harmful effects. They’ve been known to cause allergies, skin problems, disrupt and mimic hormones and cause cancer. They are showing up in our bodies, our waters and our wildlife. I do think of what the impact of all these chemicals will be on our health decades from now as well as our children we all are trying so hard to conceive (and boy, hasn’t it been hard trying??!)

  • Replaced artificially colored and fragranced lip stains with Burt’s Bees Honey Lip Balm and Crazy Rumors Hibiskiss lip color.
  • Replaced chemical sunscreen (Neutrogena Helioplex) to a mineral sunblock. (I totally loved the sunscreen until I developed an allergy to the chemicals. I was horribly itchy with red bumps every time I used it). Badger’s Baby Sunscreen uses NON Nano zinc oxide and contains mostly organic ingredients. For lip protection, I use Alba Botanica Mineral Terra Tints SPF 15 and Loving Naturals Sunscreen Lip Balm SPF 30. The Loving Naturals has a more pasty texture due to the higher percentage of zinc oxide (24.8%) compared to the Alba brand (5.5%). The Alba has a hint of color whereas the Loving Naturals does not.
  • An interesting tidbit about decaffeinated coffee, it still has some caffeine in it! But besides this, did you know there are several ways coffee beans are processed to lessen the caffeine content?? I sure didn’t know until I read about it in RAISING BABY GREEN. The 2 ways without the use of chemicals are the Swiss Water Process and CO2 process. The other methods utilize chemicals! OMG. The things I did NOT know!!! Now I only buy decaf coffee marked Swiss Water Press or has the logo.

As you can see, I’ve become semi obsessed, ehem, PASSIONATE about my other goal detoxifying our lives. I hope by making small changes here and there will make us healthier down the line. It’s been fun researching and trying out new ways of doing things. It’s also been very helpful to have my mind on other things besides injectable meds and ultrasounds! (We love those don’t we???).

I recently started working out again which has been great. To compete with my fast metabolism, I’ve been focusing on more healthy proteins, more high fiber veggies and fruits (can’t forget the carbs though, luv my rice and pasta!). After my complication post retrieval, I was so worried about losing all the weight I put on last year. What a feat!!! Not one pound lost!

2012 was the first year I started purchasing organic produce. For anything I cannot buy organic, I use this to wash; Environee Fruit and Vegetable Wash.

For those concerned about pesticide amounts in produce, here’s a helpful list made by the Environmental Working Group, http://www.ewg.org/foodnews/summary/

Arsenic in food,

http://www.consumerreports.org/cro/magazine/2012/11/arsenic-in-your-food/index.htm#chart

 These are just some of the changes I’ve made. What are some things you’re doing to change it up and get healthier??? Please share what interesting facts you’ve learned and what kinds of products are you changing up???

This one’s dedicated to my online peeps!!!

My sanity would not be here without you!!! Xoxo

hopin’ and prayin’ for us ttc 2013

Complication after IVF Retrieval – part 2

Monday 7am- 11:30pm

(20 hours later post IVF retrieval) By 7am, I was in so much pain, it hurt with each breath in and out. Apparently, bleeding into the belly is very irritating and causes your body to produce prostaglandins which are responsible for pain. At 7am, the Attending physician came by to see me. He was not happy with what he saw. I was in terrible pain. I had only had 1 bag of saline. I was feeling thirsty and not looking well at all. He spoke to us briefly and explained my RE will try to stop by after her office hours at a satellite office. After he left, there was a shift change and things got better from there; at least on some levels. The next 16 hours were filled with more blood draws, a second IV, and even a Foley catheter! Many residents from the GYN service also came to see me, so many that I lost count. My torso pain started to subside by 12 noon, I was waiting in the ER for a bed. By 11pm, a bed became available and I was transported to my own private room. My RE was really great and supportive. She made phone calls to try and get me a room sooner.

 

Monday 11:30pm – Tuesday 11:30am

I could not sleep after being admitted to the floor. I admit, the quiet was very welcomed after spending 24 hours in the noisy ER. My abdomen had gotten quite distended and was making it uncomfortable that I could only lie on my back. I managed some shut eye only to be awoken by one of the doctors around 5:30am. Sleep is not something you get a lot of while staying in the hospital. Another blood draw shows by 11am, I had lost even more blood. At this point, I am in danger of having a heart attack. My RE recommended a blood transfusion. Immediately terrified, I started to tear up and cry. I was so scared. None of us wanted a transfusion but none of us wanted me to have a heart attack either. My RE and the other doctors felt confident the bleeding had stopped and luckily I did not require surgical intervention. How crazy is this???!!! So I conceded to the transfusion because I could feel my head start hurting and I actually started to not feel well overall. I knew what needed to be done. The rest of the day was spent in bed with 2 units of blood slowly infusing. I tried to look at the bright side saying to hubby that at least these types of life saving measures are available. One bright moment in this long journey was 1 of the 2 eggs retrieved matured in the lab and fertilized. Our little miracle embryo. The next day would tell if I would be strong enough to undergo transfer. So of course, I was on a mission to get stronger in case the embryo continued to divide and was viable for transfer. Hubby and I definitely felt this to be surreal. In the next 24 hours, I became strong enough to leave the hospital. My RE felt resting at home would be better than the hospital, so she discharged me. Thursday morning, we anxiously awaited for the phone call from my RE. She said the embryo was a viable one and that I should come in for transfer. After all we had been through, we had 1 embryo to place back. Hubby and I started calling the embryo, our miracle embryo. Although it’s only a 10% chance for success, we’ll take it for now.

Since last week, hubby and I have only just begun to process what happened and what lies ahead for us. I can only focus on getting stronger, getting my endurance back and hubby focuses on taking care of me and then work. We plan to speak to the RE about what happened. We just want to make it past these 2 weeks.

Please keep us in your thoughts and well wishes. It has been 1 crazy week.

 

Complication after IVF Retrieval –Part 1

When hard or challenging situations happen to you, you always wonder, “Why is this happening to me?” and you never believe that it would actually happen to you. I want to share what happened to me after our IVF retrieval this past Sunday in December 2012. Here’s the time line of events:

 

Sunday 11am-4pm

Retrieval finished by 11am and discharged home without complication. Hubby and I went home, had lite lunch and I took a nap because I was feeling tired. At 4pm, I awoke to some lower abdominal cramping, which I thought was normal because of the retrieval and took 750mg of Acetaminophen and went back to sleep. I did have one dose of Tylenol 975mg around 11am after retrieval.

 

Sunday 6pm – 11pm

Around 6pm, I did have the urge to empty my bladder so I got up out of my bed, sat up and slowly walked to the bathroom with my husband which is about 10-12 footsteps away. I was already feeling slightly dizzy. I sat on the toilet, emptied my bladder as well as had a bowel movement. I was in a lot of abdominal pain and was feeling very constipated. Later I learned this was due to the medications taken during the IVF cycle. I had never experienced constipation like this before. The need to strain was especially hard with the pain, and within a few minutes after sitting on the toilet, I started to feel extremely dizzy. After I finished my business, I stood up and felt so dizzy I needed to lower myself to the floor. In addition to feeling dizzy, I would sweat profusely and feel as if I was going to pass out. I literally saw stars. My husband said a few words to me and I could not even hear him. I called my husband to come pick me up and bring me back to the bed. I wasn’t sure what was happening and why I was dizzy. My first thought was I was reacting to the anesthesia or pain killer since that was the last thing I took by mouth. Within 10 minutes of laying down, my dizziness subsided. I thought this would be temporary so I drifted back for more sleep. At 8pm, I again needed to empty my bladder so I asked my husband to help me up. This time, I was dizzy within 15 seconds of sitting up and I was feeling worst. I actually had to lay back down to feel better first. My husband has an office chair with wheels and had to place me in the chair to wheel me to the bathroom. After emptying my bladder, I immediately asked my husband to place me back in the chair and hurry me back to the bed. I was very dizzy before reaching the bed. My husband told me later, I appeared as if I were having a seizure because I was shaking and my eyes were rolling up to the top of my head. After about 15 minutes and lying in the bed, I was no longer dizzy and felt better. I was no longer actively profusely sweating.  My husband and I were getting a little worried and even researched the side effects of the anesthesia and pain killer I had taken. When you look up medications, the side effects could be endless and all encompassing. I decided I was hungry and asked hubby to make dinner. I was able to eat a few bites of rice, fish and vegetables. As the night progressed, I was getting more and more worried and asked hubby to call the doctor on call. He called back within 15 minutes and got the details from hubby. He said he wanted to speak to the Attending physician who then called us. After going over the details of the day since we got home, he said the best thing to do was to go to the Emergency Room. I knew I couldn’t even walk to our car parked outside, so we needed to call an ambulance. My concern at this point, “Are the EMTs going to take me to the hospital I had my procedure in?” When you call 911 in NYC, they EMTs are not required to take you to the hospital of your choice. They can take you to the closest Emergency Room. Luckily, the EMTs were very understanding and took me to the hospital where I had my retrieval because it wouldn’t make sense to take me anywhere else.

The EMTs were great, they took me to my hospital after taking my vitals. I had never been in an ambulance before! It was kind of scary, dark and cold. Plus it was pouring outside on the way to the ER. What a day thus far! I was scared but feeling good that I was going to the hospital in case my condition turned worse. You don’t want anything to happen to you over night while sleeping.

 

Sunday 11pm – Monday 7am

Hubby and I must have arrived in the ER sometime after 11pm. After receiving report from the EMTs, a nurse came by to check my vitals and checked my blood sugar. She asked me what happened and we told her the events that led up to that point. The Attending physician was in touch with the ER and the covering physician was on his way to see me. I was quickly wheeled into one of the patient areas covered only by a curtain where a doctor came and drew my blood. This was necessary to evaluate my blood count. More doctors and nurses came to speak and ask us again to recall the events of the day and also my medical history. My covering doctor finally showed and spoke to us as well. He soon left perhaps an hour later. Tests were ordered and I was to stay in the ER. Around 2pm, I was taken for a sonogram. At this point, I couldn’t sit up without feeling extremely dizzy, had extreme abdominal cramping and started to feel pain on the tops of my shoulders. I had never been in so much pain in my entire life. I have a high pain threshold but even this was way beyond my breaking point. The doctors didn’t want to give me anything because they didn’t want to mask anything if another symptom arose. It was around 3pm at this point. I have not taken any pain meds since 4pm Sunday afternoon.

This is 11 hours later.

The sonogram was extremely hard for me. Moving from the ER bed to the exam table was horrendous. The worst was when the technician asked me to empty my bladder before doing the transvaginal  ultrasound after the external ultrasound. Between the pressure on my abdomen and the poking of the device was enough to almost make me pass out. I nearly did pass out when I experienced another dizzy episode when turning on my side to empty my bladder getting onto the bedpan. The profuse sweating and almost fainting sensation hit me again. It was so frightening. I can only imagine what my husband was going through watching me. Poor thing. He must be traumatized too after all this. My husband became my hands and helped me to undress, mobilize and clean me up. Finally, when the test was done, I was brought back to the ER, behind the famous curtain. It was at least 30 minutes after I had returned, still my nurse had not returned to connect me back to the monitors and my husband didn’t know how to connect me. He went to look for her but she was no where to be found. Despite my pain, I could still manage to think clearly and know this wasn’t good. If my blood pressure was to drop any lower, it could mean I was getting in serious trouble. Near 4 pm, another nurse came to draw more blood. I asked him if I could have an IV because I was feeling dehydrated. He said he would have to ask my nurse. I overheard him asking my nurse who then asked “Is she hypotensive?” I was pretty appauled because I wasn’t even connected to the monitors that measure my blood pressure! Close to 4am, my nurse did come to bring me a bag of saline to infuse and I asked her to please reconnect me to the monitors. Could you believe my disbelief?!!! By 6am, the infusion had finished and she came to take the finished bag away. I was in so much pain on my front torso, I didn’t bother saying anything to her. Sometime before 6am, another doctor came to draw more blood. They informed me and hubby, I had bled into my belly and would be admitted to the hospital.