One Little White Light

It seems that at this point I should have lost count, but I can’t because I know how many I have lost.   I try to let the numbers and dates stay blurry, but I know how old my first baby should be. He should be 2 and a half. I purposely try not to remember the due date of the twins. But I can still see their heartbeats. There are six other embryos that disappeared somewhere in between the transfer to my body and the pregnancy test. On Monday, I had my ninth embryo transfer. Two more embryos.

On Monday morning before the transfer, I went for a walk with my dog. I had a choice to go left or right on the trail and decided to go right. We ended up near a beach where she loves to play catch but we didn’t have time for that…but she pulled me out to the beach anyway, looking back at me expectantly with a huge wide smile and tongue hanging out. The beach was empty except for the stroller in this photo. For a second I thought, well maybe my baby is right there waiting for me! Well, no that wasn’t the case, but I tried to view this as a hopeful moment. Somehow, maybe this is a sign. My babies that are watching over me and the baby that is still to be is here with me in this moment. A moment to give me courage to try again. To wait those nine hopeful, yet agonizing days again waiting for the pregnancy test.

stroller on the beach

 

The sun was blinding me, but I snapped a photo anyway, not quite sure what I would end up with. I wanted to be reminded of the stroller that was in my path. As I faced the stroller and the rock wall where we had once stood to spread our baby Jaxon’s ashes, I could feel them all with me.   A little white light ended up in the photo and I choose to see the souls that I love so much in that light.

One little white light, Two embryos, Nine days to wait.  Trying one more time.

2 embryos

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This is my FET cycle

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Everybody who goes through IVF, IUI or an embryo transfer cycle will have a protocol designed specifically for them. While there are a lot of similarities with these well-established medical interventions to create the miracle we dream of, there are a lot of differences too. This is what my frozen embryo transfer cycle looks like for me…

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For most of my cycles we have done a “controlled” cycle. This means that my cycle leading up to the embryo transfer is controlled by hormone injections (estrogen and progesterone). In the past I was able to try a natural cycle, which relied on my body’s own ability to manage my menstrual cycle and thickening of the uterine lining where there was minimal medication use. That worked one time, then the next try, my ovaries weren’t cooperating and we had to start over. In my controlled cycle, I start with a baseline ultrasound on day 2 or 3 of menstruation to check that the uterine lining is thinning and that there are no cysts developing on my ovaries. From there I start on Delestrogen intramuscular injections twice a week for a little less than two weeks. This also involves blood draws to check my estrogen levels and any necessary dosage adjustments.   Another ultrasound is performed to check that the lining is thickening appropriately and to check that my ovaries are “quiet” and no cysts are developing. Then the progesterone injections start.   My husband has become a pro at giving me injections. We went through IVF twice and have now made it through eight embryo transfers, plus a couple cancelled cycles. So, he’s really got this down.

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Here’s the cool thing about the controlled cycle. The progesterone injections (which are daily) are required for 5 days and on the 6th day, the embryo transfer occurs. This gives me and the doctor flexibility in scheduling the transfer because we can start the progesterone on the right day based on our schedules (well, mostly his schedule). Since we want to make sure we get to have “our” doctor for the transfer, we can make sure to set up the injection schedule accordingly as well as avoid weekends or holidays.

Here’s the tough part about the controlled cycle. Once the progesterone injections start, there are daily intramuscular injections into my hip/glute area. After doing SO MANY of these cycles, it’s getting pretty painful and there’s a build up of scar tissue and/or “oil” (ethyl oleate) from the medication settling into my muscles. Delestrogen and progesterone are oil based medications. After two very painful injections leading up to our transfer on Friday, we did learn some new tips from the nurse for intramuscular injections:

  1. Use a cold pack on the area of injection for 10 minutes prior to injection
  2. Immediately following injection, massage the injection site
  3. Use warm compress on area of injection for 10 minutes after injection
  4. Do glute and hamstring stretches to help the ethyl oleate part of the medication move through the muscles. This is what tends to build up. Even though the progesterone will get absorbed, the oil base of the medication can build up (yuck).
  5. Make sure you understand the full surface area available for the injections. My husband had been using a smaller surface area which left us little real estate for repeated injections. After another session with a nurse, we discovered there was a bigger area we could use that was still safe.

The embryo transfer occurs on Day 6 after starting progesterone injections. The procedure itself is a simple one and just a bit uncomfortable. This has to be done on a full bladder to help visually guide the small catheter on the ultrasound through the cervix and into the uterus.   The ultrasound wand is pressed on the lower abdomen…yep, right over bladder territory so that’s the biggest challenge. After a couple of rounds of verifying our information and number of embryos to be transferred, we are then ready to go. It’s very exciting to watch the catheter on the ultrasound make it’s way into the uterus where you can see it as a very faint white line with slight movement. Then the embryo is released and it is slightly visibly as a white flash or very small blob on the ultrasound screen. After the embryologist checks the catheter to confirm it’s empty, we are then free from medical intervention and now it’s up to luck, a healthy embryo and lots of baby dust and embryo sticky vibes to implant and make this miracle happen.

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The embryologist brings us a photo of our little embryo and we get to feel hopeful and terrified for 10 days.

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We get some time alone with our little embaby photo and think positive thoughts. Since my husband is a huge Star Wars fan, there were a lot of good vibes with references to Jedi’s and the force awakening in my uterus. Maybe it will work.

Our HCG blood test will be on November 15. We’ve been let down so many times. Please, please, please, let this be the one.

Chance #4/31: Mastering the Full Bladder Ultrasound

glass of water photoNow that I’ve been through seven embryo transfers (today was lucky number 7; fourth one from the egg donor embryos) as well as a handful of ultrasounds during early pregnancy, I’ve learned some things about preparing myself for a procedure that requires a “full bladder.” I say full bladder in quotes because I’ve learned it does not have to be painfully full in order to enable better ultrasound viewing of the uterus.

Water consumption: First of all, when told to drink 16 ounces of water an hour before an appointment, I don’t do it. (By the way, I’m not offering real medical advice. This is advice on how not to pee your pants on the way to the doctor or God forbid, pee on the doctor.) Female bladders are small and I could show up to a doctor appointment without drinking any water following a marathon and still have to pee.

Timing is everything: Appointments in the early morning are the toughest to strategize liquid intake. To drink or not to drink…that is the question. My recommendation…always pee before leaving the house. Your bladder will be full again, probably 3 times over before the procedure. Later in the day seems easier to plan out…maybe the kidneys don’t feel like working as hard as the day progresses.

Consider the car ride: Ok ladies, just by getting into a car and knowing you are going somewhere means that you will have to pee within 15 minutes of getting in the car. This is physiologically how the female bladder functions. I have a 45 minute to 1 hour drive to the doctor so I also have to take that into account. So, those 16 ounces of water you were told to drink? Once again…I wouldn’t do it, unless you live next door to your doctor’s office.

Partial bladder relief before an ultrasound: Now this takes practice and the body does not want to do this. Of all the times I’ve had these procedures, there has been only one time…let me repeat…one time, that I have found the perfect balance of liquid intake and timing of the appointment. All the other times, I’ve been completely desperate to go to the bathroom as soon as I walk through the door. So, then the question: How much to pee? This is pure guess-work and requires Jedi mind tricks on yourself to stop in time. But don’t fret, if you take it too far. You can always drink more water.

Photo by CJE