Thursday, May 28, 2009

How long does an embryo take to implant into the uterine wall after an ivf transfer?

Post transfer my thoughts have been running wild. Mostly, I'm just trying to understand what is going on in my body and how these bugaboos are doing in there. Right after transfer, the clinic and RE gave me a short do's and don'ts list and sent me on my way. Why didn't someone give me a 5 minute education on embyro development post transfer. What changes would they be going through over the next week or so?

So, 1dpt (1 day post transfer) I got to thinking.......How long does an embryo take to implant into the uterine wall after an ivf transfer?

In case you're curious, here's the snapshot answer:

How long does an embryo take to implant into the uterine wall after an ivf transfer?

1dpt....Blastocyst hatches out of shell on this day
2dpt.. Blastocyst attaches to a site on the uterine lining
3dpt.. Implantation begins, as the blastocyst begins to bury in the lining
4dpt.. Implantation process continues and morula buries deeper in the lining
5dpt.. Morula is completely implanted in the lining and has placentacells & fetal cells
6dpt...Placenta cells begin to secret HCG in the blood
7dpt...More HCG is produced as fetus develops
8dpt...More HCG is produced as fetus develops
9dpt...HCG levels are now high enough to be immediately detected on HPT

FWIW......................for those of you who plan on taking hpt's (home pregnancy test) during your tww, I recommend holding out until at least 9dpt when HCG levels can be detected on HPT.

Source(s):http://www3.fertilethoughts.com/forums/s...

Tuesday, May 26, 2009

Transfer Day-It's a Beautiful Day!

We had the retrieval on the 21st and have spent the last five days waiting to see how the embryos were developing.
Today, we transferred 2 beautiful blasts. I feel very blessed and lucky. I'm really quite shocked how easy the procedure was. All in all it took about 10 minutes and it was pretty painless. Almost like getting a pap smear. I was a little dissapointed that my RE was not the doctor performing the transfer but he wasn't on the schedule.
The embryologist stopped in to chat and I was clear on how badly we were counting on the chance to freeze some of the leftover embryos. He was very nice but still very vague on the prospects of having embryos make it to freeze. This part of the process is tough. Apparantly, they have their processes and I have mine! I wanted him to freeze everything that wasn't being transferred immediately; but they don't freeze until Day 6. All I could do was convey how important having frosties is to us.
Gosh I really hope this works...............Beta is June 5th
Cycle Tip: If having frosties is important to you, be aggressive, persistent, and vocal. Voice your concerns regarding frozen embryos. Impress that nothing be destroyed or donated prior to contacting you.

Tuesday, May 19, 2009

May I have a dozen eggs please??

Drumroll please..............retrieval day is Thursday, May 21st! The nurse coordinator called this afternoon with the "official" retr. date. I decided to pass on knowing follicle counts and size. This clinic is very conservative and wouldn't move forward if it was low or looked like a possible bust.

I decided to have faith in my RE and in their process. It doesn't matter what the count is at this point....it is what it is. I didn't want to get my hopes up by getting a high follie count to have a lower number at retrieval. For me, it's better to wait to see how many eggs are retrieved. Then, how many fertilize.

I'm over the moon. I can't believe I've made it this far. But then again, I 've never let anything get in the way of finding my bliss.

Thursday, May 14, 2009

What if we get cancelled too?

During this process I found a “cycle buddy”. For the purposes of this blog and securing my pal’s anonymity, I will call her Nancy. Her support has been helpful and welcomed. I often find myself excited to read Nancy’s emails finding comfort and humor in her stories. However, Tuesday’s email sent a chill up my spine and forced my eyes to well with tears. I couldn’t believe it. After receiving her second follicle report, Nancy’s cycle had been CANCELLED. After months of donor testing, Lupron shots, and Estrace pills, and the mental highs and lows, she had to stop and start all over again. Nancy’s donor wasn’t producing enough follicles to continue the cycle. The ED was not responding to the Stim meds. For Nancy, anger, disappointment, and depression were the feelings associated with having a cancelled cycle. But, after a weekend of emotional lows, she picked herself up and found some comfort in shopping. (Not that a pair of Manolo’s can heal this heartbreak but it’s a very good band aide ;)

What’s next for Nancy? There’s no explanation why ED didn't have a higher follicle count. The blood work indicated that ED took her meds. Sometimes this happens with first time donors. Nancy and DH asked that the donor try one more time with the hopes that she would have a better response the second try but she hasn't made her decision. If not, they will be re-matched with another donor and start the protocol over again. This process is daunting and it simply hurts sometimes. Cancelled cycles happen all the time and can occur for a number of reasons. It does happen.

Nancy’s experience forced me to be honest with my own feelings. I’ve been very cool and calm so far. Sort of like going with the flow and convincing myself that if this doesn’t happen I’ll be ok with it and just try again. NOT!!! Who am I kidding! The moment I read Nancy’s update I was sad for her. Simply, devastated that she had felt let down. Then, went into a state of panic regarding my own cycle. I was about to receive my ED’s first follicle report. What if we get cancelled too?

Our ED started stimulating meds on Saturday, May 9th. After stimulating for 5 days, we received the first follicle report. ED has 10 follicles that are all still very small. Keep in mind I have no idea if that is good or bad. The RE says it is too early to tell. I don’t know what to think or how to feel. Now, we wait for the next follicle report which will be this Saturday, May 16th.

The reality is, I’m in a state of shock that we even made it this far. I made a promise to myself when I started this that I would be optimistic…cautiously. However, in the back of my mind there's that little voice; belonging to “Lil Ms. C” (little Miss Cancer), always waiting for the other shoe to drop. I’ve been doing my best to muffle her. (“Shut up! Shut up! Shut up!.......not this time”).

I’ve championed many battles. I’ll win this one too. Believe IT!

Monday, May 4, 2009

And The Results are in.....Donor is suppressed!!!!

Getting promoted to Estrace :) Yippee!

Donor went in for monitoring this morning for another suppression check. It's a big day for us. She's suppressed!Starting tomorrow, I start 2mg Estrace 2x a day & estradoil vivelle dot 0.1 mg patches 2x a week Tues and Friday.

The DONOR STARTS STIMULATING MEDS THIS SATURDAY! We're at the homestretch!

Sunday, May 3, 2009

Cycle Delayed 1 week -Today is an important day.

Lupron is a self injected medicine that helps synchronize the donor and the IP's cycle. It also helps prevent premaure ovulation. In my case, I no longer menstruate so synching is not required and I'm on a non-Lurpon protocol. However, my egg donor has been on Lupron since April 13th, which is the official date of our D-IVF cycle. The Lupron helps suppress her ovaries (empty). She had to self-administer these injections for about 2 weeks. After 2 weeks they checked her for suppression.

Unfortunately, she had still not fully suppressed after 2 weeks of Lupron. My RE decided to have ED continue Lupron for another week before starting stim meds. I feel terrible for her. Lupron is known to have side effects like mood swings and nasty headaches. I hope she's not in too much discomfort. I think of her, what she’s going through and this truly amazing gift she’s giving us - hope.

Tomorrow she goes in for another suppression check. It's a big day for us. If she's suppressed it's the best news possible and we move forward to the next phase of the protocol. Donor starts stimulating meds and I start Estrace and Patches!!!!!! Fingers crossed for me PLEASE!!!!!!!

BTW ~ the nurse coordinator is very nice and clear when it comes to my protocol. But when it comes to giving me the 411 on the donor's protocol, not so much. I didn't realize the donor would be on Lupron the entire cycle :/

Cycle Tip: If you're like me, very analytical and need to know what's going on with all parties involved with your cycle, make sure you have your clinic/nurse coordinator outline a "draft" protocol: yours and the donor. It helps keep you on track, make markups on the protocol list when dates/meds change, and makes you mindful of what stage in the process the donor is.

Paid My Clinic $27K without Final Donor Approval

Hurry Up! Now Wait....
After accepting our egg donor, we had 2 days to "hurry up" and make the big fat full payment. Or, the donor would be released back into the donor pool. (If I had a dollar for every time we heard that.....). So, the credit card got the hit for $27,000. Yikes! It was a painful payment but for the opportunity to have a baby; worth every penny.
Cycle Tip: Sounds trivial but, use your credit card and earn some extra miles. Redeem those miles for a gift certificate at Buy Buy Baby or Baby’s R Us!

Following payment, our donor had to complete a series of final tests and blood work for ultimate "Final Approval" to start the cycle. We were required to "hurry up" and pay before she started, but suffered through the waiting process of getting the results of the donor's final panel of testing. Some of these tests included fragile x and other genetic testing like, Cystic Fibrosis (CF) (the most common congenital disease; the child's lungs and intestines and pancreas become clogged with thick mucus; caused by defect in a single gene; no cure is known (from http://wordnetweb.princeton.edu). Since my DH tested positive recessive for (CF), the donor's CF results were critical. For several reasons, the donor and DH cannot both test positive for this: 1. increases chances of having a baby with Cystic Fibrosis and 2: Effectively cancels the cycle.

Why am I telling you this? These tests are extremely important and we almost made a terrible mistake. Because my DH doesn’t have medical insurance, our clinic suggested that we could save some money by signing docs waiving DH’s genetic blood tests for CF. If we did this, we would have never known he was positive, therefore putting our future child at risk for possible CF.


Cycle Tip: If your donor is NOT proven and has no previous genetic testing - your DH, Sperm donor, or partner’s Genetic Testing is Critical. This is not an area to save $$$. After 3 weeks, we received the news: donor was negative for Cystic Fibrosis. Final donor screening came back perfect! Waiting was difficult but an important part of the process.

Please look out for a future post on the importance of genetic testing.

Friday, May 1, 2009

Finding the Golden Egg: 3/16/09

After months of dealing with online dbases and agencies, we decided to ask our clinic about their donor pool/protocols. It’s totally anonymous but we decided to submit our donor wish list anyway. I figured it would take months before they matched us and we could always decline. Two weeks later out clinic’s Donor Coordinator called us with a match! She sounded amazing. She went on and on about how smart she is, her course of study, education, hobbies, family history, physical attributes etc. She also said she was absolutely gorgeous. Now, everyone skirts around this but the truth is I was honest………….we wanted our donor to be very attractive. Yes, educated, well rounded, happy and matching ethnicity (some Italian) were top traits we desired, but VERY ATTRACTIVE was right up there!

We accepted the clinic’s anonymous donor match! In the end, I feel better that I never saw the donor’s picture. For me, I don’t need or want the image in my head. Coming from a control freak, I surprised myself. Now breathe.

The Prequel

Before starting this DE IVF cycle, I encountered some peaks and valleys. Let me start at the beginning.

Acceptance (process sucks but feels good once you get there):

When I was first diagnosed with POF, I was very young. After I had time to grieve the loss of a genetic connection associated with the prospect of mothering future children; I was able to reach acceptance. I asked myself to define the word mother. Many adjectives and responses came to mind. However, the idea of genetics never made the list.

I identified the word “mother” with love, safety, care giver, problem solver, teacher, patience etc…. It was and still is my sincere sentiment that a mother nurtures and loves unconditionally. I was confident that I had the necessary ingredients to be a mother. I wasn’t going to let a few “rotten eggs” stop me.

This self administered exercise made me curious so I decided to see what my good friend Webster had to say about it. Here is the dictionary’s definition of the word “mother”: 1. a female parent. Then, I decided to look up the term parent: 1. a father or a mother.2. a source, origin, or cause. 3. a protector or guardian. There is a mention of biology but it’s last on the list and described as one organism producing another. I met the criteria – even the biology part. How? The reality of this is simple - one human being deciding to create another human being. And whether I was able to use my own eggs, donor egg, or surrogacy; I’m making the decision to produce a child and it doesn’t matter how it happens.

Mock Cycles Suck:

After being diagnosed with POF, I wasn’t quite ready to have children at 30. Several things needed to happen first. However, I did want to know more about DE and if my body would be receptive to the protocol. So the journey began. First, my gynecologist referred me to RMA-NY. There, I got an overnight lesson in everything DE. My RE gave me all the proper blood work (FSH 40 Yikes!), and sonograms. The good new was that my uterus and everything else on the inside looked healthy enough to nurture a baby to term. Then, the RE decided to put me on a mock cycle. (Remember, at this point I’m not ready to TTC just want to see if I respond positively to the protocol). I completed the mock cycle and have one thing to say: Lupron SUCKS! Can you say HEADACHE! OMG! Whatever…I did it and the headaches, wild mood swings, and absolutely gross vaginal progesterone were the worst of it. The good news was that the RE was very happy with my uterine lining and all of my levels. i.e. I responded well.

I’m Still Single. Now What?

Like I said, several things needed to happen first. I was in and out of a relationship that simply wasn’t working and spent some time being single. Always in the front of my mind impressed the desire of having a baby. But I wanted it to be right. So now I had to decide if I was willing to take on this journey alone. It was an agonizing time. I would go back and forth between the concept of single parenting or waiting for Mr. Right. I decided to focus on my work and finishing up my degree. For now, I’ll wait.

Mr. Right is in the 2nd Row 5th Seat:

Working full time and going to school full time at night was hard work. But it was fun; challenging and I met my sweetheart. At first, he was rather annoying. He was the guy popping jokes and finding humor in everything. I was more serious and wanted to get through the daily lesson and hightail it home. However, we talked and studied all the time and grew to become great friends. He definitely had a fan club of “groupies” in class. Once I realized that annoyed me I knew there was something there….…more than friends. Since I was 5 years older than him, I wanted to keep it platonic. That didn’t stop him from trying. He was a persistent SOB and after months and months, I finally agreed to go on a “real” date with him. One entrĂ©e and a bottle of wine later and the rest is history!

Hey Honey…..did I ever tell you about my “rotten eggs”?:

Great! I’m in love with someone who gets me and loves me for me. At least what he knows about me. But will he still love me even with my sh1tty eggs? Will he love me? Will he still want me when he finds out the truth? What will he do when he finds out about my secret? I suffered with these thoughts for months before I decided to finally tell him.

“I love you. Not your “rotten eggs”, that’s what he said. I told him everything. I put it all out there. I revealed my history of cancer and the POF. When I looked up from my water filled eyes I had expected to see him running for the door. Instead, his eyes looked like mine. They were filled with tears. He comforted me and expressed that it would take more than that to get rid of him. He held my face in his hands and simply said………“I love you. Not your “stupid rotten eggs”.

Egg Donor Agencies Suck!

Last summer we started on a quest for the golden egg. That’s right! We were on a mission to find the perfect Egg Donor. Little did we know we had so much to learn about the agency process. Our clinic has a donor pool but it is strictly anonymous (no pics) and verbal profiles from your RE are provided. For us, it was important to see photographs and full profiles of prospective donors. We decided to subscribe to several online agencies and navigate through hundreds of donor pics and profiles. We did agree on a few and found one that was perfect!

We found a local donor through an out of state agency. She was gorgeous, smart, and the ethnicity was a match. The donor accepted the match and the agency contracts and legal docs were sent to us. We were so excited! But one thing that stuck out was the aggressive refund policies. As intended parents, we were not protected financially or emotionally. Basically, if the donor backed out for any reason or didn’t qualify with your clinic; we’d be out the agency fee of $5000 but as a favor to us she would allow us 30 days to select another donor. Gee thanks you money hungry @!#$@. Essentially, you pick the donor, send in the $5K and it is totally NONREFUNDABLE the minute it is cashed.

Selecting a donor is not like picking out an appliance. It’s an important decision and for many of us IP’s, many different factors go into the selection of a donor. Anyway…after marking up the owner’s agency contract and after several questions, the owner called and notified us that the donor decided to do a travel cycle with another couple. Yeah right! We asked too many questions and made it difficult for the owner to make an easy $5k. But she did take our $500 deposit.

After getting over the sting of losing that donor, we continued navigating on line donor databases. The ones I liked he passed on and the ones he liked I didn’t connect with. We fought. It was stupid and dumb. That’s the most intelligent way I could express the dynamic between us. Every time we did agree on a donor, she’d be unavailable when we called or a wait list of 3 people. We tried to negotiate and reason with agency policies but they were all pretty much the same as the charlatan mentioned above. Why? I understand it’s a business, however, if an agency solicits “great qualified donors”, we shouldn’t bare the financial and emotional strain if the match falls through. The costs associated with IVF and D-IVF are already astronomical. We couldn’t afford to lose money with agency BS and our relationship was suffering from donor obsession. Is this ever going to happen? Absolutely!