The last two weeks have been seriously crap-tacular. This past week, especially, was very much up and down, with the majority of it being down. I thought I might update.
The good of last week was our IVF consultation appointment with the doctor last Monday. Here’s a summary, in list form.
– We are proceeding with IVF (obviously).
– Though I am somewhat at a high risk for OHSS (young, many, many follicles in those ovaries), doctor says by giving me a Lupron trigger instead of Ovidrel, it cuts down the chances dramatically. He said there’s been no OHSS in the last 5 years for anyone taking the Lupron trigger. I hope this is true, because OHSS scares the crap out of me. For those who don’t know (yes, I do have a few non-infertiles who read this blog!), my understanding is that OHSS is when your ovaries hyper-stimulate, and you end up with crazy pain and you’re in the hospital. And it’s dangerous for you, not to mention possibly ruining the cycle. So this just can’t happen.
– We are doing ICSI. ICSI is a specific type of IVF, usually reserved for people with sperm problems, or unexplained infertility, which would be me. Instead of exposing my egg to a whole bunch of my husband’s sperm in the petri dish and hoping one attaches itself, they actually take a single sperm out of the bunch and literally place it on the egg (I think anyway). The doctors would select the best sperm there was to do the job. This is kind of crazy to me, that they are choosing, really, whether I’d have a boy or a girl. Not that I’ll know, but still.
– We are doing Assisted Hatching, if necessary. Again, to my knowledge, this is when, if the membrane of the…egg? doesn’t allow for the sperm to get in, because it’s too thick, the doctors would put a tiny slit in the membrane to allow it to come through. Assisted. Or something like that.
– We also agreed to participate in this study, something about exposing the embryo to 5% oxygen instead of the typical 20%. Apparently, scientists are the middle of trying to figure out if 5% is better for the embryos than 20%, and three big universities, including mine, are doing the study. My doctor assured me up and down that our success rates would not drop at all by doing the 5%. The success rates would either stay the same or get better. My husband is all about improving science, and I’m up for it too, so we said yes. I’m trusting my doctor on this one and letting it go.
– My clinic has a rule that you must freeze embryos if there are any to freeze. After that, you can do what you’d like with them. It’s not covered by insurance, but I’m not complaining. So it’s $1,000 for a year, and then after that, you pay a few hundred dollars every few months. We were going to freeze them anyway.
– Finally, we discussed the number of embryos to put in. Long story short – and for those of you who don’t know, your embryos are transferred back into your body either 3 or 5 days after the retrieval. I believe most people do a transfer on Day 3. However, if the embryos look amazing, apparently they can keep them going outside the woman’s body until Day 5, and be able to watch them 2 additional days, and then they would put them in. My doctor informed us that the success rate for getting pregnant at all on Day 3 with two embryos is the exact same success rate on Day 5 with one embryo (I believe he said 55%). Same exact thing. And for the Day 3, the chance of twins (when putting in 2) is 1 in 3. So it’s been decided that our Day 3 transfer, if that’s what we have, will be with two embryos. The bigger question at this point comes for if we make it to Day 5. If we put in two embryos on Day 5, our chance of twins is 50%. I realize that’s half, and not whole, but to me, I’m reading it like 100%. As in – by deciding to put two in on Day 5, we’re basically asking for twins. Day 3 is more of just a chance.
We think we have our answer regarding the Day 5 embryos, but we are still in discussion. N and I agree on everything – we can handle twins, we are fine having twins, we can afford twins, and twins would be wonderful. We would love it. But of course there are risks that come for babies and the mother – higher risk for complications, preemie birth, and of course I’d be having a c-section. While that’s more of a minor thing..I always just imagined I’d be pushing a baby out myself. But it doesn’t matter.
And then this came up, too. We hope to have three children, and four if we can afford it. At least one of those children was always going to be adopted, especially if we have four. At this point, I have always wanted to be pregnant twice. I want to go through that amazing time twice. By having twins, especially if we only have three and adopt the third, I’d be 29 years old and done, and I’m not sure that’s what I want. But I don’t know. I guess if I have a really horrible, stressful pregnancy I might feel different. I told N that I just can’t promise that if we do have twins, I won’t want to birth a third myself. And then if we have four, adopt the last child, and if we don’t, we wouldn’t adopt. N is fine with that, though he would rather adopt two, if we’re going to have four kids. I don’t think we’re going to be able to afford adopting two kids, but maybe I’m wrong. It’s all just..a lot to think about, just to answer the question of how many embryos on a Day 5 transfer.
If you asked me a month ago how many embryos, no matter what day they’re put in, we would’ve both said two. Now that it’s closer, now that the doctor makes me feel like making it to Day 5 with one embryo would almost definitely work, I feel like I’m taking a step back. I would love twins, don’t get me wrong. I don’t have a single doubt about raising twins, and neither does my husband. But I just want a child, so badly, that I don’t know if it’s worth the additional risks of complications. And I don’t know if I’m going to be done giving birth. So we’re on the fence at the moment. And then again, we could end up with a Day 3 transfer of two embryos and get pregnant with twins anyway, and I’m not even second-guessing that one. So maybe we’ll just…see how it goes.
The fact of the matter is, all this talk about babies, such specific decisions being made, makes me think it’s almost here. And in reality – it might not be. I have got to get my mind geared up for this IVF thing..because nothing is guaranteed. We still don’t even know why nothing has worked up until this point. There could be some implantation issue we wouldn’t even know about yet. So, I don’t know. Doesn’t unexplained infertility really just mean unexplained until they figure it out?
After we made all our decisions (with the Day 5 question being answered when the day comes), the doctor did a trial transfer, though I’m not sure why, when I’ve had three IUI’s and an HSG already. And it hurt. It always does. Apparently things are tilted in there…it always takes them a while. Then he did an ultrasound to check on my ovaries, because even though it was only Day 10 of my cycle, if all looked good in there, he was willing to give me Provera and get this show on the road. Unfortunately, that didn’t happen. I have a cyst, on my ovary. It has been there for a few cycles, hovering around 20mm. This check showed it at 34mm. Which would explain the stomach cramping I’d been having. He decided he doesn’t want to proceed with IVF until it shrinks, and said I could either wait or go on birth control. I asked him if the timeline would be about the same and he said yes, so I opted to wait. I have an appointment on Tuesday, before he goes on vacation for a week, to check in on it. So I went home.
Then, the very next day, I had the craziest thing happen to me at school. It was after our staff meeting and almost everyone had gone home. I was still feeling crampy all day long. I had just eaten a hard boiled egg and was preparing to leave when I suddenly had incredible intestinal pain. I’m not going to be graphic but I felt like I needed to run to the bathroom where..nothing happened. And I was spasming. Like, can’t walk, can’t sit down, can’t move spasming, I’ve had it before, but it always goes away in about a minute. This didn’t go away. I tried to tell myself I just needed to get home, so I tried to make it to the parking lot, and then I was doubled over with pain. I made it to my car, bent over, and then I think I started to panic, because I got dizzy, hands numb and tingly, white as a sheet, and thought I was going to throw up. Two people I work with were there, asking me if I was okay, and I was scared and a hot mess, so I basically pushed them away. They drove off, and I realized I couldn’t drive. I couldn’t even stand. I made it back to the building, but of course it was locked, so my principal had to see me like that, asking if I was okay. I thought I was going to need a hospital visit, but when I do get those spasms, I know Advil helps. Advil also gives me lip hives, but sometimes it’s worth it, and this was one of those times. Finally, a janitor went around looking for Advil and got me some, and by that time I was in the nurse’s empty office, half standing, half laying down on the couch. After taking it, I sat there, almost fell asleep, and then about 45 minutes later, the spasms stopped and I drove home.
Two nights of a heating pad, plus endless amounts of laxatives, plus eating only potatoes and tea, and finally the pain stopped fully yesterday. I did see my primary doctor and he said it could be the cyst, or diverticulitis, so I needed to watch it for a few more days. I was sure it wasn’t fertility related until I started to spot. It wasn’t a lot, but it was there, for sure, and there’s no reason for that right now. A little research told me my cyst probably burst. Also, it must have been pushing on my intestines, causing the spasms and blockage. Now, I feel like a million bucks. When I go in on Tuesday, we’ll see what happened officially. I wonder if it’ll be gone…a lot faster than I thought it would be. I feel fine now.
While it totally screwed up my week and was very painful, my new thoughts are about IVF. One cyst, 34 mm, caused me an insane amount of pain and messed up my intestinal system. What will it be when there’s like 10 large follicles on each side? I don’t want to go through this again. So I will be asking my doctor on Tuesday.
That’s a super long update, but this IVF business is no joke. I never thought, after Clomid, after injectables, after three IUI’s, I’d be here, but I am. I want this to work so bad, so at this point, I’m anxious.