ChezPerky

Couple Quick Things:

June 7, 2009 by chezperky

1. I am still angry about the doc yesterday. I thought I’d be over it by now. I clearly gave myself too much credit.

2. No, I have no idea what’s going on with email subscriptions, bloglines, google reader, or my feed in general. I’ve even tried re-burning the feed all together and that hasn’t fixed the problem either. I’m about read to ditch Blogger all together and just use my defunct WordPress Account instead. Blogger seems like more trouble than its worth – especially as related to privacy, since you can’t password protect things (esp. individual entries) – you can only privatize the entire blog and then you’re limited to 100 readers, which is why I opened my blog back up.

Posted in blogarama | 5 Comments »

Protected: And Then There Was One

June 7, 2009 by chezperky

Posted in IVF#2 (Take 3), transfer |

It's Like DeJaVu All Over Again

June 5, 2009 by chezperky

The phone call from SuperDoc on Day 4 explaining the outlook and the options. The apologetic tone in his voice. The determination to push forward. The sense that maybe things aren’t quite as perfect as he’d like them to be. I feel like I’ve lived this life before. I’ve been down this path, I know where it leads, and it doesn’t lead to the perfect single embryo transfer on Day 5.

In fact, that’s pretty much what SuperDoc told me this morning. Things looked “great” on Day 2, but apparently not so great on Day 3, and even less so on Day 4 (today).

Embryo #:	Day 2 Report:	Day 3 Report:	Day 4 Report:
1	2 cell, no fragmentation	4 cell, no fragmentation	6 cell
2	2 cell, no fragmentation	4 cell, no fragmentation	4 cell, no change
3	2 cell, no fragmentation	4 cell, no fragmentation	6 cell
4	2 cell, no fragmentation	3 cell, 15% fragmentation	8 cell
5	4 cell, no fragmenation	4 cell, no change	4 cell, no change
6	4 cell, no fragmentation	4 cell, no change	7 cell
7	4 cell, no fragmentation	4 cell, no change	4 cell, no change
8	4 cell, no fragmentation	6 cell, uneven growth	compacting embryo

Note, SuperDoc gave me no information about fragmentation – but said that the embryo quality today wasn’t nearly as promising as he’d hoped. He believes that we’ll likely have a [singular] good quality blastocyst to transfer – but he thinks it is unlikely that we will have it by tomorrow and that I’ll more likely be pushed to a Day 6 transfer.

This seems to be a chronic problem of mine – the slow growing embryos. This is the same thing that happened to me last time, essentially. By Day 4, I should pretty much be looking at morulas. I should have had 6-8 cells on Day 3. The reason that clinics don’t do Day 4 transfers (usually) is that it’s difficult to differentiate quality between morulas, so they let the morulas mature to blastocysts by Day 5. But it’s unlikely that my almost-morula (Embryo #8) is going to be a blast by tomorrow (Day 5). It’ll need the extra day. This is the same thing that happened last time. I did end up with two blasts on Day 6 (none on Day 5), but one was clearly the winner. None of my 9 embryos in IVF#1 made it to freeze. None. It is unlikely that any of these 8 will either.

So what do you do about slow-growing embryos? Not much. According to Dr. Licciardi, from NYU Fertility Center, they really don’t know what to do about it. They’ll try different things in the protocol to see if it fixes anything, but they never know whether it was the change in protocol that fixed the slow growth issue, or whether it was just luck. Probably just luck.

Since we’ve always known that PCOS isn’t my sole issue with getting (and staying) pregnant, it makes me wonder whether my slow-growing embryos contribute to the issue. But then again, maybe they’re only slow growing in a lab. This is one of those places where the science is simply too immature to help answer these questions. We just don’t know. So we keep trying.

I have long said that I am grateful to live in a time when the science and the medicine have reached a point that I know, with a reasonable degree of certainty that I can get pregnant with assistance. I went through five years of infertility, countless monitored cycles, 11 medicated cycles, 6 IUIS, and a late miscarriage before having my beautiful babies. But a hundred years ago, even fifty years ago, I wouldn’t have been able to push through all of that knowing that there was always a next step available to me. There just wouldn’t have been options (regarding getting pregnant, that is), period.

I am incredibly grateful that I live in a time where the science and medicine are so advanced. But I think it bears noting that we are still in the (pardon the pun) infant stages of this research. We have so far to go before we really understand how a lot of the embryo development works. How and why certain embryos are more likely to implant than others. Why, in the absence of chromosomal abnormalities, killer cells, a clotting disorder, etc., recurrent miscarriages occur. It is important to recognize and appreciate how far we have come … but also to recognize how far we have to go to ensure that our sons and daughters, grandsons and grandaughters, friends and families have less heartache and more hope.

I have hope that we’ll have a little George, Jr. on Day 6 this cycle. And that George, Jr. will want to cozy on up and stick around until 40 weeks gestation and make his or her appearance into the world. I have hope that this will be the case.

But I am also making plans. A girl needs to make plans, you know. I’m making plans to start my next cycle in August. It will be my last covered at YOFC. I wonder whether I’ll need to use the category, “IVF#3” in my blog posts. I hope not, but I’m making my plans, just in case, because that’s what I do.

Posted in and this is where it started to go downhill, IVF#2 (Take 3) | 10 Comments »

Club Soda, Anyone? (not for the faint hearted)

June 5, 2009 by chezperky

So you know how when you’re giving an IM shot, you’re supposed to pull back on the plunger to see if you get any blood in the syringe before you shoot yourself up with the contents of said syringe? And you know how you always think that it’s a stupid thing to bother with because after 47 shots, you’ve never ever had any blood appear in the syringe, so what’s the point?

Well, so tonight, my husband was giving me my PIO, and he pulled back on the syringe and I wasn’t even paying attention and he said, “Oh, I got blood, I’m sorry.” I thought he was done with the shot and he just meant I was bleeding from the shot. Nope. He meant there was blood in the syringe.

“Okay, well, I think you have to take it out and we’ll start over.”

I don’t know – is that what you’re supposed to do? I think so. Isn’t that the point of finding out if there’s blood? I think so. I honestly can’t remember. See, I’m in a lot of pain right now (I have a migraine plus I think I need a root canal, but who has time for that?) so I’m drugged and tired, so I can’t really think straight.

So he pulls the syringe out of my derriere and says, “And now there’s blood on the floor.” I handed him a piece of gauze. And then another when that one wasn’t enough. He handed me the syringe which… wasn’t reusable. Or maybe it was, but gosh there was a lot of blood in it. I don’t know, can you use it again? I’m thinking no, but I dunno, who knows. I’ll ask my nurse tomorrow.

So while my husband is trying to get me to stop bleeding, I drew up a new dose of PIO. And then he successfully gave me the PIO without incident. Whew.

Um. So does anyone have any ideas about how to get blood out of beige carpet?

Posted in IVF#2 (Take 3), PIO | 6 Comments »

Day 3 Embryology Report

June 4, 2009 by chezperky

Here’s what my Embryos look like today compared to yesterday:

Embryo #:	Day Two Report	Day Three Report
1	2 cell, no fragmentation	4 cell, no fragmentation
2	2 cell, no fragmentation	4 cell, no fragmentation
3	2 cell, no fragmentation	4 cell, no fragmentation
4	2 cell, no fragmentation	3 cell, 15% fragmentation
5	4 cell, no fragmentation	4 cell, no change
6	4 cell, no fragmentation	4 cell, no change
7	4 cell, no fragmentation	4 cell, no change
8	4 cell, no fragmentation	6 cell, uneven growth – not looking great.

So … pretty good. We can probably say goodbye to #4 and #8. But that leaves us with 6 embryos with good potential. There’s some concern about #’s 5-7, but they still have time to continue growing. Embryos 1-3 had a slow start, but they clearly got the message that they should get a move on. I’ll get a call tomorrow with more news and a time for Saturday’s transfer.

And then on Saturday I’ll probably get a call moving my transfer to Sunday, just for kicks. 😉 I told that to my nurse while saying, “I hate to be such an optimist and all, but…” and she said, “Yeah, but you know, when you’ve been around the block a few times, you know how this works.” It’s all good. So far, the news is far better than IVF#1’s embryology reports were. Why, these are downright positive embryology reports!

Posted in embryology report, IVF#2 (Take 3) | 3 Comments »

Embryology Report

June 3, 2009 by chezperky

Things are looking up. My day 2 embryology report in IVF#1 was not promising at all. One of the reasons I was concerned that my fertilization report this cycle wasn’t as good as the fert. report with IVF#1 despite 40% more eggs retrieved was that I was concerned that I’d be facing the same fast attrition that I had faced with the subsequent embryology reports. But, so far, my fears appear to have been unfounded.

Today’s embryology report revealed that I have four 4-celled embryos and four 2-celled embryos. There is no fragmentation in any of them (unlike IVF#1).

So I’ve been moved to a Day 5 transfer.

Shabbos. Of course.

So I have to figure out the whole, you know, getting to the clinic on Shabbos thing. AGAIN. But other than that, I couldn’t be more thrilled.

Posted in embryology report | 4 Comments »

Fert. Report

June 2, 2009 by chezperky

In IVF#1, I had 10 eggs retrieved, 9 mature, and 9 fertilized. I transferred 1 and none made it to freeze.

In IVF#2, Take 3, so far:

14 eggs retrieved
12 mature
8 fertilized

Posted in fertilization report, IVF#2 (Take 3) | 10 Comments »

Retrieval

June 1, 2009 by chezperky

I admit, I was skeptical that I’d ever make it to retrieval – but there I was at Ye Olde Fertility Clinic today. And they didn’t throw me out for having taken my trigger shot ~~early~~ er, late- they just moved me a bit later in the schedule (not by much). Somehow, I had actually made it to retrieval for IVF#2. I hope I don’t have to find out what it’s like to get to retrieval #3.

Anyway, SuperDoc got 14 eggs – which is phenomenal.

I also love that he came down to do my retrieval… he wasn’t the doctor scheduled to do retrievals today, but he came down to do mine, which I really appreciated. I’m in a fair bit of pain, but they gave me fentanyl, morphine, and vicodin at the clinic, and armed me with a bottle full of vicodin for my house. Now I’m really spacey and exhausted and completely incapable of being witty or interesting, but that’s what you get.

Fert report tomorrow. The waiting begins

Posted in IVF#2 (Take 3), retrieval | 12 Comments »

Crisis averted

May 31, 2009 by chezperky

I had resigned myself to cancelling this cycle, with the smallest glimmer of hope that maybe tomorrow wouldn’t be too late to trigger for a Tuesday retrieval to at least get the smallest of my growing eggs. In tears, I sat in my husband’s arms and said over and over again, “I’m so sorry.”

A whole cycle wasted.

Worse: I would have to call Ye Olde Fertility Clinic tomorrow and admit to my stupidity. They have signs EVERYWHERE asking if you have your trigger shot. Are you SURE you have your trigger shot? ABSOLUTELY sure? Check with your nurse if you need it, they admonish. Their paperwork reminds you constantly to ensure ahead of time that you HAVE YOUR TRIGGER SHOT because the doctor on call can’t guarantee that you’ll be able to find a pharmacy that has it in stock if you call them in a panic in the middle of the night. On Thursday the nurse who went over my trigger instructions asked if I had the trigger shot. “Oh yes,” I said. “I’m sure I do.”

“You might want to check,” she said.
“Oh, I’ll definitely check. I wouldn’t want to be THAT patient,” I said. “You know, the one who calls in the middle of the night in a panic because she doesn’t have it?”

Right. And I did have every intention of checking to see if I had it. Really. But, well, life got away from me.

We called all the 24 hour pharmacies around and, sure enough, no one had it in stock, so calling the doctor on call wasn’t going to help me anyway. So, as I said, I had resigned myself to having completely wasted an entire cycle.

But then – my brilliant, handsome, perfect, amazing, wondermous husband came downstairs and said to me as I wallowed in my misery: “Hey, dumb question… does M have hCG?”

“M’s out of town.”
“Right. So does M have any?”
“Probably, but she’s out of town and I don’t have a key to her house.”
“So… does anyone locally HAVE a key to her house?”

Duh.

Well, it was worth a shot, despite the late hour. The clock was ticking on how long I could push my luck anyway. Last time I got this far, I took my trigger shot half an hour late and my nurse said that was no problem at all. She even said an hour late was no problem at all. Any more than that and it starts to become a problem.

So at 11:38, I called M on her cell phone. She didn’t answer, but I left a message asking her to please call me if she got the message. And then, just for good measure, I tried calling her one more time, just in case she hadn’t heard it the first time. It still went to voice mail, but it turned out that calling her the second time was the thing that clued her in to the fact that the phone ringing was actually something she needed to check.

She called me back moments later.

She did, indeed, have hCG at her house. Her neighbor across the street has a key. She was willing to call her neighbor to see if she wouldn’t mind meeting me with the key. Miraculously, her neighbor was still awake and didn’t mind meeting me with the key.

M gave me instructions for how to deal with the alarm and how to find the medication, and I dashed off to her house (she’s only a couple blocks from me).

hCG in hand, I dashed home to take the trigger shot.

Tomorrow I will pick up MY hCG and return it to M. Along with some kind of super special treat. Because although there is really no repaying this kindness, I really must find a way. She said she was so glad that my husband thought to call her.

“I’m so glad we’re in this together,” she said.

Me too, M, me too.

I’m not sure she’ll ever know how much this kindness means to me. I’m not sure I can ever articulate how huge her tiny sacrifice (of an hour’s sleep to talk me through getting into her house) was for me. I don’t know how things will work out this cycle, but I do know that without her help, I wouldn’t have had an opportunity to find out. I also know that without my husband’s quick thinking (WHY DIDN’T YOU THINK OF IT HALF AN HOUR EARLIER???), I wouldn’t have had a chance to find out how this cycle will work out. I love you, sweetie. I’m so glad we’re in this together.

—————————————

P.S. At monitoring today, they thought I’m probably looking at getting 10 eggs at retrieval. Just so we’re clear, the doctor more than doubled my medications this time around in hopes of getting at least a 50% increase in response this time. I got 10 eggs at retrieval last time. I know that it only takes one, but I’m not in the least bit amused that more than doubling my medications didn’t really change the overall outcome. I *did* ask the sonographer how big my ovaries are and she measured them: they are over twice the size of an average, non-stimulated, ovary. I asked if I was exaggerating to call them baseballs and she said definitely not. My left side, she said, might be closer to the size of a softball.

Gah!

Posted in IVF#2 (Take 3) | 3 Comments »

Trigger Time… But…

May 31, 2009 by chezperky

There’s always a but, right?

My nanny’s father died suddenly on Thursday, so she is out of the country. I don’t know for how long. I am assuming at least a week.

My retrieval which we THOUGHT was going to be either Saturday or Sunday is now… Monday. At almost exactly the time that I’m supposed to be at a school conference for my foster son. A school conference at which I’m paying for the pleasure of the company of the developmental pediatrician and the speech therapist.

And I thought I’d be missing that school conference, because of the retrieval… but it looks like… maybe not so much.

I thought the problem with Monday’s retrieval revolved around childcare for the wee ones. For if I had no care for them, I was going to have to call the whole thing off. Which seemed like an incredible waste, no?

But.

Actually, just before 11pm tonight, I pulled out my bag o’ medication and…

No trigger shot.

I forgot I used it when my last cycle was cancelled and it was the one thing I didn’t refill this time around, assuming I already had it. My husband called around to all the local 24 hour pharmacies in the area and none of them have it in stock. So… I’m out of luck and I likely blew an entire cycle for nothing.

Posted in IVF#2 (Take 3) | Leave a Comment »

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