Friday, January 29, 2010

let's call it a science experiment

As you read in my last entry, my feelings ranged from befuddled to PISSED after our frozen embryo transfer on Tuesday. To recap, in preparing for our 2nd single-blastocyst FET, our clinic skipped over one super-fantastic-grade-AA embryo and two Waffle-Girl-level ABs to roll the dice with one of our mediocre BBs. Now I know that people get PG all the time with BB's, I just thought it was totally mental to pick the worst of 5 blasts for a single embryo transfer.

My mood has picked up since Tuesday for a few reasons:

1) I figured, "Meh, what can you do? Stuff happens."

2) Thai food and subsequent Thai food leftovers.

3) The "mutt" embryo seems to be trying pretty hard. I've had cramping on-and-off since the day after transfer. This is exactly when implantation should happen, so I am encouraged.

4) I've come to see this as a science experiment. As a fancy government scientist lady, I am able to step back and look at this objectively.

These are the facts:

FACT #1 - An AB-embie implanted in '07 and then an AA implanted in '09. Thus, any embryo with an "A" in the grade can be expected to implant.

FACT #2 - The BC embryo transferred in '07 did not implant. Thus, an embryo with a "C" in the grade will not implant.

Study question: What will happen when a BB is transferred? There is no "A" to predict implantation and no "C" to predict failure.

HYPOTHESIS #1 - The BB will fail to implant due to lack of an "A" in the grade.

HYPOTHESIS #2 - The BB will successfully implant due to lack of a "C" in the grade.

Just where is the cut-0ff between implanting-embryos and bupkus-embryos for the infertile breeder and Mr. Foxy? Super sexy government scientists all over the world want to know. And I'm willing to put in the time and effort to investigate this important question.

The cool thing about a scientific study is that, whatever the outcome, you've learned something. Even if your theorum is shown to be false, this is a valuable piece of information. In particular, we will learn whether our other frozen BB is likely to be another dud.


Wednesday, January 27, 2010

processing.. processing..

Our frozen embryo transfer went great yesterday and I've been lounging on the couch since then, thinking fertile thoughts. Okay, that's not totally true. I've been sulking and stewing, too. I feel like Dr. Snaggletooth executed a "bait and switch" with our day-5 blastocysts.

We had previously agreed to a single-embryo transfer, same as what we did in September, using the second of our excellent quality (AA) blasts. See this link for more info about day-5 blastocyst grading . As I'm getting prepped for the transfer, the Doc tells me we're transferring a "beautiful BB" embryo. Sure, a BB isn't bad, but why did we pass over the remaining AA and the two ABs?! The answer is that the BB was frozen in a single straw (the obvious choice for a single transfer) while the 4 higher-grade embies were frozen in pairs. Well why wasn't the AA frozen as a single, given the fact that yours truly was an obvious candidate for a future single blast transfer? It's just dumb.

So I have my legs in stirrups already and the embryologist comes to check our IDs and she explains that the AAs and BBs have the same implantation rate, so it doesn't really matter. Obviously I was in no position to argue. I figured that they'd have to defrost 2 more embies (total of 3) just to get the one AA that I wanted. So I sucked it up and went ahead with the transfer, even though I feel like we'd been shanghaied.

As a frame of reference, Waffle Girl is the result of the AB transferred in '07, along with another blast, a BC, which did not ever implant. So the BB we took home yesterday is somewhere between Waffle Girl and bupkus in terms of implantation.

I feel that we have a less-than-50% shot that this one could work. So what.. we'll do another FET in two months. Well the problem is that, after having 2 failed single-blast transfers, we'll be advised to do a double-blast transfer (pairing up the AA and an AB) next time around. We'll be at a high risk for twins, which is exactly what I'd hoped to avoid by doing singles in the first place! I think there is a definite dis-connect between how the lab freezes the embryos versus a logical progression of future FETs. I'm not sure whether I'll come in to gripe about this before or after my beta, but believe me they will hear about this.

I know I sound bitchy and greedy. I'm just frustrated by the various fuck-ups and delays in the span of one year. I know we can have another IVF baby - I don't doubt this. But I feel like it's been dangled in front of us for months and I just keep grabbing at it like a kitten at a feather.

So my lil' BB embryo is floating in a womb full of confusion and angst. Luckily, Mr. Foxy has been very encouraging. He's holding the good thought that this embryo is the little scrappy one, the mutt who will work really hard to earn his place in the family. Sure, I'll buy that. I've been promised Thai food for dinner tonight, so hopefully that will help turn my crappy attitude around.

P.S. If you're interested in the pre-FET drug protocol, here's a photo of my daily dose of meds for the week before transfer. Since the transfer, I got to stop Lupro.n and antibiotics, but all else remains the same. Is it any wonder I'm getting emotional?

Wednesday, January 20, 2010

i'm a sucker for estrogen

I gave money to a crack whore today.

I went in this morning for a final blood and ultrasound check before confirming our FET for Tuesday, 1/26. There are currently 4 estrogen patches on my belly, as I am in the pretend-ovulation phase of my fake-menstrual-cycle in the leadup to embryo transfer. You can definitely tell that I'm hopped-up on estrogen because I'm getting sentimental and teary-eyed with the slightest provocation.. like a bad chick-flick on cable.. or a soup commercial. I had warned my coworkers that I may be on the warpath this week, expecting major bitchiness, but it turns out that I'm a pathetic sap.

So as I walk out of the clinic, this disheveled woman walks up to me with some wacky story about how she's HIV-positive and pregnant and she needs to get to this hospital across town where she's being treated. Normally I'd have walked on by and rushed off to work. But she was so distraught and she said she was 3-months pregnant and bleeding and I just got sucked in! She asked me to drive her to the hospital, which wasn't about to happen. Then she asked for cab fare and I gave it to her. I helped her hail a cab and get in, even though the security guard at the nearby office building gave me a disapproving look and said "be careful".

I knew at that moment that most likely I was being scammed, but I just couldn't help it. The estrogen got the best of me. I coughed up some money on the off-chance that this lady would really go to a place that will give her some needed treatment. I know what it's like to be early in pregnancy and bleeding. I know what it's like to be in the 2nd trimester and bleeding. And to have a chronic disease and possibly homelessness on top of that? Yikes.

So maybe I helped someone today. Probably not.

My bloodwork and ultrasound were good, so we are a "go". We're transferring a single 5-day grade-AA blast next week. Yeah, you read that right - I'm a 39-year-old doing a single embryo transfer. Cocky? Maybe. The RE encouraged it and I'm okay with doing repeat FETs if needed. More on my rockin' frosties next time.

Sunday, January 17, 2010

good luck tasha!

My dear friend and godmother to Waffle Girl, Tasha the Triathlon Goddess, is going in for surgery tomorrow morning. Tasha was treated for breast cancer over a year ago. Now she's getting breast reconstruction plus a little upgrade, a.k.a. her long awaited "Rackotomy."

If you ever get the urge to read a blog about something other than infertility (huh?!), feel free to check out Tasha's blog. You could even convert a smidgen of your IF "babydust" to "boobydust," then send it her way for a speedy recovery and continued fight against The Cancer.

Like many cancer survivors, Tasha bristles every time she sees another tacky pink ribbon-adorned product. Even worse are fundraising events with ridiculous names like the A.von Walk for Breast Cancer (wait.. aren't we *against* cancer?!). As annoying as these things are, the underlying problem is that money is being raised to do more and more awareness programs when the public is already in a state of awareness overload. And where's the cure already?

So the next time you get the urge to buy a "For the Cure".. yes, there is such a thing and, no, I won't give you the link.. consider donating to an organization that puts most of its money toward medical research. Here's a link to an article "Where the Money Goes: A Breast Cancer Donation Guide" that helps sort out which groups have awareness (a.k.a. more pink ribbons) as a primary missions versus those that put all of their program dollars toward finding a cure.

Tasha - I wish you a smooth recovery and many happy years to show off the new rack. I love you!

Friday, January 15, 2010

retroactive pregnancy

As creepy and weird as fertility treatments are, there is more oddness to come (hopefully) when you're pregnant. For example, the way they calculate the length of pregnancy is interesting. We all know about the alleged 9-months of gestation. But medical professionals count a pregnancy as having 40 weeks. I didn't know this until we conceived Waffle Girl, since I hadn't bought all the baby books and was pretty clueless.

So when does the clock start ticking off those 40 weeks? You might think it's the moment of conception.. or the end of the month when you get your positive test result, the elusive BFP (big freakin' positive). Well you would be wrong! The 40 weeks start at the beginning of your last period, i.e. the first day of your menstrual cycle. The weird thing about this is that you get "credit" for being pregnant during the two weeks before you even ovulated! So, you get pregnant, which is fantastic enough by itself, only to learn that you're officially 4 weeks into it already. Bonus!

Why am I thinking of this when we are still 11 days away from our embryo transfer? Because I may already be pregnant! In a totally theoretical way. If we get our frozen embryo on 1/26 and it "sticks" and we get a BFP, then within a matter of days an actual medical expert will retroactively declare that we've been pregnant since 1/5! Which means that I am, as of this writing, already 10 days pregnant. Woo-hoo! In the present tense, this is utterly 100% untrue (not to mention physically impossible). But I truly hope that Dr. Snaggletooth will do a little time travel and make it so.

Tuesday, January 12, 2010

continuing the "flip off" theme

As you saw in my final post of 2009, I was rather amused when I saw the vial of Lupron was encouraging me to rudely gesticulate at the world ("FLIP OFF" on the cap). Now the hilarity continues. The instructions the nurse gave me last week indicate that on Cycle Day #7 (see the circled portion of the photo on the left) I should tell them all "F-You!" Right?! I'm pretty sure that I understood this correctly. (Ha ha!) Tomorrow's appointment is for bloodwork and ultrasound. My best guess is that the shorthand "f/u" stands for phlebotomy and ultrasound.. kindof. Oh, whatever.

Okay, moving on. I was advised a few weeks ago that, in addition to my beloved progesterone shots, the frozen transfer would also require vaginal suppositories of hormones. Although I'm not thrilled about shoving a capsule of meds up where the sun don't shine, I figured it's just another indignity I must endure. I imagined the "vag-candies" would come individually wrapped, in a little box. I was taken aback when they arrived in the form of a space pod, pictured below. WTF?! This looks like some type of ammunition.. maybe. It's definitely from the future, that's for sure.

And finally, if there was any doubt about how to administer this medication.. umm... see my last photo. 'Nuff said.

Friday, January 8, 2010

Suppression? Check.

After a month on birth-control pills and almost 2 weeks of Lupron shots, it looks like my internal lady-bits are in a deep sleep. I went in for an ultrasound yesterday and the technician confirmed that all's quiet on the ovarian front.
Besides the well-known flashy aspects of IVF treatment (egg retrieval, Petri-dish fertilization, etc.) I have to say I find the suppression of your reproductive system to be kindof interesting, in a mad scientist way. You're blocking your body's own production of hormones, telling your pituitary gland, "OK, you shut up now, we'll handle this." Once everything is fully suppressed, then you start taking the meds (synthetic hormones) to produce a bunch of eggs, grow your uterine lining, etc. The doc prescribes very precise levels of estrogen/FSH/etc. and doesn't want your body to contribute some unknown amount of hormones into the mix. No contribution from you, silly patient!

So, currently my natural system is totally zeroed out and ready to receive further orders.. to be sent in the form of hormone shots, patches and tablets tucked up into my hoo-ha. Crikey! I'll talk more about my protocol and schedule later. The main thing is that the embryo transfer is set for 1/26, hence the new countdown ticker widget on my blog.

In related news, I've done really well lately in suppressing my urge to say stupid things to Mr. Foxy. The kind of things that get me in trouble 'cause I appear critical/bitchy at a time when I should just shut up and be grateful. Case in point: Mr. Foxy spent many days researching and visiting auto dealerships after I made an offhand comment about wanting a newer car. On Monday night I had so many reasons to tell him he was nuts when he said he wanted me to come out to test-drive a car. But even though I was literally suffering PMS and menopause at the same time, I sucked it up. It took forever (of course) and poor Waffle Girl was over 2 hours past her bedtime, but I got a new-ish jazzy RED car.. with seatwarmers. Ahhhh..