Silver Linings

Sometimes I am amazed at the human spirit.

With everything that we go through it is incredible that we can still have hope.

After finding out that we were going to miscarry again I wasn't sure if I would ever have hope again.

It wasn't until afterwards that I was able to start to see some silver linings.

The first was the knowledge that I am surrounded by friends and family who are unbelievably supportive and kind. My amazing family called to check on me everyday and offered to jump on the next plan to be with me. My friends called, honored my wishes when I said I needed space, and then showed up at my door with a care package of pre-made meals and much needed hugs.

The other realization was that I didn't care about having to use donor eggs. Initially I had to go through a bit of a mourning period before we decided to use donor eggs. It was hard to give up the hope of having a child that was genetically linked to me.

After I got pregnant, however, I didn't once think about it. I was simply overjoyed to be pregnant.

From the moment I found out, in my head and especially in my heart, it was OUR baby.

Finally we've found a next step which I'll write about it in my next post.

Not Viable

 We did not get the news that we were praying for.

On Monday we went in for our ultrasound hoping that our baby's heartbeat had gotten stronger.

Unfortunately, they weren't able to find a heartbeat at all.

Not only was there no heartbeat, but they also said that our pregnancy had regressed.

I think the worst part for me was the devastation that I saw on Chris's face.

He stayed so positive throughout this whole ordeal. In fact he was initially excited when we first saw the ultrasound because he could see the gestational sack and thought the baby was fine. When she told us she couldn't find the heartbeat he looked shocked and then shattered.

After the ultrasound we went upstairs and talked with our fertility doctor. She expressed her condolences and made another appointment for me for next week.

After the ultrasound I stopped the estrogen and progesterone. Now it will be just a wait game. I haven't started bleeding yet and have no idea when it will start.

I took today off work, but am planning to go back tomorrow.

I don't think I can handle sitting around waiting for the miscarriage. Last time it took weeks before it started and lasted about a week.

Although I couldn't seem to stop crying yesterday, today I have been feeling completely numb. 

I want to thank all my amazing friends and family who have been so supportive. I honestly don't know what I would do without you all.

Higher

Wednesday morning, in the middle of working, I finally got the call to let me know the results of my blood work.

At first they simply said they wanted me to continue taking my meds.

When I inquired about my HCG levels the nurse told me that they had raised again. With further inquiry I found out they rose to 2139.

When I asked whether those numbers were o.k., she responded that they were rising well, but that we would know more after my ultrasound.

So here I remain in limbo.

I have an appointment with my family doctor tomorrow to let him know what is happening. (The Regional Fertility Clinic advised me to make the appointment.)

Again I am trying to remain positive and will just have to wait to see what happens next Thursday.

So again, I am asking for your thoughts and prayers.

No News

This morning I woke up early to get to the Lab Services before they opened. The clinic opens at 6:30 and I arrived around ten after six. Imagine my surprise when there was actually 11 people in front of me waiting!

Luckily I did get finished in enough time to get to work on time.

I kept my phone with me all afternoon (something I never do), but unfortunately I didn't hear anything from the Regional Fertility Clinic.

When they gave me the results last Friday, the nurse on the phone did mention that I would have the blood work taken today and then get the results tomorrow. I was, of course, hoping that I would find out this afternoon.

I'm now hoping that I will find out first thing tomorrow morning before I go to work. I have to work to until around 8;30 p.m. tomorrow so I hope it is good news. I can't imagine how I'll get through the day if it is bad!

Still rising

On Friday morning I went again to have my blood work taken.

My wait was much longer than it was on Tuesday. Of course, the longer I waited the more my nerves started kicking in.

The woman who took my blood commented on the fact that I had been there the other day and asked if I had to return again.

I filled her in on what was happening and she kindly told me that it was a good sign that they were rising.

After the blood work I went home and tried to keep myself occupied while waiting to see if I was going to hear the results.

By 3:00 I felt like a cat on a hot tin roof!

When I finally got the phone call it was mixed news yet again...

My levels rose. This time to 717  YAY!!!

It is great news that they are going up, unfortunately they are still slightly lower than they would like. BOO!!!

So yet again I need to go for blood work. They've asked me to go again on Tuesday.

The nurse did tell me to make an appointment with my family doctor and to let him know that I am pregnant. She also booked an ultrasound appointment for me on March 30.

I'm thinking (hoping) that it is positive that they got me to make an appointment with my doctor. The nurse also mentioned that they are really picky about the HSG levels at the clinic.

So here I am in lingo once again with my fingers crossed and asking for still more prayers.

IVF and Ectopic Pregnancy

My cousin Candace, like me, didn't understand how it was even possible to have an ectopic pregnancy when you have IVF.

I thought if they are putting the fertilized eggs directly into my uterus how could they end up in my fallopian tubes since they are not even traveling through them?

So I did a google search and here is what I found out:

"Fertility specialists believe that ectopic pregnancy may occur if, when the embryos are transferred to the womb, they are placed too high in the womb cavity. The embryos then have a greater chance of "wandering" and implanting themselves in places where they are not supposed to be, such as the fallopian tubes. Embryos could also make their way into the fallopian tubes if they are injected into the womb with too much force."            -Women's Health

The rates for an ectopic pregnancy are slightly higher with IVF, but to put it into perspective it is only a 2 - 5% risk. In a natural pregnancy it is a 1 -2 % risk.

While researching I also found out that ectopic pregnancies can take place when the embryo implants in the cervix, an ovary or even in the abdomen. The reason why we typically hear about them implanting in the fallopian tubes is that it is more common, and also because it can be very dangerous and even life-threatening for the mother.

Symptoms of an ectopic pregnancy are:

Light vaginal bleeding
Nausea and vomiting with pain
Lower abdominal pain
Sharp abdominal cramps
Pain on one side of your body
Dizziness or weakness
Pain in your shoulder, neck, or rectum

If you are pregnant and experience any of these symptoms you should immediately seek medical help.

*p.s. I'm trying to remain positive. I'm still praying and hoping that this pregnancy will be successful!

Still Hope

This morning I went to have my blood work taken.

I waited until 8:00 as I was hoping to miss all the people who were having to fast. My strategy worked as I didn't have to wait long.

I asked the lady who took my blood how long it would take for the results to come in and she told me that it depended on the test being taken. She went on to say that it would probably be tomorrow.

When I got home I called the Regional Fertility Clinic to let them know that I went in to have my blood work taken. I also pleaded that if there was any way to get the results of my blood work today that they please call me as soon as possible.

Around 12:00 I got the phone call from the Regional Fertility Clinic. When I saw their number I hesitated for a second because I didn't know whether I wanted to know or not.

Thankfully the news was good... kind of.

My HSG levels have risen!

They are now at 268. (Typically at 4 1/2 weeks they are between 270-1100.)

As they are still a little low, they are sending me for blood work again Friday. Depending on the results we will hopefully know more. The nurse mentioned that they may also send me for an early ultrasound to make sure that it isn't an ectopic pregnancy.

"Ectopic pregnancy, also known as eccyesis or tubal pregnancy, is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding." - Wikipedia

I am hoping and praying that they are just slow to raise and that this is still a viable pregnancy.

So yet again I am asking for your prayers... they worked last time!

Mixed Emotions

For all my complaining about the 2 week wait... I am now terrified for it to be over.

Tomorrow I go for my blood work and will finally find out the results on Monday.

Right now I have the possibility of being pregnant. If I find out that it is negative on Monday I loose that hope... that possibility.
  
As I mentioned previously I have been experiencing mixed symptoms which are most likely side effects from the Medrol (estrogen) and Crinone (progesterone). 

The one side effect that causes me the most fear is the back pain. I have been trying to reassure myself by looking up early pregnancy symptoms. (Like I've done a million times before!)

Lower back pain can be a symptom of pregnancy, but it also is the symptom I always experience a week before I start my period. The one silver lining is that I was experiencing some lower back pain before I even had the transfer so I'm wondering if it is simply a side effect of my adenomyosis. 

For now all I can do is hope and pray. 
 

Over 1/2 Way There

I'm just a little over half way through the two week wait.

Every single day I struggle to stay positive and not obsess!

I was feeling really discouraged when we didn't get any fertilized eggs to the blastocyst stage and thereby get frozen.

I felt somewhat comforted when searching online and finding out that typically only half of a women's eggs are viable, not all eggs will fertilize,  and typically less than half of those eggs make it to a blastocyst.

To be honest I don't know how accurate these stats are, but they did make me feel better.

In the past week I have experienced:

bloating, nausea, breast tenderness, lower back pain, and twinges in my uterus

Of course all of these symptoms can be for pregnancy or PMS... AND they all can be side effects of the estrogen and progesterone that they have me on.

So I won't really know anything until I have the blood work done and get the phone call from the Regional Fertility Clinic confirming either way.

In the meantime I am continuing to be hopeful and pray that we will finally get pregnant.

Eggs in a Basket

This morning I received a phone call from the Regional Fertility Clinic to let me know that none of our remaining eggs make it to the blastocyst stage. Which means:

All of our eggs are in one basket or in this case my uterus!

Although it wasn't a huge surprise it was devastating to hear. We were really hoping that we would get at least one more fertilized egg that could be frozen.

Of course my biggest fear is that there is something wrong with the eggs that were transferred and that they may have stopped growing and developing.

Unfortunately,  I have absolutely no way of knowing. I won't find out if I am pregnant for another 12 days. If I don't become pregnant I won't know if it was a problem with our eggs or if they were fine, but just didn't implant.

As I've mentioned before the two week wait is the hardest part!

I'm trying to remain positive, but I have to be honest it is really hard.

What's Happening

Now that the egg transfer procedure is done the hardest part of the entire process has begun...

The two week wait!

Up until now I have been busy taking a variety of pills, gels and a nasal spray that had to be administered 5 times a day.

In short, I didn't really have time to obsess... now I am quickly making up for lost time.

For three days before having the transfer we were receiving a daily update on how our eggs were doing. Now I have no idea how they are doing or even if they are still developing.

As it is pretty much all I can think about, I have been researching what should be happening.

As I had a three day transfer our fertilized eggs still need to develop and turn into a blastocyst (what it is called when it is made up of around 150 cells).

By about 4 days after the transfer (Tuesday or Wednesday) the blastocyst will break out of its 'shell' and hopefully implant into my uterus. Some women will experience some cramping and spotting, however, last time I didn't experience anything.

So unfortunately there is no real way of knowing until I have the blood test on March 12 which is...

two very long weeks away!

The Procedure

Chris and I arrived at the Regional Fertility Clinic for 12:00 yesterday.

I was feeling anxious, but Chris did a great job calming me down and even managed to make me laugh. On the drive there he made up a variety of 'imagine if' scenarios and even started chanting "Triplets, Triplets, Triplets!"

It was completely ridiculous, but it worked!

A few minutes after arriving we were called back, asked to verify our names and given gowns and booties to put on... including Chris.

Then we were brought into the procedural room and again were asked to verify our names, as well as identify our names on the petri dish which contained our embryos.

The embryologist who has been monitoring our eggs then informed us of some good news:

One of our 6 celled embryos had become a 7 celled embryo!

This means there is still hope for that little guy. Our doctor then decided to implant just two of the embryos- the one 8 celled and the now 7 celled embryo.

So now we don't have to worry about triplets... not that I was really concerned.

The transfer procedure itself was very similar to an IUI procedure except this time the doctor used an ultrasound to visually place our embryos into my uterus.

Similar to receiving a pap smear, my legs were put into stirrups, a speculum was inserted, and then a catheter was inserted into my uterus. Once she got the catheter into place our embryos were put into a syringe and then released into my uterus. Other than being a little uncomfortable it was completely painless.

The really amazing thing though was that we were able to watch all this take place on the ultrasound monitor. Although the embryos are too small to see, we were able to clearly see the air bubble that they were inside.

They then checked to make sure that the embryos were in the air bubble and not stuck somewhere in the syringe. Once that was verified they left me to relax on the bed for a few minutes.

Before leaving, Chris and I were given a photo of our two embryos. Chris also took a picture of the monitor which showed our embryos (or rather the air bubble) in my uterus.

Imagine how cool it would be if we do become pregnant and these turn out to be our first official baby photos!

It is so surreal to think I have two embryos floating around inside of my uterus. I know that there is a chance that they will not continue to grow or that they don't end up implanting, however, I am trying to remain cautiously optimistic.

*They will continue monitoring our other embryos for four days and if they make it to the blastocyst stage they will freeze them for possible future attempts.

Day 3 Transfer

Just after six o'clock this morning I received a phone call from the Regional Fertility Clinic. As soon as I saw who it was I jumped out of bed realizing if they were phoning that early it probably wasn't the best news.

It wasn't.

Only one of our fertilized eggs have made it to 8 cells. (Each day after fertilization the cells are expected to double.)

We have one 8 cell, two 6 cell and two 5 cell embryos...

So they want me to come in at noon today to have my transfer.

She asked me if I would be comfortable with transferring three... The one 8 cell and the two 6 cell embryos. I said yes, but she then informed me that the decision will ultimately be that of the doctor who will be performing the transfer.

So after a good cry with my mom over the phone, I've taken a few big deep breaths and am now prepping for the transfer. Which means:

At 11:00 I need to 'void' my bladder and then drink two-three glasses of water so that I will have a full bladder.

I was also asked not to wear any perfumes or use strong smelling bathing products.

So if you are reading this I'm asking for your prayers and best wishes.

p.s. The other two 5 cell embryos will be monitored to see if somehow they continue to grow, although it doesn't look good and she told me that they don't anticipate being able to freeze them.

Still Developing

This morning I received another update from the Regional Fertility Clinic. 

The technician told me that our 5 fertilized eggs were developing and growing. She explained that they are hoping to have the transfer on Monday, however, it will depend on how our eggs are doing.

If they are not developing as they would like they will do the transfer tomorrow.

After doing some research online I found out that there is some evidence that a 5 day egg transfer is more successful than a 3 day transfer.

By day 5, the healthy fertilized eggs should form a blastocyst. However, if they are not developing as much as they like by day 3 they will still try transferring them as there is some evidence that some eggs will not fully develop outside of the womb.

They will call me tomorrow morning to let me know how they are looking and when the transfer will occur.

Thawed Eggs

Yesterday morning Chris went into the Regional Fertility Clinic in order to provide a sample of his sperm.

They then thawed our eggs and used a process called ICSI to inject one of his sperm directly into each of the eggs.

This morning I received a phone call to update me on how everything was going so far.

I was excited to find out that all 6 eggs thawed successfully and that
5 of them are fertilized!

They will continue assessing these fertilized eggs and if all goes well we will be doing the embryo transfer either Saturday or Monday.

They will call me again tomorrow morning to let me know how our eggs are developing... fingers crossed that our embryos continue to divide and grow!

I will update again tomorrow with whatever I find out.

Getting Ready... Again

In order to prepare for this donor egg round there was several things I needed to do first.

Of course there were the usual blood tests that I needed to have done. Those were to check my hormone levels of which I was told looked 'good'.

I also had to have another sonohysterogram.

To say that I was beyond scared to have this one would be an understatement.

Thankfully this time it was a completely different story. I can't believe that I'm saying this, especially after all the pain I experienced last time, but it really wasn't that bad!

The technician and doctor told me that my uterus looked 'normal' and they would verify with my doctor that I was ok to go ahead with this round.

When I asked about my uterine fibroids they said they didn't see any... they mentioned it looked like I may have adenomyosis, but otherwise my uterus looked good.  I guess fibroids really can disappear?

Once I was given the all clear I had to wait to start my period so they could put me on the pill. Although this seems contradictory they do this to regulate my period and have a clear timeline.

After a month on the pill and another period, I then had to start taking Suprefact nasal spray 5 times a day. The Suprefact stops my body from producing my own hormones. I also started taking one lose dose Aspirin and prenatal vitamin a day.

Then 17 days later I started taking 2 Estrace pills twice a day. The Estrace is a form of estrogen that I need to take to build up my uterus lining.

On the 17th I will go in to have an ultrasound to check my lining. If everything looks good we may be having the transfer on the 24 or 26.

I have some other medications that I will need to take, but I haven't been given the timeline for them.

I'll update again when I have more information.

Its not cheap!

You may be curious to just how much it costs. I thought I would break it down as much as I could.

The costs of course vary for different clinics, but I would imagine that they would be similar- at least throughout Canada.

Although, the cost are ridiculously expensive, because we are doing a frozen donor egg cycle, it is significantly less expensive then a fresh donor cycle. (It is also the only option that we have.)

Registration Fee-                                    $825.00   

Vitrified Egg Donor IVF Cycle-            $5750.00
Donor Eggs                                            $11000.00 (US Dollars)
Shipping of Eggs                                   $1030.00
Mock Cycle                                           $250.00 (didn't need to do this)
Drug Costs                                             $500.00 to $2400.00
Embryo Cryopreservation                      $925.00
Thawing & Replacing frozen embryos  $1280.0

Who ever said having a baby isn't cheap wasn't exaggerating! But it will be worth it!

At this time I don't know the exact costs as I'm not sure how much the drugs are going to cost me. I am really fortunate to have really good coverage through my work.

*All the prices are in Canadian dollars except of course the donor eggs which is American dollars.

Egg Donation

Egg donation... I've had a lot of people asking me what it even means.

Egg donation is when a woman donates her eggs to a woman who is unable to conceive using her own. The donor eggs are then inseminated with the husband's sperm (or from the sperm of a donor). The fertilized eggs are then implanted via IVF into the woman's womb.

So this means:

Genetically the child will be Chris's, but genetically the child will not be mine.

I will, however, be able to carry, give birth and nurse this child.

By law, I will be considered the child's biological mother- as I am the one who will carry and give birth to him or her.

And the best part, if it's successful, we could become pregnant next month! We wouldn't have to wait three or four years, but hopefully only 10 months!

In Canada it is illegal to purchase eggs from a woman, however, somehow it is legal to purchase them from a woman in the United States???

I believe the get around it by the fact that we actually purchase the eggs from the clinic.

The Regional Fertility Program here in Calgary collaborates with  My Egg Bank in the United States. The eggs are frozen and transported to the clinic here where they remain frozen until the time for them to be fertilized.

We purchase 6 eggs from one single donor. It costs $11 000 US dollar for the 6 eggs.

The survival rate of the eggs is over 90%, and the Egg Bank guarantees at least 4 eggs. However, if only 3 eggs survive and we get pregnant with one of them it is still considered a success.

The success rates for an IVF with donor eggs is around 66%.

Beating a Dead Horse

Beat a Dead Horse- to waste time doing something that has already been attempted.

-Cambridge Dictionary of American Idioms 

 As I mentioned in my last post there are several different options that I researched in trying to figure out what would be the best next step for Chris and I to take.  

One of the options would be for us to continue trying IUI rounds with the hopes of getting enough eggs to be able to switch to IVF. The problem with this is that each round costs around $3000 and each time we have tried I have only gotten between 3 or 4 follicles.

I have been put onto the maximum amount of medications that can safely be administered and last attempt we even tried to add DHEA and C0-Q10.

When I talked with my doctor after our last failed cycle she did have some good news. Although I didn't produce very many egg follicles my body did produce a thick lining and my hormone levels were good. Unfortunately, she did conclude that it didn't seem as though my body is going to produce enough eggs to make IVF viable.

Weighing all the information we made the difficult decision to not try IUI / IVF again. Perhaps if we had unlimited money we would keep trying, but honestly even then I don't know if we would. We have been trying for almost 2 years and we haven't gotten any closer to success.

 

Research

After our last let down I have spent hours and hours researching all the different options that are still available for us.

I wish I had know / had more information about some of these options earlier, although maybe I've needed to go through all these stages in order to get to the place I am now.

Hopefully this information will help someone else who is just starting out on this journey. Maybe it will help them to make some decisions and perhaps save them some time!

Option 1- Continue trying IUI / IVF

Option 2- Adoption- both regular and private

Option 3- Embryo Adoption

Option 4- Egg donation

I gathered a lot of information in the past month and to prevent writing a ridiculously long post I have decided to write a separate post for each option. I will also fill you in on which Chris and I finally decided to choose.

I should also mention that there is of course also...

Option 5- Live without Children

But honestly this really isn't an option for us right now as Chris and I are not ready to give up!