Tuesday, March 31, 2015

The Conclusion of The Study

I've now completed my first ever IVF cycle through The Study. It was a bona fide wild ride physically and emotionally, and despite thinking I'd be all laid back and nonchalant throughout the process, I totally got sucked in.

And if you are checking in to find out the answer to one very specific question?

No, I am not pregnant.

Let's start at the beginning, shall we?

Here's a summary of all the prep that went into this cycle:

*I spent 4 weeks on birth control pills to suppress my system
*I spent 4 weeks giving myself Lupron shots each morning to further suppress my system
*I spent 11 evenings giving myself FSH shots to super-stimulate my ovaries
*I had morning blood draws and sonograms every 2-3 days to monitor follicular development & estrogen levels
*I took one Ovidrel shot 36 hours before retrieval to trigger ovulation

The first surprise BOMB dropped the night I was to do my Ovidrel trigger.

I had done a blood draw that morning to monitor my estrogen & progesterone levels, followed by a sonogram to measure my follicles. The doctor confirmed that I had enough large follicles to trigger with Ovidrel that evening, and that a nurse would be calling with instructions.

When the call finally came at 5:30pm, the nurse started rattling off my upcoming protocol. In the middle of saying: "you'll take your Ovidrel at 10:15pm tonight toward a retrieval Wednesday," she threw in: "and since your progesterone levels were too high (2.5) you won't be doing a transfer- they'll be freezing all embryos after retrieval"…. and kept talking until I finally interrupted to sputter:

"Wait, WHAT?"

Shock. I had NO idea that could even happen. That the transfer part of this cycle could be cancelled just.like.that because of elevated progesterone levels. My stomach dropped to my feet, tears welling in my eyes, and I could physically feel my heart thumping in my ears.

And so it was that this became a "freeze-all" cycle (a new term to me), where the only option was to freeze all surviving embryos toward a future Frozen Embryo Transfer (FET). The FET itself necessitates another month of medically 'readying' my body for implantation, not to mention an additional 3-4k out of pocket.

So yeah, a pretty HUGE and disappointing turn of events.

The retrieval was OF COURSE scheduled for the morning we were leaving for Wimberley (of course!). I had to do all of our major packing the day before, and thankfully was able to get our nanny to help out with Iyla the morning of the procedure.

I was put under general anesthesia, and when I awoke, a nurse told me they'd retrieved 17 eggs. 17 eggs! I was pleasantly surprised by that number, and curious to find out how many of those were mature.

Because this cycle was now a "freeze-all," I would be getting fertilization reports on the developing embryos via phone calls every 2 days. My clinic starts freezing embryos on the 5th day after retrieval up through day 7. Whatever hasn't continued to develop and grow by day 7 is discarded.

Thus began the nerve-wracking journey of waiting for my fertilization updates.

*Day 1 report: of the 17 eggs, 14 were mature, and 9 fertilized. Still feeling OK about that! Hoping the bulk of those little guys keep dividing, but also bracing myself that often the original fertilized number drops as the days go by.

*Day 3 report: all 9 embryos are continuing to divide! This was the grading breakdown:

One 8 cell grade 1 (the best one of the group)
Two 8 cell grade 2's
Two 8 cell grade 3's
One 6 cell grade 2.5
One 4 cell grade 2
One 4 cell grade 3
One 3 cell grade 3

The embryologist said that the 6 and 8 cell embryos had the best possibility of continuing to divide and grow, and that we'd know a lot more with Day 5's updates.

Here's where the 2nd bomb drops.

*Day 5 report: ONE embryo got to the blastocyst stage needed and was rated a "CC", which is the lowest grade they'll even allow to freeze. The embryologist said one other embryo was close behind but hadn't yet developed the necessary inner cell mass. It was likely the others wouldn't make it to freeze.

I was- quite simply- devastated.

Even though I'd braced myself for the fact that sometimes women have NO embryos make it to freeze, I had still hoped to have 5 or 6 of the original 9 make it. Yet here I was being told that so far just ONE embryo made it to freeze and maaaaaybe one more might get there.

I couldn't help but feel this must mean I have crappy eggs- to produce so many yet have so few survive. I wondered if paying for an FET would even be worth it with just one not-so-great embryo, given my doctor's usual protocol is to transfer 3-4 embryos at a time in women my age.

I also found out I couldn't qualify to do The Study again since I hadn't made it to retrieval. That was coupled with the fact that our lifetime infertility insurance coverage was just about maxed out, meaning any further interventions would all be paid out of pocket.

I cried over the fact that I may never be pregnant again. That there was a good chance Iyla would be an only child. I was so, so sad.

And then? Another turn of events.

*Day 7 report: miracle of miracles, the other embryo vitrified to a freeze quality blastocyst! (And look at me throwing around these big terms I don't fully understand!)

The embryologist told me that this 2nd embryo had 'completely hatched,' which is apparently a really, really promising sign. It was rated a "BC," so a little higher grade than the day 5 embryo (that she said could very well have improved in grade had it continued to develop). Talking to the embryologist completely lifted my spirits. I had been feeling like I had a low quality day 5 embryo, but she reassured me that both embryos looked very good, and both had an excellent chance at surviving a thaw and continuing to grow into babies. She even told me she'd be hesitant to transfer them both at once, given how likely each were to grow.

What an emotional whirlwind. From 17 eggs! To 9 fertilized! To only ONE froze? To pure elation at having a 2nd embryo get to freeze quality. What a fool I was to think I'd be able to stay emotionally aloof throughout this process.

The more I learn, the more I think I am actually in a more promising protocol than had I been able to do the fresh transfer. My clinic told me that there is currently a movement in the fertility world toward preferring FETs to fresh transfers, as it allows a woman's body to recover after the trauma of the retrieval itself. The prolonged observation of embryos (through days 5-7 after retrieval) also ensures that only the strongest survive.

That all sounds good to me, and has put *just enough* hope in my heart to allow me to move forward toward a future FET- complete with all of its emotional & financial ramifications. I'll meet with my doctor next week to discuss timelines toward likely doing an FET with my May or June cycle.

Until then? I plan to just sit back and really relax (and please don't tell me this is when we'll actually get pregnant- rule #1 in 'what not to say to someone facing fertility challenges!'). We have a lovely trip coming up (northern California!) that I plan to fully partake in with my NON PREGNANT body while our frozen babes sit securely on ice.

And the quest continues….

Future Lambies?

1 comment:

  1. Wow, that was quite an educational post for me. I can hear in your writing voice just how terrible it is to go through the major upheaval, physical and emotional traumas, financial costs, etc...and I'm really sorry you're experiencing that.