As I was thinking about a title for this post I kept coming back to those tried and true analogies we use with infertility like roller coaster, merry-go-round, Tower of Terror. OK so maybe not that last one but seriously sometimes if feels that way right. Well crap, the thing about amusement parks is that they're FUN. I mean people go there to have a good time and 9 times out of 10 - they are. You're dealing with a wait-in-line-for-the-front-row roller coaster enthusiast here. Let me tell you, this is one coaster that I can't wait to finally get off.
Our consult with the RE last week went well. We're going to aim for a fresh transfer instead of a frozen cycle. YAY! We may or may not incorporate PGS testing depending on how many embryos we have but we've been refereed to another company our clinic works with who can turn the results around in time for a fresh day 6 transfer. RE said he would allow a fresh day 5 transfer and then we could test any others, but he wasn't so keen on the idea. He felt like if we're going to test, we should test them all.
I've done spreadsheet after spreadsheet on this and it's going to come down to gut feeling in the end and embryo count/quality so we've put off the decision until we get the fertilization reports and day 3 information. Only thing is, the PGS clinic requires payment ahead of time which I HATE. All the paperwork says we can cancel for any reason and get a full refund but I just don't trust them with my money. I know they do this so that they can get the results in and back to us without any financial issues looking but still. This second PGS clinic is of course more expensive!
Part of me feels like it's worth it in order to know if it's just that we make crappy embryos or if my uterus is rejecting normal ones. There's certainly value in knowing that. Also, we could cut down on the number of eSETs we try next time...the number of IM shots, the trips to the clinic and the days off work if we necessarily cut out the abnormal embryos. But of course - what if the tests are wrong - and a normal embryo gets ruled out. We'll never know. We're injecting SO MUCH SCIENCE into this in the first place what's a little more, right? UGH. So there we stand, in no man's land right now with the PGS testing.
Off for a vacation tomorrow and hoping the fam can keep it together. We've decided to take in a real live amusement park while we're at it and I'd be lying if I told you I wasn't thrilled to death to be taking C to meet Mickey and Minnie for the first time. If he doesn't cry - he'll flip! My niece on the other hand who is 2.5 is sure to flip. Seeing the joy on her face is going to be incredible.
Lupron injections start on July 3rd - my own version of fireworks. These ones sting don't they?
Friday, June 27, 2014
Thursday, June 19, 2014
Toddler Time
So to lighten the mood here a little I thought I'd give a quick little update on how we're doing parenting a - gasp - almost 17-month old!
The 2 most favorite parts of my day are waking up and seeing C with his sleepy little eyes as he smiles my way. His hair is usually all over the place too which seems to add to the cuteness. The other favorite part has now become post-bath naked time. C will barely even tolerate being dried off from his bath these days before he's off and running through the house and up the stairs while I chase his little chubby naked behind up the stairs. His laughter and enjoyment makes all the day's headache's disappear.
The other big development we seem to tackle every 2-3 days or so is new words. New words left and right out of this kiddo's mouth. Today is was "bus" and "bath." Tomorrow it will be something new and I love it. I can't believe it each time he exclaims with a new word - it's just so much fun to hear his little voice. Oh and "no" entered the mix too about 2 weeks ago. Specifically, "no mama" was uttered and I almost died.
So far, he says:
- mama
- dada
- bath
- bus
- mo-mo (milk)
- al-da (all done)
- no
- elmo
- cheese
- vroom-vroom
- shoes
- ball
- quack
- oink (though it's a funny little noise he makes that is pretty unusual)
- woof
- roar (probably his favorite)
- blub blub (for a fishy)
- two (he says after I hold up any number of fingers)
- uh-oh
- hippo
- door
- nigh nigh (night night)
- hi
- bye
- stuck, truck and duck kind of all sound the same
- agua
And so there we are folks. Gearing up for fresh IVF 3.0 but slowly coming to acceptance towards being a family of 3 permanently. It's pretty fantastic so far.
The 2 most favorite parts of my day are waking up and seeing C with his sleepy little eyes as he smiles my way. His hair is usually all over the place too which seems to add to the cuteness. The other favorite part has now become post-bath naked time. C will barely even tolerate being dried off from his bath these days before he's off and running through the house and up the stairs while I chase his little chubby naked behind up the stairs. His laughter and enjoyment makes all the day's headache's disappear.
The other big development we seem to tackle every 2-3 days or so is new words. New words left and right out of this kiddo's mouth. Today is was "bus" and "bath." Tomorrow it will be something new and I love it. I can't believe it each time he exclaims with a new word - it's just so much fun to hear his little voice. Oh and "no" entered the mix too about 2 weeks ago. Specifically, "no mama" was uttered and I almost died.
So far, he says:
- mama
- dada
- bath
- bus
- mo-mo (milk)
- al-da (all done)
- no
- elmo
- cheese
- vroom-vroom
- shoes
- ball
- quack
- oink (though it's a funny little noise he makes that is pretty unusual)
- woof
- roar (probably his favorite)
- blub blub (for a fishy)
- two (he says after I hold up any number of fingers)
- uh-oh
- hippo
- door
- nigh nigh (night night)
- hi
- bye
- stuck, truck and duck kind of all sound the same
- agua
And so there we are folks. Gearing up for fresh IVF 3.0 but slowly coming to acceptance towards being a family of 3 permanently. It's pretty fantastic so far.
Tuesday, June 17, 2014
PGS Consult
Sorry gang, this one might be a boring one but I'm mainly posting so I can remember everything we talked about yesterday with the woman from the genetic testing facility.
First things first, the cost for testing 8 embryos is $1875. This is just the testing and my clinic's embryologists will have a separate charge of up to $1500 for the biopsy portion for a grand total of $3375 out of pocket. I'm pretty sure none of this will be covered by insurance but I'll try to submit it anyway if we go this route. If we only have 2 embryos make it to day 5 we can decide to stim again, then I can send any additional embryos to the facility all in one batch and as long as we don't go over 8 - that's the charge.
Conducting PGS on day 5 embryos is less risky to the embryo and more accurate in terms of getting results the lab can be confident in. Now they can't tell me if we'll have any genetic disorders aside from extra or missing chromosomes. That's all they test.
Results are in within 5 business days so there's no chance of doing a day 6 transfer with tested embryos. My RE mentioned this option on the phone after one of my failed cycles so I'll have to find out what's up. I'm not sure if they're using another company or what.
My RE will get the results and then he'll relay them to me. There are 3 categories of results I could get: normal, abnormal and no result. The first 2 are pretty self explanatory but the no result category happens about 5% of the time and is due to the fact that not enough DNA was biopsied. If we wish to retest, my clinic would have to thaw the embryo, test it, and then refreeze it. Seems like a lot, right? Oh and that's not counting the fact that when we would want to transfer it would have to be re-thawed as well. I'm not keen on that idea. The upside - there is no charge to retest the embryo.
There's also a 4% chance that even with a day 5 embryo, the biopsied cells might not be representative of the entire embryo (called mosaic). So the cells they biopsied could be abnormal but the rest of the embryo could be normal or vice versa.
Damage from the biopsy only happens in 1% of the cases but is necessarily a function of skill and experience of the embryologist. Yikes - love leaving stuff this important to human error, right?
When the results come back, the lab will tell us how confident they are about each of their decisions on the embryos. Below 75% confidence will be counted as "do not transfer" and above that will be counted toward "transfer recommended." So even if there are some normal embryos and if for some reason the lab isn't all that confident in their testing, we could be looking at a do not transfer embryo.
So after the consult, E and I talked. I feel torn because I already feel like we're taking so many chances with science here and to mess with things further might not be such a good idea. There are so many variables to consider and what I'm most afraid of is getting incorrect results, damaging embryos and the fact that there's no long term research on the children born form PGS tested embryos.
I don't think I'll be able to make a decision on this until we see how many embryos we're working with. If we've got a big batch, then I'm more inclined to test because we have resolved to transfer every embryo we create. But if we're talking 3 or less, then I might be more inclined to leave well enough alone and just risk it. Like I had said before, my ideal situation would be to "pick" the best embryo for a fresh transfer on day 5 and then test any other ones. That seems to be the best of both worlds and the only way I might feel confident in our decision to use PGS.
First things first, the cost for testing 8 embryos is $1875. This is just the testing and my clinic's embryologists will have a separate charge of up to $1500 for the biopsy portion for a grand total of $3375 out of pocket. I'm pretty sure none of this will be covered by insurance but I'll try to submit it anyway if we go this route. If we only have 2 embryos make it to day 5 we can decide to stim again, then I can send any additional embryos to the facility all in one batch and as long as we don't go over 8 - that's the charge.
Conducting PGS on day 5 embryos is less risky to the embryo and more accurate in terms of getting results the lab can be confident in. Now they can't tell me if we'll have any genetic disorders aside from extra or missing chromosomes. That's all they test.
Results are in within 5 business days so there's no chance of doing a day 6 transfer with tested embryos. My RE mentioned this option on the phone after one of my failed cycles so I'll have to find out what's up. I'm not sure if they're using another company or what.
My RE will get the results and then he'll relay them to me. There are 3 categories of results I could get: normal, abnormal and no result. The first 2 are pretty self explanatory but the no result category happens about 5% of the time and is due to the fact that not enough DNA was biopsied. If we wish to retest, my clinic would have to thaw the embryo, test it, and then refreeze it. Seems like a lot, right? Oh and that's not counting the fact that when we would want to transfer it would have to be re-thawed as well. I'm not keen on that idea. The upside - there is no charge to retest the embryo.
There's also a 4% chance that even with a day 5 embryo, the biopsied cells might not be representative of the entire embryo (called mosaic). So the cells they biopsied could be abnormal but the rest of the embryo could be normal or vice versa.
Damage from the biopsy only happens in 1% of the cases but is necessarily a function of skill and experience of the embryologist. Yikes - love leaving stuff this important to human error, right?
When the results come back, the lab will tell us how confident they are about each of their decisions on the embryos. Below 75% confidence will be counted as "do not transfer" and above that will be counted toward "transfer recommended." So even if there are some normal embryos and if for some reason the lab isn't all that confident in their testing, we could be looking at a do not transfer embryo.
So after the consult, E and I talked. I feel torn because I already feel like we're taking so many chances with science here and to mess with things further might not be such a good idea. There are so many variables to consider and what I'm most afraid of is getting incorrect results, damaging embryos and the fact that there's no long term research on the children born form PGS tested embryos.
I don't think I'll be able to make a decision on this until we see how many embryos we're working with. If we've got a big batch, then I'm more inclined to test because we have resolved to transfer every embryo we create. But if we're talking 3 or less, then I might be more inclined to leave well enough alone and just risk it. Like I had said before, my ideal situation would be to "pick" the best embryo for a fresh transfer on day 5 and then test any other ones. That seems to be the best of both worlds and the only way I might feel confident in our decision to use PGS.
Friday, June 13, 2014
What We're Doing Next
I'm not sure exactly. Beta Monday was a negative - shocker.
With E still out of work, we've had a number of conversations around moving. In fact, there have been 2 separate positions that seem promising elsewhere in the country. Both are interesting and may prove to be good moves for our family and E's career. Moving would put my career on hold most likely, but I think I could work out a telework situation if it came to that. The thought of moving has necessarily sped up our next IVF moves.
We had planned to take a month off between these FETs and any fresh cycle, but if we move we'll have to start all over at another clinic or travel back and forth if we wish to stay with our current RE. Neither seems appealing so here we go - head first into a fresh cycle. I am not sure what this cycle will look like yet because my consult with my RE is next Thursday, but he wanted us to go ahead and schedule a phone consult with the PGS lab for Monday. This way, we'll know all the details ahead of time and we can decide for sure what protocol we're going with on Thursday. Today was day 1 of pills so technically we've already started.
What I'd like to do is go through a fresh cycle and transfer a 5 day embryo just like we did during C's cycle. Then I'd like to test any remaining embryos with PGS and have those frozen. I'm not sure if that's an option because my nurse mentioned that there might be a change in the days I start stims. Also, I'm curious how they bill for a stim and freeze all cycle. Will my insurance even cover any of it? We switched at the beginning of the year so we'd have some coverage...it has helped immensely with the cost of the FETs, but transferring one blast at a time has left us $10K in the hole already.
I'll update you after Monday's call. PGS testing makes me a bit nervous because it's so "new" relative to other medical procedures. Nervous because I inherently wonder about damaged embryos. Of course, I'm deathly afraid of not getting any blasts this time around too. And that roller coaster from retrieval to transfer....oh LORD... I am not looking forward to that again.
Just trying not to think about it till I have to.
With E still out of work, we've had a number of conversations around moving. In fact, there have been 2 separate positions that seem promising elsewhere in the country. Both are interesting and may prove to be good moves for our family and E's career. Moving would put my career on hold most likely, but I think I could work out a telework situation if it came to that. The thought of moving has necessarily sped up our next IVF moves.
We had planned to take a month off between these FETs and any fresh cycle, but if we move we'll have to start all over at another clinic or travel back and forth if we wish to stay with our current RE. Neither seems appealing so here we go - head first into a fresh cycle. I am not sure what this cycle will look like yet because my consult with my RE is next Thursday, but he wanted us to go ahead and schedule a phone consult with the PGS lab for Monday. This way, we'll know all the details ahead of time and we can decide for sure what protocol we're going with on Thursday. Today was day 1 of pills so technically we've already started.
What I'd like to do is go through a fresh cycle and transfer a 5 day embryo just like we did during C's cycle. Then I'd like to test any remaining embryos with PGS and have those frozen. I'm not sure if that's an option because my nurse mentioned that there might be a change in the days I start stims. Also, I'm curious how they bill for a stim and freeze all cycle. Will my insurance even cover any of it? We switched at the beginning of the year so we'd have some coverage...it has helped immensely with the cost of the FETs, but transferring one blast at a time has left us $10K in the hole already.
I'll update you after Monday's call. PGS testing makes me a bit nervous because it's so "new" relative to other medical procedures. Nervous because I inherently wonder about damaged embryos. Of course, I'm deathly afraid of not getting any blasts this time around too. And that roller coaster from retrieval to transfer....oh LORD... I am not looking forward to that again.
Just trying not to think about it till I have to.
Thursday, June 5, 2014
Numb
I tested this morning - negative. Again, not even a hint of a line. I sat there expecting to feel worse, but I knew there was no way this was going to work. I'm sure it will hit me later today that this is all over - 4 eSETs in 8 months. Yikes, that's a lot but nothing to show for it at all.
I realized last night I wouldn't have enough POI to get me through the weekend at the beach if I needed it. I would have needed to order more today so it could get here tomorrow ...so that was my rationale for testing. Yes, I guess there's still a "chance" I'm pregnant, but that's like one in a million. I'm tired of shots. I need to be done and this weekend, the only shots I'll be taking are going to be tequila shots.
I realized last night I wouldn't have enough POI to get me through the weekend at the beach if I needed it. I would have needed to order more today so it could get here tomorrow ...so that was my rationale for testing. Yes, I guess there's still a "chance" I'm pregnant, but that's like one in a million. I'm tired of shots. I need to be done and this weekend, the only shots I'll be taking are going to be tequila shots.
Wednesday, June 4, 2014
8dp5dt
Could this week pass any slower? I am trying to stay strong and wait until Friday morning to test again but I can feel my resolve weakening already. At 8 days past, surely the result would be accurate. Eager to move on to something that's going to work- I just feel like I've been stuck on a merry-go-round for the last 8 months and I'm dizzy.
Monday, June 2, 2014
I'm Weak and a Bit Crazy
I tested yesterday afternoon at 5dp5dt. Yeah, I know it was a bone-head thing to do. I was just desperate for some good news - but found none as the stark white FRER starred back at me like usual.
I guess I was expecting a miracle because testing so early and after having about 10 glasses of water throughout the day and not holing my pee in, I think it would have truly taken an act of God to turn up a positive in that situation. I don't think HCG even starts getting released into your bloodstream until about 6 days past and then it's got to get to your urine too. Plus, I've got a week to go before beta AND have 4 more days of shots on the books till I can feel confident about testing. Taking shots after negative tests sucks. I literally, lost it in a moment of weekness but I couldn't stop myself. I just want the uncertainty to be over.
Living through this type of stress the second time is torture. It not only hurts this time around, but also brings back all the old emotions too and makes me feel helpless. If this doesn't work, we'll be looking at another fresh which simply makes me cringe.
I'll hold off testing again until Thursday but really, I don't expect any of it to work out. That would simply be too easy and nothing has been easy about this process at all.
I guess I was expecting a miracle because testing so early and after having about 10 glasses of water throughout the day and not holing my pee in, I think it would have truly taken an act of God to turn up a positive in that situation. I don't think HCG even starts getting released into your bloodstream until about 6 days past and then it's got to get to your urine too. Plus, I've got a week to go before beta AND have 4 more days of shots on the books till I can feel confident about testing. Taking shots after negative tests sucks. I literally, lost it in a moment of weekness but I couldn't stop myself. I just want the uncertainty to be over.
Living through this type of stress the second time is torture. It not only hurts this time around, but also brings back all the old emotions too and makes me feel helpless. If this doesn't work, we'll be looking at another fresh which simply makes me cringe.
I'll hold off testing again until Thursday but really, I don't expect any of it to work out. That would simply be too easy and nothing has been easy about this process at all.
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