This is a log of my efforts to have children in my late 30s. I started this journey at age 35 and am now 39 and trying for a second child. My first successful pregnancy was at age 37 after 3 IVFs, 1 medicated IUI, 1 miscarriage, and 3 Reproductive Endocrinologists.
OK so I had a dream I did a HPT last night. First I saw the base line. Then next to it, a pink line, then next to that, a blue line. I didn't know what the blue line meant, but I was thinking (in my dream) that it meant negative, and I was trying to figure out if the negative and positive canceled each other out. I was confused and then I woke up.
Weight-wise my body is doing bizarre things. I normally weigh around 120 at 5'4." <Fighting urge to go into long rant and history about weight and my preferred weight and why it sucks to get old because it's hard to lose weight and how I can't eat carbs like I used to...but let's not go there.> Anyhoo...when I was taking DHEA, and then HGH, my weight spiked to 128. <OK we'll go there just a tad: I haven't weighed that much since five years ago when I was in a relationship that was going nowhere and was unsure about what to do with my life.> But that was emotional eating. This was not -- this was drugs doing funky things to my body. I was not thrilled about it, but in the spirit of TTC, I didn't let myself get too worked up about it. (Other than being pissed I got rid of all of my "fat clothes" in the hopes I'd never need them again -- mental note to never do that again.) Since Saturday, which was Transfer Day, my weight has come back to a more normal 122. I have been nauseous but have been careful to eat enough calories (even dipped into Ben & Jerry's Chunky Monkey last night), so it's not from lack of eating. It's just bizarre.
Also and maybe related, my heart rate has been around 80. I have a blood pressure cuff at home so I've been testing it. It's normally around 50. I'm thinking the HGH boosters that I'm taking are telling my body to make more blood. I can't find anyone on the Internet that has these same two things during their 2ww -- high heart rate and weight loss. Which I guess makes me a freak of nature. So if anyone has heard of anyone having these (esp. the heart rate), please let me know.
Motivated by the urge to know when I can test, I did an estimate of when the HCG should leave my system, and it seems that there will be a bit left at my beta on Tuesday. HCG has a half-life of 24 hours, so half the dosage leaves your body every day. To figure out what's left, you halve the amount every day, as in: if you took 10,000 on Friday, you would have 5000 in your system Saturday, 2500 Sunday, and so on. Here's my calculation. MON – 10,000 TUES – 5000 WED – 2,500 THURS – 1,250 FRI – 625 + 1000 BOOSTER = 1626 SAT – 312.5 + 500 + 1000 BOOSTER = 1812.5 SUN – 156 + 250 + 500 = 906 MON – 78 + 125 + 250 = 453 TUES – 39 X+ 62.5 + 250 + 1000 BOOSTER = 1226.5 WED – 19.5 + 31 + 62.5 + 500 = 613 THURS – 10 + 15.5 + 31 + 250 = 307.5 FRI – 5 + 8 + 15.5 + 125 = 154 SAT – 2.5 + 4 + 8 + 62.5 = 72 SUN – 1 + 2 + 4 + 31 = 38 MON – 0 + 1 + 2 + 15.5 = 18.5 TUES - 0 + 0 + 1 + 8 = 9
No HPTs for me now. Unless it's just to play pretend. Which admittedly would be fun, but brings to mind that story of Elizabeth Smart, that girl that was kidnapped in Utah six years ago, and her female captor that carried around a baby doll like it was her baby.
My ER was today, with 10 eggs retrieved. Not bad considering that on our last try at IVF#3, in March, I never made it to ER due to two leading follices, and cycle was converted to an IUI. This time around, I was officially acepted by my new RE as an IUI patient with the option to convert to IVF if I had at least 4 follies, due to my "poor history," so I trumped the 4-follie criterion.
I had a 6:30 a.m. conference call for work, and then woke up DH at 7:30 a.m. He was up til 2 a.m. last night chatting with his niece and nephew after we all went to see the Police at Red Rocks (great show!), and needless to say, was not too excited to be awakened. Of course I think, why does he have to be a grump when we're trying to make a baby. But then I figure, it's not like he was up late drinking -- he was up late being a very cool uncle to two teenagers who love him to death. And anyway, he cheered up once we got to the doc. Being a health care worker himself, he always goes out of his way to make the health care workers smile because he knows what it's like to be in their shoes.
Things were quite a bit different at Conceptions compared with CCRM. At Conceptions today, I was the only ER patient of the day. When I had my last ER -- with CCRM back in November 07 -- I was the 12th, and last, patient of the day and was wheeled out to my car in the dark. Seems like the fact that they have only my eggies to focus on today is a good thing.
Tomorrow we'll get the fertilization report, and on Friday (day 2) the embryologist will be able to tell us if it's a 3-day or 5-day transfer. At that point (day 2), the embies should be at the 2- or 4- cell stage. Should be interesting to see what embryo quality is since last time we had high fragmentation. With 4 straight months of 2x/week acupuncture, and HGH, I'm hoping for better quality. The criteria for day 3 versus day 5 transfer is that, if > 4 look good on day 2, then they plan a day 5 transfer. I prefer a day 3 regardless of what they look like on day 2, but I'll wait to see what they look like before putting my foot down. No sense being adamant now about going against their preferred ways of doing things if I'll only have a few good ones anyway.
I'm happy that on transfer day, the embryologist is going to have a full size pic of every embryo for us to look at. I've never got to see pictures before. My first embryologist, in Tampa, said that taking pictures was bad for the embryos. The current embryologist says that's not the case.
Not much to do now other than send those little embies happy thoughts.
Here's Sarah McLachlan performing Ice Cream. This is my 2nd last song / blog title from her Fumbling Towards Ecstasy album. Not sure how to relate this to fertility, but I have plans to go to Dairy Queen tonight.
I started stimming on Tuesday, so today is day 3 of my 2nd attempt at IVF #3. I'm on Saizen, which is a human growth hormone produced by recombitant DNA technology. It's actually produced from mice and then modified to equal human growth hormone genes. So basically I'm injecting myself daily with serum from mice as well as the urine of postmenopausal women. Just think about that for a moment. Mouse juice and pee from strange old women. The things we do to get what we want.
I've had insomnia since stim day 1, and since I don't recall having that side effect on any other cycle, I'm blaming it on the Saizen. I also finally rode my new touring bike on Tuesday for the first time -- it's been sitting in the garage for 4 months, and I've been a wanna-be cycler for months now, but finally I got on the thing and went 30 miles. DH is giving credit for that to the HGH. Which mildly pisses me off because I want all the credit, especially for going uphill most of the way back home! ;)
Here's the main study that corrolates GH with increased pregnancy rates.
I actually read the entire insert that came with the Saizen, since I'm oddly excited to be on it. Here's some highlights:
It stimulates skeletal growth, cell growth, and organ growth.
It increases uptake of amino acids.
It can decrease body fat (still hoping this is a side effect -- but doubting 8 days will have an impact).
It's contraindicated if you have a malignancy (guess it helps tumors grow big and strong).
It can impact the metabolism of cortisol (interesting esp. since cortisol is apparently toxic to eggs & embryos -- but I'm not quite sure how it impacts it).
Overdose can lead to hypoglycemia or giganticism (freaky, nothing better get giant, especially not my feet which at size 10 on my 5'4" frame are already giant).
At my U/S today, the tech measured 9 follicles, 7 of which were over 10mm. Things are happening fast. I wonder if my body didn't have some left-over effect from cycling just 2 months ago.
On the home front, DH's niece (18) and nephew (16) came to visit us today from FL and are staying a week. And I have a nice, 5-day weekend to spend time with them. So it'll be nice to have a distraction from what my body is or isn't doing. And very nice to be off of work during a stim cycle, for once!
Here's Sarah McLachlan with Fumbling Towards Ecstacy.
All the fear has left me now I’m not frightened anymore It’s my heart that pounds beneath my flesh It’s my mouth that pushes out this breath
Good thing I didn't commit to NaComLeavMo this month. I've been a horrendous commenter, too many trips and distractions. Maybe the big commenting month should be in January not June!! I am very very happy for all of my newly pregnant blogging buddies, your successes bring me joy and give me hope.
I got back from Wisconsin on Monday. I also got AF on Monday. As much as I promise myself I won't be surprised, I have still had this feeling like I'm going to regurgitate all of my internal organs ever since I took a HPT on Saturday morning. I had a mini-meltdown at the wedding. Partially because I found out that a person I had been very close to for a long time had recently passed away. And I guess partially because of the BFN. And partially because of the bourbon I slammed. This fertility mumbo jumbo is affecting my emotional balance more than I want to admit.
My dumb-ass SATC wedding moment came right after I heard the news of the death, when I gently excused myself, walked down the steps towards the ladie's room, and let out a big sob as I was coming down the steps. This also happened to be mere seconds before the bride and groom were being announced. Instead of walking up the steps together, the groom ran up alone, went to the bar, got me a glass of water, and ran back down, while my friend watched in horror. I am SOOOO not a drama queen, and making a mess of the intro was just an embarrasing and ill-timed event. My DH was also at the bottom of the steps. He gave me a very kindly worded talk of how this was a wedding, not a funeral, and how I'd have to postpone my mourning for my friend's sake. I knew he was right, of course, but my emotions had got the best of me. He drove me to buy visine, I fixed my makeup, and went back in an hour later with my party smile and my dancing mojo.
Today I went to see Dr. Surrey for a regroup. I wasn't sure if I was going to even schedule it, even though he requested me to, because I didn't want to hear him say I'm a lost cause. But he didn't say that. Here's my Q&A with him. His responses aren't word for word, of course, but the thought is there.
Me: Do you think my last cycle, with two lead follicles, is indicative of a future decreased response to meds, or do you think it was a fluke?
Dr. S: It's hard to say, and we can retest ovarian reserve, but I doubt if your fertility has decreased that drastically in less than a year, considering your good response to meds the time prior.
Me: If I get my ovarian reserve tests done today, would they be skewed since I just did a medicated cycle?
Dr. S: No, it shouldn't matter.
Me: Do you use human growth hormone in your protocols?
Dr. S: No, Dr. Schoolcraft had used it in a study a while back, but we don't use it since it's not approved by the FDA for infertility.
Me: Do you use DHEA in your protocols?
Dr. S: No, there are studies that have shown it to be effective, but they are not the best studies, they didn't use controls, and they had small numbers of patients.
Me: Would you recommend a change in protocol if I cycle again?
Dr. S: Yes, I'd want to try antagonist with estrogen priming.
Me: What is estrogen priming? I've read about it but am not clear on it.
Dr. S: We give the patient estrogen for a month prior to the IVF cycle. The estrogen primes the ovarian FSH receptors and increases response, and also avoids a situation of lead follicles
Me: Would it make sense to do something like stim a woman every 3 months, do a retrieval, do PGS, freeze them, and save up the embies for one transfer of only the best?
Dr. S: It could be done, but you have the expense of drugs, plus the expense of PGS each time. We have done this type of thing with eggs for women who aren't ready to have a baby yet, but not with embryos for women who are.
Me: How long would you recommend I wait before trying again?
Dr. S: You could try in two months. Normally we wait three, but since you didn't go through the whole thing, you could do two.
Me: My husband is still not sold on donor eggs, but if we'd decide to go that route, how long would it reasonably take to find a donor with blonde hair and blue eyes?
Dr. S: It seems to be cyclical the types of women that we get. For a while we were getting a lot, but there haven't been a lot lately. You may be better off going through a service than through our program for that. You may have to wait six months.
Me: I'd like to try again with my own eggs, and then talk donor eggs.
Dr. S: Yes, I'd recommend that, I think you should try again with your own eggs.
Whew! I didn't expect that. I thought I was a total IVF flunkie as far as CCRM was concerned. I had the ovarian reserve retested after the meeting. Lab fee was $490, ouch. I've heard that testing immediately after a medicated cycle skews the numbers -- Dr. Swanson had told me it would, but Dr. S said it would not. But I was so damn curious that I couldn't help myself, I have to find out ASAP.
I wasn't sure if I should cycle with CCRM in 2 months or Conceptions in 4 months. I went to Conceptions to have a baseline DHEA test too today. I'm a total IVF junkie now. And indecisive. The looks of the lab at Conceptions wierded me out. I'm wondering if their office in N. Denver metro is a bit more modern, but this one is small.
DH thinks I should go to CCRM. The cost for us will be about $5K due to their lab and surgery center being out of network. Conceptions would be practically free -- copays only -- maybe $300. My gut is telling me to try with Surrey though since he's letting me. Because they SEEM better. Even though both docs are really good. Thing is, I'd have to start the estrogen TODAY. I have an RX waiting for me at the pharmacy RIGHT NOW. Should I or shouldn't I....that's the question.
I talked to the nurse at Dr. Swanson and asked her if they do estrogen priming as part of the antagonist protocol. She said no, they used to, but they weren't getting a good response.
It's very hard to make a decision, each doc has their own way of doing things, and each thinks his way is the best way. Really I know my eggs matter more than any other factor in the mix. But still, I want to make the very best decision.
I looked into your eyes They told me plenty I already knew
Today I chatted with Dr. Swanson, the head RE at Conceptions. A prior patient of his told me that he used to be partners with Dr. Schoolcraft at CCRM...haven't had that info confirmed but it's interesting.
He verified my IF history and he said sounds like an egg problem due to age, which I knew. His plan: first, in July, he'll retest my day 3 FSH, E2, AMH, and LH. These numbers indicate ovarian reserve. He won't check these numbers in June because they may be skewed due to my recent stim cycle. If my numbers are poor, then he will not be willing to take me on as an IVF patient, but if my numbers are acceptable, then he will. My last FSH was 7.4, which is good, but that was last August. I know I'm at an age where ovarian reserve can take a nose dive, but I'm hopeful that mine is still in his acceptable range.
If I pass the initiation blood test, then he has a plan to get PLENTY of eggs. He wants to:
Up my amps of Menopur from 2 to 3 or 4 per day
Add growth hormone. There is some evidence that this improves the live birth rate.
Go back to an antagonist protocol. That's what I did the first time. Microdose flare has the potential for causing leading follicles which is what I just experienced.
No BCPs. This is standard for them for antagonist protocols.
Use Letrosol as a lead-in, which releases a surge of FSH & LH.
Go back to Bravelle instead of Gonal-F. Bravelle is natural, Gonal-F is synthetic.
Take DHEA for 3 months prior to the cycle. Studies have shown that this increases follicular count.
Continue acupuncture.
The cycle wouldn't take place until August / September to give me 3 months of DHEA. He said my chances of success are 10-20%. Not great. I guess my past failures say a lot because his success rates for the age group of 35 - 37 are 68%. I feel very grateful that he'd be willing to take me on, knowing that I am statistically not a clear winner. If my numbers report well, I'm going for it. Seems like a big risk except that, #1, insurance pays, #2, looks like it may be my last grain of hope, albeit a teeny-tiny grain, and #3, time is going to pass anyway, so it can't HURT anything.
Sarah McLachlan's Wait. Couldn't find a good video, but the music is still great to read by!
Upfront warning, this is a long one! I haven't blogged for over a week (other than show-and-tell) so gotta catch up!
This upcoming Sunday, the CO Bloggers are getting together to see Sex and the City. I'm bummed that I can't hang out with all these amazing women, as I will be at a friend's wedding If you happen to be in Denver that day and want to join them, send an e-mail to Lori. I didn't wait long after the movie's release and went yesterday to a matinee. It was fantabulous!
The only thing I regret is that I didn't go when I was in Manhattan on Thursday night -- I had a girl's night out that night with work friends, but since one of the women had never been to NYC before, we opted to sightsee, plus we had an early meeting Friday, so a midnight showing would have been hard to manage, BUT it would have been a once-in-a-lifetime blast too. All over Manhattan, there were groups of women looking more stylish than I ever have in my life. I noticed lots of women were wearing bright pink stilettos (is that a thing? Maybe I missed that episode...but I figured, what else could it be for!).
I'm now on Facebook. I was partially inspired by Mel's post Facebookiquette, and partially inspired by all the younger people at my company who are into social networking. Send me an e-mail if you want to find me there.
I am so not wanting to blog about infertility because it reminds me that my story is not leading to a happy ending as quickly as I wished. But here goes.
Our Monday IUI almost didn't happen. For those of you lucky enough to be uninitiated into the IUI routine, husband arrives at set time to give donation, (or he does it at home and then has to keep it warm on the drive there by placing it in the armpit, an imaginably awkward driving position). Then wife arrives 90 minutes later for the insemination.
So, GS was in the RE's office, sample in armpit, and they had him in the waiting room, but apparently the embryologist didn't know he was waiting, so she called me.
Embryologist: Your husband isn't here, if he's not here soon we'll have to cancel.
Me: He should be there by now, he left 40 minutes ago and it's a 10-minute drive. Maybe something happened on his way there (I'm thinking he got pulled over!). Isn't there anything you can do to help us out?
Embryologist transferred me to a nurse.
Me: Is there anything you can do to help us out? What if you thaw our frozen sample?
Nurse: We have to thaw and process and that takes 90 minutes. The earlies we would have you in is 1pm.
Me: I have to jump on a plane that leaves at 3pm. Is there any way you can accommodate us any earlier??!
Nurse: No. We have to cancel you.
Me: Oh. (shocked and speechless)
When they finally realized he was there, they sent him home and told him that I said it was OK. I didn't so much say that.
GS was pissed and swore we would never ever go back to The Palace for anything, no matter what, after that situation. After $4K of injectibles and $600 of acupuncture, mind you. I agreed, but I wasn't in the mood to be upset. We regrouped. GS suggested putting the "sample" in a turkey baster and squeezing it in. Seriously. I'm like, you're kidding, right? He said, no. We settled on trying to do it natural (i.e. no turkey baster), and just then the phone rang. Another nurse called, apologized profusely, and asked if I could come in at 11. I said yes.
When I arrived, the nurse was super nice, super apologetic, and said that the first nurse I'd spoken to didn't realize the situation. I'm so used to the "wham-bam-thank-you-mam" 3-minute ultrasounds, that I was surprised she was super chatty and took her time to make conversation, reiterate their dedication to helping us get pregnant, and apologize about 20 more times.
So that was that.
On the upside, NYC was great. I went out on the town three nights in a row and <holding head down in shame> gave into peer pressure and had a few drinks. I justified it by telling myself that the eggs were already created, and until the embies implant, they don't get any nutrients from my blood. To my credit, I nursed the hell out of my cocktails. It's all for the best, since I can't hold my liquor anyway. I made the mistake of saying the word "titty bar" when describing why I liked Denver better than Tampa (as in, I had to pass five titty bars on my way to work every day in Tampa), and the look on my co-workers' faces made me thankful I wasn't drinking more and saying worse.
In NYC, I called Cornell to see if they couldn't squeeze me in that week for a consult. Since I was there and all. They could not.
Tomorrow is my appointment with Dr. Swanson from Conceptions. It took me four hours on Sunday to gather up all my IF-related medical records and fill out their 20-page new patient forms.
As you can see, I am not considering myself to be in a true 2-week-wait . If only 1 in 10 of my eggs are good, then with only two mature eggs, my chances are 20% at best. So I'm better off emotionally just focusing on the next steps.
I fear I have nothing to give I have so much to lose I have nothing to give We have so much to lose...
These song titles are way too easy to relate to infertility.
My IUI is scheduled for Monday morning. Then I hop on a plane. No bed rest, no special doctor's orders. I've never done an IUI before, so it's a bit of a novelty to me. I had a pre-surgery check-up with Dr. G yesterday, just in case Dr. S. recommended retrieval, and so I bombarded the poor guy with questions. He looked tired. I asked him if he would recommend an IUI given my circumstances (2 lead follicles). He said, your chances are about equivalent with an IUI and an IVF. I asked if he thought a lower number of mature eggs at trigger meant better quality. He said no.
My biggest fear now is that my fertility jumped off a 14'er in the last 7 months. My last IVF wasn't too shameful. This one, however, is not impressive, in a "you absolutely, positively need donor eggs" sort of way. I have feelings of embarrassment as I talk to the nurse and doc now, as if I have failed them. As if I should have known, given my age, that my body would not be super responsive indefinitely.
I fear that the fact that some of my meds had an expiration date of June 08 means that they went bad. And, I fear that that's not the case.
I fear that this is as good as it's gonna get with stimm drugs from now on.
I fear that God is punishing me for putting work before motherhood.
<Is this as fun for you as it is for me, dear reader? I fear my readers are going to start charging me for reading this and providing therapy to an in-denial, over-the-hill IVF'er, LOL.>
I fear that I've made mistakes down this road. For my first IVF, I went to an oddball, sub-par, two-man-show (OBGYN + embryologist) in FL. The doc was super nice, but he had a policy, due to religious reasons, to only fertilize as many eggs as you want to put back. I had 18 retrieved, so 16 were just tossed from the get-go. I was a year younger then, so some of those may have been my lottery tickets to mom-hood. His embryologist insisted on being paid cash and had a huge "save the squirrels" farm in Lakeland, FL. No lies. In my defense, I went to these guys because they had gotten a 41-yo friend of mine prego with twins with her own eggs. At the time I didn’t realize how much luck was involved there. But she put back 6 embies. I didn't know to put back more than two embies. I didn’t know that other REs fertilize the whole batch of eggs and watch them all. I didn't know about acupuncture use for IF. I didn't know about blogs. There is so, so much that I didn't know about IVF.
I fear that I waited too long between IVFs 2 & 3. A lot can happen in 7 months. For anyone reading this who is over 35 and thinking of taking a long break, I'd urge you to not do it. I think it was a mistake. I know it takes some major pushing, but I urge you to push yourself.
A week from Tuesday, I have an appointment with Dr. Swanson from Conceptions. Because I suspect the CCRM Dr. S's won't let me do IVF with my own eggs anymore. I’ll do a follow-up consult with Dr. Su as requested but that’s what I’m expecting to hear. Thing is, I have about $40K of IF insurance left, so I'm hoping that some doctor will let me try longer. (I hesitate to write this because I know so many don't have insurance. But I'd trade anyone, any day, $ for better eggs of my own! And trust me, I am not rich.) Even if I have to fly out to NY or Vegas or somewhere else to go to another clinic, I'd like to use every penny of it, if only to be able to say I tried every which way I could with the funds I was fortunate enough to have available to me. Maybe I'll try the whole Chinese herb thing, get my spleen chi in balance. I'm thinking to give treatments another year and perhaps at the same time, pursue adoption. With adoption, GS only wants to do it if we can get a baby who otherwise wouldn’t have much of a chance, like an orphan from another country. With donor eggs, GS isn’t on board at all. I am, quite frankly, open to anything -- DEs, domestic, foreign, older, younger, crack baby. Seriously. I think. As long as I can put a kid in daycare, since I have to earn money to feed the kid and all.
And ya, there's like a 10% chance or something the IUI will work. So there's that. But with those chances, I've got to be pragmatic.
I can tell you this, if I have a daughter via birth or adoption, I am going to have her freeze plenty of her eggs as soon as she's old enough.
My husband brought a CD with him to Naples with a bunch of pictures we've taken since we've moved to Denver, so he could show his family. Mostly of beautiful places we've been, but also of our home and dogs. When he showed them to his uncle yesterday, he told me, his uncle said if he sees one more dog picture, he's going to bark. Looks like I'm already a weird dog lady. I want to at least get a chance to be a weird mama.
Through this world I stumble So many times betrayed Trying to find an honest word to find the truth enslaved Oh, you speak to me in riddles and you speak to me in rhymes My body aches to breathe your breath Your words keep me alive
My eggs may remain in my possession this cycle. No I haven't built an embryology lab in the basement. Although with what I and my insurance company have now paid for IVFs, perhaps I could have.
My cycle may get canceled or converted to IUI because I have two follies that are much larger than the rest. The logic is that If only 30% or less of my eggs are good, DNA-wise, then retrieving 2 doesn't make statistical or financial sense. I'll see how tomorrow's U/S goes and then see what the doctor says. The nurse said that if I do proceed with IVF, they could either go for retrieving the two big ones, or stimm me longer and get the smaller ones, but they don't tend to go with the second approach because the longer you stimm, the lower quality the embies tend to be.
I am doing some research on when it's ideal to do the trigger shot. CCRM orders it when 4 embies reach 1.9 - 2.0. However, this study shows that for women > 35 doing a microdose flare protocol (which I am), it's better to give the HCG trigger when the 2 leading follicles are < 18mm. Pregnancy rate was 45% versus 17%. Last IVF they triggered me a day late to fit into their criteria, wonder if morphology issues would have been decreased had they triggered me on the planned day.
Thanks for the support on my marital spat. I think you all made me feel so good that by the time I talked to GS, I wasn't even mad anymore. When we finally talked yesterday, he had been out with friends and was in a great mood and I didn't want to ruin it, especially over the phone long distance. I'm chalking the argument up to the fact that he's visiting his parents and had elevated anxiety. Last time we saw his dad was at Christmas and we left Baltimore 4 days early due to his dad's drunken tirade and they haven't spoken since. I guess given that and my hormones, he can have a free pass.
I just talked to my MIL on the phone, she knows I'm staying home on this trip because I'm trying to get pregnant, but she doesn't know details. She asked, "do you feel pregnant?" I just said, not yet.
This is more of a follow up to my last post. Wanted to elaborate on the Preimplantation Genetic Screening (PGS), especially because I left out all the background info & presentation info from my meeting and just put my Q & A.
Comparative Genomic Hybridisation (CGH) is new as far as PGS goes and this new use was discovered by Dr. Geoffrey Sher in Las Vegas (see http://www.newscientist.com/channel/sex/mg19325893.900-egg-screening-doubles-ivf-success.html). It sounds like FISH may be on its way out. CGH can test either the polar bodies (and thus check for maternal chromosomal damage only) or the embryos (and thus check mom + dad). Testing of the polar bodies should theoretically not affect the eggs because the polar bodies would otherwise be shed by the eggs. Testing of the embies is more risky because one or two cells are removed, thus possibly (a) compromising the embryo, (b) causing damage due to human intervention, or (c) giving an inaccurate reading due to mosaicism. Per Dr. Lincardi at NYU (http://infertilityblog.blogspot.com/), mosaicism means “that some cells have one type of DNA and other cells have different DNA. For example, in an 8 cell embryo, it’s possible to have some cells that cause Down’s Syndrome (this is an extra chromosome 21) and some cells can be normal. Just to back up, almost all of us have 23 pairs of chromosomes, for a total of 46. If an embryo is missing at least one, or had an extra 1, we generally call this aneuploidy. Aueuploidy is the genetic problem related to aging. Down’s is an extra chromosome 21, but any of the chromosomes affected in the same way, either an extra or missing. Getting back to PGD, if the embryo has 2 normal cells, and 6 abnormal cells, and the biopsy plucks off a normal cell, this mostly abnormal embryo will be transferred, probably producing no pregnancy. If the embryo is mostly normal and an abnormal cell is tested, that embryo will not get transferred, yet it may have produced a normal child."
Dr. Licardi's blog also says, "CGH may someday be the answer, but it’s way too early to tell. There is one doctor in particular who pushes CGH, but he has pushed a lot of other things in the past, none of which were any good. I am not saying he is wrong about this, I just need to see data reputable data from him or others."
Obviously CCRM is on a mission to get reputable data.
I can understand why a person would want to do PGS if they expect a lot of embies. For me, mine had morphology issues, and so it would be unlikely that selection would be needed. I'd just put back in what I have and hope for the best.
IVF is seeming to me more a game of statistics, since it takes a lot of women 3-4 IVFs to get pregnant and since most eggs are bad, even for young women. In the New.Scientist link above, it says that CGH on donor eggs (from mostly twenty-somethings) shows that 65% of them are poor quality.
In talking with the genetic counselor, I was most surprised to learn that morphology issues (fragmentation) is unrelated to genetic quality (chromosomes). However, this would explain cycles where the embies are fragment-free but don't implant or otherwise survive long. So that perfect blast could have a DNA issue, yet the struggling 5-cell at day 3 could have kick-ass DNA. And you would never otherwise know.
The other thing that struck me as undesirable is that CGH can determine chromosomal damage with 90% accuracy, yet chorionic villius sampling and amnio can test with 99.9% accuracy. And they highly stress that you should still have CVS or amnio -- that CGH is not a replacement for it. So in my opinion, CGH is best for those with (a) lots of embies who want to avoid risk of multiples, or (b) a motivation to isolate any imperfect DNA ASAP, thus avoiding a BFN, a blighted ovum, a miscarriage, or an abortion.
As far as I'm doing, I'm not doing great. GS and I had a big fight in the car while I was driving him to the airport. I was trying to explain egg quality and he said I was explaining it poorly and wasn't making any sense, and I got pissed because that's just rude, and he got pissed because I got pissed, and we had a shitty goodbye. I won't see him again until Sunday night, he's going to his niece's graduation in FL (deep breath...interestingly enough, his niece is headed for Yale for a pre-med degree and wants to specialize in genetics).
Anyway, back to me, I'm mad at him because he didn't apologize and doesn't even seem to get that he should. I don't even want to have his stupid baby at the moment. Shit.
First I'd like to present the very talented Sarah McLachlan performing her song, Ice. It's one of my favorites of hers, and this is a beautiful video, definitely worth a few minutes of your time.
Hours pass days pass time stands still Light gets dark and darkness fills My secret heart forbidden...
Did I ever write that I used to want to name my maybe-someday-daughter Sarah? I made that decision 20 years ago, WAY before I met my husband. Would that be a totally creepy fan thing to do now, now that I've married someone with her same last name? (not that a baby girl is a certain option in my future, but...a girl can dream, can't she?)
So, my latest development....our embies are going on ICE, ICE, BABY (sorry couldn't help myself).
I got invited to the meeting in NYC, and not only can I not NOT go, I REALLY WANT to go. I'll be able to meet people from all over the world that I've been working with for a year now -- people from Austrailia and Canada and China and Mexico and the UK and....you get the idea. I am super-psyched to put a face to the name of all these amazing co-workers of mine, most of whom I've worked with very closely, yet very remotely. You know....kind of like meeting bloggers in person!!
So to make it happen, we have to put the embies on ICE. Given that, I'll probably do the PGS afterall. I know, I know, I wasn't going to cave into the pressure of The Palace. But, this is the only way to get the best freezing technology. I could do a regular freeze cycle, but it's less likely that all embies will make the freeze. Plus, it will be intriguing to find out maximum info about our little cell blobs. My meeting with the genetics counselor is tomorrow. I'll let you know how it goes.
In other news, nurse Rachel said that Menopur is no longer available. Wonder why...economy downturn perhaps? Hopefully there's not new evidence that it causes alzheimers in monkeys or something. So instead, I'll be doing Repronex. Actually 1/2 and 1/2, because I still have 2 boxes of Menopur left over from last time. Ellie said it's fine to use both, as they're essentially the same thing. I've read that Menopur is more pure, and Repronex causes more skin discomfort, plus it's intra-muscular (oh goody, more giant needles).
