Fertilization Report

Our ER was yesterday and below is the report and our next steps. We are very happy with the results, but will be on pins and needles until we get our final report on the 19th.

We will try and keep busy over the next few days. I found a place to hang our good luck egg in our hotel room. Tomorrow we are taking a day trip to Saltzburg which we are very much looking forward to.

Here is our report:
Yesterday we retrieved 12 eggs from a donor,

12 of them were mature, and 10 were fertilized with  PICSI, so you have 10 embryos now. They are monitored by EmbryoScope.

Your partner had his semen analysis done and the result is  asthenosperm (sufficient for IVF)  . He had 0 dose of sperm cryopreserved because the whole sample was used for fertilization.

Embryo transfer is scheduled for Tuesday 1:00 pm( 13:00 pm).

Please, have all your medication as prescribed as well as morning Progesterone (Utrogestan) pills vaginally. The main ingredient will be absorbed within 30 mins and white discharge will be cleaned in the operation theatre during embryo transfer.

Please come at 10:00 am  to 3d floor to give your blood for progesterone level.

You can have your breakfast before giving a blood.

You will have your consultation with embryologist at  12:40 pm    – please come to the 3d floor, you will be given an information about how many embryos you have and what quality they are.

Take your passports  and filled consent forms, which you will sign in front of the doctor or other clinic staff.  We cannot provide ET without signed consent forms.

After the consultation please come to 1st floor to financial dept. to balance your payment.

Then please come to 3d floor for the transfer. Please, take a bathrobe (long t-shirt) and slippers (socks) with you.  You will stay in the recovery room after the transfer for about 1 hour and I will then bring you the final report to your room.

It is better if you have a half full bladder for embryo transfer. You may drink around 2 glasses of water 1 hr before the embryo transfer, or just do not use the bathroom 2hrs before the procedure. Please, do not lead it to the critical as well, because you need to lie for 1 more hour once embryos are transferred.

You will continue taking medications prescribed, so please  make sure you have enough until  week 12th . I can give you the prescriptions for the meds you missing or make sure you will be able to arrange the meds in your country.

Thanks for reading,
HEATHER

Clinic Day 1

Well after months and months of planning, today we finally stepped foot into our clinic. It is called IVF Zlin.

The morning started off super frantic. We had asked the hotel to call us a cab for 7:45 am and that time came and went with no cab. We had an 8am appt at the clinic. There is never anyone at the reception because they live next door. We figured this out last night. So Ryan went down to the restaurant to find someone to call a cab for us. Well 15 min later still no cab. One eventually came but we ended up being almost 30 min late to our appt. Lesson learned, call our own cab.

First stop was the 3rd floor for intralipids. Of course they had a problem finding my veins the first few times. The nurse ended up not being able to do it and she called for a more experienced person to come try. After several minutes she finally got it and she started the drip. The room where you get it done has two comfortable beds. I laid down and got comfortable. Ryan set next to me and we set up the tablet and watched a stupid Ben Stilled movie. It took about 90 minutes.

Next stop was our first meeting with our doctor. He was very similar in his consultation with us to what we have heard from other doctors back home, just in a very thick accent. Our doctor is Dr. Milan, second from the right on the top row. Our coordinator is Anna, bottom row far left.

After we met with the doctor we did an ultrasound. They wanted my lining to be between 7 and 16. My lining was at 11.5. He found two cysts in my cervix but he said that wouldn't interfer with the transfer. Ovaries were ok and there was no fluid in the uterus so we got the green light to transfer.

Next was a consultation with our IVF coordinator. This is who I have been emailing for the last several months so it was nice to finally meet her in person. She gave us our next medication schedule. And our schedule for tomorrow.

Great news is I don't start PIO yet, they want to check my blood before the transfer after being on progesterone suppositories and oral pills first and see what the levels are. So 4 more days without PIO. Best news ever!

Our donor had her final exam yesterday and she was at good numbers so she triggered last night for retrieval tomorrow. Ryan does his part between 8 and 9am and then the ER. We will get an update that night and another one in the morning with our transfer time.

After all of this we are exhausted and going to take the day off from traveling. We asked if there was anywhere to walk around even and the answer was no, this is an industrial town. They directed us to a zoo, but living in San Diego and having access to one of the best zoos in the world, I think we will pass.

Also everyone keeps telling us the cabs and the people at our hotel speak perfect English. We haven't really been able to communicate with anyone at all. As I am writing this we are still having issues trying to get a cab.

Tomorrow we leave for Vienna and we are very much looking forward to it.

Thanks for reading,
HEATHER

We Have a Green Light

We are officially moving forward with our cycle in the Czech Republic.  Today I went for an ultrasound with our clinic here in San Diego and was given the green light.  Our clinic in the Czech Republic require a lining of 7 or higher after being on estradiol for 10 days.  Today marked day 10 so off to the clinic I went at 8am.  My lining measure 10.5 and we measured 3 times to make sure.  As a side note my AFC was 9.  I swear they were just there mocking me.  So I sent off my ultrasound pictures and results and received an email back from my clinic in the Czech Republic saying:

Your lining is excellent. Please, continue with the medication schedule without any change.

 Look forward to see you soon.

So off to the Czech Republic we go.  First we are heading to Budapest to get in a quick 4 day vacation before the whole process starts.  Here is our anticipated timeline:

April 9th - 12th - Budapest
April 13th - Ultrasound and Blood work at the Zlin clinic to make sure my lining and estrogen and progesterone levels are correct
April 14th - Egg retrieval from donor
April 15th - 18th Vienna
April 19th - transfer
April 19th - 22nd - bed rest in BRNO
April 23rd - home

We appreciate all the love and support we have recieved.  We can really use your prayers and well wishes in the next several days especially on the 19th.  CZ is 9 hours ahead so we are guessing our transfer will happen at around 1am or 2am west coast time.

Thanks for Reading,
HEATHER

Shrine to Fertility

     Over the years we have received various good luck charms from family and friends.  Today I decided to put them all together and create a shrine to fertility.  Hopefully putting all of that love and energy in a spot where I can see it, will really help me feel the support that I desperately need.  At this point in our journey, it is so very important to stay positive which is something I really have a hard time with.  Thanks to all that have added to our shrine.

     My brother gave me this wooden stretch Saint bracelet as a good luck charm.  He isn't Catholic, but he is religious.  He has one too that he wears. I was wearing it the day we found out that we had two normal embryos which is the first time I have ever gotten good news from the doctor.  I had a friend that was also going to get a phone call from her doctor and I kept it on until the phone rang for her.  She received good news too!  The power of the bracelet.

     My friend who is Catholic, gave me this St. Gerard laminated prayer card.  St. Gerard is the patron saint of expectant mothers.  I used to keep it in my car so that I looked at it every day, but now it is on the mantle.  The St. Gerard prayer is written on the back and reads :  O good Saint Gerard, powerful intercessor before God and Wonderworker of our day, I call upon thee and seek thy aid. Thou who on earth didst always fulfill God’s designs, help me to do the holy Will of God. Beseech the Master of Life, from Whom all paternity proceedeth, to render me fruitful in offspring, that I may raise up children to God in this life and heirs to the Kingdom of His Glory in the world to come. Amen.


     My Aunt gave me an amazing gift.  She gave me a special pouch with some very special items inside.  My Aunt is very spiritual and spends a lot of time with Native American friends and loves the spirituality the culture provides.  She was very close to a woman named Phyllis Big Left Hand.  Phyllis was Southern  Cheyenne.  I met her a few times.  Once Phyllis blessed me at a Pow Wow in Los Angeles years ago.   She was raised by a medicine man in the traditional ways of their culture so she was the real deal.  The leather that the pouch is made of is buckskin.  It was gifted to my Aunt during a healing ceremony on the Pima Reservation in Arizona.  Inside the pouch is all spirit sage, tobacco, cedar and lavender.  The all spirit sage, tobacco, cedar were also gifts from Phyllis.  They were meant for my Aunt to inspire her to learn the old ways and songs.  The stone my Aunt found at a crystal shop when she was looking for something for me.  She said the stone placed itself in her hand.  The stone is the shape of an embryo which is what drew her to it.  My Grandmother contributed by added some lavender to the pouch.  Not only does lavender smell great but it is also my favorite color.  In the Native American culture the turtle is the oldest symbol for Mother Earth and often a sign of fertility for many tribes.  Other Native American tribes see Turtle as a symbol of persistence and endurance.  The beadwork along the edge of the pouch is symbol of a Cherokee medicine wheel.  Then my Aunt said she blessed it off before she gave it to me.

     Lastly, my Grandmother gave me a candle for Christmas.  She saw that this candle had a picture of a baby on it and thought it would help to bring me good luck.  Technically it's a picture of a statue known as Divine Child Jesus.  But hey, if she thought of us when she saw it and thinks that it will bring us good luck, I'll take it!  At this point I will take all the luck and good thoughts anyone wants to send our way.  Ryan and I lit this candle the night before our transfer and said a baby dust prayer.(shown in a previous post called Egg Retrieval).  

Thanks for all the love and support!  The mantel looks lovely.  Here's hoping some baby dust is coming our way! Please still keep us in your thoughts and prayers.  It means so much to us and we really appreciate.

Thanks for reading,

HEATHER

Embryo Report - Day 5

Today's the big day, the Day 5 report.  Today is  the day that all this hard work, the tears, the elimination diet, the stress, the supplements, the doctor appointments, the blood draws, the 100+ vials of medication given by my husband in 13 days and the anxiety have all been for.  The ultimate goal is getting as many embryos as you can get to make it to Day 5 blasts.  Blasts (Blastocyst) are basically when the embryo takes on the shape of what will hopefully the future baby.  There is an inner portion which will form the embryo and grow to become the baby and an outer section that forms the placenta.  The Morula stage has about 16 cells, the blast stage has 200-300 cells so a lot has to happen  to get here.  If the embryos makes it to this stage today, they will be biopsied and frozen.  If they are slower than they should be, they get 1 more day and 1 last chance to catch up and will be kept in culture and looked at tomorrow.

Because of the gravity of the situation, I achieved about 2 hours of sleep last night and Ryan got about 4.  Even Parker couldn't sleep, she picks up on our anxiety I think.   So I waited all day for the results.  The phone rang around 4pm.

We have:
1 blast (Good quality) - this is the only embryo that is right on track and exactly where it should be
4 early blasts (fair to good quality) - these are much farther behind where they should be
2 poor quality - discarded
5 officially not growing anymore - discarded

WE ARE DEVASTATED.

Embryo Report - Day 1

I am still recovering from the effects of the surgery.  My stomach is still very bloated and I'm still a bit sore.  Overall I am feeling how I should be feeling at this point in time.  I have Tylenol and Tylenol with codeine and that is managing my pain.  I also have a heating pad to help with the sore stomach.

ICSI

Over the next 6 days I will be getting daily updates from the lab about how my embryos are doing.  We started off with 18 oocytes and we used ICSI on all of them.  Today's embryos check is looking to see how many eggs were successfully fertilized.  At this point the embryos are at the 1-cell stage.  Here is today's results:

18 follicles were retrieved
17 contained a mature egg
14 have fertilized and are embryos now

Thanks for reading,
HEATHER

Egg Retrieval

Last night we started off by attending a lecture at UCSD about infertility.  We met a few fellow couples from the support group there.  It  was nice to see friendly supportive faces on the night before the ER.  I loaded up on hugs and learned a few new things.  It is amazing to me how quickly protocols change in the infertility world.  An example in our case, our very first IVF was in Nov 2013.  It was a fresh transfer with no genetic testing with two embryos.  Now at the same clinic, they do 80+% frozen transfers and 60+% genetic testing.  Every 2 years it seems like they are learning new things and getting more data to make the changes.  I also learned that one of the universally horrible tests you have to do for your work up is something called an hsg test.  It is done in a hospital and it is very painful.  Not only that, but they use x-rays to look at your tubes which is harmful.  Now they have moved on to a bubble test which is PAIN FREE and done with a sonogram at a doctors office.  AMAZING!

After the lecture we went and got ice cream for the simple reason, because I felt like it :)  A scoop of nutty coconut and I was a happy camper. After ice cream, I cut up the watermelon and ate as much as I could.  I also lit a candle with a baby on it that my grandmother gave me for good luck.  I tried really hard to get some sleep, but I could not relax enough.  My mind was racing with anxiety.

In the morning I woke up and took my final shower with the antibacterial soap.  On a side note, I have nerve damage in my leg and had a neurostimulator implanted back in 2011.  I have to turn that off before any surgery. This always make me so nervous because I forgot about 4 surgeries ago and Ryan had to run home to get my remote before the could start.  I remebered and turned it off and started to feel less anxious.  When I got dressed, I had a silly thought.  I have worn really ugly sweats and IVF pajamas to all my other IVF cycle. My embabies probably think I'm a super dork.  This time I rocked out in one of my favorite band t shirts.  This way they know their Mom is cool and not afraid to go home with us someday.  Ridiculous I know, but we latch on to anything we can to try and help the situation and think positively.  I was such a ball of hyper energy that I decided to go for a walk while Ryan finished getting ready.  When it was time to go, he found me and off we went to the clinic.

We checked in, turned in all our used needles in a sharps container (bye you jerks, never do I want to see you again) and prepared for the ER.  They have a massage chair for when you first check in and that really did help to relax.  Its not as great as the bair paw gowns that RPMG has, but I'll take whatever I can get.  Ryan had to sign a few forms stating that he will be a responsible adult and take care of me over the next 24 hours.  Its nice to see a contract demanding that your husband take care of you.  The nurse and I joked that it includes unlimited foot rubs. Then I had to kiss Ryan goodbye and head into the OR.  I am very happy to report that the watermelon again did the trick and they got my IV going on the very first try.  This is monumental news because this hardly ever happens.

After the ER is over, they tell Ryan all my numbers and then when I wake up he tells me how well we did.  As soon I open my eyes, he comes back and keep me company in the recovery room. I have to take in an IV bag of fluids and then I can go home.  We checked in around 8:15 and we were back home by 11am.

The results of the ER was very promising.  They were able to retrieve 18 follicles.  This is the most we have ever had.  Before this, the most we have had is 15 and the lowest was 7.  Ryan also had great numbers today.  His results were also higher than we have ever had.  I guess all those supplements finally paid off.  However, there is no reason to jump up and down and celebrate yet.  Now we need to hope and pray that they do well and continue to grow in the lab.  We need them to make it to day 5 blasts in order to biopsy them for genetic testing and freeze them for a future FET.  No one gets 100% to make it to day 5 blasts, but we need to hope that we can get as many as possible.  To put this in perspective we have had 3 as the most that have made in and 2 as the least.  We have 2 frozen and banked now.  Statistically I need 6 to get one normal back from the PGS test.  The reason we need 6 is because our odds are less than great since I have had 3 failed FETs so far.  After 3 you automatically drop to a really bad category of basically hopeless cases.  So that means ideally we would need 4 day 5 blasts.  Fingers and toes are crossed, prayers are being sent and all our energy is focused on trying to stay positive and hopeful for our embabies to continue to grow.  I am doing pretty well.  I have serious bloating still and some cramping but that is very normal and to be expected.

Thanks for reading,
HEATHER

Cycle Day 14

Today's symptoms: headache is gone finally, huge gross bloated stomach is even bigger, tired due to lack of sleep, emotional and weight gain has lowered to +7lbs.

Today is the day before the ER and I feel like it is the calm before the anxiety storm.  At this point I have done so much but starting tomorrow it will be all out of my hands.  I will be glued by the phone waiting for daily updates.  It will last 6 - 7 until we get our final numbers.

Yesterday my E was 2900.  This means by the time of my ER I will again be 4000+.  That makes the day of and day after critical to how quickly I recover from all this.  Here is my prep for the ER.

Today

• Remove nail polish.
• Take a shower tonight.  Wash hair and dry natural, no products (not the best look for me).
• Wash whole body and face with antibacterial soap, no lotions or products afterwards.
• Eats lots and lots of watermelon from 10pm - 11pm.
• Take a stool softener.
• No eating or drinking after midnight.

Tomorrow:

• Take a shower and wash with antibacterial soap.
• Check in for ER at 8:30am.
• Take my antibiotic.
• Procedure starts at 9:30am.
• Eat salty food.
• Drink coconut water.
• If I need it I have tylenol with codeine.  I didn't take anything last time because I knew I was going to be doing back to back cycles and I didn't want anything to delay the process.  This time I have a month or two before the transfer so it is ok to take something if needed.

Kite ceiling tile from the exam room

At our last check we still had 16 follicles.  The picture to the right is the ceiling tile in the exam room.  We are keeping our fingers crossed that they can retrieve all 16 and that each has an egg.  It is not uncommon for the doctor to not get all the follicles, but usually you get 90% or more of your count going in.  It is also not uncommon to not have an egg in each follicle.  I'll post updates as soon as I can,  Thanks for all the love and support during our stims.  

Thanks for reading,

HEATHER