blast off

just when we though we were in the clear.  we did get good news this morning as all four embryos are still kickin', however, the next 24 hours is very important.  they will transfer the embryos to a new medium today to hopefully develop into blastocysts.  let me attempt to explain...up until several years ago this would be the day of transfer.  because on day three it is difficult to predict what embryos would be most likely to result in pregnancy four or more embryos would usually be transfered with hopes that at least one would result in live birth. the downside is that sometimes all the embryos become ongoing pregnancies and the result is high-order multiple gestations (triplets or greater).  In such pregnancies there are considerable medical risks as well as financial and emotional.  So the couple would be faced with the agonizing decision of whether to opt for selective reduction (the removal of one or more embryo) or to continue with a risky pregnancy. 

however, with blastocyst transfer, only two or three embryos are transferred practically eliminating the possibility of triplets or greater.  and the same pregnancy rates are achieved as would be expected when four or more embryos are transferred on day three.  i should probably mention that a blastocyst (referred to as blasts) is a highly developed embryo that has divided many times to a point where it is nearly ready to implant on the walls of the uterus.


during maturation, an embryo rests inside a protective shell called a zona pellucida.  you can think of this protective shell as being much like a chicken egg.  but, unlike chicken eggs, human embryos do not remain inside a shell.  instead, the embryo hatches (breaks out of the shell) on the fifth or sixth day so it can attach to the uterine wall (implantation).  just prior to hatching an embryo becomes a blast.

embryos developing to the critical blastocyst stage have a much greater chance of implanting successfully and resulting in an ongoing pregnancy.  that is because these embryos have passed an important test.  during the first few days, the embryo relies on the mother's eggs for all its  nutrients.  however, in order to survive past day three or four, the embryo must activate its own genes.  not all embryos are successful.  yet, these embryos are more highly-developed, healthier, stronger and have a higher rate of implantation when compared to day three embryos.  due to higher probability of survival, they only have to implant one or two blasts.

clear as mud?  in know, welcome to my world.  i better wrap up for now and try to figure out how in the hell i am going to get through the next 24 hours.  i have an acupuncture appointment this morning so hopefully shamayne can balance me out a bit.  oh yeah, josh gave me my first intramuscular shot last night and it wasn't bad at all.  i am starting to think he should go to medical school:)  maybe that is how we can pay for all of this...

more eggcellent news...

another 24 hours down!  just received our morning call and we still have four embryos!  i asked if they could tell anything about the quality and they said at this point they like them to be splitting into 2-4 cells and we have 2 that have split into 2 cells, 1 that has split into 3 and 1 that has split into 4!  such great news!  obviously, josh and i are elated.  we are definitely not out of the woods yet but as long as we keep getting the same news with our morning phone call we are headed in the right direction!  we will of course let you know tomorrow morning's news.

eggcellent news

just want to state right off the bat that josh came up with today's title.  he is pretty proud of himself:)  we received the much anticipated phone call from rrc at about 8:20 this morning and it was good news!  they were able to fertilize four of the seven eggs and now we have four little baby embryos growing!  i seriously almost exploded!  another 24 hours down.  it is likely that not all of the embryos will make it until next wednesday but we are keeping our fingers crossed that at least two of them make it for transfer.  josh and i are both recovering very well, still a little sore but nothing excruciating.  we will be certain to share our news after tomorrow morning's phone call!

lucky number seven

what a day.  josh and i went in for my egg retrieval and his testicular biopsy this morning at 6:45 am.  we went to rrc first where we met with dr. nangia before taking him back for his procedure.  i then met my mom and we headed over to one day surgery where we encountered the rudest check-in lady ever.  some people are clearly in the wrong profession.  it wasn't long after checking in that they took me back to put on that sexy gown and get my iv started.  by the time they got me set up josh was already done with his biopsy and he and my mom were able to come sit with me until they took me to the operating room.  josh's procedure went really well, it was a nice relief to see that he was okay before they put me under.  after about a half an hour they sent my mom and josh back to the waiting room and gave me the anesthesia.  wow,  a dose of that every evening and insomnia would be a thing of the past.  i remember them wheeling me into the or and moving me to the table and nothing else until i woke up.  when i awoke, i just kept asking the poor male nurse standing next to me how many eggs they were able to retrieve.  seriously, i bet i asked him 15 times.  every time he would leave for one second and come back i would ask him again.  it wasn't long after that they allowed my mom and josh to come back there with me where they informed me that they were able to retrieve 7 eggs.  while this is not the best news, it is not the worst either.  while most doctor's agree that getting 10-12 eggs gives you the best chances of success, it does not mean that it won't work.  it was not the news that we wanted but it is the news that we got so all we can do is move forward.  they made me eat some crackers to make sure i didn't get sick and sent us on our way.

after we left, they took the eggs over to the ivf lab where they began preparing them for fertilization with josh's sperm.  they will pick the best sperm and the best eggs and combine them with hopes of creating an embryo.  they pick up one of josh's sperm and insert it straight into the center of one of my eggs.  it is likely that not all seven of the eggs retrieved will be mature enough to attempt to fertilize but they will try with all of them that are.  they will call us in the morning with our first embryo count.  we want it to be four or above, anything below that and there will be cause for concern.  not all embryos will continue to grow until next wednesday and they would like to implant two so that phone call is very important.

we are both doing very well.  josh is really moving around with ease and i am not as sore as i had anticipated. they said i would be much more sore tomorrow and sunday but as good as i feel today i don't think it should be too bad.  this whole process has been such a challenge for me mostly because i have felt so out of control but up until now i have at least felt like i could help by my juicing, eating healthy, cutting out caffeine and alcohol, acupuncture, guided imagery, and so on.  now it feels so out of our hands.  our little embryos are an hour away, all by themselves.  i just need them to be strong and continue to grow until next wedensday where they can transfer them and i can take extra good care of them.  i still feel positive, i knew all along that this would be the most difficult part.  all of the needles, meds, procedures, are pale in comparison to having to wait each day over the next five for our embryo report each morning.  maybe that is what the vicodin is for:)

i have to say again, to all of our friends and family, it is because of you that we are able to do this.  we know that you all have your own busy lives but it has meant so much that you have all kept us so close to your hearts at this difficult time.  it sometimes feels very lonely and scary going through this but your support has eased that burden tremendously.  i look forward to delivering some fabulous news after our early morning phone call.  until then...

eggs, sunny side up

good news!  i went in this morning for another blood draw and scan and the follicles are looking much better.  sheesh, what a difference a day can make.  the follicles on the left side are humongous (my term, not theirs) and the ones on the right while still small are still growing. egg retrieval will be this friday bright and early. josh and i are staying overnight in a hotel near the hospital thursday night as they requested.  if we were to drive up the morning of and hit traffic or have an accident i could ovulate and my eggs would be gone!  crazy stuff.  we are definitely not taking any chances there!

i am going to go up prior to josh on thursday and squeeze in one more acupuncture session before the procedure. my favorite little nugget emily is going to bring josh up after work so we don't have two vehicles.  i imagine it should be a pretty good nights sleep considering it will be one of the few times in the past two years that i haven't had a 90 pound chocolate lab sleeping on top of me.

as far as results go, we will know before we leave he hospital on friday how many eggs we have.  brandi, my ivf coordinator, says to pray for eight and if we end up with ten or twelve great.  after we leave they will combine my eggs with josh's sperm an hope they make embryos.  they will call us first thing saturday morning and every morning thereafter leading up to implantatin with an embryo count.  we are hoping for four or more on saturday morning.  assuming there are embryos and at least one of them makes it, implantation will be next wednesday.  this is not a big procedure and is relatively painless.  i go in, they give me valium, implant the embryo or embryos and i am on my way.  the whole thing takes about 15 minutes.  then, eight excruciating days later we go in for the much anticipated blood test....omg this is really happening.

they said i will be in quite a bit of pain for the two, possibly three days following egg retrieval but i will try to post results as soon as i can.  if ever there was a time to remain calm and positive it is now....

knowing is half the battle

ugh.  i went in for my blood draw and scan this morning, practically skipping into the doctor's office thinking i was finally going to get to make my plan for this week and next and to my surprise i don't know much more than i did friday.  my eggs are growing a lot but slower than most.  between my eggs and josh's sperm i hope these kids are good lookin' because they might not be riding the normal bus to school if you know what i'm sayin:)  all joking aside, there is still no need to worry they assure me.  i have to go back in tomorrow morning for another blood draw and scan and then they will supposedly determine the date of egg retrieval but they think it will likely be friday because my estradiol level is getting pretty high.  g.i. joe really nailed it when he said "knowing is half the battle."  that was g.i. joe right?  anyway, whoever it was they sure nailed it.

i had an acupuncture appointment right after my doctor's appointment that went very well.  i am not sure how she does it but i was pretty edgy when i went in there and within 15 minutes i was sleeping like a baby!  covered in needles and sleeping like a baby.  it is truly beyond my comprehension.  i have became completely fascinated with the whole procedure honestly.  it makes me feel like i did after i first saw a therapist, that feeling of why haven't i been doing this my whole life?  it just goes to show you can't rely solely on western medicine.  i shouldn't say can't because i am sure western medicine alone works great for some people but for me i feel i need a healthy balance of eastern and western medicine.

i am still feeling pretty good, i would say side-effects are minimal.  my ovaries, or ovary i should say since the left one doesn't want to cooperate, is quite large which is making me have to pee what feels like every 5 minutes.  and my boobs hurt so bad i want to have them removed and i am completely exhausted but other than that i would say i am one of the lucky ones in regards to the severity of side effects.  i am not really so much nervous about egg retrieval as i am anxious.  i have been doing very well so far at keeping all the bad thoughts at bay but i would be dishonest if i didn't say the possibility of not getting any or enough eggs to proceed wasn't weighing on me a bit.  i challenge you to find me one person who has been where i am sitting that hasn't had any of those thoughts.

anywho, i need to get some work done this evening because i wasn't planning on having to go back in tomorrow morning.  i have a jam-packed afternoon tomorrow at work but hopefully i can crank out a blog post over my lunch break after my appointment.  i should have quite a bit of information to report.

so close, yet so far away...

another appointment down.  i went in this morning for another blood draw and scan, i think i could drive to overland park with my eyes closed at this point.  my scan was to check and see how many follicles there are resting on my ovaries.  remember, the follicles produce eggs.  i was pleased to learn i have an average amount of follicles at this time.  although i only have 5 on the side with the smaller ovary, i have 11 on the other side.  even though i have a decent number of follicles, they are growing at a fairly slow rate which means my egg retrieval might be next friday or saturday instead of thursday.  if egg retrieval is on friday implantation will be on the following wednesday, if it is on saturday implantation will be the following thursday.  i should know more next tuesday when i go in for another blood draw and scan.  my estradiol was 694 which brandi said is perfect!

i took maddox to mornings with mom today because cassidy had clinicals.  it was a nice reminder of why we are going through all of this.  i look at maddox and zoe and can't possibly imagine how you could love anything more.  i think being a parent, while the most challenging job ever, has to be the most rewarding.  i can't wait until our little ones are here, maddox, zoe and rayna will be fabulous role models.

 overall, i am feeling very good, better than i could have ever imagined.  i have surprised myself with how well i have been able to handle all of this. the hormone shots have been going very well and will soon be over.  i must say this whole process has been going by a lot quicker than i had anticipated but i am so ready to do this!  i was hoping they would be moving my appointment up rather than back...oh well, it will be here in no time at all.  i will be sure to post an update after our appointment on tuesday!