Miracle will be 2 yrs old soon. Hard to believe it. I mean how cliche is it to say time flies, but boy is it so true. The past year or so I have found myself struggling through stages of infancy and toddlerhood only to blink and see a new stage upon me and miss the old stage like crazy.
Back in early 2014, we had 18 eggs retrieved via IVF with ICSI, 8 of which made it to day 6 blasts. 7 were put on ice and 1 transferred back fresh at that time. 5 transfers total, 6 embryos miscarried, 1 miracle baby boy & 1 embryo that never implanted.
Our last embryo was transferred back to us early this month. We had high hopes that it would complete our family and bring Miracle a sibling. The cycle failed. I sort of knew going into it that it would not work. That sounds awful, and so much for the power of positive thinking. I blame myself sometimes for my ‘mindset’, that maybe if I had been more positive it would have worked. If I would have taken it a little easier after the transfer. If, if, if.
And of course I blame my body. The actual transfer itself was a nightmare. The catheter would not go in correctly which was never an issue in our prior 4 transfers. I guess since I dilated the full 10cm during labor with Isaac things changed down there. Who knows. Finally it worked but the cramping was not ideal. I wasnt exactly relaxed.
And then there was the quality of the embryo itself. 30% of it did not survive the thaw. The inner cell mass was still in tact as it was the trophectoderm (aka future placenta) that died off. We were told that successful pregnancies have occurred with even 50% not making it and to stay positive. Sigh. It was just another sign in my mind that things wouldnt work.
But the truth is none of this even matters because in reality if it was meant to be it would have been right? So now we pick up the pieces and try to move on from life after IVF. There will be no more IVF for us. It has taken up too much of our lives for too many years and I dont want it anymore. This cycle brought back so many ugly feelings that I remembered all too well once they surfaced. And I dont want those feelings anymore.
If this IVF cycle fails, I already have my next tattoo picked out. Just need to decide on the spot it will go.
I would really like to have a cute, normal pregnancy annoucement one day. I feel like infertility and pregnancy loss have robbed me of this.
We have decided to transfer 2 embryos again this time (Ill save the logistics of why for a later post). Thats right, we could be twinning soon! We currently have 3 embryos left in all, so after this cycle just 1. The amount of embryos we have transferred each cycle so far has followed the pattern of 1-2-2-
The pattern will continue at 1-2-2-2-
It will eventually end at 1-2-2-2-1.
I prefer the intramuscular injections this cycle over the vaginal inserts (never again) in all of our prior cycles, which I never thought Id say. Dont miss the mess at all. I can deal with a few moments of pain everyday.
I am struggling to get off the coffee. Not even going to lie.
I have no clue how I will give up my steaming hot baths that I love in less than a week. I cant bath without it super hot, so that isnt an option. I think I will miss it more than anything else.
I am already planning out our gender reveal party and baby shower. I know, crazy to some. But I have found having hopes and dreams are much better than not. Our gender reveal will include just close friends and family, and we will most likely have more than 1 shower. If this cycle works out, we want our reveal to be in July & our showers in October/November.
I know there will always be another milestone to reach from transfer day on out . Here they are as they come to mind-
A positive pregnancy test
Rising betas (3 blood draws over 3 days during wks 4/5)
Viability ultrasound at 7 wks
Passing 10 wks (the furthest along we have ever been)
It is our hope & dream that we do our FET this April and bring home a healthy and happy singleton just in time for Christmas this year.
But we all know that sometimes things dont work out exactly as we plan them to. Those of us suffering from infertility and pregnancy loss know this all too well.
In the last 24 hours, two of my fellow bloggers have had failed IVF cycles. My heart aches for them. Its a reality that none of us like to think about going into a cycle. We simply cant fathom putting everything into something to come out with nothing. Its so incredibly unfair.
These failed cycles hit close to home and have me thinking about how it is very well something that could happen to us in little over a month. Im not being negative, Im just being realistic.
We have never had a ‘technical’ failed transfer. All positives ending in loss. I have no idea how I would react to a negative, but I know, just like my fellow warriors, I will pick up the pieces and keep moving forward. And in all honesty, I really do not want to deal with miscarrying again ((obviously)), so if something is wrong Id rather the embryo not implant at all to begin with.
So hubby and I sat and discussed what our next move will be if this singleton FET fails and ends in a BFN in April.
The plan would be to transfer both of our remaining frozen embryos in June.
Its hard to believe that when we began this fresh cycle back in February 2014, 2 years ago, we had 8 embryos in total.
Ive now miscarried 5 of them, and we have 3 left.
April we transfer 1 embie in hopes of our dream coming true.
If not, in June we transfer both embies and pray our dream comes true then.
We arent thinking any further than that for now. I do feel good being on the same page and at least knowing what will happen should things not go as planned in April.
We find out during my hysteroscopy that the mass has NOT shrunk from these Lupron injections?
This has been the topic of conversation the past few nights in our household.
We easily reached an agreement that might sound absurd to some–
We will transfer our embryos anyways.
Yes, you heard right.
Why? Well, for starters we already tried surgery in May of 2015 to remove the mass and it failed. We do not want to go that route again and we have informed our RE of this decision already and she respects it.
Secondly, we will have tried medically managing the mass through the Lupron. If this did not work, we will not do it again obviously.
Third, plenty of women have successful pregnancies with fibroids or masses in their cavities. Even my OB and RE support this fact.
You might be wondering why we even cared about the mass to begin with then?
Why not have just transferred months ago?
The answer is simple…
After 3 miscarriages, we all wanted to give it our best shot. We want my uterus to be as healthy as possible for a baby.
If we hadnt ever miscarried, and just found a fibroid, we probably would have just transferred as many do. But that was not the case.
Moving forward, we now know that we have done everything we possibly could have done. We pray it works for us.
Today I am featuring a guest post from a couple diagnosed with unexplained infertility who are so very dear to my heart- my 1st cousin, Nina and her husband, Bryan.
Although I am sad that we both have had to battle infertility, I am forever grateful for the support and love we have been able to give to one another through this time in our lives. Those of you who follow my blog know that I always say infertility has brought my husband and I closer. Well, I can easily say the same thing about my cousin & I’s relationship, too.
Here is their story.
Nina & Bryan’s Story
So, when Ang asked if we would want to share our journey, I right away thought yes of course….then I thought oh goodness I am no writer and have never really written out our story….but quickly let her know that we would be honored to be a part of this amazing avenue for those on the infertility rollercoaster! I am so proud of you Ang!
If you would have told me 7 years ago that I would be sharing our story on an infertility blog, I probably would have said, “No certainly not me…you must have the wrong couple!” I say 7 years ago because my husband and I just celebrated our 7th wedding anniversary on June 21! As newlyweds, we knew we wanted to have a year to enjoy being married, but wanted to start our family soon after. We envisioned choosing a month to start trying, become pregnant and soon after have our sweet little bundle of joy! Perfect picture right?! Well, the reality was much different….
After about a year of trying with no success one of my very best friends (who was going though infertility) told me she would, without a doubt get to the doctor to get things checked out. Without hesitation I did just that, all the while still thinking we weren’t going to find anything wrong and would be pregnant soon enough! My friend advised that it was a good idea to start with the male factor to rule out anything. For this, I would have to get a referral from my OBGYN first.
Here begins our journey! To be quite honest I am horrible with dates and I cannot remember the exact timeline. But, here are the steps we took. First, I made an appointment to see my OBGYN. We explained our concerns and asked for a referral for my husband to have things looked at. She reassured me that I was young and healthy (I had no previous issues, regular cycles, etc.) and that these things take TIME….oh boy was she right about the TIME thing! The next step was heading to the Urologist for Bryan. We found that Bry had sperm for days, but they seemed to be taking a vacation. Our urologist also informed us that Bry had some sort of infection. One that could easily be taken care of with an antibiotic and that after we would do another analysis. Fast forward to a few more visits to the urologist and a few more tests….she basically tells us that she is stumped and isn’t sure what to do! Hence, our unexplained infertility diagnosis. It felt like months of “wasted” time!
So, I then make an appointment to see the fertility specialist for a consultation. It was over Christmas break, being a teacher I took any appointment I could get…that being said Bry couldn’t get off work. So I take my sisters along with me for support and extra ears!
December of 2010 began our journey with the amazing Dr. Karnitis! He thought that we were great candidates for IUI. We started up right away. We were so excited….first IUI cycle was simple. Clomid, trigger and Bry to the office for his “intimate” alone time, then the procedure…wahoo we were sure to be pregnant after all of this! We had everyone praying and hoping for the great news. We choose to be pretty open about everything. We figured we needed the prayer and support regardless of what was going to happen! The IUI’s continued….another round of Clomid with injections, then we tried Femara with injections. Nothing seemed to be wrong, but things just weren’t working! Even with the injections my eggs didn’t seem to mature like they should be. We tried a few more rounds of IUI, thinking it just had to work. But after 5 failed IUI’s, we were finally ready to move on to IVF. You are probably wondering why we continued trying IUI’s. I think it was a combo of our doctor being very conservative and careful, and honestly I’m not sure that we were ready to make the IVF move quite yet!
We started up on our 1st round of IVF. We were both very excited, knowing that with this more invasive procedure our chances of having the sweet babe we have been longing for was pretty great! Dr. K was always so very optimistic as well. During this process we were very fortunate to have a wonderful support system and prayer chains galore! After our many rounds of IUI, we were able to find out that my body did react a little funny to the meds. It was almost like I would need them upped, but when he would my body would go a little too crazy when they were. We had to tread lightly. Again, my eggs weren’t quite what Dr. K wanted, number or size, so he would up the meds just barely. The eggs ended up getting there, but my levels shot through the roof. He said it was too dangerous to trigger and continue with the retrieval. We were so extremely devastated that our cycle was cancelled! We then took a little break to give my ovaries and body some recover time.
Then it was on to IVF Round 2. This time around we used a little different med concoction. Things were going very smoothly, many eggs were developing and my lining was just where he wanted it. My levels were getting nice and high, which was scary, but he felt comfortable moving forward to the egg retrieval. YAY!!! I apologize for not having many details, but to be honest I have difficulty remembering it all. What we were living day to day, that I never thought I could forget, seems like a blur!
I will tell you that I did not forget any part of the egg retrieval. We were so excited to finally get to this part. We were one step closer to our goal! During the retrieval I was in twilight and was feeling very good. I remember trying so hard to focus because I wanted to see every single egg Dr. K got and wanted to be sure everything was good to go…as if I could change anything that was taking place! Dr. K was able to retrieve 17 eggs!! The next few days were just crazy…we got calls daily explaining how our embryos were doing. By the end, we had 4 awesome day 4 embryos. 4 days later we did our fresh transfer of 2 embryos. The other 2 were then frozen. The day of the transfer was super calm and easy. We just took it easy and prayed!
I thought for sure that it didn’t work. I am a worrier to say the least…I didn’t feel any different and I was totally bummed. Then watch out….here came day 11. Bry was actually sick with the Norovirus. So to get me away from it all my mom took me to Outback to eat. I felt a little queasy, thinking I had caught the awful bug that Bry had. Oh my goodness was I wrong! I was a hot mess. I was getting sick, had migraines, and was passing out on the bathroom floor. We were on the phone with Dr. K who advised us to get to the clinic, which was located in the hospital and that this was actually great news. Ummm…I felt absolutely terrible, how in the world could this be good?!
I got there and was hooked up to IV’s right away. I was extremely dehydrated and had OHSS (Ovarian Hyperstimulation Syndrome). They kept me all day. Dr. K then decided to do a beta….he said it was early and that if it was negative, there was still the possibility that it could be positive, but if it were positive I was in fact pregnant! He came back shortly, and the news we had been waiting to hear for years was given to us! CONGRATS…we were pregnant!! I am going to be honest we literally looked at each other, smiled and kissed. I then tried to fall back asleep! We had def pictured something a bit different, but hey who the heck cares!!! We were going to be parents finally! As Dr. K walked out of the room he had a smirk on his face and said under his breath, those are twin numbers!!! Oh my…could it really be!? I felt pretty terrible for weeks after. I remember Bry literally carrying me to put me into the bathtub! He is my ROCK! I looked like I was 4 months pregnant in the matter of a few days, due to the fluid because of OHSS.
Our next appointment was scheduled at 7 weeks to have an ultrasound. I was still under the weather, but doing a bit better! We were nervous…so so nervous. We just wanted to be sure we really were pregnant. We wanted to see that heart beat! In comes Dr. K and here we go…“Yep….2 sacs, and 2 heartbeats”!!!!!! WHAT…….we literally looked at eachother and started laughing! It was a nervous, super excited laugh! Dr. K joined in the fun!! Then I had to triple check that they were both healthy so far and look just as they should! He reassured me they were.
We gave birth to two beautiful babies on September 8, 2013. They just couldn’t wait to meet us and came 2 months early, but we made it through the 5 week NICU stay! We thank God everyday for our sweet miracles.
Thank you for allowing us to share our story! I hope that it can give everyone reading this hope. No matter where are you in your journey! Infertility is so very frustrating and it can be easy to lose all hope. We were there on numerous occasions…keep the faith!
When it comes to the future of our 3 frosties, should we…
Do all Single Embryo transfers (SET’s) meaning transfer only 1 embryo at a time, for a total of 3 possible transfers?
Do a Double Embryo transfer (DET) the next time, meaning transfer 2 embryos at once, and if that doesn’t work do an SET with our last embryo?
Do a SET next time, and if that doesn’t work, do a DET with the 2 remaining embryos?
Sounds like enough to give you a headache, I know. According to ASRM, SET’s are generally the way to go if the embryos are blastocysts of “good” grade and you are a healthy woman under the age of 35 ( How many embies to transfer according to ASRM )
We have now done 1 SET and 2 DET’s, all ending in miscarriages. In our minds, there are both pros and cons to SET and DET.
Pros to SET:
Better chance of carrying to full term (especially with my RPL history)
Usually healthier mom & healthier baby
Pros to DET:
It’s like a BOGO transfer (2 for the price of 1 deal). Sounds bad, but trust me, once you have dropped 30 grand you would consider it too.
Do not have to worry about the sibling factor down the road (we already know we would like more than 1 child)
Cons to SET:
More expensive if it doesn’t work (more transfers=$)
Sibling factor down the road
Cons to DET:
High risk pregnancy
More money all at once being spent on the babies (makes up for those extra SET’s!)
Tough decision. We were just as elated when we got pregnant off our SET as when we got pregnant off our DET’s. We were just as thrilled to have 1 baby as 2 babies. All we want is a healthy, full term pregnancy. Right now, my hubs is leaning more towards the SET for our next time, while our current RE says we should do another DET. I’m curious to see what the RE we are getting a second opinion from will say. I really have no idea what to think at this point.
Since we didn’t do PGD testing, we really don’t know with certainty that any of our embryos are truly of “good” grade. Yes, they made it to day 6 so that says something positive about them. But when it boils down to it, our embryos were graded by their looks. I like to think of it as a beauty contest that the embryologists were judging. Unfortunately, anyone who did not have PGD done for an additional 7 or 8 grand is in the same boat as us technically speaking.
Here are the judges scores from the beauty contest for our remaining 3 embryos:
1 6AB (same grading as the embryo we transferred the 3rd FET)
2 6AC’s (the lowest grade we had out of all 8 of our embryos, have not transferred any of this grade yet)
From my understanding, based on the Gardener blastocyst grading system (what our clinic uses, some clinics use different systems), there are 3 separate quality scores assigned to each embryo. 1 number, and 2 letters, like above.
As you can see, the number represents the expansion grade, with a 6 meaning the embryos have hatched out of their shell. This was the best number we could receive & we paid for assisted hatching so it only makes sense!
The first letter following the number represents the inner cell mass quality (baby component), with an “A” meaning there are many cells, tightly packed. This was the best letter we could receive in this category. This is also supposed to be the most important category, but I would argue they are all equally important.
The second letter represents the Trophectoderm quality (this is the placenta component) with a “B” grade meaning there are few cells, forming a loose epithelium and a “C” grade meaning there are very few large cells.
All of this only matters if you believe in the beauty contest ratings they received anyways. The first embryo we transferred from our fresh cycle was rated a 6AA, the highest they come, & we miscarried right away. After that we transferred another 6AA & a 6AB & still miscarried early on. The third transfer we lost 2 6AB’s, one being baby Isaiah.
Supposedly, there is a minimal decrease in pregnancy rates when the placenta component (2nd letter) is not rated an “A” like our embryos from the last transfer, which were 6AB’s. Well obviously these statistics didn’t apply to us; it was the furthest along we ever got in any pregnancy.
That being said, we aren’t really too concerned that our remaining embies are not 100% beautiful to the embryologists because so far their system hasn’t held much weight. I think the biggest decision we will end up having to make is how we want to transfer these precious little embies. Whatever God leads us to decide, I sure do hope at some point 1 of them can sport this hilarious shirt!
Right off the bat, I should say that I know no person is perfect, and no IF clinic is perfect either. Perfection should never be the expectation. However, in any profession, if you aren’t reflecting and trying to improve or do better, that could be a problem. Experience only makes you wiser if you learn from it and apply it to future situations. I know this from being a teacher the past 5 years.
This being said, we have made a list of things we think could be improved upon at our current clinic, or any clinic for that matter. Here is what we have so far:
The most advanced uterine tests should be performed on all patients before IVF. This means a Hysteroscopy should be done on every patient prior to IVF. You heard me right. That is our opinion after the hell we have gone through. We are proof in the pudding that an SIS and HSG aren’t always enough. If we had done this procedure from the start, there would be no questions in our minds or our RE’s if that fibroid had truly been around for all 3 losses or not.
PGD should be offered to all patients before they begin IVF. Looking back, we were never informed of this option & I wish we had been. We cannot do PGD testing now with our remaining frozen embryos, as it can only be done in the days following the retrieval. We never knew about this option until we miscarried and started searching the web. Suddenly, we started seeing all of these women who did PGD before transferring. I mentioned it to my doctor at that point, and found out it was too late to genetically test our embryos. Since we looked good on paper (under 35, appropriate weight, etc), perhaps it was assumed we would succeed & not need this expensive option added on. If we were to miscarry again, I do not know if I could go through another transfer. Instead we have discussed a surrogate. How much more confident we would feel knowing we were transferring a genetically normal embryo into a surrogate than not! While I get that PGD is not 100% accurate, it should be offered to the patients if it is a service the clinic provides.
RE’s should discuss the worst case scenarios upfront with their patients before they begin IVF. When we began IVF, we were so set on it actually “working” that we didn’t think of anything before that point or after that point. We didn’t discuss that only embryos making it to day 5 or 6 would be kept. We never talked about the chances of chemical pregnancies, miscarriage, or RPL. We had no idea we would go through the torture of beta testing and what would need to happen with all that if we ended up pregnant.
The RN’s should not do all of the ultrasound monitoring during an IVF cycle. This is probably common at most clinics simply due to the amount of patients undergoing treatment. It was never an issue to us before we miscarried either as we do trust our RN. However, our nurse ended up missing something early on in one of our cycles that our RE probably wouldn’t have if she had been the one doing the ultrasounds to begin with. Moving forward, we have told our RE we will not be monitored by anyone other than her and she has agreed this is best. If our RE would like to have the nurse with her for another set of eyes, great! Bottom line…I want the person who will be transferring those embryos into my uterus monitoring it before hand. No exceptions.
All viable embryos should be considered for transfer. At our clinic, only embryos that make it to day 5 or 6 are transferred. On the day of the retrieval you are handed a piece of paper that says “be here on day 6 at _____ am for embryo transfer.” I know several women who have had successful day 3 or 4 transfers, so I do not think it is fair to limit to just a day 5 or 6 transfer. Thankfully, our 8 embryos made it to day 6, but what if they hadn’t?
After retrieval, the embryologist should provide daily updates on how the embryos are doing. I never once talked to the embryologist for an update. I received a voicemail the day after retrieval with a brief summary, but that was it. Those days after the retrieval are sooo stressful as it is, and remember we had to wait until day 6 not knowing anything. In my opinion, not knowing anything until you show up for the transfer is adding a lot of unnecessary stress to the situation.
Get input from the patient about their IVF treatment plan. Sit down and show patients all of the different “protocols” available for an IVF cycle. Short, mini-stim, antagonist, un-medicated, etc. Tell them the success rates with each. Explain what type of patients you have seen do well on each type of protocol. Understand that this should not be a “one-size-fits-all” approach. Ask them questions about their bodies, and act like they are educated. Through this process, I have learned that I know my body better than anyone. Just because Susie did well off all of the drugs you gave her, doesn’t mean I will. Show me what is available, whether it is your preferred method of treatment or not.
Clinics should disclose what will happen if you do get a positive beta post IVF. We never talked about the cost to continue a pregnancy if we achieved one. We had no clue we would be spending thousands more on medications after the actual IVF cycle itself ended. Medications are only paid for up until the beta test in case you get a negative. If you get a positive, you will need meds for 6 more weeks, at least. That adds up to thousands more.
Designate clear roles within the practice. Since it is so easy to communicate with everyone at the practice (listed as a perk yesterday!), you never know exactly who to talk to about things. For example, we have had prescriptions not called in, called in twice by different staff members, etc. It would be great if each person had a clearly designated role or each patient had a clearly designated go to person.
Wellness services should be provided at clinics. Everyone goes into treatment hoping it will work the first time. But, that is not always the case. Actually, majority of the time it is not the case. After all of the emotional and physical trauma, we wished that our clinic offered things like acupuncture, counseling, etc. Don’t get me wrong, when asked, they provide recommendations, but we have ended up finding our own specialists in these areas. It would be great if clinics started including these in their treatment packages.
Hind sight is always 20/20. But we hope this list is helpful to those searching for a clinic to call home!