Statistics schmatistics (post by Jessi)

Maggie, Ben and I headed into this life-altering journey armed with statistics.  Based on my age and Maggie's age, we had a 60% chance towards a positive outcome.  The odds were in our favor considering those statistics were based on success rates for women (or their partners) with known fertility issues. None of us have any problems going on with our downstairs.  If you've followed this blog for any time you'd know that my eggs are perfecto, Ben's sperm army is nothing short than admirable and Maggie's ute has produced two gorgeous children without any complications and required nothing more than "legs up the wall pose" for planned conception.  Maybe we were a little over-confident, but wouldn't you be, too, given the circumstances?

We only got three embryos (8 eggs from retrieval, 3 of which fertilized). Two embryos were transferred and failed which leaves us with one frozen embryo.  The odds are already stacked against us for the next transfer because just like any fruit, vegetable or meat, fresh is better than frozen.  The embryos transferred on 11/4 were both fresh and Grade A.  Bet you didn't know that embryos are graded!  Last time I heard, our sole frozen embryo was a Grade B.  Because of its inferior grade, it's less likely to nestle into Maggie's ute than the two As but there's still a chance.  How much of a chance, you ask?  Hell if I know! [Oh shit, did I just say that?  I've had two margaritas and now I'm channeling my Grandpa Holcomb with the "hell if I know" shit! - Also, sorry for the swearing, Grandma, but you know . . .  tequila.]

At any rate, we pick ourselves up and carry on.  'Cause that's what people like us do!

 Special thanks to all of you who've kept the positive vibes, prayers, love and support flowing and will no doubt continue to do so as we embark onto chapter two.  Also, thank you to my parents who kept my mind busy this afternoon by blowing up my ceiling fan (No, really Dad.  That fan was already half dead.) And taking me out to dinner because otherwise I probably would've just eaten  microwaved cheese.  Finally thank you all of you reading this and those that sent happy, supportive texts, vmails, etc (you know who you are).  Today's winner is our BFF, Kate. 

Thanks for the laugh.  This chapter is now closed.  Chapter two begins NOW.

Participating in Miracles

There is this feeling that you have when you leave the hospital, or your home, or the birthing center after giving birth to your first child. It's like you can't believe that the rest of the world continued to go on as normal, while you have been participating in miracles....It's surreal.  You want to stop everyone you see and tell them, "do you know what just happened? The world became a better place because I made this baby. See?"

Today, Jessi and I are headed back into FAHC to do a blood test that will determine my HCG levels which will indicate if the embryos are nestled all snug in their bed or not. We have had almost no contact with the IVF clinic since the transfer. I really miss Nurse Mo so I'm really excited to check in with her but I am also becoming increasingly nervous.

I could barely sleep. I am going over every move I've made in the past 10 days. Every bit of food I ate. People have been asking me how I feel. If I feel "pregnant". I feel guilty when I say no. Mo told me I wouldn't be able to tell, but I mean, I seriously have NO IDEA.  I have noticed slight changes in my body-My digestion, "the ladies" are a little sore, but other than that-NOTHING.

I hope I didn't screw this up.  I hope Jessi and I get a phone call later that confirms that we are participating in miracles.

Transfer Day (post by Jessi)

Today, November 7^th, is exactly 300 days from my first appointment with the docs at the Reproductive Endocrinology and Infertility clinic.  I met with Dr Merhi for a consult and we talked at a high level about the process for gestational surrogacy, success rates, risks, costs and our ideal timeline.  When I think back to that day, it feels like a lifetime ago.  And yet, the last three weeks have passed in a total blur.  

Transfer day is the day we have all been waiting for.  It is the end result from the prerequisite appointments, screenings, procedures and drug therapy.  It’s the day the embryo leaves its simulated environment for a natural one, aka Maggie’s ute (ute = fun short hand for uterus).

On the morning of Transfer Day (11/4) Ben kissed me goodbye before he left for work and said “Happy Transfer Day!”  And a happy transfer day it was!  Maggie picked me up at exactly 1:20, just as she promised.  Those of you who know Maggie know that there are very few events she’s perfectly on time for.  This was one of them; she was just as excited as me.  I hopped in her car after she refused to let me drive and we left for the hospital.  

Somewhere in between jokes about getting “knocked up” and patient registration Maggie remembers that she was supposed to arrive with a full bladder.  Minor detail, NBD.  (Hey Ma – NBD means No Big Deal).  Maggie heads into Registration and I got her a bottled water to which she immediately starts chugging.  We arrive at the clinic halfway through the bottle and Mo was already out front in the waiting area.  Maggie explains that she’s been downing water because she forgot about the full bladder thing to which Mo replies “Whoa, just sip it.  We don’t want you to have to pee that badly.” [or something to that effect, honestly I was too excited to pay attention and couldn’t help but notice that everyone in the waiting area was fully enthralled in our pee discussion]

Mo takes us to the way back where the magic happens.  We’re both given fancy clothing to put on – a johnny for Maggie and the hospital version of a Breaking Bad meth lab suit for me.  Then we wait, she on the stretcher and me in the chair next to her.  Across from us is a window to another room with computers and other equipment.  This is where the IVF docs and nurses are getting on the “same page” for the procedure.  This is the very moment our Facebook fan page goes live.  You allow a couple of multitasking masters like us to have some idle time and we’ll make full use of it.  POW!  Created a Facebook page in the IVF recovery room.  [Also, we have to give a special shout-out to Maggie’s colleagues.  You were our first fans and gave us quite the laugh when you liked our page literally seconds after it went live.]

About twenty-five minutes into the wait, Maggie really has to pee.  No duh!  She and Dr Davenport talk about the possibility of her relieving some but not all of her bladder contents but she ultimately decides to just hang in there until after the procedure.  LIKE A BOSS, MAGGIE, LIKE A BOSS!

Five or ten minutes later we’re headed into the procedure room.  It’s modern, clean and much more welcoming than the room I had my egg retrieval procedure in.  The monitors are LED and the equipment looks brand new.  Mo shows me over to the stool where the accompanying partner is supposed to sit and I take a seat.  That’s when I notice the god-awful stirrups.  [I realize now that I should’ve taken a picture because there’s no good way to describe them.  Also, it’s NEVER a good idea to GIS (Google Image Search) stirrups at work.]  They were unlike anything I’ve seen but I’m willing to bet that if you gave birth to a Generation Xer, you’ll know exactly what I’m talking about.  They were wide, brown leather stirrups without the foot pegs and they looked like they had been salvaged from an underground abortion clinic.  

Maggie gets settled into the archaic contraption and Dr Davenport starts the process of cleaning her cervix and ute.  This is the most time-consuming part because, as you know from Maggie’s previous post, the hormone tablets have NOT been taken by mouth!  Mo is happily giving us a tour of Maggie’s innards via the ultrasound – “I guess you do have to pee, Maggie.  Here’s your bladder.”  A little more poking and prodding and then Dr Murray steps in to prepare for the transfer.  Mo explains that the embryos are floating in a tiny capsule of solution which is surrounded on both ends by air pockets.  Dr Murray positions the straw-like device exactly where it needs to be and flushes it, releasing the air pockets and embryos right into position.  Yes, I said embryos!  We decided to transfer two and doubled our chances.

Below is the ultrasound picture.   Not much to see here other than Maggie’s full bladder (red arrow) and the air pockets surrounding the microscopic embryo party of 2 (yellow arrow).   

And now we wait.

More Estrogen, Please

I began strengthening my uterus on October 20th.  Apparently, in order to provide an optimal environment for the adorable little embryos it is ideal to have a uterine wall that is greater than 7 mm thickness, ideally greater than 8 mm. I was slapping those patches on like a champ when I cheerily skipped to my Tuesday, October 29th ultrasound appointment.  The IVF Clinic appointment rooms line a hallway and in between each two patient rooms there is a shared bathroom. When I'm in those bathrooms I constantly recite to myself, "don't forget to unlock the other door." So I can remember. I wonder how many times the hospital staff have to unlock those doors.  These were my thoughts as I used the bathroom and then, I heard Jessi's and the doctor's voices.

Awkward! I had to use a great deal of self restraint not to yell out, "hey guys, it's me, Maggie!" I've got a good relationship with the doc's but that might be pushing it.

Based on tone and assumption but certainly not me leaning my ear against the wall to listen, I deduced that there was a doings a transpiring.  Then I diligently headed back to my room where I undressed from the waist down and hopped up on the table for an ultrasound that would indicate how my uterine lining was thickening. The doctor came in and we got down to business.

"Oh man!" He says. My uterine had NOT been progressing as he had hoped.  F.A.I.L. I immediately blamed myself, asked what I was doing wrong? How I could fix it? What's wrong with me? The doctor assured me that I was not doing anything wrong, but that my uterus was just not responding to the estrogen as quickly as they had hoped. In other news, Jessi was progressing more quickly than they had thought. So that she might be ready to go sooner rather than later. So we would need to boost my estradiol and thicken my uterine wall, or we would have to freeze eggs and wait for my uterus to catch up before doing the transfer. He said it was more important to have an optimal environment than to have freshies. Okay, he didn't say freshies, but I did.

Next stop, blood work.  Where Nurse Mo explained that I would have to take additional estrogen so we can try and force my uterus to grow. So in addition to the 4 Vivelle patches on my body and the shot of Lupron I would also get to take 2 doses of estrogen a day.

So yes. I failed my appointment.

Later that day, Ben, Jessi and I received an email from Mo with explicit directions regarding the next few days. It was long, so I'll spare you the details, but not the highlights:

** Retrieval is on Friday!! Jessi has specific rules about meds and not getting jostled.
** I was to take the estrogen tablets-not orally- I can stop the Lupron on Wednesday! And have an additional ultrasound on Friday to monitor progress, which will help determine the rest of the timeline.
**Ben had directions including, but not limited to the words "abstain", "sample", "fresh" and the phrase "not enough staff to receive it."

On Friday, my uterine wall, according to the doctor measuring the lining was still not thick enough. Moments after leaving the room, the doctor came back in the room and said to stay tuned because the "team" was scrutinizing over the image. Next stop, blood work. Again.

It was about a C+ appointment.

Later that day, I was told to start the progesterone, 3 times a day. And to come back in for another ultrasound on Sunday morning. Yay! Fingers crossed for more blood work! And if anyone is keeping track, I now would be taking 2 estrogen tablets and 3 progesterone tablets (not orally) each day and 4 estrogen patches being changed every 3 days.

Jessi and Ben picked me up on Sunday at 8:20 for my 8:45 appointment. We were ready for some answers! When the doctor came in he assured me that no matter what it said on the monitor, that it did not have a bearing on the likelihood of this pregnancy working. This did not convince me, but I nodded anyway, because I think that is how you are supposed to respond to doctor's. Obviously, if it didn't work it would be my insufficient uterus' fault.

Lucky for everyone, my ute was on the up and up. Turns out all those doctor's are not on the same page. They have conversations where they disagree about how each of them measure uterine walls. Plus, additional estrogen helps. And I like to think I've been willing my uterine wall thicker. For real.

And so there you have it. I'm ready. The embryos are ready. And then they give us an appointment.
Monday, November 4th at 2:00 PM.