Moment of truth. BFN? or BFP?

I know everyone has been on the edge of their seats waiting for an update, and although we knew the outcome when I made the last posting I needed a little more time before updating everyone!!

When it comes to embryo transfers they can be done at so many different stages between Day 2 and Day 6.  The typically timeframe though is either at Day 3, Day 5, or Day 6.  Obviously the later you wait to transfer, the less time you have to wait to get the results.  With a 5 or 6 Day transfer (what our embryo transfer was) you find out if your pregnant, or not, about 7 or 8 days later, it really ins’t a long wait but it feel like f.o.r.e.v.e.r.  And if you are anything like me, you POAS (pi$$ on a stick), otherwise known as an HPT (home pregnancy test), starting just a few days after the transfer .... and know 5 or 6 days after the transfer.  I don’t recommend this because POAS can be pretty unreliable, you can get false negatives and false positives, it really is much smarter to wait for the beta (blood pregnancy test).  The false negatives can be due to an HPT with low sensitivity and not having enough hCG in your urine for it to pick up, and false positives are typically due to taking a test too early and having left over hCG in your system from the trigger shot, or hCG boosters.  If you are a good patient and follow directions just wait for your blood test ... but if your like me and always had that report card that said "Talks to much and doesnt follow directions" then we obviously know 10+ years after your last report card you probably still are not following directions.  My advice, go ahead and do it, just make sure you're not to POAS too early in the game.  

I have to admit this time was a lot easier when it came with the 2ww (2 week wait). I didn’t have the ablity to sit an anlyze every twing, or cramp,  count how many times I peed in a day, if I could sniff out a dust bunny with my blood hound nose or how sleepy I got after just 5 loads of laundry and 2 rounds of dishes.  I didn't have the ablity to sit online and compare my symptoms or lack of them, to other women at the same DPT (days past transfer) as I was.  Not having the ability to know all this was both a blessing and a curse.  When it comes to analyzing symptoms during the 2ww its really hard due to all the different medications you're on.  Mostly due to the progesterone injections.  This medication is a devil for a handful of reasons one of them being that progesterone mimics almost all pregnancy symptoms.  Typically progesterone rises in pregnancy but when your an IVF pt you're getting lots and lots of this hormone (50-100mg/day) so the levels in your blood are going to be high if your pregnant or not and very so-called-pregnancy symptom you feel can always be traced back to progesterone ... or another one of the 10's of meds you're on!!  Its an evil plot from the manufacturing companies and I know plenty of women that will agree with me on that!!   

Not only did I have a lot more free time during this 2ww because I wasn't glued to the computer, not much you can do when you're stuck on bed rest, but I also was able to save myself a lot of money on HPTs because I wasn’t purchasing 3 or 4 a day.  Although...  if you didn’t know HPTs can be written off on taxes, so one may say I can be a little obsessed with HPTs during the 2ww,  I really am only thinking about our taxes and getting a better tax bracket! 

When you do Day 5 or 6 transfer the embryo is just about ready to hatch, if it isn't already hatching at the time of transfer, so implantation can happen within hours or a few days.  Below is a rough guide to how an embryo progresses after an IVF transfer. 

By this chart it says that by 9dpt (dpt - days past transfer) that hCG can be detect on an HPT, but most HPTs now a days are super sensitive and it can actual detected as early as  5dpt ... although I dont recommend testing that early at all, thats just an evil way I like to torcher myself. 

Our original beta date was set for 9/28 (8dpt), but due to some pre-planned plans, the 2ww (although really not 2 weeks, only 8 days) was pushed out to 10 days ... another lesson to teach me patients, apparently I don't learn this virtue well.  And by no means Lord and I asking for any more lessons :)  I thank you for the patients I do have, even if it is low!!  After it was all said and done it was actually nice having it push out 2 days because we were able to get the news just hours before I saw the hubby ... after 7 long months!!

Beta test are done every 2 days because hCG levels usually rise in a progressing pregnancy, every 48-72 hours.  A single beta alone can not tell you much and because of that 2 -3 blood draws are done as a way to measure the viability of a pregnancy, and sometimes even more can be needed!!

This is a chart of 'average' beta numbers based off women who submit their numbers at DPT.  

    DPO     Median hCG Level      Lowest hCG                   Highest hCG                 # of women reporting

TWIN PREGNANCY BETA LEVELS

SINGLETON PREGNANCY BETA LEVELS 

Despite all the horrible percentages of how this cycle was going to go, it goes to show how big our God is.  Whats impossible to man, is possible with God!  God is working behind the scenes, no matter what we face or what the trial!

Our beta 10dp5dt (10 days past 5 day transfer) = 165 (15dpo for chart comparison)

Beta 12dp5dt = 371 (17pdo for chart comparison)

Beta 17dp5dt = 3411 (22pdo for chart comparisons)

I read this days after our transfer in August was canceled, its from 'Today's Word w/Joel Osteen' 

If God made everything happen right away, or whenever we wanted it to happen, 

it wouldn't require anything of us.  We would miss the opportunity to grow because 

we grow in the difficult times.  We grow when our faith is being stretched, when we

have to believe when we don't see any reason to believe, when we stay in faith when

when our mind is telling us we're wasting our time, when we give God praise but we 

really feel like complaining.  That's passing the test.  When you do that every day, your 
faith is not only increasing, your character is not only being developed, but you are one 
day closer to seeing the promise come to pass. 

Today, don't give up on a promise just because you've been waiting a longtime.  Dig your heels in.  
Put on a new attitude.  God is saying, "Every promise I've spoken over you, every dream 
I've placed in your spirit, even the secret petitions of your heart, the dreams you haven't 
told anyone about, I still have every intention of bringing them to pass."  
Stay close to Him.  Obey His Word and move forward in the blessing and victory 

He has prepared for you!"

so, now that we're pregnant .... whats your guess.  One on the way?  Or two?  

7 month after this all started ... finally its Transfer Day!

First baby pictures ...  Embryo A & B.
Why is one lighter and bigger, and one dark and more compact?  Embryos are like a sea anemone, the one on the left is fully expanded making it look larger, while the one on the right is still expanding after the thaw.

Here we are again.  Feels a little like Déjà vu, been here too many times before ... but this time was a little different ... I was able to sit on the other side of it all.  I have to say, I have never walked into doctors office and walked out with another woman carrying my husbands baby – and excited about it!  I think it was a first for both of us!  

Sitting in the waiting room gave me a little chuckle.  There were 3 other couples in there waiting and I could only think that here we are – both sitting together, no husbands, just us.  I know same-sex couples go in often to extend their families but that is all I could think of sitting there – I am sure everyone else just assumed we we’re that lesbian couple – I am surprised we didn’t get more looks coming in, or while we waited … maybe it was because no one wanting to look up from their phones to give that impression or no one really cared.  Either way it gave me a laugh and helped to lighten the feel of what was waiting for us in the back room ... my nerves going into another transfer were through the roof. 

This transfer was a little different – typically on 'transfer day' I wake up and shower, but have to shower with non-scented soap (thank you Dove), and then proceed to get ready making sure I have no lotion, deodorant, hair spray, makeup, perfume or any other possible scented thing on my body.  I was once told by an RE that scents can harm the embryos during transfer because they are extremely susceptible to outside environmental factors, so it a ‘rule/guideline’ I have taken with me to all transfers (even though I have since been informed thats more for the embryologist - not the parents).  Not sure if you have seen that deodorant commercial that 'stress sweat' is different than other sweat … but it is.  There is nothing like going into a transfer with 4-6 other people in the room, more than half of them deal with vagina's, and lots of them, on and every day bases … its there job, so of course they probably don’t care.  But knowing you have an audience of on lookers you usually make sure you spend a little extra time in the shower (or wax salon) getting that baby all cleaned up and ready for the spotlight.  But let me tell you when you’re spread eagle in stir-ups and have a Doppler pressing hard into your bladder (praying to yourself you don’t pee on the doctors face) and your vajaja spread with a speculum and getting prepped for a uterine catheter, you kinda of forget all about your girly-parts being on display because your just hoping no one can smelling you, like you can, because you know you stink like a 14-year old boy who just left 5 hours at the gym. 

They stress relaxation is the best thing for transfer, a relaxed uterus is the best environment for implanting embryos, which is why they give patients Valium before transfer.  So this transfer morning we went to a day spa and got 'BB' set up with a quiet and relaxing facial.  The plan originally was to spend the morning at the spa to enjoy a facial and massage, but we didn’t have enough time to get it all in before having to be at the clinic.  
Shortly after arriving at the clinic they took her back to get her set up with pre-transfer acupuncture and Valium … although I think it might have been better for me to get the Valium, or 3!  But apparently no one thought I would have the driving ability afterward ... no faith :)

If you ever have a desire, or dream, to be a unicorn, acupuncture is probably the closest you will get, and 'BB' was able to experience being unicorn that day.  One of the spots of the acupuncture is dead center between your eyes, and the needles they use during the transfer are quite l.o.n.g. … so she had a lovely little unicorn horn she was able to stare during the whole process, because she wasn't able to see much of anything else.

I don’t claim to be a radiologist, or a doctor, but I have seen enough ultrasounds of my darn uterus that I can pretty much tell what is normal vs what is not … and having that knowledge is not always a good thing.  After we said our hellos my nurse when straight over and started getting her prepped, as we were running a little behind, first thing was to take a look at the lining … that was when the mood in the room changed some.  As soon as I saw the screen I knew something was not quite right , but I kept telling myself I wasn’t a doctor and everyone’s uterus looks a bit different and started praying like crazy.  Dr. S was quiet through the whole thing, as was my nurse, and things started to feel a little tense and weird.  He let out quite a few heavy sighs and I was hoping it wasn’t due to the reason I saw on the screen.  Trying to feel everyone out I started asking some questions ... how their day had been, if they had been busy with transfers and retrievals ect.  I knew we were coming in on the very last day of the cycle, 2 straight weeks of seeing patients, performing egg retrievals and doing transfers would make for an exhausted last day, and I hoping that his demeanor was due to just that!   Much to my dismay I was told it had been a slow morning (because it was the very last day of cycle) and with that news, the knot in my stomach only got worse.  Dr. S left the room for a bit and came back in, didn’t really think much of it, but he went on to the transfer very quietly.  Some people are able to hid emotions very well, my nurse is one of them …. My doctor not so much.  

We transferred our 2 very best embryos, both which were Grade 1 ... its the highest of grading the embryologist gives out.  They were in layman's term "perfect" embryos.  The transfer its  went smooth and our 2 little ‘twinkies’ were all settled in.  They draped her up, pulled her up on the table and had her lay there, still looking like a unicorn, for about 30 mins.  I left the room and allowed her to have her quite time to relax.

The bright white dot at the base of the arrow, is the embryos all snuggled in for  some hibernation 

As soon as I walked out of the room I met my nurse outside the door, in tears. I was hoping it was tears of happiness but knew deep down my worries were about to be confirmed, I already had a hunch about what was going on…. I wasn’t an armature at this.  

'BB' went in on Sunday and made the 9mm cut, amazing and shocking news for everyone, and she was cleared for transfer.  That night she stared progesterone, which is suppose to “lock in” uterine lining, but at the same time as starting progesterone, you also stop all the other meds that help to grow the lining.  When they checked her lining moments before transfer, what I saw on the screen was in fact confirmed.  Her lining had shrunk, and dramatically.  It was only about 6/6.5mm, they said at very best maybe 6.5-7mm, but that was pushing it.  Apparently when my doctor left the room, mid-prepping, it was to talk to the embryologist.  He was going to call off the transfer because the lining was not likely to be successful, it wasn't prime to be susceptible to the embryos, but our embryos were already thawed … and they cant be re-frozen.  Given those circumstances our doctor went ahead with the transfer, because it was either throw the embryos away, or transfer, and of course the best place for the embryos at the point in time, was in the uterus – extremely thin lining or not.   We were given the success rates of 60% per embryos, but that was with healthy uterine lining, the success rates dropped by 80% due to the extreme thinness. After the transfer, we went an had a little lunch at Smash burger, then headed back to the hotel for a day of bed rest and vegging with movies, magazines and tv!  

I am thankful that we are only required to have ‘faith like a mustard seed’ because every day my faith ranges.  One moment I go from confident and leaning fully on my faith knowing God's got this – I mean we did pray over everything and all the doors were open to moving forward - but then another moment I am doubtful, worried and and will admit only have a mustard seed of faith.  The past is haunting and its very easy to remember that we have been down this road numerous times before and it hasn't ended very well.  In the end I just have to remembering, “If God brings you to it, he will bring you through it” no matter what the end results is, good or bad! 

Transfer day ... to beta.  Let the wait begin.  

2nd Lining: Make it or Break it Time!

I know everyone has been anxiously awaiting an update and I apologize for the lack of information over the past few weeks.  September was a crazy month of ups and downs for me (awful news, good news, bad news, followed by good news & homecoming) at times I feel lucky I made it out of September with my sanity.  It did sit down a few times and attempt to blog and update about everything going on but never could finish anything that made much sense.

Mid- September I received a very, very unexpected phone call from my mom informing me I had to drop what I was doing and get home.  Being that 'Miguel' was 2 weeks shy of coming home I assumed he decided to do a surprise homecoming and so I found myself racing home expecting to see him sitting on our porch swing  - instead I found my best friend waiting for me.  Typically it would not have been a big deal, she knows the door is always open for her invited or not, but there was something very different this time.  I came in and saw her oddly hanging out - I walked down the hall and peaked around the corner thinking I would see my husband sitting on the couch, but again I was wrong the couch was empty.  I had seen that face before, a face that does not need to speak a word you just know something is terribly wrong.  Of course the first thought comes to a military wife, especially in the mist of a deployment, is of course the worst case scenario ... he's dead ... or critical injuries, and before a word is even spoken you are already planning on fast you can get on a plane to Germany.  

Thankfully I was not needing to plan my flight to Germany but the news wasn't to much better.  It was news, very unexpected, shocking, and unimaginable new that my dad had past away!  I had seen him all of a few days before hand, for the most part he was healthy as a horse but the Lord decided it was his time and called him on in the middle of the night.  He passed away in his sleep and was found that morning lying peaceful in bed, I guess that is the way we all want to go - but still it was horrific news.  

That news came on Friday morning and shortly after that ... Sunday to be exact ... it was time for the “make it or break it” lining appointment with my “BB".  We were needing for a minimum lining of 8.5/9mm, anything less than that and the transfer would have to be called off again.  It was a crazy day; delayed flight time and a Jewish holiday for my doctor which made for non-negotiable hours at the clinic, they would be unable to stay open for us.  I stayed behind as “BB” did the traveling, which ended up working out due to the news of my daddy I received a few days prior.  The flight from SD to LV is about 45 mins, which typically would be nothing, but when long delays come about, it makes for a very stressful day of travel.  By the time she landed in LV (a few hours later than what the flight was scheduled for) she ended up having to make a mad dash from the terminal to the rental car place.  At this point I can only envision elbows being thrown in crazy 'Home Alone' airport scene, only to find the line a mile long at the car rental facility ... so off to find Mario Andrei in his bright yellow taxi!  She got there within minutes of the clinic closing.  At this point both her and I needed a few of those airplane shots ... or blood pressure pills.  I still think a great addition to the waiting office at SIRM is a mini-bar, something more than water, coffee and tea to take the edge off ... I know I am not the only one that needs a shot or two to calm me!  

It was a long wait from the time she walked into the office to the time an email was sent out from my nurse, really probably only a half-hour but it felt like a lot longer, but as soon as I heard that lovely little “DIIING” on my phone I popped open my email and there in big bold caps from my nurse was “SHE DID IT, LINING WAS 9mm!”  And a few minutes later my phone was ringing with my awesome nurse on the other line.  It was a shock to everyone in that clinic, including me (and probably even her) that her lining made the cut – I think everyone involved took this news with wide open mouths.  This was truly a miracle in an of itself!!
She was sent home with new meds, a new med calendar and the official transfer date was set for 9/15 ... this was really happening.  

And with that I leave you on a cliff hanger ... I will update early this week about the transfer!