Doin' The Ultrasound Boogie!

We went in for the second ultrasound yesterday morning at the regular OBGYN office that will be taking over now. After some parking adventure we went in and joined my sister in law in the waiting room. Then we waited. And waited. And waited.

After an hour or more they called her in. She had to have blood taken and her history so we staid in the waiting room for that. Then she came out and told us that since the exam room was so tiny they would only allow one person in there with her. Naturally my wife went, so I didn't get to see the ultrasound live - just a couple stills.

The machine was reportedly nearly a couple decades old, so the images weren't as clear as they might be, but I could still make it out. But my wife tells me she could see the arms and legs moving! It's an energetic little guy or gal in there. The doctor says you don't always see that, but when you do it's a good sign. W00t!

One Baby On The Way!

Okay, the poll is closed and of the many many guesses - okay, one guess - nobody guessed right.

We have one baby on the way. The results couldn't have been better. By every measure it's right down the center of the expected range for a healthy baby. We even counted the heartbeats together.

There were three of us in there besides my sister in law: me, my wife, and my mother-in-law. Since it was done with a vaginal ultrasound probe (the dildocam, as my wife calls it) we were huddled together towards the head of the table. We all got a good view of the screen, though. When the doctor announced he spotted the heartbeat (which was obvious when he held the probe still for us) we were all elated. It was such a relief. Here you can see one of the stills he printed out for us. The baby is over the little "X" and the yolk sac is above it to the left. Both are within the amniotic sac.

Afterward in conference with the doctor he told us we had walked in the exam room with a 15-20% chance of a miscarriage, and walked out with a 5% chance. Our next ultrasound is two weeks after this one, but with the OBGYN practice that's taking over.

First Ultrasound's Friday Morning

It's almost 2AM and we're heading out for the first ultrasound at 8AM. My mother-in-law is tagging along. My wife has mixed feelings about that, in case things go badly, but she was in the waiting room for the transfer so maybe she's good luck.

I'm nervous. I'm really scared of things not turning out right, but I've been trying not to show it, and not to think about this these past two weeks. If things go bad I'm going to have to be the strong one. I guess I'll cry on my own. Hopefully it won't come to that.

But even though I've been trying to occupy myself and not think about it, this has been the slowest damn two and a half weeks of my life. Yeesh!

I had been thinking of putting up a poll to have visitors here guess how many we had growing and whether any looked to be identicals. I've decided not to, though, unless and until we see a healthy fetus in the ultrasound. After that, I'll put up a poll for a few days before announcing the real result. Hopefully it'll be fun.

Beta Test 2

We got the levels for the second beta test today. The beta level was 335. I did some math and figured three days of doubling every 48 hours would give a level of about 322, so we're right in the groove for a single baby. My sister in law's progesterone seemed a bit low, but when we asked the doctor about it he said her levels were just fine considering she's using vaginal suppositories. The progesterone's at higher levels locally, apparently.

Next stop: first ultrasound in two and a half weeks. We should find out for sure how many we have then. We're testing right in the zone for a single, but we're still in the range seen for multiples, so it's still not 100% sure. Pretty sure, but not 100%.

My wife has been having stomach- and headaches the last couple evenings. I think it's stress and worry over all this. She's better during the day when she's occupied. Fortunately the next several days look like good weather, so we might be able to extend the day with some walks around town or along some local trails to keep busy. It'll be good for us to get back into an exercise routine. Doing IVF cycles does interfere a bit with that, what with the bloating and all.

Anyway, that's one more hurdle out of the way, and things look good so far. Stay tuned.

Beta Test 1

We got the results of the beta hCG test: 114. From what we gather the average at this point for women who have a single baby is about 100, so we seem to be in the groove. The next test, to see how it's increasing, is scheduled for Monday. The real test, though, is the ultrasound later on. That will tell us how it's developing and if we have more than one.

Testing... Testing...

We've been doing a lot of pregnancy tests the last couple days, or my sister in law has anyway. Here are the latest. If there was any doubt, having it confirmed by a third brand of test, the digital, removed it.

Friday she goes in to get blood drawn for the beta test which will tell us how much hCG she has in her, which will give us some idea of how well things are along. There will be another one later to see how things are progressing. Then it'll be officially official, but I'm going to say it now: WE'RE PREGNANT!

Hope or a Tease?

Faint lines on the latest pee sticks. They run in the picture from the earliest at top right to the latest at bottom left. Click the picture for a larger view.

We stopped at my sister in law's house this evening to check on her report of faint lines on the pregnancy tests she's been taking. We were honestly expecting them to be merely evaporation lines - greyish lines sometimes visible on such tests after they dry, even if the result is negative. This is what we saw.

The fourth down was from this morning. The next was from this evening. The last was from late tonight, and was done about an hour after my sister in law last used the bathroom. We were not expecting to see anything at all on that one, but the fact that we saw a faint line on that one leads up to believe there is something happening. We know it's not an evaporation line since it started to show while the strip was still wet, and they are definitely pink/purple colored.

False positives are very rare, but we are trying to be only cautiously optimistic. Even so, it's difficult to restrain ourselves. Only our past disappointments keep us from being more positive about our chances. Realistically, though, a pregnancy can fail at any time. Our previous attempts failed before this point, so hopefully the one problem was that my wife's uterus was somehow inhospitable, but these are from forty year old eggs so we're not free and clear yet. On our first attempt we got a single test with a faint line - probably what's known as a "chemical" pregnancy, when an embryo starts to implant but doesn't quite. This has gone on longer, so we're hoping for better but still worried.

Wish us luck. We'll still need it!

Going For Five

We did the transfer this morning, putting five of our embryos into my sister in law. They were of average quality, all with some degree of fragmentation. We have some somewhat lesser quality ones still incubating, and will hopefully see a couple make it to blast and be freezable.

My wife's parents tagged along this time, though they had to sit in the waiting room. I was waiting with them during the actual procedure, though I did go back with my wife and her sister to weigh in on how many to transfer. We were pretty much unanimous on five given the quality and the nine we'd transferred in previous failed cycles. They had her drop trou and get ready right away, though, so I had to duck out of the room until she was in the bed and covered. The procedure went smoothly and afterward they left a freeze frame of the ultrasound up for me to see, showing my sister in law's uterus in magnified cross section with a little white line visible where the embryos and the fluid containing them were released. We talked with the doctor and estimated about a 20% chance of success.

Afterward, we went home to tend to some business and then went to my sister in law's to hang out and talk while my father in law cut the grass. My other sister in law, the middle one, showed up later with her two kids.

The doctor recommended three days bed rest, but everyone says he's a bit conservative about that. We talked about it among ourselves and decided her taking off work today and tomorrow would be a good compromise, given that she has a desk job.

We'll find out in about a week and a half if it worked or not. The odds are long but we can't help but hope for the best.

IVF 3: Post-Retrieval Update

The retrieval went better than we were anticipating in some ways, not as well as we'd hoped in others. Despite the worryingly estrogen plateau we got a good number of eggs. If I recall correctly it was 11 or 12 mature ones out of 21 good ones. As before, five others had cracked zonas which has the doctor puzzled. Still no idea why she's had so many do that, five every time.

The doctor called yesterday to tell us we had 13 fertilize. If things go as they have in our previous tries we'll have about half of those give us embryos, so we're anticipating roughly six or seven to choose from. Not sure how many we'll put back. I think my wife would like to put them all in, after having nine fail in her, but I think ultimately it's up to her sister to decide what she's comfortable with. The transfer is scheduled for tomorrow morning, though thankfully not near so early as the retrieval.

Wish us luck!

My wife's in the retrieval

My wife's in the retrieval room now. They've already given her a shot of anesthesia and I can hear her laughing.

IVF 3 Update: Triggered But Anxious

We triggered last night, but we're not feeling all that secure about it. My wife went in for a progress check yesterday. The follicles were the right size, but her estrogen was not up as much as expected. The doctor doesn't think that continuing the stimulation will make any difference so he told us to go ahead and trigger. We did so at 9:30 last night and have to be at the clinic for 7 tomorrow morning. In case you haven't read my earlier posts, it's about a hour drive so we're going to be getting up pretty early. I'm used to getting up a little before 8, so this will be fun, I'm sure.

We're not sure what we'll be getting out of this in terms of egg quantity or quality. I guess we'll find out tomorrow morning. Wish us luck.

IVF Take Three

Well, a lot has happened since my last post on this subject. I started a draft post mid July, but let that sit so long it's woefully out of date. So here's what's going on...

We went to the consult with the new doctor. We thought it would be a straightforward deal, just getting the details down for a try with my sister in law as the carrier. The doctor presented us with some options to mull over, though, including using donor eggs since my wife is now over forty. We went home and after a bit of hand wringing my wife decided that this is our last chance to have her own child so we would go with her eggs this time. Her sister is several years younger so if she's still willing we could try again later with donor eggs or adopted embryos. (Probably the latter since we're both not entirely comfortable with a child being from one of us but not the other, but would be fine with adoption if it weren't such an ordeal.)

Anyway, the protocol is underway. My wife is in the stimulation phase and will probably be ready for the retrieval in a week or so. Meanwhile my sister in law is primed for the transfer and waiting. (She has it easy: instead of shots she gets to use vaginal suppositories.)

We also got some good news today. My sperm numbers have improved greatly. The motility is greatly improved and the morphology is at 4% normal. The best morphology I've gotten in previous collections was 1%. I've been taking coenzyme Q-10 and vitamin E supplements most nights with dinner for the past month or so, the E for a bit longer. I don't know if that's what's made the difference, but my numbers are all at or near the minimum levels to be considered "normal" and I intend to continue. We both will be increasing our exercise as well to get in better shape, given that we now have an off chance of getting pregnant on our own. (It would be really crazy if she and her sister were both pregnant with our babies at the same time.)

I do believe we'll be having more sex. We've been off it for a bit. The low sperm counts & quality have been a bit of a downer, and it's hard not to think about it when you're thinking about sex. It just gives the whole thing a feeling of futility. Now, though, that load is lifting and we're both excited about it. I'm not sure when or if I'd be having any more analyses done, though, so there's a danger of uncertainty undermining that feeling if much time goes by with no luck that way. I guess we could always request an analysis.

With the numbers improved my wife asked the doctor if we were in IUI range now, and he said yes. I don't know if we'll do that, though. I read about a study recently that indicated that in cases of unexplained infertility using IUI (artificial insemination) or Clomid (to stimulate egg production) work no better than increasing the frequency of sex. Of course, you might say our infertility would be explained by my low counts & quality, but that in itself in unexplained, as is the fact that we've had three transfers of decent numbers of decent embryos with none implanting. I guess we'll see.

Gonna Need An Ocean Of Calomine Lotion

Got a little poison ivy, or poison something, on my legs this week.

I was power washing the deck, and the yard does need a little work around it. The grass needs cutting and several bushes need some big-time trimming. Also there were mosquitoes, though I did manage to get rid a few with well-aimed 1550-psi blasts of water. As often happens in such case, I foolishly did the work while wearing shorts and came in rather itchy. I have allergies, so that's par for me. This time things went a bit worse.

Over the next couple days it got worse, with the skin turning red, firm, and bumpy. Oh, and itchy, though if you've ever had poison ivy, etc., that goes without saying. That's bad enough, but here's where that bandage in the photo comes in. When I went out to do the deck washing I already had scratch right there. Well, evidently when you get poison ivy on an existing scratch it itches worse. I resisted scratching though, and put on some neosporin with an analgesic. The overall itch persisted, though, so I gave that leg a good scrub-down. In doing so I scrubbed away the scab. That may have been the big mistake because it immediately started weeping clear yellow fluid. I ran around looking for the bandages & tape (why we don't keep them in a handy kit is beyond me) with the fluid running down onto my foot. Nasty.

I put together a makeshift bandage with a couple gauze sponges held together with three bandaids instead of the tape I never found. My wife went out and got some calomine, gauze pads, and some rubber stretchy tape that will breathe and won't stick to my hairs. Only problem is it won't restick if you unstick it, so you have to make sure it's at the right tightness the first time.

It was still weeping the next day, even after a saline compress, so we tried to get an appointment to see a doctor. It was the 4th so they were closed, so we decided to give it another day. This morning it was still weeping (though perhaps slightly less so) so we called again. Still closed. We went to a nearby walk-in clinic we've used before and the doctor there looked it over. He said it looked like poison ivy, and that the sore looked to be just becoming infected. He squeezed on a glob of neosporin the size of a pecan half and put a large stick-on bandaid on it. He also gave me a shot of cortisone to speed the poison ivy clearing and gave me a prescription for an antibiotic and an oral steroid.

A couple hours later I noticed the weeping was passing through a wrinkle in the bandaid and soaking into my sock so I changed to the dressing I have on in the picture. (The dark part is the stretchy rubber tape overlapping.) It's much more comfortable and should absorb much better. I globbed on a bit of neosporin myself, as well.

Hopefully I will be able to report some good news about this soon.

Another Dip In The IVF Roller Coaster

A couple days ago my wife and I ran into a bit of a conflict.

After a conference call between us and an adoption agency rep that didn't go so well she indicated she was having second thoughts about going through with the upcoming IVF cycle. I think the call may have only brought this to a head, but that her doubts may have been mostly stoked by an orientation meeting we had with another adoption agency with a local branch. At the meeting one of the things they mentioned was embryo adoption. (One of the couples there is older than us and is planning on doing that.)

She said she wasn't entirely comfortable with creating embryos without their being able to survive. We've discussed this before. My view is that this is what happens when people conceive naturally, or us at least. A naturally fertilized embryo has little more chance to implant and carry to term than an artificially fertilized one - less if the protocol includes measures to stimulate the growth of a better, more hospitable, lining in the uterus. All we are doing in IVF is accelerating the process so that we get to the one that survives sooner. Her problem, though, is in knowing that's going on.

She also is frustrated with going through all the pain of the injections with nothing to show for it. The expense is a factor too. Adoption would be much more expensive, and would bring in outsiders with a say in things, but is much more of a sure thing.

As for myself, I really want us to have our own child. I'm an atheist, if I haven't mentioned that before. I don't believe in any kind of afterlife. I believe that the only way we live on after we die is through our biological descendants, and I don't want to disappear when I'm gone. I'm ready to accept that when we've tried everything we can it will be time to move on. I'm just not ready to accept it before we've done everything, and this cycle with her sister as the carrier would be our best chance yet for a child of our own.

She's gone through such doubt before, and it was also around this time in her cycles. She does get very emotional when she is premenstrual. I'm not dismissing her feelings. I'm just saying they are hormonally amplified at the moment. I think that ultimately we will go through with the IVF. We have a consult with the doctor coming up this week, with my sister in law present, so we can go over the protocol and know what to expect. (There is some extra testing, for STDs mainly, beyond what was done already for our earlier attempts.) My wife hasn't indicated she was canceling that, so I think we will likely ride through this dip.

It's still very frustrating and depressing. I didn't anticipate this kind of thing when we started. But I think that ultimately we can get through it.

UPDATE: My wife was out this morning and came back to pick me up to get lunch and bring it to Secret Headquarters. Over lunch she mentioned the appointment we have Friday and how we should go about convoying or carpooling with her sister. (I suggested that we carpool in her sister's car since she has the GPS and we've only been to the doctor's office once before, and that we should pay for the gas.) She said she hoped it worked. We also talked about what to do after if it doesn't, like maybe trying out doing interim care (short-term foster parenting) for infants and/or small children in the process of being adopted. It could be a foot in the door if we decide adoption is right for us, and would help us decide and get ready.

Another IVF Back On The Table

My wife's sister called last night and said she was up for carrying our baby for us. My wife was trembling while she was on the phone with her. I talked her down, a little, since we want to keep our expectations realistic: though this may well be our best shot at our own baby yet, the odds are still against us. We're hoping, though, that the big factor was my wife's health and the conditions in her uterus. We're also hoping we get some extra embryos to freeze again this time. Oh heck, we're hoping for a baby.

Meanwhile, we have an adoption orientation meeting/class coming up. We're going to be laying what groundwork we can for that, particularly researching adoption agencies. (Any tips, recommendations, or warnings are welcome. Please comment.)

Infertility Endgame

It looks like we're going into the final stages of our fight with infertility. Our plan was to do a couple IUIs with my sperm supplemented with a donor's, then if that didn't work (and odds are it wouldn't) we'd try one last IVF with my wife's sister as the carrier. After a bit of delay, I looked over the info we had on donors and picked one I thought matched me best. (Redheads are scarce among sperm donors, by the way, so if you're a healthy male redhead who wants to make a few extra bucks, head on over to your local sperm bank.) It was a bit late to catch that cycle, so we waited until the next month.

The next month is here. In the mean time my wife has gone back and forth on whether she could do another IVF, so that's still technically up in the air, but I think if it comes to that she'll come to a point sooner or later where she's up for it. Her sister has also been having second thoughts. It seems their mother has been pressuring her to do it. I think we should tell their mother we've decided not to do it that way, for some sort of medical reason, just to take the pressure off. It's possible whatever reticence she's feeling is from an instinct to resist the pressure.

As I said, the next month is here and today my wife expressed some doubts about doing the IUI. It's a more expensive proposition with donor sperm in the mix (so to speak,) not likely to work, and with her health issues it would be a high-risk pregnancy if it did work (even though her health has improved with better diet & exercise habits.) I told her we shouldn't do anything unless and until she is comfortable with it. She went off on an errand, saying she'd think about it while she was out, and order sperm when she got back if she thought she was ready.

After she left I realized I had felt a bit of relief when she talked about not doing the IUI. As the time went by the thought of ordering that sperm, and having my wife pregnant by another man got me sicker and sicker. I realized I couldn't handle it, at least not yet, and, with the doubts she was having, maybe this approach just wasn't right for us.

When she got back I told her what I thought. She says she agrees.

I guess the plan now is to see what happens with her sister. If she and my wife sync up on the IVF we'll try that once. Beyond that, there's adoption which we may start looking into soon regardless.

This infertility thing is not for sissies.

Further Fertility Developments

We saw the new doctor today. He was very personable and more forthcoming than our old one, or at least more talkative. He looked our case over and asked some questions. He recommended that if we did do another IVF that since my wife's sister is willing using her as a gestational carrier would be the way to go, given the number of decent embryos we've put in so far. He also said, though, that our chances with three tries at IUI with donor sperm would be about the same as one try at IVF. IVF tries are generally at least two cycles apart, so with the financial considerations the IUI seems to be our best long term shot. Also, my wife is really feeling worn down emotionally by all she's gone through in the IVF's we've done and gotten nothing.

For IUI we would also have a better shot if my sister in law did it, but we were told tonight by my mother in law that my sister in law told her that while she would be just fine with carrying our child, she wasn't sure she'd be able to give up a child that was genetically hers. I can certainly see that, and understand. I think we were a bit blinded to that possibility by our desire to have a child by whatever means are left at our disposal, and I think my wife was especially so and is having a hard time dealing with it.

So, it seems our next try or three will be an IUI with my sperm augmented by donor sperm, put into my wife. I hope it works, but my wife has other health issues that would no doubt make pregnancy difficult. If the IUI doesn't work, I hope she can find it in herself to do one more IVF with her sister as the carrier.

Wish us luck. We're going to need a lot.

IVF Update And Plans

Well, in case you hadn't heard, the frozen transfer didn't implant apparently. We knew it was a long shot compared to the fresh transfers, but it's still disappointing.

We're changing gears now. Tuesday we have an appointment with a new doctor. We've heard good things about him. He does his procedures at the same fertility center as our original doctor, (I believe they and a few other doctors own it together,) so that will be convenient if potentially awkward. I'm sure other couples change doctors often enough after a few failures for them not to be really surprised. I think it's good to get a fresh pair of eyes on the situation anyway.

Unless he has some really novel insight into what could be done to improve our chances with another IVF, our plan is to shift to doing IUI with my sperm augmented with a donor's.

I'm a little bit of two minds about that. On the one hand we've produced multiple embryos via ICSI with my sperm, transferring nine in total and having some that did not make it nevertheless survive longer than initially estimated. So we know my sperm can work if given a ride to the egg. It's tempting to say "why are we bringing in donor sperm when mine is good enough?" In fact our chances per try are much better with IVF than IUI.

On the other hand, IVF is rather expensive and the protocol is rough on my wife. She is also still rather overweight, but has lost a good forty pounds or so since we started this and is continuing to improve over time. Taking a break from IVF for a little while would give her a chance to improve her health and through that improve our chances, and also give us a chance to catch up a little on the financial side of things. While we're doing that, we may as well take a few shots with the augmented IUI and maybe get lucky.

The plan is to do that for a few months, then maybe, if she is still willing by then, have my wife's sister do the IUIs. She has no interest in being a mother again, has said she would be willing to help out, and would be much cheaper and easier to monitor than a paid gestational carrier. I'm not sure if my wife would still try alongside her at that point. If their cycles were offset enough so that each would start the drugs after the other had their pregnancy test that would let us avoid the possibility of having both pregnant.

At some point my wife may decide she's up for another try at IVF. We just turned forty, so we can't put that off too long, but as long as she's losing weight it's a question of whether the aging is making our chances worse faster than the weight loss is making them better. If only we had some sort of indication of the optimum window. We don't though, so we can only guess and do what we can when we can.

Maybe Tuesday when the new doctor weighs in we'll know better where we stand.

Frozen Embryo Transfer.

We transfered two frozen embryos today. The quality varied a bit between the two. When blastocysts are frozen the collapse like raisins. When they are thawed and survive they reexpand like grapes. (Well, grapes don't actually reexpand, but you get the idea.)

One of the two was in the process of expanding at the time of the last check before the transfer. It had some ruptured cells, but that is expected in frozen embryos. The other one was still raisiny, but did have plenty live cells. The doctor told us that usually if they had only the one raisiny blast they wouldn't bother transferring it. Since we did have the fair one, though, we put back both.

Now we wait. The pregnancy test will be on the 17th, if I recall correctly. (It's been a long day.) We asked what our chances are, and after thinking about it a bit the doctor said we have a 20% shot. It's not that much, but a frozen transfer is a much less expensive and uncomfortable cycle, so it's a shot worth taking. If this doesn't work, I'm not sure what we'll try next. My wife may or may not feel up to doing another fresh cycle. Our contingency plan is to do IUI with donor sperm supplementing mine. Hopefully, though, we'll get pregnant this time and not have to worry about that.

Lining Is Good

We went in for another uterine lining measurement yesterday. It was over 8 mm and the doctor declared us ready to move on to the next phase. Today I start giving my wife injections that will shift her from growing the lining to making it hospitable.

The transfer is set for this coming Thursday afternoon. If neither embryo survives the thaw - they pretty much always lose some cells, but at this stage they can usually weather that - they'll call us around mid-day and tell us not to come in. They said we can call if we don't hear anything, to make sure. I think we'll probably call when the employees go to lunch.

I hope this one works. After this the next thing to try is IUI augmented with donor sperm along with mine. If we simply can't have a child that's mine so be it - I'll take what we can get. When we were first getting to know one another I briefly suspected our nephew might actually by my wife's son, and I was okay with that. I really hope this new child will ultimately be our own, though, and as long as what we're trying involves sperm, and I have some to contribute, I will.