IVF Cycle #3 – Hope this One’s the Last

So evidently, my pregnancy tests were all negative (after trying on our own) and we decided to start IVF Cycle #3. In my earlier 2 posts, I talked about the IVF Co-Culture I went through at Cornell. In this cycle, they did draw an extra vial of blood for the Co-Culture process. I’ll provide an overview of what’s transpired already in this 3rd IVF (hoping it’s the last!). My RE did say this protocol would be more similar to the first protocol I had but ultimately she did make a minor tweak in the Menopur dosing. Instead of 150 IU, she increased it to 225 IU.

DAY 12 – LH SURGE

DAY 20 – START CLIMARA PATCH #1 (8 DAYS AFTER SURGE)

DAY 22 – CHANGE TO PATCH #2

DAY 24/ DAY 1 – CHANGE TO PATCH #3. NEW PERIOD STARTS

DAY 2 – GO IN FOR BLDWORK + U/S. SIGN CONSENTS. PAID FOR CYCLE FEE. INJECT GONAL f + MENOPUR 225 IU EACH X 4 NIGHTS.

DAY 6 – BLDWORK + U/S. INJECT GONAL F + MENOPUR 225 IU X 2 NIGHTS.

DAY 8 – BLDWORK + U/S. 4 -5 FOLLICLES SLOWLY GROWING. EXTRA VIAL OF BLD DRAWN FOR CO-CULTURE (ABOUT 25 CC). INJECT GONAL F + MENOPUR 225 TONIGHT, THEN ADD CETROTIDE 1 CARTRIDGE TOMORROW NIGHT.

DAY 10 – BLDWORK +U/S. SAME FOLLICLES STILL GROWING. CONTINUE PROTOCOL X 2 NIGHTS.

DAY 12 – BLDWORK + U/S. SAME FOLLICLES SLOWLY GROWING. CONTINUE GONAL F + MENOPUR 225 IU AND 1 CETROTIDE CARTRIDGE.

DAY 13 – BLDWORK + U/S. SAME FOLLICLES NOW ABOUT 15-16MM IN SIZE. 1 SMALLER FOLLICLE AROUND 12MM. INJECT GONAL F +MENOPUR 225 IU AND 1 CETROTIDE CARTRIDGE.

Today is DAY 14 and so far I am waiting for my phone call from my nurse. As of this morning, retrieval date could be this Wednesday or Thursday. I saw my RE last week and asked her who would be performing my retrieval this week (of course this was the main thing on my mind!). she informed me it would not be the doctor who performed my last retrieval and that she would not put me through that just because she thought it would be too traumatic! (like thank goodness).

As it turned out, I did see the doctor who performed my last retrieval in the hall (I don’t think he saw me) and as I waited in the room, I could feel the fear hitting me as my thoughts drifted back to December last year. I could feel my eyes starting to feel funny like when you’re about to cry, but somehow, I held it together and brought myself back to the present. No one thinks this complication I had in December will happen again, so I am counting on them to be right. I’m just taking it day by day right now and when retrieval day comes, I’ll just have to to brave (GULP!).

So that’s where I’m at now. Wish me luck! I hope this IVF cycle’s the last!

 

IVF Co-Culture Done, IVF #3 On the Horizon

It’s been quite some time since my last post, but of course life always manages to throw some extra challenges our way. What’s been going on in the past few weeks?

At the end of April, I went in for IVF Co-culture. I think I put too much thought into the procedure and it actually wasn’t bad at all (causing myself a bit of needless anxiety). The day before the co-culture biopsy was to take place I went in early for blood drawing. In total, the assistant filled 6 or 7– 25 cc syringes. It wasn’t too bad, I made sure I ate breakfast and she used a butterfly needle. I think my anxiety about the blood draw stemmed from my recent experience in the hospital. The multiple blood draws daily, the IV and blood transfusions has made me want to run away from hospitals for good! OK I digress…

Getting back to the IVF Co-culture…

One hour before the biopsy, I took 400 mg of Ibuprofen as instructed. After a negative urine pregnancy test, the assistant took me to the procedure room. The room is actually the same type of rooms used for ultrasounds during IUI or IVF cycles. The biopsy took about 10 minutes in total. A speculum is used, then a catheter is inserted to suction the sample of tissue. The sensation you feel during the procedure is very mild cramping and the tissue suctioned is immediately placed in a cup. I had no problems getting dressed and making my way back home via the train. Spotting is common but I did not experience any. Thankfully, I survived this one without complication!

Also in the same month as co-culture, I started to experience panic attacks. For those of you who have never had one, it’s actually a pretty scary thing. Basically, you feel as if you can’t breathe, feel extremely anxious and you’re afraid you’re going to die. Sounds overly dramatic? Not to the one having the panic attack. So I’ve been going to therapy for about a month now and have gotten over the cycle and fear of my anxiety attacks. My therapist thinks the attacks are partly due to post traumatic stress from my recent stay at the hospital (see complication after IVF post). Mentally, I feel stronger than I did in April when my panic attacks started. Emotionally, I am feeling more stable and not a hot mess whenever someone would ask me “how are you doing?.”

I am happy to report I can ride the NYC subways without fear of an impending anxiety attack now! Hooray! It has taken me quite a bit to get to this point. Working through anxiety is tough sh@#$%t!

So what’s on the horizon? Hubby and I are still ttc on our own but decided if no ++ turn up on the urine sticks then IVF cycle #3 it is (gulp). A few months ago, I definitely couldn’t wrap my mind around another IVF, but now I can think about it and not be frozen with fear. We just pray for no complications this time.

Stay tuned possible IVF #3 mid July.

(the center is closed for most of June!)

 

 

 

 

2013 A New Year for Trying

It’s been some time since my last post. I confess I have not been in the best of spirits since my complication in December. In my last post, I was still holding onto a bit of hope for our miracle embryo but again, it wasn’t our time yet as we found out on Christmas Day, our embie didn’t implant. 2013 is a whole new year for trying to conceive.

Since I was already feeling down, sad and slightly traumatized after everything, my wounds needed more salt rubbed into them, apparently. During the day, hubby and I attended a Christmas party with more than a hundred people. Some people knew I had been in the hospital and asked how I felt. It was pretty hard not to break down and cry in front of them, but I somehow managed to keep it intact (mind you I was only feeling 80% recovered). Then during secret santa, our newlywed friends announced they were 4 months pregnant. 4 months pregnant after their wedding 5 months ago! It was one of those days you never want to replay. Everywhere I went, someone else was telling me they were having a baby. When hubby and I arrived home, one of the workers in the building informed us he and his wife were expecting their second child in March 2013. I told my husband if another person told me they were expecting a baby that I would scream. My sanity was dangling by a thread.

New Year’s came and we stayed home to relax so I could recover more. 10 days later, I decided I was ready to face the “what’s next” meeting plus we had questions we wanted answers to related to the complication. Hubby and I met with our RE and talked for 40 minutes or so. The weird thing is, there are only 2 topics that stuck to my head; donor eggs and third cycle. Well, when donor eggs came out for discussion, I had no words because I was in shock. Hubby immediately responded that we felt we were not at that point yet. Nonetheless, she told us to think about it because it would still provide us with a child that was half ours biologically speaking, without placing me at risk for complications again. I’m still working my head around the donor eggs. Of course if possible, I would still like to try to have our own biological children. In terms of a third IVF cycle, she’s prepared to have it play out this way:

  • Protocol similar to 1st IVF cycle
  • Add co-culture procedure (only a few centers do this anymore)
  • Stay on estrogen patch before stimming meds and after transfer
  • Stop stimming meds earlier when follicles reach about 15-16mm

My RE did say that our chances for success with IVF now have gone down to 20% when they were about 40% for cycles 1 and 2. The Clomid trial for the 2nd cycle didn’t help our embryo quality in any way. It seems the 1st protocol yielded more and better quality eggs.

Our RE also informed us this complication I experienced was rare and really seen in women with greater quantity follicles (where I only had 4). For some reason, my body failed to stop bleeding where it should have.

She checked my abdomen via ultrasound and found very minimal blood and fluid left. If I wanted to go ahead with co-culture, I was able to regardless of when I wanted to start a 3rd IVF cycle. Co-culture requires a biopsy of the uterine lining to harvest then freeze the cells until time for transfer. The idea is these helper cells may increase chances of embryo implantation by adding growth factors or removing toxins from the medium. This has to be done at least 1 month in advance of an IVF cycle as a biopsy and without anesthesia.

At this point, I’m barely able to keep back the tears. After everything, it just wasn’t what I wanted to hear. She brought me right back to when she told me I should receive a blood transfusion!

Since that visit, I’ve been trying to keep busy. I went through days of severe depression, self-hatred of my body, oh and of course, tons of crying. I somehow thought my days as a nurse driving myself so hard for so long had somehow taken a toll on my body. 13-hour days, 5 minute lunches, standing on my feet, juggling 40+ patients a day, referrals, treatments, and all this in a very stressful work environment had caught up to me. I’m only 38! This year, I promise to really love and take care of myself; to say yes to myself more. I’ve decided, I’m the patient now.

I still have to try. I need to think positive. I haven’t reached my end yet.

Hope and success in 2013 for me and all my friends. xo

IVF Cycle #2 – Part 1

Here’s an update on our IVF Cycle #2 and what’s happening. Cycle # 2 started when I received my LH surge using the home digital ovulation kit. I called the center nurse and she instructed me to start wearing Climara patch #1, exactly eight days later. I was to change the patch every other day until the infamous period came or if no period came by the fourth patch, I would have to just go in to the office. I wore the patches as instructed through the 3rd patch when Day 1 came. So on Day 2, I went in to the office to start my monitoring. During this visit, I met with an IVF nurse who reviewed my protocol and answered any questions. If the blood work and ultrasound looked good, I would get the green light to start. In this 2nd IVF cycle, my doctor did make some changes for hubby and me. One change is the addition of Clomid. Hopefully, Clomid will enable my body to find the best quality eggs for this IVF cycle. We won’t know if the Clomid provided any benefit until my doctor sees the embryos to assess for quality. Luckily , all my results were good so we could proceed with the protocol. This is what the first half of the 2nd IVF cycle looked like thus far:

 

Day 2: Blds, U/S, Start Clomid 50mg x 2 tabs between 7-10pm

Days 3-4: Clomid 50mg x  2 tabs each night same time frame

Days 5-6: Clomid 50mg x 2 tabs, 300 IU Gonal F, 150 IU Menopur each night

Days 7: Blds, U/S, 300 IU Gonal F, 150 IU Menopur

Day 8: 300 IU Gonal F, 150 IU Menopur

Day 9: 300 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

Day 10: Blds, U/S, 300 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

Days 11-12: 300 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

Day 13: Blds, U/S, 300 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

At this point, I do have 4-5 follicles growing in the Right ovary varying in size from 9-12mm. My Left ovary has only 1 follicle slowly growing. I did have a nice break during days 2-6, but this week, it’s daily visits with monitoring by an Attending physician.

Day 14: Blds including a CBC, U/S, 300 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

Day 15: Blds, U/S, 225 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

Stay tuned for the rest of the cycle! And wish us luck!

And the IVF Cycle Begins :O

So on Day 12 of my last cycle, I experienced my LH surge. The center nurse instructed I start wearing the Climara patch 8 days later replacing it every 2 days. So here’s what the IVF cycle looked like through Day 12:

Day 12: LH surge

Day 20: Climara patch #1

Day 22: Climara patch #2

Day 24: Climara patch #3

Day 25/Day 1: full menstrual flow

Day 2: Monitoring begins at the center. Bloodwork, Ultrasound and Consents (hubby came with me today) Results: uterine lining still requires shedding. Do not start stimulation meds yet. Instead inject 1 cartridge of Cetrotide SQ.

Day 3: Ultrasound with Dr. L. Results: uterine lining still requires some shedding. Inject another cartridge of Cetrotide.

Day 4: Ultrasound with Dr. K. Results: uterine lining looks good. Start 300 IU Gonal-f, 150 IU Menopur (2 vials) x 2 nights, SQ injections to RLQ abdomen by hubby

Day 5: 3rd Climara patch removed, no need for 4th patch. 300 IU Gonal-f, 150 IU Menopur, SQ injections to LLQ abdomen by hubby

Day 6: Bloodwork only. Results: continue 300 IU Gonal-f, 150 IU Menopur x 2 nights, SQ injections to RLQ abdomen.

Day 7: continue 300 IU GONAL F, 150 IU MENOPUR, SQ injections to LLQ abdomen

Day 8: Bloodwork, Ultrasound with Dr. K. Results: continue 300 IU GONAL F, 150 IU MENOPUR x 2 nights, SQ injections to RLQ abdomen

Day 9: 300 IU Gonal f, 150 IU Menopur, SQ injections to LLQ abdomen

Day 10: Bloodwork.Results: continue 300 IU Gonal f, 150 IU Menopur, Cetrotide x 1 cartridge. SQ injections to RLQ abdomen.

Day 11: Bloodwork, Ultrasound with Dr. K. Results: continue 300 IU Gonal f, 150 IU Menopur, Cetrotide x 1 cartridge.

Day 12: Bloodwork, Ultrasound with Dr. S. LINING EXCELLENT, continue 300 IU Gonal f, 150 IU Menopur, Cetrotide x 1 cartridge. AT LEAST 5 FOLLICLES > 10MM, 2 IN RT OVARY, 4+ IN LT OVARY!!!Low AMH levels take that!!!