Beta #2

I am preparing for the worst.  The nurse, on the other hand, was positive when she gave me the number.  In fact, she wanted to go ahead and schedule the 6 1/2 week ultrasound.  But me?  I freaked out.  Beta #1 was 167 at 10d5dt.  Beta #2 taken 96 hours later was 482.  482 at 14dp5dt.  

She assured me that betas do not have to double.  She said doubling makes the math easy.  They just need to increase by 1 1/2 times over the course of 48 hours.  Mine did and are within normal range (she said).  They increased somewhere around the minimum amount, twice.  They doubled in approximately 61-62 hours.

I'm having a really hard time convincing myself that it is okay that they did not at least quadruple in 96 hours.  Every guide I read online states that normal doubling times range from 48-72 hours.  Shouldn't that range be more like 24-72?  Anyway, my betas have always doubled faster than a rate of 48 hours.  Ha, the ones that weren't viable pregnancies.  Maybe I should take this as a good sign.

I guess there are one or two possible reasons they did not double perfectly.  1. There were two embryos for beta #1 and one bailed for beta #2.   2.  I used two different labs for beta #1 and #2.  Different labs may obtain slightly different values?  I don't know about the second possibility.  Different labs have discrepancies in values for other tests so maybe for hcg as well?  I've used different labs in the past though.

I asked for a third beta and now I am terrified.   Beta #3 will be on Wednesday.  Like I said, I am preparing for the worst.  I want to trust the nurse, I want to believe everything is okay.  I know my numbers fall within normal ranges.  I just want flying colors.  I want my results without a doubt.  I just want things to work out this time.  I'm holding out as much hope as I can.

BETA BETA BETA!

I feel like I've been waiting forever for my first beta date to arrive.  Beta results always seem to bring both reassurance and fear.  I already knew I was chemically pregnant.  The lines on my hpts continued to darken.  Quantifying that line is reassuring but nothing will really reassure me until the ultrasound.

The RE was the one who actually called to give me the results.   This was a first and something I am trying not to read into, as usually it is a nurse who calls with results.  It probably means nothing, just unusual.  He said I have a nice, good number.  167 at 10dp5dt (compared to 124 at 9dp5dt IVF#1 and 67 at 9dp6dFET, both of which doubled appropriately).  He said he had a good feeling about this one.  I hope he is right.  So far so good, but it is early.

48 hours from beta #1 will be Saturday.  Even though my local clinic does blood draws on Saturday, I'm not sure when my clinic would actually get the results and when I would get the call, so I'm going to wait until Monday for beta #2.  That actually sounds better to me than 48 hours.  For some reason waiting longer in between betas makes me feel like I will be getting more accurate results.  Doubling seems too easy in 48 hours.  Let's see if this pregnancy is still on track after 96 hours.  More reassurance.  Less days of fear in between beta #2 and the ultrasound.

October ICLW

Happy Comment Week week to the ALI community.  Thanks for stopping by.  I've received some incredible support recently as I've been up and down through a hectic IVF #2.  The good news is that I got a BFP this week.  The scary news is that I've been here before and it never works out.  My beta isn't until Thursday (10dp5dt) but I am determined to spend this week blissfully and chemically pregnant until something tells me otherwise.

I took an hpt again this morning and the line is darker still.  I compared it to my 6dp6dFET BFP and to my 7dp5dt BFP from IVF #1 and it is quite a bit darker than both.  I know it doesn't mean anything but it still gives me a huge boost of confidence that this pregnancy could be for real.

I'm going to keep up with symptoms this time: 

5dp5dt:  Queasy working in the garden and queasy hot flushes in the car.  Nap at 3:00.  Beginning sensations of sore nipples and breasts.  Thirsty. 

6dp5dt:  Not the same symptoms today.  Chapped lips.  Headache this morning.  No breast tenderness.  Twinges and full bloated feeling.  Twinges when I sit down or move suddenly.

Stay tuned...
 

5dp5dt

Last night I told F that waking up today would be like trick-or-treating (The grimm way, the way Charlie Brown goes trick-or-treating.  "I got a rock.")  We would either see that we (I) got tricked by the hcg trigger or that we do indeed have a BFP.

The line is darker.  A good line for 5dp5dt I have to say.

I can't help but be excited.  F can't get excited yet.  He just can't.

A Post About Symptoms

I don't usually do symptoms on my blog.  I don't trust them.  But the more cycles I accumulate, the more I learn about what certain symptoms might mean.  The more days past transfer I wait, the more I wish I had recorded the symptoms from previous cycles to refer back to.

I don't remember when I started feeling side effects from Progesterone alone during past cycles.  I've been taking Endometrin suppositories 3 times a day for a week now.  I know that Progesterone causes fatigue, sore breasts, nausea, constipation and other pregnancy symptoms.  Until yesterday I didn't have ANY, not even the slightest bit, of those symptoms.  Yesterday I started feeling the slightest twinge of those symptoms.  Only the slightest, mind you.

The following is a list of symptoms I have experienced after IVF #1, when I was pregnant, and after FET #1, when I was also pregnant.

Insatiable Thirst.  I know that insatiable thirst is a definite symptom of pregnancy for me.  With my FET I was so thirsty, as early as 3 days past my transfer.  Do I have that this time?  No, not really.  Last night my mouth felt dry, not like thirst, but like I needed something liquid, or a particular tasting beverage, that I just didn't have in house.  So I drank a ton of water.

Sore Breasts.  Progesterone is often the culprit for sore breasts.  But for me, in early pregnancy, the nipple area is always involved.  A stinging, tingling, on fire sensation that comes from the deep center of my breast, rather than the sides which is usually progesterone soreness.  Do I have that this time?  No, not really.  This morning I felt a little of that central soreness but my breasts feel pretty floppy and small.

Stuffy nose.  I've heard women talk about this a lot and I experienced it too.  I do have a stuffy feeling this time, or I did yesterday.  But with it also an achy feeling like I was getting sick.  The night of 2dp5dt, my throat felt scratchy and I felt run down like I was getting sick.  I was able to sleep in on Thursday so I either kicked it with sleep or it was a pregnancy symptom.  The next morning I was a little stuffy but by the end of the day it had cleared.  I did still have a rundown feeling last night.  In fact, I watched Project Runway in bed.

Fatigue.  Another symptom of progesterone.  I'm not so much tired as I am run down.  The last two weeks have been stressful. Again, am I feeling run down because I am fighting a cold or am i feeling run down because I am pregnant?  I feel better today anyway.

Low abdominal bloating.    For me pregnancy bloat feels different from PMS bloat.  I know what pregnant feels like.  And I don't have that puffy feeling in my lower abdomen this time.  It should be there from transfer and not go away.  I don't feel like the embryos are implanting and nestling in.    The times I have been pregnant, I knew because of the puffy feeling, because of how my lower abdomen looked.  I, maybe, have a little puffiness, but I think it's deflating each day.

Constipation.  I always get constipated very early on when I'm taking progesterone.    I may be a little constipated, but not like the last transfers.  I'm not sending F out to buy any prune juice this time.

Crying.  This could be attributed to all the hormones from IVF, but every time I have been pregnant I cry all. the. time.  I am a wreck with emotion.  I did cry for much of my 3 hour drive home 2 days past transfer, but nothing since.  I am not a wreck.  I did laugh until I cried at a commercial last night.  F looked at me like I was insane.  It was a MacDonald's commercial of all things.

Frequent Urination.  Nada.  No getting up in the middle of the night to pee.  No discomfort when my bladder feels full.

Hot Flashes, Night Sweats and Flushing.  In the first few days after the transfers I would wake up soaked.  I would get hot flashes during the day.  My face would get flush at night.  Last night I did have a flushing after cooking dinner.  It usually reddens the bridge of my nose and my cheeks making my face hot.

Wooziness and Dizziness.  Possibly from progesterone as progesterone can cause nausea.  I usually experience it when I am out walking or after I get out of the shower.  This goes with feeling run down this time.  This morning I did feel hot and woozy after I got out of the shower.


Symptoms aren't looking as good this round.  Yes, I have a few, but not enough to convince me that I am pregnant.   I was so sure I was pregnant with my FET that I tested 4 days past the transfer and got the faintest of lines.  I knew 4 days past the transfer.  Today I am 4dp5dt and I know nothing. 


................UPDATE:  4 HOURS LATER......................

I went to the store this morning, just normal shopping, etc, and decided to go ahead and buy a box of FRERs before the weekend, when there is a very good chance that no matter what time you do your shopping you will run into someone you know, or one of F's students.  So I bought a box of FRERs.  I came home.  Tried to hide the box until at least Sunday.  But I just couldn't resist.  I am so weak.  I tested.  And it is positive.  Hold On.

My worry?  It has only been 11 days since the trigger.   From what I have read online, it takes about 10 days for the hcg to leave your system, about 1,000 iu a day.  If I took 10,000 iu on the night of Oct 8, then it should have been out of my system yesterday.  One day ago.  That's too close to bet on.

I could be pregnant!  I can't stand it!  I'll have to retest tomorrow to see if the line gets lighter (trigger) or darker (pregnant).

3dp5dt

Yesterday on my long commute back home I would spontaneously find myself in tears.   Sometimes not even thinking of anything in particular.  Other times having a full on sobbing reaction to songs such as Gillian Welch's "Orphan Girl," especially the lines, ....No sister, no brother..., and to the comedy set by Tig Notaro in which she talks about being diagnosed with cancer.  The closer I got to home the more I would tear up.  I think because the wait to see if this worked was really just beginning.

It felt good to cry.  I realized that I haven't really cried this cycle, even though it was the most emotional and stressful cycle yet.  I wish I could have a do over because I feel like I could do better, given the chance.

But there is no do over and we are one cycle short of THE END.  I really am devastated that we had nothing to freeze.  I don't see having something to freeze as a "bonus."  I see it as an indication that IVF is working well for you.  This cycle did not go very well.  Not my response, not my interactions with my RE, not the timing, not my embryos.

My levels of hope and optimism are low.  Given the progression of the cycle, I don't expect this to work.  I feel like it HAS to work, but I don't think it will.  I'm working on my attitude.  Give me a chance to relax and maybe I will find myself in a better place.

My first task of cheering up and finding hope?  Putting the photo of our embryos on the fridge.  It does help a little.


I had to move my beta back one day due to a schedule conflict (the bad timing continues! I should call this cycle the Monday-Wednesday curse), so it will be next Thursday, at 10dp5dt.  That's okay with me.  I always pee on a stick before the blood draw anyway.

IVF #2: Transfer (after all)

We got the call from the embryologist on Monday morning. 

As of this morning you have three embryos still growing.  
 I held up three fingers for F to see and motioned to him in a way that meant, are we still proceeding with the cut-off plan? 
From what I see here of your instructions it looks like we will be doing a transfer today?
F whispered, transfer, and I confirmed with the embryologist that yes, we would be doing a transfer.

When I hung up the phone my first thought was, wait, what did she mean by three embryos still growing?  She didn't say 3 blasts, or 3 perfect embryos, or two perfect embryos and one slightly behind, she said 3 embryos still growing.

We would find out right before the transfer that we had one expanded blast, one early blast and one still in the morula stage (growing a day behind).  We transferred the expanded blast and the early blast and would wait to see if the morula caught up to qualify for vitrification.  This morning I got the call that the morula stopped growing.  We have nothing to freeze.

I don't think the blasts looked particularly great either.  I know that doesn't mean they are doomed by any means.  We all know how my "perfect" looking blasts turned out. 

Before I knew the fate of our morula, I think I felt more relief than disappointment that we were doing a transfer instead of biopsies that day.  I can't quite identify why I feel ambivalent toward Genetic Screening for our embryos.  Maybe I needed to try one more time before going that route, maybe I don't want to know the results, I'm not sure.  I do know that F wanted to be able to biopsy a good number of embryos.  I wanted to at least have one to freeze. 

I was already in transfer mode before we got the news anyway.  I was planning my week as if it were prefaced by a transfer.  And here I am, typing in bed, hoping, hoping that this is the one. 

I want to say this has to be the one. 

IVF #2: Fertilization Report

We started with 14 eggs yesterday.  Well, actually, on Monday, we started with 9 follicles over 10mm and a few smaller ones that probably wouldn't catch up to produce mature eggs, even if they were aspirated at retrieval.  Okay.  14 eggs at retrieval.  Not sure how many were mature.  Today we have 8 that fertilized.

14 eggs --> 8 fertilized --> how many day five blasts???

We won't get an update or know if we will proceed with CCS or a transfer until Monday morning.

Visualize a number greater than or equal to FOUR.

IVF # 2: Egg Retrieval

I'm feeling good.  The retrieval process went well.  I think today was one of the first days in this entire cycle that I didn't feel stressed out or rushed.  I got to sleep in the same bed with my husband last night for the first time in over two weeks.  He brought our dog up for the retrieval so I got to snuggle her as well.  I drank water until the midnight cutoff.  I ate a chocolate bar at 11:30 pm.  Like last time, F and I made bets on the number of eggs we would retrieve today.  Basing my guess on the number of follicles I had on Sunday, I chose 9.  F chose ten.  This morning when I woke up I wanted to change the number to 12 for some reason.  F wouldn't let me make any changes to my number.  If he had, I would have won.

BECAUSE WE GOT FOURTEEN MUTHAF@#KIN EGGS!!!

I think that's a pretty awesome start.

The embryologist should call tomorrow morning with the fertilization report.  After that we won't get any updates about our embryos until the morning of the possible transfer.

I say "possible transfer."  I noticed on the forms I signed this morning that Embryology is saying, "possible freeze all."  It would seem to them that my glass is half empty.

Red Carded

When a change in procedure is made before retrieval, my clinic uses a red form to alert the embryologist that a change has been made.  I filled one of these out with the nurse coordinator after my monitoring appointment yesterday even though I told her that the information MUST be in my chart because I've been telling my team all about our embryo number plan for CCS since we turned in our paperwork.  I'm pretty sure F and I even wrote our stipulations on the consent forms we gave them.  Yet somehow,  my RE says that he did not know of our wishes until yesterday when he saw the red card on my chart.

I feel like I've been red carded.  My RE called me today to tell me that if he had known of our cut-off number we would have had this discussion earlier.  And to explain (in a tone that sounded a bit too scolding) that based on my follicle count, we probably won't be doing CCS, but a fresh transfer. 

Oh, so many things.  So much biting of the tongue.  And blinking back tears.

I fucking know that already you smug asshole.

We asked about having a cutoff number at our WTF consultation with him.  We specifically asked about the benefits, in terms of cost and success, of testing four embryos versus transferring two fresh and freezing two for later.  We talked about an embryo cutoff number with the genetic counselor.  I told him about our embryo cut off number at my hysteroscopy post-op appointment.  I explained our logic in that choice.  I asked him about thawing the frozen blast we have for biopsy and the chances of it surviving re-freeze and re-thaw.  I've been reviewing with at least two different nurses instructions on how we will prepare for a transfer in case we don't meet our cutoff number.  I don't understand why this is suddenly a red card situation.  And why I am being made to feel like a naive patient who thinks she's stimulating so well that she's gonna get more than 4 embryos out of nine follicles.  I know this is going to be a close call.

And FINALLY I get a clear, intelligent answer about how my cycle is progressing!  I have 9 follicles greater than 10mm.  With IVF #1, at trigger I had 10 follicles greater than 10mm.  I am responding to stimulation in an average, normal way, not great, but not poorly.  I just can't expect to have more than 5 blasts on day 5, it could happen, but statistically it won't.

Thank you for actually giving me useful and specific information about my cycle!  But I do have to explain, AGAIN, that our cutoff includes the frozen blast.  Five embryos including the frozen blast.

If he has an issue with our cutoff number then he needs to convince us why we should do CCS with only 2-3 embryos.  Is this why he called?  Or did he call because he thinks we are delusional about the number of embryos we will produce this cycle and wanted to set us straight?  Based on the conversation we had, I think it is the latter. 

IVF #2: Day 11

I am such a wreck!  The timing for IVF #2 has been a nightmare in terms of my work schedule and load.   Cancellations, rescheduling meetings, missing meetings, delaying projects, showing up unprepared; wow, I really suck at my job right now.  I live in one city, work part of the week in another city and travel for IVF to yet another city.  I haven't been able to go home since September 23rd.  My monitoring appointments have been on the worst days possible for my schedule.  For the past week on Mondays and Wednesdays I have had to leave by 6am to make my monitoring appointment, rush out of my appointment and drive 70 miles an hour for two hours only to be late.  This morning I gave the completely WRONG set of instructions to a class of university students.  But that's okay because I will just have to cancel lectures on Wednesday for the retrieval AND next Monday for the (possible) transfer.  And I'm talking about a Monday/Wednesday class here.   I don't know what to tell them at this point.  Certainly not that I am in the midst of IVF.  I think for Wednesday I will just send out an email explaining that I am having a medical procedure and will be out through Monday, with instructions for coursework.  That sounds reasonable.

Whew.  I need to put my legs up the wall and take some deep breaths.  This stress can't be good for my eggs.

Speaking of:

Follicle Count:  10 on the left.  That's just the total.  I think we're really only working with 5-7 between 14mm and 20mm.  The right has just been lackluster this cycle.  There were 3 follicles between 10 and 19mm.  One sad little bubble only measured 5mm.

As for totals for retrieval--maybe ten at the most?  I know what size they should be at trigger but not how small is too small.  Is 14mm too small to expect a mature egg?   Blah.  I'll find out soon enough.

E2: 2,285
P4: 0.5
LH: 0.29

I shoot my last dose of meds tonight and then I trigger at exactly 10:15 for a Wednesday retrieval. 

RE wants to have a chat about our embryo number plan for CCS tomorrow.  I wonder what that's all about. 

IVF #2: Day 10

I really thought (hoped) I would be triggering tonight.  Instead, I'll be continuing with my 300 IU of Follistim.   In fact, the nurse gave me a free vial because I was O-U-T.   What's that, like $300?  Thank you, thank you.

I go in tomorrow morning to see if I am ripe for trigger.  Thank you to all my cheerleaders.  I feel like I'm working with the Bad News Bears up in here.

I actually don't know what is going on with the ovaries.  My appointment was so early I had trouble  paying attention to the count after measurements were given for the right: 18, less than 18/maybe 16? and 10.  That's three.  The largest follicle also measured 18 on the left.  I think the smallest measured 7mm.  I heard the NP say something about seven total with five smaller follicles.  I don't know if that means twelve total or seven total or seven contenders and five that are too small.  Probably the latter, but I wasn't in the mood to ask.  I hadn't had my coffee yet.   I was trying not to stress out about the numbers again.  They will change by tomorrow anyway, hopefully in an ascending fashion.

E2 is 2,000 exactly. 
P4 is 0.4
LH is 0.24
Lining is good and hopefully won't matter anyway because we don't want a transfer, we want enough blasts to biopsy for PGD.  We'll see.  I think it's going to be a close call.

IVF #2: Day 8

Calling all Follicles!!

The count is up to nine, maaaybee ten.   The tenth has a way to go as it is only seven something mm.  Far behind the leaders who are sixteen and fourteeners.

I've got six on the Left and four on Ms. Right Ovary.   Way to go Rightie!  I guess she realized that this is IVF, not an IUI, and recruited two more since Day 6 (though one of them is the small seven mm and probably not a contender).  I am definitely starting to feel the left side when I'm on my bike.  And that is with just six.  I can't imagine the sensation hyper-stimulators must feel. 

E2:  1,154
P4: 0.2
LH:  0.77
Lining: 10.2

RE thinks I will be ready to trigger on Sunday or Monday.  I go back in for monitoring on Day 10, bright and early at 7am.  Actually, I don't think it will be bright yet at 7am, just early.

IVF# 2: Day 6

Or, "Don't focus on the numbers."


Dr H measured 8 follicles today.  There were some smaller ones but he didn't think they would grow enough to be contenders.  The leaders are between 10mm and just over 12mm.  My right ovary only had two measurable follicles, one at 12 mm and one at 10mm.  

I'm hoping for quality at this point.  And trying not to put too much emphasis on the numbers.  I do wish Ms. Right Ovary had a little more hustle...  Oh, well.  8 is great.  8 is enough.

Am I hiding my disappointment at all?

Here's the rest:

E2: 660
Progesterone: 0.3
Lining:  5.5

Tomorrow I add in Ganirelix (added when follicles are around 14mm to prevent any LH surge) to my daily injections and continue with 2 vials of Menopur and 300 IU of Follistim.

Stay tuned for the next monitoring report, Friday, Day 8!  Maybe those small straglers will get a move on and we'll have a few more eggs in the race.

IVF #2: Day 4

Today was my first monitoring appointment after starting injections on Friday.  Thankfully my ovaries were visible immediately this time.  My right had about 4 contending follicles measuring 9, 7, 4 and 4.   The left ovary was about the same in terms of follicle size but the NP counted 6 or so.  I think we are looking at 12-13 including the small follies that weren't measured.   Even so, I have a feeling the final numbers will be similar to IVF #1, where 10 eggs were retrieved.

On Day 4 of IVF #1, I had 11 follicles all under 10 mm with an E2 level of 315.

My follies must be smaller this round because my E2 is below 300.  I go back on Day 5, Wednesday, and until then, continue with the same dosage: 2 vials of Menopur and 300IU of Follistim.

Grow follies, grow!  Uniformly, that is, all together now.