Monday, December 16, 2013

Embryoscopy and D&C

So, on 12/4/13 there was no heartbeat.  Bean had grown a couple of days worth so was measuring 6w1d.  I was 7w6d.  This isn't really a blog about feelings, more about facts, but I think I'm feeling every emotion in the book.  It's so complicated.

Back to the facts, the embryoscopy and D&C was scheduled for Friday, December 6, 2013.  It went fine.  The doc said that he was able to detach the entire gestational sac from the uterine lining very easily.  Mostly, I think this is my inherent problem.  The bean just never attaches fully to the endometrium.  And, no one knows why.  So, it was all sent off to Natera Labs for their analysis.

My follow-up appointment with the D&C nurse (I really like her, BTW) was Monday, December 16. And the results are.....  Drummer roll please....

Complete triploidy of maternal origin. So, for some reason, most likely, at meiosis stage 2 which is when the embryo goes from 2 cell to 4 cell, it all went terribly wrong. At least, that's my understanding. I learned that 2% of all pregnancies are triploidy. And it does not appear to be affected my maternal age. So, unlike other genetic abnormalities, it happens at the same rate if you're 20 or 40.

So what does this all mean?  Well, maybe, just maybe, it's not me!  Or at least it's not my uterus killing my children. This is great news. So maybe, just maybe, there will someday be a take home baby in my future.

Also, this doc is wiling to be aggressive with a gonadotropin IUI going forward which is just what I wanted to hear.

Lastly, myHCG was at 10. This is great news. It means that my HCG should be negative (less than 5) before my next cycle, so that shouldn't hold us up.

My planning for my next cycle with my regular RE was Tuesday, December 17th. 

Thursday, November 14, 2013

Ultrasound Results

Ultrasound set for Thursday, November 21st.  I'll be 6 weeks exactly. 

Beta recap:
14 dpr: 79.4
18 dpr: 300
20 dpr: 542
25 dpr: 1172

And the results are:

Miscarriage #6

No one is surprised here.
No heartbeat.
Gestational sac was 5mm. It's supposed to be 15 mm.
Yolk sac was 2.4mm. It's supposed to be 3.4mm.
There was a possible fetal pole at 1.2mm. It's supposed to be about 3.4 mm.
And, of course, there's supposed to be a heartbeat.

I'm trying to set up a consult with Dr. Morris of IVF1 who can hopefully do an embryoscopy. This will give us a chance to look hard at anything that's there and then make sure they get a direct sample from the bean itself to do genetic testing. The earliest appointment I could get is for next Wednesday.

Doc wants to do a more detailed u/s with color flow Doppler, so I'll do that on friday. I think I'll need it to convince Dr. Morris to do the embryoscopy anyways.


So, 5 days later I followed up with Dr. Morris and what do they find?  Of course, a heartbeat.  But, it's too slow at 89 BPM and the bean is measuring too small. 

The CRL was at 3.15mm which puts the bean at 5w6d when I'm 6w6d. 

The yolk sac is extremely enlarged at 6.92 mm which is a seriously bad sign. 

The gestational sac is at 8.36mm which is small at the size of a 5w3d bean. 

There's nothing to do but wait it out.  I go back in next Wednesday for a followup. 

Friday, November 8, 2013

Next steps: Letrozole and Neupogen (G-CSF)

Let's be real.  This will probably be a miscarriage.  So, it always helps me to have a plan.

First off, 'm going to have a consult with the doc on Monday when I do my repeat beta.

My thoughts are this:   With this pregnancy, no matter what the number is I'd like to keep the progesterone going strong until the late 6 week or early 7 week time frame.  The day before Thanksgiving is 6w6d, so I'll try to get an u/s then.  If there's going to be a heartbeat it'll be there.  (I'll take a miracle.  And, I figure someone must live in the tail ends of the HCG bell curve, I'd be thrilled if it was me.)  But, there won't be.  So, then we can have a D&C.  This will give us the opportunity to karotype the bean.  I think this will give us a firmer answer as to whether this is a soil or seed problem.  At this point, the odds are there's a problem with the endometrium (the soil), but we haven't ruled out that maybe we just make a lot of genetically incompetent embryos (bad seeds).  I think this'll give us some answers.

Moving ahead, we have only 4 IVFs covered by insurance.  I'm not sure, but I think after the fourth IVF all infertility benefits cease.  And, overall, I don't think the lab is really doing anything for us.  We seem to make great embryos that make it to blast all the time.  So, an IUI would give us just as good of results as an IVF.  I'd like to talk the doc into keeping the same high dose of stims.  I think we need every target we can get to get a baby out of this.  So, I'll ask about that.

The meds I want to add are this:
Letrozole (Femara)  Letrozole is a first line med to get women to ovulate.  But, it has the nice side effect of regulating Beta 3 Integrin levels.  There's no reason to think I have this problem, but it's such an easy fix and fits in well with an IUI plan I don't see any reason not to.

The other thing I want to add is more controversial.  It's Neupogen (G-CSF).

I've read the article numerous times to try to figure out what Neupogen actually does, but I still have a hard time understanding it.  According to the article, "Granulocyte colony-stimulating factor (G-CSF) is a cytokine which stimulates neutrophilic granulocyte proliferation and differentiation. It is expressed and produced by the decidual cells, and its receptor, c-fms, is expressed by the trophoblastic cells"   

The great part is this, "Results In the group treated with G-CSF, 29 out of 35 (82.8%) women delivered a healthy baby, whereas in the placebo group, this figure was only 16 out of 33 (48.5%) (P = 0.0061, odds ratio = 5.1; 95% confidence interval 1.5–18.4). Significantly higher β-hCG levels were found in gestation weeks 5–9 in women treated with G-CSF versus placebo"

I REALLY like the idea of higher HCG levels.  I have always suffered from this problem.  I wonder if the HCG is a chicken or the egg sort of problem.  Which comes first.  Does a bad embryo produce poor HCG numbers?  (The common theory).  Or, can the low HCG numbers cause the body to not make the necessary changes to fully accept the implanting embryo?  It would seem as if the problems fed off each other.  But, no one seems to really know the full effects of HCG on the endometrium.

Sigh.  So much to think about.

But, that's the plan for next time.  IUI with Letrozole, Follistim, Menopur. Lovenox, Prednisone, HCG trigger and progesterone support.  And, I'll also ask about HCG boosters in the 2ww.

Thursday, October 24, 2013

IVF #3 Final results

October 24, 2013 - 9 eggs retrieved

Oct. 25 - Day 1 report. Of the 9 eggs, 7 were mature and 4 fertilized.

Oct. 26 - Day 2 report. Of the 4, 3 are 4 cell grade 1. That's perfect. The other one is still a 2 cell and severely fragmented. So we're looking at a transfer of the 3 tomorrow!  Eek!

Oct. 27, Sunday - All 3 were looking great, so we transferred all 3!  One was a 10 cell & the other 2 were 8 cells. All were perfect, no fragmentation and graded 1, which is the best.

Let me see if I can post a picture of them.

I'll also keep you updated on my POAS saga. I'm doing HCG boosters, so HPTs will be harder to decifer, but I think I'm experienced enough in these sort of things to read the tea leaves. :P

Oct. 29, 5 DPR (Days past retrieval) -  I did my 2nd of 3 boosters shots this morning.  The $ store HPT had a faint line.  Good.  That means the trigger or the last booster is still in my system a little.  I'd hate for it to not make it from one booster to the next. 

Nov. 1, 8 DPR - I've been feeling the crampiness of early pregnancy. I've been pregnant enough to know the feeling. Someone's trying to settle in. We'll just see if they can do it or not. Today was my last HCG booster. Every morning I test first thing. And the test this morning was darker than yesterday's. Since I gave the booster AFTER I took the test it should've been lighter.  Unless of course there's another source of HCG,,,,,  Here's hoping.

Nov. 4, 11 DPR - So here's the HPTs from yesterday and today.  Since my last HCG booster was Friday I may still HCG from that in my system, but these are still pretty dark IMO.  I'll keep testing and update.  Beta is Thursday.

I'm a little worried.  OK, a lot worried.  The line seems no darker today than it did yesterday.

I don't think I'll test again until Thursday which is the morning of the beta.  I need to know the results before the nurse calls with them.

(I don't know how people don't test at all and just wait for the nurse to call.  What if you're in a meeting or miss the call or whatever?  Is that really the way you want to find out?  I can see waiting until the morning of the beta to save the above troubles, but having no idea until the nurse calls????!?!?!  No way.)  

Thursday, 14 DPR, Beta test day.  This is going to end in another miscarriage.

And, the Beta is ....


As these things always seem to go for me.  It's nothing definitive either way.  It's a solid meh.  The next beta is Monday, 18 DPR.

Here's the next HPTs.  Day 16 is Saturday and day 18 is Monday.

Beta on Monday, Day 18 was 300.  Of course, it's supposed to be 320-ish.  52 hour doubling time

Another beta on Wednesday, Day 20.  I'm out of HPTs and I have no desire to buy more.  :P

Wednesday, Day 20,  Beta was 542.  53 hour doubling time.

On a side note, I went for the second intralipid treatment on Thursday, Day 21 (5 weeks pregnant).  Also, I'm going to start drinking grapefruit juice.  Maybe it'll help my liver excrete the HCG and not hold on to it.  (Boy, I'm getting desperate...)

They want to do an ultrasound next week, but I'm disinclined.  One ultrasound will be hard enough.  I want to go when I can have a definitive answer.  I agreed to another beta on Monday, Day 25.

Monday, Day 25 beta =1172.  That's really, really bad.  It's a 111 hour doubling time. 

Ultrasound scheduled for November 21 at 6:30 am.  I'll be 6 weeks even. 

Sunday, October 13, 2013

IVF #3 Day by day...

October 10, 2013 - CD 1 - I got my period.

Oct. 11 - CD 2 - I went in for my baseline appointment.  All was quiet and the tech counted 10 antral follicles.  That's ok for me, had better, had worse.  I stared on Saizen (Human Growth Hormone) which I'll take for 5 days.  675 iu Follistim (we do a high dose fsh to start and then taper off and add in Menopur).  Estrogen = 36, Progesterone = 0.74, LH = 3.73 and FSH = 5.65.

Oct. 12 - CD 3 - Saizen, 675 iu Follistim

Oct. 13 - CD 4 - Saizen, 600 iu Follistim, 75 iu Menopur

Oct. 14 - CD 5 - Saizen, 450 iu Follistim, 150 iu Menopur, start Lovenox and a follicle check. The right hand side had 11, 8 and 6 more under 10. The left side had a 10 and 5 more under 10. My lining was at 4.2.  E2= 98. P4= 0.586

Oct. 15 - CD 6 - Saizen, Lovenox, 450 iu Follistim, 150 iu Menopur

Oct. 16 - CD 7 - Lovenox, 450 iu Follistim, 150 iu Menopur and another follicle check.  The right side had a 14.5, 12, 10, 9 and 4 more tiny ones. The left side had a 13, 10, 6 and 2 tiny ones. My lining was at 8.8.  E2 = 187, P4 = 0.589

Oct. 17 - CD 8 - Lovenox, 450 iu Follistim, 150 iu Menopur (I'll do this same pattern until trigger.  But, the Lovenox I won't stop.)   Start Ganirelix.

Oct. 18 -CD 9 - Follicle check.  The left side has a 17 and an 11. The right side has 17, 15.5, 12.5, 12 and an 11. My lining is at an 11.  E2 = 448, P4 = 0.7

Oct. 20 - CD 11 - Follicle check.  The left side has a 19.4 and a 16.3. The right side has a 22.1, 16.6, 16.2, 15.5 and a 14.9. I don't like the one that's pulling ahead on the right, but what are you going to do?  Hopefully, they'll be able to let the 22 go to get the cohort of 16s up to speed. The tech measured my lining at a 10. I asked how it could shrink and she said it didn't. It was just because I had a full bladder pushing on it, so it appeared smaller. It also had the triple stripe pattern that they want to see, so that's fine. My E2 was at 651. Meh. I wish it was higher but there it is. Another follicle check tomorrow.

Oct. 21 - CD 12 - Intralipid infusion.  Follicle check.  The left side had a 23, 17.5 and a 13. The right side had 19, 19, 17, 17, 16, 11.  So they found 2 more, but they're small, but the 13 might make it, especially if they push me out another day which I think they'll do. My guess is my estrogen will be too low.  Bad news. My estrogen is low. It was 681. It barely rose from yesterday.

Oct. 22 - CD 13 - follicle check. The left side had a 23, 16, 12. The right side had a 25, 21, 19, 18, 17, 12. (I think some of those numbers are wrong. I wonder I the lady yesterday got the sides screwed up.)  Anyways estrogen did rise today to 860, so that's good. We trigger tonight at 9:20 pm for a retrieval at 9:20 AM on Thursday. I'm worried about this one. My prediction is 7 eggs, 5 mature and 2 able to be transferred for a 3 day transfer.

Oct. 24 - CD 15 - Retrieval day.  9 eggs retrieved!  :)

Thursday, October 3, 2013

Planning appointment

So for the next IVF we'll be doing a fresh transfer.  With 7 blasts in the freezer, I feel comfortable going for it!  There's nothing to really report.  We'll pretty much do what we did last time.

We'll also be adding in intralipids and Lovenox.  So sometime around October 14th I'll start meds and we'll be on our way!

Saturday, August 31, 2013

IVF #2 Final Results

10 eggs retrieved

Of the 10, 8 were mature and 4 fertilized. So basically the same results as last time when it was 9 eggs retrieved, 6 mature, 3 fertilized. Let's hope it stays the same as last time and all 4 make it to blast.

So on day 2 they called and left a message. (They called at 9:30 which was way before I expected them to call). The nurse said that all 4 were continuing to cleave and the lab would be following up with me. I tried to call back and was on hold for 2 hours. Clearly no one is there on Labor Day. I'll call tomorrow.

On day 3 they are 1 8 cell (perfect) and 3 6 cells.  I wish they were all 8 cells, but anything from 6-10 cells is considered normal.   They all have no fragmentation and look picture prefect according to the embryologist.  It's a very good thing. 

On day 4, there was one that was a compacted morula (which is exactly where they're supposed to be).  The other 3 were "we'll on their way". She said they just rank them as greater than 9 cell and that's where they are. More tomorrow....

On day 5 there were 2 early blasts which may be ready to freeze this afternoon and 2 compacting morulas.  The embryologist was pleased and felt that we may be able to freeze them all.  She stated they are growing as they should.  :)

On day 6 we have 4 high quality blasts frozen!  :)  The embryologist was very pleased with them.  2 were 2AA and 2 were 2BB.

It's simply unheard of that all fertilized embryos make it blast.  And it's been 2 cycles now!  That just doesn't seem possible for it to be a fluke at this point!  Does anybody out there have any thoughts on this?

Thursday, August 22, 2013

IVF #2 day to day results.

In 2 weeks DH will be out of town. Last cycle I had my retrieval on the Saturday when I started my period on a Saturday. Just in case I run late this time I'm going to start my stims a day earlier.

Saturday, August 17, 2013 - CD1 - I started my period.

Sunday, August 18 -  CD2 - Did 450iu of Follistim.

Monday, August 19 - CD 3 - All looks good to start. They didn't give me an antral follicle count. Estrogen was at 65.5, progesterone was at 0.559 and FSH was at 11.6. (Not surprising since I injected a ton of FSH the night before.)

Thursday, August 22 - CD 6 - Five measurable follicles.  I wish there were more, but there it is.  The left ones were 11.9 and 9.7 with no smaller ones.  The right ones were 10.5, 9.4, 9.3 with some smaller ones. Estrogen was at 202. (It's much higher than last time. I hope that means there's more follicles growing than reported.). Progesterone at 0.7.

Saturday, August 24 - CD 8 - 8! Right measurable follicles at 15.9, 13.5, 13.5, 13.1, 12.7, 12.6, 10.9, 9.4. And 6 that were too small to measure. Five on the right and three on the left. (I knew that witchy u/s tech missed some).  Estrogen was at 398, so it basically doubled so that's good.

Monday, August 26 - CD 10 - I had the u/s tech who does a horrible job, IMO. I was watching and in sure she missed some and did bad measurements on others. BUT, she came up with 7. 18.6, 17.1, 15.8, 13.9, 12.8, 12.6, 12.2, 9 and 2 other smaller ones. Estrogen was at 573. 

Wednesday, August 28 - CD 12 - I knew that u/s tech missed some!  11 measurable follicles today. :) They are 21, 20, 18, 17, 17, 17, 16, 16, 13, 12, 11. And 2 smaller ones that won't make it.  Estrogen at 1031, P4 at 0.9 and LH at 0.8. I'm a little worried about the progesterone going above 1, but that only matters if we end up with a fresh transfer. They're going to push it for one more day and probably trigger tomorrow.

Thursday, August 29 - CD 13 - everything looks good today!  13 measurable follicles!  I guess those 2 small ones came out to play. They are: 22.5, 22, 21, 21, 20.5, 20, 17.5, 16.5, 15, 14.5, 14, 13.5, 13.  Estrogen was only at 1138, so it barely rose from yesterday. I'll still trigger tonight at 8 pm, but I'll also take my meds for one more night to help everybody keep growing. In good news, progesterone was at 0.8 so it remains nice and low.

Saturday, August 31 - CD 15 - Retrieval at 8 am.  10 eggs. It's a little disappointing. We'll find out tomorrow how many were mature and how many fertilized. 

Wednesday, August 14, 2013

The results from Dr. Kwak-Kim

So, the gist of it is that the bloodwork from Kwak-Kim does not match the bloodwork from Coulam.  :( 

Kim's bloodwork showed my NKC's to be low or normal!  She does not recommend IVIG.  (Which I'm glad about because I wouldn't have done it anyways!  I'd stick with the intralipids.  But, since it doesn't appear it's going to come up, I won't have to battle her!) 

She found a positive result for antithyroglobulin antibody.  Coulam ran the same test and found it to be negative.  This particular antibody is one that attacks the thyroid over time.  Currently my thyroid levels are completely normal.  Kim feels that the stress of a pregnancy may be more than the thyroid can handle, the antibodies start to win and I become hypothyroid (have low thryoid levels).  Luckily the only treatment plan for this is to check my thyroid levels weekly through early pregnancy.  Fine with me. 

By the way, I trust Coulam's tests more.  Coulam's tests gave an actual level, whereas Kim's test just said normal or not normal.  That just doesn't seem as accurate to me.... 

Also, both Kim and Coulam tested about 30 different antiphospolipid antibodies.  Coulam found none of them to be elevated (and had precise numbers as to what each of them was at).  Kim stated that almost all were normal and one was considered borderline and one was considered elevated.  Again, she didn't have actual numbers, just the test results that said elevated and borderline, so I don't really know what the numbers were.  Kim's treatment for that would be Heparin.  I'm starting to lean toward taking the Heparin anyways.  Many studies seem to show that it falls into the we-don't-know-if-it-helps-but-it-can't-hurt category. 

So, that's the gist of Kim's findings.  She wants me to do Heparin and prednisone daily from cd6 and test my thyroid regularly.  Coulam wants me to do intralipids about every 4 weeks from ovulation onwards. 

My plan is to do Heparin and intralipids and to NOT do the prednisone.  I have some concerns about taking a steroid.  Last time the dexamethasome really screwed me up.  But, if we have another loss, I'll certainly be revisiting the steroid issue. 

That's it for now.  Now, I'm still waiting for my period which should show up any day now....

Thursday, July 25, 2013

Another doc, another opinion

So to keep everyone up to speed, I got my period last Thursday after an 11 day luteal phase. Not surprising since I quit the progesterone at 4 dpo when it became apparent that all my embryos would make it to blast (woo-hoo!). So now another 3-4 weeks before I start my next IVF cycle. Today I have 3 docs appointments:

1. I set up an appointment with Dr. Kwak-Kim in Vernon Hills. She's the other RI in the area. I actually set up the appointment months ago, but she is extremely hard to get into. So, they ran an in depth u/s, a ton of bloodwork and a full history and then I talked to the doc. It'll be a few weeks until the bloodwork comes back, so I'll go back 8/13 to find out those results. The u/s was the interesting part. She determined that my Resistance Index (RI) was at 0.61 for my uterus, 0.57 for my left ovary and 0.46 for my right ovary. It's a scale of 0-1 with lower being better. 0.6 is their cut off. Higher than that is bad, lower is good. So the ovaries look good and the uterus looks bad. I have a few concerns about this determination. Since I'm at cd5 wouldn't it make sense that my ovaries are getting a lot of blood flow as the start to grow a follicle?  And wouldn't it make sense that my uterus is limiting blood flow since its at the very tail end of my period and its trying to stop the bleeding?  They acknowledged this, but still felt it should be better...  Eh, I'm not sure. I know she's going to want to put me on Lovenox and I need to do more research on that to determine if its something I want to do.  

One interesting study I found is this:

It states that the RI is greater in women with elevated NKCs.  Hhhhmmmmm.  So it would appear that treating the NKCs would solve the decreased blood flow problem.  

Another interesting side note is I often wonder why the twins did so "well".  They were unlike my other low and slow losses.  They looked great at 13 weeks.  All of the docs have just dismissed the twins as a red herring saying well they probably died from the twinning process itself.  I don't disagree, but my question is why did they do so well???  One thing that was different was before they were conecived I started on low dose aspirin (LDA).  After they died, I quit the LDA, afraid that it might have contributed to their death.  Since I had 2 losses after that I've gone back on the LDA and have since had some high quality cycles.  Correlation does not equal causation, but I'll be staying on the LDA.  

2.  The dentist. After a lot of self reflection, I wonder about my teeth. After my dd was born I had a bunch of dental work including a root canal. Since the elevated NKCs indicate a low level infection somewhere in my body, I wonder if its not the root canal. I saw a homeopathic dentist, but she takes no insurance nod wanted about 4K to pull the root canal tooth. I also have a couple other cavities. I decided to go to my regular dentist who takes my insurance and get the work done here. First I'm going to get one of the teeth fixed that has a particularly bad cavity. Honestly, and this is a little embarrassing, it's the tooth right next to the root canal. And for quite a while there been a bad smell on the floss from that tooth. I thought it was the root canal, but in hind sight, and the homeopath said this, it's probably from the cavity. Also, each IVF cycle has put me on antibiotics and each time the smell has gone away for awhile only to come back later. So I'm hoping to get that tooth fixed. Maybe that's the source of the infection. It certainly feels like a good candidate. And I REALLY don't want to lose a tooth.....  

3. Follow up with the RE.  So, she was pleased with the cycle.  She said she wasn't surprised, though, since I get pregnant easily enough!  Well, I was surprised.  She offered an alternative stim cycle of the Micro Dose Lupron Flare.  My only concern with it is that I'd have to start with BCP.  Last time I took the BCP, it completely messed up my cycle.  Or, maybe it was the Dexamethasome.....  Either way, I have no desire to take either one again.  She was fine with that.  We did decide to add the Saizen (Human Growth Hormone) to the first 5 days of this next cycle and then the antagonist cycle again.  We'll up the starting dose of Follistim to 450 iu.  Sounds good.  And, that's it.  It'll be another freeze all cycle and then if it's as successful as last cycle, we'll do a fresh cycle. 
So, that's it.  I'll update again when I start my next cycle. 

Saturday, July 6, 2013

IVF #1 Results

7 measurable follicle seen on ultrasound on the day of the trigger shot.

9 eggs retrieved. 

6 eggs were mature. 

3 fertilized by day 1. 

All 3 still alive at day 2.  They are officially two 4 cells with no fragmentation and one 3 cell with no fragmentation.  We're going to push out to day 5 and see what happens. 

All still alive at day 4. They are officially one "compacted", one "half compacted" and one is a 12 cell. In layman's terms, this is one excellent, one good and one fair. I'm currently scheduled for the transfer tomorrow morning, but first they'll call me tomorrow before that as tell me the status of them.  If the 12 cell is going to make it, it might not make it blast until the 6th day.

Woo-hoo!!!!  Great news day!  When they called this morning the best was a 2AA and they were going to freeze it immediately. The next was going to be ready to freeze in a few hours and she thought it would be a 2AA or a 2AB at the time if freeze. The last was a perfect compacted embryo (also known as a morula). The tech felt it looked great and would be ready to freeze tomorrow. I'm so happy and relieved. When we only got 3 fertilized embryos I wasn't sure we'd make it freeze. Now, hopefully, they'll ALL make it to freeze. Unbelievable. 

Final status report:  All embryos made it to blast!  The first one from yesterday was a 2AA.  The one they froze a few hours later was a 2AB and the one they froze today (day 6) was a 2BB. 


Monday, July 1, 2013

Next steps. Thoughts?

So, after this cycle DH and I will be taking a vacation.  This vacation has been very successful in baby making in the past.  Our 2 children were both conceived on this vacation we take every year. 

My question is this, should we try again this year? 

My P4 has stayed remarkably low this cycle.  So, if I get the intralipids to treat the elevated NKC activity before we go, wouldn't this cycle have just as good of a chance as any other? 

Of course, if we get pregnant and miscarry it'll set us back again.  Right now we're looking at our next cycle being in the end of August.  The end of July will be out of the question because of the vacation.  A pregnancy and loss will set us back again until October.  :(  But, of course, if the only problem is the NKCs, we could be successful.... 

Or, do we just stay the course and do 4 rounds of IVF, freeze all and then do a completely controlled FET? 

DH wants to stay the course.  I'm inclined to go for it. 


ETA - Well, my latest thoughts are that if we are wildly successful or wildly unsuccessful at this cycle, we'll go for it.  If we're wildly successful (4 or more 5 day blasts), we won't  need to do any more cycles.  If we're wildly unsuccessful (Zero blasts) we will be wondering if any IVFs will work so we might as well try on our own. 

Thursday, June 27, 2013

IVF Day to Day Results

So, I'll just keep this post updated with my day to day results: 

  • Saturday, June 22nd was CD 1

  • Monday, June 24th was CD 3 and the day the meds started.  (375 follistim and 150 menopur). On this day I had 12-14 antral follicles and my estrogen was at 57. 

  • Thursday, CD 6 and I had 1 visible follicle on the left and 5 follicles on the right, the largest being 10.  Estrogen was at 108 and Progesterone was at 0.827.  (I'm pleasantly surprised by the progesterone.  Let's see if it stays down.  And, the Estrogen is rising nicely.  I wish there were more visible follicles, but not too bad.)  So, overall, better than the last 2 times. 

  • Saturday, CD 8 and I still had the same 6 follicles growing. I wish there were more but at least I didn't  lose any. They are 13, 12.3, 12.3, 9.1, 8.6 and 8.  My estrogen was 237.  So, it's good my estrogen is rising appropriately. I keep on my meds and tomorrow night I add Ganirelix to prevent premature ovulation. Progesterone at 0.682. 

  • Monday, CD 10 and the follicles on the right grew perfectly at about 4mm each.  They are now 17.5, 16, 16, 14, 12.  The one follicle on the left does not want to play and it did not grow at all and remains at 8.6.  Estrogen was at 520, so it continues to double nicely and Progesterone remains low at 0.7.  The doc upped my dose to 450 iu Follistim and 150 of Menopur.  I'm a little concerned that she's upping the dose now.  Shouldn't she have upped the dose on the first day when it was apparent that only a few were growing?  Sigh.  Oh well.  Maybe we'll start out with a higher dose when the next cycle starts. 

  • Wednesday, CD 12 and the follicles continue to grow right on track, so that's good.  Again they all grew about the requisite 2mm a day.  They are now 22, 20, 19, 17.5, 16 and a small one on the right also decided to join the party and is at a 13.  The left side barely grew and is now at a 9.5.  I thought I'd trigger, but my estrogen was only at 757. :(  I'll do one more day of meds. 

  • Thursday, CD 13 and the follicles are at 23, 23, 21, 20, 18, 15 and the one on the left is at 11.5. My estrogen is at 1027.  I triggered at 8:20 pm for a retrieval on Saturday morning, cd 15.  Keep your fingers crossed.  
  • Saturday, CD 15 : retrieval day. 9 eggs retrieved. So, that's good news. I doubt whatever 2 little ones they found will be mature enough to fertilize, but we'll find out more tomorrow. 

Monday, June 24, 2013

IVF #3 (?)

So after a long break, we're back at it.  About 3 weeks after the miscarriage started I ovulated and I had a blood test which showed an HCG back at zero.  And this last Saturday I got my period.  (I was sweating it for awhile there.  A 14 day luteal phase!  Who would of thought!?!?!?) 

And in bigger news in the meantime, I met with one of the Reproductive Immunologists.  I was completely expecting her to say, nothing's wrong, everything's fine, I have no idea why you're miscarrying.  But, she actually found a problem!  My Natural Killer Cell activity was at 14.7% and it's supposed to be less than 10%.  So, in addition to the elevated progesterone problem, this appears to also be a problem.  The good news is, it's treatable.  We would do intralipids from before the transfer to birth every month or as needed.  So, maybe, maybe, we're finally getting down to the heart of the problem. 

Anyways, so today is CD 3 and I went in for bloodwork and ultrasound.  Everything looked great.  This new doctor's office is less intensive, which is fine with me.  They didn't actually count the number of antral follicles, but she said I had 6-7 on each side.  Woo-Hoo!!!!!  That's 12-14 all together.  That's great news.  It seems like everything is back where it should be.  It'd be great to get 12-14 follicles!  But, let's not get ahead of ourselves. 

My meds are as follows: 
375 iu Follistim
150 iu Menopur

And, I do this every night and come back Thursday morning.  On Thursday we'll have a better idea on how things are going.  But, for now things look good.  Keep your fingers crossed. 

ETA - And just for the record, this is my bloodwork: 

Estrogen - 57
FSH - 7.69
LH - 3.42
HCG - Negative

Sunday, May 26, 2013

My fifth miscarriage

So, the title says how this will end. 

The first HCG was 36 at 15 dpo.  We all know this is a bad number.  2 days later it was 52 at 17 dpo.  And, 2 days later at 19 dpo it was 102.  3 days later at 22 dpo is was 209. 

At 6w1d, I started bleeding.  It picked up and they did another blood test at 6w3d and it was 146.  So, that's that.  I'll do another blood test next Tuesday and as long as it's down, I'll be happy. 

So, whenever I get my period next (which won't be for another 3 weeks at best) I'll start my IVF cycle with the new doc.  One thing this does seem to point to is that all these losses could be due to the premature rising progesterone.  So, possibly, the premature rise in progesterone is causing the endometrial lining to be out of sync with the embryo giving the embryo a suboptimal place to implant. 

I'm doing two things to help my chances.  First we'll do freeze all cycles with the IVF and then put the embryos back during a hormonally controlled cycle. 

Second, I've made appointments with 2 reproductive immunologists to have them run all those sorts of tests and make sure that there's no problem along those lines. 

Saturday, May 4, 2013

so, wow....

Wow.  It's been a busy week.

So, I got the new doc appointment pushed earlier to last Thursday on May 2nd.  I wanted to get in before my period in the hopes that she'd be willing to start this cycle.  Well, she was on board!  She's willing to start as soon as I get my period!  So, great news!  I spend the next few days getting all the paperwork together and all the records from my old doc.  I also saw some brown spotting and starting having cramps.  I've been down this road before and I started to get suspicious.

Sure enough the HPT was a faint positive.  Sigh.  I don't know if I should be sad, excited, angry, frustrated, terrified, all of the above?  It was a late BFP (12 dpo) and we all know that's a bad sign.  So, I took a FRER this morning at 13 dpo and it was fairly dark, so that gives me some (false?) hope.

I called up the old doc and set up a beta blood test for Monday.  I don't want to tell the new doc in case this is going to be a quick chemical.  If it is, I'll just flow right into the IVF.  I'm afraid if she knows, it'll completely delay the IVF.

So, we'll see what the blood test says Monday and I imagine they'll want to do a second test on Wednesday.  I think then we'll have a good idea on how this (my seventh pregnancy!) is going to play out.

So....  wow....

Thursday, April 25, 2013

Letter to the new doc

So I want to write a letter to the new doc to explain my history and wishes as succinctly as possible.  Here goes:

Dear Dr. Hirshfeld,

I don't know if you remember me or not.  I started seeing Dr. Stephenson after my second miscarriage.  She did lots of testing on me and never found anything wrong.  I followed her when she moved from U of C to U of I and I met you during my next pregnancy.  This one turned out to be monoamniotic identical twins.  This would be my third miscarriage.  I got pregnant again quickly after that and immediately had my fourth miscarriage under your care.  We talked and I decided I wanted to try to do IVF with PGD, to hopefully find a the euploid embryos.

I went to see Dr. Hickey at Hinsdale IVF and as I started my IVF cycles it became clear that I have Diminshed Ovarian Reserve.  My first cycle was cancelled when I only had 3 follicles developing and my next cycle I only had 4 follicles develop.  My FSH was always around 5-7, but my AMH was at 0.24.  Additionally, it became apparent that my hormones were also out of sync as my Progesterone began to rise before ovulation.

Here's what I would like to do.  I have infertility coverage on my insurance and I would like to do 4 IVF cycles in which we would freeze all embryos we get and then start putting them back in a hormonally balanced cycle.  I hope this would circumvent the previously listed problems and hopefully preserve whatever fertility I have left so we can continue to grow our family.

Thank you for reading this.  I'm really hoping you can help me.

Signed, Me

So how does that sound?  If you were just reading this letter from the outside would it make sense?  

Friday, April 19, 2013

The end of a doc...

So, the follicles were about 23.5, 22.5, 20 , 19 and a 10. 

So 4 good follicles today, estrogen at 717 (it should be about 200 per mature follicle) and lining at 11.

BUT, the doc called and they never call if its good news. He said my progesterone was already starting to rise and was at 4.8. This is too high for pre ovulation. He feels that this is the reason I've been miscarrying. He feels that my hormones are out of sync with my cycle.

The phone conversation was almost comical. He clearly wants to get rid of me and started giving me the speech that I'm not going to have any more kids, love the ones you have, the only answer is donor embryos an I cut him off and said. "So if the problem is my hormones are out of sync with my body then won't a freeze all cycle and FET solve that?" He stopped and admitted that that would actually work. Ha!

But I'm done with him. I'm moving on. So I'll still trigger tonight and get together with DH. And what will be will be.

One thing I don't understand. I understand the implantation window for the endometrium. But embryos have a few days to implant as we all know. They can implant anywhere from 6-12 dpo and still be fine. We know that 8-10 dpo is a very good implantation window. So if my hormones are just a couple of days out of sync, I still could have a successful pregnancy, right? 
After looking it up, I DO see the studies that say that high progesterone on the day of HCG administration has a much lower pregnancy rate.  But, it seems to me that because my body wanted to ovulate a few days ago, my endometrium was just advancing like it wanted to as if I had ovulated when my estrogen peaked.  Did that make sense? 
And, I found a study to back this idea up.  It seems the endometrium keeps advancing as it should even if you chemically stop the LH from surging. 
Once again, the answer for this is to freeze all and put the embryos back in during an in sync cycle. 
So, this all comes down to that I'm one with this doc and I have an appointment with a new doc for May 6th.  So, a crappy 2 week wait (which will probably be less than 2 weeks since the endometrium will have advanced faster....) and then I'll see the new doc. 
The full plan going forward is to do 4 IVF cycles and then do FETs.  So, here we go again.  I just hope this doc is on board with my plan. 

Wednesday, April 17, 2013

IVF 1.2 (?) Update

So, on Sunday the Doc had me come in and check things out.  I had the following follicles:  16, 13, 13, 12, 10,7 and they later told me my estrogen was 180.  So, I'm feeling slightly vindicated for keeping going.  I asked the doc about the Ganirelix to stop me from ovulating the 16 before the others were ready.  He seemed unconcerned but said I could start it Tuesday night if I really wanted to.  I started it Monday night.  I know follicles grow 1-2 mm a day and I didn't want the 16 to become an 18 and ovulate before the others were ready.

Well it worked!  Today, Tuesday, the follicles were at 18, 17.5, 17, 16, 12, 10, 8, 7, 7.  So the 4 good ones are still going strong and are really close in size.  The Ganirelix let the 16 slow down and the 12 and 13s catch up. 

The nurse today said the doc wants to see a minimum of 3 to do IVF.  Now, I'm not sure I want to do IVF with him.  I've already made another appointment with a different doc who might see more willing to work with someone with DOR.  But, if I go to a new doc, I'm afraid that I'll have to start this whole process over again which just sounds exhausting.  At the same time, I don't know if this doc is able and willing to treat me.

My plan is still to do my 4 IVFs covered by insurance and freeze all embryos we get.  Then once we have a pile start putting them back.  Whatever doc I start that process with I'm stuck with.  I wouldn't want frozen embryos all over the place.

So, what should I do?  IUI this month with 4 very good follicles and 2 behind?  Or stick with this doc and start building my pile of embryos?  Or just do one cycle of IVF with this doc and if that doesn't work do my next 3 IVFs with a different doc?  (I really don't think I'd the third option.  If I'm going to do IVF I'd like to try to build the pile.)  

Thursday, April 11, 2013

IVF #1 Take 2

So, this cycle didn't start out much better.  Only 3 follicles seen on the initial u/s, but we charged ahead anyways. 

Not much has happened and the doc's wanted to cancel us yesterday.  Estrogen has not been rising as much as it should.  But, I feel why bother cancelling?  What's cancelling going to get me.  It's certainly not going to get me pregnant! 

So, there were 2 good follicles today and 3-4 little ones. I have good insurance and meds are only a $40 co pay. So, I talked the doc into continuing on at a lower dose to try to get those 2 to grow and either doing timed intercourse or an IUI. None of this makes any sense. We never had a problem getting pregnant. The longest amount of time to conceive was 4 months!

I'm trying to figure out what went so wrong and there were only 2 things that changed from testing to cycling. That was the addition of dexamethasone and the birth control pill. I'm starting to suspect the dex even though the doc says it can't be the problem. If DHEA is so important to older women (and lots of studies say it is), dex is the anti-DHEA. Dexamethasone causes DHEA to fall. I asked the doc today about DHEA and he felt it doesn't really do anything, but if I want to try it go ahead. Well, I know the studies show it does do alot for women with DOR. Here's a list of the studies in case anybody's wondering: So maybe after a few months and the dex gets out of my system... After looking that up, the half life of dex is only 36-54 hours, so it should be all out of my system. The more depressing theory is that since DHEA seems to work at improving the follicular environment, the dex may have damaged the follicular environment. Since folliculogenesis takes months it may be a long time before the follicular environment has recovered from the assault. I'll know I'm right if my AFC recovers over the next few months.

So, doc also ordered an AMH test. That's fine I've never had one. If the AMH comes back low, we'll know it's DOR. If it comes back ok, the doc's other theory is that some women's bodies just don't respond to exogenous FSH. So, all the Follistim in the world wouldn't have that much effect on me. In that case, the only other answer is to use my body's own hormones through a Lupron flare protocol or clomid.

So much to think about...

Tuesday, March 26, 2013

IVF #1 Cancelled

So I haven't posted in awhile be aide I've been angry. They cancelled me on Sunday. There were only 3 follicles and they were pretty good size. Like 15, 12 and 11. So the doc felt that we should just try again next month. So everything was cancelled.

Fast forward to today and last night I had a ton of EWCM so there's only one thing to do and that's jump DH. :)  So we're technically still in the running this month.

I also had an appointment with the doc to plan for next month. We'll do a natural start and so we'll see how everything goes then.

I've had some crisis of faiths that we're doing the right thing here, but I'm feeling back on track. Hopefully next month will start out better. I'll keep you posted.

Friday, March 15, 2013

IVF #1 Begins

So I got my period Tuesday and Wednesday I went in for baseline u/s and bloodwork. 

After a bit of a freak out, it all comes down to this.  My body was pretty suppressed by the BCP as they could only find 2 antral follicles and my E2 was at 18.  They want to see it at least at 20 before starting stims.  So, I go back Thursday for more bloodwork. 

For the record:
FSH - 7.8 (This is higher than the usual 5, does this mean my body's trying to get something going?) 
E2 - 18
P4 - 0.8 

I **think** the AFC that matters is one when there's no suppression.  So, the last one at 15 is what counted.  I hope so.  I would not be happy to go through all of this and get 2 measly follicles. 

Thursday I went back in for bloodwork and my estrogen was still at 18!  Ugh. I have to go back in on Friday for an ultrasound and more bloodwork!

Which brings us to today, Friday. The bitchy nurse wouldn't tell me how many follicles she saw, but I heard 12 clicks. I'm hoping its 12, but it might just be 6. But, the important news is my estrogen was at 20, so I start stims tonight. 225 iu follistim and 75 iu Menopur. I'm going to split that into 2 doses because I read a study about how 2 doses a day is more effective than one. So 150 iu follistim tonight and 75 iu follistim and 75 iu Menopur in the morning.

I have to go back in on Sunday for more bloodwork and ultrasound. That seems a little early. What do they expect to see after 1 1/2 days if meds?  But I like information anyways, so it's fine with me. I actually think they just know insurance we pay.

Also on Sunday I'm going to talk to someone about giving me information. Information makes me feel in control of a situation in which I have no control. It makes me feel better. And in the end it's no skin off their nose, so just tell me what I want to know.

Wednesday, March 6, 2013

The plan.

So today we did the mock transfer and the injections teaching class.  DH also gave his sample to be frozen as an emergency back up in case something happens to him on the day of the ER (egg retrieval). 

So, Saturday is my last birth control pill and I should get my period in 3-5 days.  The doc said my lining was thin even though I was on the pill, so I guess my period should be light. (?)  Anyways, I then go in on my cd2 and start meds that night. 

So, let's say my period starts Wednesday, I go in on Thursday and they do an AFC and check for cysts and then I start the meds that night.  The plan to start is 225iu of Follistim and 2 doses of Menopur (that's 150iu) a day for 2 nights and then we'll do another u/s and bloodwork to see where we're at.  After 5 or 6 days of that, I start the Ganirelix to prevent premature ovulation.  Once I have at least 3 follicles at about 20x20 mm, we trigger. 

I'll post again when I start.  Wish me luck!!!

Thursday, February 21, 2013

Lets do this thing.

So, just to get you all up to speed, my progesterone at 6 dpo last cycle was only 6.5.  That's kinda low.  No big deal, really.  I was only at a 9 when I (successfully) was pregnant with my son.  And, they were going to supplement me anyways, so it's ok. 

I went in today for my cd 3 check.  My antral follicle count (AFC) was 15 which is pretty good.  I that in your twenties 10-15 is an average number, in the mid 30's it's 5-10 and in your 40's it's less than 5.  AFC has also been shown to have a strong correlation with pregnancy rates despite age.  Since I'm 37, I'm pretty happy with this number. 

My next appointment is 3/6 in which Jim will give a sample for the SA and to freeze in case somehow he can't make the retrieval day.  He also gets a bunch of bloodwork done to show he doesn't have any infectious diseases.  I have to do a class on how to give myself a shot and they go over any questions I have. 

So, I started birth control pills (BCP) yesterday and the dexamethasomne at 0.5 mg.  I'm hesitant on the Dex (it's a low dose steroid).  Some studies show no difference, some studies show a better response.  So, I think I'll take it during stims and stop after retrieval.  I know the doc will recommend I keep it through the early pregnancy, but I'm not comfortable with that.  Every study sees no benefit of taking it after implantation and there's a study in which it was given to premature babies to help them with their breathing.  It did that, but also caused long term lower IQ scores.  ....  I'm off track... 

************Insert caveat***********

I should warn everyone. I tend to take my medical care into my own hands.  So I listen to the docs, research their advice and make my own decisions.  Please don't send me a message saying that I should "just listen to my doctor."  Doctors aren't gods.  They don't know everything and they certainly don't know you like you know you.  It takes a smart doc and an informed patient to make the best medical decisions for you. 

*************Caveat finished************

On that thought, I'm supposed to stop taking the BCP on Sunday, 3/10 and get my period Wednesday - Friday.  But, I'll stop taking it Saturday and get my period Tuesday - Thursday.  Let's get this show on the road.  (For the finicky ones out there, I started taking the BCP yesterday which was a day early, so the total number of days will work out to be the same.) 

The next week, 3/18, will be the busy week of bloodwork, ultrasounds and stims. 

The procedure week should be 3/25. 

And then hopefully, we'll have some answers.... 


My cd3 bloodwork came in from this morning.  (I like how fast they are!) 

FSH - 5
E2 - 21
LH - 7.2

(I don't like how my lh is always a little higher than it should be.  I'm going to have to research that.) 

Wednesday, February 6, 2013

A test cycle

So, to pick up where we left off.  I did in fact cancel the 2nd RE appointment because I liked the 1st RE so much.  He was very much on booard with the plan.  So the first step for him is to see what one of my cycles looks like.  So, we run all the tests for the a normal cycle and see how it looks. 

The first step is CD 3 (CD=cycle day).  This can actually happen anywhere from cd 2-4 and since 3 wouldve been a Saturday I came in on CD 2.  They do an ultrasound and bloodwork.  The ultrasound showed that my uterus and ovaries look good.  No cysts, no malformations or anything like that.  No surprises.  The bloodwork was as follows: 

Estrogen - 27           This should be 25-75 with lower being better. 
LH - 4.3                  Should be less than 7. 
FSH - 4.8                Under 6 is excellent, 6-9 is good, 9-10 is fair, 10-13 is poor, over 13 is very bad. 
Progesterone - 1.8   Should be less than 1.5.  hhmmmm

Now for anyone who knows what all that means you'll notice that the FSH is excellent.  Really all the numbers are excellent especially for a 37 year old!  But, any FSH under 6 is considered excellent if I was 20 years old.  I was hoping for anything under 10 which would be only OK.  So, I was pleasantly surprised with such a great number.  It's also important to note that my estrogen was low and my LH was similar and slightly lower than my FSH.  All good signs.  The progesterone may have still been falling form the end of my last cycle, so I'm not too worried about that. 

The next step was a HSG on CD 7-10.  I went in on CD 9.  I'm kinda annoyed that the doc wanted this test since it was clear there was nothing wrong with my ability to get pregnant, only stay pregnant.  Anyways, this (as you all know) looks at the shape of the uterus and if the fallopian tubes are open.  Perfect and yes.  Moving right along...

Next is the "CD 14" tests.  CD 14 should be about ovulation day.  Since my cycles are pretty regular cd 14 does, in fact, tend to be ovulation day.  I had not had an LH surge by CD 14 so the office had me come in anyways for an ultrasound and bloodwork.  The ultrasound showed a perfect lining of 10.5 and one dominant follicle measuring 20x21 with fuzzy edges, which means it's about to ovulate or in the process of ovulating.  This is slightly odd since the OPK was negative that morning.  But, I guess the LH just hadn't made it to my urine yet because.... they also did bloodwork:

Estrogen - 258          Should be 200-600 per mature follicle
LH - 27.8                 Over 20 is considered the LH surge
Progesterone - 2.8    The nurse said this shows I ovulated. 

The last bit seems odd to me.  Maybe it's just rising as I ovulate?  But, honestly, this all seemed to happen too fast.  Shouldn't the LH surge first and then ovulation happen 24-48 hours later?  Yes, it should.  So, did this whole testing moment just catch the moment of ovulation?  I think the nurse was a little confused.  I think progesterone was only starting to rise.  Since the follicle hadn't collapsed yet and the surge was still occuring, I think ovulation will actually happen tonight or tomorrow. 

One annoying thing is that I guess they're used to speaking to the lowest common denominator.  I get that, but that's not me.  Today the nurse (different nurse) said as she measuring the endometrium, "That's the uterus - it's the place where the baby's going to be."  Um, yeah.  I think I got that part.  I just laughed and asked the exact measurement of my endometrium.  The I think she understood then she wasn't talking to a rookie. 

So, anyways, the next step is the "cd 21" testing.  It's really 7 dpo, but since my ovulation date is going to be almost "perfect" at cd 14, cd 21 is close enough.  By then they want to see the progesteorne at about a 15.  This is where I may not meet their standards.  My progesteorne tends to be a little low.  But, that's fine.  I really want to be supplemented with progesterone (which I think they'd do no matter what anyways).  There's some evidence that progesteorne helps the body not over react to an implanting embryo, so it's a good thing anyways. 

Well, the most interesting thing about this latest bout of information was that the IVF nurse said that if it all checks out (and it does) the doc could easily start the IVF cycle right away.  Like as in next cycle!!!!!  ARGH!!!  All this was only talk, but now it could actually happen!!!!!

Monday, January 14, 2013

First doc appointment

So, things went so well at the appointment with the doc that I'm thinknig about cancelling the other appointment.  I mean, what are hey going to tell me that the first doc didn't already tell me? 

I like this doc's more aggresive style.  AND, my biggest concern about this doc was that because he was a smaller outfit that their embryologist wouldn't be able to do the day 5 blastoderm biopsy that I would want to do for the PGS.  (There's a whole school of thought on what day to take out a cell to run the testing on it.  Here:  if you want to read all the studies.  Personally, I found them fascinating, but I'm wierd like that.) 

What it comes down to is that there's a certain amount of mosaicism that naturally occurs in splitting embryos.  Mosaicism is when the egg has one cell that split incorrectly, but all the others are normal.  The egg does a pretty good job of pushing the bad splitter to the side and continuing to develop the baby from the good splitters.  From the outside, you can't tell which eggs have split chromosonally well and which haven't.   So, the embryologist will take out one cell from a 3 day embryo (there are only 8 cells at this point, so the embryo can only afford one) and 2-3 cells from a 5 day blastocyst (which has over 100 cells at this point).  And, the embryologist can take the cells from the trophectoderm which is the part of the cell that will become the placenta. 

So, then the lab can look at those 2-3 cells and decide if there is mosaicism present and we can make a judgement call at that point.  Also, if they happen to take the day 3 cell that has the "bad" mosaicism, the whole embryo will be graded as bad.  Whereas if you wait, the embryo may have stopped dividing that cell and all the other cells are normal and you'll only get normal cells at day 5. 

BTW, studies show that about 1/3 of embryos have some mosaicism. 

But, the point of all this is, is I asked the doc how he felt about the ability of his embryologist to do a blastomere biopsy and he stated, "Frankly, we'd have the lab come out and do the biopsy.  They're more experienced and there the ones taking responsibility for the cells.  They like it that way."  And, so do I!  I'm always super impressed with someone who can see their own limitations and find a way around it.  So, right now I see no reason why we wouldn't go with this doc. 

Tuesday, January 8, 2013


So, for anyone who doesn't know the details, this is my current theory on why I've been having all these miscarriages. 

This article sums it up well:

Essentially, the theory is that some women have a uterine lining that is "too" receptve to embryos.  While as a "normal" woman will have a uterine lining that will reject low quality embryos, some women ahve a uterine lining that will let anything implant.  This leads to a shorter time to pregnancy than average (me) and a greater number of miscarriages than average (me) because the body fails to reject the low quality embryos. 

So, hopefully, IVF can help to preserve any fertility I have left and with PGS I can pick only the good chromosonally sound embryos to put back.