Transfer Day!!!

Soooo... today was the day! We arrived at the surgical center at 10:30am. I had to start drinking 3 bottles of water as soon as I sat down to make sure I had a full bladder by 11:30. The nurse brought me back about 11:10 to take my vitals and have me take my prescription-strength Ibuprofin & Valium. Then we both got dressed in our Sunday best... :-)

After that, Dr. Griffith came in to discuss the latest embryology report with us. Of the 12 embryos we had on Day 3 (Wednesday), what we had remaining on Day 5 (today) is: 6 blastocysts, 3 morulas, and 3 were discarded due to lack of development. The 3 morulas will be watched through tomorrow to see if they develop into blastocysts as well. Those that do will be frozen. Those that do not will be discarded. So then it was time to decide how many blastocysts we wanted to transfer. Dr. Griffith said that we had 2 scenarios: 1) If we transferred 1 blast, we would have a 60% chance of becoming pregnant. 2) If we transferred 2 blasts, we would have a 70% chance of becoming pregnant and a 33% chance of having twins. So, at that point, we had a BIG decision to make. 1 or 2? We thought about it for a few minutes and decided we would "go big or go home!". (That means 2!) The reason we chose 2 is because this procedure is so expensive. If it does not work, we would have to spend more money to try it again with the frozen embryos. It's not near as much money as the IVF, but it's extra money that we do not have right now. So we figured we might as well give ourselves the best chance we can now. And, if God decides to give us twins, then it is meant to be! He will only give us as much as we can handle! Pictured below are our 2 blastocysts, or "little beans" (as I have been calling them all day)...

Next, we were lead into the surgical room, which is right next to the embryology lab. As soon as I was set up on the table and in the stirrups (sorry for the visual), Dr. Griffith had to make sure he had the ultrasound set up to see my uterus clearly and to make sure he was using the right-sized catheter. Shawn was able to sit next to me the entire time, which was wonderful for me and that he got to experience it all in-person. After a few minutes, the embryologist brought Dr. Griffith our 2 little beans. The catheter was inserted, and the little beans were deposited safety into my uterus. Circled in the picture below is a white line, which is the pocket of air that the embryos are in. Dr. Griffith said it looks like a beautiful shooting star because it went perfectly! The embryos are of course too microscopic at this point to see with the naked eye, even on an ultrasound. The long, white line above the circle is the separation between my bladder and uterus. The reason that my bladder had to be full was so it would push down on my uterus and make it easier for Dr. Griffith to reach. Speaking of a full bladder... I had to lay down for 30 minutes after the procedure to give the embryos time to settle. I have not had to pee that badly in a long time!!! When I finally got dressed, I was sprinting to the bathroom! I didn't think I would make it in time! Haha! But seriously... The moment the embryos were inserted, my emotions took over and I broke into tears. Not to worry -- they were happy tears! It was like the culmination of the last 4 years of trying to have a baby was finally coming together. What a miracle! I am so blessed to have such an amazing opportunity in my life! Just to think that there are now 2 little lives snuggled in my body trying to grab ahold of their future is amazing! Like I've said before, I do not know what the future holds. I won't even know for 2 more weeks if our little beans are going to make it. But I will pray without ceasing that God will take care of them and have faith that He is in control. Amen.

Day 3 Embryo Update and Happy Transfer Eve!

Sorry I haven't blogged in a few days. Between going to work every day this week and recovering from the egg retrieval, I've been kind of ho-hum. I haven't had much to blog about. Or maybe I just haven't had the energy. I've been pretty tired since the retrieval on Sunday. I have also had a lot of soreness and bloating in my stomach, which is completely normal. Apparently, the follicles fill back up with fluid after the retrieval and take a little while to get back to normal. Everything is still really swollen and bloated. But, overall, I'm doing pretty well!

The embryo transfer is scheduled for 11:30am tomorrow. I have been waiting all week for someone to call me with instructions for the procedure. But the only thing I could see was the appointment time on my online patient portal. So, around 4:00pm today, I called my nurse to see if there is anything else I need to know about tomorrow. She said "Didn't the surgery center call you with instructions today?" I said "No. Where were they supposed to call me?" She said "Yes, between 1pm and 4pm today." Well, obviously either they forgot or they were way behind on their calls. So the nurse proceeded to give me instructions, which consists of showing up 1 hour early tomorrow to take my Motrin and Valium and get my bladder as full as possible. Then, right before the transfer, the doctor will go over the latest embryo report with us and discuss how many we want to put in. We may have come to a decision on that, but stay tuned until tomorrow for the final weigh in... ;-)

Speaking of embryo reports... when I was on the phone with my nurse today, I asked her how the embryos are doing. The only thing I have heard all week was on Monday morning when I got the call that we had 13 embryos. So, since then, I have been wondering how our little beans have been doing. I have been praying for them every night. The nurse said that, as of Day 3 (yesterday), we still have 12 embryos hanging in there. Yesterday, two of them were 10-cell, one of them was 7-cell, and 9 of them were 8-cell. By day 3, ideally, you want them to be at least 8-celled -- so we are doing really well with at least 11 of them! Unfortunately, one of the original 13 had to be discarded earlier in the week. RIP little bean! But to still have 12 embryos growing strong at this point is such a blessing! I believe tomorrow they will check the quality of each embryo and decide which ones will be good to transfer, freeze, and discard. So the number may continue to go down, but we will see. I will make sure and post an update of those results tomorrow or this weekend.

So tomorrow is the day!! I am getting excited! Honestly, it hasn't sunk in yet that this is really happening. I'm sure once I am in the stirrups, having an embryo (or two) inserted in me, it will all hit home. I thank God every day for this opportunity and for the miracle of modern science. Without it, I would be so lost in my life right now. This has given me hope, and I am so blessed. Can't wait to see what the future holds! :-)

Video: Embryonic Development, Days 1-5

Lucky 13!

Today at 10:41am, I got a very important phone call. It was the fertility clinic calling to tell us that we have 13 embryos currently incubating! It's funny because that is EXACTLY the number of mature eggs that I guessed there would be, based on last week's ultrasounds. When we checked in yesterday at the surgical center for the egg retrieval, a nurse asked us how many eggs we thought would be retrieved. I told her I was not sure about the total number, but I believed that 13 of them would be mature. And I was right! They "eggs-tracted" 19 eggs, but only 13 fertilized. Which, more than likely, means that the other 6 eggs weren't mature enough to become embryos. This woman knows her body, let me tell ya! ;-)

So today the nurse also told me that, based on the high number of embryos we have, we will do a 5-day transfer instead of a 3-day transfer. It will happen between 8-11am on Friday. We still have not decided if we want to transfer just 1 embryo or 2. Everyone we talk to says 2, of course. However, we are a little nervous to do more than 1, as both embryos could end up implanting. On the other hand, we could transfer 2 and only 1 could be successful. And there is even the possibility that neither embryo could make it. So we are just going to wait and see what our doctor suggests, based on the statistics and quality of the eggs. You will just have to stayed tuned to find out! *evil laugh*

Realistically, by Friday, all 13 embryos may not survive. Typically, some of the embryos don't make it all the way to the 5th day. We will be very happy if at least half of the embryos survive. That way, we can transfer 1 or 2 of them and freeze the rest. If I do not get pregnant this time, then the frozen embryos will allow us to keep trying. Or, if this time does work and we want more babies down the road, all we have to do is thaw one of our embryos. All we can do is trust that God is in control and that He has our best interest at heart. I have been thanking God all day for this precious miracle! Just to think that 13 potential little Kirby babies are sitting in a lab right now with our DNA is amazing to me!! We are so blessed to have had this opportunity! I am definitely looking forward to the coming weeks to see what may be in store for us. If it is not the ending that we expected, then it is not the end! We will keep on trying until we are parents!

Heavenly Father, please watch over our 13 little embryos as they grow big and strong in the lab. If there are any that grow weak and do not survive, please bring them to heaven to be with You. I thank You so much for this opportunity and look forward to being a mommy one day, in Your time. I am so thankful for all of the blessings You have placed in my life. Amen.

Grow, little Kirby embryos! Grow!!

19 Kids and Counting...?? ;-)

The egg retrieval went magnificently this morning! Dr. Williams was able to extract 19 eggs from my follicles! The nurse said that, typically, about 75% of those eggs will be fertilized. If that is the case for us, we should have about 13-15 embryos to work with! However, it may not end up being quite that many, due to quality variances. But we will take whatever we can get! Only the best embryos will be transferred into my uterus or frozen for later use. We should know by tomorrow or Tuesday how many embryos we have. If there are more than 5 good embryos, we will transfer 1 or 2 of them on Friday. If there are 5 or less, we will do the transfer on Wednesday. We have not decided yet how many embryos we want to transfer. As we would prefer to have just 1 baby at a time, we would like to transfer no more than 1 embryo this week. However, the doctor will tell us on the day of transfer what he thinks the odds are of just 1 embryo being successful versus 2 embryos. The factors that determine the best number of embryos to transfer are: my age, health, embryo quality, etc. We will make our decision at that time, based on the data we are given. In the meantime, this afternoon, the eggs will be fertilized and monitored over the next few days. On that note, I think a prayer is in order:

Our heavenly Father, thank you for a successful retrieval this morning! Please guide the embryologists' hands and watch over our little embryos as they grow big and strong in the days to come. Thank you for the miracle of life!! Amen.

I thought that it might be helpful to post a few videos on IVF, since the process can be a little confusing and unfamiliar to most. Note: the second video below mentions that there are 2 ways to fertilize the harvested eggs: either by putting many sperm in each dish containing an egg to fertilize on their own or through ICSI (instracytoplasmic sperm injection). ICSI is where they take the good sperm and inject one directly into each egg. Due to our male factor fertility issues, we have opted to use ICSI as a means of assisted fertilization. Luckily, our fertility clinic uses this method exclusively as well and does not charge extra for the service, as most other clinics do! I chose to post 2 videos, as one is short and to-the-point, as the other video goes a little more in-depth through the process. Enjoy!

"The 5 Phases of IVF" (2-minute video)

"Inside the IVF Lab" (10-minute video)

So Egg-cited!

In less than 10 hours, all of my mature eggs will be harvested to be fertilized! I can't believe this day is almost here! We have to be at the surgical center by 6:30 to get me prepped for the procedure. I will be put under anesthesia, and the whole thing shouldn't take but 30 minutes or so. Usually, when retrievals are done on the weekends, you don't find out until Monday how many embryos there are and their qualities. However, as Monday is a holiday, we will have to hold out until Tuesday to find out! Talk about major suspense! As soon as we know something, I will be sure to blog about it.

I thought this photo was appropriate for the eve of my retrieval. It is fertility humor, so not everyone will get it. For those who do not already know, women are basically born with all of the eggs that they will ever have. Each month you ovulate one of those eggs. Tomorrow, I'll be rounding up a bunch of my girls to try and make some babies. Giddy up!

Day 13... TRIGGER TIME!! :-)

Just to re-cap from my last post, as of yesterday, my follicles were not getting bigger and my estrogen had decreased. There was a possibility that this cycle might be a bust. So, last night I did a lot of praying! I also came to terms with the fact that if it didn't happen this month for us, it would not be the end of the world. Sure we would lose about $900 in medications and 4 weeks of our time. But we would be able to try again next month. I knew that worrying myself to death about it wasn't going to help anything or change the situation. So I made my peace with it, one way or the other.

Luckily, when my doctor checked my follicles on the ultrasound today, they popped right out on the screen! There were lots of 17's, 18's, and 19's! I think we even saw a 20mm follicle! Needless to say, tears of relief ran down my cheeks. I was HAPPY!! The increased dosage had done the trick! The doctor said he was pretty confident that I should be able to trigger tonight and that our retrieval would be on Sunday. However... we would still need to wait for the bloodwork results to come back to make sure all of the stars were still aligned. Most importantly, we needed to know that my estrogen had gone back up since the drop yesterday.

Below you will see only screen shots of my right ovary and follicles from today's ultrasound. I am not sure why the nurse did not print pictures of my left ovary, as the doctor measured sizable follicles on both sides. In addition, for some reason, the left follicle sizes did not show up on my online results. So I don't have that exact information to share this time. But the right follicle sizes were: 19mm, 16.25mm, 14.8mm, 19.7mm, 18.98mm, 14.76mm, 17.24mm, 17.43mm, 18.85mm, and 17.74mm. We saw about the same number and sizes in the left ovary as well. The follicles will probably grow about 1-2mm or more between now and the retrieval. So, anything that is under 18mm still has a chance to mature and hopefully be fertilized.

RIGHT Ovary & Follicles

RIGHT Ovary & Follicles

RIGHT Ovary & Follicles

The rest of the afternoon was just a waiting game. I did not get the call from my clinic until 5 o' clock!! Talk about pins and needles! When I answered, the nurse said that my estrogen had increased to 2045! She also pointed out that my LH and progesterone were still low, at 0.109 and 0.862 respectively, which is the perfect scenario. If they had spiked, it could mean that I was about to ovulate. And we do not need ovulation to happen until Sunday morning. On that note, I will be administering a trigger shot of HCG (Ovidrel) tonight at 7:45 in order to prompt my body to ovulate within 36 hours. The timing has to be exact so that the ovulation will not occur until I am on the operating table on Sunday morning for the egg retrieval at 7:15. Not to worry... the shot is laying next to me as I type and will be administered in t-minus 8 minutes.

I am so thankful to everyone who prayed for me last night! I know God heard our prayers and answered them today! I have such wonderful people in my life! Most of all, I want to thank God for giving us this opportunity! I know good things will happen if I just trust in Him to let it be. To God be the glory!!

IVF Day 12... Need prayers!

I had my day 12 ultrasound and bloodwork done this morning. Here are my lab results: progesterone was 0.566, LH was 0.116, and estradiol was 1738. The nurse called me this afternoon to bring to my attention that my estrogen dropped a little bit (from 1965 yesterday to 1738 today). She said that it was not too significant, but the doctor would like to increase my medication dosages tonight from 150 units to 225 units for both Menopur and Gonal-F. They are hoping that this will bring my esterogen level back up. In fact, I just received a call from my doctor a few minutes ago to brief me on the drop in estrogen. He said he would like to personally do my ultrasound tomorrow to make sure everything looks ok. (Normally, the nurses do the ultrasounds & bloodwork, and then he is given the results in order to advise them how to instruct me to proceed.) He is concerned about the hormone decrease, as well as the fact that my follicles are growing so slowly. He said that he would actually be more concerned if my estrogen dropped and my LH & progesterone had spiked. That could have meant that my ovulation was not being suppressed, as it should be, and would be bad news for this cycle. But that did not happen, so he is hopeful that we are still in the game for IVF this month. I will know more after my followup appointment tomorrow.

As for my ultrasound today, here are the follicle sizes: (left) 14.23, 15.52, 10.81, 11.88, 12.9, 11.07, 15.01, 13.65, 10.38, 7.58; (right) 15.06, 11.84, 11.97, 14.97, 14.46, 17.14. The screen shots below are a little harder to make out this time. My ovaries decided to play peek-a-boo today and made it a little more difficult for the nurse to see/measure them. I'm a little bummed out because I feel like they didn't grow very much since yesterday -- maybe 1mm, if even that much. I hope that increasing my injection dosages tonight will also help my follicles mature a little faster, as well as improve my estrogen level. I am right on the cusp of the 18mm minimum for retrieval, but some of "my girls" need a little boost. I guess we will know by tomorrow if the extra dosage helps any.

LEFT Ovary & Follicles

RIGHT Ovary & Follicles

As for me... I am feeling really bloated and full these days. I can't wait to get all of these eggs out of me! (But not sooner than necessary, of course. I'll keep doing this for another week if I have to!) I've been wearing my "comfy" work pants and shirts this week to allow me a little extra breathing room. I will probably be a little worried tonight about my progress, as well as whether this cycle might be a bust. But all I can do is trust that God will see us through the remaining time we have left in this month and hope that it works out. Praying praying praying...

IVF Update... Day 11??

Yes, you read the title correctly... day 11! It has been 11 days since I started my IVF injections. Normal stimulation time is between 8-10 days, but my follicles are taking their sweet time to get mature enough for retrieval. The nurse told me today that it could be taking longer because I was on birth control prior to starting IVF (which is standard protocol). So my follicles might be taking a little longer to respond to the medications. Nevertheless, she also told me that I am still on track and that sometimes women just need a few extra days on meds to catch up. And I am ok with that!

So this morning was my day 11 ultrasound and bloodwork. My lab results are as follows: progesterone was 0.386, LH was <0.100, and estradiol was 1965. And my follicle measurements were: (left) 15.95, 13.16, 13.42, 13.83, 15.5, 10.81, 10.61; (right) 14.33, 15.28, 14.17, 10.06, 11, 9.6, 15.2, 14.34, 16.36, 14.25. The average sizes right now are 14-16mm, which means they only grew about 1mm per day since my last checkup. Normally, follicles will grow between 1-2mm per day. So the fact that there was growth, even on the low end (1mm), is good. They say that having follicles grow/mature too quickly can sometimes compromise the quality of the eggs. So I would much rather have slow-growing, quality eggs than rush into retrieval with a bunch of duds. It is also possible that not all of the eggs listed above will be mature enough to fertilize successfully -- specifically the ones currently between 9-11mm. Odds are they will probably not reach the 18mm minimum mark by the time of retrieval like the others will. But you never know! I at least have 10-12 eggs that may make the running. And, as long as they are quality eggs, that is more than enough for me!

LEFT Ovary and Follicles

RIGHT Ovary and Follicles

My doctor would like for me to come in tomorrow morning for a followup ultrasound and more bloodwork. Since I am getting closer to the "mature" follicle range of 18-22mm, they want to watch me closely to make sure that we do not miss our opportunity. I am still going to take 150 units each of Menopur and Gonal-F tonight to help my follicles continue to grow. I will also still take 250mcg of Ganirelix, which prevents my body from ovulating before it is time. Depending on my growth over the next few days, I may continue to take these shots until the doctor feels that the follicles are of optimum size and ready to be retrieved. Right now, they are guesstimating that the retrieval could happen on Sunday or Monday. I should know for sure within the next day or two. We're getting closer!! :-)

On a side note, my nurse mentioned on Monday that I would probably need to order refills of my medication, just in case. I only had enough to last me through Tuesday night, and the meds ship out from Walgreens Specialty Pharmacy in Pittsburgh, PA. These are not meds you can just go to your neighborhood Walgreens to pick up on the way home from work. They have to be overnighted. So right after I left my appointment on Monday, I called to place the refill order. They confirmed that the meds should deliver to my home the next morning. My sister-in-law Megan was going to watch for them so they could be put immediately into the refrigerator. Around 4 o'clock yesterday, I texted Megan to make sure the meds had arrived. She said they had not showed up yet. So I called Walgreens, and they showed that the package was left on our front porch around 10:40 that morning. The box was nowhere to be found. Needless to say, I started panicking. If I didn't get those meds in time for tonight's injections, the whole cycle could possibly be ruined. So Walgreens shipped out a duplicate order, but this time I had them delivered to my work instead. They showed up at 10am today, and I was so relieved! Thanks, Walgreens, for rescuing me!! And UPS... thanks for nothing! ;-)

Express IVF

Yeah... I wish!!

IVF Day 9 Update

I went in for my day 9 ultrasound and bloodwork this morning. Here are my blood results: progesterone was 0.401, LH was 0.234, and estradiol was 1408. The nurse said my labs look great!

As for the ultrasound, they counted 13-14 potentially mature follicles today! Most of them averaged around 12mm, which is still right on target at this point in the "game". In the left ovary, the follicle sizes were: 15.31, 11.63, 10.96, 11.26, 12.52, and 11.42. On the right, they measured at: 12.56, 12.94, 12.09, 11.76, 12.96, 9.79, 8.75, and 12.71. Here are a couple of screen shots for your viewing pleasure:

LEFT Ovary & Follicles

RIGHT Ovary & Follicles

We were originally thinking that I would stop the medications on Tuesday night and that the egg retrieval might take place on Thursday or Friday. However, they told me that I should plan on continuing the medications through Wednesday or Thursday, possibly even Friday night, to allow the eggs to keep growing. We are now anticipating for the egg retrieval to take place on Saturday or Sunday. This actually works out better for us since we won't have to use any vacation days off from work this week. (Even though I was looking forward to a day off!) So that would put the estimated embryo transfer date sometime between May 29th and June 1st, depending on which day the retrieval happens and if we do a 3 or 5 day transfer. My next ultrasound and bloodwork appointment is on Wednesday morning. Stay tuned for more updates!