IVF #4 Results

13 eggs retrieved

Day 1: April 30, 2014: 10 were mature and 9 fertilized!!! That's my best response yet!


Day 2: May 1, 2014: All 9 still growing. 8 are 4 cell (right where they're supposed to be) and 1 is a 3 cell. We decided we're going to PGS them and include the 7 frozen since we're going to do it anyways. I hope this is the right decision.


Day 3: May 2, 2014: Feeling more discouraged today. :( They are supposed to be 8 cell today. 6 are 8 cell, BUT 3 of those are experiencing 10-15% fragmentation. One is a perfect 6 cell. (This doesn't worry me. I've had 3 6 cellers on day 3 before and they all made it to blast.) The other 2 are a 4 cell and a 5 cell, both fragmented. Those 2 have probably arrested. We finished the consent paperwork and our own bloodtests for the PGS stuff. We'll see how it goes tomorrow. If there are 1 or 2 that look great, we'll transfer them on day 5. If everyone's looking like they'll blast on day 6, we'll biopsy and freeze everything. Stand by to stand by....


Day 4: May 3, 2014: So, OK today. I found out they cultured them separately, so we know who has done what.
2 of the 8 cell-ers from yesterday are fully compacted morulas today. (This is just where they should be.)
2 of the 8 cell-ers from yesterday are 12 cell-ers today with no fragmentation. That's ok. I've had them at 12 cell before and they've made it to blast by day 6.
2 of them are 10 cell-ers. One of them was the 5 cell from yesterday! I'm surprised he turned it around! He has a little fragmentation, but otherwise looks good. What a fighter! The other 10 cell-er was an 8 cell from yesterday.
There's an 8 cell and a 6 cell from yesterday that are an 8 cell and a 6 cell today. That's a bad sign. Too bad about them. I had high hopes for them. :(
The last one is the four cell that was a four cell yesterday and probably a 4 cell the day before. This one's basically out of the running.

So, the plan is to see if 1 or 2 of the morulas are good looking blasts tomorrow and look ready to transfer. If so, we'll transfer at 9 am. If not we'll do no transfer this cycle. We'll just hope as many make it blast as possible and we can biopsy and freeze them.


Day 5: Here we are! So the 2 morulas from yesterday formed a perfect AA hatching blast and a 2cc blast. (We'll talk about the 2cc in a second.) One of the 12 cell-ers from yesterday jumped ahead and made a beautiful AA early blast.

Those 3 were transferred this morning.

The others are now 2 compacted morulas and 2 half compacted morulas. The 2 half compacted morulas don't look that good, so we'll see how they look tomorrow. One of them is the 5 cell to 10 cell from yesterday and the day before. :( Come on little fighter!

So about that 2cc....... They didn't want to transfer it. I insisted. When I looked at it with the embryologist she said that the ICM was actually really well formed, but the trophectoderm was degenerating. So would that make it a 2ac? I looked at some studies and feel really good about the decision to transfer it.

So, without further ado.  Here are the pictures I have: 

The one on the bottom left is the "2CC".  The top one is the top one below and the bottom right one is the bottom one below. 

This is the top one in the picture above.  It was an early blast rated AA in the morning, but really started to expand and by transfer it looks like it's hatching at the one o'clock in the above picture. 

This one is the 2AA in the morning.  It is definitely hatching at transfer which you can see in the top 2 pictures at between the 6 and 7 o'clock.  See that little bit sticking out?  That's the beginning of hatching. 

Day 6:  The embryologist called and stated none had made it to freeze.  Very angry about this.  She said they had made it to blast, but were 2CC and therefore not good enough to freeze.  I don't know if this speaks to an excellent quality for the 2 good ones and for an excellent quality of our frosties or what.  Hindsight being 20/20, I would have transferred the 2 morulas and the runt from above and vitrified and tested the 2 excellent ones with our frozen 7.  I think that would've given the most number of embryos a chance.  Or, I wish I had thought of really forcing the issue to freeze the bad ones.  If they don't survive the thaw, then so be it. At least they would've had a chance....  :(

Oh well, there's many things I would've done differently in this TTC #3 journey.  (Especially started sooner!)  But, all we can do is move forward and do the best we can. 

IVF #4 Plan for April / May

So for our fourth and final IVF we'll do a Microdose Lupron Flare.  I'm perfectly OK with cancelling if this doesn't seem to be going well.  But, my understanding is that the Lupron Flare tends to give higher Estrogen levels overall, so hopefully this will reflect on good quality embryos. 

We'll do 2 weeks of birth control with a hysteroscopy on Thursday, April 3, 2014 just to check and make sure everything is ok and to do an endometrial scratch.  Then somewhere around the 11th-ish, we'll stop the BCP and start the microdose Lupron and then we'll throw in 225 iu Menopur and 225 iu Follistim.  Here goes..... 

Update:  The hysteroscopy went fine.  My uterus looks normal as expected.  I guess the uterine scratch was successful because I'm still spotting 4 days later.  :$  I hope that'll stop soon.  I'm still not sure how Letrozole will figure into all of this.  I tried to ask while drugged after the hysteroscopy, but I don't think I was too coherent!  :P 

I'm just standing by to stand by......

March Plan...

Friday, February 28 - Get my period.  Start 2.5 mg Letrozole.

Saturday, March 1 - CD 2 - Follistim 450 iu, Letrozole 2.5 mg

Sunday, March 2 - CD 3 - Follistim 450 iu, Letrozole 2.5 mg

Monday, March 3 - CD 4 - Follistim 375 iu, Menopur 75 iu, Letrozole 2.5 mg

Tuesday, March 4 - CD 5 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg

Wednesday, March 5 - CD 6 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg

Thursday, March 6 - CD 7 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg

Friday, March 7 - CD 8 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg

Saturday, March 8 - CD 9 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg

Sunday, March 9 -  CD 10 - Follistim 300 iu, Menopur 150 iu, Letrozole 2.5 mg (BD)

Monday, March 10 - CD 11 - Follistim 300 iu, Menopur 150 iu

Tuesday, March 11 - CD 12 - Folistim 300 iu, Menopur 150 iu

Wednesday, March 12 - CD 13 - Follistim 300 iu, Menopur 300 iu, Trigger (BD)

Thursday, March 13 - CD 14 - (BD)

Friday, March 14 - CD 15 - Probable Ovulation Day (BD)


And the results are..... 


BFFN

February IUI Plan

Sunday, February 2 - Got my period.  This is shaping up to be a strong period.  After last month's period, I'm glad to see it.  Start 2.5 mg Letrozole today.

Monday, February 3 - CD 2 - Follistim 450 iu, Letrozole 2.5 mg

Tuesday, February 4 - CD 3 - Follistim 450 iu, Letrozole 2.5 mg

Wednesday, February 5 - CD 4 - Follistim 375 iu, Menopur 75 iu, Letrozole 2.5 mg

Thursday, February 6 - CD 5 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 30iu
Ultrasound: 11 follicles growing.  The biggest ones are 10 and 8.  Woohoo!!!!!  E2 = 60

Friday, February 7 - CD 6 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 25iu

Saturday, February 8 - CD 7 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 25iu

Sunday, February 9 - CD 8 - Follistim 300 iu, Menopur 75 iu, Letrozole 2.5 mg, HCG 25iu

Monday, February 10 - CD 9 - Follistim 225 iu, Menopur 150 iu, HCG 200iu, Ganirelix
Ultrasound shows follicles at 18, 17.5, 12, 12, 12, 11.5. Estrogen =122.
DH and I got together in the evening.

Tuesday, February 11 - CD 10 - Follistim 450 iu, Menopur 150 iu, HCG 200iu, Ganirelix
Ultrasound shows follicles at 18, 17, 16, 13, 12.5, 11. Estrogen at 157.  P4 = 0.6

Wednesday, February 12 - CD 11 - Follistim 450 iu, Menopur 150 iu, HCG 200iu, Ganirelix
Ultrasound shows follicles at 19, 18, 17, 15, 13.5, 13 and lining at 11.5. E2= 271.
DH and I got together in the evening.

Thursday, February 13 - CD 12 - Folistim 450iu, Menopur 150 iu
Ultrasound shows follicles at 20, 19, 18, 16, 16, 16 (but the tech thinks one of the 16s is a cyst). Lining at 13.5!  And E2 = 397. 15,000 HCG trigger at 10:30 pm

Friday, February 14 - CD 13

Saturday, February 15 - CD 14 - IUI at 12:30 pm (They were running late.). :(  So that's 38 hours past trigger and since I didn't take the Ganirelix Thursday night, it's technically possible that my body could've started surging earlier....  Eh. Who knows?  What will be, will be. But, if there's a next month I'll definitely do the 2 IUIs instead of the one. DH's count was great. 415 million total sperm with an 88% motility. The sample ended up with 71M total and 63M motile. They just want to see anything above 10M in the sample and at least 50% motility, so it clearly conquers those goals.

So, I guess now we wait.

And the results are: 

BFFN

I'm supposed to get pregnant and then miscarry.  I'm supposed to at least get a +.  I guess my body didn't read the script....

January IUI Plan

January cycle IUI:

December 6th - D&C
December 29th or 30th - Probable ovulation (finally!)
January 1st - Estrogen patch and progesterone injection
January 2nd - PIO injection
January 3rd - PIO
January 4th - PIO and another estrogen patch

January 9, 2014 - Got my period. CD 1
January 10 - CD 2 - U/S shows an early large dominant follicle. :( at 13.
                     E2 = 57, FSH = 7.2, LH = 6.1, P4 = 0.985, Endometrium was at 5.27

So, this cycle's not looking too good. It's like my body's already started days ago. I think rhe eatrogen was not good for me. So, we'll play this out, but it's not looking good. 450 iu Follistim.

January 14 - CD 6: Follicles = 17, 12, 8 and a few more under 10. E2 = 84, LH = 2.15, Lining at 6.55
                     Continue Follistim at 450iu, add 150iu Menopur and Lovenox

January 16 - CD 8: Follicles = 17, 13, 11. E2= 142, LH = 2.35, Lining is at 10 with a triple line.
                     Continue Follistim at 450iu, 150 iu Menopur, Lovenox and add in Ganirelix

January 17 - CD 9: Follicles = 19, 15, 12. E2 = 202, LH = 2.14, Lining is at 9
                     Follistim 450iu, Menopur 150iu, Lovenox and Ganirelix

January 18 - CD 10: Follicles = 21, 17, 13. E2 = 249, LH = 1.17, Lining = 9.2
                     Follistim 450iu, DTD with DH in the am

January 19 - CD 11: Trigger at 4am.

January 20 - CD 12: DTD with DH in the afternoon. Should've ovulated 4pm-ish.

BFN

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....

69XXX
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. 

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.


*****UPDATE*****

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.