IVF #3: The Conclusion

    
     It was the best of time, it was the worst of times. Yes, my latest IVF cycle can be paralleled with the timeless classic, A Tale of Two Cities. Somehow, some way, this cycle managed to be my worst and best.

     To get straight to the good stuff, on Propofol Day egg retrieval day, we retrieved 12 eggs (!!!) but only fucking 5 were mature. I knew this. I had predicted this shit. My estrogen on the day of trigger was 3100+, which was by FAR my highest yet, but, having been around the block too many times, I knew better than to get excited. Highest highs followed by the lowest lows. That is all IVF is to me.

    Aside from the 5 mature, it looked as if a few more may mature in the lab. Thankfully, two more did. That brought our total to 7. Seven. This is the same number of eggs retrieved for IVF #1 and 2! My ovaries are pre-set apparently.

   The Holy Grail of this cycle came in the form of ICSI. This is the first time we did it and 6 of our 7 eggs fertilized! All 6 were still cookin' by day 3, albeit 4 were good and 2 were crapping out. We decided to press on to blast. That was terrifying! Three were blasts on day 5, and one was able to be frozen that day, with the other two frozen on day 6.

   Now that I am a few weeks out from stims, in my non-hormonal state, I'm thrilled with this cycle. Three blasts!! 3!!! We have never, ever had a blast before! Yet, in my drug-induced stupor I was a mess. It was so hard for me to reconcile that we had 12 eggs but not all 12 were mature. And I was frustrated with our low blast rate, even though it is an absolutely normal and expected number. I was ungrateful, and hormonal, and bitter. Truthfully, I was having a hard time with the reality that I won't ever make it rain eggs. I won't ever be the girl who gets 25 eggs and 19 embryos and winds up with 10 frosties. And I hate that. I was also feeling a ton of pressure to get many embryos because this cycle was to be followed with depot lupron for three months for my wonky endometrium, after which, I may not stim as well for a while.

   On day 6 after retrieval, I got an e-mail from Dr. Wang and he told me the second blast had been frozen but we still had to wait on the third, which, without some growth, wouldn't make the blast cut. I lost my shit. I wrote a long and angry e-mail (not anger directed at him) and he immediately called me. This is why I love him and he's the best ever. He spent thirty minutes talking me off the ledge and, telling me that my cycle went just as expected, explaining why he really felt that depot lupron is the right choice for me and giving me some hope. He made me feel so much better, and I was able to begin to realize how wonderful this cycle went.

    We all agreed not to test the embryos at this juncture. I'm praying that we have at least one baby in there. Please, oh please. It's time. It really is. I hope the HGH did it's job and we have some excellent quality pre-babies in there.

    As for now, I'm slowly settling into a menopausal state and trying to enjoy a well-deserved break from infertility treatments. Hopefully I can take some time to decompress, relax, focus on school and try to get back into shape for a short period of time before my body is (hopefully!) ruined by a baby.
   

IVF #3: Roundup

     To recap, this cycle started with a baseline of 3 follicles and an estrogen of 195. Then I had a mental breakdown. A few days later, I had 5 follicles and my estrogen of 196. So, not a great start.

     We did everything completely different for this cycle. I was on a MDLF protocol with prednisone (for high normal Th1/Th2 Cytokine Ratio). I took 10 units of micro-dose lupron AM & PM beginning 2/8 and added300 units of Gonal-F in the AM starting 2/10. We added in a vial of Menopur in the PM on 2/12 and continued with that. I then added 20 units of HGH (Omnitrope) for four nights beginning Thursday 2/18. So, by the end, I was up to 5 injections a day!

     My follicle count grew to 11, which is the most I have ever had during a cycle, and my estrogen on the day of trigger was 3116! I was so blown away by this because I had never had an estrogen at trigger higher than 1979! However, I know how this IVF shit works...nothing good happens without anything bad...and I said to my husband "watch, we'll get 5 eggs."

Guess what?

   We got 5 fucking eggs. Ok, that isn't the whole story. We actually retrieved 12 eggs. I was pretty uncomfortable towards the end so props to you PCOS girls who have 1023232 follicles. Although I still hate you bitches because you make it rain embryos. #sorrynotsorry. #Iamkidding. #kindof.

     Annnyyywwwaaayyy, of the 12 retrieved, 5 were mature and 5 looked like they could possibly mature in the lab. 2 did. So, that brought our total haul to 7. This is hilarious because we have wound up with 7 eggs every cycle! My ovaries are pre-set on a very specific number apparently.  This is also the first cycle we have done ICSI and 6 of our eggs fertilized normally!! This is the highest number of embryos we've ever had!!!

     If I'm being honest, I'm slightly disappointed. I was really hoping more would mature and fertilize. However, 6 embryos is a totally normal number to have for anyone, let alone someone with DOR. I just feel so much pressure to freeze several embryos because I'm about to go on 3 months of depot lupron, after which, the lupron will hang out in my system and keep my ovaries suppressed for several months so stimming again too soon will yield a shit cycle.

     We are culturing out the embryos to day 5, which is nothing short of terrifying. We've never done this before. I'm praying that this protocol shift, my supplements and HGH really kicked the quality of my eggs into high gear, and that ICSI helped us get the best sperm possible.

     Mostly though, I'm just hoping that somehow, someway, my future child is in there.
    

 

I HATE IVF

     Today was finnnaalllyyy the day that I was slated to go in for my baseline for IVF #3 and I'm certain this is going to be my worst cycle yet. An epic fucking failure of a cycle. Mark my words.

     After my chemical pregnancy in November, I had an annovulatory cycle. This put off the EFT, and switched me from cycling in January to cycling in February. In January (on CD 13 to be exact), I went in for my 3D saline sono and we happened to see 11-12 antral follicles. Holy shit. With numbers like that I could make it rain eggs. And so I entered my baseline this morning full of hope and optimism.

     Actually, I'm full of shit. Since school started my anxiety has been out of control, which was compounded by the anticipation of my Dr. KK and EFT results, which was further compounded by average IVF stressors, which was further compounded by the fact that MY FUCKING FERTILITY CLINIC IS CLOSING!!!! I can't even get into that now, but trust me, that information took the pile of shit I was wading through and made it look like a sun shiny day.

   Anyways, in true "my luck is absolute shit" fashion, I rolled up to my baseline appointment ahead of a winter snow storm. The only clinic that would monitor me locally and go through my insurance was Mass General Hospital (MGH). The doctors do the monitoring there, which is a huge shift from Boston IVF and meant I had to wait for the doctor to see me. I was fairly convinced that I had been left for dead in the ultrasound room, and had begun napping with my feet in the stirrups, when the doctor graced me with her presence. She was so sugary sweet to me and it was so disingenuous, but whatever. She proceeded to tell me I had a cyst on my right ovary (no shit), and when I pointed out that it's actually 2 cysts, and that they are endometriomas, she proceeded to educate me about how we "won't know how much the cyst is impacting my cycle because I'm already on estrogen." Ugh yea, lady, about that, they're effing endometriomas and they're fine. Way to listen.

     Mostly though, I wasn't aware that the doctor required the use of a medical assistant to write down my follicle measurements. Which meant she had to verbalize all of the follicle information. Which meant I heard it. I can't believe I forgot to tell them I didn't want to know anything about my numbers. It leads to personal disaster. My baseline AFC was three. Yup, 3.

     Apparently my old clinic categorized my last baseline AFC as "2-4" follicles on each ovary...so I could have been anywhere between 4 to 8, which would make my paltry 3 seem not so bad if I was on the 4 side of things last time. In any event, I ugly cried all day, threatened to cancel the cycle, threatened to stop fertility treatments altogether. Oh, and I decided a blizzard would be a great time to take up running...while donning a parka and winter boots. Mind you, I haven't worked out since August 2014. When running lasted about 10 seconds, I switched to power-walking around my neighborhood for about an hour and a half listening to my favorite angry songs from college....still in a blizzard.

    We decided to proceed with the cycle. I'm seeking confirmation, but it seems like I can cancel at any point before retrieval and it won't affect the number of cycles I'm allowed by insurance. So if my follicle count doesn't increase, we'll cut this cycle loose. If we make it to retrieval and have a shit amount of embryos (again) I'll be so disappointed. Especially if my EFT results come back that I need depot lupron because it takes about 6 months for the lupron to leave your system, so after one FET post-lupron, we'll have to wait about 5 more months before we can stim again.

     I'm so frustrated and sad about this. I had the highest of hopes by getting all of this testing and switching to SIRM and Dr. Wang, and so far, all it's brought me is additional waiting, profound disappointment and intense stress. It's not funny now. I really need a break. IVF has been a series of disappointments and bad news and there truly is only so much of that someone can take before they break.

    

The Luck of the Infertile

     I'm a graduate teaching assistant (TA) and today we had our pre-semester training. One of the girls I TA with did IVF last semester due to male factor infertility (MFI). Long story short, we commiserated over our infertility journeys and then she went on to get knocked up during her first IVF and sock away 10 frosties!!! For a DOR girl who is now headed to IVF #3, I think she can eff off. Nothing against her, I just think that women who get pregnant on their first IVF AND have a fucking trillion frozen embryos are "the infertility fertile." She'll get her whole family on those embryos and then some while I'm all over here with jack shit.

     Mostly, I'm pissed at her because after I told her I was having a chemical pregnancy (in November), she immediately went on to tell me how her betas were so high they called her in for an early u/s to make sure everything was ok. And they saw everything they needed to. But, she was nervous because there was no heartbeat...at like 5w1d pregnant when its very much not expected to see one and she knows it. Fuck her.

      I may or may not have gone home after that encournter and collapsed into a breakdown of epic proportions. It was seriously my lowest moment in infertility. Luckily, I've rebounded a bit from that, but my world spins on a shaky axis, which is already slightly off-kilter due to the birth of my friends baby earlier this week.

     Anyways, my plan for the day was to avoid her. I just can't. Seriously. So, I was doing a great job directing my attention to my phone and pointing my glare in the opposite direction when another TA walks in and she's visibly fucking pregnant. WHAT THE ACTUAL FUCK?!

Ok, fine. Sneak attack. I can deal. Right?? Wrong. My boss then proceeds to notice the pregnancy, squeeee about it for ten damn minutes, repeatedly bring it up throughout the day, and then  facilitate a baby conversation that went on forever. Ugh. Not today. Not now. Not when I'm on shaky ground. Not when my anxiety is sky-high, not when my cycle is starting and test results from Dr. Kwak-Kim are going to come rolling in.

Obviously I don't expect the world to revolve around me, but would it kill the world to throw me an infertility softball one of these days? 

The Calm After the Storm

Source

      IVF is a giant, fucked up roller coaster ride of emotions. At first, you are super excited to try something new. Then reality sets in that several weeks of your life will ultimately culminate in one stupid test and you start to freak out. The other part of  the equation is that unless you are one of the 30-40% who get pregnant the first cycle you do IVF, have 434333 frozen embryos and generally swim through IVF, you wind up going up shits creek without a paddle each and every cycle. As I am thoroughly up shits creek enduring a shitstorm, I'm going to focus on the unlucky group of us who struggle through IVF.

IVF has taught me to never be too optimistic, no matter how great things are going, because inevitably, your infertility will find a way to fuck you up at some point. Case-in-point, my first cycle, I left my monitoring appointments balling my eyes out over how few follicles I had, yet the cycle ended on an upswing when we retrieved 7 eggs and had 4 fertilize. We had a downswing again when I ended up needing a 3 day transfer, but up-swinged when it was a really excellent embryo. That cycle resulted in the biggest kick to the balls yet when I got my motherfucking period two days before beta. That sucked so bad, and while I thought I dealt with it well, I didn't. It really demolished me.

IVF #2 was sure to bring great things as we were moving on to an estrogen priming protocol (EPP) for poor responders. The stimming process went awesome. I got my period unexpectedly early (which was very exciting since IVF is so much of a hurry-up-and-wait process) and I started stims as we went on a weekend away in the mountains. My estrogen levels and follicle counts were a bit higher this cycle and I set my sights on retrieving 10 eggs. The downswing was when we retrieved 7 eggs again (WTF?!?!?) and only 3 fertilized. When I heard that, I lost my shit. Having learned a thing or two from the previous cycle (and after threatening to not attend transfer), we transferred two embryos on day 3 - an excellent 8-cell and an average 10-cell. Unfortunately, that resulted in a chemical pregnancy, which was actually super exciting to me as I never thought I would get pregnant ever and I did. 

I can't really adequately explain the depression I fell into at some point in this process. After 6 months of testing alone, followed by two IVF cycles and no baby in sight, my body and mind finally had enough and we succumbed to infertility. I finally realized that I had been fighting this path that I'm on, and it resulted in so much anger and resentment - mostly focused on those who were fertile, and then on those for which IVF worked immediately. Accepting infertility really helped to change things up for me. A therapist, mind/body group and acupuncture also do their fair share in keeping me (somewhat) sane as I exist in this infertility limbo until next cycle. 

What has helped you endure this battle?