Last Days in Ohio

I have been very busy my last two days in Ohio. I have gone sledding with my cousin Cole. I drove to Dayton to visit Duncan & Aine. I came back to Columbus to see my second cousins Grace, Jason & Genna. Tomorrow I get to fly on another airplane to go home to New Mexico. It was a lot of fun out in Ohio and cant wait to visit my family again. On a sad note my mommy and daddy were trying to turn me into a big brother on this trip to Ohio but found out today that it didn't work. I am sad for them but also happy to continue to be the center of their universe :)

Medical Updates

Medical Updates (easiest to hardest)


1) Dexter saw the dentist today.  He has 5 healthy teeth, exam took 30 seconds.  That picture is Dexter at the dentist's waiting area.

2) I saw the fertility doctors today for my ultrasound.  This was also quick, they just measured my endometrial wall thickness (8.8mm - perfect) and then sent that info off to my doctor in Ohio.  We are now locked in to our 12/17 embryo transfer at 11:30am

3) Dan spent the day in the ER.  His left eye has been hurting him for a few days and it finally hurt so bad he thought he should get checked out.  A CT-Scan and MRI later showed a large sinus infection which is likely pressing against his eye causing the pain.  He now has some meds to clear that up and hopefully his eye pain goes away soon. 

That was our day today!

Let the shots begin

My Fertility Calendar

Picture of my meds for this cycle

Today I had my first of many shots to start this current frozen embryo transfer (FET) cycle.  I also had my ultrasound to make sure everything looked good inside (which it did).  This cycle isn't nearly as exciting as the first go round. Far less bloodwork and ultrasounds needed for a FET cycle but way more shots!  I have 3 different medicines that are injections this time and only one is a nice easy SQ shot in my fat.  The other 2 are in the muscle and Dan (and then Heather) is going to have to give me some of those shots.  The IVF cycle had so many ultrasounds because we had to constantly monitor the follicle growth of my eggs.  But since we already have a 5 day old embryo frozen in time we just have to give me tons of medicines to get my uterine lining nice and thick and welcoming to the embryo.   So I don't think there will be many updates on this area of our life until the actual transfer day (12/17) in Dayton.

Next Round of IVF has started

Ah, my old friend the ultrasound machine.  

Round Two of In Vitro Fertilization officially started today.  I got bloodwork, an ultrasound and started on a birth control pill.  In a few weeks I will start on shots and more ultrasounds, etc in preparation for the big day December 17th back in Ohio.  This will be a frozen embryo transfer so the process will be a bit easier than a fresh cycle.  I will be sure to let you know how things go.

baby number two?

Mommy and I went to a fertility doctor today to start the process of making me a brother or sister. I am not sure what that means but I got to sit on a chair and eat animal crackers while mommy talked with the doctor so I am all for it!

Back when I was made in the lab (Dexter's laboratory?) there we other little embryos with me. I was deemed the best (and really based on what I have done so far, can you blame them!) and got to grow in mommy's tummy. One of the embryos I was with was frozen in time and left back in Ohio. Well when mommy goes back to Columbus for Christmas they are going to put that embryo into mommy's tummy and see if it grows. Its called a frozen embryo transfer and I am sure when it gets closer to time to do this mommy will tell you all about it.

If it doesn't work then perhaps mommy and daddy will try IVF again, perhaps they will not. If not I will have to visit my cousins more than I do now because I miss them and mommy and daddy are not nearly as fun to play with as kids are.

What is a blog post without pictures of me? Boring, thats what. So here I am from a minute ago playing outside with my hose and water table. I know the two are connected but I can't seem to make the hose work.

OB Nurse meeting

Today I had my group meeting with the OB nurses. There were probably 6 pregnant women there for the information session. Before we all got together they took our weight & blood pressure and scheduled my appointment with the nurse practitioner. (Oct 14th, Tuesday). My blood pressure was great as usual, I remarked to them that several times at work I have checked my heart rate and it was ~120, during my check in the office today my heart rate was only 108..they didn't seem concerned as your blood volume is greatly increased during pregnancy.

At this meeting we saw several different groups from the hospital. The OB nurses went over what we could expect during some of the early appointments. A nutritionist went over that information. A person from Family Advocates group talked to us about support programs they offer (baby classes, financial classes, etc) And they gave us alot of handouts, videos and books. In fact they gave us 3 big books for free (What to expect when your expecting, what to expect the first year and what to expect in toddler years).

So next Tuesday I have 2 different appointments. First thing in the morning (8am) I meet with the nurse practitioner and I assume get a baby heart rate check and physical. Then at 11:15 I have an appointment with ultrasound for a Nuchal scan. This scan along with some blood work looks at certain birth defects. The main things they check for is Downs Syndrome and they will look at its heart and make sure all four chambers look normal.

Until next Tuesday!

8 week 5 day ultrasound

Had a great ultrasound today. The baby had a rocking 173 heart rate and has grown very nicely. The baby measures right on schedule and I have officially graduated from my IVF team to the regular people doctors! I am no longer on any fertility drugs except vitamins which is very nice also. Well that's all from here, not sure when my next appointment will be I have to call the other clinic and set something up. I hope you are all having a wonderful day.

We have a Heartbeat!

I am sure you can tell from the crystal clear ultrasound image that there is a small child in my uterus. From those who cant see I will attempt to break it down for you. On the main screen is my gestational sac like last week (black blob) and snuggled in on the left side of the black blob is a slightly larger than last week gray blob. Now if you were present for the ultrasound which I was and Dan just made it there by minutes after driving across town to the wrong clinic you would have seen the gray blob dancing all over showing off its 127 bpm heart rate. (bpm = beats per minute). On the right side of the picture is a zoomed in version so he could measure, he measures 0.59cm which is perfect for a 6 week 5 day ultrasound. The very bottom it says I measure 6 weeks 3 days plus or minus 2 days with a due date of 5/1/09 based on that measurement.

Needless to say, we are all pretty happy here. Next ultrasound is in 2 weeks, until then keep the good thoughts and baby dust heading my way!

Fertilty Humor

Just a little fertility humor mixed with Olympic glory!

Next ultrasound is Monday morning, cross your fingers we see a little person in there!

5 week 5 day ultrasound

The egg transfer was exactly 3 weeks ago, but technically I am called 5 weeks 5 days if going by estimated due date of April 29th, 2009

Well, the good news is there is a little gray blob (yolk sac) inside the black blob (gestational sac) They want to get another ultrasound in a week. What we would hope to see at that ultrasound is the yolk sac and a fetal pole (like this picture here). Best case would be a heartbeat, but that's a 50/50 shot this early.

They also saw tons of fluid in my belly and very large ovaries from my OHSS (which is much improved now since we lowered my medicines).

I hope the little guy keeps growing, keep praying and sending baby dust!

HCG # 5

919

Pretty good one day jump for me and making me feel a bit more confident again.

Ultrasound is scheduled for Monday at 9:00.

Keep the baby dust heading my way!

HCG # 4

My HCG today was 666. It keeps going up but sure is being slow about it. I have read that most people double their HCG in 48 hours but some take 72. It seems I am more of a 3 day doubler. They want to check yet another level tomorrow and do an ultrasound on Monday. Hopefully those will go ok and tomorrow's HCG is above 800! The ultrasound hopefully shows a gestational sac in the uterus and a yolk sac (Sounds like a chicken!). It would be too early to hear a heartbeat or anything like that.

So think extra thoughts for me this weekend and send me lots of baby dust!

HCG # 3

My level today is 408. So little walker or texas ranger is slowly but surely getting stronger. Getting yet another level on Wednesday and as long as the number keeps going up they plan on doing an ultrasound in 2 weeks. Its funny I find these past few days more nerve racking then the initial blood test. I am glad I am pregnant but since the only other time I was pregnant I miscarried I think I still find it hard to believe.

HCG # 2

The HCG today is 194 and progesterone is 228.48. They said that sometimes when the progesterone levels are so high that we don't see a doubling of the hcg level in 2 days. The good news its the level is higher and a good number for day 11. Its most likely 1 baby, not sure if it was walker or texas ranger who held on :)

Repeating the labs again on Monday, so lets hope it keeps going up!

On the OHSS front, I am still super swollen. I have gained like 6 pounds of fluid in 4 days and I am tight as a drum. I feel like I have jumped from not being pregnant at all to like 4-5 months pregnant in 1 week.

edit - Doctor's office called back. I am decreasing the Progesterone from 200mg three times a day to 100mg twice a day.

It's Offical

My HCG level on 9 days post 5 day transfer is....drumroll....118 Yea! That's a great day 9 level

My progesterone was a whopping 265, that tells us why my abdomen is so swollen. Its normally 25-50 at this time. For now I will continue the progresterone 2 tabs three times daily, but depending on the progesterone level on Friday it may be cut back or stopped all together.

So I am repeating the levels on Friday. We expect the hcg level to double in two days, so hopefully Friday's is around 235

Ovarian Hyperstimulation Syndrome

So apparently all this swelling is not normal. I got diagnosed today with moderate Ovarian Hyperstimulation Syndrome. This is a potential complication of doing fertility treatment, and occurs in approximately 1% of patients! (I am so special). Basically my symptoms are: Abdominal bloating and bloating all the way up to my lungs, increased abdominal girth (39inches!!), Mild Shortness of Breath, and some fatigue. It hurts to lie flat so I am actually sleeping with 2 pillows under my head and 1 under my knees. Yesterday when I was taking a shower I had to stop and sit in the shower because I thought I would pass out from the humidity in there, so figured it was time to let my clinic know how I was feeling.

The plan is daily weights, abdominal girths and hydration. I need to drink plenty of Gatorade to keep my hydration up. Basically fluid is leaking from my ovaries and the follicles into my abdominal cavity and as long as my ovaries keep producing progesterone they will keep secreting this fluid. Now the silver lining here is that the clinic says I am probably pregnant, as if I wasn't my symptoms would have gone away after 3-4 days post egg transfer (I am 8 days post transfer). However since your ovaries keep producing progesterone the entire first trimester this is something I will be dealing with for weeks and could get worse. In extreme situations you get so dehydrated that your kidneys stop working right and you need IV Fluids or even an abdominal tap (long needle into your belly to suck out fluids as if I was a liver patient with ascites or something.)

So that's the excitement here, I am clinging to that silver lining so I am not going through all this for nothing!

EDIT:
You see a 2nd line right? Faint but being only 8 days post transfer....

Waiting

So not much to report, after 4 weeks of busy excitement, shots, ultrasounds, bloodwork, etc now there is nothing to do! Since the egg transfer on Monday my main goal was just to feel somewhat normal again. I was so bloated and swollen from about Monday-Wednesday from my large ovaries & fluid that for Monday and Tuesday especially it was actually painful to breathe or move around. I felt full from my throat to my pelvis like everything was just swollen. I kept making up diseases that I am sure I had like toxic mega colon and other fun stuff. But now I am feeling more normal, I dont feel like running any time soon but I can bend over and touch my toes again!

Ok, enough complaining. In one more week I will do the blood test that hopefully shows defiantly one way or the other if the IVF worked. I am hoping for an HCG level around 100, anything above that would be super, below that would be a bit worrisome. No matter the level they will repeat it probably 2-4 days later to see the trend (hopefully rising). I dont "feel pregnant" but no one should at this point.

Not much else to report, its going to be a long 7 days.

Frosties

The laboratory report this morning was that only one blastocyst was frozen. The three remaining embryos were cultured overnight but upon further inspection two candidates for freezing were abnormal blastocysts with inner cell masses that were “not good”. They were not frozen. Not the best news in the world but its ok. Should this current cycle not work we can try with the 1 frosty next cycle.

Not much else going on, been resting alot and watching Olympics non-stop (How about that swimming relay and men's gymnastics!). The 2 blastocysts are supposed to break out of their shell somewhere between day 7-10 and implant. So until then I guess they are just floating around in there :) Hopefully they start digging in tomorrow and get ready for a long 9 month ride.

Embryo Transfer

Ok, I am all back from my whirlwind morning. I had acupuncture at 10, embryo transfer at 11 and then another acupuncture session at 12. I am feeling good and hopeful. The transfer itself was really simple, took perhaps 2minutes. Basically they did an external ultrasound just to check how my uterus was laying (they wanted it basically in a straight line so its easier to get the catheter in). They then went over the embryo report. We had 3 grade 1 blastocysts, 1 grade 1 early blast, and 1 grade 1 morula. The remaining ones were still slow to grow and not good candidates for freezing. They double checked that I want to transfer 2 and that I wanted to freeze the other 3. Tomorrow they will be freezing the 3 that I didn't use giving us a good option for our next attempt. After we told them we want 2 placed back, it was "load and go" time. They loaded the 2 best ones (pictured below) into a catheter and inserted it into my uterus. They were watching the catheter progress on the ultrasound until it was near the back of the uterus. They then injected the embryos out and you could see two little flashes of light on the screen. They then double checked the catheter to make sure that both were inserted and I was done.


My temporary name for these 2 guys are: Walker (Left) and Texas Ranger (Right)

Fertilization Report # 3

OK, more good news, the 9 little guys are chugging along.

We currently have: 4 - 8 cell, 1 - 7 cell, 1 - 6 cell, 2 - 5 cell, 1 - 4 cell.

The lead embryos have no fragmentation and the cells look even, making them class 1. The lead embryos are also beginning to show signs of compaction which is the next stage of development. While the slower growing ones will most likely not be the ones we transfer on Monday they will be good candidates for freezing as long as they keep growing. And then we can use the frozen embryos in another try later on.

Blast Development

2pn stage (1 cell with 2 pronuclei)

Cleavage stage (2 to 10 cells)

Compaction

Morula

Cavitation

Early Blastocyst

Full Blast

Hatching blast

Hatched blast

The plan is now set. Tonight I do another HCG shot (but only 0.5cc instead of 1cc). This is a booster shot. It will promote secretion of progesterone by my ovaries which aids in implantation.

Monday I have acupuncture set for 10am. Then the IVF Clinic at 11am for an 11:15 transfer. I should be home by noon. And then at 2pm I have another acupuncture session.

Then I wait 11 days until they can do the pregnancy test and see if it all worked.