Dum Spiro Spero

"While I breathe, I hope." That was what was written on the silver bracelet I was wearing today for my transfer, along with a really awesome pair of purple unicorn knee high socks. Through this journey I've developed many friendships with other women who also struggled to start their families. Despite most of them finding their way to motherhood over the years, they still support those of us in the trenches while we still pursue this dream. Thank you to those wonderful women - this picture is for you:

We arrived at the clinic at 11:20 am, me downing water to try and fill up my bladder, Derek belting out "We're gonna make a baby the expensive way" in a Scottish accent (don't ask). Standing in line to check in, the fire alarm started going off. Despite this, I was calm and confident, and when the alarm was shut off less than 10 minutes later, we were still on schedule.

My acupuncturist was already there waiting for us and we were lead in to a room with a reclining chair. We signed all the paperwork, only then being told that both of our frozen blasts had survived thaw and were in great condition. I relaxed with some needles in various places while my bladder quickly filled up and we waited for the call to go to the transfer room.

You can't see them, but I have needles everywhere, including my abdomen.

 At exactly noon, we were led to the transfer room and given this picture:

Our day six blasts were rated 5BB and 5BA. The clinic uses the Gardner grading system, so these were both "(5) Hatching out of the shell", several celled, loosely grouped, and one was forming a loose epithelium while the other was forming a cohesive layer. But the coolest part was when she showed them live on the screen before taking them up in the catheter. They were both very clearly hatching, and we were seeing it in real time. It was a bit emotional.

Despite issues I've had in the past with doctors getting through my cervix, my very overfull bladder seemed to straighten everything out and the RE got through with minimal cramping. Using ultrasound, they guided the catheter in, prepped the blastocysts, and did the transfer. The green cross over the white spot in this picture is where the blasts landed (the catheter is that white line below and to the left), which we watched in real time. Amazing.

After 10 minutes on the bed letting things settle I was able to go pee (longest pee I have EVER had in my life considering I didn't want to push it out too hard), then back to the recliner for another 20 minutes with the needles before we left at 1 pm. It's all over, after years of waiting. It's happened.

And now we wait. See you on the other side of the two week wait.

Checkmark. Transfer date is set!

My uterus has not failed me, nor have the twice daily doses of estrogen. Today my lining is at 10mm, and is trilaminar. A trilaminar endometrium is the ideal state for this phase of my cycle, and ensures a receptive environment for embryos. According to the research, "At the time of embryo transfer, it is favorable to have an endometrium of a thickness of between 7 and 14 mm with a triple-line configuration...".

So, transfer is scheduled for one week from today, June 18th. In preparation, I soon stop the five times a day Suprefact nasal spray, continue with twice a day estrogen, and start vaginal progesterone thrice daily, starting five days before transfer. 

During my meeting with the nurse today, I had her bring up the information about our blastocysts. We have a 5BB and 5BA. The '5' represents the type of embryo (blastocyst), the first letter represents the degree of fragmentation (A meaning little or no fragmentation, C meaning lots of fragmentation), and the second letter is the overall grade. We have one average blast and one above average blast. I asked about thaw success rates, and the nurse reassured me that success rates for blasts are the highest of all at the clinic, and it is very, very unlikely that we will lose one or both. Then she asked if we were ready for twins.

I know it's going to be a slow week to get to Thursday, but one of the longest waits I've ever experienced in my life is the time between transfer and pregnancy test. Thank goodness it's summer.

T-9 Days Until Ultrasound (but not the exciting kind, yet)

Here we are, day 18 of Suprefact, day five of Estrace (estrogen) and baby aspirin, day four of an antibiotic, nine days from an ultrasound to check my lining, and ~14 days from embryo transfer.

I'm almost in shock that it's actually here and finally happening. I keep expecting something to go awry, but so far, so good, and no historical issues with lining development to cause me to worry. Granted, I'm emotionally tired most days (though generally in a good mood, lucky for Derek), I've been having headaches, and oh man, the hot flashes, but despite those minor inconveniences, I'm feeling pretty good about all of this. The addition of Traditional Chinese Medicine (TCM), acupuncture, and a Qi Gong healing session over the weekend from Derek's lovely Aunt Shirley seem to be helping with the anxiety and worry. I feel good. I feel confident even! This might work!

Of course, it also might not work. There are still things that can go wrong (i.e. the whole embryo thaw process is one of those things that is unknown), but my overall positive outlook, and the fact that I'm pretty busy with life in general, override my minds ability to dwell too much.

Almost there. And hopefully 'there' is just the beginning of the journey.

Suprefact Side Effects, Ugh.

I am on day four of taking Suprefact nasally. Five times a day, every four hours starting early, early in the morning, I spray a dose of Suprefact up each nostril. The first couple of days I was still on vacation in the Okanagan area of B.C. riding my road bike with a group of team mates and I felt great. I had zero side effects the first few days despite having to spray gross stuff up my nose at the top of a hill climb on a stomach full of gels and bananas.

And then yesterday morning I woke up a few hours after taking my morning dose (and going back to sleep for a few hours) with some pretty severe stomach cramps. The memories of stomach pain associated with the Suprefact during my IVF came flooding back. I think what happens is the small amount of medication that does not get absorbed by my sinuses runs down the back of my throat and in to my stomach. It's probably especially bad when the stomach is empty, like it is first thing in the morning. Of course, to compound the fun, I started getting hot flashes as well (and I run pretty hot already).

We made the eight hour drive home yesterday with me cringing in the passenger seat every 20 minutes or so from a stabby cramp. I put off taking my next doses until the very last minute in fear the cramps would worsen, and made sure my stomach was full of absorbent foods each time. The cramps eased up by about midnight, and despite taking it again this morning on an empty stomach, I am not cramping today. I do still feel like a furnace though, so I'm thankful for the cooler weather here at home.

So here we go, first medication is started! I should start AF late next week or weekend and we add estrogen to the mix. I can't believe in less than a month I will be PUPO!

Here we go!

Eight days ago I called in to the clinic with cycle day one and on Monday we got the offer for FET. This time we were able to say yes. Here's the schedule:

May 15th - start Suprefact, which is a suppressant that prevents me from ovulating during the FET cycle. I also start taking daily low dose aspirin for possible clotting issues (more preventative than anything).
Around May 29th - start taking Estrace (estrodol). This starts to build up my uterine lining.
Around June 11th - ultrasound to check lining, blood work to check estrogen levels. If all looks good, I will start taking Prometrium (progesterone) for further uterine lining development and potential pregnancy support.
Sometime between June 16th and 19th, the transfer will happen.

I pulled out our big fertility file because although I know we have two totcicles, I couldn't recall what age and grade they were. We have two day six hatching blasts, average grade. Our hope is that these two embryos were the best of the lot (I had 17 eggs retrieved, 14 fertilize during the IVF in 2012 - only four made it past day three, two of which are these frozen ones) and are strong, as evidenced by having made it to day six and starting to hatch. There is a risk that one or both don't make it through thaw, but the success rate for thaw is around 90%, so we won't let that worry us too much.

Now here's the thing - Derek and I have agreed that there will be radio silence for a few weeks following the transfer. He is aware of this blog and how public I am with our fertility journey, and he's open about it as well, but we both want to (hopefully) enjoy the first few weeks of a successful pregnancy, or mourn a failure privately, before we let you all in on the results. Trust me, this will be as hard on me as it is on you, but I think it will be good for us to have something between just us, even if for a short time.

FET Non-Update

We're on the call list and will hopefully stay there. We got 'the call' this cycle (this past Monday); unfortunately we had to say no because the tentative transfer date was smack in the middle of a vacation we have planned in May. The nurse went to the effort of seeing if there could be any adjustments made to allow for it, but with ultrasounds and blood work requirements, it wasn't going to work.

So we said no, but have been reassured that we're at the top of the list now. This means that we are pretty much guaranteed a call next cycle. Looks like transfer will be in June!

Happy Easter everyone!

The FET Lottery

Over the years, I have come to find that patients at the Calgary Regional Fertility Clinic are really just numbers. There is no holistic or personalized care, and they only used standardized protocols with minimal, if any, deviation. I would guess that the reason for this is efficiency - with the rise in the number of couples and individuals (because there are single women out there who decide to use a donor to become mothers on their own), the clinic is becoming more busy, therefore standardization tends to move things through more quickly.

The unfortunate side effect is that there are hundreds (thousands?) of CRFC patients playing the waiting game each cycle. Here's how it works if you are waiting for a frozen embryo transfer (which is similar for IVF):

• Day one of your period you call in to the 'period hotline', leaving your name, chart number, and phone number.
• You spend about a week to ten days hoping that you get a call back. You make sure you have your phone by you at all times and answer all calls, leaving meetings, interrupting conversations, answering when you're in the bathroom taking care of business (I'm serious). You constantly check for messages. And sometimes they just never call.

Not getting the call sucks. You've looked at the calendar and calculated when your transfer might be (it's about 6 or 7 weeks between cycle day one and the FET transfer on the typical CRFC medicated protocol) and start to get excited. However, your hopes, once again, are crushed. And the waiting game continues on.

Last month I didn't get the call. In about a week, I will call in again, and wait to see if I win the FET lottery this time. I hate being a number.