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....






http://scholar.google.com/scholar_url?hl=en&q=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2125731/pdf/9022487.pdf&sa=X&scisig=AAGBfm2i5-VGN_VD2PMB7u6SY23P7pdrog&oi=scholarr

http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1999.tb08208.x/full