Waiting for a Window to Open

While I initially hadn't held much hope for Mort's success, I experienced a glimmer of renewed hope two days ago (7dp3dt)when I felt a slight burning sensation in my uterus. I couldn't find any evidence via Google that this was a normal sign of pregnancy, but while reviewing the potential symptoms I experienced during Murtle's 2WW, I learned that I experienced a different sensation in my lower abdomen at 7dp3dt, too. I had described it as feeling as though I had worked out, yet I clearly had not. So, I thought maybe this burning / working out feeling was one of my early pregnancy symptoms and I had a renewed desire to POAS. But considering I didn't get a very faint + on an HPT until 11dp3dt, I knew the chance of me seeing a + today (9dp3dt) was slim to none...even if I really was pregnant. I went ahead and decided to torture myself anyway. I did not see a second line, but I was starting to believe so strongly that Mort was going to make it, that I ended up convincing myself that maybe, just maybe there really was a faint one trying to show through and that it was just going to show itself tomorrow.

Considering I hadn't experienced any spotting yet (I started to spot at 8dp3dt during my last unsuccessful cycle), I thought that was another good sign that this IVF had worked. Unfortunately, my eager anticipation was short-lived because when I got to work this morning, I noticed that I had spotted at some point earlier. It's now been a few hours since I spotted and things seem to be quiet again, but basing things on my past unsuccessful IVF experience, early spotting means the embryo stopped growing. I did experience some spotting when I was pregnant with Murtle, but that didn't start until after I had my second beta.

Prior to and during this cycle, I swore to myself that if this cycle doesn't work, I'm done trying to grow our biological family. I can see why younger mothers seem to have an easier time caring for a baby - not just physically, but also because they probably have a more care-free and laid-back attitude towards parenting. We've already been blessed beyond our wildest dreams with one perfect, happy baby and to think that we'd experience another miracle like this may have been asking for too much.

However, if we didn't try again, I would regret not trying more so because I want Murtle to have a sibling. Not only does she have older parents, but she also doesn't have a very large extended family, either. I am an only child and my husband only has one sibling.

Now that it seems that this cycle is over, I'm not sure what our next step will be. I thought I'd feel a sense of relief in knowing that all of the shots, bloodwork, sonograms, travel to and from DC, and stress of TTCing was over. But I just kind of feel as though I'm in limbo. I met my husband for lunch today and asked him what's next. He wants to try again! I brought up the subject of possibly using donor eggs if we did and, to my surprise, he wasn't as opposed to it as he had been prior to Murtle's arrival on the scene. We had originally talked about using my younger cousin's eggs before I got pregnant with Murtle and my husband was ONLY open to that if we had to go the donor egg route. But he's even now on the same page with me that it might be weird to use her eggs as opposed to an anonymous donor's eggs. Anyway, I really don't know what the future holds, but for now, I'm just going to sit back and see what happens. God has been very, very good to me up to this point and I'm excited to see what He has in store for our family next!

Come On Mort!

Hoping to re-coop my IOTO success with Murtle, a friend of mine suggested to name the new embaby I transferred yesterday, "Mort" -- as in "Mortoise the Tortoise." I think the name is perfect!

So, Mort was successfully transferred yesterday (Wednesday) at about 7:45 am. The only information I got prior to his transfer was that he contained 6-cells and was fragmented. I was able to get a picture of him to compare to Murtle's pre-transfer picture and I'll try to post both here. Dr. Sacks said that he was pretty clear, but contained just two cells on Tuesday morning. Once he expanded to 6-cells, he became fragmented, but Dr. Sacks didn't give me a percentage or grading quality. He simply told me that in his experience, cell growth has proven to be a better indicator of success than fragmentation. But that didn't give me much re-assurance considering Murtle had reached 9-cells by the time of transfer. So hopefully Mort's fragmentation percentage isn't too high and he will keep on growing and dividing now that he's back with mommy. During my "nesting" yesterday, I found Murtle's embryologist report. She had 25% fragmentation and was graded as a "2", with "1" being the highest score. There was another category that had been graded as "perfect." I think it had something to do with the cell shape. If that's what it was, Mort's looked better than Murtle's. Regardless, I need to stop trying to compare the two and just hope for the best. I thought this 2WW would be easier for me this time than it was for Murtle, but it's already going very, very slowly.

CD14 - On the Way to Embryo Transfer?

Work has been keeping me very busy (which probably is a good thing), so I haven't been able to post any updates until now. After the last check-up I wrote about, I had two more and both continued to show promising news:

SD7 (CD9): Three follicles (16, 15, 14); E2 was 675.
SD8 (CD10): Three follices (18, 18, 15); E2 was 795.

I then triggered on Friday night (CD10). Actually, my wonderful former nurse, Emily, came to my home to give me my trigger and boy did she do a great job! My HCG on the following morning was 220. The nurse who called with my bloodwork results said that whoever gave me my trigger must have known what she was doing! And it seems as though she got the job done because Dr. Sacks was able to retrieve TWO eggs during egg retrieval on Sunday morning!

However, the roller coaster ride continues...just one egg ended up fertilizing. I emailed Dr. Sacks for more details about both eggs and he told me the following: "I looked this morning. The one embryo that did fertilize looks good. The other egg was mature and injected with the sperm, but this morning there was no sign of fertilization and the egg was rather dark and poor quality. I’ll continue to watch the embryo and look forward to seeing you on Wednesday for the transfer." After I receievd that email, I felt more hopeful despite having just one of the eggs fertilize since at least the egg that did fertilize looked good and that he expected to see me for transfer!

But then the story took another turn - the nurse who called me this morning to give me another update burst my bubble yet again. She simply told me that the embryo is still growing and that I will receive a call later this afternoon about the the time of my embryo transfer tomorrow. I then had to ask her how the embryo looked today. She told me that it had two cells and didn't offer any more information - or compassion. Aside from her bluntness, this was pretty discouraging news because Murtle was a 4-cell embryo at this stage of the game. I think that even my only embryo from my failed IVF attempt this past fall was 4-cells on the second day after transfer, too. Anyway, this nurse then rudely rushed to get off the phone. I can understand her not wanting to give me bad news, but at least try to show some compassion. Not only is the IVF process expensive, we are talking about people's potential future children here! Plus, I had assumed the news was bad yesterday based on the fertilization report I received from her, yet Dr. Sacks was able to give me the real story. I am hoping that the real story is when they called to tell me about Murtle, it was later in the afternoon, so she may have also just been 2-cells in the morning, but expanded to 4-cells by the time I received the update. There is a big difference between a 2-cell and a 4-cell embryo two days after egg retrieval. It would have been nice for this nurse to offer that information - or any information. I wonder if she's simply clueless about things. When I asked her yesterday if the reason one egg didn't fertilize was because it was immature and if it then matured, would they still try to ICSI it, she told me that it was immature and that they wouldn't ICSI it since I had one egg that fertilized. Huh? Not only does that make no sense, but the information was wrong since both eggs were mature.

Since I was still pretty fired up about this nurse's bedside manner, I emailed my current favorite nurse, Amy, who is on the top of the ball and is compassionate (imagine that), to see if she can offer me any more information (like is this new embryo really worse than Murtle) and I even asked for her to give me the updates from now on since I really don't want to deal with this other nurse.

Ok - I feel better now that I vented. In the meantime, I will continue to try to be hopeful about this cycle!

SD6 (CD7) - A Promising Check-Up!

I went in for my first check-up to see if I'm responding this cycle. To my surprise, the ultrasound showed three measurable follicles on my left ovary (a 12, 12, and a 10)! My lining is also responding nicely (which I suspected since I haven't noticed any spotting this time). Dr. Sacks and Amy were also very pleased with my bloodwork results. E2 - 427; P4 - <.2; LH - 1.30. So, my E2 is rising really nicely and it doesn't seem like I'm starting to surge too early. I start my Ganirelix tomorrow, continue my current dosages of stims and Estrace and return in two days for my next check-up. I'm still feeling good and very calm about this cycle!

EPP Deja Vu - SD1 (CD2)

I had my CD2 baseline appointment today. The ultrasound showed no cysts (!) and 2 antral follicles on each ovary (!). The bloodwork also looked "terrific." E2 - 184; P4 - .30, LH - 1.10 and FSH - 4.7. Don't get too excited about the low FSH - it's supposed to be lower because I have been estrogen priming for the past eight nights. The only concern I have is this cycle appears to be an exact replica of my last EPP attempt. The CD I got AF would have been CD 18 (same as last time), I didn't have any cysts on baseline, my lining was fine and my E2 was 187. So, we'll see if I respond. Dr. Sacks decided to try a low-stim approach this time, though - he lowered my nightly dose of Follistim from 450 ius to 150 ius and kept my Menopur the same at 150 ius. I continue to take the Estrace two times a day. My first check-up to see if I'm responding will be on Tuesday...after five nights of stims. I must say that I'm feeling good about this cycle, though. I think I must feel that way, though, because I've made the decision this will likely be my last attempt. Stay tuned!

And the Scenario Winner Is...

#2! I went in today for an ovulation check (CD11) and my blookwork shows that I ovulated (E2: 238 / P4: 3.9). The ultrasound revealed two follicles (we can call them follicles and not cysts since I ovulated). They were both large (at least 25 mm), but one was cloudy, which typically indicates rupture. I'm a bit concerned that the second one wasn't cloudy though, because that means it did not release an egg and could turn into a cyst at the beginning of the next cycle. Anyway, since I ovulated, Dr. Sacks decided to put me on the estrogen pills again. I asked my nurse if doing so will result in the same response I had the last time I had taken them (no response to stims). She is going to check with Dr. Sacks to confirm and get back to me. I'm really trying to take this cycle in stride, but I am optimistic that this cycle will yield better results.

A Little Bit of Information Goes a Long Way

Dr. Sacks is back on my good side. After I sent my new favorite nurse, Amy, an email telling her that I was surprised Dr. Sacks didn't want to do anything until the start of my next cycle and asking her if she knew what his plan was for me, he sent me the following email:

"In general, the cysts on your ovary are either from the previous cycle, or new this month because your body is trying to compensate for the reduced ovarian function. In that case, the level of FSH is higher just prior to the menstrual cycle beginning and the “cysts” are really follicles.

It is impossible at this point to distinguish between these two scenarios, but neither one should delay the onset of the next cycle or stop us from moving forward. In addition, they should not need to be aspirated prior to starting a cycle.

I was going to check you in a week to get a better idea which scenario is more likely, and they would make some recommendations.

If it looks like you have already ovulated, then the second scenario is the case and I may start estrogen pills to block the early rise in FSH for the next cycle. If you have not ovulated, then it is the first scenario and I will just await the resolution of the cysts and the onset of the next cycle."

So, all is well again. I'm very happy he emailed me. However, had I not emailed Amy, I would have simply gone in on CD1 and another cycle would have been lost. This all goes to show you...be proactive ladies!