Transfer and PUPO again

Well, last week was fun. On Wednesday the clinic eventually called and let us know that 2 of the 4 eggs had fertilized. When they called, while I was saying hello, I walked as fast as I could to J's desk and received the news with him. I lift 2 fingers to him while I heard the instructions from the clinic, hanged up and started crying. J took me to the car so I could cry as much as I needed in privacy. I cried of happiness for having some fertilized, I cried of sadness because not all fertilized. It was hard to hear that only 50% of the eggs had fertilized with ICSI, maybe the quality wasn't good, would they be able to survive until the transfer?, we wanted to transfer 3 and we didn't even get that many. It was a lot of emotions in that little moment.

After that I came back to the office and tried to survive the rest of the afternoon, which I can't remember at all. During the call they also told me the doctor wanted a day 3 transfer, so the little miracles had to survive until then, that right then was a very scary thought.

Next day they called me again (way earlier than the day before) and when the nurse said both embryos were still fine and growing I almost lost it. I was in the lunch room and I started shaking, tears in my eyes and I just told her "you made me cry". This time it was for sure of happiness, these 2 were fighters, they had already survived two whole days in the incubator, come on little guys, you can make it another day! I took my things and went back to my desk as I couldn't be in the lunch room anymore. J wasn't there and I was just desperate to tell him. When I saw him after, I just jumped at him and said "we still have two". Who would have imagined that would be such a happy phrase to say.

Friday I took the day off and J took the morning. We went to the clinic (with a full bladder, agghh, I hate it) and got prepared by the nurse. When the doctor came in he said "you still have 2 embryos" and again I almost cried. Day 3 and both of our little ones were doing so good! He said one was an excellent grade 4 quality with 8 cells, and the other one was a "not too bad" grade 3 with 6 cells. "We are going to transfer both". I was beaming, stressed, happy, relieved, nervous. The transfer went without a hitch and the doctor said "we now wait and hope".

Here we are now, waiting and hoping. Every so often I talk with them, after all, I am technically pregnant, I have 2 embryos inside me. Are they growing? Will they attach? I don't know, but the 2WW of being PUPO has started. Pregnant until proven otherwise. I am pregnant, I have 2 little embryos inside me. If this fails, it will be a lose, it technically won't count as a miscarriage, technically we will go back to saying I have never been pregnant, but technically I was pregnant already twice with our 2 embryos at Karma, and technically I am pregnant right now with 2. When do you consider the pregnancy to start? For me, it has already started and I hope I don't have to mourn again.


Today we are 3DP3DT.

Retrieval

Yesterday was my retrieval. I feel like it was a bit less painful at this clinic. It might have been that I had way less follicles, or I had more drugs in my system, but at least I survived it. The process started on the left foot, with the nurse trying to get the IV on my left arm. It doesn't work!! I am tired of telling nurse after nurse that my left arm is useless for IVs or to draw blood, they all end up having to switch. After switching to my left wrist, then it was very similar to the first IVF. Wait, go to the operating room, have the doctor come in, get the eggs, tell me how many, go to the recovery room, feel better, go home and rest.

They got 4 eggs, which is a lot lower from the 11 on my first try, but I am hoping these are better quality!. I still haven't received the call to tell me how many fertilized, so I'm up the walls and a nervous mess. Can't concentrate on work or anything else but look at the phone every few seconds to see yet again that is is ON and that I don't have any missed calls. Please call me!!!

During egg retrieval, they go through the uterine wall with a big needle to aspirate the eggs in the follicle.

Today I have some pain left from it, specially when I go to the washroom, but it also includes walking and changing positions, so yet another reminder of what happened yesterday!

This cycle we are also doing ICSI (Intracytoplasmic Sperm Injection), which is the direct injection of the sperm to the egg to make sure the doctor is choosing the best possible sperm instead of some random one, plus helping the sperm getting exactly where it needs to.

If there are fertilized eggs, aka embryos, then we would do a transfer tomorrow or Friday! To the people at the clinic: Please call now!!!

Inject, Cry, Repeat

I started the stimulation phase on Friday. Ultrasound, blood work, injections. At least in this clinic I don't have to go every day at the beginning, but on the other hand that means I have to inject myself. So, went for ultrasound and blood work in the morning plus training about how to inject myself (including J so he can help me) and a "goodie bag" full of medicine to last me until Monday at my next appointment. I also had to pay enough money that I couldn't put it all in one credit card, fun.

Friday afternoon J injected me and everything went great, painless, easy. Saturday I injected myself with J supervising to make sure I could actually do it. Not that great, bled a tiny bit but survived, I also did it on the other side of my belly button. Then it came Sunday, J wasn't going to be at home so I asked my mom to be with me on Skype. I did it myself, I managed, but I made myself bleed more than before, and because it was on the same side as Friday it also hurt more, and because I tried to do too much I also pinched myself with the needle on my knee, sigh... That night I cried.

After that I cry after every injection. Everything has been going ok on the monitoring appointments, but I am tired, I fall sleep at 8pm, I am sore, bloated, and get headaches after each injection. J is back at injecting me so I am not bleeding anymore, but yesterday we also added an extra injection to stop me from ovulating and that one has to be in the morning, so injections in the morning and injections in the afternoon. Injections at home, injections in the car. Injections and more injections.

We inject, I cry, we repeat.

The day everyone was pregnant

The header is not exactly true, it has been more like a week and a bit of it, which might make it worse because it's every single day that I hear these things.

First almost every TV show we watch had babies or little kids or pregnant women, seriously, even the first few episodes of House of Cards? Can't be safe in any show :( Then it was baby dedications at church 2 weeks in a row, and then 2 people in J's family. Yesterday to top it off we learned that someone from church too, but the cherry on top? It was the woman that told me in January that she preferred to be sick than pregnant again, yes, she is now expecting her 4th child just when the third one is learning to walk.

Now I feel like trash. Not only it is so hard for me to feel happy for them, but I also feel horrible that I feel bad about it. It's an endless cycle! Why does this happen? Why when I'm about to go into another IVF, when I am feeling so bad, when we are going through something so hard why all these pregnancies around us. Why do I have to make it about myself? I know it's easy to think that I am putting the focus on the wrong place, or that they didn't do it on purpose, I get that. Logically I get all of it, but sentimentally I am a mess.

I am so looking forward to having therapy on Wednesday, I need it, I really need it. Specially because I keep waiting for the other shoe to drop, only thing missing is someone from my family to announce they are also pregnant. Any bets as to when or if it will happen?

Unraveling the numbers

There are so many numbers to learn during an infertility cycle it can be a full time job. Now that I am trying to get back to everything, I am trying to understand how I am performing according to my previous numbers. At least for now I am concentrating in 3 numbers, AMH, FSH and LH.

What is Follicle Stimulating Hormone (FSH)?
FSH is a hormone released by the pituitary gland. In women, FSH helps manage a women’s cycle and stimulates the ovaries to produce eggs. When a women goes into menopause she is running out of eggs in her ovaries. The brain senses that there is a low estrogen environment - and signals the pituitary to make more FSH hormone. More FSH is released from the pituitary in an attempt to stimulate the ovaries to produce a good follicle and estrogen hormone.
In conclusion, the lower the FSH the better. According to this web site recommended in many infertility forums, less than 9 is normal, between 9 and 11 is fair, 11-15 is reduced ovarian reserve, etc. Another thing to keep in mind is that the higher the FSH is, it tends to indicate lower quality of the eggs, and that your FSH is as bad as the worse result, a lower number in different cycles is not a sign of getting better.

What is Luteinizing Hormone (LH)?
LH is a hormone released by the pituitary gland. In women, an increase in LH level at mid-cycle causes release of eggs (ovulation). On day 3 (when the FSH is measured) a normal LH level is similar to FSH. An LH that is higher than FSH is one indication of PCOS. If your FSH level is much higher than your LH level, then this suggests poor ovarian reserve.

What is Anti-mullerian hormone (AMH)?
AMH is a substance produced by granulosa cells in ovarian follicles. Since AMH is produced only in small ovarian follicles, blood levels of this substance have been used to attempt to measure the size of the pool of growing follicles in women. Therefore, AMH blood levels are thought to reflect the size of the remaining egg supply - or "ovarian reserve".

These are my numbers in previous cycles:
* February 2014: FSH - 8.4. LH - 4.6 (Investigative)
* June 2014: FSH - 7.2. LH - 4.9 (IUI)
* July 2014: FSH - 6.4. LH - 2.7 (IUI)
* November 2014: FSH - 10.6. LH - 3.9 (IUI)
* March 2015: FSH - 6.7. LH - 4.3 (IVF)
* June 2015: FSH - 11.5. LH - 5.2 (FET)
* August 2015: FSH - ? . LH - ?. AMH - 5.8pmol/L (Investigative)

Putting it all together:
* My worse FSH (that I know) was 11.5
* My FSH to LH level is between 1:2 and 1:3
* My AMH came back as low ovarian reserve

With all these numbers it shows I don't have that many eggs left and the ones I do have don't have a really good quality. When I was at my other clinic they knew my FSH and LH levels, indicating low quality and never said anything about that, plus refused to run the AMH test to confirm! The third IUI should not have happened either, I think it was a money grab given the numbers. The FET I can understand because we didn't care about my eggs at that point. It's frustrating that some clinics won't give you the whole truth :-(

Well, next week I should have my blood tests again and we shall see what my FSH and LH are (did they get worse?), but at least I am going to this IVF with open eyes, chances are low, but there is hope!

Beginning the process again

Well, the process has started for me. We are not in a cycle yet, still a week or so to go, but my brain and heart know what's coming and they are making me pay for it already.

Last week I didn't feel like working and didn't feel pretty, then on the weekend I started triggering. Saturday I started to see all these new pregnant women in our TV shows, Sunday I almost lost it at a baby dedication at my church and then spent the whole day being triggered by family comments, like yet another pregnant cousin.

The funny thing was the moment I almost completely started bawling, during the first episode of Super Girl. Even if you haven't watch it I don't think it would be a spoiler to say that she saves some people during the episode. So here I am having dinner with J and watching the episode when Super Girl goes and starts working on saving these people and I just completely choked. My heart was a mess, I couldn't swallow, my eyes were watery and I am going crazy because I want to cry THIS MUCH during something so simple and not because of the scene.

I manage to keep it together, finish eating, continue baking and the episode ends. I am waiting on the muffins in the oven so decide to sit in the couch with J and then lost it. I start crying just a bit, then some more until I am a complete mess, bawling and crying my eyes out; J just hugs me, knowing that asking is futile.

Eventually I calm down, happy that I was calm enough for J to take the muffins out of the oven so I don't cry this time about that. We talked about everything in my head but I specially blurted out how "I thought I had moved on". The problem was that I was being triggered so much, which I didn't expect, and then when I almost cried during Super Girl I started wondering if I was sentimental because we are actually pregnant this month. Yeah, that happened, I started wondering again with no basis whatsoever except "I was sentimental" :-(

I am not crying so far but I am asking for help. If this is before starting the process, I can only imagine how much worse this new IVF is going to make it. It is all worth it right?