.3rd times a charm?.

so, call us crazy, but cameron and i are gearing up to try ivf #3. this time we were a little smarter about it. first, we have changed drs, we'll be seeing dr. fisch in las vegas..who deals specifically with egg quality problems. he thinks the protocol i've been on is "ruining" my eggs from the beginning so they don't stand a chance to make it past day 3. with our first cycle, i had 9 eggs retrieved, 6 mature, 0 fertilized. with ivf #2 i had 14 eggs retrieved, only 9 mature, 5 fertilized with icsi, only 2 made it to day 3. we did a day 3 transfer of 2 8-cell embies, grade 1. but still bfn. second change is that dr fisch is going to put me on their a/acp protocol, an antangonist protocol, which he thinks will give me better eggs, with better fertilization rates. third change that we've made to maximize our results is that we've purchased a buy 3 cycles and if you don't take home a live baby, you get a portion of your money back. good deal if you ask me, because that includes everything except meds. it even includes all associated fet cycles if we have frozens to use.

as for this cycle, we're looking forward to having much better results on the antagonist protocol

so here's my schedule...
12/30 bcp (yaz) starts
1/20 add dexamethasone and lupron
1/24 stop bcp
1/27 stop lupron, add 0.25 ganirelix, continue this thru to hcg trigger
2/2 start follistim 375 for 2 days then drop to 225
2/4 first luveris dose 1 vial
2/6 second luveris dose 1 vial
2/10-2/11 possible hcg trigger
2/12-2/13 possible egg retrieval
2/15-2/17 possible embryo transfer

once again, this is mostly for journaling purposes, since i don't write this all down. if you're interested, then that's just a bonus.

ash

.i think explains it.

From an article by Dr Aniruddha Malpani, MD:
"The third group is perhaps the most difficult. These are women who grow a sufficient quantity of follicles in response to superovulation ; and have high estradiol levels as well. Egg collection is usually uneventful ; and the doctor often retrieves 8 to 16 eggs for them. If IVF is done, when the fertilization check is performed the following day, much to the embryologist’s surprise and the patient’s dismay , it is found that the fertilization is very poor even though the sperm are fine and actively motile. If ICSI is being done, the embryologist often finds that the eggs are morphologically normal ; or are very fragile. For example, these eggs have granular cytoplasm ; or vacuoles in their cytoplasm ; or dark areas within the cytoplasm. Since normal eggs are simple spherical formless blobs, these subtle cytoplasmic abnormalities are often missed or overlooked. The embryologist may also noticed that the eggs are fragile, and the cell membrane offers little resistance to the injection pipette. Many of these eggs may die during the ICSI process.
Unfortunately , because egg morphology has not been adequately studied , we still do not have good descriptive terms , when talking about these abnormalities. Since the eye only sees what the mind knows, often these abnormalities are not picked up. The patient is often subjected to repeated IVF or ICSI cycles , with the same poor results each time."


we're just a "hard egg case."

.ivf report.

unfortunately i didn't have the computer in cali so i've had to wait til now to update my blogs. first off i wanted to write down everything that happened in california regarding our ivf cycle.

thursday nov 12 i had my first ultrasound at dr. marrs office in LA. i had about 10-12 follicles, but some were pretty small. they were predicting that i'd be ready sat for trigger, and that we should have about 10 eggs to retrieve. i was happy about that. they did lower my fsh and upped my lh to help the smaller eggs "catch up." my e2 this day was 1158

saturday nov 14 i had my second ultrasound and it looked about the same. about 12 mature follicles, and my e2 was 2710, getting a little too high. i was given the go ahead to trigger that night at 1030 pm.

monday nov 16 we arrived for our egg retrieval. this time was WAY different. it was an actual OR, not some scary 1930's exam room. i got my WONDERFUL anesthesia and woke up to the news that they had retrieved 14 eggs. i was thrilled. cam gave his "sample" and we went back to the hotel to relax..our work was over.

tueday nov 17 got a call from dr. bronte stone, the embryonologist, and gave us the report that only 9 of my eggs were mature and of those only 6 fertilized with icsi. we were kinda crushed..but happy that we at least had that many.

wednesday nov 18 took a break from worrying about it and went to disneyland!

thursday nov 19 went back in to get knocked up. they gave us an update of the little embies. we had 2 that had stopped growing, but the 4 remaining were going strong. finally, they brought the little embryos in, in their little incubator and we got to look at them in the microscope. we got to see our little babies first photo shoot, as seen below. anyway, i have two perfect, 8 cell embryos inside my little uterus. the remaining 2 will be frozen tomorrow if they make it to blastocyst stage. we're praying for them too, in case this doesn't work, we could have a frozen embryo transfer in a few months.

.our babies.

i'm feeling so much more hopeful this time around and i feel like it's our turn. we've been patient. it would be an added reason to celebrate this holiday season.

.off we go.

we're off to los angeles today. my mom and i are driving out, with a small stop in st. george and then cameron and my dad will be flying out friday after work. i'm super excited to go to disneyland and price is right and hopefully all the ivf stuff will go as planned.

as for my appt yesterday with lindsey (who i absolutely love).. everything looks a lot better this time, than at this point in the game last cycle. i have 15 follicles and about 12 are the same size.. so we can hope to expect about 10-12 follicles. my e2 was 261, at this time last cycle it was only 123. so i'm happy.

i just want to tell cameron i'll miss him til friday. can't wait to make some babies this weekend.

.all clear.

well bloodwork and ultrascan both indicated that we're all clear to start stimulation injections tomorrow night. it's great news. you can never predict whether your body will respond appropriately to all the "over-riding" that ivf protocols do to you. i'm grateful that my little ovaries are perfect and so is my little old uterus. last cycle i had 9 antral follicles and we retrieved 9 mature eggs. this time i had 11 antral follicles, so we're hoping for 10 or more mature eggs in LA. as for the protocol we're using this time...it's the same as last cycle.. 75 menopur, 225 bravelle, and 5 units lupron. it's so exciting and a little nerve racking. so far, so good. hopefully icsi will work and we'll get good fert rates.

.phase I.

i think that i am lucky. i'm sure most girls that try ivf go on mad horomone mood swings. i'm blessed, i really don't have much of that (well, i guess you could ask cameron if that's true). i think the worst part is the birth control. so i'm happy to report that i finished that on thursday. i should be expecting a wonderful red flow here tomorrow. it should be right on time. if so, i'll be having my baseline scan (love the wand) and bloodwork. i'm getting really anxious to see how this cycle will pan out. i think i'm definately more hopeful and more calm about this one. it feels good. so maybe in 3 weeks we can have some of these:

and an update on what i think is wrong with us: this has not been diagnosed, but from my research i believe that cameron's swimmers have anti-sperm antibodies on them (mostly on the heads), thus preventing the sperm from binding to an egg. when the dr explained that we have a "receptor" problem, i think he meant this. i'm not going to push for an actual diagnosis, because at least we know that whatever the problem is, we have found it and have a way around it. thank goodness.

.let's talk about shots.

so with ivf you have to do tons of shots..big surprise, right? well, i have yet again, began doing these shots and after a whole cycle last month of doing this you would think i'd be "used" to it... nope. last night (my first one) i sat with the needle facing my belly for about 3 minutes before i got up the courage to stab it in. i can't believe how easy it is to do to other people..like my patients, but when it comes to me..i'm a baby. i'm not complaining at all, and don't need sympathy, it's just a realization to me, that maybe my patients hate it too. i'm excited to go to my baseline ultrasound next week...hopefully i'll have lots of follicles!