How we did it - Part 3

While we were going through this whole process, we had a night out with friends downtown Tulsa. There were a few outside events going on so we were just walking around when this balloon artist (we aren't really sure if it was a he or a she) came up to us and started making balloon objects for each of us. David and I were kind of standing off to the side just watching when all of a sudden he/she came up to me and started twirling and twisting balloons around until he/she handed me a little balloon dog. Ok, no big deal right? You see balloon dogs every time you see a balloon artist. But this one was different...it had a blown up balloon in it's belly...it was a pregnant balloon dog!!! Every one's mouth just dropped because this he/she obviously had no idea that we were going through what we were going through at that moment. I took it as a sign and I tried to hang on to the pregnant poodle for as long as possible, but within the next few days it withered away and just became empty balloons so I had to throw it away. I wish I would have taken a picture of it at least!

OK, on to the rest of the process:
May 27th - Egg Retrieval! I was so anxious and excited all at the same time. I just knew I was going to get tons of eggs and they were all going to fertilize and be perfect! Well, that didn't happen. I got 9 eggs. Not bad, but I was a little disappointed because I had always heard about people getting like 18 eggs normally and then only half of those fertilizing and then only half of those making it to the transfer. So if I did the math in my head, half of 9 would be 4 or 5 fertilized and then half of that would be about 2 embryos making it to transfer. Those are not good odds! But I just kept trying to remind myself that we only needed one good embryo for this to all work. In reality though, everyone wants to have a few backs ups just in case, so that's what I was worried about.
Also, this was the night that I started the dreaded Progesterone shots that came in a needle about the size of a cork screw. I was scared to death of these shots. But I was given some numbing creme and David gave the shots in my rear end and I ended up not even feeling it. It just started to get hard after a few weeks of these shots because hard spots had formed on my butt and it was difficult to find a place to shoot up.

May 28th - This was considered Day 1 in terms of the embryo development. Starting on this day, we were to call my patient line to find out the results of how many eggs were fertilized and then each day after we would call the line to find out the progress of the embryos.
Well, another disappointment for me...out of the 9 eggs I had, only 3 had fertilized. And fertilized means that the embryologist inserted a sperm into each egg and out of the 9, only 3 became embryos. All I could do was just hope and pray that at least one of those embryos would make it another 4 days for the transfer.

May 29th - Day 2 - This is when they started "grading" the embryos from best quality to worst quality on a scale from 1 to 4, 4 being the best.
We had 1 grade 4 (yah!), and 2 grade 3 (still good).

May 30th - Day 3 - We now had 3 grade 3 embryos.
This is also the day that the embryologist did the embryo biopsy for the PGD test I told you about before. I was scared that the biopsy would some how damage the embryos and their quality (this is possible, but very rare). The samples were then overnighted to California for testing.

May 31st - Day 4 - We now had 2 grade 4 and 1 grade 3!! Such good news. They made it through the biopsy and even got stronger! I was very optimistic at this point.

June 1st - Transfer Day - When we got to the doctor's office, she called us in to discuss the results of the PGD and what our options were. I didn't take this as a good sign until she told us that all 3 embryos were normal before we were even able to sit down! Finally, some good news for us. 2 embryos were graded perfectly and 1 was just a little behind but if it made it one more day it would be freezable to use at a later time. The doctor made sure we were comfortable with transferring 2 and of course we said yes! We were ready. I couldn't believe that this was actually happening. I was so convinced that this was all going to work perfectly that the moment those 2 embryos were inside my uterus, I felt pregnant! I know it sounds crazy, but I was very confident because those 2 little embryos were strong and perfect and they were meant to be ours.

Before we left the doctor's office that day, the nurse gave us this picture of our 2 embryos that were transferred.

This is our babies' first picture! How crazy is that? And they were so strong and healthy that they were already hatching on their own before the transfer.

P.S. That 3rd embryo did make it another day and it's now sitting in a freezer somewhere waiting for us :) So I got my back up but now I consider it a bonus.

How we did it - Part 2

Because we were still considered as having "unexplained infertility" and with the additional information about the DNA Fragmentation, our doctor suggested that while we were going through the IVF process that we have a PGD test done on the embryos that are made before the transfer.

PGD stands for Preimplantation Genetic Diagnosis. The process is this: After my eggs are retrieved and combined with the sperm, an embryo forms. The embryologist would then do a biopsy on the embryos and send that sample off to a lab in California. The lab would run a test on the sample that looks at all of the chromosomes that are made up in that embryo. Each embryo should have 23 pairs of chromosomes and if something is off on one of the pairs or if there is an extra chromosome in there, the test would pick it up. This test would be able to check for any kind of genetic syndrome such as Down Syndrome. And because your gender is the 24th chromosome, the test also tested for that. Keep that part in mind for later :)

The doctor suggested this test for us for a couple of reasons, but mainly because we still have no clue what's wrong with us, why we aren't getting pregnant, and what caused the miscarriage. This test might be able to give us a little more insight into our situation. But on the other hand, it in no way would be able to tell us if the sperm that was used to form these embryos had any DNA Fragmentation. The discovery of DNA Fragmentation in sperm is so new (like in the last 3 to 4 years), that they really don't know what to do with that information yet.

In the end, we decided to go ahead with the test, even though it was an extra $6,000 on top of the total cost of the IVF (I'm not sure if it's weird to post the cost or not on a public blog, but I will just say this, there was a loan taken out and these babies will be paid off on their 5th birthday! But if anyone is interested, I don't mind at all filling in the details in a personal message).

Once we got all of that taken care of, the IVF cycle began and it went a little something like this:

April 10th - Start Birth Control - Birth control is used to suppress the ovaries and get them ready for all of the stimulation. It's a little weird to be taking birth control when you're trying to get pregnant, I know...

April 15th - I had a doctor's appointment to get up to date on my Pap, something called an ultrasound with contrast - where they do an ultrasound while shooting liquid up there, and a trial IVF - this is basically a practice run on the most important part of the procedure. The doctor does everything like the real thing and takes notes and measurements to follow for the big day.

April 26th - Patient Education - We met in a room with about 4 other couples to learn about the whole process. We ended up seeing one of these couples every single time we were in the office because they were on the exact same schedule as us. And each time we would check in with each others progress. I haven't seen them since our last blood test, but I'm pretty sure she got pregnant with twins too.

May 12th - Baseline - This was an ultrasound to check my ovaries to make sure everything was good to go!

May 16th - Start meds for IVF - At this time, I was on one oral medication in the morning and then 2 shots a day. It got up to 3 shots a day at one point though. It wasn't too terrible because I got used to them. I had already been taking shots for the IUIs that it was no big deal to me. The only thing different was that I was taking a lot more shots at one time and my belly was sore and bruised and I would run out of spots to poke.

A little while after starting the meds, I started having ultrasounds every other day to check to see how many follicles I was producing and how big they were. I was producing normally, just like I should and I would get a good report every time and then told to come back in the next few days to check again. The follicles had to be a certain size to be able to trigger my ovulation at the exact right time to be able to do the egg retrieval. This was very important because if we missed the right time, all of the meds were done for nothing.

May 25th - I got the ok to finally take my trigger shot. This made me a nervous wreck. I've had to take a trigger shot with all of my IUI's, so I knew how important it was. But with the IUI's, the shot was prefilled and all I had to do was just insert it in my stomach at the exact time they told me to. Well, this shot had to be mixed, part powder and part liquid. And I had to take it at exactly 11:00 pm on this night. So I set 2 alarms in case I feel asleep. I got up and started the mixing process. But then I realized I didn't have the right needle. The only needle I had was too big to draw the mixture into the syringe! I start freaking out. I'm yelling at David that "we can NOT mess this up!!!" We finally get as much as we can into the syringe and I literally jam it into my stomach, I didn't try pinching or anything to make it go in better, I didn't care. That thing just needed to get in there. I do all of this while I'm crying because I just know I didn't get the full dosage. This was the most important step on my end and I had messed it up. I was devastated.
But the next day, I find out from the doctor that we were fine and it's not a big deal if we didn't get the full dosage. So I just relax because it's all out of my hands at this point.

How we did it - Part 1

Now that I'm safely cruising through my 13th week of pregnancy, I decided it was time to tell how we finally got to this point.

After I lost the first babies back in October, I had a D&C and then had to wait until I got a normal period before we could start trying again. I thought about taking a few months off for about half a second and then realized that's not possible for me to do. We've waited so long already and I just knew that I needed to get out of the rut I was in after the miscarriage and the only way to do that was to get back up and keep trying. I knew we would have a baby eventually, I just didn't know how much longer it would take. So I was still hopeful, but I didn't want to have to wait another 3 years.
And everyone kept telling me "oh you'll get pregnant really fast now since they say you're most fertile right after being pregnant", or "you got pregnant once so you know it will happen again". So I was very optimistic that it was going to happen the first or second month of trying. I was so optimistic in fact that I only put enough money in my work flex account for 1 1/2 IUI's. I knew it would happen that first month and then I could just blow through the rest of the money on some contacts or something.

Well, needless to say, I blew through the money alright, but it was all in the first month! We ended up doing 2 IUI's, one in January and one in February. Neither resulted in a pregnancy.

I was at my limit, so after 6 total IUI's, I was ready to move onto IVF. We are still diagnosed as having "Unexplained Infertility", so I was sick of the guessing game and tired of the IUI's and the disappointment each time, even though it had happened once.

The doctor wanted to test David again before we started the IVF process. Even though he had made frequent "deposits" over the past couple of years, he hadn't been officially tested since the very beginning of everything back in 2009. The doctor decided to send him for a new test at the same time. This test was to check for something called DNA Fragmentation. And we were told anything less than 30% fragmented was a good sign and we would be good to go. Well, David's test came back with 98% DNA Fragmentation. That means that out of the batch of sperm that he submitted for the test that day, 98% out of 100% was fragmented. Not good.

DNA Fragmentation basically means this: There are DNA strands in the man's sperm. If you can picture what the DNA Helix looks like (rethink back to your science class in school...it looks like 2 strands wrapped around each other), well the strands are frayed at the ends or "fragmented". So what happens is that I might be able to get pregnant with these sperm, but at a certain point the embryos cannot develop any further and they self abort. So this could have very well been the cause of the first miscarriage, but there is no way to tell for sure. And there's nothing that we could to about it. We would just have to go ahead with the IVF and take the chance that we would maybe get a sperm out of the 2% that wasn't fragmented.
We did know another couple that had the same issue and they had twins through IVF, so we knew it was possible.

Just to get a better idea though, we had David tested again about a month later because sperm regenerates itself and we wanted to compare the numbers between the 2 tests to get a better idea of what was going on.
The second test came back with 72% DNA Fragmentation. Even though it was still way over 30%, that was music to our ears. It had gone down and that's all we cared about. So we moved forward.