First Beta Test

Isaac is trying to figure out how long this whole process takes.....

So after you transfer your embryo the next major milestone that every IVF/FET gal waits for is the first beta test.  The beta test is a blood test that shows whether or not there is HCG is your system, HCG is the hormone that you secrete when you're pregnant.  All the other symptoms that I've been having up until now, (sore boobs, very tired etc) are things that the estrogen and progesterone supplements I'm taking can explain.  As of now my body isn't producing these hormones on its own, so these pills, patches and shots are what will sustain the pregnancy for the first few weeks/months until my body realizes that it needs to step it up.

Who doesn't want to start their day with a 2" needle in the booty?

Thankfully my clinic tests 8 days after the transfer, so its not nearly as long of a wait as it could be (the TWW or two week wait, is the time frame that's usually between transfer and testing). One of the things they tell you is that you should *never* use a home test, they aren't usually as sensitive as the blood test so you can get a negative on the home test even if there is HCG in your system.  I waited 6 days without testing, on the 7th day I couldn't hold out any more and POAS (peed on a stick, infertility jargon).  I got my very first positive pregnancy test.  EVER.  In my life.  I did it again this morning and was excited to see that the line was darker, also it showed up right away this morning, yesterday it took about 2 minutes to show up.  This tells me that the HCG is stronger today that it was yesterday, which is a really good sign.    My beta result today was at 62, when I asked the doctor on the 17th where the like to see the starting number at he said "anything in the upper double digits" and then went on to clarify that the first number isn't all that important.  Especially testing so early after transfer the initial figures can be all over the place depending on when the embryo actually implanted and started to secrete the HCG. The important part is that the figures rise on the subsequent tests.

After the initial beta test they re test again 2 days later, then again 2 days later (although in my case it will be 3 days because they don't test on the weekend).  This is just to make sure that the HCG is doubling/rising the way that it's supposed to.  So my fingers, toes, arms and legs are all crossed that when I go back the figures are up to the triple digits!

I think I peed the baby out

Suddenly after we transferred Snowman I'm noticing that every time I move, get bumped, jostled and/or breathe heavily I'm suddenly convinced that I had mortally damaged or wounded Snowman and I have a minor panic attack.  Now, let me be clear, I have taken an anatomy class, I'm aware of how the female reproductive system works, and that it is physically impossible to actually pee out the baby.  But, lets be honest, logic isn't playing into my head all that well.  I'm also noticing that every time I have a twinge or a minor cramp I suddenly start flashing to the "what happens after transfer" list and wonder if its possibly implantation starting, even though I know that its probably too early to tell, and that most people don't even actually feel implantation.  Add into it that thanks to the massive doses of progesterone and estrogen make "symptom spotting" a moot point, since the high levels of the hormones mimics early signs anyway and I'm laying low and going steadily crazy.

We transferred!  As I type this I am officially "pregnant until proven otherwise" which basically means they've transferred the embryo and now we have to wait and see if it implants and results in a pregnancy.  This post won't get published for a while, we're keeping this a little under wraps until we find out if it worked (aka that I'm pregnant).

Getting ready for the transfer, I'm 30 minutes into the valium pill and a little loopy here!

 

When we saw the photo of our embryo Spence commented that it looks like a snowman, so we've decided to call him/her Snowman/Snowy until we think of a more creative nickname (we don't know the gender yet, so technically embaby could be snowoman, but snowman rolls off the tongue a little more so we're going with that).  The embryologist said that when they defrosted snowy he/she started to expand and grow, so that's an excellent sign!

 

Spence practicing holding Snowman, he is doing this solely because I was on valium and asked him to, he's a good sport.

Successful transfer!  the blue circled area is where they implanted Snowman

 

 

Now that we're pregnant until proven otherwise we are just waiting to go in for blood work to test my HCG level.  I anticipate the days crawling from now until then!

Whats Going On In the 'Ol Uterus

Assuming that everything goes well after the transfer (date to be announced) and the embaby implants and grows this is what will be unfolding inside of me!  I'm excited and terrified and nervous and giddy and hopeful and every other emotion under the sun.

http://www.bubblesandbumps.com/what-happens-after-embryo-transfer-day-3-day-5-transfer-calendar/

5 DAY TRANSFER

Days past transfer	Embryo Development
1	The blastocyst begins to hatch out of its shell
2	The blastocyst continues to hatch out of its shell and begins to attach itself to the uterus
3	The blastocyst attaches deeper into the uterine lining, beginning implantation
4	Implantation continues
5	Implantation is complete, cells that will eventually become the placenta and fetal cells begin to develop
6	Placenta cells secrete human chorionic gonadotropin (hCG) starts to enter the blood stream
7	Fetal development continues and hCG continues to be secreted
8	Fetal development continues and hCG continues to be secreted
9	Levels of hCG are now high enough to detect a pregnancy on HPT

Getting Ready, and Getting Away

So the prep for the frozen transfer is quite a bit different than the prep for the egg retrieval.  There are still shots, still pills and all that but the drugs don't have quite the same impact on the body (meaning I can stay awake past 7pm).  Mainly at this point I'm taking a lot of estrogen and a lot of progesterone to make my uterus a happy healthy place for the embaby to implant itself.  I started on Lupron for a few weeks, then added in estrogen patches, then an estrogen pill.  I've started the progesterone shots as of this week, those are *super* fun.  The shots themselves don't hurt much, but the next day I can tell you EXACTLY where the shot was and it is soresoresore.  In the next few days we add in another pill I'm taking 4x a day, then a zpack, and then we get to the transfer.  Then if the transfer works I'll stay on most of those pills/PIO shots for the first trimester.

It was great to get away from home for a few days and go down to the lake with my family and spend time with them hiking, paddle boating, swimming and just hanging out after dinner playing skip bo and drinking some wine.  I was still working so it wasn't a total break, but its amazing what a change in scenery can do for your mental well being.  This year was a little bit sad though, my Papa (my moms dad) has been on the decline for the last few years.  Slowly going from the Papa I remember from growing up, always on the move, with a quip ("I always get the last words, 'Yes Dear'"), playing the piano and singing, always up for a hike or a round of golf to a man who is really only ok if my Nana is around to ground him.  He is still happy to be around, but really isn't present like he always has been.  I keep thinking that if this transfer works and we get pregnant that my Papa won't really remember my son/daughter, or that he may never get to meet him/her.  It was the same thing I thought when my dad was diagnosed with cancer, that even if we got pregnant that day that with the average survival rate of 8mos that he likely wouldn't meet him/her, (I was right too, my dad made it just barely over 8 months from when he was diagnosed before passing away, there was no way he could have met my kid).  For the first time everyone seemed to be intent on getting a full family picture, thanks to the selfie stick we have one!

Now its back home and just trying to stay calm until we transfer.  If I'm this jumpy before the transfer I can't imagine how I'm going to handle the wait until we find out if it actually worked.  I see some closet cleaning and house purging in my future to keep me occupied!  The good news is that my clinic will test 8 days after the transfer so it's not a full 2 week wait like some have to get through!

Frozen Embryo Transfer Prep

We did the egg retrieval in January.  We had a trip to LA planned for the end of February to visit our friend Kyle (the same one we cruised with around Christmas a few years ago and the friend who performed our wedding) and then mid March we had a trip planned to Florida with my high school friends (the Cool Kids Crew lol).  We decided that we wanted to have (hopefully just these last) trips where we could have some drinks and relax with our friends so we decided to push the embryo transfer to April/May.  I'm being vague about the date because Spence and I decided that we aren't going to tell people the exact date of the transfer.  It'll be nice/weird to have part of this process just be ours. 
There are 2 different types of FET's, a natural and a medicated cycle.  The natural FET is basically where they monitor your cycle and do the implantation right after you ovulate, there are no shots and minor medications etc.  The medicated cycle (which is what we're doing) is basically where you decide what day you want to transfer, and then the clinic builds you a schedule of medications and timing for it all to happen on that date.  I'll be on birth control, Lupron shots, shots of progesterone in oil (PIO), baby aspirin, estrogen patches, estradiol pills, and  the process can take 6-8 weeks.  The PIO shot is the only medication I'm scared of lol.  Those have to be given intramuscular (IM), its a big ass needle and its a shot I can't do myself. 
My family goes to Big Cedar Lodge on Table Rock Lake every spring for a week vacation.  This year Spence can only come for a few days, and I start the PIO shots while we're at the lake.  My aunt has some experience with shots so I asked her to give me the PIO shots for the mornings we're at the lake.  If anyone reading this (I'm pretty sure no one is reading this) has done a FET or is in the process you can probably figure out the timing of our transfer.  Luckily, for secret keeping purposes, no one in my family is really familiar with the process and timing of this so they won't be able to figure it out lol.

So we're in the process of getting ready for this transfer.  It's crazy to me that all the time an ALL the money we've put into this process comes down to the next (however many) weeks. 

Egg Retrieval and PGS Testing

So we went in for our egg retrieval on Jan 31, I had 2 full ovaries filled with lots of follicles that we hoped contained lots of mature eggs.  By the time we did the trigger shot (which was a super fun shot that had to be given intramuscular which means in the bum with a BIG needle that Spence had to do due to the location, he was as excited to give the shot as I was to receive it) I was exhausted all day long and I was pretty bloated.  I had some minor anxiety the day we went in for the retrieval and they went ahead and put me under a little early, which I appreciated. 
I woke up to find that my right ovary had shifted slightly and moved behind the veins/arteries (whatever the correct medical term is, I told you I'm not good at the science stuff) that supplies blood to the left side of my body and the doctor wasn't able to move through them to access the ovary.  This means that instead of getting close to the 20 follicles that could have had a mature egg in them (based on the size) we got 10 from my left ovary only. I was so upset, the larger number of eggs you get the better chance you have of getting mature eggs and more embryos that fertilize, IVF is totally a numbers game and the bigger numbers you have the better chance you have of taking home a baby at the end of the process. One of the first things they tell you when you start IVF is that
(1) not every follicle will grow,
(2) not every follicle that grows will have an egg,
(3) not every egg that is retrieved will be mature and
(4) that not every mature egg will fertilize.

All I could think of was that right off the bat our chances were cut in half.  I almost cried in the recovery room when I found out that they couldn't do anything with the right ovary.  The recovery for the egg retrieval was rough for me.  I was at a high risk for OHSS, which is when you respond too well to the stims and can lead to your ovaries being enlarged, fluid retention in the stomach, and a host of medical issues.  More than likely not being able to get to my right ovary is what saved me from having OHSS, but I was still really bloated (I couldn't wear normal non legging/sweat pants pants for a week) and I think I was just all jacked up from the hormones because it was about a week before I was ready to be around people again.  Some IVF procedures will do a fresh transfer, which means on day 5 after fertilization you go back into the clinic and they implant the embryo then.  Since I was at risk for OHSS we opted to do a freeze all cycle which means that we opted to give my body a few months to heal after the medications.  Studies have shown that FET (Frozen Embryo Transfers) have higher success odds and people say its because the woman is on fewer medications.
We did beat the odds when it came to the eggs fertilizing, we got 10 eggs and all 10 fertilized.  Some clinics will call you on day 3 after fertilization and tell you how many have progressed that far, my clinic does not they only call you on day 5 to let you know how many made it that far.  On day 5 they either implant the egg or freeze it.  On our day 5 report we found out that of our 10 that fertilized we had 2 that made it to day 5 (see what I mean about it being a numbers game?).
We decided early in the process that we wanted to test the embryos for any chromosome abnormalities (PGS testing), most first trimester miscarriages are caused by abnormalities in the chromosomes.  After the stress dealing with infertility and IVF I wanted to make sure that we had the best chance of a healthy pregnancy as possible.  I know there's nothing fool proof in this process, trust me, I know, but I wanted to make sure that we did everything possible to know we had the smallest chance of problems after the transfer.  The PGS testing and results take about 10 days from the day 5 report.  The embryos are biopsied and the biopsy is sent off to the lab to test.

I got deployed to Reno NV after the first of the month, it was a fantastic distraction while we waited to hear if our 2 embryos were "normal".  I was working 10-12 hour days and it was the best distraction ever.  I got the call on Feb 14, yes on Valentines Day, that we have 2 "normal" embryos waiting for us to transfer.  I wasn't totally aware of how stressed I was about the wait until I got that call.  I was sitting in a café having a late breakfast, I literally cried when I hung up the phone I was so relieved at crossing this hurdle.  One of the other benefits of PGS testing is that it also tells you the gender of your babies.  So both Spence and I know, but we've decided not to tell anyone else until after we transfer and have a healthy pregnancy underway.