Huevo Retrieval

My egg retrieval was this past Friday, February 5th. All went according to plan and I survived! This being my second egg retrieval, I was far less anxious, and I was even looking forward to that drug induced nap. Seriously, going under is kind of awesome.

I’m probably the most annoying drugged up patient. When I got rolled into the OR I remember talking and talking and talking and then I was out. The doctor probably asked the anesthesiologist to, “give this chick a little extra so she shuts up.” ( Next time they will probably put me out before I even make it into the room). I would be interested to know exactly what I was saying. Hubs told me that when I was coming to that I kept saying how good I felt and was asking if I could have some more. I do remember I kept asking the nurse the same two questions because for the life of me I could not remember what she said! She told us we had gotten 11 eggs, but I kept saying 13. We got 13? No honey 11. 13? No 11. I remember before my retrieval a girl came out of her own harvest and I heard them tell her she had 13 eggs. That makes sense now… hahaaaaa. Hubs also told me that while I was coming to I kept trying to talk but all that was coming out of my mouth was “djfhkdejeroijdfdekjen”. Oh and when hubs told me he loved me in my ear while I was still asleep a tear came from my closed eye and streamed down my cheek. I guess I can be sweet and cute when I am unconscious. Seriously, you can’t make this stuff up!!

I like to think of an egg retrieval as picking apples from an apple tree. My ovaries are the tree producing these beautiful, juicy apples. The apples are all my little follicles. The doctor is the apple picker. He is in charge of taking his apple picker tool thingy and plucking each apple gently, one at a time, off of the tree. Making sure not to bruise or drop the apple on the ground he gently places the apples, individually, into his bag or test tube in this case. Then the magic happens!

Results thus far:

11 eggs retrieved >>> 5 more than last time! Which is a significant amount.

9 mature

9 fertilized! >>> I guess Hubs and I really like each other. Fertilization does not seem to be our issue- last time all of our eggs fertilized as well.

We will find out today if the other 2 eggs matured and fertilized. The embryologist will try and mature eggs that aren’t fully there yet after they have been retrieved in the lab… who knew! I think this makes our clinic pretty cutting edge since our last clinic did not do this. It’s cool because they give every egg a chance! Crossing fingers and toes that we have more good news today xoxo

Here is a picture of me posing as usual before the surgery.

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Genetic Testing

Genetic testing. What? How? Why? And is it playing God?

What is Genetic Testing? There are two types of genetic testing that can be done on  embryos. Both genetic tests are preformed on a day 3 or 5 prior to the embryo being transferred into the uterus. The distinction between the two types of testing: PGD and PGS.

  • PGD, preimplantation genetic diagnosis, involves removing a cell from an IVF embryo to test it for a specific genetic condition (cystic fibrosis, genetic disorders, cancer, for example) before transferring the embryo to the uterus.
  • PGS, preimplantation genetic screening, is the proper term for testing for overall chromosomal normalcy in embryos. PGS is not looking for a specific disease diagnosis – it is screening the embryo for normal chromosome numbers.

PGS is the more common genetic testing done in IVF. It basically tests for down-syndrome and sex chromosomal abnormalities (i.e. embryos with an extra sex chromosome). These are the two types of chromosome abnormalities that can result in a live birth- all other genetic chromosome abnormalities usually end in miscarriage or never lead to a viable pregnancy.

How is this process done? After the eggs are retrieved, they are then fertilized using ICSI. For 3 to 5 days these embryos will continue to grow and split. The embryos that are at the appropriate stage will be sent off for these genetic tests. We will be doing a biopsy called trophectoderm biopsy, which is performed on day 5 or 6 of embryo development. It is performed at the blastocyst stage after the embryo has differentiated into an inner cell mass, a trophectoderm component and a fluid filled cavity. With trophectoderm biopsy at the blastocyst stage a small hole is made in the shell of the embryo and several cells that are precursors to the placenta (trophectoderm) are removed for testing

  • This technique has shown promising results in US IVF programs. It is now considered by many experts to be the biopsy procedure of choice for PGD and PGS testing.
  • Genetic testing, like many medical procedures, is not 100%. Embryo’s can be damaged in the process of collecting the cells, and can be graded abnormal when normal or visa versa.

Why genetic testing?

In general, there are 5 main groups of patients that might utilize PGS or PGD.

  1. Patients that are having IVF with advanced female age – 38 or older (common)
  2. Patients of any age with repeated IVF failure – usually defined as 3 or more failed attempts
  3. To screen for inherited genetic diseases
  4. Patients that are carriers of chromosomal translocations
  5. Patients that have had recurrent miscarriages

PGD / PGS and Age – aneuploidy screening (PGS) – checking the chromosomes

  • The most common reason that PGS is done in the US is for “advanced age”.
  • This would often mean older than about 37 in many programs offering PGD.
  • The logic relates to the fact that women of advancing age have increased rates of chromosomally abnormal eggs – which after fertilization will become chromosomally abnormal embryos.

Human eggs are often chromosomally abnormal – and the percentage of eggs with a chromosomal abnormality increases with increasing female age. In general, about 30-60% of human embryos have some type of chromosomal abnormality. This increases significantly with advancing female age.

Furthermore, in an IVF cycle that is not doing genetic testing they will grade growing embryos on day 3.  Healthy graded embryos will be transferred and/or frozen on day 3. Embryos with genetic abnormalities can look healthy from the outside- you would only know if they were abnormal by looking inside (genetic testing). The potential for transferring a genetically abnormal embryo is pretty high. These pregnancies usually end in early miscarriage. For example with our first IVF, cycle before our eggs were sent to genetic testing, we had 4 embryos that were graded good/good (which is the highest grade they can receive). Out of those 4 that were then genetically tested, we only had 1 normal egg. ONE. This raised a red flag for us and our doctors and is one of the reasons why we have decided to do genetic testing again with these 2 IVF cycles.

We decided to do genetic testing for a few reasons. 1. With the diagnosis of Low AMH my eggs are at higher risk of being chromosomally abnormal. (please click link for more info about AMH). 2. When doing genetic testing, you decrease your chance of miscarriage significantly. Miscarriage usually occurs because there is a chromosomal abnormality in the fetus. We have already been through so much I don’t know what would happen if we got all the way to a pregnancy and then I lost the baby. 3. It increases IVF success. 4. If given the option with genetic testing to bring a healthy child vs. an unhealthy child into the world, we wanted a healthy child. Not that an unhealthy child would be loved any less, but given the option we would go with the obvious. Which brings me to…

Is genetic testing playing God? I don’t know. This is a hard question. God created the world and life, so didn’t he create and give us medicine as well? Genetic testing has definitely opened the discussion for ethical and social issues. As of now genetic testing is solely used to weed out chromosomally abnormal embryos and embryos that have genetic diseases.  With that said, genetic testing does supply you with the gender of your healthy embryo’s, which could lead to gender selection. You do not have to find out the gender if you do not want to, but the information is there for you. Hubs and I want to transfer one healthy boy and one healthy girl. I guess that would be considered gender selection…  At some point in the future, tests will no doubt be marketed for genes that are associated with behavioral traits such as intelligence, sexual orientation, possibly even perfect musical pitch, or physical characteristics like height, hair color and eye color. A way for a parents to create a so- called “designer baby”. Many of these claims will be highly questionable.  And what about gene mutations that have, say, a 20% or 30% chance of causing disease when the child is in midlife? Should parents discard an embryo based on that percentage? Consequently, over time, certain disease will become relegated to certain social groups, but not others. The gap between the wealthiest 1% and everyone else is already expanding. Should we allow this method to widen it more in the genetic pool? Others see this technology as raising troubling issues of eugenics, which had horrific results under the Nazis, who sought to “purify” the gene pool in Germany, and eliminate people whom they felt were genetically inferior. I know I am talking a little extreme, but with the way science and the world are heading this is a big topic of debate. I just pray that doctors remain moral and ethical with the use of these tests.

My husband is devout in his faith. It took him a while to get on board with IVF, because at first he felt that IVF was “like playing God”. Obviously, after he learned more about the process, he was all for IVF to start a family. Myself on the other hand, I have my faith, but I am more “spiritual”. I didn’t know if I really wanted to do genetic testing. My husband was the one really pushing for it. I think it’s a bit ironic. I am glad we did genetic testing on our last IVF cycle. If we would not have, our journey would have been quite different and would have cost us a lot more money, time, and energy. This time around we are doing genetic testing again because of how many abnormal embryo’s we had during our last IVF cycle. If God blessed us with a child with special needs we would love and care for that child like no other, but we feel that because we have the opportunity to do genetic testing it would be unfair to bring a child into this world with health issues, when we can prevent it. Not all will feel the same. Some will downright think it is wrong. But, this is our journey…

“How beauteous mankind is,” Shakespeare’s Miranda exclaims optimistically in “The Tempest.” “Oh brave new world, that has such people in it!” Huxley used these words ironically. Between her hope and his pessimism may lie the reality.

source: CNN, Advancedfertility

 

 

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Here We Are

Here we are, right in the midst of our second IVF cycle. I don’t really know if this is considered our second because we banking eggs at this point. What constitutes a full IVF cycle? Whatever. All I know is right now we are here. We decided to do two egg retrieval’s back to back so that we could bank as many eggs as possible since eggs are the issue. I can already tell a huge difference from this cycle from the last- and I’m not just talking about the decrease in meds, but the length of time I am taking them. I have been doing shots for almost 3 weeks. July of last year when we did our first IVF I did not have any side effects, other than being extremely tired. This time around I just don’t feel “good”. I am tired. I am short. I just feel off. I am taking this as a good sign that my body is liking whatever the doctor is prescribing.

Low down of our “IVF Plan”:
On meds now. Egg Retrieval will be sometime the first/second week of February depending on how my body is responding to the meds. Praying they get an abundance of healthy eggs. Eggs will be fertilized and sent out for genetic testing. Whatever eggs are genetically normal will be frozen.
After my egg retrieval they will give me a shot- oh joy another shot- of progesterone to make sure I get my period.
After good ol’ aunt flow shows I will start meds again and have another egg retrieval sometime in March, hopefully. They will harvest my eggs, fertilize, send out for genetic testing, and whatever eggs are genetically normal they will freeze.
Then I will let my body heal. And if you mean heal by going to a music festival and drinking lots of booze, dancing my ass off, and staying up until all hours of the night, then yes, heal. My downtime just so happens to land during one of my favorite music festivals. Who planned that? This is my last hoorah before I get knocked up! Anyways, back to the point. I will let my body recover from all the stimulating meds and then I will start the meds for a an embryo transfer.
Next, embryo transfer. In our case we will hopefully have one healthy boy and one healthy girl embryo to transfer. The joy of doing genetic testing is that we will know the sex of all our little embryos. We will be transferring two, to increase our chances of success.
Finally and hopefully a positive blood pregnancy test!

I do have to say I am way more confident and have less anxiety this time around. Maybe it’s because there is not the looming pressure of an embryo transfer. Or because our doctor is a million times better than our last. All I have to focus on right now is growing eggs. I have been working out as normalish as I can. I cut my workouts down to three days and week I have had to lower my weight since I am not allowed to lift more than 20lbs. Do you know how hard that is? My precious puppy weights 25lbs. I have been taking all my antioxidants to help my egg quality. I have been doing my Circle and Bloom meditations.

We had our first appointment last week for my baseline ultrasound. I couldn’t believe it. I had 13 follicles!! Lucky 13! And this is before any stimulation meds. For me this is 3 more than I have ever had before naturally (I have low AMH). Obviously I have been doing something right with my body. I am not getting my hopes up just yet though because I know this rollercoaster. Just because I have 13 follies it doesn’t mean they all have an egg. But, this is a great start!

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Hello. It’s me.

I can’t believe it has been a whole year (and a little more) since I wrote my last blog post or have visited this site. I think I needed a little break from the infertility community. Not that I don’t love and appreciate each and every woman I have met and connected with, but I felt like all this energy was going into being “infertile” and I really needed to focus on being fertile. I finally feel back on track with life. So with a little push from friends I decided it was time to get back on the blogging train. I really do want to document this journey so that when we do kick infertility in the face and my children are old enough to understand how badly they were wanted and why mommy got so fat and gross, I can share this journey with them. So lets recap what has been going on. If you haven’t gotten  your lifetime ear full of infertility shenanigans yet and you care to know what has been going on in the life of R Lee T, read ahead. Or don’t. I don’t care.

We got a puppy last January! I told my husband 2 years ago, “if we are not knocked up by January (2015) we are getting another dog!” So as the year went by and January came again, it was time to get that puppy, because no baby. I would like to introduce you to our French Bulldog, Pierre Louis Tieman. He is now 1 year old. He is my little angel puppy. Hopefully I get pregnant soon because I don’t know how many more puppies my husband can take.

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Pierre with his big sister Dorie

 

We decided to do IVF in July. Long story short: We FINALLY found out what the underlining issue was for us not getting successfully pregnant. (it only look 5 failed cycles of clomid and fermera, 2 failed IUIs, a new doctor at a different clinic, and 4 years). I have low AMH. If you aren’t familiar with this, get familiar. If you have been diagnosed with “unexplained infertility” make sure they test your AMH. It basically means my eggs are shit and my 30 year old body is more like a 45 year old. We got to a transfer, but for whatever reason our embryo did not want to implant.  Another failure. (I will be writing a blog post solely on this experience).

g_tieman-i-do-so-much-lifeinlove-hubby-toocute-bigday-fingerscrossed-specialinstructions_23895139054_oMy Mom’s got hitched after 32 years! It was one of the best days ever. How cute are they?

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I turned 30. Fuck.

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The last thing I remember from that night.

 

We went to Hawaii for my birthday and my Mom’s birthday. It was great. We really needed a vacation and some time to just be. Be silly. Be spontaneous. Be normal.

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I got my shit together. AKA my body. I have been using infertility as an excuse to why I haven’t worked out in 4 years. We all know it is very hard to stay/get motivated in that department when you are pushing hormones and emotions through your veins constantly. But, I got to tell you. This is the best I have felt in 4 years. My body is stronger and more ready for a baby than ever.

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Shameless selfie time. My hard work. It may not be perfect. But it is mine and I am proud of the work I have done to get this baby maker back on track.

 

So much more happened this last year, but these are a few of the big moments. And that brings us here. Now. “A thousand disappointments in the past cannot equal the power of one positive action right now.”

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Great Article

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I came across this very relatable article online by resolve.org… So yeah be nice to us!!!

Why Can’t I Get Pregnant? The Emotional Impact of Unexplained Infertility

 

By Victoria Hopewell
Published in Resolve for the journey and beyond, Winter 2011

You and your partner have just been punched––you have been told that you are among the twenty percent of couples who suffer from “unexplained infertility.” That news is devastating. It hits you both in belly and heart. How can there not be a reason? You’re right back where you started, a year or two or three ago. Once again you are in the dark. Infertility without explanation in the twenty-first century feels as if you have been told that you have bubonic plague in the Middle Ages and no one knows why.

Your anxiety increases because no one can identify the cause. Even if the result of those interminable, painful, intrusive tests had been that you or your partner could not have a biological child, at least then you could grieve and move on. You feel powerless to act because you do not know what the problem is or how to correct it. Your sense of hopelessness and immobilization brings with it a greater risk for depression. No surprise––anxiety and depression are the two predominant emotional reactions for the diagnosis of unexplained infertility (Wischmann et al.,1998).

You find it more stressful to talk with the family and friends who might provide much-needed support because you have no answers for them. You are not alone. One study found that the couples with no clear etiology for infertility experienced the most social strain (Smith et al., 2009). In another study, even three years after failed IVF attempts, couples with unexplained infertility were found to have unresolved grief and to be haunted by their inability to explain to others and themselves why they could not become pregnant (Volgsten et al., 2010). The researchers concluded that counseling might be needed to help couples deal with the ambiguity of their situation. Counseling also can help those with unexplained infertility focus on other life areas that are controllable and that provide a sense of efficacy and well-being (Paul et al., 2010).

In my own baby quest, I developed a bad case of “delusions of eggdeur” when my hormone levels were good and I passed my hysterosalpingogram with flying colors¬¬ — that pretty-in-pink procedure where the doctor shot pink dye throughout my reproductive system to make sure that the passages were clear. After I had optimistically tried IVF five times with my own eggs and failed, the loss was even more traumatic. I had been positive that I would succeed since the doctors had found no physical roadblocks on my path to pregnancy. After all those doomed attempts, the phrase that I kept repeating was from Shakespeare’s Macbeth: “full of sound and fury, signifying nothing.”

Why can’t we get pregnant? That may remain the unsolved mystery that a couple needs to accept. Then you can decide how to proceed while living with the unknown. Some couples with unexplained infertility will become pregnant on their own (Guzick, 2000). Even without knowing what is the matter, modern medicine can offer other baby- making opportunities and the possibility of a successful outcome (Guzick, 2000). I myself journeyed toward acceptance of using a donor egg. Making choices along the baby route leads to a sense of empowerment, and it can help to overcome the anxiety and depression that often accompany the unexplained infertility diagnosis.

 

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