Follow me on the crazy, hopeful, discouraging, funny, and ultimately successful (one way or another) path to parenthood while facing infertility.

Monday, June 16, 2014

Waiting to Wait; A Bizarre Protocol Addition



Ok, little embryos... you've been hanging out in that dark, special-medium soup for three days now. If we were doing a three-day transfer you'd already be in my uterus, and I'd be that once-wonderful, now-terrifying Pregnant Until Proven Otherwise state.

But, we're holding out for blasts, so you're still in the dark.

And so are we.

It's like a practice run on the two-week-wait--will I be able to keep sane and busy and not drive myself crazy? Because right now, I have not received word on our little embryos since Saturday, when we got our fertilization report. As of then, 15 fertilized eggs were starting to divide and work their magic, 4 of Bryce's and 11 of the donor's. Are there still 15 in there? I doubt it. How many are left, still dividing and making their way from 8-celled to morula? For reference, here is a cool chart I lifted from www.maxhealthcare.in/newsletter/2010/january. I hope I cited it ok, because it is really awesome and if I drew it myself it would be a hot, hot mess.

Stages of embryonic development

Previously, we have done all of our fresh transfers at the other clinic at the 3-day point, when most of them were 8 celled (but we occasionally had a 6 or 7 celled embryo in the mix as well). Then the rest were left to keep dividing to the 5-day mark and frozen at the 6-day mark. When we did our DE cycle, we actually had fresh blastocysts, which was novel! Then we had three to freeze at the 6-day mark, but only one looked good upon thaw. 

Newer research shows that blastocyst transfers are the best way to go. We heard it over and over from our second opinions and all the internet research I did for other clinics that are well-known. On the flip side, I know people who transferred one lonely 2-day embryo for fear it wouldn't make it to Day Three and that embryo is now a toddler. So, it doesn't mean that earlier transfers are a waste of time. However, overwhelmingly, the research shows that making it to blast is a chromosomal hurdle. If an embryo can make it to blast, it has more going for it in terms of normality and possibility of implanting. CCRM actually said that they don't consider embryos who don't make it to blast as likely to do anything, so they only do blast transfers. Success rates are apparently higher with blast transfers, too. 

Here's the downside though -- you lose a fair number of embryos when you wait for blasts. You can start out with 15, and end up with 2-4. We are hoping for a 40-60% blast production, which would leave us with up to 10, but somehow I think that's hoping for too much. I would be ecstatic with 6, because that would give us two FETs after our fresh transfer. But it could very well be less. 

The biggest fear is that we don't end up with anything from the Bryce Batch. We're only starting out with 4, and historically speaking we have quite the attrition rate with our own materials. While I'm feeling great that a full 75% of my eggs fertilized (GO EGGS!), I feel guilty because we don't have a whole lot of faith left in our sperm. After 5 fresh transfers using our own sperm, the attrition rate plummets and we don't know if a new lab will make up for whatever it is that's going on. The last SA that we have showed higher numbers than ever, which is fantastic! Except our morphology was <1% normal. Which is not fantastic. I am not a morphology expert, so if you are and can explain this better please leave a detailed comment below, but I'm pretty sure the wonky-shaped sperm have a higher rate of being chromosomally abnormal. But, I'm not sure if they can even fertilize, so maybe our Fantastic Four are in the clear on that score. I could look up all our old numbers, either in my trusty notebook or my old blogs, but I am refusing to do that. What possible good could it do to know our historical rates of crappiness, when we have so many changed variables? I am really attempting to be more in the present with this cycle. 

And so I am sitting on my hands and refusing to call the clinic to find out what's up with our little dividing babylings. When I spoke to the doctor who did the retrieval on Saturday, he said that they really don't like to look at them hardly at all because it can disrupt things. So no news is good news. We may not get any updates until Wednesday morning, the morning of transfer, which is REALLY HARD TO WRAP MY HEAD AROUND. I am used to getting an update on a more regular basis, but maybe all that peeking meant my embryos weren't as robust as they should have been. I am going to let it lie. Even though that is REALLY HARD. I want to know. But, what good has knowing done in the past? Still no baby... so maybe embracing the not knowing is to embrace the mystery of this whole process. Even with everything we do know about how to help babies come to be, there is still so much we don't know and may never know about the mysteries of implantation. So we wait. Until we have the REAL wait. 

And that REAL wait is a bit longer here. They don't count from retrieval. They count from transfer. And it's a longer number than I'm used to. So I will be waiting a really, really, really long time for my beta. Like, a how-can-I-resist-peeing-on-that-stick-I-have-hidden-in-the-back-of-the-bathroom-cabinet long time. I am going to need some strategies. Plus school is out after next Thursday, and so I won't have as much to keep me busy. Maybe I can just sleep through the what feels like THREE weeks of waiting. Maybe they can put me in a little coma so I can wake up and find out if I'm pregnant or not. I dreamed I was last night, and while that's encouraging by a smidgen, it's just a dream. That I hope becomes reality, but it was a lovely dream while it lasted. 

The last piece to today's post is my new addition to my protocol. Speaking of being in a coma throughout my wait, I am apparently to take 25 mg of Bena.dryl THREE TIMES A DAY starting tomorrow. Apparently, this is a protocol that came out of Colorado and then was swiped by a New Jersey clinic and now has been appropriated by my doctor to try on me. The thought is that with patients with recurrent implantation failure (me, me, me), maybe there is an inflammatory response that can be mitigated with the antihistimine. And in the cases where they've done the weird allergy med treatment, there have been increased pregnancy success rates. Very strange, not gonna lie. BUT, it kind of makes sense. I am ridiculously allergic when it comes to my skin. I have broken out into hives that covered my entire body with just the wrong detergent. When my cat's claws get me, no matter how superficial, I get this raised bubble around the scratch. I am allergic to Bryce's beard. That's right, as awkward as it is to imagine how this might come to pass, when his beard touches my skin I break out immediately into big, puffy, angry hives. Sometimes I get hives and I have no idea what I've touched. Air? Could I be allergic to air? My first acupuncturist said I had "very high histimines," so I guess that makes sense. Plus, not to overshare or anything, but I have that really gross Geographic Tongue thing. Go look it up, it's not horribly gross but not the most beautiful thing in the world either. I find that when my body is under stress, my tongue acts up and gets all uneven and sensitive. The "raw" patches FEEL raw and like I've eaten about 5 atomic sourballs in a row. I can't tolerate acidic foods like orange juice. When I stim and I'm on all the fertility meds, my tongue acts up. When I'm sick, my tongue acts up. When I'm stressed, my tongue acts up. I've always wondered but have been unable to find any correlation between my tongue and allergy or autoimmune responses. Because, I've got that whole Celiac thing, too. Inflammatory is my middle name. So yeah, sure--pump me up with Bena.dryl until 6.5 weeks of pregnancy, why not? If it gets me pregnant, I will be thrilled. 

And conversely, if it's the BENAD.RYL THAT GETS ME PREGNANT, I may shit myself. That would be so crazy that one of the fixes could be an over the counter drug that helps Bryce to get to sleep on insomniac nights. 

And it makes me nervous. Will I be Sleeping Beauty for these couple of weeks? How am I going to DRIVE? It doesn't affect me as hardcore as it does Bryce, but I do still get sleepy. Will I get used to it? I have to start the regimen tomorrow, and tomorrow is my first day back to school AND a marathon day -- full day of school plus the 8th grade awards ceremony from 7:30 to as late as 9. I AM IN TROUBLE. I figure I can take my first dose after I get to school, so I don't have to worry about sleepy morning driving. Then though I'm screwed for the afternoon. Tomorrow I'm crashing at a friend's house between school and ceremony, but what will I do Friday? Or all the days next week when I have to be in school, cleaning up/ closing up shop/ prepping for next year??? SO CRAZY. I will let you know how it goes. Hopefully I don't end up the narcoleptic teacher who gets drawn on with sharpies the last day of school. 

Wish me peace to make it through these days with my sanity intact. Wish me the serenity to NOT bomb the phone lines of my clinic with calls begging for info on our miniature progeny's progress. Wish me the ability to stay awake while I'm bombarded with massive amounts of benad.ryl. I'm going to try my best, but in the meantime, I'm going to nap. Because it makes the waiting time less.

10 comments:

  1. Thanks for the table--these terms have been bandied around the blogosphere, and honestly, I was never quite sure what they meant. Until now. So thanks. Although I know the sats, I really want to do a 3-day transfer. I would be so, so sad if we went through all we went through and only ended up with nothing to transfer. I think I might be a little insane for wishing that.

    Oh, I hope that there's something in Bryce's batch--that the new clinic/lab was just what you needed. All my fingers and toes are crossed.

    I wish you so much peace over the next few days and the following two weeks, and maybe you're right, you'll sleep right through this time thanks to the Benadryl, which maybe isn't such a bad thing.

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    1. I don't think you're insane at all for wishing for a three-day transfer. Given everything you've had to go through to have the eggs for the embryos that are marinating, I don't see how you could NOT worry about losing some of those precious embryos. Like I said, while so many clinics are shifting to blast only, that's not right for everyone. Still amazes me that that one little 2-day embryo that wasn't looking so good became a healthy little baby! You just never know. Thanks for all the crossing and the peace... I hope I can make it through all these hurdles in one piece! We'll see in a couple of days how it all pans out... I will keep tabs on you, too!

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  2. Benadryl makes so much sense - that had never occurred to me before. And yes, what a simple answer to such a difficult question! I've found that, as long as I don't sit or lay down, I'm ok on Benadryl - so I hope that will work for you. Can't wait to hear about Wednesday!!! And, btw, mine were 3-day-transfers and none of the other ones made it to day 5. If all clinics were switching to 5-day-transfers only, I would not have my babies... I don't fully understand the reasoning behind that... Is it becoming procedure if you have fertilized eggs above a certain amount?

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    1. I think it's dependent on number of eggs and other factors, but the lab technologies are also advancing so quickly that more embryos are making it to Day 5. A lot has changed even in the short time since your wonderful babies came to be! It's truly amazing. I don't think you can't do three day transfers though, its still an option.

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  3. Eek...good luck with all that waiting!!! I'll be thinking of you. I totally support your goal to embrace the unknown though...what else can you do? Though it is hard not knowing, knowing always seems to leave you wanting to know more or wishing for something different.

    The Benadryl sounds like it could be the ticket...and if nothing else, help you pass some of the wait time. Just take care of yourself ... I know how crazy the end of the school year can get and how exhausted it can leave you.

    I'll be staying tuned for updates...hang in there as you wait!!

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    1. Thank you! One part of waiting is done, now for the BIG WAIT... So far the benadryl isn't too bad, although I fear it's cumulative because I was fine the first few days and now I am pretty tired all day, yesterday especially. Last day with kids is done--and I have lots of help for the final cleanup/setup stuff for next year. Thanks for your thoughts!

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  4. Oh sweet lord. Laughing so hard: 'if it's the BENAD.RYL THAT GETS ME PREGNANT, I may shit myself." I so hope it helps with no feces involved. :) As for morphology...we had issues with that as well. I don't fully understand it either, but think that ICSI helps address it. Wishing and hoping with you, dear. I'm one-handed typing this because my blast from 13 months ago is a wild man this morning! :) Anxiously waiting with you!

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    1. HA HA! No feces would be great, but it really would be something if a little pink OTC pill was a magical ingredient in the fix to our frustrating mix of woes... Thanks for the hopes and the thoughts on morphology, such a mystery some of this is. I love the image in my head of your wild man success story squirming all over the place, you made me smile big with that one. :)

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  5. Is it wrong that this post makes me want to run out and stock up on Benadryl? :) I hope that you get to shit your pants because the "bendryl trick" worked!! Wait. I don't think I should wish for that. But you know what I mean.

    I am sending lots of little cheers up for your embryos, but don't tell the donor ones, I'm sending extra love to the Bryce batch. As teachers, we aren't supposed to have favorites, but you KNOW IT HAPPENS. :)

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    1. Seriously--watch this drive the price of benadryl right up and then there's news of runs on drugstores by ladies dying for the implantation magic... It seems so bizarre to me, but I'm willing to try anything. As are you I'm sure! Your extra love to the Bryce batch must have also been magical, because that's what we were able to transfer. And I have to say, I totally agree on the favorites. Makes it harder to make it not apparent, but yeah. Definitely happens. :) Thanks for the cheers and the love, lady!

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