Thursday, December 12, 2013

Preparing to transfer our one miracle embryo...


Following the epic failure of our IVF cycle that resulted in having only one embryo to freeze, we had a sit-down with Dr. N. She said she and everyone in the office was so upset about what had happened. She also agreed that it made the most sense to move on to the transfer of the embryo next month, especially since the plan was to only transfer one embryo anyway. (In some cases, 2 embryos are transferred to increase the likelihood of success – in which case it would have made sense to go right into another IVF cycle to try to get more.)

Another thing we of course had to come to terms with is that the embryo could possibly not survive the thawing process. She informed us that the success rate for thawing is 95%. So there is a 5% chance that we will go through all of the prep work for the transfer and our embryo won’t make it. Hard to swallow.

The doc reassured us that the requirements for freezing at RMA are very stringent (even more so than where she worked before) and that our embryo had to be super quality. (As an aside, although this was meant to be comforting, and it was, I can’t help but wonder if we would have had more embryos if we had gone forward with a fresh transfer and the quality requirements hadn’t needed to be so tough. But I try not to dwell on this now since there is really no point in looking back.)

I also asked more about why the cycle had gone so poorly and what the scoop was on the egg quality issue. At this point, it could be one of two things: (1) It was just a bad group of eggs; or (2) My eggs are all of poor quality, which hurts our overall odds of success. If we go on to another round of IVF, we will likely get our answer. She also commented that next time she would probably reduce my meds, even if the cycle takes longer, in hopes of perhaps getting better quality eggs even if there are fewer of them.
She reassured us that the preparation for a frozen embryo transfer was much easier than a fresh IVF – just pills and patches to build up the lining of my uterus. I felt very relieved. However, upon scheduling my baseline scan and going through the discussion about getting my meds ordered, of course another bomb was dropped on us. Three terrifying words: Intramuscular progesterone injections. Yep – the doc had failed to mention that I would have to do these for 2 weeks. I have read horror stories about these shots – that they leave your behind sore and bruised and lumpy. Needless to say, I was pretty pissed. Plus, the nurse seemed to think it was pretty funny to joke with me about how long and huge the needle is. And to top it off, because they are done in the butt muscle, Jared would have to do them!

When my box of meds arrived and I saw the size of the needle, I freaked. I emailed Dr. N right away to see if there were any other options. I was already completely overwhelmed and frustrated. In my head, I was thinking that if I had known about the IM progesterone shots I might not have chosen to allow them to freeze the embryo! She replied that I could certainly opt to just use the Crinone (progesterone) cream instead and that she would just have to get it okayed by the rest of the docs. I felt instantly like a weight had been lifted.
When I arrived at the office for my scan, the nurse was on me right away. She said she saw the docs email and that the rest of the practice wanted to make sure I was aware that studies show better pregnancy rates when the injections are used instead of the cream. UGG. I was so upset and didn’t know what to do. I allowed the nurse to go through the injection teaching with us but had still not made up my mind. I wanted to talk to Dr. N to get her opinion (she was out of the office that day).

Also, at this appointment, we got the official calendar for our cycle. It was 2 weeks of estrogen pills, with a scan and blood work once a week (patches were no longer being used). In the third week, progesterone gets added (thankfully I had some time to make my decision on the shots). Our transfer was to be December 8 and our pregnancy test on the 17th. I was so happy that everything would be done and we would know by Christmas, and even before the slew of Christmas gatherings began.
Later than day, Dr. N called. She confirmed that the success rates are better with the shots. She suggested that I at least try them and if it’s too awful, we can switch. So, in the end, I decided to buck up and deal. When I told Jared, he was less than enthusiastic. I think he was really liking the idea of not having to give me these shots. But once he realized like I did how much regret we would feel if it didn’t work and we hadn’t done everything we could possible do, he got on board. That night when I got all my meds out on the counter with the calendar and dosages (I have to check off every time I take a dose – I am too afraid I won’t remember if I took something or not!), I got one of the progesterone needles out, unwrapped it, and let it lay there on the counter. I felt that if I could stare it down – look at it every day – that I would be less fearful.

All looked good at my first scan after starting the estrogen – lining was thickening and levels were good. I got the okay to up my dose for the next week. My next appointment was supposed to be when my shots would begin.

An issue that I have been dealing with throughout this whole process, that I felt was getting worse, was my weight. I HATE putting on weight. At this point, I can probably wear about half, if that, of the pants I own and most of the other half is uncomfortably tight. I just felt like a big blob every day and it was wearing on me. Once my ovaries were shrinking back to normal size after the IVF cycle, I began to run again. And as time passed, I began to work on getting back my endurance, gradually increasing the length and speed of my runs. And I hate to say it, but the worse I felt about the extra pounds, the harder I was pushing myself on the treadmill. During my 2nd week on estrogen, I was finally almost back to my normal running routine. I felt that it wouldn’t matter if I was running harder since my ovaries weren’t being stimulated this time.

At my week 3 appointment, Jared and I were geared up to start the injections and to hopefully (if the embryo survived the thaw) have the transfer that weekend. Why can’t I learn that nothing is a guarantee? My scan showed no growth in my uterine lining – in fact, I lost a little bit of it. Blood showed that my estrogen had actually DROPPED, despite the fact that I had been taking an increased dose for a week.  Due to this setback, we wouldn’t be starting the progesterone and the transfer would be delayed. I was instructed to stay on my current level of estrogen and I also had to start wearing an estrogen patch. These little boogers are pretty annoying – they go on the lower abdomen and get changed every 3 days. I spent the first few days worried the thing was going to fall off (although after I experienced the pain of removing the first one, I realized that sucker wasn’t going anywhere!). Plus, by the end of the 3rd day, the edges are pretty nasty. I was to come back for another scan at the beginning of the next week.
Even though it doesn’t seem like a big deal, I was completely devastated by this turn of events.  Why doesn’t my body ever work like it’s supposed to?!  And, again, I felt like it was an obstacle at every turn – like we were being warned that we were doing the wrong thing or going in the wrong direction. I also felt completely fed up with putting my life on hold for these treatments.  This delay pushed us further and further into the Christmas season, which I just didn’t want to be ruined by being in the middle of treatment.

The next day, (as I always do) I did some internet research on exercise while trying to conceive. The consensus seemed to be that light to moderate exercise is deemed beneficial for conception but strenuous or excessive exercise is detrimental. What I was having a hard time pinpointing was what exactly is “moderate” exercise or “strenuous” exercise? If I weighed 250 pounds, walking might be strenuous, whereas if I ran marathons, a 4 mile run might be moderate. I found it all to be rather ambiguous. In the end, I decided that it was better to just err on the side of caution and cut back my running (speed and distance).
Finally, it was back to the office to see if my lining/estrogen levels were any better. At this point, I was less and less stressed about the progesterone shots – I just wanted to get moving forward! The doc said my lining was a really good type – “sticky” was the term she used. I could tell she was less than overjoyed by the thickness (just shy of 8 mm – I believe the goal is 7-9) but it was better than the previous week so she gave us the go-ahead to move forward (pending lab results). We had our nurse draw 2 big circles on my hiney with a sharpie so Jared wouldn’t have to worry about finding the right spot for the injections, which would begin that night. She also reviewed the whole process with us and I feel that we left the office feeling okay about it. I would also start Medrol that night, a steroid that suppresses the immune system so my body doesn’t fight against the embryo.

We were both nervous about the first progesterone injection. I just kept telling myself that thousands of couples go through this and are fine – we could do it too.  Jared did an amazing job – it didn’t hurt at all. He even knew just what to do to comfort me – counting to 3 before starting, singing while the liquid is going in, telling me when it’s almost over.  My butt did feel a little sore that evening and the next day but it was not anywhere near what I thought it would be. Since then, we have settled into an evening routine of the shots, and even though I still get a little nervous every time, I am thankful that it’s not so bad and that I have such an amazing husband who turned out to be a stellar shot-giver!
So where are we now? We are in a state of prayer. Praying that our little miracle embryo survives the thaw on Saturday morning. Praying that she hatches out of her shell and attaches to my uterine lining. Praying that she grows and grows and that in 9 months we are blessed with a beautiful, healthy Baby Graybill!

I think over the past year or more, because of all the treatments we have been through, I have allowed the science of baby making to take over my brain. It’s been all about medicine and scans and timing and numbers. I need to allow faith to take over and to refocus on the miracle of God that a child is. I have to just pray and believe that God will answer my prayers. Last evening, the pastor from my family’s church visited us and spoke to us about what we’ve been going through. He prayed with us and anointed me. I felt overwhelmed – and for once it wasn’t with anxiety or sadness, it was with peace. I feel at peace knowing that it’s all in God’s hands.
 
Will this be our last Christmas as a family of 3?
The Graybills 2013
Jared, Kristen, & Peanut Butter

 

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