Did my blood test this morning and I just got the call from the nurse. No surprises... negative as expected. So, just to summarize everything up to date:
IUI #1 March 2010: Clomid – Cancelled
IUI #2 April 2010: Clomid – Cancelled
IUI #3 May 2010: Gonal-F – Cancelled
IVM #1 November 2010: Cancelled before starting (cyst)
IVM #2 December 2010: Repronex etc… - 4 embryos, 2 transferred and 2 frozen, Negative (BFN)
IVM #2 March 2011: 2 frozen embryos transferred, BFN
IVF #1 February 2012: Repronex etc…, converted to IUI #4, BFN
I will be meeting with my doctor soon and we will go over the medications I have been using, what I will use the next time, and anything else that needs to be discussed. I believe the next round will also be scheduled but from what I understand there is a LONG list ahead of me so who knows when it will happen...
Showing posts with label IVM. Show all posts
Showing posts with label IVM. Show all posts
Monday, February 13, 2012
Tuesday, January 24, 2012
Round 1 (IVF): Ultrasound 2
Ok so the second ultrasound is done. Things are going well but it's still far too early to tell anything. I go back in 3 days for another one so hopefully I will have a better idea of how I am responding to things then.
The injections on the other hand... ouch! I don't know what's wrong this time but I am just not coping with them well. I am taking 2 different ones a day right now (the Repronex like last time and Orgalutran as well) and every day it seems like a different one is acting up on me. My legs are sore, I have huge lumps at each injection site that last for 2 days or so and I will not be ending them any time soon right now. Even the blood test this morning hurt! I guess it's age LOL. Anyhow, it's all for a good purpose so I will stick with it. I may have to try using other injection sites though if I am going to make it through... arms or stomach (ew)!
That's it for now... will post more when I know more!
The injections on the other hand... ouch! I don't know what's wrong this time but I am just not coping with them well. I am taking 2 different ones a day right now (the Repronex like last time and Orgalutran as well) and every day it seems like a different one is acting up on me. My legs are sore, I have huge lumps at each injection site that last for 2 days or so and I will not be ending them any time soon right now. Even the blood test this morning hurt! I guess it's age LOL. Anyhow, it's all for a good purpose so I will stick with it. I may have to try using other injection sites though if I am going to make it through... arms or stomach (ew)!
That's it for now... will post more when I know more!
Tuesday, January 17, 2012
Round 1 (IVF)
Yes, you read that correctly; we are beginning our first round of IVF today! The process isn’t very different from IVM at the moment so I will not go into details just yet, but I wanted to announce that we have begun. The injections start tonight and my next ultrasound is a week from now so I will update then.
Friday, April 1, 2011
Round 3 (IVM): Summary
As some of you already know, I did another cycle in March using the embryos I had frozen back in December. Of the 2 embryos transferred on March 16th one of them was as perfect as can be in IVM! However, I did not let myself get my hopes up because I saw firsthand what that can do back in January when I was devastated.
I remained pretty neutral throughout, even went back to work after a couple of days instead of a couple of weeks (yes, the doctor agreed to this) and I did not include very many people in this cycle either. It was so much easier this way and I have learned that, in future, this is the way to go! In fact, I will probably include even fewer people. No offense to anyone, just my choice.
On March 28th I did my final pregnancy test at home and saw that it was still coming up negative. At this point, I pretty much knew that my blood test would only confirm what I already knew… and that is just what it did.
I met with my doctor yesterday and will be moving into IVF. Like he said, we tried IVM and it didn’t work… but it was far more successful that IUI ever was so there is hope in that. Yes, I already have a schedule set up and have a pretty good idea of when things will be happening but, as I mentioned above, I will be keeping things to myself for now. Only a few people know at the moment and very few others will be informed.
So… round 3…. bust again…. moving on….
Tuesday, February 8, 2011
Creating My Monster – 1 Year Anniversary and Updates
One year ago today I started this blog about my journey TTC with PCOS. I had hoped to have better news to share by now but unfortunately things have not worked out as we had hoped for.
For those of you who do not already know, Round 2 (IVM) was not successful. I had a strong feeling that it hadn’t taken but went in for my blood test on Jan 15th to confirm. I met with my doctor on January 18th and now have a better understanding as to why it didn’t work. Basically, they believe it came down to embryo quality – not anything that I did wrong (I have to keep telling myself that).
There are 3 grades of usable embryos from what I understand: Grade 1 which has never been seen in the lab, Grade 2 which is the best quality to hope for through IVF/IVM, and Grade 3 which are acceptable but have a lesser chance of success. Any embryo that is lower than a grade 3 is considered unusable, and in my case they had to discard 2/6 that were of lower quality. In January they transferred two Grade 3 embryos in hopes that at least one of them would implant despite their lower quality, but neither did. However, the two embryos that I was able to freeze are Grade 2 quality and have a much higher success rate in thawing as well as transferring so we remain hopeful, at least for now!
No decision has been made as to how many embryos will be transferred the next time, but we already have a date set for Round 3 (IVM). Unfortunately, as the hospital is heavily overbooked we were not able to start again right away, but that gave us the chance to go to Cuba! It was a last minute decision with only a week of preparation and very little research (very abnormal for me) but it was needed! We just got back so I will post more about the trip later on! As for Round 3 (IVM), I have decided to keep things a little less public this time around because it made the failure of the last round really hard for us to handle. Too many people knew the exact time I would be finding out if if had worked or not and that meant a lot of phone calls to make at a time when we really didn't want to talk to anybody and share our bad news. This time, a few people will know but even then, I am not sure in how much detail. Once we get the news, good or bad, it will give us some time to process things for ourselves before sharing with others. And hopefully it will be good news this time around!!!
Now, I think this post needs a bit of uplifting news, don't you?
Well, last but certainly not least, I am thrilled to announce that I am going to be an aunt this May! I have known since late November and have told a few people, but I had decided a while ago to wait until this post to let everyone know regardless of our own news (or lack of)! I just hope that I get to give my niece or nephew a little cousin soon!
For those of you who do not already know, Round 2 (IVM) was not successful. I had a strong feeling that it hadn’t taken but went in for my blood test on Jan 15th to confirm. I met with my doctor on January 18th and now have a better understanding as to why it didn’t work. Basically, they believe it came down to embryo quality – not anything that I did wrong (I have to keep telling myself that).
There are 3 grades of usable embryos from what I understand: Grade 1 which has never been seen in the lab, Grade 2 which is the best quality to hope for through IVF/IVM, and Grade 3 which are acceptable but have a lesser chance of success. Any embryo that is lower than a grade 3 is considered unusable, and in my case they had to discard 2/6 that were of lower quality. In January they transferred two Grade 3 embryos in hopes that at least one of them would implant despite their lower quality, but neither did. However, the two embryos that I was able to freeze are Grade 2 quality and have a much higher success rate in thawing as well as transferring so we remain hopeful, at least for now!
No decision has been made as to how many embryos will be transferred the next time, but we already have a date set for Round 3 (IVM). Unfortunately, as the hospital is heavily overbooked we were not able to start again right away, but that gave us the chance to go to Cuba! It was a last minute decision with only a week of preparation and very little research (very abnormal for me) but it was needed! We just got back so I will post more about the trip later on! As for Round 3 (IVM), I have decided to keep things a little less public this time around because it made the failure of the last round really hard for us to handle. Too many people knew the exact time I would be finding out if if had worked or not and that meant a lot of phone calls to make at a time when we really didn't want to talk to anybody and share our bad news. This time, a few people will know but even then, I am not sure in how much detail. Once we get the news, good or bad, it will give us some time to process things for ourselves before sharing with others. And hopefully it will be good news this time around!!!
Now, I think this post needs a bit of uplifting news, don't you?
Well, last but certainly not least, I am thrilled to announce that I am going to be an aunt this May! I have known since late November and have told a few people, but I had decided a while ago to wait until this post to let everyone know regardless of our own news (or lack of)! I just hope that I get to give my niece or nephew a little cousin soon!
Friday, January 14, 2011
No Answers Yet, But... To Tell Or Not To Tell...
Once the embryo transfer was done, as far as I was concerned I was/am pregnant until proven otherwise. This was suggested to me to do by another friend in treatment and it is probably the best advice I have received in recent months and something I have tried to keep in practice as best I could. I still do not have any answers but I wanted to address the “do we tell or don’t tell” issues now, before I find out for sure so no one can say they were not warned ahead of time.
Everyone knows the “don't tell until you are at least 3 months pregnant” rule. It’s as though by telling you are tempting fate. It is completely understandable to wait, as many pregnancies do not make it through the first trimester and it can be scary to celebrate a new life not knowing what will happen in the weeks to come. I guess that the 3 month wait is sort of a safe-haven for some; a sign that they are out of danger and free to share their news with the world. For others it is simply the way things are done. We are creatures of habit, after all!
But, as much as it is understandable to wait, it is also just as reasonable for others to share their news right away. Some feel the need to celebrate parenthood openly from the beginning and they turn to family and friends for support and advice immediately. And, should something terminate the pregnancy, they have a large network to help them grieve and get through the process. However, there is also a down side to this in my opinion; too much advice, no control on who hears the news, when they hear, and how they hear. And, often times, scrutiny by others for telling so early!
So, what is the right thing to do? Well, the answer is simple... do whatever is right for YOU. Not because someone tells you to, not because society dictates that you must do this or that, but because it makes you happy. If it feels right to tell, then share the news. If you would rather wait, then wait. You are parents now; you get to make the decisions!
One thing that makes this decision a little more complicated for us is that this whole process has been very open from the start and it is pretty obvious when we will be finding out the answer we have been waiting for. Unlike a traditional pregnancy, everyone knows what we have been doing! Already, a large handful of people know the exact date and time that I will be finding out the answer. Do we keep up the suspense, and if so, how? Do we tell some people but not others and hope that the news does not spread like wildfire? Do we tell everyone we know? I do not have answers to these questions yet but they will come in time. Certain people will definitely be told from the start I am sure, but as for everyone else... we will see!
No matter what happens, it is a big decision to make and it is OUR decision to make. Whether you are one of the first or one of the last to find out, all I ask is for a little r-e-s-p-e-c-t for whatever we decide to do!
Everyone knows the “don't tell until you are at least 3 months pregnant” rule. It’s as though by telling you are tempting fate. It is completely understandable to wait, as many pregnancies do not make it through the first trimester and it can be scary to celebrate a new life not knowing what will happen in the weeks to come. I guess that the 3 month wait is sort of a safe-haven for some; a sign that they are out of danger and free to share their news with the world. For others it is simply the way things are done. We are creatures of habit, after all!
But, as much as it is understandable to wait, it is also just as reasonable for others to share their news right away. Some feel the need to celebrate parenthood openly from the beginning and they turn to family and friends for support and advice immediately. And, should something terminate the pregnancy, they have a large network to help them grieve and get through the process. However, there is also a down side to this in my opinion; too much advice, no control on who hears the news, when they hear, and how they hear. And, often times, scrutiny by others for telling so early!
So, what is the right thing to do? Well, the answer is simple... do whatever is right for YOU. Not because someone tells you to, not because society dictates that you must do this or that, but because it makes you happy. If it feels right to tell, then share the news. If you would rather wait, then wait. You are parents now; you get to make the decisions!
One thing that makes this decision a little more complicated for us is that this whole process has been very open from the start and it is pretty obvious when we will be finding out the answer we have been waiting for. Unlike a traditional pregnancy, everyone knows what we have been doing! Already, a large handful of people know the exact date and time that I will be finding out the answer. Do we keep up the suspense, and if so, how? Do we tell some people but not others and hope that the news does not spread like wildfire? Do we tell everyone we know? I do not have answers to these questions yet but they will come in time. Certain people will definitely be told from the start I am sure, but as for everyone else... we will see!
No matter what happens, it is a big decision to make and it is OUR decision to make. Whether you are one of the first or one of the last to find out, all I ask is for a little r-e-s-p-e-c-t for whatever we decide to do!
Friday, January 7, 2011
Round 2 (IVM): Step 5 - Assisted Hatching
I phoned the hospital today with some questions about the last 4 embryos I had in the lab and while I was at it I asked about the assisted hatching. It seems that it WAS done and I just missed it with everything going on around me. So, what is it?
Embryos are transferred once they reach the blastocyst stage of development. Normally, the blastocyst itself would perform the zona hatching in order to implant on the uterus but in many cases with IVF or IVM, the lab performs a technique called Assisted Hatching in order to increase the chances of pregnancy.
The easiest way I have found to describe this is with a chicken egg. Basically, the yolk inside is what needs to attach to the uterus. In order to do that, it must first break through the shell. Research has shown that, for a variety of reasons, the "shell" of the embryo can sometimes become too tough for this to occur so a small hole is made by the lab making it easier for the yolk to spill out once transferred.
I cannot find any clear statistics but it seems as though the opinion on assisted hatching varies. Some research says it has no effect while others show significant increases in success rates so who knows! As long as it works for me I am happy!
And, as for my remaining embryos... 2 did not make it and the other 2 have been frozen for future use.
Embryos are transferred once they reach the blastocyst stage of development. Normally, the blastocyst itself would perform the zona hatching in order to implant on the uterus but in many cases with IVF or IVM, the lab performs a technique called Assisted Hatching in order to increase the chances of pregnancy.
The easiest way I have found to describe this is with a chicken egg. Basically, the yolk inside is what needs to attach to the uterus. In order to do that, it must first break through the shell. Research has shown that, for a variety of reasons, the "shell" of the embryo can sometimes become too tough for this to occur so a small hole is made by the lab making it easier for the yolk to spill out once transferred.
I cannot find any clear statistics but it seems as though the opinion on assisted hatching varies. Some research says it has no effect while others show significant increases in success rates so who knows! As long as it works for me I am happy!
And, as for my remaining embryos... 2 did not make it and the other 2 have been frozen for future use.
Thursday, January 6, 2011
Round 2 (IVM): Step 5 (Transfer) Complete!
As many of you already know, yesterday I completed step 5 of the process – embryo transfer. Assisted hatching was not used in the end as far as I could tell so I won’t bother going into details about that as I had planned. It was cool, though, to see my embryos right in front of me under a microscope! That’s definitely not something you see in a regular pregnancy!
As usual, some complications were involved (it wouldn’t be me if there weren’t any) but overall things went well and I even had a couple of little surprises along the way too (which will remain secret for now). I am off work for a couple of weeks taking it easy until my blood test as well as eating a “preggo” diet (no more rare meat or sushi), and taking my remaining medications to help things along.
Final tally on my “soccer team in a petri dish” as some of you have heard me talk about:
11 eggs were collected, out of which 7 matured and were fertilized. 1 egg did not make it through fertilization so I then had 6 embryos to work with (my soccer team). Of these 6, 4 are still splitting in the lab and cannot be frozen yet (I hope they all make it). The remaining 2 have been used as of yesterday; either transferred or frozen for later.
And now we wait and see what happens!
As usual, some complications were involved (it wouldn’t be me if there weren’t any) but overall things went well and I even had a couple of little surprises along the way too (which will remain secret for now). I am off work for a couple of weeks taking it easy until my blood test as well as eating a “preggo” diet (no more rare meat or sushi), and taking my remaining medications to help things along.
Final tally on my “soccer team in a petri dish” as some of you have heard me talk about:
11 eggs were collected, out of which 7 matured and were fertilized. 1 egg did not make it through fertilization so I then had 6 embryos to work with (my soccer team). Of these 6, 4 are still splitting in the lab and cannot be frozen yet (I hope they all make it). The remaining 2 have been used as of yesterday; either transferred or frozen for later.
And now we wait and see what happens!
Saturday, January 1, 2011
Round 2 (IVM): Step 4 Updates!
Firstly, I want to wish you all a Happy New Year! 2010 is over... bad luck has come to an end... and 2011 is the time for new beginnings! Ironically, on December 30th 11 eggs were collected from me. I am not into numbers, but 11 eggs going into 2011? Kinda cool, no?
Anyhow, so here is the update:
Dec 30 – 11 eggs collected but only 1 was mature. I was disappointed in this but 1 is all we needed!
Dec 31 – In the morning, no changes. The 1 mature egg was fertilized but the others were not doing much. However, in the afternoon 2 more eggs matured and were fertilized bringing us to 3 healthy embryos.
Jan 1 – Over night, 4 more eggs matured! This morning they will be fertilized bringing us to 7 embryos if all goes well.
No word yet on when the transfer will be but my wish was to transfer in 2011 and have at least 2-3 to freeze so it looks like things are going mostly as planned for once!!! For once, I have happy tears. I think the biggest joy I have had thus far was telling my grandmother the good news. She couldn't have been happier for us and I like making her smile.
Thank you everyone for your support!!!
Anyhow, so here is the update:
Dec 30 – 11 eggs collected but only 1 was mature. I was disappointed in this but 1 is all we needed!
Dec 31 – In the morning, no changes. The 1 mature egg was fertilized but the others were not doing much. However, in the afternoon 2 more eggs matured and were fertilized bringing us to 3 healthy embryos.
Jan 1 – Over night, 4 more eggs matured! This morning they will be fertilized bringing us to 7 embryos if all goes well.
No word yet on when the transfer will be but my wish was to transfer in 2011 and have at least 2-3 to freeze so it looks like things are going mostly as planned for once!!! For once, I have happy tears. I think the biggest joy I have had thus far was telling my grandmother the good news. She couldn't have been happier for us and I like making her smile.
Thank you everyone for your support!!!
Thursday, December 30, 2010
Round 2 (IVM): Step 3 and 4 - Collection and ICSI!
I had my collection done this morning at 10AM. Not my favourite experience throughout this whole process, but certainly not my worst (hysteroscopy without any pain medication takes the cake)!
First, they attached me to a regular IV drip to hydrate me. Then, a couple of hours later we were in the operating room. I was given Ativan to calm my nerves and relax me as well as Fentanyl for the pain. I will spare you all the details, but let’s just say that more Fentanyl will be requested (demanded) if I have to do this again and next time, I think DH will have to give me something other than his hand to hold because I nearly broke his fingers. Sorry! After this, I went to recovery for an hour or so and then waddled my way to the car. I am still in pain, having trouble getting up from the couch and such, but all in all I am fine. I have started taking all of the other prescribed medications as well: Doxycycline, Medrol, Estrace, and Prometrium. Oh, and lots of Tylenol! So far so good!
In the end, they collected 10 immature eggs and 1 mature egg from my right hand side only. The left ovary was not co-operating as it was hiding behind my uterus. The decision was made that 11 eggs were plenty and the additional punctures (which would have gone through my uterus), pain, and work to get to the left side were not going to be worth it. I was SO happy when I heard this! I was in a lot of pain and cramping like crazy at this point.
I was not told, but as far as I can tell the mature egg has already been fertilized using ICSI (which you can read up on here) and the others are being incubated to hopefully be fertilized tomorrow. The hospital should keep in touch daily to keep us up to date.
Transfer of the best embryo will be done within 2-5 days if all goes well and any remaining embryos will be frozen for future use.
First, they attached me to a regular IV drip to hydrate me. Then, a couple of hours later we were in the operating room. I was given Ativan to calm my nerves and relax me as well as Fentanyl for the pain. I will spare you all the details, but let’s just say that more Fentanyl will be requested (demanded) if I have to do this again and next time, I think DH will have to give me something other than his hand to hold because I nearly broke his fingers. Sorry! After this, I went to recovery for an hour or so and then waddled my way to the car. I am still in pain, having trouble getting up from the couch and such, but all in all I am fine. I have started taking all of the other prescribed medications as well: Doxycycline, Medrol, Estrace, and Prometrium. Oh, and lots of Tylenol! So far so good!
In the end, they collected 10 immature eggs and 1 mature egg from my right hand side only. The left ovary was not co-operating as it was hiding behind my uterus. The decision was made that 11 eggs were plenty and the additional punctures (which would have gone through my uterus), pain, and work to get to the left side were not going to be worth it. I was SO happy when I heard this! I was in a lot of pain and cramping like crazy at this point.
I was not told, but as far as I can tell the mature egg has already been fertilized using ICSI (which you can read up on here) and the others are being incubated to hopefully be fertilized tomorrow. The hospital should keep in touch daily to keep us up to date.
Transfer of the best embryo will be done within 2-5 days if all goes well and any remaining embryos will be frozen for future use.
Tuesday, December 28, 2010
Round 2 (IVM): Step 3 - Collection Scheduled!
Since the last time I posted I have been back and forth to the hospital and pharmacies all over again. I took the 3 days of Repronex as prescribed and returned to the hospital Boxing Day morning for my fourth ultrasound only to find that it hadn’t done very much at all. I was then given 2 more days of injections (totalling 620$ at this point - covered by insurance) and asked to return today for a fifth scan.
And... success! I still have a number of smaller follicles ranging from 6-8mm, but enough larger ones (10mm or larger) that we are going ahead with step 3! I have to take my HCG injection this evening and we return to the hospital 38 hours later for collection. Thursday morning here we come!
So, once again, things did NOT go as smoothly as hoped for but at least we are getting somewhere this time!
And... success! I still have a number of smaller follicles ranging from 6-8mm, but enough larger ones (10mm or larger) that we are going ahead with step 3! I have to take my HCG injection this evening and we return to the hospital 38 hours later for collection. Thursday morning here we come!
So, once again, things did NOT go as smoothly as hoped for but at least we are getting somewhere this time!
Wednesday, December 22, 2010
Round 2 (IVM): Back to Step 2...
I went for my 3rd ultrasound today expecting things to be growing nicely and ready for the next step by Friday. HA! My follicles have hit a brick wall again and need yet another push. I will be on 150 IU of Repronex starting tomorrow for 3 days and back for another ultrasound on Sunday. This injection is scaring the crap out of me right now because it requires mixing and such but I will get through it. I've come too far now not to!
Body... make up your mind and work properly!!! Hopefully things will straighten out by early next week and we can go back to the next step.
Body... make up your mind and work properly!!! Hopefully things will straighten out by early next week and we can go back to the next step.
Tuesday, December 21, 2010
Round 2 (IVM): Step 3 - Egg Retrieval / Collection
I have had 2 ultrasounds already, and a third is scheduled for tomorrow and things are going extremely well this time around. So, the time has come! I should be going in for Step 3 within the next few days; probably Christmas Eve or Christmas Day from the looks of things. Must be all those fingers and toes crossed around the world for us!
When I first heard the terms “egg retrieval” and “collection” all I could think of was the Easter Bunny for some reason (I know... my head doesn’t always think right). However, once I found out that the more technical term for the procedure is “follicle aspiration” I became quite content with the term “collection”.
So now that we have settled on a term... what is it?
Inside the ovary, there are numerous fluid filled follicles in which eggs develop – also known as cysts. With ultrasound, each follicle can be seen and measured. Once a follicle reaches around 18mm, it is considered to be a mature follicle – one which will release an egg for fertilization. In my case, I have trouble reaching this size so my eggs will be collected (at around 10-12mm) and further matured in a lab rather than inside my body. This is where IVM begins. When doing IVF, matured eggs are collected.
Where I go for treatment, women are mostly awake for this procedure. An IV drip is given but it does not nearly knock you out from what I have been told. Great if you want to watch, horrible if you cannot handle the pain. A thin needle attached to a catheter with a test tube on the end is passed through the top of the you-know-what (ask me if you don’t) and, with help from ultrasound, is guided to the ovaries. The needle pierces the ovary at each follicle and the fluid is aspirated (drained) through the needle. The egg also detaches from the follicle wall and flows with the fluid into the test tube. It seems to take about a minute or so per follicle from what I understand. It doesn’t sound like long, but when you have PCOS you have multiple follicles which means I could be there for a good half hour or so. Thankfully, DH should be with me this time around!
The fluid with the eggs is passed to the lab where the eggs are taken out and placed in small dishes kept in special incubators to continue growing and maturing. Repronex (hormones) will also be added to help the eggs mature (which cost 340$ for one dose I just found out – yikes!).
If you are interested, you can find some pretty detailed information about this process as well as images here. This is not where I go for treatment but I liked the amount of information they give.
Also, during this time, the lab is supposed to contact you daily to give you a progress report on how your eggs are doing. If all goes well, ICSI should be preformed within a couple of days. More information about ICSI and the following steps to come once I know more about what is going on!
When I first heard the terms “egg retrieval” and “collection” all I could think of was the Easter Bunny for some reason (I know... my head doesn’t always think right). However, once I found out that the more technical term for the procedure is “follicle aspiration” I became quite content with the term “collection”.
So now that we have settled on a term... what is it?
Inside the ovary, there are numerous fluid filled follicles in which eggs develop – also known as cysts. With ultrasound, each follicle can be seen and measured. Once a follicle reaches around 18mm, it is considered to be a mature follicle – one which will release an egg for fertilization. In my case, I have trouble reaching this size so my eggs will be collected (at around 10-12mm) and further matured in a lab rather than inside my body. This is where IVM begins. When doing IVF, matured eggs are collected.
Where I go for treatment, women are mostly awake for this procedure. An IV drip is given but it does not nearly knock you out from what I have been told. Great if you want to watch, horrible if you cannot handle the pain. A thin needle attached to a catheter with a test tube on the end is passed through the top of the you-know-what (ask me if you don’t) and, with help from ultrasound, is guided to the ovaries. The needle pierces the ovary at each follicle and the fluid is aspirated (drained) through the needle. The egg also detaches from the follicle wall and flows with the fluid into the test tube. It seems to take about a minute or so per follicle from what I understand. It doesn’t sound like long, but when you have PCOS you have multiple follicles which means I could be there for a good half hour or so. Thankfully, DH should be with me this time around!
The fluid with the eggs is passed to the lab where the eggs are taken out and placed in small dishes kept in special incubators to continue growing and maturing. Repronex (hormones) will also be added to help the eggs mature (which cost 340$ for one dose I just found out – yikes!).
If you are interested, you can find some pretty detailed information about this process as well as images here. This is not where I go for treatment but I liked the amount of information they give.
Also, during this time, the lab is supposed to contact you daily to give you a progress report on how your eggs are doing. If all goes well, ICSI should be preformed within a couple of days. More information about ICSI and the following steps to come once I know more about what is going on!
Thursday, December 16, 2010
Round 2 (IVM): Step 2 and Good To Go!
Well, good things come to those who wait apparently.
I just had my first ultrasound (step 2) for my second attempt of IVM and everything is clear and good to go! No more pesky, random, 20 mm follicles in the way anymore. The medication I took for the last 3 weeks did exactly as it was supposed to and now I am waiting for a call back from the doctor to let me know when I go in for my next ultrasound and to get a better idea of how the steps will play out in the next few weeks.
No more "Bad News 2010"... bring on "Good News 2011"!
I just had my first ultrasound (step 2) for my second attempt of IVM and everything is clear and good to go! No more pesky, random, 20 mm follicles in the way anymore. The medication I took for the last 3 weeks did exactly as it was supposed to and now I am waiting for a call back from the doctor to let me know when I go in for my next ultrasound and to get a better idea of how the steps will play out in the next few weeks.
No more "Bad News 2010"... bring on "Good News 2011"!
Wednesday, November 24, 2010
Round 1 (IVM): Cancelled
I had my second ultrasound this morning and there were no changes since Saturday unfortunately. I met with the nurse right after and we set up my “calendar” to try again. This round is not exactly considered as being cancelled seeing as I didn’t get anywhere, so it is essentially postponed. In other words, this will NOT count as one of the rounds covered by the government. Also, instead of going the Provera route again and getting stuck, they are giving me 1 month of Birth Control to do the job. It has been a long time since I have seen these! I just hope they work. Oh, and the good news is... even if AF doesn't arrive when it should I still go in for an ultrasound as though it did.
I am surprisingly not too upset about it either because the timing of things should work out extremely well if everything is smooth. My retrieval should fall over the Christmas holidays (and yes, possibly on Christmas morning if necessary) so I won’t have to worry about missing work and I can stay home and relax. And then, the transfer should come just before or after New Year’s so I will have an extended “vacation” if you want to call it that. Not a bad way to start 2011 I guess.
All in all, I am ok with all of this. It’s too bad it didn’t work out right now but at least it’s because my body woke up for once and not because my condition got worse. Another month won't make that much difference in the greater scheme of things.
I am surprisingly not too upset about it either because the timing of things should work out extremely well if everything is smooth. My retrieval should fall over the Christmas holidays (and yes, possibly on Christmas morning if necessary) so I won’t have to worry about missing work and I can stay home and relax. And then, the transfer should come just before or after New Year’s so I will have an extended “vacation” if you want to call it that. Not a bad way to start 2011 I guess.
All in all, I am ok with all of this. It’s too bad it didn’t work out right now but at least it’s because my body woke up for once and not because my condition got worse. Another month won't make that much difference in the greater scheme of things.
Monday, November 22, 2010
Round 1 (IVM): Step 2 (Expect the Unexpected)
There are times in life that simply do not make sense… and this weekend was one of them. On Saturday I went in to the hospital for a CD3 ultrasound, the first of this cycle. In the past, I have always seen a number of tiny follicles at this point waiting to grow and nothing more which is good for that stage of the cycle. This was also my hope for Saturday, but not the case.
When using both Clomid and Gonal-F in the past, the goal was to reach a follicle of about 18mm in diameter so that I could continue the process in order to get pregnant one way or another. However, this never occurred and all of my follicles simply remained around 8-9mm. We began to think that reaching anything larger was impossible and this is why I changed to IVM. There was no use continuing on with daily injections if they weren’t being effective.
On Saturday, the doctor started to do the ultrasound and the first thing we both see is a large black circle on the screen. He measured it and, sure enough, it’s a 20mm follicle! That’s great, in the sense that it means I am not completely useless and I can actually do it (and on mine own - without medication), but it is HORRIBLE timing. Basically, there is no way to be exactly sure what it is and what it is going to do at this point. It is definitely left over from my last cycle, but is it empty? Is there an egg inside? Will it go away in the next couple of days to give room for the new follicles? These are all questions that remain unanswered for now.
If it is in fact a proper follicle with an egg in it, taking Provera has messed up my “natural cycle” and has now ruled out the possibility of using that egg. And if there is an egg inside that is still giving off estrogen it will cause the other follicles around it to make lesser quality eggs and I need high quality eggs to continue with IVM so we would have to wait until it is gone to try again. The other side to this is that it may be empty and ready to shrink down any minute now. Who knows?
Initially the plan was to cancel the cycle and try again next month. But, after speaking with a nurse, they have decided to give this a second try. They took a blood test to check my estrogen levels and called me back later in the day to schedule another ultrasound for Wednesday (CD7). If all goes well, they will allow me to continue… but if the larger follicle is still there, I will have to start all over again next month!
Expect the unexpected! That is all I can say at this point.
When using both Clomid and Gonal-F in the past, the goal was to reach a follicle of about 18mm in diameter so that I could continue the process in order to get pregnant one way or another. However, this never occurred and all of my follicles simply remained around 8-9mm. We began to think that reaching anything larger was impossible and this is why I changed to IVM. There was no use continuing on with daily injections if they weren’t being effective.
On Saturday, the doctor started to do the ultrasound and the first thing we both see is a large black circle on the screen. He measured it and, sure enough, it’s a 20mm follicle! That’s great, in the sense that it means I am not completely useless and I can actually do it (and on mine own - without medication), but it is HORRIBLE timing. Basically, there is no way to be exactly sure what it is and what it is going to do at this point. It is definitely left over from my last cycle, but is it empty? Is there an egg inside? Will it go away in the next couple of days to give room for the new follicles? These are all questions that remain unanswered for now.
If it is in fact a proper follicle with an egg in it, taking Provera has messed up my “natural cycle” and has now ruled out the possibility of using that egg. And if there is an egg inside that is still giving off estrogen it will cause the other follicles around it to make lesser quality eggs and I need high quality eggs to continue with IVM so we would have to wait until it is gone to try again. The other side to this is that it may be empty and ready to shrink down any minute now. Who knows?
Initially the plan was to cancel the cycle and try again next month. But, after speaking with a nurse, they have decided to give this a second try. They took a blood test to check my estrogen levels and called me back later in the day to schedule another ultrasound for Wednesday (CD7). If all goes well, they will allow me to continue… but if the larger follicle is still there, I will have to start all over again next month!
Expect the unexpected! That is all I can say at this point.
Wednesday, November 17, 2010
Round 1 (IVM): Step 1 (continued)
It has been 3 days since I finished the Provera... and still no sign of AF! Not one sign! In the past it has always been 3-4 days max that I had to wait. I am not completely freaking out (yet) but I knew this would happen. The one time I really need it to work and it has to go and do this on me. ARGH! I have never been so upset to not get AF. May try some herbal remedies to see if I can get thgins going... can't hurt, right?
Thursday, November 11, 2010
Round 1 (IVM): Step 1 Begins! (Steps Included)
“In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.”
Remembrance Day has always been close to my heart as both of my maternal grandparents were in the war and I grew up hearing all of their stories. My grandfather passed away when I was 12 but my grandmother is still alive today and I love her to pieces! I am hoping, though, that Remembrance Day of 2010 gives me even more to remember and be thankful for than ever before because today I officially begin my first attempt at IVM! I did not pick this day specifically, more so because it worked with our schedules, but it feels like a good day.
These are the steps and how things should go in an ideal world. Obviously, when dealing with the human body, anything can happen so this is not at all set in stone!
Step 1: Since I still do not have a regular cycle, I need to take Provera (a synthetic variant of the human hormone progesterone) in order to begin AF. I need to take 2 pills a day for 3-4 days and then I can expect AF shortly after, bringing me to CD1.
Step 2: On CD1 I call the hospital to schedule a couple of ultrasounds in order to monitor the growth of my follicles followed by an injection of Human Chorionic Gonadotropin (hCG) to mature the eggs 36-38 hours before egg retrieval.
Step 3: Egg retrieval. This will not be the most pleasant experience from what I have heard but it must be done. Once I know more about it and when I am scheduled I will post about it. The interesting thing about this day is that my pregnancy test will actually occur 16 days after this date. In the “normal” baby-making process, this would be the date of conception basically. At this time I will also begin taking Estrace and Prometrium (a combination of Estrogen and Progesterone to help support the endometrium - lining of the uterus), and Doxycycline and Medrol (an antibiotic and a corticosteroid to help create a favorable environment for implantation of the embryo) in addition to the other medications I am currently taking.
Step 4: My collected eggs are matured further in the lab, fertilized using ICSI, and then monitored for a number of days afterwards before transfer. Not all of the eggs will make it through this process but the hope, obviously, is that at least a couple of them make it through the process strong, healthy, and ready for transfer. The embryos that are not transferred will be frozen for a future attempt so that I can avoid repeating all of the previous steps. This could be a month after (if IVM is unsuccessful) or years later for a sibling.
Step 5: Transfer time! I will go in and meet with the Embryologist to choose the best looking, strongest, and healthiest embryo. They will then perform what is called “assisted hatching” on the chosen embryo and then transfer the embryo to me. And then we wait. I will be placed on a 2 week sick leave in order to give me the best possible chance of success; little activity, no stress, lots of rest, fingers and toes crossed... you get the picture. I will stop taking Doxycycline, and Medrol at this time but stay on everything else.
Step 6: The blood test. If positive, I schedule an ultrasound 2 weeks later to determine the number and position of any pregnancies (yes, twins are still possible) as well as an appointment to see the high risk doctor. If negative, I go back to my fertility doctor and schedule round 2 (using the frozen embryos) as soon as I am ready.
Wednesday, November 10, 2010
Round 1 (IVM): Begins Tomorrow!
About a month ago I said that I would post more details about my IVM schedule and the medications involved… and the time has come!
I have to say that it feels good to be getting back into the baby-making process! I feel like so much time has passed and been wasted since we last tried this past May, but we are back in the saddle, we overcame the roadblocks, won the battle, and we are now “back to work”! And, bonus, it’s going to be paid for by the government! Yay!
So, to answer a couple of questions, what is this IVM I keep talking about? IVM stands for In-Vitro Maturation. It is a much newer procedure than the In-Vitro Fertilization we have grown up hearing about (the first baby born through IVM was in 1999), but for a variety of reasons it is the best option for me right now.
Basically, immature eggs are collected from me, matured in the lab for 24-48 hours (thus no hormone injections for me, yay!), and then fertilized one by one using Intracytoplasmic Sperm Injection (ICSI) and left to mature once more. About 2-5 days after fertilization, one embryo is transferred back into me and then we keep our fingers crossed. Before the government was involved in the process I would have been able to try with 2-3 embryos at one time, but now I am limited. But, at least it is free! They will cover 6 rounds of treatment per pregnancy. I have posted this link before, but once again, you can read more about this and even see some pictures here.
And, as some of you know, I have had a long running joke that I will get pregnant by my doctor while DH is out of the country and some other person (friend, family or nurse) holds my hand. Well, it WAS a joke but it seems like it will also be the case! DH is currently away on business again, and then he will be home only briefly before leaving once more (and hopefully for the last time in 2010). So, if things go as “planned”, he will only be here for my egg retrieval! It still makes me laugh, but don’t get me wrong… it isn’t easy. As a friend said to me a couple of weeks ago (about her own life), “My husband missed pretty much all the big events in my life too because of work! Not to sound insensitive but I am used to it, calloused if you will... Everyone thinks I am so strong too, but it's a facade that you have no choice but to put on, otherwise you crumble”. I couldn’t have said this better myself.
So this is it for now. Tomorrow, I will post all of the steps and medications involved! Fun!
I have to say that it feels good to be getting back into the baby-making process! I feel like so much time has passed and been wasted since we last tried this past May, but we are back in the saddle, we overcame the roadblocks, won the battle, and we are now “back to work”! And, bonus, it’s going to be paid for by the government! Yay!
So, to answer a couple of questions, what is this IVM I keep talking about? IVM stands for In-Vitro Maturation. It is a much newer procedure than the In-Vitro Fertilization we have grown up hearing about (the first baby born through IVM was in 1999), but for a variety of reasons it is the best option for me right now.
Basically, immature eggs are collected from me, matured in the lab for 24-48 hours (thus no hormone injections for me, yay!), and then fertilized one by one using Intracytoplasmic Sperm Injection (ICSI) and left to mature once more. About 2-5 days after fertilization, one embryo is transferred back into me and then we keep our fingers crossed. Before the government was involved in the process I would have been able to try with 2-3 embryos at one time, but now I am limited. But, at least it is free! They will cover 6 rounds of treatment per pregnancy. I have posted this link before, but once again, you can read more about this and even see some pictures here.
And, as some of you know, I have had a long running joke that I will get pregnant by my doctor while DH is out of the country and some other person (friend, family or nurse) holds my hand. Well, it WAS a joke but it seems like it will also be the case! DH is currently away on business again, and then he will be home only briefly before leaving once more (and hopefully for the last time in 2010). So, if things go as “planned”, he will only be here for my egg retrieval! It still makes me laugh, but don’t get me wrong… it isn’t easy. As a friend said to me a couple of weeks ago (about her own life), “My husband missed pretty much all the big events in my life too because of work! Not to sound insensitive but I am used to it, calloused if you will... Everyone thinks I am so strong too, but it's a facade that you have no choice but to put on, otherwise you crumble”. I couldn’t have said this better myself.
So this is it for now. Tomorrow, I will post all of the steps and medications involved! Fun!
Thursday, October 7, 2010
Signed, Sealed, and Delivered!
Just as the title says... all of our forms and waivers have been signed and were delivered to the hospital this morning. In addition, I signed the government paperwork for the free IVF/IVM treatments and received my "calendar" (projected schedule of treatment) as well as all of my prescriptions and the one for DH to take.
Also, in the event that DH's travel schedule changes, we froze some of his "boys" this morning (or maybe I should be hopeful and say "girls").
And last but not least, we attended the mandatory information session this morning which, while late as usual, was actually more helpful than I had expected!
So, things are all set and good to go now! Come on November!!!
I will post more details about the schedule and the medications later on!
Also, in the event that DH's travel schedule changes, we froze some of his "boys" this morning (or maybe I should be hopeful and say "girls").
And last but not least, we attended the mandatory information session this morning which, while late as usual, was actually more helpful than I had expected!
So, things are all set and good to go now! Come on November!!!
I will post more details about the schedule and the medications later on!
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