Wednesday, November 11, 2015
What a difference a year makes...
Today is my 200th post!
It's also been exactly one year since our IVF transfer resulting in our precious babes! Since hearing about our IVF process is something some of you have expressed interest in, and has been on my blogger To Do List forever, today seems like the perfect day to share the details of what this experience was like for us. This post is super word heavy, and picture light....so if you're not interested in this process, you might just want to bounce now..
I'll be back to regular stuff with Friday Favs on Friday!
I'll be blunt, an IVF cycle sucks. Lots of needles, running to appointments, and not feeling that great due to the massive amounts of fertility drugs. But I'm not writing this post to scare you off...quite the opposite, because it's also the best thing that ever happened to us!
When we were contemplating IVF and later planning for it, I devoured posts like this in an effort to prep myself for what was coming, and so I hope this information can prove helpful for someone else out there in that position. Also, this blog has turned into a bit of a scrapbook of our home and our life together, and having our IVF experience as a part of that ensures that we won't ever forget this time of our lives, challenging though it may have been.
Leading up to my cycle, there were a few appointments for baseline blood work and ultrasounds...but once the cycle actually started, here's what it looked like!
October 22nd- started daily injections and other drugs designed to stimulate my ovaries to produce several eggs at one time. Overall, I tolerated the meds pretty well. But I did have some headaches, bloating, and trouble regulating my emotions.
I'm sure it was tons of fun for Mr. M.
October 25th - November 3rd- 8 visits to the doctor's office over the course of 10 days for blood work and ultrasounds to monitor hormone levels and the growth of the follicles (which contain the eggs). It's incredibly important that the eggs are retrieved at exactly the right point in their development, so the follicles need to be checked almost daily to ensure that the window of opportunity is not missed. When these visits fell on weekdays, I could go to the office super early in the morning before work. But when I needed to go for a monitoring visit on a weekend, I had to travel about 2 hours to Maryland to visit the main office, which is open on weekends. This was the case for 3 of my 8 visits. All monitoring visits occurred in the early morning, so that they had time to analyze my blood work and ultrasound, and then call me in the afternoon with instructions on dosing for my nightly injections. During this process, these near-daily visits and conversations with my nurse and ultrasound technician were my lifelines, my daily dose of hope and reassurance.
November 4th- The follicles were finally ready, so I gave myself a 'trigger shot' that caused my ovaries to release them precisely 36 hours later, at the time they would be retrieved from my body.
November 6th- Egg retrieval day! We traveled to Maryland again for the retrieval. It was scheduled for the early morning, so we arrived the night before and stayed in a hotel. We had a fantastic dinner that night in a restaurant that was far dressier than what we had packed for, but was the only option near our hotel. It was fun!
On retrieval day, we arrived at the clinic early for pre-op, and then they put me under anesthesia in order to go in and remove as many eggs as they could. When I woke up, we learned that they had retrieved 8 mature eggs.
During our previous round of IVF, we had not had a great rate of fertilization (of the 9 mature eggs they retrieved, only 3 fertilized normally, and only 2 of those were healthy enough to make it to transfer). So this time around, we added an additional procedure called ICSI, which means that instead of merely putting the eggs and the sperm in the petri dish together and letting them do their thing, they actually injected each of my 8 retrieved eggs with a single sperm.
November 7th (one day past retrieval)- My doctor called first thing in the morning with our fertilization report. While 7 of our 8 eggs fertilized (thanks ICSI!), only two of them had fertilized normally. Unfortunately abnormally fertilized embryos have no potential for producing a viable pregnancy, so we went from 8 chances of success to only 2 literally overnight. This low fertilization rate across two cycles indicates that there is probably some undiagnosed fertilization issue that would likely need to be explored if we were to pursue another IVF cycle. But at that point, there was nothing to do but hope and pray for the two embryos we DID have!
In IVF, the transfer of the embryos back into the mom typically occurs either 3 days or 5 days after retrieval. During the time the embryos are in the lab, they are being monitored by the embryologists for the division of cells and graded on their quality. The doctors use that information to help them decide when, which, and how many eggs to transfer for the highest chance of success. The decision of whether to transfer the embryos on Day 3 vs. Day 5 seems to be a really complicated one, and I don't truly understand all of the reasoning that goes into making those decisions. But that's what we relied on the doctors and embryologists for! With just two growing embryos, they told us to prepare for a Day 3 transfer.
November 8th (two days past retrieval)- Both of our embryos looked really good on Day 2! One of them was four cells, and the other was five cells! Since they both looked good, my doctor decided to switch us to a Day 5 transfer, in order to allow the embryos to continue to grow and provide more information regarding which of them would be more likely to achieve a viable pregnancy. Embryos that survive until Day 5 are called blastocysts, which is a really big deal! Apparently, often something happens that inhibits continued development of embryos between Day 3 and Day 5, so making it to Day 5 is a big milestone.
November 11th (five days past retrieval)- BOTH of our embryos made it to blastocyst stage! One was deemed good quality, while the other was of fair quality. At this point, we discussed with our doctor and decided that we wanted to transfer both of our embryos back to me. This decision wasn't quite in line with our fertility clinic's preference for single embryo transfers (They prefer to avoid multiple births, which come with risks to mom and babies), but our doctor supported us and we really wanted to give them both a chance without the risk of losing one of them in the freezing/thawing process. SOO many factors went into this decision, and they're all pretty personal...so I'm not going to get into them. But I will say that we were very relieved to not have any 'left over' embryos to have to make decisions about. We were thrilled to be able to give all of ours a fighting chance!
Mr. M. wasn't able to take more time off work to drive me back to Maryland for the transfer, and to be honest, there wasn't any real reason that he HAD to be there. His part was already done, if you know what I mean ;) So my mom went with me. We joke that she's probably one of the few grandparents who was present at the conception of her grandchildren!
As I explained, we had decided to transfer both of our embryos--a decision that we made after a lot of discussion and soul searching. However, when the doctor who was performing the transfer (not my doctor) came into the room, he only brought one embryo with him. When I asked him about the other embryo, he strongly encouraged me to transfer only one, citing the risks to me and the babies if they both made it. I remember him saying 'If you were my daughter, I would never transfer two'. Now remember, my husband wasn't with me. So it was on me to either follow the advice of the doctor in front of me, or to stick with the decision that we had made. It was daunting. I'm not a super-assertive person, and it's definitely not in my nature to contend with a doctor about a medical issue...but I stood my ground and insisted that he transfer both of our embryos.
Embryo transfer is wayyy simpler than egg retrieval. There's no anesthesia required, so I was awake during the procedure (which didn't hurt at all). Before the procedure, they matched my identifying info to the embryos about a million times before the transfer to ensure that they were giving me our embryos, which were transferred through a tube threaded into my uterus. Aside from the fact that they had just put two babies inside me...it was no big deal, and I was able to go home immediately afterwards.
This is really them!
November 12- November 23rd- The dreaded two week wait. After weeks packed with blood draws, ultrasounds, and appointments this period was filled with ......nothing. Other than anticipation, an almost obsessive fixation on monitoring my body for a sign that it worked and, I'll be honest, peeing on every pregnancy test I could find within a one-mile radius. After a few days, the tests started having a second line...but I'd been there before and knew that a positive pee stick doesn't always equal a baby. I needed proof in the form of a blood test. So we waited...and kept on injecting drugs designed to support whatever was going on in there.
November 24th (13 days past Day 5 transfer)- Early morning blood draw to test for pregnancy...and that afternoon they called to confirm that it was positive! My hcg level was high--1,981--something that can be associated with multiples. Could there be more than one baby in there?
November 26th (15 days past Day 5 transfer)- Another blood pregnancy test to monitor the rise in my hcg level. Having the hcg number double in 48 hours is said to be a sign that a pregnancy is developing as it should. A less than doubled number can be (but isn't always) an indication that something isn't right, and that the pregnancy is headed for trouble. So I was praying for anything higher than 3,900.
My hcg level? 6,219. More than tripled in 48 hours. Holy crap...could it really be twins?
December 8th- My first ultrasound. Two gestational sacs, two heartbeats, two babies! Twins!
Not my ultrasound from that day...this is a several weeks later. But it was just as surreal every time I got a peek at them.
Fast-forward 7th months and one relatively easy twin pregnancy later, and we got to meet those little embryos! Which was worth every single needle stick, mile driven, anxious moment, and everything else that went into bringing them home.
It's so cool to think that they've been with me, in one way or another, for a full year!