Best & Worst Case Scenarios

Hey! I know it has been awhile but nothing exciting has happened in the fertility world for a few weeks for Justin and I until now!  I had a great recovery from egg retrieval and I'm feeling back to normal.  I even went to the gym today!  Can you believe it?!  It has been at least 6 months.  I am motivated to get some muscle strength back before I feel crummy from pregnancy and I don't want to do anything.  I have also heard from multiple people these days about how they have compared their pregnancies before and after exercise and how much easier everything was once you were active!  I have heard this before but I guess since I don't have anyone nagging me that I should be going to the gym, I am finally motivated to go! haha  I'm so weird- when people tell me I should do something, I tend to not want to do it until I decide for myself that it's a good idea.  I also will be attending a few Barre Forte classes in the upcoming weeks because I'm craving some structure with my exercise where I can get strength and be girly and I am so over Zumba and the elliptical.  Should be fun to be a ballerina for an hour!  I hope I like it so I have something to look forward to during the week. :) 

So how has my diabetes been doing?  Great!!  I don't know what's up and what has changed but my blood sugars are SO much better!  Sure, I have been following the guidelines from that book I posted about earlier, but I have also lost some weight, been eating better, and I also wonder if my body feels better with my hormones somewhat regulated the last few months.  Here's a current screenshot from my Dexcom today.  It show's my estimated a1c is 5.5% which equals an average blood sugar of 112 over the past 2 weeks.  I'm sure it will be higher than that when I actually get my blood drawn because there's always a big error margin with the continuous glucose meter readings vs. actual blood sugar readings.  And I have to stay this way until my next check in August!  I hope I do!  I even had a diabetes doctor appointment recently and she didn't make any changes and said I was doing great.

So the most exciting thing I have to update is about our fertility appointment we had today!  I found out some great things!  First, we went over our embryo results and Dr. Christman confirmed that we had 4 good and 4 fair embryos and the last embryo died once it multiplied to 5 cells.  Here's a picture of a blastocyst and what I expected my 8 embryos to look like.  I find it so neat to understand the anatomy of it.  The Trophectoderm is the outer layer of cells which forms the placenta! The blastocoel is just a fluid filled cavity.  But the inner cell mass is the little baby! 

A normal blastocyst on Day 5 of life but not mine

I was picturing the above picture in my head but I was in for a surprise when Dr. Christman said all of my embryos were hatching already when they froze them!  How cool is that?!  Here's a picture of the progression of an embryo on day 1-6 of life.  Normally it starts hatching on day 6 but they froze all of mine on day 5 and they were already starting to break out of their shell.  I asked Dr. Christman if that was bad to be early and he said no it's a good sign! This is the last stage before implanting.  They must just be ready to get in me!!  This is great news because now we won't have to pay the extra $475 to have the lab hatch them themselves. 

The last picture is of a hatching blastocyst- I have 8 of these!

Of course I wanted to know the specifics about Justin's sperm count at egg retrieval and I saw that he had 2 million total sperm with 64% motility which is a huge increase from the 10-50% motile he typically has.  It said 0% total normal on the paper so I'm assuming that means all of them were slow or shaped weird.  But Dr. Christman says it doesn't matter because we have perfect little babies growing.  Justin is enjoying having his beer again and knowing he can be a "normal person" from now on as long as one of these embryos work out! 

Now I have saved the best for last!  I asked Dr. Christman what would happen if it took forever for my next period to come.  I had my withdrawal bleed 6 days after egg retrieval (June 8th) but they are waiting for my period to come on its own to start meds again.  He said that he would give it 35 days and if it didn't come, I could start progesterone to make my period come and then start the frozen cycle right away!!  That guarantees that I'll be able to start my frozen cycle before the clinic shuts down for inspections and I'll be able to transfer the babies in September!  

So of course I'm a planner and I calculated the best and worst case scenario according to the clinics schedule they gave me.  

Here's the best case:

I start my period on my own 30 days later (the soonest I have ever started) on July 8th.  I start my meds 3 days later on July 11th and then I already know the exact date that an embryo would be transferred into me would be September 5th.  That's equal to a baby due date of May 24th!

Here's the worst case:

I counted 35 days from June 8th and that's July 13th!  So I would call the clinic that day and be like "yo, I didn't start my period!" and they would say "ok, here's some progesterone."  Last time I had to take it for 10 days and I didn't have a period until 3 days later.  So I'm expecting a period around July 26th- right before my 30th birthday on the 29th!  (Didn't I say that's all I wanted haha).  So that means the transfer dates of my embryo would be September 19th or 26th depending on which week they start my estrogen patches. Which is equal to a due date of June 7th or June 14th! 

It helps a lot to know that I only have 3 weeks before I start this process again.  The best part about it is that I will only have to come to the office for 4 visits this time!  One day is a med teach, baseline labs and ultrasound, & mock transfer to measure me again, 2 more days of estrogen levels and ultrasounds, and then my transfer date!  Let's get this show on the road!!!

Prayers:  I'd love to know that my body is functioning normally on its own and have the best case scenario.  Continued good blood sugars.  

Praises: We received a $2270 credit from not doing a full cycle so we will only owe $1743 to do the frozen transfer.  But if this doesn't work out, the next frozen embryo transfer will be about $5000.  Hopefully we won't need to go there! I am enjoying my coffees, sandwiches, and getting stuff done around the house.  We re-planted some of our plants since they were dying and not spaced out enough before the rain came and I love checking every morning to see how many flowers or new leaves I have.  I finally found curtains that I like and hung them up!  Now on to finish painting the house.  Until next time!

Justin & Christy Kate Plus Eight?

Can you believe it?  As of today (Day 5), Justin and I are the proud parents of 8 frozen embryos!  We have 4 good and 4 fair.  This is a fantastic response for only one to arrest and die!  Most embryos decrease by 50-70% by day 5!  I came across this graph from 2011 while doing my research which shows the average number of excess embryos a woman has available for freezing by age.  I have 4x that!  All of your prayers are working wonderfully and God is SO good!  

Each embryo is now called a blastocyst.  They have developed perfectly on time and therefore were able to be frozen today before they hatched!  We have 4 vials containing 1 "blast" each and 2 vials with 2 blasts.  I guess you could say that this IVF cycle has officially been completed!

  
Justin has made me laugh thinking about the names for our frozen little ones.  He jokes that we need to name them after the Frozen characters with names like Olaf for a boy and Elsa for a girl.  Justin has Norwegian heritage so he thinks it would be perfect.  I need you all to tell him otherwise. Lol!

It is bitter sweet as this has been such an exciting time for us.  You sit there over the years hearing of more and more friends having babies and you just feel so left out.  Now I can finally feel like I am part of the club knowing that there is a HUGE likely chance that our baby is just sitting in a freezer 5 miles from our home!  I am so happy to finally get good fertility news again.  Wish I could just be pregnant now with all of you. :(

So what's next do you ask?  I plan on stopping by the fertility clinic tomorrow to get another financial estimate based on our insurance for a frozen cycle.  We were quoted approximately $5000 but we should be getting a credit of hopefully around $1000-2000 from not doing a transfer this time.  If you have any further fundraising ideas, please let me know!  I think our neighborhood would look at us funny if we had any more garage sales.  I have included our link to our YouCaring page above the "about me" on the blog.  

I have an endocrinology appointment tomorrow that I am nervous about because let's be real- I have not cared about my diabetes one bit since the egg retrieval and have eating horribly.  I am feeling motivated again to be good though so don't worry.  I just needed to treat myself for awhile.  

I will be notifying the fertility clinic once I have a withdrawal bleed within the next week.  I don't have to have any further ultrasounds since I am feeling so much better after the Ganirelix injections.  We will sit down with Dr. Christman again to discuss our plan for the next cycle like meds and how many babies to transfer.  Lately, I have been leaning towards just putting in one like they recommend.  I'm not sure why but it's kind of a gut thing.  That may easily change though! haha

My 30th birthday is July 29th which is literally the last day I can have my period to officially start the frozen cycle!  I never thought that I would be saying all a girl wants for her 30th birthday is to start her period! hahaha The clinic shuts down for the whole month of August to do their inspections and quality control checks that they do 4 times a year.  If I don't have a period on my own before my birthday, I'll have to wait another month which means it would be October instead of September before transferring! AHH!  Please please come!

So I am struggling with the decision of whether to make this next cycle as public as I did this time.  I really have enjoyed writing these blogs and all the support you all have given me throughout the ups and downs.  It has been a great story that I will be able to refer to for years.  However, it would be fun to surprise you when I finally get that big fat positive test!  But let's be real, I am horrible at keeping secrets and if any of you asked me how things were coming along, I wouldn't be able to lie! lol  So I will probably keep you all posted.  In the meantime, I may periodically update with fun stuff Justin and I are up to in the next months.  So stay tuned! THANK YOU!

Day 3 Embryo Update

What a week full of emotions! I was feeling super bloated after the egg retrieval and spent the majority of Friday lounging on the couch watching Netflix and missing Justin while he was at work. I had to go back to work on Saturday myself which I was not looking forward to because it was still difficult for me to get around without feeling uncomfortable.  I have gained 5 lbs since the start of my injections!  I could only imagine how much fluid was in my abdomen.  I have been taking the Ganirelix injections to help my body shut down all the hormones and get back to normal.  I have also been drinking those Propel waters!  

Seeing how I worked so hard to produce 40 follicles which only yielded 26 eggs, and then within hours the count went to only 17 mature eggs, and then only 9 eggs taking fertilization with ICSI on Day 1, it left me in this pessimistic state of "this isn't going to work."   Before starting all this, I did pray that God would only give us a handful of embryos as we do believe that we have created lives and would like to use what we are granted.  However, it gets stressful thinking what if we just aren't compatible?!  You start reading online how many embryos other IVF couples made and it just makes you more anxious.  This has really taught me a lesson that for once I have no control over something. It's all up to the specialists and God and if we are supposed to have a baby, then we will be granted a child!

I had to float to the Pediatric ICU on Saturday which made matters worse since I was feeling crummy and I would have to explain my situation to them and make sure I had an appropriate assignment etc.  They worked my butt off but overall it was a good day.  

I took care of a sweet precious baby girl with a chromosome abnormality who I got to love on.  She had an IV line in her head which the parents were so nervous about her pulling at it.  I made her a headband with a cute pink bow out of some random supplies I found that would cover her IV.  The parents asked if I had any children and then of course I had to explain our situation.  I left the day with them telling me how thankful they were that I helped their baby look somewhat normal despite the IV lines and monitors and how great a mom I would be.  This is why I love being a pediatric nurse.  It's so much more than just pill pushing!  Overall, I received some distraction and was actually feeling much better and like myself by the end of the day!  The bloating was practically gone.  Praise the lord!  We had prevented ovarian hyperstimulation syndrome.  That was another positive thing.  

I started to get anxious again at night remembering that we would be getting a call today on how our babies were growing.  I told Justin that I felt like I needed to watch church early because I just needed God to talk to me and give me some reassurance it would all work out.  Literally right after saying that out of no where, I received a text from my cousin saying she was praying for our babies right then.  It was a great feeling!  

We took the dogs to the dog park this morning since Tucker (our big dog) was starting to act out at the house.  He ate literally half a big bag of crunchy Cheetos when Justin stepped away for a second!  They haven't been to the dog park since before Ollie's surgery last Fall.  It was great distraction as I totally forgot that we would be getting a call in a few hours!  

Family of Four!

Well Melinda called and said we had great news!!  ALL 9 BABIES WERE GROWING!  Now 5 of them are great 8-cell embryos and 4 of them are lagging and slow but they could always catch up later.  Justin joked that the 5 perfect ones had mostly my genes and were overachievers and the 4 slow ones were his.  Hey!  Justin may need reminding 5 times but he eventually gets the job done.  Maybe the babies will do the same haha.  Either way, I'd be SO happy with 5!  That's a handful! Here's a picture of a typical Day 3 embryo with 8 cells.  

An Example of a High Grade Day 3 Embryo with 8 Cells

The embryos are supposed to double each day.  On day 1 you have two cells, day 2 has four cells, day 3 eight cells, day 4 etc.  If they haven't doubled quite yet, then an embryo will be considered "fair" and may eventually die off.  So we currently have 5 great and 4 fair.  They also look at the symmetry of the cells and see if any cells have fragmented which kind of looks like it crumbles into a lot of pieces.  Melinda didn't get any information from the embryologist about fragmentation so that is a good sign!  Eventually we will see the cells start to compact on day 4 and a blastocyst forms on day 5.  They will freeze all the blastocysts that live on day 6!  We will be getting a call on day 5 (Tuesday) and day 6 (Wednesday).  Please keep praying for our little fighters and that I will continue to stay positive throughout this whole process!

"This is the life!"- Ollie

"I'm bored. Please make me a playmate mom!" - Tucker

Egg Retrieval

Yay!  I survived egg retrieval!  I had to be at Springhill at 7am so it was an early wake up. I couldn't wear makeup, jewelry, or perfume so I was looking great. ;) We were greeted by my recovery nurse, Brenda who I actually knew from when she used to work with me as a lactation consultant on my unit so I felt much better having another familiar face there.  Justin enjoyed capturing all the moments. haha

UF Health Springhill

They got me dressed, started an IV, and hooked me up to all the wires.  

They must have asked me like 10,000 times if I had my glucose meter.  Here's a picture of me showing the anesthesiologist and my two nurses how my continuous glucose monitor works.  Melinda said that because of me, they were now purchasing a glucose meter for the clinic!  That's probably a good thing as you never know what kind of patients you will get!

I had to empty my bladder and then Justin and I said our goodbyes as I walked right into the operating room.  

Isn't this such a cool picture? The window you see on the right is the embryology lab where they had 2 specialists standing right there to immediately receive my eggs and start creating babies! This will also be the room where they transfer the embryos back in me in a few months so I will be able to watch on the ultrasound screen showing on the wall.

My nurse anesthesist was really hilarious and always having me laughing.  She told me to "show her the finger" to put my pulse oximeter on and I had to wear an oxygen nasal cannula that would give her CO2 numbers which would tell her that I was breathing.  The last thing I remember was her telling me the Propofol would feel "spicy" in my veins and I had no clue what she meant until BOY did it feel SPICY! lol. Such a weird sensation.  Almost tasted like one of those cinnamon spicy candies.  Then she was telling me jokes and I went right to sleep and I couldn't remember a thing!  It seemed so quick.  Justin was sent to give his specimen while they did my procedure.  I woke up on the recovery stretcher and Justin was right by me! I was giggly but I didn't say anything inappropriate so that was good.  

Dr. Christman met up with Justin while I was knocked out and I guess he told him that he retrieved 26 eggs!  Of course he likes his stats, so he said that I was probably in the top 2% of highest egg retrievals.  Always an over-achiever. haha 

Dr. Kramer, the embryologist met up with us next while I was still really groggy.  He said that he was going to wash down my specimen to visualize which eggs were mature and only fertilize those.  I asked about Justin's count number and he was vague saying I think it went from 1 million to 2 million.  That's good enough for me!  Justin only has about 25% that are shaped right (according to a previous analysis) so that's really only 500,000.  Dr. Kramer immediately said that Justin's motility was a lot better this time too.  If you go by our motility percentage last time, if he has around 500,000 normal shaped ones, only 10% of them move slowly leaving around 5,000 to choose from.  That must have improved to higher!  I'm wondering if it helped that we did a sample at the clinic vs. at home like before.   In IVF c/ ICSI, it's like a beauty pageant.  They want to pick the fastest moving, most normal looking sperm to inject in the egg.  Melinda then updated me that I had 17 mature eggs that they were able to inject with sperm and she didn't think they needed to use Justin's frozen sample.  I should get a number of embryos that took fertilization tomorrow!  Once again, the embryologist really recommended only putting in one baby at a time as we may only end up with a handful of embryos and you don't want to exhaust your options quickly.  We will see!  They only freeze fair and good looking embryos so it just depends on our count. 

I was only there for about 30 minutes after the procedure.  I got dressed and said my goodbyes and left our 17 little babies to grow!

And then got some Opus coffee of course ;)

I'm having some slight pain in my pelvic area.  It feels really tense where you don't want to stand up without some help.  I have a pretty big pain tolerance so they offered some Percocet but I only took one Motrin so far.  Justin is a great husband and nurse to me and Ollie has been my little therapy dog.  

I will update each check with how many embryos are surviving! Yay for kinda being like a parent for 6 days haha!