August 31, 2006

Better Fertility Through Fat

Our first frozen embryo cycle is officially underway. Lupron? Check. Delestrogen? Check. Ultrasound appointments scheduled, plane tickets reserved, infusion of fat cells planned? Check, check, and check.

Yep, fat cells. And I’m not talking collagen to add extra pout to my lips, which, believe me, are pouting plenty on their own over this latest development.

Doc wanted me to repeat a few tests before we do the FET. He doesn’t have all of the results yet, but the NK (natural killer) cells results came back today. I had done that test and several others at a local lab during The Bloodletting of 2005. The NK results were normal that time, but Doc wanted me to repeat a few of them through a lab he uses. This time, my NK level came back at 13.9 percent, with anything over 10 percent considered elevated.

I haven’t done a lot of homework on NK cells yet, but my rudimentary understanding is that if they’re elevated, it can mean that they’re attacking the embryo and the developing placenta instead of recognizing them as things that are okay to be growing in the uterus.

REs who believe in immune issues often use a blood product called IVIg to treat women who have elevated NK cell levels. Doc is among those who prescribe IVIg, but he and one of his colleagues have also recently begun using something called intralipids in place of IVIg. It’s hundreds of dollars per IV infusion rather than thousands, it only takes an hour as opposed to three or four hours, and it’s not a human product, so it doesn’t pose a risk of disease transmission. There isn’t a lot of data on intralipids as a treatment for NK cells in infertility yet, because it isn’t widely used for that purpose at this time, but Doc says success rates are proving to be about the same with IVIg.

The intralipids infusion involves an IV bag full of a milky white solution that includes 20 percent fat cells (from soybean oil I believe), hence the “lipids” part of “intralipids.” I asked if I couldn’t just eat a couple extra bags of potato chips instead, but no such luck. The infusion is scheduled for mid-September, about a week before transfer.

Like most of you, there are things I never thought I would have to do, such as give myself shots or go through IVF. But allowing myself to be injected with fat cells?!? That is so far beyond “things I never thought I would have to do” that I’m at a loss for words in some respects.

I do, however, still have the ability to form at least a couple of thoughts:

1) Boy, are the future kiddos ever going to owe me for this! Forget the “do you know how many hours of labor I had to go through for you??” guilt trip – they’ll have to sit through my “do you know how many fat cells I had to have injected for you??” tale of woe. (I’m joking, I’m joking. Mostly, anyway.)

2) Since I have to suck it up and have this infusion, I think it would only be fair if I could at least direct the fat cells as to where they’re allowed to take up residence: “The cells on my hips and thighs already have plenty of company, thank you, so can you please make your way to…well, never mind that, there are very few slender places on my body to begin with, and I’d really prefer that you not make any of those places bigger, either.”

“So once you’ve done your duty by binding to the NK cells and neutralizing them, can you please just make a speedy exit out of my body? Because, let’s be honest here, even I know my threats to exercise you away will only incite mirth and not instill fear. And I certainly don’t need any more of you jiggling around on me while you’re laughing.”

So there you have it, the latest weapon in the infertility fight: bags of fat. Is it just me, or is all of this starting to sound a little bit insane??

August 22, 2006

Following Our Hearts

Despite what my silence since the second beta post probably implies, R and I are okay.

It’s just now occurring to me that I never mentioned that we have frozen blastocysts. Ten of them, actually – four that are Grade A, six that are Grade B. Because of that, R is still very optimistic and took the news of the negative betas pretty well.

The thing I was dreading most about the whole cycle was how he would react if we didn't get a positive. Once I was able to believe he really was okay (either that, or he’s become a very good liar as of late), I was fine. Well, at least as fine as one can be under these circumstances. I just didn't think I was up for handling it if he was as devastated as he was by the first miscarriage or as angry and disappointed as he was by the second one. I'm to the point where it feels like I can take just about any pain myself, but please don't make me have to watch him go through any more pain and heartache.

So, the plan is that we’re going to do an FET cycle next month. Since the betas weren’t ever even at a level of 1, Doc said we could go right into a cycle without having to wait a month. I started the BCPs last Thursday, and the Lupron shots begin again on Saturday. The transfer will be sometime in the second half of September.

Right now I’m just trying to focus on being positive and visualizing that I can stay pregnant. I haven’t exactly been a shining beacon of optimism these past few years, and it doesn’t help that my dad called me today to say, “Honey, God spoke to me this morning and told me that what you’re doing – the treatment – won’t work.”

In all fairness to him, he did go on to relay what he believes to be a very positive message: that God will heal us and R and I will become “very fertile” and will have biological children…just not through treatment.

R and I are Christian, and I credit my faith largely to my dad. However, he has some views on faith and God that I don’t necessarily subscribe to in the same way. I absolutely believe that God can and does heal people, so I’m not making fun of his comments. Miracles happen. To R and me, our pregnancies, as brief as they were, were miracles nonetheless.

But I also feel like we are doing what God wants us to by going through IVF at this point in time. That we’re with the right clinic, with the right doctor. I can’t say for certain that I know IVF is what will get us to parenthood, but I have a peace about pursuing this that I didn’t have when we were pursuing adoption.

Deep, deep down, I always felt like I was forcing adoption too soon; it was a back-up plan I was trying to keep under my control in case God didn’t “come through” for us with fertility treatment. I needed to let go of that and step out in faith to do IVF without a safety net that I had created for myself, if that makes any sense, so we let our adoptin certification expire this summer. That’s not to say that I wasn’t sincere in my desire to adopt, because I absolutely was. And despite all of the heartache we’ve endured in that area, if IVF doesn’t work, we will go back to adoption, albeit probably via an agency or international route. But it wasn’t the right time, we weren’t doing things in the order God wanted us to, and underneath it all, as much as I tried to bury it and ignore it, I felt that.

Now I feel like we’re on the right path for us at this moment and time. R and I prayed about starting our family pretty much every single night for seven months before we started actually trying to conceive. We’ve prayed through all of the pain and misery of the past three and a half years. Sometimes they’ve been internal, “how can we bear this, why are You allowing this to happen to us, I’m angry at You, God” kinds of prayers, but we haven’t stopped praying.

If a time comes when IVF is no longer the path we should pursue, I believe we’ll feel God leading us in a different direction. I just hope my dad can accept that we’re choosing to follow our own hearts on this one, and that they’re telling us something different than his is telling him.

August 14, 2006

It's Official

The results were the same today, so this cycle is officially a BFN.

We're doing okay. I went to lunch and a movie with a couple of friends on Saturday, and R and I jumped into shopping for a small home improvement project on Sunday, so those things kept me from dwelling on the likely reality of today's news.

We have a consult with our RE tomorrow to review the cycle and find out if there's any more testing he wants us to do or any changes he wants to make in protocol before we do an FET. If he says it's okay and I get a period this week, I'll start Lupron again on Aug. 26 for the FET. If he wants me to wait a month or so, then the FET wouldn't be until October.

But I'm anxious to get going again, and I'm feeling great physically, so hopefully he'll let us cycle sooner rather than later. My hormones are normally out of whack, as is the nature of PCOS. I think the stims and the progesterone make my hormone levels much more balanced, because my skin has been so much more clear these past three weeks, and I feel better physically than I normally do. Silver linings, people, silver linings. I'm trying to focus on the positives.

Interestingly enough, when the clinical coordinator called to tell me the results this evening, she also mentioned that she would recommend transferring three embryos for the FET. She said she thinks there's a better chance with three than with two, but of course she also said to talk with Doc about it. Given that he offered to transfer three for our fresh cycle, he'd prbably be agreeable to it.

At the beginning of this journey, my mom kept cautioning me about all the bad things that she thought could happen - like the drugs causing cancer, or me having a "litter," etc. She would "tsk, tsk" any time we started a new protocol. Tonight, she said, "I think you should transfer back three or even four." When I reminded her that she used to be against treatment because she was afraid I'd wind up with seven or eight at once, she replied, "I'm much more educated now." And really, she is. She has a much, much better understanding of infertility and treatment processes than a lot of infertility patients themselves, much less her fellow 70-somethings.

Then I teased her that if we wound up with triplets, she'd have to pitch in to help. "Oh, I've already thought of that! I have two arms and a big lap. I'm all ready for 'em - bring 'em on!" she told me.

Easier said than done. But who knows? Maybe we will transfer three after all.

August 11, 2006

Three Strikes and You're Out

Great eggs, great sperm, terrific embryos, a beautiful lining.

Big, fat negative beta.

It came back at less than 1.

August 10, 2006

I Caved...

...and it ain't pretty.

Yes, you guessed it. I HPT'd this morning, and it was negative. Not even a hint of a line, no matter how hard I looked. And believe me, I looked hard.

Today is 8dp3dt (well, technically 7.5dp3dt, since my transfer was in the afternoon). I want to try to stay positive because I know that it's still early, but I don't think this bodes well.

The first beta is tomorrow (Friday). Since 48 hours would be on Sunday, my second beta isn't until Monday. For some strange reason, our clinic refuses to give the results until after the second beta.

Unfortunately, I have things at work on Tuesday and Wednesday that I just can't get out of. So if the results aren't what we hope for, I'd like a little time over the weekend to deal with that. I think I'm going to try to get the lab tech to give us the results tomorrow. She knows me and our situation, and she was good about sneaking the results to me during the May pregnancy.

August 09, 2006

Something NOT To Say While Helping Your Wife With Her PIO Shot

All is going well here. We got home fine, then jumped back into work, although I probably haven’t been as productive as I could be this week. I had some twinging, sharp-ish kinds of pains intermittently throughout Saturday afternoon and Sunday, so I’m hoping those were implantation cramps, but time will tell.

For some reason, I’ve started having a slightly tougher time with the shots. It reminds me of when I was in gymnastics while I was growing up. I’d learn to do a tough trick, like a backflip, without spotting from a coach. I’d do it for a few weeks, and then one day I’d regress. I’d walk into the gym and say, “Uh-uh, no way, too scary. I could fall and break my neck.”

I’ve run into a similar mindset with the shots. “I don’t want to stick this needle into me, it will hurt.”

The other night, R was helping me with the PIO shot. Laying on my side in bed, I tried to stick the needle in. I got the tip of it in, and it hurt. Ouch! I pulled it back out, and a drop of blood appeared on my skin.

R tried to be encouraging. “Here, why don’t you try that spot.” He pointed to an unbruised area of my backside.

“I. Don’t. Want. To. The last one really hurt.”

His eyes widened in surprise and fear. This was not something he had anticipated. “Oh, come on, you can do it.”

“I. Don’t Want. To.”

Now the fear turned into a look of terror. He was probably envisioning having to sit on me and jam the needle in himself.

Finally I worked up the courage and gave it another try. The needle went right in, no pain at all. As R was pushing in the plunger, he said, “Boy will I be glad when we don’t have to do this any more!”

I don’t know if it was his tone, or the absurdity of his use of “I” when it was me who was getting the shot, or just the emotions of the past couple of weeks rising to the surface. Whatever the reason, his comment struck me as outrageously humorous.

I began to laugh. Big, whole-body guffaws that made it look like I was having convulsions. While the needle was still in me, the syringe now waving madly back and forth.

R did not expect this reaction. His head snapped up. “Stop that! Stop that right now! You’re making the needle move!”

Which only served to make me laugh harder, until tears poured down my face. I tried to stop, tried to bring myself under control. Finally, when I had calmed down enough, I told him to continue pushing the plunger.

As soon as he started, the laughter began again. It took us about three minutes of starts and stops to get the last half of the PIO in. R has vowed never to make any more comments during the shots, lest he trigger a repeat performance of the hilarity.

August 04, 2006

Transfer Update

I've asked R to put these two posts up for me...

Transfer was Wednesday afternoon, and it went well. We transferred two 8-cell embryos that were graded Stage 1. (If you want to read about the full Day 3 embryo report, please see the post below this one.) Betas are next Friday and Monday the 14th.

The afternoon was not without it's moments, though.

I'm prone to leg cramps, and I think that drinking a lot of water quickly can trigger them. So there I was, laying on my back, the transfer table angled so that my head was lower than my pelvis. Doc had just transferred the embryos.

Then the cramping set in.

Both of my hamstrings began burning. I focused on not allowing myself to bounce around and dislodge the embryos. I tried to will the cramps away, but no luck.

After what seemed like an eternity but was really less than 10 seconds, I had to speak up and tell Doc what was going on. Still positioned with a full view of my nether region, he had to lift up one leg toward the ceiling to relieve the cramp, then the other leg. Laying there with two embryos newly transplanted inside of me, I was doing what looked like can-can dance kicks, wearing nothing but a paper drape below the waist.

I would have been mortified, if I hadn't already lost all semblance of modesty and dignity about 18 vaginal ultrasounds ago.

Day 3 Embryo Report

I've been very, very fortunate and blessed to have (so far, at least) the kind of IVF cycle that I wish every one of us could have. Of course, the betas are still a ways away, and I know that not all great cycles result in great betas, so my optimism is still very much guarded.

Nevertheless, I am feeling what I can only describe as "survivor's guilt" for having the cycle go well so far when I know that some of you are struggling right now.

I realize some of you are curious about how the rest of the embryos are doing. The short answer is that they're doing well. But I don't want to put the details in the post itself, so as strange as this sounds, I'm going to put the report in the Comments section instead.

If you want the details, please go to the Comments section of this post. If now is a tough time and "the transfer went well" is about all of the news you want to hear, please skip the Comments. And if you could use a good laugh and haven't already seen the post above this one, go read about how I wound up doing some physician-assisted, can-can style dance moves while still on the table after transfer.

August 01, 2006

I Am A Wimp

This will be brief, because I am sitting in an underground parking garage, with the laptop propped at an odd angle on my lap in order to get a wireless internet connection, one which alternates between having full connectivity and none at all.

At any rate, I just wanted to post to let you all know that it turns out I don't have OHSS. Instead, I am simply a wimp when it comes to pain. That's not a surprise - I readily acknowledge that I have practically no tolerance threshold for pain.

My ovaries are irritated with me, and they're making their feelings known, but yesterday's ultrasound determined that there's no excess fluid in them, in my abdomen or around my liver or gallbladder. So, like I said, I'm a wimp.

Thank you all for your words of encouragement and support. I'm not sure how much I'll be able to post during the next few days since we don't have internet access in the room, but I'll probably make R find a way to post at least one update to let you know how transfer goes. It's set for 2 p.m. tomorrow.

I'll be sooo glad to get back home, where I can jump online any time I want!