Retrieval 2 – Cycle Cancelled

Monday morning I had my 5th monitoring appointment. I honestly didn’t go in to the appointment with very high hopes after my last appointment on Saturday. My follicles had shown a little bit of growth, but were still measuring between 9 and 11mm and my estradiol level was a measly 147.2.

When I arrived at the clinic, they were behind schedule and I wound up having to wait for almost an hour. Once I was called back to the room, vitals and blood were drawn and the ultrasound tech came in to do my scan. My uterine lining was great but my follicles hadn’t grown at all. I told her that with those numbers and the low e2, I think that we should cancel the cycle. She told me that the nurse would be in to talk to me about it and then left.

When the nurse came in I again expressed my concerns with the lack of growth and low e2 level. The nurse pulled up all my past labs and my previous cycle to compare. My body definitely responded differently this cycle than it did last cycle. I was told to hold on for just a little bit longer until the days labs were back in to see if there was any forward progression. If there was barely an increase in e2 levels they would call to talk, but wanted to run it all by the doctor before making a final call.

The nurse called me at 4pm. Admittedly the results were in my portal at 3, and I looked before they called. Not only did my e2 level not increase, it actually decreased. Paired with no follicle growth, the difficult decision was made to cancel this round. The follicles were likely empty, or the eggs being produced weren’t a good quality.

I was advised to stop all stimulation meds, as well as the prednisone and plaquenil for now. They also recommended that I start taking Serovital and DHEA in addition to the supplements I’ve been on since November to help with egg quality next cycle. They are going to review my two cycles and see what changes can be made to the next cycle to hopefully be more successful. I’m not sure if we’re trying a higher dose or a lower dose, but will know more when I call on cycle day 1.

At this point I need to buy more Follistim/Gonal F and am going to get Menopur instead of HCG-LH to see if that makes a difference. I also need to buy more Cetrotide/Ganirellex because I used 4 of the 6 I bought last round. I still have the triggers that I bought for this round and won’t need those.

My emotions are all over the place. Some (a lot) of it is probably hormonal. I go through phases where I feel like this is Gods way of telling me that I’m not meant to have another child. To get one abnormal embryo and then the following cycle is cancelled is a huge blow to my mental state. I also have periods of time where I feel like this is just a test to see how far I’m willing to go to have my dream come true. I just need to remind myself that everything happens for a reason, and to take things one day at a time.

Follicle Check 2

After dropping my husband off at work a little bit early, I made the hour drive to my second follicle check my myself. The entire way up to Colorado Springs I felt a mild sense of anxiety. I don’t like going on my own, and wasn’t prepared for the new of the appointment.

I was checked in and called back quickly. The nurse took my vitals and blood while we chatted, and then I got undressed from the waist down. The nurse who came in to do my ultrasound was doing training on how to do ultrasounds, and did my second ultrasound in a row. I’m not complaining about the fact that she was learning how to do it. Everyone’s got to learn somewhere. But, in something that costs this much money and is so dependant on measurements and outcomes…..I really wish someone more experienced would do a follow up scan to verify measurements.

My uterus is looking fine. My lining is triliniar, which really doesn’t matter since we aren’t doing a transfer this cycle. My ovaries are still on the small side, but they said that was appropriate given my follicle sizes. I still have 2 follicles on the right that were measured at 6mm and 7mm (only one was measured at 8mm on Tuesday). My left ovary had an 8mm, 7mm and 4mm follicles measured (Tuesday there were two 8mm follicles measured). My estradiol level went from 105.4 to 150.2….so it increased by not by alot.

I asked if we should increase my meds to have the follicles grow more and was told to keep things the same. They said that my follicles are growing slowly, but it could be a good thing because they are all pretty evenly sized and the smaller ones can catch up. The nurse said that since I only had 3 eggs last time that resulted in one abnormal embryo, that it might be good that things are going differently this time. She said that the slow growth could be follicles actually maturing eggs and not just growing to grow.

I will go back tomorrow for a third follicle check and to see what’s going on, and will probably go back on Monday as well. I need to figure out a few more days of Follistim and possibly Ganirellix. I might also need more HCG-LH if things don’t start growing soon.

Retrieval 2: Stims Days 1-4

Stimming for our second (and probably final) IVF retrieval started on Friday night. So far all seems to be going well. When I wake up in the morning, my lower abdomen feels pretty heavy but it goes away fairly quickly. My stomach is also really sensitive to weeks of pokes. Last nights Follistim shot left an immediate nice sized bruise. I considered trying the thigh or arm, but was told that it is better absorbed when you do the abdomen.

The protocol so far has been:

  • Tuesday: 1 tablet estrace twice daily, Ubiquinol 400mg, Low Dose Naltrexone 4.5mg, Vitamin D 10,000, Pepcid, Iron, Plaquenil 200mg, Folic Acid, Prednisone 5mg twice daily, Claritan, Benadryl 25mg, Omnitrope 6 units, Melatonin 3mg
  • Wednesday: 1 tablet estrace twice daily, Ubiquinol 400mg, Low Dose Naltrexone 4.5mg, Vitamin D 10,000, Pepcid, Iron, Plaquenil 200mg, Folic Acid, Prednisone 5mg twice daily, Claritan, Benadryl 25mg, Omnitrope 6 units, Melatonin 3mg
  • Thursday: 1 tablet estrace twice daily, Ubiquinol 400mg, Low Dose Naltrexone 4.5mg, Vitamin D 10,000, Pepcid, Iron, Plaquenil 200mg, Folic Acid, Prednisone 5mg twice daily, Claritan, Benadryl 25mg, Omnitrope 6 units, Melatonin 3mg
  • Friday: Ubiquinol 400mg, Low Dose Naltrexone 4.5mg, Vitamin D 10,000, Pepcid, Iron, Plaquenil 200mg, Folic Acid, Prednisone 5mg twice daily, Claritan, Benadryl 25mg, Omnitrope 6 units, Follistim 300IU, HCG-LH 30 units, Melatonin 3mg
  • Saturday: Ubiquinol 400mg, Low Dose Naltrexone 4.5mg, Vitamin D 10,000, Pepcid, Iron, Plaquenil 200mg, Folic Acid, Prednisone 5mg twice daily, Claritan, Benadryl 25mg, Omnitrope 6 units, Follistim 300IU, HCG-LH 30 units, Melatonin 3mg
  • Sunday: Ubiquinol 400mg, Low Dose Naltrexone 4.5mg, Vitamin D 10,000, Pepcid, Iron, Plaquenil 200mg, Folic Acid, Prednisone 5mg twice daily, Claritan, Benadryl 25mg, Omnitrope 6 units, Follistim 300IU, HCG-LH 30 units, Melatonin 3mg
  • Monday: Ubiquinol 400mg, Low Dose Naltrexone 4.5mg, Vitamin D 10,000, Pepcid, Iron, Plaquenil 200mg, Folic Acid, Prednisone 5mg twice daily, Claritan, Benadryl 25mg, Omnitrope 6 units, Follistim 300IU, HCG-LH 30 units, Melatonin 3mg

I go back Tuesday morning at 7:00 for a follicle check and lab work. As of right now everything has gone right according to plan. I don’t really know if my follicles will have any eggs in them or not this time. I hope so, but there is no guarantee. I’ve officially been on the Omnitrope and vitamins 2 months 15 days and I’m really hoping that it is making a difference in quality.

One thing that is definitely different this month is the addition of Claritan, Pepcid, Benadryl, Prednisone and Plaquinel. The main reason for the addition of these meds prior to retrieval is the possibility that thanks to Sjogrens Syndrome, my immune system is attacking my ovaries. With Sjogrens, the immune system will frequently attack moisture producing tissue in the body. With the increase in follicles, we can make an educated guess that my immune system is revved up and ready to attack. By adding in immunosuppressents and antiinflamatories, we are hoping that my body will settle down and let the follicles grow and eggs develop.

I am still praying every day and trying to stay positive. I have connected with an amazing support system and am nervous but hopeful.

Cycle day 1, Baseline Round 2

Aunt Flow showed her ugly face on Saturday morning. It took two weeks from trigger to finally start. Aside from larger clots than normal, my period was relatively “normal.” I already have a super heavy flow and severe cramps so it’s hard to say if it was any rougher.

I called CNY Saturday morning and set our baseline appointment for Tuesday (cycle day 4). Hubby and I spent the weekend relaxing and hanging out at home.

Tuesday morning, hubby and I left the boys asleep at my parents house and made the hour drive to the clinic. I went in alone again because spouses still aren’t allowed in thanks to covid.

I was called back to the room fairly quickly. Blood was drawn, I undressed from the waist down and waited. The clinic I go to is currently training quite a few new employees, so I was shocked when the ultrasound tech came in with two new doctors. She quickly took a look around and said that everything looks great. I have 2 follicles on the right and a few smaller ones, and 4 on the left that are 5-6mm and quite a few smaller ones that definitely can catch up.

The clinic does not start stimulation meds on Tuesday’s or Wednesdays because of the possibility of a Sunday transfer. Thursday there was already the maximum number of stim starts so I will be starting on Friday. In order to prevent a lead follicle from developing, I am to take 1 tablet if Estrace twice a day until Friday.

At the time we also discussed the possibility of transferring our sole embryo if the genetic testing came back normal. They said if my hormone levels were good then we definitely could thaw out our embryo and transfer it back in on day 5 post retrieval. I was told to start the transfer meds and we would go from there.

Because our embryo tested abnormal, we are going to keep her frozen and I am stopping all transfer meds. I will continue to prime for retrieval and start stims on Friday.

Embryo Update and Next Steps

I waited to do an update until I had more information to pass on. Our solo embryo made it to a day 5 blastocyst and was biopsied and then frozen.

Our day 5 blastocyst, hatching from its shell.

The biopsy was sent to Cooper Genomics on Monday January 25, 2021 and arrived on Tuesday. There was a snag in the lab and they didn’t actually start testing on it until Monday February 1st.

I called and Cooper agreed to rush the results because they messed up. Today they sent an email saying the results were ready and would be sent to the fertility clinic. After waiting fairly impatiently for almost 2 hours, I decided to give them a call. I wasn’t prepared for what they had to say.

The first thing the nurse said was that someone was going to call to talk to me about the results. My heart sunk. Why couldn’t she just tell me then and there? I asked her what it said and I was informed that the embryo is an aneuploid, abnormal, embryo. After doing some research it basically means that the embryo is incompatible with life and would more than likely either not implant or implant and miscarry in the first trimester.

I asked the nurse if Solo (the name we gave our embryo) was a male or female embryo…..and it is a GIRL.

My heart is heavy knowing that we were able to get a female embryo but she isn’t going to make it. It brings up so many feels from losing our daughter.

At this point we are gearing up for a second retrieval. I took a days worth of transfer meds thinking that if solo was a genetically normal female, we would transfer her after the retrieval. I am going to stop the transfer meds and keep priming for retrieval. I start stim meds on Friday and will go from there.

Fertilization Report

After our egg retrieval, I spent most of the day sleeping off the effects of the anesthesia. Thankfully hubby was able to keep the boys occupied for the most part. Occasionally I would wake up to one, or both, of the boys staring at me.

The nurse called at 7:15 Tuesday morning to let us know that of the 3 eggs collected, 2 were mature and 1 fertilized. She wanted to know if we wanted to push the embryo to day 5 for testing or do a 3 day transfer.

After a lot of discussion and prayer we decided to push the embryo to day 5 for testing and prep for a back to back retrieval. We’re hoping and praying that our sole embryo is a genetically normal female, but doing another retrieval just in case the embryo is abnormal.

The thought process is that often times and second and even third retrieval give better results because of the meds priming the eggs from previous cycles. I don’t want to lose any forward progress by skipping a cycle to see how this embryo plays out. Thankfully I have most of the meds needed. I just need either Menopur or HCG-LH, Cetrotide or Ganirelix and 1 Lupron trigger. I have everything else.

Genetic testing should be back by the time we hit retrieval. If that’s the case we may be able to do a day 3 transfer of the frozen embryo. If not, I’ll have a period and with my next cycle well be able to do a transfer.

Retrieval Day

Today (01-18-2021) was retrieval day. I went into the day feeling like something was off. I wasn’t fully feeling good about the experience.

The drive was fairly uneventful. We got to the clinic a few minutes early and headed up. After checking in, hubby was brought back to a room to make his contribution to this process while I sat in the waiting room. When he was done, they asked him to wait in the car until I was done. I almost lost it at the thought that my husband wouldn’t be with me to get started. I was led to the bathroom to get a robe on, and then taken to the sterile procedure room.

In the procedure room, one nurse tried to get an iv started while I answered a billion quotations from another nurse. They couldn’t get an IV started so another nurse came in to give it a try. She couldn’t do it either so we waited for anesthesia to come in. After 3 attempts he was finally able to get the iv started and I was out pretty quickly after that.

I woke up SICK. I couldn’t stop dry heaving and puked up some bile. I was in a lot of pain, crying uncontrollably and nauseous…..not a fun combination. After quite awhile (maybe an hour and a half) my husband was brought into a room and we were told that they were only able to collect 3 eggs. I’m not sure what happened because on Saturday they measured 2 follicles on the right and 7-8 on the left.

To say I’m devastated is an understatement. I feel so incredibly stupid, ashamed and like I have failed everyone. There is no reason that the majority of follicles should have been empty. I feel like a fool for even trying to complete our family. I feel like an idiot for spending so much money on something that didn’t work.

We’re still waiting to hear if any of the 3 eggs were mature and fertilized. We have a decision to make now as well on whether to transfer what we have in the hopes that they 1) attach and stick around and 2) are female embryos…..or continue with our plan to pgt test what we have if they even make it that far. Or to try and scrape together another $4-5k to try again. I don’t know what to do and a LOT will depend on the update tomorrow.

Monitoring Appointment 3 – Grey Zone

The drive up to the fertility clinic was a long one this morning. I was so incredibly nervous and scared of what was going to happen. My husband drove me up there which helped a bit with nerves.

We arrived early and sat in the car for a bit. With a quick smooch and a “good luck babe!” I headed inside alone. Spouses aren’t allowed in for monitoring appointments due to Covid. I was called back quickly, blood was drawn and the scan was done.

My lining is “perfect” so if we wanted to do a fresh transfer my uterus is ready. Aside from that, the smaller follicle on the right side was now big enough to measure – making 2 follicles on the right. I had 5 follicles measuring between 8 and 15mm on the left, and several smaller ones on the left. I am so incredibly relieved because I seriously thought that I would be getting more bad news.

Right now we’re in this weird grey zone, with follicles measuring all over the place. The clinic is having a hard time figuring out if I should do a Monday retrieval or a Tuesday retrieval. The end result is I have to come in tomorrow (Saturday) for one last scan to see how things grow overnight.

So for now I am staying the same with meds overnight.

  • Friday – 1 vial Cetrotide, 300 IU Follistim, 30 IU HCG-LH, 6 units Omnitrope, 1 tablet LDN, 1 tablet prednisone, 400 mg Ubiquinol

Tomorrow we will make the decision on whether to do the retrieval Monday or Tuesday. If retrieval is Monday I will add trigger shots. If retrieval is Tuesday we will have one more day of meds before adding the triggers in on Sunday.

Lab test results:

  • Estradiol: 1081 pg/mL
  • Progesterone: .674 ng/mL

Total numbers so far:

  • Blood draws – 8
  • Ultrasounds- 6
  • Injections – 75

Monitoring Appointment 2

Today didn’t go as well as I had hoped, and I spent the day crying. I still have the follicle on the right, but might lose it while we wait for the follicles on the left to catch up. I went from 6-7 follicles on the left to having 4 measured between 9 and 11mm.

The nurses were VERY rushed and didn’t spend a lot of time looking for follicles. They didn’t mention if there were any other smaller follicles that would catch up or really tell me much of anything. When it came time to get the flow sheet updated, the nurse literally said “We can’t spend any more time in this room, we need to get to the next one.” Didn’t instill much confidence in the clinic treating me as a person and not just another person walking through the door.

I tried to ask them about the Cetrotide after having a pretty nasty reaction (see pic below) but they didn’t look at the picture and told me to keep taking it.

Cetrotide reaction

The current plan is to continue meds as prescribed and come back Friday for another monitoring appointment and blood draw.

Med list:

  • Wednesday- 1 vial Cetrotide in am, 300 IU Follistim, 30 HCG-LH, 6 units Omnitrope, 1 tablet LDN, 400 mg Ubquinol
  • Thursday – 1 vial Cetrotide in am, 300 IU Follistim, 30 HCG-LH, 6 units Omnitrope, 1 tablet LDN, 400 mg Ubquinol

Lab test results:

  • Estradiol – 779.1 pg/ml
  • Progesterone – .155 ng/pl

Total counts:

  • Blood draws – 7
  • Ultrasounds – 5
  • Injections – 61

Monitoring Appointment #1

Today is our first monitoring appointment and I’m not going to lie, I’m NERVOUS! At my baseline appointment I had 4-5 follicles. I’m hoping to have more than that today.

Post visit: Well, the appointment went pretty well. I have an 11mm follicle on the right and a smaller one that we’re hoping will catch up. I also have 6-7 follicles on the left measuring in the 8mm range, with several smaller ones that might be able to catch up. Overall I’m really happy with the numbers and the potential that it comes with.

Tomorrow morning I have to start the Cetrotide to keep me from ovulating, but all other meds stay the same and then come back Wednesday for a repeat scan and labs.

Current plan:

  • Monday – 300 IU Follistim, 30 IU HCG-LH, 6 units Omnitrope, 1 tablet LDN, 400mg Ubiquinol
  • Tuesday – 1 vial Cetrotide in the am, 300 IU Follistim, 6 units Omnitrope, 30 IU HCG-LH, 1 tablet LDN, 400mg Ubiquinol
  • Wednesday – 1 vial Cetrotide, 300 IU Follistim, 30 IU HCG-LH, 6 units Omnitrope, 1 tablet LDN, 400 mg Ubiquinol.

Lab results:

  • Estradiol – 386.2 pg/ml
  • Progesterone – .059 ng/pl

Total counts:

  • Blood draws – 6
  • Ultrasounds – 4
  • Injections – 57