It’s a No

Our IVF cycle failed, apologies for my silence – I’ve been regrouping; reassessing and just overall feeling a bit shitty.

I’m Ok though – I promise. The road is rough but it’s fine. 5dp5dt I got my period (wtf right?) and I knew I was out. The progesterone should have held my period off for a bit longer I would have thought; but I guess not. I had my blood test which confirmed that I was in fact not pregnant. I have been once again weaning off Prednisolone and stopped Clexane. Not really even sure how to feel about the fact that we had a perfect hatching 5 day embryo transferred and it once again, did not stick around for the long haul. After our failure, I felt pretty bad. It was an emotional few days just once again feeling as though my body couldn’t continue to do this – I don’t know why my body was rejecting these perfect embryos like they weren’t meant to be there. I had intralipids, I was on a pretty high amount of these dangerous steroids and blood thinners that stung – yet we still had another negative result.

I have felt so many emotions – I have guilt; my Husband is stuck with me now and despite the fact that he insists that parenting with anyone else would be his form of a nightmare I can’t help but wonder if sometimes the better thing would be for me to just disappear and hope that he finds someone better who can give him all of the things he needs and this, this one thing in particular that I know he would do anything for. Sorry, I know that’s depressive and it’s not a nice thing for me to write let alone to have to read back – but I know that’s how I have felt and I know one day i’ll read this back and I want to remember all of the emotions, even the crappy ones.

I have been strongly leaning towards taking a step back and just beginning to accept that my body just will not do this. What happens if I do fall pregnant by some miracle and my body just rejects the baby at anytime? I don’t think I can do it. I was feeling just completely done with myself until I received a phone call today from the PGD lab. I spoke to a really lovely lady who was the Genetic Councillor for my clinic, and she informed me that our other perfect, grade 1, hatching embryo that was frozen on day 5 – had TRISOMY 22. Trisomy 22 is basically a chromosomal defect where there are 3 copies of chromosome 22 instead of the 2 that it should have. It’s pretty much a fatal condition that rarely gets to the 2nd trimester and often fails to implant. So that was interesting. But even more-so, our 6 day embryo was a ‘mosaic’ embryo with Monosomy 2.

This is an explanation given from my clinic on what a Mosaic embryo means:

At times PGS testing of embryos shows a mixture of cells, some cells having the correct chromosome number (‘euploid’) and others an incorrect number (‘aneuploid’) of chromosomes within the same embryo biopsy sample. These embryos are referred to as mosaic (euploid/aneuploid). Mosaic cells can arise either when an error of cell division happens in very early embryo division or if an aneuploid embryo tries to ‘correct’ itself back to a normal state. Mosaicism detected by PGS may represent cells in both the trophectoderm (which forms the placenta) as well as the inner cell mass (which forms the fetus) or may be only confined to the trophectoderm. Mosaic embryos may be suitable for transfer and have resulted in the birth of healthy babies. However because these embryos carry some evidence of a chromosomal abnormality there may be a risk of an adverse clinical outcome which may range from failed implantation, miscarriage or the birth of a baby with a serious medical condition.

Basically, out of 100 little cells from our Blast they have taken 4 and 3 of those are normal, but on the 4th it looks as though on the 2nd Chromosome (and the largest) it is missing one of the 2nd. Which basically means that if we were to transfer this embryo, if it was a normal embryo and did in fact have the 2nd chromosome it has the potential to implant – however, because it has shown that it may have it – if it IS in fact missing this 2nd Chromosome, there is no chance that it would implant as it would just not be able to continue to multiple and divide. It would literally not make it past a few days in my uterus. We are lucky in that regard that it is a Mosaic embryo carrying something that isn’t an ‘abnormality’ as per say, as the embryo actually can’t develop with that – but most of the cells were normal. They have graded this embryo as ‘transferable’ so the ball is in our court.

Has anyone even come across this before? It’s so foreign to me. I don’t feel comfortable transferring that embryo at all though – so I guess it’s back to the drawing board. I have an appointment with our fertility specialist to discuss next steps. I am just in so much shock that our perfectly looking embryos are carrying these genetic conditions, and I know that there were only 2 but I’m 23, and it just seems so fishy to me. What if we have only ever had abnormal embryos? I think we will do another fresh cycle and PGD test again, because I don’t think I can go on without knowing what is really going on or if we would ever get a healthy embryo. I think we need more than just 2 to base our opinion on. Who knows – but that’s a bit of an update from me. Not an ideal one or the one I was hoping to do but an update nevertheless.

 

We have frozens!!!

We have 2 frozen embryos! They are being sent for PGD biopsy. A day 5, grade 1 blastocyst and a Day 6, grade 2 blastocyst. The rest weren’t looking good enough. I’m thrilled with the result and so thankful for our clinic. The results will be back in about 3 weeks, so we are hoping they provide some answers for us! 

The drop off rate has been far less than in past cycles and from our 4 good embryos on day 3, 3 of them have made it so we are just so thankful that we have that! Obviously we don’t know the results of the genetic testing but it certainly helps to take the pressure off if this cycle doesn’t work. 

Today is a good day! 

Lucky #7

Transfer day today. M is working away so I had to drive into the city to be there by 7. I had a call yesterday from the nurses who informed me that my hormone levels had levelled and I could potentially have a transfer (if we have any embryos to transfer). The embryologists don’t check the embryos on day 4, so they wanted me in the city prepared for transfer in case there was one good to go. I’m so thankful that my body has calmed itself down and brought those hormone levels to an acceptable level. I was really hoping to be able to transfer this month. We had put so much preparation into this, with the removal of the endometriosis, steroids, clexane and intralipids. The next thing was, would we have any embryos? 

On day 3 (Thursday) i recieved a phone call from the embryologist who informed me that of our 7 fertilised embryos (2 were weirdly fertilised- so 9 in total) we had 4 that were progressing well. On day 3, they like to see the embryos between 7-10 cells but ideally 8 cells. We had 3 x 8 cell embryos, 1 x 9 cell embryos, 1 x 6 cell, 1 x 4 cell, and 2 x 3 cell (these were the weirdly fertilised ones) and another hadn’t progressed at all. 

One embryo in particular that was 8 cell, seemed to be a stand out – with absolutely no fragmentation and perfectly formed. In our past cycles, we have had pretty good day 3 results, but our drop off between day 3 and day 5 has been pretty bad. The fact that we only had 4 embryos that were technically where they needed to be, was a bit of a concern – but I just had to let them go and hope for the best. That’s one of the hardest things about IVF – it’s all out of your hands. 

This morning I arrived at the clinic about 6.30am, and sat in the car while I waited. I am usually pretty calm but I felt my heart racing, just feeling a bit deflated and as though we were going to be facing some bad news. I literally was preparing myself to walk in and be told that we had nothing to transfer, or that our embryo quality was terrible. I hate to sound negative, but I think it’s my mental way to prepare myself for things to come. When you are so used to recieving bad news, it’s hard to accept that you may have a different outcome. The fact that M couldn’t be there with me was a bit hard, but I knew that regardless we had tried our best! Just before I left the car, Chasing Cars by Snow Patrol came on the radio. This was exactly what I needed, it’s M and my favourite song. We danced to this at our wedding and it felt like a nice reminder from the universe that although he may not be right beside me, there’s definitely love around me and I needed that. 

Once I got into the room, I changed into that beautiful transfer kit (white gown/blue foot covers; you know the drill 😂) and I couldn’t help but feel as though I was tempting fate by being dressed to go for a transfer. Our embryos weren’t even being looked at until 7am, so we wouldn’t know if they had all arrested or not. 

The embryologist came and saw me first, and my heart was racing so fast – I swear that I could feel it in my throat. He introduced himself and asked me to confirm my date of birth before telling me ‘We have a great blastocyst for you this morning – in fact it’s absolutely perfect’ 

Sorry what? Perfect? Every time we have had IVF we’ve had pretty ordinary embryos sitting at about a 7/10 or grade 2/3. I was in shock. 

He graded it a 1-1 which apparently for this clinic, is the best that you can get. He said you couldn’t get better. It was hatching blastocyst and almost completely out of its shell. (We did assisted hatching though, as we wanted the option for possible testing) He then explained that we had 3 more blastocysts that were looking good, but they were more early blasts. He said this was fine though, considering how early in the day it was. He thinks our little hatching blast is just an overachiever. Technically, our embryos weren’t created until about 1pm on Monday so really this ones a little ahead 😉 

Apparently, this transfer embryo was our perfect, no fragmentation embryo on day 3, so it looks like it’s just staying on track with its development, which is awesome. 

We have opted to genetically test our remaining embryos if there ate anything. The embryologist believes that at least one will be good for biopsy this afternoon, with another 2 potentially. I have a feeling it will just be the one though. I am keeping my fingers crossed! 

Our doctor Allison came to see me before transfer, and saw that I had a few tears in my eyes. She thought I was upset with the news and began to explain how great our today-blast is. Bless her. I explained that I was completely the opposite, that I was just feeling completely blessed right now to have at least one to transfer, and it was perfect in their eyes. I know this may not be ‘it’ but it means that M and I can create embryos that look good. We have the potential to do this and we just have to get everything else right and we could get there. 

So, transfer went smoothly and I got to see our little embryo on the screen! Just looked like two balls of stuff (I’m good at describing) but most definitely the most perfect two balls of stuff ever! 

It was the best feeling to make the phone call to M. Argh, we’ve just been through so much & to have some good news to give to him was so great. He’s been my absolute rock during this whole thing and I’m just so grateful to have such an incredibly supportive partner who would move mountains to ensure I’m OK and happy. 

So, our lucky 7th transfer is over and now we wait. I’m on 25 mg prednisone daily, alongside the clexane. Keeping everything crossed that this could be it! Guess we will find out in two weeks. 😛

I’m feeling pretty shattered this morning. I’m tired & a little sore from EPU yesterday, but we’ve just had our fertilisation report that has been a bit of a kick in the guts! 

Of 15 eggs collected yesterday, 13 were able to be injected with ICSI, and only 7 fertilised normally. Apparently there are 2 (not included in the 7) that have done something but they’re not sure what? (Not sure if that means they’ve just abnormally fertilised) but apparently they are going to be watched to see if they progress. 

Ahh I know I’m lucky to have at least 7 to work with and I shouldn’t complain…but our drop off rate from previous cycles is what’s making me so concerned. Last egg pick up (December 2014) we had 15 eggs, 13 mature and we had 7 fertilised with ICSI and 3 with IVF so 10 to work with in total and ended up with ONE on day 5 (another frozen on day 6). The cycle before that we had 7 eggs, 5 mature and all 5 fertilised but once again only one on day 5. 

I’m absolutely petrified for the next few days, I’m just sure that the next call on Thursday will be to tell me that we’ve had another large drop off and we’ll be left with one or none on day 5.

To make matters worse, M is working away at the moment so I’m home alone. I’m emotionally exhausted and I just don’t know where to go next. Hoping that those little embryos do their business over the next few days but I know there’s nothing more that I can do from here.

Also- the fact that we got 15 eggs made my FS a bit concerned; she is worried that I may get OHSS and she has suggested we do a freeze all cycle. Sigh! Just what I need. I’ve already been pumping myself full of steroids, had my hit of Intralipids, and everything to prep for a fresh transfer including the biopsy previously; so I’m just hoping that we’ll be able to do a fresh transfer if there is anything there to transfer. We also thought about doing PGD testing on the day 5 embryos but knowing us, we probably won’t have any to biopsy so I won’t really think too much about that until Thursday.

So from here, just waiting to see how those embryos go. I have to have a blood test on Friday to see if I am able to have a fresh transfer but I have a feeling they will tell me to freeze all. Seems like another way to squeeze a few more thousand out of us. 

Apologies for my negative post! So hard to be positive when you feel as though you’re taking one step forward but two steps back every time. 

Jabs and Ultrasounds

I’ve just returned home from a solo week away back in QLD visiting family & just enjoying myself! It’s nice to be home and back in my own bed but going back home certainly reminds me what I’m missing out on. It’s not forever, but another few years until we can get back to QLD. Family is so important to me, I just can’t wait to be able to be there for everyone. 

Unfortunately, My mother in law was in a car accident while I was visiting. Fortunately though, I was able to be there (as M’s sister was in North Queensland visiting her in laws) and be with her at the hospital so she wasn’t so alone. We definitely made light of a bad situation which was great! I’m lucky to have a great mother in law. She’s doing well, although does have a fractured eye socket and a black eye. ‘You should have seen the other guy though!’ She’s an absolute trooper! 

As for our current cycle, I am on day 8 (CD10) of gonal f injections (175iu) and day 4 of blocker injections (cetrotide this time). I had my first bloods/ultrasound this morning which showed 17 follicles on my right ovary and 11 on my left. A lot were quite small though, so it looks like we will hopefully have a least a few good eggs (keeping everything crossed….except my legs…that camera 😜). 

I’m having an intralipid infusion on Thursday, so we’ll see how that all goes. Also having another ultrasound/blood test to test my levels and to work out when the best time for epu would be. I’d say we would have trigger over the weekend and egg pick up early next week. Time is flying! 

IVF #4 

Yep, another fresh cycle! Our fourth, geez! It has been almost two years since our last fresh cycle and a year and a half since we have done anything IVF related and it has been a nice break. I think it has been needed, and I’m feeling refreshed & ready to go! 

We had our follow up appointment with our fertility doctor last week, and she showed me the pictures of my endo – which was interesting! Little spots of red scattered throughout my pelvis which they removed. Our doctor thinks that the endo may have played a large role in our ivf failures. She seems confident that we will get there, but every doctor we have seen has always been sure. 

So, the plan is – a fresh IVF cycle with 175iu gonal f (originally she said it would be 200iu but my AMH came back at 41 so she thinks a bit lower dosage would produce better eggs). We will transfer our best embryo (if we get one) on day 5, and if we have any to freeze, we will PGD test them. She has suggested doing Intralipids, clexane and prednisone. 
Our Reproductive immunologist suggested Neupogen and LIT treatment which is expensive and invasive, so I think we will just try and see if one embryo sticks now that there is no troublesome endo in the way, and if we have frozens we will do the other treatment. 
So, it looks like it’s going to be a fresh cycle for us, with two intralipids as recommended by dr M (to try and dampen those NKC’s) and 25 mg prednisone, and clexane. 
I’m excited, nervous and anxious all in one, but I know we need to take the first step again. I think we will limit ourselves to 2 more fresh cycles (including this next one) before really reassessing and figuring out our next move. 
I don’t know whether transferring this embryo fresh is a great idea, or whether we should just go all out and do the immune treatment. I just want to trust my body and not put too much pressure on it with different meds etc.

Oh- I also had a biopsy on cd 22 during my hysteroscopy, and the results showed I only had about 6% natural killer cells in my uterus which is actually within normal perimeters. Interesting! 
We will see how it goes. Fingers crossed! 

Steps after Lap

Oooo wow the recovery from the laparoscopy has been a lot worse than I expected! It doesn’t help that I went straight into CD1 just 2 days after the lap so I had excruciating period pains alongside the lap pain, but now that I’m more on the mend I’m feeling slightly more human. I’ve had my stitches removed and the scars are pretty much non existent now which is good. 
I’ve had a bit of time to think about where to go from here. I have a doctors appointment in 2 weeks where we will go through next steps and hopefully we are in the same page. I’d like to do another fresh cycle, and hopefully get a few day 5 embryos to PGD test. The last idea we discussed with the doctor, was a short protocol with probably 225iu Gonal F (this is what I was on previously that got us 15 eggs) and get our embryos pgd tested. Then, we will begin our immune protocol process which will include

-2 Intralipid infusions (2 weeks before and 1 week before transfer)

-Neupogen injections (stimulates production of good white blood cells – not sure when I’m supposed to start this!) 

-lymphocyte immune therapy (LIT) in order to combat our partial DQ Alpha match (two treatments one month apart – aiming for a feb transfer so will probably start in January) 

-steroids & clexane daily 
It is so hard working with two doctors because I’m trying to organise when I need these treatments and how to coordinate everything. Ehhh so much to think about! I’m going to make an appointment with dr M (immune doctor) for after my appointment with the FS and hopefully can coordinate things to work out. 

It has been over a year since our last cycle which was a FET in May 2015 I believe. So it will be nice to be back in the game a bit after a long break. We’ll see how it all goes. Basically throwing absolutely everything at it before we really have to reassess and work out another option for us to keep going. We’ll get somewhere soon I’m sure of it ☺️