Hiiiiiii FET Cycle

Hiiiiii Mid Cycle FET! If you unfamiliar FET stands for FROZEN EMBRYO TRANSER, and I happen to be in the midst of mine!

For all you geeks out there that are not familiar with some of this verbiage let me educate you :: A Frozen Embryo Transfer (FET) is a cycle in which the frozen embryos from a previous fresh IVF cycle are thawed and then transferred back into the woman’s uterus. An Embryo is an unborn or unhatched offspring in the process of development. ::

Last time I posted, I was at the end of my egg retrieval cycle. Hubs and I were deciding if we were going to do another egg retrieval to bank more eggs or move forward with an embryo transfer. Because we have a decent number of healthy frozen embryo babies this time we were presented with a couple more options on how to proceed with this IVF cycle… We decided to move forward with a transfer!

A few reasons we decided to move forward are 1. I wouldn’t have to put my body through all those nasty stimulating meds again. Affordability and health wise I think this was a smart decision. 2. We still have our second egg retrieval as insurance if we are unsuccessful at getting pregnant with any of our frozen embryos we have now. Win. Win. 3. We thought we would have gotten 5 eggs total with two egg retrieval’s based on the poor results we had last year with our first IVF cycle. Again, whatever this doctor is doing is a miracle and my body responded 1,000,00o times better than last time. We consulted with our doctor and asked what he suggested as far as doing another retrieval or going straight to a transfer. He said lets do the transfer! 3. We prayed and talked about it a lot and we both felt like this was the time. I am feeling excited, scared, anxious, calm, confident, all in one… is that even possible?

I have to say a FET cycle is kind of boring and calm and easy peasy so far. Going from 4 shots a day to just 1 a day and 2 every other day is cake. I am trying to focus on getting my body (aka baby palace) ready for this transfer. I am feeling so incredibly calm so far, my family is actually in shock, which is hard to do. Getting the healthy embryo’s seemed like the hard part and now that, that is over I really just need to focus on my mind/body health so that when these little babes are implanted back in me they want to stick around for a while… 9 months to be exact. I say “they” because we have decided to transfer two embryo’s. Our solo boy and one of the girls. Transferring two increases your chance of pregnancy. Yes we could have twins, we actually have a chance for triplets and quads if any of the embryo’s decide to split, but those stats are extremely low. Bring it on at this point I guess! My transfer will be sometime between the last week of March and the first week of April.

For now I am keeping calm and carrying on by doing almost daily yoga, meditation, and prayer. Lots of prayer. I am living in the now and not thinking about the future or what could or could not happen. I have so much faith in our doctor, in our embryologist, in the timing, in God, in the process. I know how hard this process is and sometimes it is easy to get lost in it. Lately I have been embracing the process. I have been leaning into the tension, the areas that may be a little uncomfortable and I have found the strength and calm on the other side. (duh I got that last part from yoga… such a yogi nowwww).

Namaste sistas.

 

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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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vitamins for daaaayyyssss

whatcha know ’bout dis life…

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AMH aka Almost Motherf&!king Hopeless

Almost. Almost.

Anti-Müllerian Hormone (AMH) is a hormone secreted by the cells of the developing antral and pre-antral folliclesantral and pre-antral follicles (or egg sacks) in the ovaries. AMH is a strong indicator of a woman’s ovarian reserve (OR). As women age, the number of follicles gradually decline, and AMH levels decline with age as well. In essence, reproductive endocrinologists can assess how well a woman’s ovaries are functioning, by evaluating her AMH levels.

Low AMH. .06 to be exact. FINALLY ANSWERS!

In laymen’s terms having a low AMH means my eggs are shit. Well some of them. A normal women my age should have around 17 eggs just laying around in her ovarian reserve. This does not mean that you only have 17 eggs left, this is just your reserve and gives an idea of how your ovaries are working to produce eggs. The most I have ever had is 10 (until recently when I had 13, but I will go into that later). It also means that my egg quality is not as good/normal as it should be. So, although I might have eggs that look normal from the outside, inside, the quality is abnormal and won’t lead to a viable embryo once fertilized. Basically my 30 year old body is more like a body of a 45 year old. As women we are born with all the eggs we will ever have in our lifetime. As we get older our egg quality may decrease and we start running out of eggs, which leads to menopause. The only good news is that I will go into menopause early. Hallelujah because I hate periods.

So where does this leave me now? I guess we have two options:

Donor eggs. Our last clinic was really pushing for the use of donor eggs after our failed IVF cycle. At first I agreed and was on board. We really just want to start our family already. At least our baby would have half of us- aka hubs. I even went as far as to look at the donor website. Some of the girls were really pretty and smart. They all had nice things to say about why the were donating their eggs, “I really want to help someone start a family. The gift of life is the greatest gift I could give someone.” Please, you just need money and that’s ok haha! (If one of the girls would have written that, I would have chosen her). I was imagining what our baby would look like. It would be half hubs and half some random girl. Sounds like a Jerry Springer show. I realized I would never see my self in our child. She wouldn’t have my sky blue eyes. She wouldn’t have my bitchy personality. She wouldn’t be my husband and my creation, something I just couldn’t grasp. So we decided to get a second opinion. Boy am I glad we did…

Keep trying with my own eggs. Dr. Acacio is one of the best fertility doctors in Southern California. That was the one great thing that came out of our last clinic. A secret referral from a couple of women who worked for our last clinic to one of the best doctors in Southern California. (Now that tells you something). I never looked him up because his clinic is 1 1/2 hours from our home and I never thought of traveling. Worth it. The first thing he asked us when we sat down anxiously in his office was “Why would you be thinking about using donor eggs?” We explained our history and what our last clinic had told us, but Dr. A repeated, “You absolutely do not need to be looking at donor eggs yet.” Really? Who was this guy. I loved him already. We did our homework this time and we asked all the right questions. After a very eye opening appointment we sat convinced that us together, could still create a baby that was all our own. A little background: Dr. A came up with the protocol I was on at my old clinic 10 years ago. He sold it to them 10 years ago and has not used it since because it doesn’t work. Especially on someone with low AMH. 10 YEARS. Just that information alone told me that the clinic we had just come from was a blast from the past. Dr.A works with a lot of “challenging” cases and has high success rates of IVF in women with low AMH. He was the only doctor that ever wanted to know why. Why does a young woman like me have low AMH. This was important to me because it shows he cares and wants answers. I asked if it could be from using fertility drugs for so many years, but he seemed to think not. He has done several studies and has come to find that autoimmune disorders in women can lead to low AMH and unsuccessful IVF cycles. (An autoimmune disease is when your own body starts attacking itself. Affecting different organs or functions in the body). Mind blown. Diagnosis and treatment: there is a blood test that I will be taking to see if I have an autoimmune disease and whether or not I do have a disorder, I will be receiving intralipid treatments right before our transfer and when pregnant to ensure piece of mind.

I bet you can guess, but we decided to keep trying with my own eggs. God knows, you may have to fight a battle more than once to win. And other ladies who have low AMH, keep fighting, keep researching, keep believing. It is not a death sentence. IVF can still work, it may just be a longer more windy road.

 

 

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