Embryo Transfer Day

 Posted by at 6:58 pm  Pregnancy  No Responses »
Dec 202012
 

I’m currently ensconced in a cozy little motel room a stone’s throw from the beach, officially on bed rest straight through tomorrow and under orders to use my ab muscles as little as humanly possible. (My gods, it’s amazing what you use your abs for!)

Transfer was a little after noon. They thawed the 10 frozen embryos in our selected donor batch four days ago, and 9 of them were still growing as of this morning. There were 2 blastocysts, one that looked really good to the embryologist, and another that was malformed, and a bunch of morulas that looked good, too. After a discussion with both the embryologist and the reproductive endocrinologist, we decided to go with their recommendation to transfer the good blastocyst and the best morula. They were willing to add the malformed blastocyst if we wanted because, really, this is not an exact science and no one knows whether it would have been okay anyway, but it would have raised our odds of ending up with twins (maybe even triplets!) and if it turned out to be nonviable later on, it raised the odds of carrying a sibling off with it in miscarriage.

So, now begins the wait. A couple of days of bedrest. A week of reduced activity (no lifting, no pushing). Continue my hormone treatments. And on January 2, the first pregnancy test.

Dec 092012
 

Had an ultrasound on Wednesday morning, along with blood drawn to test hormone levels. The uterine lining is apparently not quite where they want it, so I’m now using 2 Vivelle estradiol patches every 2 days, on top of the oral estradiol I’ve been taking for more than a week.

And getting the patches was an adventure in itself. The clinic called the prescription in to the specialty mail-order pharmacy that I got my Lupron from (Village), and they called me Wednesday night to say that it might be simpler to use my usual pharmacy; since Vivelle is commonly used for hormone replacement therapy, most pharmacies carry it. They told me it wouldn’t be a big deal to to transfer the prescription to the CVS across the street from my office.

I spent half the next morning calling first CVS and then Village and then CVS again, trying to figure out who needed to do what to get the prescription where it needed to be, and when it finally arrived at CVS at 11am, they told me they were out of stock. “We can get it for tomorrow,” they said. Which didn’t do me a whole lot of good, seeing as I should have started it the night before. They instead found another local CVS who did have it in stock and transfer the prescription over there. It was just a few blocks away, and right on the same trolley line as my office, so I figured it would take me 30 minutes, tops, to go and get it. Unfortunately, a fatal collision between a bicycle and a semi directly across from my office that morning was still roped off, and the trolleys were all kinds of messed up because of it, so I ended up spending my whole lunch hour retrieving the patches. Done, and administered before 2pm. Only 20 hours or so late.

In the meanwhile, the clinic told us they want another ultrasound early next week to check my progress again. When, on Wednesday afternoon, they told Andy it should be Monday, he asked them if Tuesday would be okay, as he’s out of town until sometime Monday afternoon, and they said fine. The folks at the clinic where my ultrasounds are being done then somehow received orders for Monday anyway and then on Thursday called Andy’s cell phone (the one number I have no access to of the 4 they have on file, and the one that’s all but useless during his work hours since he gets no reception at all inside his office) to say so. By the time we got the message and I called them back on Friday morning, they’d received a second set of orders for Tuesday and were thoroughly confused.

My Gods. This fertility thing is like planning the invasion of Normandy.

Oh, the Lupron headache died off after a few days, maybe because the dosage went down. But now I’m feeling bloated and emotional, like a really bad premenstrual stretch. Joy.

Baseline Trip

 Posted by at 7:25 am  Pregnancy  No Responses »
Dec 022012
 

The trip down to Florida on Tuesday was pretty darned uneventful, really. The TSA folks at Logan were almost bored by my declaration of a refrigerated med with an icepack and syringes. “The icepack is solid? Okay. Just put it through the x-ray.”

The appointments at the clinic went well, too. The nurse practitioner did an ultrasound, then we did a mountain of paperwork and paid them an exorbitant amount of money. After lunch, we saw the doctor himself, who did a hysteroscopy so he could gauge where the best landing site will be for the embryos. All apparently looks good.

Which makes putting up with the low-grade headache I’d had for almost 48 hours almost entirely worth it. (Lucky me, I get the Lupron headache side effect.)

We got back to the airport Wednesday night with a comfortable margin to return the rental car in and get through security, which again was no big deal. Things were going far too smoothly. We should have known.

We got to the gate to discover that our flight was delayed a few minutes because of some sort of landing restriction happening at Newark, where we were supposed to change planes. And then it was delayed a few more minutes. Our connection had been a squeaker to begin with and now it looked like we weren’t going to make it. And that flight was the last one to Boston before morning.

There were 6 of us who were trying to make that connection. One couple opted to rebook the whole trip for the next day, but the rest of us soldiered on, convinced by the ground crew that there was still an off-chance of making up for lost time in the air and that the airline would put us up in a hotel if we didn’t make it to Newark in time.

Here’s where I started making backup plans regarding my Lupron and the icepack keeping it cold. I wasn’t really worried about the med itself. The icepack would last just fine for at least another day, I was sure. But it we had to leave the airport and come back through security, it was probably not going to be solid enough to pass inspection. So the cold soda can backup plan was resurrected.

Once we were in the air and started talking to the cabin crew, we discovered that our squeaky connection was, in fact, “illegal” (ie, too tight for the airline to support), and that we’d be on our own once we reached Newark. We might be stuck sleeping in the terminal, which is exhausting and painful even as a concept once you get over age 25 or so.

When we got to Newark and discovered that, yes, we had missed the connection, the four of us presented ourselves at the United customer service desk. The other couple insisted they take us first, as they were aware by now of my issue with the Lupron, and honestly, I think that was what got us all hotel rooms that night. If they had gone first, the illegal connection issue would probably have gotten them denied the vouchers, but once the people behind the desk found out I had a medical need, they couldn’t refuse us, and then they could hardly refuse the others.

The hotel did not have rooms with fridges, but the desk clerk directed us to the 24-hour cafe stand across from the elevators, and the very nice man there was kind enough to put my icepack in his freezer for a few hours. The Lupron went into the ice bucket, insulated by a plastic cup and a facecloth.

Shall I tell you how much fun it is to do a subcutaneous self-injection at 5:30am in an airport bathroom while operating on 3 hours sleep and fighting a Lupron headache? No, nevermind. You can probably imagine it for yourself.

We got home in one piece, though. I’m just glad we’re planning to drive back from Florida after the embryo is implanted on December 20. Trying to keep my stress level down while dealing with airlines and the TSA the weekend before Xmas would be a lost cause.

Nov 232012
 

They found and removed 3 polyps on Tuesday, with no complications. The pathology report should be back today sometime. And I’ve been told that there’s virtually no recovery time for this — in fact, some fertility specialists actually recommend going in and roughing up the uterine lining a bit before attempting an IVF implantation, so the thing may actually up our chances.

The clinic in Florida is expecting us on Wednesday for my baseline tests, so we’re in process of arranging travel and accommodations. And I’m starting the first of the staggering number of prescriptions that I’ve been given. (Staggering, to me, though, is 5, so that’s obviously a relative thing.) This one’s called Lupron, and, lucky me, it’s a daily subcutaneous self-injection.

The fertility pharmacy we’re using sent along a bunch of literature, and they have instructional videos on their website, so even though I worked myself up a bit over the concept of sticking a sharp object into my own body, my first dose this morning was actually really easy. Almost painless, too. I didn’t even feel the needle go in, or come out, and a couple of minutes later there was just this tiny little tingly burn as the med disbursed through the tissues. Now, 3 hours later, the site feels mildly bruised. At 5:45am I was wondering if I was going to be able to do this. Now? Easy peasy. What’s next?

Actually, what’s next is traveling with the Lupron. Going through airport security with syringes is going to be so much fun. Plus the Lupron needs to be refrigerated, so I have to bring an insulated bag and a cold pack as well, and we have to book a hotel with a fridge. The clinic will have someplace we can put the Lupron while we’re there, I hope, and a freezer we can stick the cold pack into, as we’re currently planning to go straight from there to the airport, and TSA will confiscate the cold pack if it’s the least bit melty when we go through security. (Though I supposed if that happens we can buy a couple of cold sodas and use those for the flight, right?)

Surgery

 Posted by at 5:33 am  Pregnancy  No Responses »
Nov 152012
 

I’ve been putting this off because I’m nervous, but sometimes writing it down helps, so here I am at the keyboard at last.

There’s a big-ass dark spot on the films from one of my tests, so Tuesday I get to possibly have surgery to remove a polyp. Mind you, it may not actually be a polyp; it could just be a shadow caused by an air bubble in the saline solution they’d filled my uterus with for that test, in which case the doctor will go in, look around, tell me there’s nothing there, and pronounce us done. If that happens, we’re looking at a trip to Florida the week after Thanksgiving for the preliminaries and then implantation before Yule.

If, on the other hand, there’s a polyp there, it will have to be removed. Which I’d want anyway, seeing as there would be a slight (2-3%) chance that it could be cancerous. If that happens, there may have to be a few weeks of recovery before we can make that first trip.

Half of me is scared of the cancer possibility, however small the odds. Because, seriously, if I weren’t doing tests for the embryo donation, how long would it have taken for such a thing to be noticed? Plus, you know: cancer.

On the other hand, if everything is fine, I can start being truly terrified of all the other stuff. The will this work, are we too old to be parents, do we realize what we’re getting into, what the hell are we doing part of the program.

Sep 092012
 

Over the last few months I have had to have blood drawn for all sorts of preliminary tests: hormone levels, cholesterol, blood sugar, hepatitis, HIV, etc., etc., etc. Plus a saline-infused sonogram of my uterus, to make sure all the parts are where they ought to be. I got to the end of the long list the clinic sent me, thinking “There. That’s done, then.”

But, no. As we discovered with the sonogram, I have fibroids. Not big ones. Not unusual ones. But they are there. And so the clinic decreed that I ought to also have a hysterosalpingogram (HSG), just to make sure that there’s nothing there that might interfere with embryo implantation. So I made a series of increasingly confusing phone calls in which my ob/gyn’s office transferred me to the fertility people across the hall, who then said I should be talking to my ob/gyn, who then sent me back again to fertility, who then admitted that, yes, I can self-refer to them for something like this and would I mind going to their Burlington location, as no one was available to do the procedure there on the day I had to have it done. The test itself was nothing compared to getting it set up. And all, apparently, looks good.

So now the clinic has put me on oral contraceptives to gain some control over my hormones, and round about the time I finish with those, they need me to be down there, so they can get a “baseline” on me. So, I’m anticipating a bunch more poking and prodding and sticking with needles. And in the meanwhile I need to set up an appointment for yet another test, to happen between the baseline and the actual implantation: a transvaginal ultrasound this time.

I started working on that on Friday. And I suspect it’s going to take even more effort than the HSG did, as after three transfers back and forth between ob/gyn and fertility, I found myself having to leave a message for a supervisor to call me back, who then called to tell me I had to talk to someone at a completely different facility. Who the left me on hold long enough that I had to hang up eventually and go back to work.

The Quest Begins

 Posted by at 11:27 am  Pregnancy  No Responses »
Aug 262012
 

For several years now, Andy and I have been trying to get pregnant. We’ve been fairly quiet about it, telling only our parents and a very, very small number of close friends.

It didn’t take us long to realize that this wasn’t going to be easy — I was already 40 when we started seriously feeling like we wanted to be parents, so we weren’t terribly surprised when it didn’t happen right away. We consulted our doctors and had some tests done and discovered that, no, my eggs had very little chance of being fertilized.

You can probably imagine how disappointing that was. But it was also a relief for me. You see, I have an uncle with Huntington’s Disease, which is caused by a genetic defect. One of my grandparents had to have passed it on to my uncle (we’re pretty positive it was my grandfather, who had other health issues that could have masked HD’s early symptoms), so my late father had a 50% chance of carrying the gene, too. But he was never tested for it. And I’d rather not have the test myself. Considering HD is untreatable, it would be far too Sword of Damocles for me if I knew for sure that, sooner or later, I was going to come down with it. One of the reasons I put off thinking about having kids was the quandary it put me in where HD was concerned.

So. It wasn’t going to happen naturally, with my own egg, but that wasn’t entirely a bad thing.

Adoption? Awfully expensive. Not to mention personally intrusive. Between Andy’s atheism, and my Paganism, a lot of adoption agencies probably wouldn’t even consider us. Besides, I really wanted the experience of pregnancy, if it was at all possible.

Our next option was an egg donor. Which, we quickly found out was also exorbitantly expensive, seeing as how we’d have to basically hire a donor, and pay all the medical expenses she’d incur through the donation process. Then there’d be the IVF process to pay for, and finally the implantation itself.

Things were beginning to look a little grim.

Then Andy stumbled across some information about an emerging concept: embryo donation.

It turns out there are couples out there who have frozen embryos left over from their own fertility treatments, who would rather see them go to another fertility-challenged couple than have them destroyed. And in the last few years, a few clinics have started putting together programs. It’s less expensive than using an egg donor, because all the preliminaries have already been done.

Because it’s a new idea, it’s taken us awhile to find someone we can work with on it. A lot of the organizations doing this are religious in nature and won’t even consider a non-Christian family. And most of the rest are just getting started — they don’t have donor pools yet, among other issues. We eventually found two that looked promising and started seriously talking to them.

The one we eventually decided against was pricier but close enough to be a day trip. We got the feeling, though, that their embryo donation program was tertiary at best on their agenda — we found that we had a hard time getting timely responses to our questions.

But that’s okay, because even though the clinic we’ve chosen is in Fort Myers, Florida (a place we swore we’d be delighted never to see again after the last few months of my father and stepmother’s lives), the doctor heading it up is one of the big pioneers in the field.

I’m keeping this post, and others on this topic, private for now, because the success rate for embryo donation is only about 30% per try, and the fewer people who know ahead of time, the less stressful an unsuccessful attempt with be for us. I’m feeling optimistic that I’ll be going public with this whole thing round about the new year, though, or a little after.