Wednesday, November 14, 2012

A lone contender

Its been an incredibly tough few days. I'm still not over how my cat died- the violence and the wrongness of it. And I miss her so much-- I've had multiple pets in the past few years- I had a cat when I was a student, and when I moved, I found her a good home and kept tabs on her for a couple of years, but letting go of her, while not easy, was possible.I've lost an another dog and cat which were family pets and while those losses tore me up, it was nothing like this. I never bonded with any other creature the way I bonded with H. I could not imagine parting from her, so I never even considered trying to find her a good home when I left New York, even though bringing her across oceans was not easy, neither for her nor me. In the world of a gzillion cats and dogs, she was special. This is really, really hard.

 Now, to the part I'm sure some of you were wondering about--my IVF cycle. In the end, I only had 4 mature eggs. 3 of these fertilized to form 2PN embryos. One embryo arrested immediately, started up again, arrested at the 4 cell stage and stayed there. The second looked perfect (Grade 'A') on day 3, but started stalling on day 4. The 3rd, met all of its developmental benchmarks perfectly, compacted on day 3, morulated(??) on day 4 and was a 'gorgeous' 3AA blastocyst on Day 5, at which point it was frozen.

So---all that, and I end up with what I would have ended up with in an IUI anyway- one great looking embryo, my sole contender.  Since we had only one, we could not even think about comprehensive genetic screening- we have to transfer this one, and pray. We are currently on the surrogate recruiting portion of this program.

A detailed postmortem of my IVF cycle is badly needed, with all the following questions:
1) Am I a poor responder to superovulation or was it the combination and timing of drugs which was not optimal for my system? On CD9, I had 6 synched up follicles, which, I suspect, gave rise to my 4 M2 and 2 MI eggs.  At that point, we switched to from Foliraf (recombinant FSH) to menagon(Urine extracted FSH + LH), upped the dose of stims, and on paper, based on E2 and follicle size, I responded, but most of what came then were immature eggs. So all of that later stimulation, and waiting for the last follicles to respond, *may* have been futile. .As my doctor said, this is gambling to a extent- we did, and we lost. If we had aimed for just 6, and triggered me sooner, would these 6 eggs have been better?
2)My follicles were probably not synched up, whatever that means. Here is a question for you all- does a long lupron or BCP protocol help? I have to go back and look at my baseline ultrasound, but I remember thinking that the follicles in one of my ovaries (the right one) looked larger, and those just turned out to be cysts. 

Anyhow, all of these are things for the future. I pray I will not have to do another IVF and  my one blastocyst turns into a take home baby, But I have to say, my odds are much, much poorer than I thought they would be at this point. I'm so down, for so many reasons. The unimaginable result of this cycle. The massive fight I've had with somebody close to me that near shattered me yet again, just when I thought I'd started to recover from my poor cat's loss. Issues with living in India-that is what triggered that fight. And still, by far the most painful, the loss of my cat.  This is the roughest time I've had in a while, almost on par with the darkest period in my life, the weeks after my first loss. I have not been able to stop crying for the past 2 days and this morning, just in passing, I thought about anti-depressants. I NEVER think about anti-depressants, not even during the worst times of my life so far, so that was a shocker. But- if nothing more comes along, I will mend and get over this. I'm really praying for some kindness from the universe right now.

Sunday, November 4, 2012

A time of horror

I had my retrieval last night. They got 11 eggs, so that did not seem too shabby.

I came home, was given Lyrica by my mom and went straight to sleep. Around 3 am, my parents woke me up. My cat, who likes to hang out in our garden (only at night, she is so contrary), which is gated and fenced, was attacked by feral stray dogs that came in through the gate somebody left slightly ajar. My dogs, who were inside the house started barking and my dad and housekeeper rushed out,chased the dogs away,  to find her mauled and barely alive. They bought her in and 10 minutes later she died.

This was a cat I'd rescued from a shelter. I  formed such a deep bond with her that when I left the country, I bought her with me, to keep her safe and give her a good life. It took her a while to get adjusted- which she finally did and now, this happened. I could not keep her safe, I feel so guilty and I'm such a mess emotionally, I can't believe she is gone, I have not been able to stop crying since I woke up this morning.

To add to the misery (that is all that seems to be on the menu for now), I got the fertilization report- out of the 11 eggs, only 4 were mature(in the M2 stage), and 3 out of the 4 fertilized.  None of the 2 M1s fertilized, and from the 4 immature eggs, which were put through in vitro maturation, one made it to M1 and was injected with sperm today.

So at the very best, I may end up with 4 blasts to freeze on day 5, but I doubt I will be that lucky.

My RE is baffled-my case is so, so weird. He says he will do another IVF only if something changes with my AFC or AMH, but right now, I am a shitty responder to superovulation, apparently.

The best thing for me would be to try again naturally- I've gotten pregnant 3 out of 4 times. But I'm done with that- I can't handle another loss.

I'll figure out what to do later, but right now, I'm shaken and saddened to my very core. Out of the two horrible things that have happened today- If I could make  the universe fix one of these 2 things, it would be what happened to my poor, poor cat.

When the universe hurls crap at you, boy is it generous.

Friday, November 2, 2012


I got the first piece of good news this cycle so far yesterday- my estradiol (E2)went up from 2200 (pg/ml) on CD12 to 3521 48 hours later. My ovaries are filled with largish follicles. We did not bother measuring anyway- we could tell that many had increased in size from 2 days ago, but there are no foolproof indicators based on size of whether a follicle has an egg, and a mature one at that.

An E2 of over 3000 is considered decent territory for an IVF response, but when I asked my doctor of how often E2 levels can predict mature follicle number (assuming each follicle produces between 200-300 pg/ml of E2)--he said--75 % of the time. So yeah, its always a crapshoot.

He did say that, barring my lowish AFC(13) for my age, my response has been 'textbook'.

So I triggered (with 5000 units HCG) this morning. And unfortunately, something happened. The injection is given IM, I asked my mom to give it in the hip area, bad call. As I was getting it I felt the muscles in my leg seize up. 4 hours later, I'm limping horribly and can't sit, and nor can I take any muscle relaxants/anti-inflammatories. Spending the day in bed---not as enticing as it sounds, unfortunately!

Minor issue though-egg collection is tomorrow evening, and I hope that brings good tidings. Wish me luck!