Beta#3 - 19 DPO (14dp5dt) & 1st U/S (4w5d)

I got it I got my 3rd beta (hCG) and u/s

When the technician took me in the room, she sounded kinda annoyed with me and kept on mumbling that she has no clue why the heck we are doing this ultrasound because I am only 4 weeks and 5 days today and there is absolutely nothing there to see...

She was wrong....

They failed to establish the reason for my bleeding but they found two gestational sacs in my uterus. I am not sure if we are having twins for sure just yet because I have heard of many girls who have gone through IVF and had vanishing twin (see below). I am also way to early to even know if both gestational sacs will have a baby or not. Conclusion will be drawn at 7 week u/s with heartbeats, I guess.

Needless to say, the ultrasound tech was extremely surprised to even see anything. I did not even expect to see anything but again, I did some research online and all websites say that a transvaginal ultrasound should be able to see at least a gestational sac once the hCG levels have reached between 1,000 - 2,000mIU/ml.

I was very excited, but to tell you the truth, me and my husband are so freaked out by my bleeding that we almost try to imagine that I am not pregnant just in case something happens. I feel like I have this mood switched on, for self-preservation. I am scared to think I am pregnant because i am scared to death that if I loose it I will not know how to deal with the pain.

One gestational sac is measuring at 4 weeks and 1 day
Second gestational sac is measuring at 4 weeks and 0 days
Beta (19DPO)(14dp5dt) is 2,073

More than doubled again. I guess statistically everything is ok, just this annoying bleeding is bothering me so much. I am so scared I feel like this is just a sweet dream that I will eventually wake up from.

What is vanishing twin?
Once a twin pregnancy has been diagnosed by an very early ultrasound, about 1 in 5 of these will subsequently disappear before 12 weeks. When one of a twin conception fails to survive at this early stage, the remaining twin continues to develop normally and hormone levels stay high which prevents a miscarriage, though sometimes there is some vaginal bleeding. As the remaining twin grows, its sac spreads to fill the uterus and the contents of the other sac are absorbed.

I want an ultrasound!!!!!!!!!!!!

Oh my....what a week for me...

WARNING: TMI (Too much information)

So I've been having clots and tissue come out. It freaks the living breath out of me. Everytime I have this bleeding my life turns into drama. So I called my wonderful RE yesterday and told her what is happening. It took a while to convince nurses to even let me speak to her.

Here is my point: I've been bleeding and passing clots for a week now. My 1st u/s was scheduled for Dec 10 which is 3 weeks away. Let's say I have ectopic and because no one wants to check on me, in 3 weeks I will either bleed to death or my tubes will rapture. What the heck! I want and u/s!

If I get my u/s tomorrow, I will be 4 weeks 5days along.

It is so so early but I did some research and found that the gestational sac can be visualized as early as 4.5 weeks by trans vaginal technique. As long as hCG is over 1,500

In my case, hCG should be over 1,500 tomorrow, since my beta yesterday was 831 so if I have normal pregnancy and it doubles, then my hCG tomorrow should be at least 1,662 to consider this pregnancy "normal"

Annoyed....

Beta#2 - 17 DPO (12dp5dt)

Today is a good day...

My second BETA increased from 327 (15DPO) to 831 (17DPO)...
Due to my bleeding I asked for my Progesterone to be measured too and it came back at 40.1

I guess that is a good number so I still have no clue why am I bleeding then. I'm scared. Really scared that something so amazing could finish so fast and so soon. The worrying never stops. Maybe is I got pregnant naturally I would feel different. I beleive that all women becoming pregnant through assisted reproductive technology know this and could relate.

My ultrasound is scheduled on December 10, 2008 @ 2pm.

We'll see what happens.

My small precious bean...please stay with us...We love you

Beta#1 - 15 DPO (10dp5dt)

Yes, I am still spotting but I should say it's less, much less. Mostly when I walk too much or sometimes in the mornings. No pad required though (TMI ) I hope it's ok.

I got my beta
Today I am 15 DPO (10dp5dt) and my beta is 327.
I think I'm happy, just hard to be positive when having spotting and on and off bleeding.

Am I dreaming???

13 DPO

Still have slight on and off bleeding...

After 1 year and 10 months since we started trying to conceive a baby
After months of natural cycles
After 3 failed IUIs
4failed IVF
3 IVF cycles being canceled due to poor response
After laparoscopy, hysteroscopy, sonohysterogram & hysterosalpingogram
After spending out of the pocket this year (2008) alone $31,168.55 on meds and procedures
After genetic councilors tried to advise against IVF due to my BRCA1 cancer mutation gene
After almost getting the “donor egg” talk

This just feels surreal and even more scary with the bleeding still here

12 DPO - There's life inside me...

What a day...So I was freaking out because I hated that evaporation line. I posted it on my two favourite websites (www.twoweekwait.com & www.ivf.ca) because I just wanted to share with the girls how unreliable those internet cheapies could be. Thanks to my online friends (I don't know how I could survive without their constant support) I went to Shoppers Drug Mart and got some more test. Spent $50 and felt like a fool.

So I go into a bathroom at home and dip them all into my cup. Leave it and by the time I came back two bright pink lines were there....

I started to shake and almost threw up..n I've never in my life expected this. I already moved on from this cycle because I had spotting and red blood come out and cramping and now this happens. I think I would be more excited if I did not have bleeding, because now with excitements comes worries. What ifs.

Beta Monday, November 17

12 DPO with Period but STUPID EVAPS!!!!!!!

I have been spotting all day yesterday and today I have red stuff so my AF is here at 12 DPO Besides being frustrated with not being able to get pregnant, I Just don't understand why my body won't "listen" to medications that are supposed to hold of AF even if I'm not pregnant. Annoyed with that actually more than BFN.

On top of that today I just decided to test one last time for fun and I got a nasty evap. Just proves how unreliable these tests are because I know it's not trigger so I hate this brand, but because AF is here I know for sure I'm out just again annoyed with stupid evap. Take a look at my tests since trigger and 10 DPO and today's is the last one.

I will not buy FRER because I know I'm not pregnant, just wanted to share the stupid evap.
I know for sure it's evaporation line because I had brown spotting yesterday all day and today it turned to red light flow, so I know for sure this is AF .

Just wanted to share because I am still annoyed with it because if AF wasn't here I would think it's a BFP too. Such a cruel joke....

IVF#5 - 11DPO - I'm done...

Psychological distress

How do I feel…when all I feel is

Gloom

Despair

Hopelessness

Grief

Sorrow

Heartache

Anguish

Pain

Torment

Misery

Unhappiness

Sadness

Mourning

Regret

Distress

Suffering

Agony

The life I live expresses the grief of being barren, childless, of not reproducing, and being unable to confirm one's relationship through parenthood.

My buddies....BFNs

So since 10 DPO (5dp5dt) & today 11 DPO (6dp5dt) I've been getting BFNs.

I know it's over because my stomach hurts and I have no symptoms except cramps and spotting just like last failed IVF at exactly the same time of 11 DPO. It even happened in the afternoon like last time. Ugh...Yeah, sure I felt ALL imaginary symptoms of elevated temperature of 37.2 C, "twinkles" in my uterus and imaginary movements in all other parts of my body.

Actually as I'm typing I am coming to a great discovery that at this point my brain is so skillful of imagining and mimicking symptoms, that I should just dare myself to pretend to go into labor and experience it, since it seems like I never will otherwise....

Trigger out in 8 days

Just tested my trigger and it's out at 8 days post trigger.
I was a bit surprised it was out so early, but I guess that's what happened.

IVF#5 - Transfer

Day 5 - Transfer

…And so we get there. I change into my stunning blue robes and wait….

My RE came to see us before we went into the procedure room.

“So are they still alive or have they all perished?” I said

She lets me know that she will go and check with the lab.

Tick-tock.... Tick-tock.... Tick-tock.... Tick-tock....

“Yes. They are all still there. You have two blastocysts that are both 2AB with grading of 1 being the best. Actually, one of them is already hatching out of its shell. The other three are still late morulas and we will continue to monitor them until tomorrow to see if you have any to freeze.”

A silent sigh….A very heavy stone fell off my chest. I can breathe. At least I get to have a transfer…and I did.

IVF#5 - Day 3 embryo report

Day 3 embryo report

They're alive My miniature "babies" are still alive!!! Thank lab!!!!

So they are:

• 10-cell Grade 1
• 8-cell Grage 1
  
• 8-cell Grade 2
  
• 7-cell Grade 1
  
• 7-cell Grade 2

I will not get any more updates. Starting day 3 morulas go through a crucial time of turning into blastocysts. Therefore, my clinic will not "disturb" them from their incubator. I am going to go to the clinic on Friday Nov 7th around 7am and have my transfer. Unfortunately, I will not know if there is even anything survived to transfer, but that is a chance we have to take.

Please embabies, grow grow grow!!!!

IVF#5 - Day 2 embryo report

I just got my Day 2 embryo report.

Out of 5 that fertilized yesterday, today those 5 are still "alive" and are:

• 7-cell Grade 1
• 5-cell Grage 1 A
• 4-cell Grade 2 A
• 4-cell Grade 2 A
• 2-cell Grade 2

My clinic grades from 1-4
1 being the best

But I am sad still and worried like crazy that they won't make it to day 5. I cannot even watch TV because I cannot stop thinking about it. I wish I fell into deep coma and woke up on Friday. So frustrated with this wait and we don't have many embryos to play the waiting game with

IVF#5 - Fertilization report

I get my reports early. So:

10 eggs retrieved
7 mature
5 fertilized

I'll be getting daily updates up until my transfer (if I get one). Oh, I hope at least one will survive to Friday.

IVF#5 - Retrieval

Retrieval will be on CD 20!

Drama last night. I realized that I took trigger at 11:30pm on Friday; so my ER was supposed to be on 11:30 today on Sunday. We'll tonight the clock went back 1 hour because of daylight saving time, so if I came today at 11:30 am for ER, my body would really "think" it's 12:30am. That's 37 hours post trigger. ER should be 36 hours after trigger, yet my clinic did not say anything about that. I called the nurse yesterday night and freaked out so they change my ER to 10:30am (11:30am old time) today. Confusing, isn't it? Well, my body is on it's own clock and cannot adjust to our society's standards....Anyway....Just shoked my clinic would disregard something that important when they leave me messages with "make sure you take it exactly on time , only 5min plus or minus"...

In total disbelief since we got 10 eggs. (last IVF got only 5 eggs/ 3 were mature + got canceled 3 times prior due to poor response) I cannot believe I almost got canceled on Monday. Look what happened in 5 days. I went from 4 to 10 so weird.

I know not all will be mature but I think at least 6 should be. Also getting my fertilization update tomorrow.

My ET is Friday (Nov 7) regardless. We will not do 3day even if we have 1 embryo left, so I might not even make it to transfer yet. We just want to see if it's an embryo problem (it stops growing after 3 days) or maybe it's uterine implantation. This is the only way we'll know. Unfortunately it's a risk we have to take.

Feeling fine. Just regular post ER pain/cramps/light headedness. Nothing that I can't handle in order to have a baby in my arms someday...

He was right!

He was so right!!!!!! I have more follicles that FINALLY caught up by CD 18 today. Wow, this is a very long cycle. Very long but it seems like by the end, my follicles caught up a bit.

I don't have many on my left ovary, but I think it's because I have a cyst there. It was there from the start but we decided to proceed with this cycle regardless. It was 1.2 cm at the beginning and grew to 1.5 cm by today. I read somewhere that cyst "drain" estrogen from the ovary, so probably that's why even though there were 10 antral follicles discovered there during my base u/s, only 1 is somewhat growing...

CD 18 today - I am triggering tonight!!!!!!!!!!!!!

Thanks to my husband...

Cycle day 14....

Only because if him and his persuasion, I decided to fight back. I was gonna give up, but he said "don't quit" and I won't...I wasn't even going to purchase any more meds. I called him and said, that's it! I'm done with this cycle. In a calm voice he encouraged me to give this cycle one more day, so I bought the meds.

Spoke to my RE and decided to give this stupid cycle 4 more days of injections. If by Friday (Oct 31) I am not at least close to being triggered, then we'll cancel on Friday. That will be cycle day 18!!!!

I doubt those miniature follicles will ever catch up. I only have 1.3 / 1.2 / 1.1 / 1.0 / 0.7
Estrogen only 1,993 (CAN) or 543(US)....

IVF#5 - Getting cancelled AGAIN?

So today is Cycle Day 14

I am so so sick of this. Today is CD 14 and my RE will most likely cancel me. After all these injections, I have only 5 follicles that are developing s..l..o..w..l..y and are ranging from 1.3 to 0.7!!!!! WTF!!!!

I got canceled twice before in July and my August attempt got converted to IUI. All because my ovaries are not cooperating for unknown reason. I'm 24 and my FSH is 5.5 and no known problems. I am on 450iu of stim meds!!!!!!

IVF#5 - CD10 ...Dragging on.......

I've never produced more than 8 follicles with my 1 failed IVF and 3 IVF attempts (canceled/converted to IUI due to poor response)

I do know that when someone does Estrogen Priming Protocol (EPP), one should expect a slow stimulation. I also know that EPP helps produce more follicles, help with issue of dominant/leading follicles; but takes longer stimulation before trigger (12-17 days of stims)...

BUT!

I am on Cycle Day 10 (after 7 days of stimulation 450iu Gonal-f) and I have this:

Estrogen - 566
LH - 3.8
Prog. - 13.6
Right ovary: 9 follicles; only 2 measurable; They are 1.0 & 0.8
Left ovary: 10 follicles; only 1 measurable; It is 0.5
Lining: 0.7cm

Seems like I can compare to my last cycle day 6. So I'm statistically 4 days behind...Ugh! Patience...Patience....I think I have about 5 days of stims to go....

IVF#5 - Stimming S..L...O...W..L...Y......

This cycle drags on sooooo sloooowwww....Ugh! They say that I should expect to be stimming up to 17 days I am used to things going very fast once start stimming meds, but this cycle is really testing my patience.

Today is my CD 8, had u/s and u/s tech asked if I am on the meds yet and if this is my baseline today...I also searched online and apparently all girls on this protocol say that the shortest stimming time is 12 days and many trigger only on CD 16, so I still have a whole week or more of stimming. Every injection costs me $480 CDN (about 235 UK pounds or 300 euro)

IVF#5 - Cycle Day 3

It's my cycle day 3 today and I had my base ultrasound today.

Me and mu husband were shocked to learn that I have 17 follicles !!!!!!!!!!

I never in my life even on highest doses produced more than 8

NEVER

I was canceled 3 times due to poor response to Long Lupron Protocol and Antagonist!

Right before we went in to see the nurse, DH and I discussed as to what we are gonna do if it's 4 or something...

Obviously I overdosed myself with Estrace and it helped. This is first-time trying Estrogen Priming Technique. The downer is that I have a 1.2cm cyst but that should not be a problem, because my RE will drain it before the procedure. I am just sitting here and waiting for them to call me (based on bloodwork) and If I am ok to start stimming today...

IVF#5 - Estrace - I messed up!

I am so pissed off!!!!

For the preparation for my IVF#5 I am on Estrogen Priming and this is what happened!

I was taking
2 pills (4mg) of Estrace 2 times a day = 8 mg in Total,

for my Estrogen Priming and continues to CD2 once period shows up. Well, I am a 28 cycle always and today is CD31, so I reviewed my messages only to find out that

I was supposed to be taking
1 pill (2mg) of Estrace 2 times a day = 4 mg in Total

I am so pissed of at my stupidity and I am always meticulous about my treatment and this time I just screwed up!

Now no wonder my AF is not showing up. I also probably messed up my cycle by over-suppressing myself. I will probably go for my baseline and have only 2-3 follicles because of this! I was taking the double dose. No wonder I was so nauseous that I did not even eat normally for the last week.

What should I do? I am scared to tell RE because she might cancel my cycle. Should I tell her? Maybe I should just start taking normal dose and see what happens at my baseline after AF shows up? Then if it's bad, I will say what I did so she would not think that this protocol just does not work for me but it was my mistake.

$#@@$%! I hate myself right now!

Sorry for venting...

BRCA1 - My genes are holding me down!!!!!

....I have not posted for a while. I am just a bit depressed.

I am depressed because I've been having issue with my IVF future that stirred up my other issues and it's a big mess that I don't want to think about and it makes me emotional...

Well, my mom passed away at the age of 50 in 2004. I just turned 20 and quit my job and second year university to stay by her bedside for 5 months of palliative care. She always struggled with cancer and every woman in my family died before reaching 50. My mom had her breast removed at 31 to save her live and the battle never ended ever since. I didn't know about it because my mom was strong and shielded me and my sister from it. Before she passed away, doctors and oncologists were shocked by her aggressive breast cancer, ovarian cancer, esophagus cancer that were all non related...They tested her positive for BRCA1 gene...

BRCA1 is a breast cancer susceptibility gene. People who carry a mutation (abnormality) in this gene are at an increased risk of breast or ovarian cancer. The normal gene plays a role in repairing breaks in DNA. However, when the gene is mutated it is thought that this repair function may become disabled thus leading to more DNA replication errors and cancerous growth.A woman's lifetime chance of developing breast and/or ovarian cancer is greatly increased if she inherits an altered BRCA1 or BRCA2 gene. Women with an inherited alteration in one of these genes have an increased risk of developing these cancers at a young age..

People who carry the gene have an average 81% lifetime risk for breast cancer and 60% chance of ovarian cancer...

They tested me and my sister and we both have it...

Back to the point...

My case was taken to the medical board and they were very concerned that I am even undergoing any treatments because hormones are my enemy. I am under no circumstances allowed to have any fertility treatments. My oncologist and cancer clinic that I go to believe that it is very bad that I took all those hormones and that I should have never been allowed to take them in the first place. They said they understand that I want a baby but I most likely accelerated my chances of cancer. They said it is ok to complete this IVF cycle , maybe one more cycle after that...... but no more...NEVER because it jeopardize my chanced for future survival...

I need to get pregnant because I have already been advised by oncologist to face the fact that in order to survive this fate I will most likely have to undergo preventative surgery to reduce the risk of developing breast cancer by removing one or both breasts before the disease develops. Also called prophylactic mastectomy. As well as surgical removal of the fallopian tubes, ovaries & uterus. Preferably by the age of 35-40.

This IVF has to work or I'm out on my own in search for miracles..

I don't have time to wait for miracles.....

****************
I just want you to know that my post does not call for pity. I just merely wanted to share why I feel so negative...

IVF#5 - !!!!!

Had my review today and I'm on to:

Estrogen Priming & MicroFlare Protocol - Supposed to work for unexplained poor responders.

Daily b/w from now on to see when my LH surge/ovulation happens. Today is my cycle day 14 so they want to see if I ovulated already or just going to. My RE wanted to do Flare and I convinced her to do Estrogen as well...so basically I start Estrace vaginal pills as of day 21 to AF. Then just start stimulation with Gonal-F 450iu which is a max dose of any stimulation drug (around Oct 10) with a very-very small dose of Lupron/Superfact at the same time. Then Crinone for progesterone support.

ER should be around Oct 23, though they said that estrogen priming sometimes makes it longer to stimulate like 14-18 days of stims before ER.

Flare Protocol is one of the most potent IVF protocols available. It has helped many women with poor ovarian reserves to conceive, and in our opinion, is the last resort before donor egg IVF. The protocol takes advantage of a special property of Lupron. When used in tiny amounts, Lupron stimulates the release of natural FSH from the pituitary for several days before exerting its suppressive effect. During this 'flare' period, the ovaries are stimulated by natural FSH. The subsequent addition of high doses of FSH from medications gives the ovaries maximum stimulation.

Estrogen Priming of FSH receptors has been reported to slow premature follicular development and to promote granulosa cell FSH receptor induction. Estrogen support of the endometrium with vaginal suppositories was used to maintain the endometrium and to prevent withdrawal bleeding until an estrogen-producing follicle has emerged. This protocol over the past four years has given several insights into the treatment of poor prognosis patients. Basically it helps improve egg quality and help with leading follicles becoming too big before the rest of small follicles catch up.

I'm not even excited though...

Oh, and this time we are going to do day 5 transfer regardless of how many embryos I have because we want to see if maybe they stop developing after day 3, so maybe we will know that it's not implantation issue but embryo issue...

IVF#4 is getting cancelled

I am so upset and was crying like mad on the way home.

Today was my cycle day 8 (stimulation day 6)
I am on Gonal-F 225iu & Menopur 150 iu (high dosage for my FSH and my age)
I was no supressed at all this cycle (no BCP, no Lupron/Suprefact)
My FSH 5.5
I'm 24
No known problems

YET!

My follicles are not growing and not responding to anything. I have only 11 follicles but only measuring 16,13,12,10. I wanted to do day 5 transfer this cycle, but I don't have enough to play around with. My RE called to cancel my cycle. So I said that I already picked up meds for the next two days and she said to take them then and come back on Saturday (Aug30) to see what's there and most likely she will convert my cycle into IUI.

Why is this happening?! This is second kind of protocol I'm on and it's not working! My ovaries are stubborn! Last cycle I was on long/down-regulation protocol. This one is short flare protocol.

Such a waste of time and the worst part is that there is no explanation why my ovaries are not responding to meds and the meds dosage is high and I was not suppressed at all. My FSH is 5.5 and that is very good number since anything less than 10 is a reassuring level and one should expect a good response to ovarian stimulation. I'm only 24. No known problems.

She (RE) said she can try another type of protocol next. A Microflare Protocol. It is used for slow/poor/older responders and that it often works much better in the hopes to get more follies.....

I have to start again...Oh...I'm so tired of this.....

Existential Frustration

Life has lost its meaning. I’ve lost my purpose and significance of my existence. Sounds so dramatic, I know, but I just feel like I will never get pregnant. I am not sure if I am delusional but it seems like everyone around me is pregnant. It hurts so much. It is so sad but this infertility burden turned me into someone else. Someone who has lost that vital passion for life. Someone who is envious. I’ve never been like that! Life is not as interesting as it once was. Yet people do not understand, especially those who did not have any problem conceiving. What am I supposed to say to “You’re so lucky you don’t have kids yet, it’s a lot of work. I need a break. Do you want to take mine since you can't have your own?” Their insensitive, brainless remarks, like “you just need to relax” or “you’re still young” do not help. They do not understand that relaxation is not a medical treatment of infertility.

The most hurtful thing is when people that have kids say that they wish they didn’t have them. This world is unjust. They wish they could have my freedom and opportunity to go wherever I want and to have more funds available for themselves. When I hear that my heart bleeds. I know it does, I can feel it. I don’t want to travel because when I come back home there is silence of the empty walls around me. I have no one to share my stories with; I do not have someone missing me here. I go to work and I don’t know why I am trying to succeed in it when I will have no one to leave its rewards to. I’ve lost my drive. I’ve always had it and I’ve lot it. It’s hard and it is so much harder when people around you just don’t get it. I look at the old pictures of myself and I don’t recognize that person; the person with a sparkle in the eyes and a smile. I don’t know if my face is capable of that anymore. How sad. Sad of what I’ve become.

And no, I will repeat it again and again until no breath comes out of my lungs - I will not relax, take it easy, go on vacation, forget about it, move on or wait until a miracle happens until I have a child in my arms. And I don't believe in miracles. So everyone who wants me to pretend to be a happy cheerful clown can just wait. I am sad now and I will take my time being sad. I will not put on a smile. I will keep on doing every other possible medical procedure until I am where I need to be in life. A mother. So I guess after all, I do have a drive….

IVF#3 - Canceled - High Prolactin

IVF#3 - Canceled !!!!!

I have high Prolactin - 36.6

Additionally to being diagnosed with our unexplained infertility, that affects only 20% of all couples that stuggle with infertility, I have another unexplained syndrome.

After excluding all the possible causes like prolactinoma for which I did MRI, to by doing various blood test and excluding PCOS and hypothyroidism, in which an inadequate amount of the thyroid hormone is produced - I also fall in about 30% of the cases, in which the root cause of high prolactin is also unexplained.

What! Can you beleive that!

It's either I have some mysterious biological functions or our medical diagnostic test are not advance enough for my alien body!

PUREGON vs. GONAL-F

Tottaly Obsessed!

I start stimming this Monday. I am also very interested on the outcome of my ER this time. I think I am definitely on higher stim dose now, just a slightly different medications. I am on totally different protocol and being a nut like me, I spent most of my weekend researching medical data available on the net. Not like it will help me have better results, just being nosy. Here is some of the stuff I put together for anyone else interested.

It is long, sorry, just had to share

Before I WAS ON:

Gonadotropins (Follicle Stimulation) injections of:
Puregon 200 IU

GnRH antagonists (Ovulation Prevention) injection of:
Orgalutran 250 mg

Result: 5 eggs retrieved, 3 mature, 2 embryos transferred on day 3 (both 8 cell grade 1 no fragmentation, even cell division)

I WILL NOW BE ON:

Gonadotropins (Follicle Stimulation) injections of:
Gonal - F 225 iu
Menopur 150 iu

GnRH antagonists (Ovulation Prevention) injection of:
Cetrotide 250 mg

Result: Coming Soon


I did some research and gathered some information from various published medical studies/articles, since I have to know everything as to what I’m injecting into myself. I guess I am a control freak! Anyhow, here is some general info on my follicle stimulation drugs if anyone interested:

PUREGON: Follitropin beta belongs to a class of medications called gonadotropins. Follitropin beta contains a hormone similar to the human hormone, FSH (follicle stimulating hormone). For assisted reproductive technology procedures, the usual initial dose is 150 IU to 225 IU daily.

GONAL-F: Follitropin alpha belongs to the class of medications called gonadotropins. It is a synthetic version of the naturally occurring follicle stimulating hormone (FSH), a hormone produced by the pituitary gland that helps egg development in the ovaries. Doses usually range from 75 IU to 450 IU (5.5 µg to 33 µg) per day. For Assisted Reproductive Technologies, therapy with Gonal-f® should be initiated in the early follicular phase (cycle day 2 or 3) at a dose of 150 IU per day. Treatment is usually started at a dose of 150 IU or 225 IU (depending on your circumstances) once a day. Usual range is 150-300. Doses larger than 450 IU of FSH per day are not routinely recommended.

MENOPUR: Menotropins are a mixture of naturally occurring hormones that include follicle stimulating hormone (FSH) and luteinizing hormone (LH). The recommended initial dose of menotropins is 225 IU injected under the skin daily for a maximum of 20 days. The dose may be adjusted according to your response, but should not exceed 450 IU.

PUREGON vs. GONAL-F: Both of these medications are made from highly purified human Follicle Stimulating Hormone prepared by recombinant DNA technology. Both are non-urinary products and contain only FSH. There is no LH component. Meanwhile, two published direct comparisons between both follitropins (Tulppala et al., 1999 ; Harlin et al., 2000 ) justify the conclusion that the slight differences between the two molecules do not have any clinical significance. The fact that in the IVF studies, the odds favor follitropin alpha and not beta appears to be mainly due to the fact that, compared to the follitropin beta studies, the control patients perform significantly worse in the follitropin alpha studies (difference: –5.5%; 95% confidence interval: –10.7 to –0.3%; two-tailed P = 0.037). This should have been recognized by the authors.

American Journal of Obstetrics & Gynecology. 189(2):342-346, August 2003. Williams, R. Stan MD *; Vensel, Theresa MD; Sistrom, Christopher L. MD; Kipersztok, Simon MD; Rhoton-Vlasak, Alice MD; Drury, Ken PhD

Abstract:
OBJECTIVE:
Our purpose was to assess the efficacy of two recombinant follicle-stimulating hormones, follitropin beta (Follistim, Organon, West Orange, NJ) and follitropin alfa (Gonal F, Serono, Norwell, Mass) on pregnancy rates in varying age groups of women undergoing in vitro fertilization (IVF).
STUDY DESIGN:
Three hundred sixty-five IVF cycles were retrospectively compared, 233 by use of follitropin beta and 132 by use of follitropin alfa, both after gonadotropin-releasing hormone agonist down-regulation. Assignment to each medication was indiscriminate. The primary outcome measured was pregnancy evidenced by fetal heartbeat on ultrasonography. Secondary outcomes included days of stimulation, ampules per patient cycle, estradiol level on the day of human chorionic gonadotropin administration, total follicles present on the day of human chorionic gonadotropin administration, follicles greater than 14 mm, oocytes retrieved, mature eggs, fertilization rate, and embryos transferred. Outcomes were stratified by age, including women less than 36 years old, 36 to 39 years old, and more than 39 years old.
RESULTS:
There was no significant difference between follitropin beta and follitropin alfa in either the primary or secondary outcomes, although the pregnancy rate was significantly decreased with advancing age.
CONCLUSION:
Success rates are similar, when stratified by age, in women undergoing IVF with either follitropin beta or follitropin alfa.

Here we go again...IVF#3

Had my follow-up/review appointment with RE today. So once AF arrives from this "natural" cycle, which I am not hoping will work...

We are doing it again! Yep! All over again!

July 2008 - IVF#3

Hoping to get more eggs and this time, not going to be on BCP or any kind of pre-suppression because last IVF did not do any good for me and I was over suppressed. Also, if everything goes well, we're going for a 5 day transfer this time.

All of my medications were switched, which is good. So now I will be on:

Gonadotropins (Follicle Stimulation) injections of:

• Gonal - F 225 iu
• Menopur 150 iu

GnRH antagonists (Ovulation Prevention) injection of:

• Cetrotide 250 mg
  

Trigger injection of:

• Ovidrel 250 µg (10,000iu)

After ER

• 81mg Aspirin

After ET

• Progesterone (intramuscular injections) 50 mg daily

Implantation Failure???

I think I might be...nuts

I am doing something weird and yes I know it, so please don't be shy if you think I've gone bonkers

Somewhere deep down in my heart, I believe that the reason why I am not getting pregnant is because I have implantation failure. I think that even though my eggs get fertilized with my husband’s sperm and create normal embryos (as shown by IVF) they are just not able to implant either due to NK natural killer cells or because of blood-clotting.

My RE will most likely will not agree to go the blood-clotting test and NK activity test which have been studied as the cause of many unexplained infertility cases. In fact, some researches believe that it is "implantation failure”, and not poor egg/embryo number or quality that is often the root of the problem.

“Considering its importance, it is not surprising that failure of proper function of this immunologic interaction during implantation has been implicated as a cause of recurrent miscarriage, late pregnancy fetal loss, IVF failure and unexplained infertility. A partial list of immunologic factors that may be involved in these situations includes: anti-phospholipid antibodies (APA), antithyroid antibodies (ATA), and, perhaps most importantly, activated natural killer cells (NKa). Presently, these immunologic markers can be adequately measured by only a few (less than a half dozen) highly specialized reproductive immunology laboratories in the United States, from patient blood samples.”

So,

I did a research about therapeutic doses of aspirin and now I am taking 81mg everyday. I am also going to be using Pre-Seed when we BD and I am taking something to help with CM (Guaifenesin). Aspirin is suppose to help with uterine lining and help with even blood-flow (decrease clotting).

“For these patients, and even many without endometrial lining issues, we will typically recommend that she take a baby aspirin per day (81 mg) starting with gonadotropin stimulation. The rational for the use of baby aspirin is that on a micro-vascular level, vasodilation and decreased blood platelet aggregation occurs and therefore improves blood flow to the uterine lining, providing a lining with functional improvement. Blood platelets are the blood cells, which promote blood clotting. Two well designed studies confirm the benefit of baby aspirin use in improving pregnancy rates for patients with endometrial linings <8mm.>

Also an interesting fact that it has been found that aspirin, when taken 12 hr prior to donation of the blood sample causes an 80-100% reduction in the NK cell activity.

IVF#2 - BFN

Wednesday, May 28, 2008

This cycle was a bust!

Even though we have unexplained infertility and had two good embryos transferred.

My BETA today was 0

Just as I thought

What next?

Going to try to take a a break if I can.

We've tried before, but it is so so hard to stop dreaming that one day I will hold a baby in my arms. How can I give up that dream and just "take a break", forget about it?.....How can I? Could you? If you were in my shoes...I bet you would not....

IVF#2 - 1 day post ER

Got my update

5 eggs retrieved
3 mature
2 fertilized



This is only day 1 after retrieval

I don't think they will make it to even day 3 transfer

IVF#2 - CD 12 - RETRIEVAL

5 eggs retrieved.

4 from my right ovary
1 from my left ovary

The retrieval wen smooth. We came in at 7:30am. I was called in to the prep room. Changed into hospital gown and was right away was hooked up to glucose (sugar water) and sodium (salt water) IV. My husband was called to produce a sample. Around 8am he was allowed to come in to the prep room. We stayed there until 9:15am. After that we were taken to the procedure room and I was administered sedative medication as well as the pain medication.

Sedation drugs used:
Fentanyl - a powerful opioid analgesic
Metazoline - sedative

My doctor came in and together with an ultrasound technician, they did an ultrasound to double check my follicles. Then a spectrum was inserted and a gauze with topical anesthetic was applied. Minutes later I felt a sharp needle "down there" which was some additional local anesthetic.

The procedure started. Me and my husband were able to see on ultrasound screen my eggs "shuffled" around in my ovary. Then my doctor picked out the big ones and I felt a lot of pressure and poking/pulling sensations on the ovary. Eggs were sucked out through a tube and given directly to an embryologist through a little glass window that was connected to the embryology lab.

Later I was whisked away to the recovery room where I stayed for 1 hour.

Feeling bloated and have a constant feeling like I need to go to the bathroom. Also some other things that I will not mention since its too much information ;-)

Now wait until tomorrow afternoon for my RE to call with the results of cell devision and fertilization. I am not sure if my eggs will make it to 5 day transfer. We might just have to do a 3 day. We'll see...

IVF#2 - CD 10 - Trigger

Ok.....scared now. Tonight I am suppose to take my last injection of Puregon 200IU and finally trigger with Ovidrel (HCG) @ 9:30pm. Scared because RE told the nurse to "advise patient that she only has 4 follicles for retrieval"....to me sounds like a warning before a disappointing fall....we'll see how many eggies we will get. I hope I will end up with at least one embryo for the transfer. I truly hope...

My stats today:

Right Ovary - 2.1/ 1.9/ 1.4/1.3/ 1.3 + 2 small ones = 7 follicles
Left Ovary - 2.0/ 1.3 + 2 small ones = 4 follicles
Uterine lining - 0.9cm

Taking last shot of Puregon 200 IU + Ovidrel (HCG) @ 9:30pm

Day 11 (May13)

Just bloodwork

Day 12 (May14)

Egg Retrieval @ 9:30am

IVF#2 - CD 9

I now have ultrasound and bloodwork everyday at 7am. Lack of sleep is really getting to me.

It seems like I made a right decision to fight for my cycle to stay "alive" because my leading follicles slowed down in growth a bit, while the other ones are catching up. Now it seems like ER will be as schedules. Just thinking that if I was not persistent in persuading my RE not to cancel, I would have been doing IUI now instead of this. I really hope I was right, and if I was this is just another example that you should sometimes listen to your gut instincts rather than to your doctor.

Here are my stats as of today:

Day 9 (May11)
Estrogen - 2481
LH - 2
Prog. - 9.9
Right Ovary - 1.9/ 1.6/ 1.3/1.2/ 1.1 + 2 small ones = 7 follicles
Left Ovary - 1.8/ 1.0 + 2 small ones = 4 follicles
Uterine lining - 0.9cm

IVF#2 - CD 7 - Almost Cancelled!

So frustrated and upset!

I am now on my day 7 of IVF cycle.

My doctor was about to cancell it because she said that my follicles got into "groups" of mature ones and immature. She wants them all be at the same level. I put up a fight with her not to cancel.

I said - "I am progressing well and I still have 5 more days of stimulation to go, and my estrogen level is good, I already have 6 follicles. They might grow more in 5 days. Please let's wait and see and if not, I think 6 follicles is enough for ER. I'm willing to risk."

She said - "Only because you are young, I am willing to give it a try and go to ER even with 6 follicles, but that decision is up to you. You night end up with no embryos to transfer, that would be a waste"

My ER is scheduled this Thursday, May 15. So upset and scared now. Tired of waiting. This is second attempt and this crap again??!!

Here are my stats so far:

Today - Day 7
Estrogen - 1515
Right Ovary - 1.5/ 1.2/ 1.1/ 1.1 + 3 small ones = 7 follicles
Left Ovary - 1.6/ 1 + 2 small ones = 4 follicles

IVF#2 - CD 5 Stats

So I went today. My lining is 0.8 cm. Not sure if that's good or not.

I have:

5 follicles on right ovary @ 1.3 / 1.1 / 1.0 + 2 very small ones
4 follicles on left ovary @ 1.5 + 3 very small ones

Because I already have at least one "leading follicle" over 1.2cm, I started my Orgalutran today to prevent me from ovulating.

Back for ultrasound Friday, May 9 (CD 7)

IVF#2 - CD 4 Stats

I had my CD 4 blood work done to see my Estrogen and it was at 652 today. The nurse had asked me to come back again tomorrow for blood and ultrasound. They want to see if I have a "leading follicle" of at least 1.2cm and if I do, they will add Orgalutran (delays ovulation) to my Puregon shots. We'll see how it goes. Just an update.

IVF#2 - Base Ultrasound

Today had my base ultrasound for antral follicle count. Scheduled Day 0 for IVF. My cyst is gone!!! Well, at least the ultrasound technician did not see it. I'm very happy.

I had:
5 follicles on my right ovary
4 follicles on my left ovary

Start Puregon (200iu) May 3 - CD 1

Wow, Puregon is expensive - $223 CAD per shot (200iu)! Wow!

Next B/W & U/S May 6 !

IVF#2 New Protocol

I just got back from my RE and was very happy because she changed my protocol from "Long" to "Antagonist". I was switched from Suprefact to Orgalutran. This cycle will also be shorter because my est. ER is May 15 (!).

About my cyct, my RE said she will "ignore" it if it's less than 4cm and if it grows, then she will "drain" it and still get on with my cycle. This makes me happy, because even though this is my IVF#2, I really did not get a chanse to even finish IVF#1 and did not even get to do stimulation phase of it.

Here are my dates:
Start BCP - April 4
Last BCP - April 30
Day 0 - May 2
Retrieval (est.) - May 15
Transfer (est.) - May 19

IVF#1 - CANCELLED

I am very sad today…started crying at work and just left…because….

I went for my repeat Day 0 ultrasound today and they found that my cyst on my right ovary grew from 2.2cm to 3.2cm in just 6 days. So, my IVF#1 cycle is canceled….All those birth control pills for 31 days and injections in the stomach for 3 weeks is for nothing. Now I have to stop all my medication and wait for my period to come. After that, it’s all over again – birth control in April, injections in May and MAYBE I’ll get ho have IVF egg retrieval and embryo transfer in June. That is IF my cyst goes away. If not, then I have two choices: wait for up to 6 months for the cyst to go away by itself OR remove it through surgery. I am so upset… I never had cysts before and don’t even know why the heck I have it NOW, out of nowhere

I am also on medication (Bromocriptine) for my elevated prolactin. My doctor wanted to cancel my IVF before because of it, but then decided to wait and see if meds help…

I am so heart broken…

I am such and emotional piece of nerves right now. This was supposed to be my first IVF and now I realize that all of you girls out there, who had/have fertility problems, had their cycles cancelled or had BFN after IVF – let me tell you, that you are the most remarkable women that have so much patience and strength that all you girls should be put on a pedestal and given a medal for being able to deal with this emotional & physical burden of infertility…

First base b/w & u/s

Well, I went for my base ultrasound today (March 20) and my RE said I have a cyst (2.2cm) on my right ovary and therefore should continue Suprefact (suppression) for another week (3rd week). I was supposed to start stimulation phase with Puregon on March 21. Now everything is pushed back 1 week because of this cyst.I also have 4 follicles on the right and 5 on the left ovary.

Going for a second "base" ultrasound March 27th now to see if the cyst is gone.