Perfectly Normal

We had our first trimester screen yesterday and the news was good.  Or, as I keep repeating in my head, the perinatologist told us that everything was "perfectly normal."  

I love perfectly normal.  I have absolutely no interest in "perfect" alone.  It's an impossible goal and statistically unrealistic.  We don't live in Lake Woebegone;  most children are "average". In my world, average is not only good, it's wonderful.  

So yes, heart rates for both twins at 160 something.  I was 11 weeks 5 days yesterday and they were measuring 11w6d and 12w0d. Their nuchal folds are thin.  Perfectly normal.  

I also had a wonderful conversation with our perinatologist, a man whom I now consider the best doctor I have.  As a research scientist, I don't expect doctors 1) to be up to date on the research, much less 2) able to effectively critique it.  Indeed, when I brought my OB a copy of Dr. Luke's research on the effectiveness of her nutritional program from a top peer reviewed journal, I attached my own critique of the study's strengths and weaknesses.  (Overall, my critique is that the effect sizes are so large that her program should be given serious consideration for mothers of twins) Anyhoo, my perinatologist was able to use his knowledge of the research to logically convince me that I can go off the Lovenox at the end of the first trimester (Saturday) without harming the babies.  He also said he would support me if I decided to stay on the meds, but there is no research based reason to do so---because I do not have a diagnosed thrombophilia problem.  

I'm not sure all my doctors understand how much I know about evaluating and interpreting research, but I do think that he understands research better than my other doctors.  

So things are moving apace.  I thought everything was going to be ok with the twins, because I am HUNGRY a lot of the day.  And I am TIRED the rest of the time.  I've never been this hungry or tired, so it seemed like all was going the way it should.  

We're off for a family vacation next week.  Happy New Year to everyone!  May we all have an easy year reaching our dreams.

Still Here

We're at 9 1/2 weeks now.  Although it sounds like it ought to be an especially tawdry time of the pregnancy, I am just starting to get fat and am moving into maternity clothes.  The bottom of my belly, where my uterus should be, isn't showing, but my waist has expanded, which is apparently what should be happening.  

I go for my second OB appointment tomorrow and am (hopefully not obnoxiously) bringing a research article on the benefits of Dr. Luke's diet, so that they will not give me grief for gaining 5 lbs already.  That is the bottom of Dr. Luke's range of what I should have gained by 10 weeks.  

In any case, if they don't want me to gain as much weight as Dr. Luke recommends for twins (40-65 lbs), they are going to have to show me the research, not just state their opinions.

Do you see why I worry that I could come off as obnoxious?  I don't want to be obno, but I am probably a bit more informed than the average patient.  And if I can help other MOMs (mothers of multiples) in the practice, why wouldn't I?

It's almost time for my next snack.  And yes, I am getting hungry for it, less than 2 hours after I've had breakfast!  

Eating for Three

The spotting has gone away:  Hooray!

Now I'm focusing on having a healthy pregnancy and carrying these twins to term.  Has anybody else started following Dr. Luke's book "When you're expecting Twins, Triplets or Quads?" I'm on day 2 of the feeding frenzy and wondering how every one else is doing.

I have never eaten so much food in my entire life.  But her research shows that gaining a boatload of weight early on reduces NICU, preterm labor, preterm delivery and preeclampsia (all the bad pre stuff).

Anyhoo, any of you other twinners following her advice?  Can we commiserate on how much food 3500 nutritious calories really represents?

Spotting

Despite reassuring everyone that spotting is completely normal in IVF procedures and telling them not to worry, my spotting has gotten worse and freaked me out.  I've been spotting, slightly, about every day in the last week.  

Today, however, the spotting turned into bright red bleeding for about 30 minues.  It stopped after that and is now back to the brown blood which indicates that things are "resolved."

Nonetheless, I finally broke down and called the OB to get an ultrasound.  I'm heading out in about 30 minutes and then heading to work after that.  

All I really want to do is nap.  I think everything is ok.  I know I'm not shedding my lining because my HCG is nowhere near 0.  Nonetheless, I have looked up the vanishing twin synrdome and freaked myself out.  

I'm hoping this is just a problem with my fluffy estrogen induced uterus and using Lovenox.  I really just want to take a nap.

UPDATE

The ultrasound went really well.  Both babies have great heartrates:  151 and 156, which indicates a 3% miscarriage rate at 7w4d.   I am also happy that they are going to go ahead and keep my u/s appt on Friday.  So more looks at the babies, then, too.

Ohmygoodness

Well, we just got back from the OB for our ultrasound.  And much to my surprise, there are actually TWO in there!  Holy Cow!  I had totally convinced myelf that there was only one, and I was once again, wrong.  WOW.  

They are measuring exactly on schedule:  6w4d and their heartbeats are 124 and 125---perfect.  Once you get heartbeats in the right range, things just look a lot better for a positive outcome.  

So, we're pretty excited!!  And a bit freaked out!!!

Holy COW!

Oh, and I Forgot This

I was getting my hair cut last week and read an article about Courtney Cox in a magazine.  Her efforts to get pg through traditional IVF are well documented and I believe that the procedure was traditional IVF (with auto-immune treatments).  However, in the article, she was saying that she was trying to add a sibling to the family and she was exploring some "high tech options that involved freezing" or something like that.

If she had some frosties already, she would have already had another child or two.  And at age 45, I just don't think she's undergoing traditional IVF.  So if she does get pg soon, I think we can be assured it was the high tech option of donor egg, not FET.

Just a thought.  

Checking In

I have to be honest:  I hate when the blogs I follow do not update regulary.  It's annoying, worrisome, and it makes me cranky.  So to the folks out here who are following:  my bad.  Work is crazy and also as this is my donor egg blog vs. my "regular" blog, I'm just more focused on discussing issues DE issues here than every thing else.  

So far, I'm not feeling a lot of "DE" issues. In fact, I mostly forget that this wasn't a traditional IVF procedure.  I'm certainly much, much less worried over this pregnancy since any of the others since DS.  I'm certainly having a lot more "signs" in this pregnancy (fatigue, nausea, boobage pain) than the other pregnancies.  I did look to see if this was related to age, and couldn't find any research that supports that.  So maybe there are two in here.  I'm not convinced, to be honest.  Maybe both blastocysts made it, but I'm thinking there is just one strong one in there.

That said, my best previous indicator that I was pg was being convinced I was not.  So maybe for the first time believing that there's only one in there, I'll be very surprised.  

The only DE issue that continues to work me us is seeing people whose cycles don't work.  It's very frustrating and sad and it still bothers me a lot.  

In any case, ultrasound next week to see how many people are in there!  I'm glad on the days I feel like crap, of which today would be one of them.

Beta's are In

The clinic called and I have, I think, good numbers for the betas:  the first one was 600 and the second one, 4 days later, was 2900.  

The dates are 10dp5dt and 14dp5dt, which are in the normal range for both twins and singletons at betabase.info.  BTW, if you don't obsess ove the numbers at betabase.info when figuring out how your numbers compare to others, you should.  

The doubling rate is about 43 hours, which is good, although not great.  40 hours would be "great."

In any case, I voting on a very strong singleton in there.  I don't think there are two little ones making a home any more, although I did after the first numbers came in.  

I have to be honest that I don't feel out of the woods yet.  I know this is a whole new ball game with fresher eggs.  Nonetheless, after a bazillion miscarriages, I'm just not sure when I'm ever going to feel "safe" and "pregnant."  The only time I felt that way was the first pregnancy, when I was too stupid to know any better.

I'm Freakin' Pregnant

I have mixed feelings posting this because although I'm thrilled for me, some of the blogs I'm reading do not have good news.  So I'm very sad for folks who do not have good news.

But Holy Crap, we're pregnant.  I've taken 3 HPTs starting at 5dp5dt (10 dpo) and we started off with a faint but visible BFP and this morning it is a shining, bright pink line.  I know by the darkness of that line that we've passed the level of chemical pgs that I've had in the past.

The official blood test is still Friday, but we are feeling very positive about how things are going.  

Holy crap!  Yay!!!

Thinking of Testing Soon

Well, I know I'm not supposed to be having any real symptoms yet.  I'm really only 9 dpo. 

Nonetheless, starting at about 2dp5dt (7 dpo), I started getting serious indigestion after eating.  This has always been a good sign of pg for me, especially when it occurs after several meals across several days, which it has.  

Last night at 3dp5dt (8 dpo), I started getting the tingly boobs.  This, again, is generally a good sign for me. 

And then today, 4dp5dt, I have had the worst nausea.  It comes and goes, but when it's here, it's pretty damn crappy.  I have also had anxiety nausea, but this feels completely different.  

Yes, I do understand that this could all be in my head.  Or it could completely be side effects of PIO.  But usually I have one or the other, not all three and not at "appropriate" times.  

I am so not one to wait for the blood count.  Even if I do test too early, I'd rather be prepped for bad news than to have bad news sprung upon me.  Plus, I've taken so, so, so, so, so many pregnancy tests (including a positive one with a 4 beta blood count), that I do know the difference between a really faint positive test and an absolutely, completely negative one.  (At least on a FRER).

Of course, the only times I've ever been pregnant have been when I've been completely convinced I'm not, so now I'm pretty much doomed.

Holy Freaking Shit

We ended up with 14 frozen embryos.  

That means with the 2 that are digging around in my body (and can I just say OH!  I'm having real cramps), we ended up with 16 out of 21 high quality embryos.

I am *only* putting this number on this blog and am telling only one or two friends about this.  Clearly, we are excited, but realize we are going to have several serious choices down then road.

But right now,  hooray!!! Something is going to work out some how!!

(And yes, I do feel guilty for others out there reading the blog who are not getting as good as news.  I am sorry.  I hope my 8 miscarriages allow a little softer feelings directed our way)

Transfer

So far, so really, really good.

They transferred 2 blastocysts that were just beginning to hatch.  The doctor said they look "great".  The embryologist said that they were starting to hatch is a good sign that they are going to continue developing.  The hatching thing, in the DE Mommy household, means that the embryos have got their downpayment in their pockets and are looking for a good location to buy their house.  

I am actually not overly stressed right now that things might not work out.  They have already frozen 9 other blastocysts (a number the embryologist called very "unusual" and "good") and it's possible that there are another 2-5 yet that could make the grade for the clinic to freeze them.  

At this point, things seem good.  I'm "taking it easy" for the next three days.  I don't need to be flat on my back, but they'd prefer I stay off my feet, so I am going to.  

I'm already feeling a little crampy.  I hope the little guys have decided the location has a good view and it's time to dig out the foundation.

Didn't See That Coming

For the first time in what seems like a long time, the surprise has brought us good news.

As of yesterday morning, we have 15 fertilized eggs.  As of today, we have *21* fertilized eggs.  Apparently, some of eggs decided to wait a little bit before they got going.  

Yes, that is right.  15/22 yesterday 21/22 today.  I have to be perfectly honest with you:  this is the first time EVER that I think things have a chance to go well.  

Of the 21 embryos that we have now (21!!!),  there are four 5-cell ones rated fair, 16 4-cell ones with 6 good and 10 fair and 1 little 3-celler who is fair and trudging along.

I repeat: Holy Shite.  Maybe, just maybe this is going to work out.

Fertilization Report

We were on the road yesterday and just now got an internet connection.

15 of the mature eggs fertilized. 

They said that was a good number.  We are waiting for the report today which tells us how the eggs are doing and whether the transfer will be tomorrow or on Tuesday.  

Emotionally, I'm doing well.  15 fertilized eggs is good, I know.  I, oddly, remain anxious for each day's update.

The nice thing is that my insomnia is keeping me on east coast time.  So hopefully, the trip back will not require a lot of adjustment.  I remain happy for the little things.  ;-)

Update on Eggs

Well, things are so far looking good. They retrieved 26 eggs and 22 are mature. They are going to call us today and let us know how the ICSI and fertilization rate. They decided to go ahead and fertilize all 22 of them.

This is all good news for us, but I am sad for one important person. Our clinic has a policy of freezing any extra eggs past 20. One reason is: what is a couple going to do with 10 extra embryos after they have twins? With an 80% success rate with fresh embryos and a 70% success rate with FETs, couples in this clinic are probably often faced with this issue. In fact, I came to this clinic because my good friend had 15 frozen unfertilized eggs that she donated to me. I guess because it was so "easy" to get those eggs, I thought it must be a common occurrence. Apparently, having extra eggs to freeze is not all that common.

We wanted to give these extra eggs to a good friend of ours who, as we do, really wants to have a baby. In every, single scenario I've imagined for this cycle, we were going to have extra eggs to give her and she was going to get a "good" chance with these frozen eggs. I felt like we would be paying karma forward.

So I am very happy for us. I think we may actually have a chance with these eggs, although like Summer said, when it's your cycle, you expect the next news to be bad. But I am very sad for our friend. I feel like we promised her something we can't deliver and took back an incredibly precious gift.

I feel like this post sounds sad even though we have some great news. And I'm not sad for us. But I am sad for my friend. And sadness while trying to get pregnant? Well, that's an emotion I'm used to.

Also, my ass hurts like hell. PIO doesn't hurt going in, but my booty is wondering what the hell it ever did to me for me to treat it like that

Retrieval is Thursday

One weird thing about using an out of state clinic is getting on the airplane and thinking, "Holy crap, we are going to California to get pregnant.  This is a BIG deal."  

Trust me on this one.  

The retrieval is officially on for Thursday.   I went in today for my final uterus review:  it was perfect.  It's nice to hear one's woman parts are doing well and even attractive.  I don't have an estimate of the number of follicles right now, but everyone is very excited about it.  The nurse says "all the boxes are checked" for us to get pregnant.  We are planning on a 5 day transfer on Tuesday.  

YIKES!

I am still not fully convinced this is going to happen.  DE Daddy was late coming home the other day (by about 10 minutes).  I heard some sirens and I thought "well, that's it.  He's dead. That's this cycle's reason why it won't work."  I'm actually a positive person, but with all that's happened, I'm still not convinced about our good luck.

I think I need to go have a glass of wine.  While I can. 

Still Still On!!

It looks like retrieval is going to be on Thursday.  

!!!!

The donor has between 25 and 30 mature follicles.  She's coming back in tomorrow and I think they will trigger whenever it is so that retrieval will be on Thursday.  I am actually quite relieved because we're flying out on Tuesday and I would rather have a day of wiggle room in case there are problems with the flight.  And please don't let me have just cursed the flight by blogging that.

I also learned that they have a pretty standard protocol that is what Beer's recommends and that my real struggle (?) is going to be getting my regular OB to follow Beer's protocol should I be fortunate to get pregnant.  My OB is pretty progressive, so I'm thinking that will work out, too.

In any case, we're packing up the pharmacy and a few clothes and heading out tomorrow.  I'm hoping the hotel has internet so I can check in and let folks know the status.  I still am not convinced this is going to happen.  We'll see.  And we'll definitely hope!!

Getting Ready

We've spent some time this weekend getting ready for the trip.  I took all the medicine out of the cabinet and put it on the counter so I can pack up the small pharmacy to carry on the plane with me.  I would look like a terrorist with all these syringes if it wasn't for the fact that all I could do is make the pilot get a better uterine lining.  At least if I was doing traditional IVF, I could make him or her ovulate.  

I also went through the boatload of books on my bedside table to clean up a bit.  There, I found the Dr. Beer's book on auto-immunity and pregnancy.  Despite being an academic and an infertile turtle (thus reading everything), I found that book very hard to read and understand.  His web site is not much better.  It doesn't help that he's been dead for quite a while, eh?

Nonetheless, it's been a year and a half since the doc's suspected an auto-immune problem and I started looking through the book.  That's where I discovered that the low dose aspirin/prednisone/heparin (or lovenox) regimine that I am on is pretty much the real standard one.  Beer recommends a couple of other transfusions, but those are quite controversial and my problem, if I have one, does not require that.

I generally am skeptical that I have a problem.  I mostly see this as a "can't hurt and might help" approach.  And then I read about rashes, like the massive excema I had during my last pg and have never had before or since, are good indicators that the body is dealing with some "inflammation" from the pregnancy--a sign of an autoimmune problem.

And then I start to freak.  I am using donor eggs because it's obvious my eggs have gone past their use by date.  However, if I have an auto-immune problem, it doesn't matter whose eggs I'm using, there is still going to be a problem and I could not be able to carry my child(ren) to term.

Here is where 1) I love my clinic and 2) I'm glad I reread the book.  I have emailed the clinic several times asking about this problem:  I don't have the MTHFR mutation (I call it the m*ther f*cker mutation), but the excema is still a sign.  They have apparently done additional research and are now running bi-weekly tests on my blood to see how things are going.  This is exactly the protocol from Beer for auto-immune testing before conception.  

Folks, the clinic actually took my questions and concerns seriously.  Holy Cow.  I don't recall that ever happening before.

I also now know what Beer recommends for both protocol and testing during a pregnancy.  The heparin should last until 34 weeks.  Testing for progesterone among other tests should continue weekly until 12 weeks.  Ultrasounds should occur every 2 weeks after week 6 for the entire pregnancy to see how the placenta and the baby are developing.  I know this is a lot of monitoring.  But if something is going wrong, we need to know soon enough to adjust my meds so I don't lose the baby.

In any case, things don't seem so carefree any more.  I am happy that I am at a place that I trust and who will listen to me.  But I worry about being more of a freak than I originally thought.

Tune in tomorrow when we find out the donor's next follicle count and when she will trigger.  It's getting kind of crazy!!

Still a Go

Our donor went in for her follow up today.  She has 20+ follicles from 8-13mm today with a 500+ Estradiol.    Apparently, that is good. 

Even better, we are fully on.  The FDA tests came back normal.  We are, at this point, planning on going to CA for our retrieval and transfer.

It's on!  

Testing Continues

I went back in today for my second ultrasound and bloodwork.  My lining is 7 and I do have a triple stripe.  (yay!)

The clinic in San Diego has decided to monitor my blood work more closely this go round, so they are running several different tests including a CBC and other clotting measures (I think).  I'm on the auto-immunie pregnancy protocol despite the fact that I do not have the MTHFR (which I pronouce to myself in quite profane terms) mutation.  Nonetheless, 8 miscarriage and only one for sure we know is genetically caused could be an indication of auto-immune problems.

I've requested their input on what we should do in regards to staying on heparin and prednisone.   love this clinic because they've decided to monitor me every two weeks while I'm on the auto-immune meds.  I *think* that if they see changes after I get pg, they'll keep me on the meds and if they don't, they'll take me off at 12 weeks.  

I'm just speculating here, but since I've never been monitored before while on heparin and I've asked them about using heparin for a limited time or a full time, it makes sense to me. 

Plus as DE Daddy says, more monitoring can't be bad.  

Thirty Freakin' Five

The donor has an antral follicle count of 35.  

!!!!!!

35!!!!!  That's amazing!!  That means that before she's had any stimulations, she's got 35 eggs ready to go, vying to be the next one out.

!!!!!!!

We are pretty excited about that!

Something Weird

Because I like numbers and statistics and large sample sizes to compare, I often spend time that I shouldn't looking at the objective, government statistics on IVF and DE success rates.  The reason I think it's important is that as my colleague said this week, you want to go to the medical clinic that has the best batting average.

Here is the weird part.  I would assume that if a clinic has a really good DE success rate, they should also have a really good IVF success rate or vice versa.  However, the clinic I'm in love with in San Diego, while it has an over 80% success rate in DE (waaay higher than my local clinic).  However, it has a slightly lower success rate with regular IVF than the local clinic.  

Hmmmm.  In the process of writing that paragraph, I just answered my own question.  I know for a fact that the San Diego clinic doesn't turn down anyone whereas the local clinic has a reputation for not offering IVF to people whom they don't think it will work.  

That could explain the differences in regular IVF rates.  I still think the differences in DE rates have to do with lab skill and donor pool.

Well, dang.  I thought I'd found a real conundrum to blog about and really, I'm just wasting time. 

Meds Starting

So I started the vivelle estrogen patches yesterday as well as my prednisone and heparin.  The donor doesn't go in for her antral follicle count until the end of the week.  Then we'll be able to compare her Fertile Myrtle follicels to my Fertile Turtle follices (I have 5). 

This was the first time I've found out how many resting follicles I have.  It's actually reassuring. 1) there is something happening in there and 2) that few means that IVF wouldn't work for me.  

It still amazes me how many doctors are willing to go through with traditional IVF for women when their antral follicle count strongly suggests that it won't work.  It makes me cynical wondering about their exact motivation for a procedure that will bring in money for them but in all likelihood will not provide a child to the couple.  I don't like to be cynical, but sometimes I am quite skeptical.

Anyhoo, we hope to get good news this week about our donor's healthy, high follicle count.

Pre-Cycle Insomnia

It's not that late for normal people, but considering I usually get up at 5 am to exercise, it's late for me.

Nothing big is going on.  I'm still neglecting to blog about the spate of 40+ women who have given birth in Hollywood.  Basically, Marcia Cross is the only one I think  who used her own eggs (although she had twins, so I'm not really sure).  Everyone else:  Geena Davis (twins at 48), Jane Seymour (twins at 45), Joan Lunden (twins at 54), Elizabeth Edwards (age 48 and 50 with her last two children), and Holly Hunter (twins at 47) really seem obvious that they used donor eggs.  

I actually had someone on my other blog get all cranky that I suggested that Geena Davis used donor eggs.  She had twins at age 48 and a son at 46, even though she claims the twins were an accident.  Really.  Reallllllly.  First, the statistics suggest that she didn't have these children by accident.  Three children in two years also suggest somebody was on ice: i.e., there were frosties from an IVF process.  Second, what does it matter?  Why does finding out that someone you like used donor eggs to finish their family bother you?  What if you found out that someone you liked adopted a child?  Had stepchildren?  Had a child out of wedlock?  Was a foster parent?  Used a sperm donor? What difference does it make to you and your relationship to this person, much less to their child?

Second, I'm starting to get annoyed at hearing The Definitive Answer as to Why Women Choose Donor Eggs.  I chose donor eggs because I wanted the best probability to have another child considering the amount of money we could spend.  I did not choose to use DE just because I want the intimate experience of giving birth.  I just know that 30% of domestic adoptions end up in "adoption miscarriages" in which the birth mom changes her mind.  That's a risk that feels too hard for me, right now.  Plus, I'll get to breastfeed more easily-and considering our DS breastfed until he was 40 months old, it is important to me.   

  

So don't tell me why I did what I did and stop saying that Hollywood simply has enough money to do multiple tries at IVF so that they get pregnant.  They didn't.  They used donor eggs, and all of us know that.

Phhht.  Now, let that sleeping medicine works soon so I'm not up for another two hours.  

But boy, reading back over this blog post, I sound CRANKY!!  I'm not really all that cranky. (And I've come back on Saturday morning to edit this--so it was worse before now!!) I'm really  excited that we're starting another cycle, but I'm just not that naive anymore.  

So whatever.  I also may be picking up on the fight I'm halfway watching on HGTV.  Now, there is some crankiness going on.  I may try to find some other program to calm me down.  It's a floor gone bad on HGTV.

Finally!!

No, I didn't fall off the face of the planet; it just felt that way.

We've been waiting for our donor to start her cycle so we could start the process.  I have been incredibly worried because she was due to start Sept 12 and when we didn't hear from her for a long time, I was freaking that she had either changed her mind or was pg.  (It could happen!)

She very, very kindly emailed our clinic on Friday that she was still waiting to start and new how important it was for us to get started.  (Everybody now:  awwwwww)  And she finally started her cycle today!

HOORAY!!!

Even better, we now scheduled cycle with her aiming for a retrieval on Oct 22-25  and then a transfer back to me October 25-29 depending on whether we do a 3 day transfer (not so good) or a 5 day transfer (great!).  

We are looking at flights now and I am figuring out how to work my teaching schedule.  Also, I've been invited to give a research talk at my graduate school alma mater, which would be very prestigious, but scary. I'm not sure how I can manage stressful baby and work at the same time.  I also might be able to count my ticket as business expense, should I give the talk.  Tax deductible IVF is always a good thing.

We are pretty psyched to get started.  This has certainly been a slow to GO GO GO process!! 

Diddly Squat

Fortunately, I have nothing new to report.  The donor has not balked or tested positive for an STD.  I am just living life and waiting for the "real" part of the cycle to start.

I have told a few more people in my world what is going.  99% of the people who know are people 1)  whom I trust to not tell a soul, 2) who don't know anybody in my day-to-day world, or 3) who don't give a shit.  There is only one person I've told who I think could say something, but I've given her the story of what to say:  she can say she  knows "somebody" who has used DE, but she can't say it's me.  I think it's wrong to not let others know thatDE  is a viable option.  Nonetheless, there's that one neighbor of mine who has already stated her discomfort with a friend who used a surrogate.  I do not want her to EVER know we've used DE.  We might as well write it in neon around our city and have her comment that it's not our "real child" as a subtitle.

One thing that is funny is that since we seriously considered adoption, I don't worry about thinking a DE child will be mine.  It is so not even a part of my mindset that sometimes I don't understand it.  But I fully realize that when DE Daddy and I were dating we never expected that we would be able to conceive on our own.  So our son is ths shock, not that we're on some other path to finish building our family.

I still need to post on the spate of twins in Hollywood for the 40+ women.  Bleah.  I was all worked up when I read it.  Now it's late and I want to go to bed.  

Back to the Future

We're going back to the first donor we chose after the last cancelled cycle--the Proven One. We decided that it would be much worse to try with the Really Smart One and fail than to use the quite wonderful Proven One. She is pretty, athletic, and in college. She is truly a wonderful person.

And we could have a baby if she does again what she did before.

And stay tuned when I dissect Star Magazine's Glut of Hollywood Twins article. I guarantee that at least half are DE.

The Ride Continues

I don't even know where we are as far as the Number of Donors We Have Chosen. We do have some unexpected good news: the donor we chose first a few weeks ago is back from vacation and very willing to cycle in October. On her last cycle, she had 30 mature eggs, they ended up freezing 10 and she had 10 frozen embryos in addition to the BFP her intended parents had.

Them some good numbers. She is basically 2 for 2 in BFPs and I don't know about the frosties for her first round, but this second one makes her clearly a super-donor.

And then we have a entirely new donor: She's but very similar to me in education, academices, body type, and apparently, from her genetic report, some personality characteristics. However, she is UNPROVEN. We don't know how well her eggs are going to perform. I know this clinic has an 80% success rate and that includes both the proven and the unproven.

But do we want to chance it? If I found out later that she was a good donor, would I be sad we didn't go for it? Or would I fall into a deep, deep funk if we don't get pregnant because we didn't choose a donor whose history we know?

DE Daddy is out town for the night and with a buddy, so he won't be able to talk. What do you all think about everything, Internets?

Crappity Crap Crap Crap

Well, there are apparently no suitable donors willing and available for October. There are donors available, but they are not proven. There are also proven donors available, but they appear to have problems (28 eggs retrieved and no frosties; they live across country adding in thousands of dollars to the fee).

There is one donor who is willing to cycle in November. We're trying to find out whether that will be early, mid or late November.

Then we'll be hitting December, which if October is a problem, I'm sure everyone will be lining up to donate over Christmas. Then with my maternity/academic schedule, we're now looking at a February cycle.

I am beyond sad.

Re-re-re-re-re-re-WTF

Oh, for heaven's sake.

Donor Last Week has yet to return the clinic's call about cycling in October (which would actually turn out to be November based on her last cylce). We have thus moved on to another super donor (28 eggs last cycle, 10 frosties and a BFP). She would be available early in October and the coordinator is expecting to hear from her today or tomorrow, as opposed to Donor Last Week whom she warned me up front would take a few days to respond.

I'm getting frustrated. And remain sad. I was expecting to be on bedrest right now, not back at home trying to find another donor.

I'm really ready for this to be over. And to finally have my children here on earth, healthily with me.

New Donor

I think we have our new donor. We've officially chosen her, but the coordinator has not let us know if she's agreed to do this.

Taking your advice and speaking with DE Daddy, we're going with the best donor who meets most of our needs who is available *now*. DE Daddy's best point was asking if I was willing to sacrifice 6 weeks of my maternity leave to wait for That One Donor who looks great. I am not.

So our new donor is tallish with brown wavy hair (some close relatives have curly hair), has some college in her back ground and appears to be a super donor: Her last two cycles had 34-36 eggs. Her last cycle had 34 eggs with 32 mature eggs. 10 mature eggs were frozen, 10 high quality embryos were frozen and they are waiting on the beta results for the two excellent embies transferred to the intended parents.

We know that past behavior is not a guarantee of future behavior, but it's also our best guess.

We are hoping this is it.

Re-re-re-re-choosing a Donor

I might note, at the beginning of this post, that I am in less of a good mood today than I was yesterday. And I wasn't in a particularly good mood yesterday.

I am really, really tired of the dramz in having this second (and third) child. I'm tired of knowing I had 8 miscarriages in the last 3 years. I'm tired of having our cycles canceled for reasons that have nothing to do with me (e.g., inept lab, stupid government regulations on a false positive). I am ready to TRY and get pregnant and get on with my life. I am tired of waiting to see what is going to happen.

I really want to complete my family. I know all the readers here (fellow DE bloggers) know what that means: it's not just that I want another child, it's that I know there are some empty spaces around our table that are waiting to be filled by our children. And I'm tired of being coy about how many more children I want: I want at least two more children. We are too old to want two more children, but I want two more children. I'll take either twins or two more pgs in quick succession.

Nonetheless, here we are again. I am so annoyed at being here again, choosing another donor. And our clinic has not recently kept their donor records up to date. There are donors who we were previously interested in but were in cycle (May, June, July) but we don't know whether those cycles were successful or not. There is a donor who is wonderful (tall relatives, curly haired relatives, athletic, smart (3.95 college gpa!), thin, my eye color and very pretty) but she's in cycle now and won't be available until the end of November. DE Daddy is perfectly willing to wait until the end of November. But our coordinator told us that we would be ready to cycle again at the beginning of October *if* we find a donor who is available right now.

((sigh))

I know that in the long run 6-8 weeks of delay does not make a big deal of difference. In 10 or 20 years , it just won't matter. (It will matter in 5 years because of our school's cut off age for entering school) But right now, it feels like it matters a substantial amount. I am an academic. I get the summers off. I get a semester off for maternity leave. An early July due date (October transfer) will give me a guaranteed 6 months home with my baby or babies. An August/September due date will give me 4 or less months home. I know that is more than most women get in America, but it certainly less than I could have and that is recommended to keep a child home.

I want to choose a fertile Myrtle donor who has at least some of the characteristics that we want and who is going to give us a ton of amazing eggs (we're only looking at proven donors who pop out a lot of eggs and have a lot of left over frosties) and I want her to be available now.

What is your advice? You've helped me before in choosing my donors. What do you think?

Oh and feel free to throw in a few: wow, things suck for you right now. Cuz I am not happy that our cycle has been cancelled.

Cycle Cancelled

The donor tested positive for HIV. It is a false positive test--they've tested and retested and used tested and retested with 2 other tests and only one of the 5 tests came back positive. But the FDA considers any postiive a positive.

So the donor is now very upset and thinks she had HIV---I might too in her case. It would definitely freak me out. And the doctor called the cycle because the FDA could sue him or put him jail or something like that if he went forward.

We're ok. We're going to try to cut our trip short because there's no need to stay out for 2 weeks when my conference is one week and we can see our friends.

I'm ok. I still feel like today's meditation was right. We're on the right path. There's just a delay.

7 Day Update

As of today, our donor has 16 follicles measuring 13-14 mm. I take this to be unambigously good news.

Also, I found out that 7 mm (?) which is what my lining measured is the minimum level for success and therefore is just fine.

I've been meditating off and on these last few weeks, and had a great one today. I like the meditations where one prays/talks/asks and then listens. Somtimes I get answers. Today's meditation was that we're going down the right path. Things may change, but right now, we're doing what we should be doing.

I'm also pulling for the other new DE bloggers that I'm reading now and hoping for good news. I want us to all be in the same pg boat together.

Bleah

I wish I felt as positively as you all do about this cycle. I appreciate the kind comments and words, but so far the news from the clinic is not unambigous.

I did look over our donor's history. She has had 9 cycles before us yeilding 10 to 34 eggs with 8 pregnancies. Of course, it's been 2 years since she's stimulated, but I don't think 2 years for a super donor is the same as 2 years for someone, oh, I don't know, say like me.

We're doing the best we can at the best place we can be, so I'm hoping the best will come out of this.

It's really hard to focus on any other work, though.

Bleah again.

Update 2

Well, my lining is apparently OK. The clinic considers the next one, when I'm actually at the clinic, to be the more important one.

And we got an update on the donor's follicle count. She's doing well and not having any side effects from the drugs (yay!). I don't know whether to start the next sentence with "and" or "but." So I won't use any conjunction:

Her follicle count is 11 after 5 days of stimulation. My coordinator says this is "as expected" and their goal is 10-20 eggs for us. They are going to do another u/s on Wedsnesday, so we'll have another update then. The coordinator also says that this donor typically develops more eggs as the stimulation goes forward. We can expect 80% of the follicles to yeild mature eggs, so at this point, we're close to the minimum.

I know I'm asking the impossible: I'd really like unambiguously good news from now until we get that positive HPT.

Life doesn't work that way, so I have to learn this coping skill. Still, I would like to worry as little as possible until we're done.

Update 1

I went in this morning for the second look at my lining. It was a 7, which I'm pretty sure was the same thing it was last week. I'm not supposed to have my "passing" ultrasound until next week....in California...at the clinic. I hope this is where it's supposed to be.

Nonetheless, it's starting to freak me out a bit about that a week from now we may...no we WILL know about the number of eggs, the retrieval dates, and how my lining looks.

Crappity crap that just freaks me out.

I did reassure myself that if my lining looks horrible, the clinic will freeze all the embryos and with a 70% success rate with frosties, that won't completely derail us.

But I'm sort of becoming a little anxious thinking "A week! A week! Holy shit, it all starts in a week! And in two weeks, the embies will most likely be back in me and in three weeks, we'll know whether I'm pregnant or not. Holy. Freakin'. Shit. "

I wonder why I'm having a hard time sleeping at nights?

It did occur to me that this feels a lot like moving to me. I've moved completely across country three times now. Each time, I was excited but relatively calm getting ready for the move. And then on the day of the move, I freaked our realizing "HOLY SHITE, I'M MOVING ACROSS COUNTRY!!" I'm fine before the move and I'm fine once I'm on the road. But the day of travel freaks my freak.

This cycle feels a lot like that.

Something up?

Can anyone on there in the internets read this blog? I'm getting a weird error every time I try to access it.....

All You Need is One Good Egg

DE Daddy: Do you want one egg or two?

DE Mommy: One egg is fine.

DE Daddy: OK. Then you'll have one, DS will have two and I'll have two.

DE Mommy: Oh! You were able to cook all 5 eggs at one time! I'm so glad. I was worried you'd have to cook two batches.

DE Daddy: Well, usually, I have 3 and DS has 2. But today, I'm giving, no, I'm donating one of my good eggs to you.

DE Mommy: All I need is one good egg.

Donor Update

I received an email yesterday from the clinic: the donor has 20 antral follicles!! That's 2 more than she had last month. My understanding is that that the more antral follicles (up to 26) the better the IVF outcome--meaning more usable eggs. Does that mean that we're looking at retrieving around 20 eggs? More? Less? Would anyone out there share her experience on antral follicles and retreival? In any case, we're pretty excited about that number.

And yes, I have gained weight since starting this whole process a year ago. I was blaming myself and the wine I've been drinking until my regular OB suggested that the prednisone I'm taking for 10 days to 2 weeks per month (after ovulation, when we were trying on our own) wasn't helping any. I still think I need to be very careful of everything I eat and also how much I exercise so I won't blow up before we actually get pregnant.

And speaking of weight, I've been really surprised at how fat I've thought I was and how apparently, I'm not nearly as fat as I thought. All the donors we've seen are very, very cute and normal looking in their weight. Even our donor, who I'd say is quite "normal" as far as weight goes has a slightly higher BMI than I do. Actually, I'm not sure that means I'm thinner than she is--I am a tall woman with a tiny frame with tiny bones and this donor is normal height and it looks like she has a wonderful bone structure (it's one of the reasons we picked her---she actually has "cheeks" and a "jawline" unlike my husband and me whose horse faces simply fade into our necks).

There's not a lot to feel positive in the DE process, but finding out I'm not as fat as I thought I was---priceless. Well, that and having more children---winning the lottery.

Ramping Up The Meds

Well, we've moved on from just lupron to lupron, estrogen patches, heparin and prednisone. One odd thing here is that we're starting the heparin and prednisone now instead of when we start the PIO (i.e., at ovulation/retrieval).

I may have mentioned at some that there is a possibility that I have an auto-immune problem because I've had so many miscarriages since DS and only one of them (that we tested) came back with chromosonal problems. I usually think that the prednisone/heparin combination is just smoke and mirrors, but Hippogriffs just found out that if she hadn't used heparin her whole pg, she would have likely lost one of her twins. She thought it was a bit voodoo medicine, too, so it sort of freaks me out.

Yikes.

DE Daddy and I continue to marvel at the differences in protocol between clinics. Less estrogen patches and more heparin/prednisone early here, more estrogen patches and more heparin/prednisone later there. At our old clinic, the doctor pretty much would have kept me on prednisone and heparin for the whole pregnancy, I think. This clinic says only the first 12 weeks are needed.

It makes us think that this whole IVF/DE/auto-immune thing is more preference than science. The doctors don't run double-blind randomized designs to determine what the best treatment is, they just sort of go with what works. As long as this works with us, we don't really care. I'll give birth with bruises up one side of my watermelon belly and down the other, if that helps us have this baby. I don't really care.

No news on the donor stats yet. I'm dying to see how she is doing.

ICSI: Good? Bad? WTF??

A NY Times article today suggests that ICSI can lead to birth defects, learning disabilities and sterility in boys. She does not cite any medical journals but says there could be problems.

I searched my academic databases to find a meta-analysis that argues ICSI does not cause more birth defects, a meta analysis that argues that IVF and ICSI have more birth defects than spontaneous conception, and a large study that shows no differences in birth defects for ICSI over IVF.

I trust large studies and meta analyses over single articles because these sorts of studies are able to account for odd blibs in procedures and studies that can cause errors in any one study. I also do not always trust the media because they like to exploit fears in their readers, and this is most definitely a possibility. I've emailed the author, Peggy Orenstein, to ask her to provide her reference for that suggestion and am waiting to hear back.

I know one of her main points is that IVF/DE/ART procedures are a market not a science. Nonetheless, I don't know whether to request that we don't use ICSI because of a potentially incorrect belief in a nominal increase in birth defects at the risk of decreasing our chances of success at having a baby come home with us from the hospital.

Final point: these are traditional IVF and ICSI, not DE IVF or ICSI. People using traditional IVF/ICSI have fertility problems to begin with (egg and/or sperm quality) that DE can take completely out of the equation. I have to keep reminding myself that DE IVF compared to traditional IVF is simply not a fair comparison.

I think I've talked myself back into using ICSI in our cycle.

Waiting Mode

We're in waiting mode over here at the DE Mommy household. I start Lupron on Sunday and come off BCPs 5 days after that and estrogen 8 days after that. Really, there's not much going on except starting the medication.

Of course, now I'm not as naive about the medication and I'm concerned that the estrogen patches look fewer in number and change over a greater number of days, but I think I'm on them for a longer period of time. So I guess everything is ok. I assume if it isn't they will let me know.

We continue to stalk the clinic's donor board. Although our current donor remains our favorite, we're still seeing if someone comes up looking exactly like me and absolutely ready to go in 3 weeks. It's not likely, but cognitively, it makes us like our current donor more.

We're also deciding what to do in case we have the exciting outcome of having "extras." Our clinic only fertilizes the first 20 eggs and then they freeze the rest. We have decided to offer these frozen eggs to a friend of ours who is having a hard time starting her family. It's sort of a pay it forward considering how we got here in the first place. And since our friend lives in California and is relatively close to our clinic, we will strongly encourage her to use this clinic to defrost and fertilize the eggs.

I'm still looking forward to posting on disclosure (what I've found in the literature) and the contributions of genetics to behavior (from an academic standpoint). But right now, I'd kind of like to be pregnant while that is happening. I'm not too keen on putting the cart before the horse in figuring out how we'll tell our child(ren) about egg donation before there's even a possibility of children.

Nonetheless, I have been pondering what we know and what we don't know about how genetics are affected in utero. I have a friend who just had her twins from egg donation (HOOORAY!!!!) and we're thinking that one of the twin's nose doesn't look like her husband's, doesn't look like the donor's, and may well look like hers! I keep thinking "wouldn't it be ironic to learn in 30 years time when we have enough surrogate and donor egg babies to learn that certain characteristics such as noses or curly hair come from certain genes being turned on or off or even just favored in utero and not prescribed from the moment of conception?"

We don't know. We just don't know. Until the last 20 years, we've never been able to tease apart the influence of the mother's genes and the influence of the uterus on fetal development. We may find out that there is more of an influence than was expected after some good research.

I am not saying that genes aren't important. But I think we don't yet know how much the womb affects genes in their development. And that may be something that's exciting for DE mommies and freaks the freak out of couples who use gestational surrogates.

Just my rambling to pass the time until I have something really exciting to post about.

Protocol Differences Part II

I was going to leave this as a comment to my last post, but it was getting too long. And this is my blog, so what the heck.

It occurs to me that clinics don't have a real incentive to have better success rates if women continue to support them. More failures = more cycles = more money for them. That's a cynical view, I know, but ever since I was pg with DS, I am much more cynical about the medical profession. I'd rather think success rates in different DE clinics is due to differences in donor pools, but when their protocols significantly vary from the best (e.g., Crinone vs. PIO), I have my doubts.

Also, DE Daddy's father was a doctor. The protocols are not propietary. So if clinics aren't using the best methods, it's not because they are not available to them.

Of course, after our failed frozen egg cycle, our RE did discuss a learning curve. So changes in protocol do incur a learning curve. Our first clinic had a real set back moving from thawing 3 day old embies to thawing 5 day old embies. But by the time they learned how to do it, their success rate for FETs nearly doubled and approaches the success rate for their fresh cycles.

To be honest, we would have stayed at our first clinic if they had not failed so miserably at the frozen egg cycle. But then we finally understood that you can use any clinic in the country, or the world for that matter, for your IVF or DE cycle. Your home clinic can do all the monitoring and the more successful clinic can do the procedure. All you have to do is get to the clinic in time for the man to make a deposit and the woman be available for the transfer. What's an extra $1000 in plane tickets and hotel rooms when you're talking about a $25,000 procedure?

I think that's the only way we can get all the clinics to step up their success rates.

Protocol Starting

My DE coordinator sent me my schedule of meds for this cycle. It's pretty exciting to be moving ahead or at least doing something. Also, I'm not stressing out about this. It may be because I've changed my diet and no longer eat sugar (which can affect freaky out nerves), but also, I just feel intuitively that this is the right thing to do whether or not we actually get pregnant. I'm sure many veterans feel the same way at the beginning of a cycle when they don't know what will happen. But I do feel like we're on the right path.

I have to also admit that sometimes I get surprised when I read about other people's protocols at their clinics. I'm a research academic in the social sciences at a research intensive university. I don't make decisions to do things without thoroughly researching what I am doing. In fact, a friend and I were talking yesterday about how annoying it was to (think we) know more than our doctor does about our own particular fertility issues.

In any case, it worries me that clinics vary so much in their IVF or DE protocols. I'm less concerned about medical protocls (which already, I see differences between the two clinics in the number of estrogen patches they want me to use and when to change them as well as the amount of lupron they want me to use), but more on basic things like regularly scheduling 3 day instead of 5 day embryo transfer. The research solidly shows that 5 day transfers are more likely to be successful. Yet most of the folks I'm following in the blogosphere have clinics who routinely do a 3 day transfer. Both of the clinics I've worked with only do a 3 day transfer when things look really crappy, a sort of Hail Mary pass to your uterus. And they all grow the embryos out past 5 days before they freeze them to get the best ones possible.

This freaks me the freak out. Why are so many clinics not following the "best" practices for successful IVF and DE outcomes? 5 day transfers have double the success rates of 3 day transfers, no matter what the age of the mother. Why do some clinics continue to use 3 day transfers as their default? It also makes me a little angry, too, that other women who want a child just as much as I do are not getting the best chance they can. And I blame the doctors.

Testing

We continue to march forward in this cycle. Our donor was measured with 18 antral follicles, which according to our understated DE coordinator/nurse is "perfect." In fact, she even added that "Everything is coming up roses!" with her own "!" added in there. While I am a "!" kind of writer, she is not at all. So I'm thinking that she is quite pleased with how things are going.

Since I have never done IVF or even had my antral follicles counted, I consulted Dr. Google, who said that why, yes, this is a good sign. With over 11 having a moderate rate of success, but between 15 and 26 being the optimum level of IVF success.

I take this all as good news.

We have a Date!

So, everything is moving along. Our donor has officially agreed to the cycle and is available at exactly the time I'll be in the California conference. I spent most of last night dreaming about arriving in CA, which days it would be best to be there and how we'll see everyone and, in my head, emailing my donor to say Thank You. I also spent some of my dream yelling at my MIL, so let's hope not all of that is predictive.

I really do not feel anxious about this process right now. I am learning to trust my intuition which indicated a real fear that the first donor would say no and that something was off with the second donor and, now, that things are really going to work out with this donor.

Maybe now I can spend some time on this blog writing about why we are choosing DE over adoption and why we plan on disclosing to our child (but not necessarily to our families at this point) and what we are going to do if we should be so fortunate as to have leftover frosties from this process.

But right now, I feel happy and even keeled and I am following the other DE blogs to see how their stories turn out, too.

Re-Re-Matched

What an eventful day.

I have not been feeling "right" about the donor we chose second. There were several characteristics that were bothering me, including finding out in her genetic history that a close relative has hypothyroidism. Although the clinic says that it is not worth worrying about, the research I saw (from even that lame institution Stanford U) says that there is a genetic component to hypothyroidism. Yes, it's easily (easily!) treatable, but it was a concern.

So Dave and I went back to the pool of candidates and found (oh, God, can I say this?) "her." She's shorter than I am, has had 8 out of 9 successful cycles, started college at 16, has the same odd ethnicity that I do, has wavy hair (according to her pictures and the coordinator's statements), she's really pretty (much prettier than DE Daddy or me), AND SHE SAID YES!!!

The coordinator placed a call just to see what she was thinking about cycling this summer and she said yes, yes, yes!!!

This is once again an example of trusting my guts. I just knew my Monday that our first donor wasn't going to cycle. And this second one just kept making me feel anxious. (oh, I forgot to admit, we were going for another donor---the one who looks like DE Daddy---but her last cycle wasn't successful and they ended up with only 4 frosties. That freaked me out and we moved on)

Oh, I hope this is it. They start her testing soon and I think they are going to be able to work around my conference in CA. Hooray!! I feel so much better than I did this morning!!

Re-Matched

We are now officially matched up with a new donor and as far as I can tell, she has said YES, she will do it! (I was out of town for a meeting yesterday and only exchanged one email instead of the zillion calls and emails I've been doing before)

I have to be honest: I'm a little more cautious about this one, now that I've already tasted disappointment. This donor has had 5 pgs out of 7 cycles. The last cycle did not result in pg, but the couple ended up with 11 frosties. The FET failed for this couple too, so their may be an undiagnosed problem with the couple because "the embryos and frosties were top notch!!" (says the coordinator)

This donor is as tall as I am, although she's a bit heavier. (As an aside, I realized that I am not nearly as heavy as I thought I comparing my weight to the donors' weights and they are all so cute!!) Nonetheless, this donor's mother was a ballet dancer all her life and some of thedonor's older pictures show her as being quite thin. She doesn't have curly hair, but it's dark like mine. (our next donor choice is bloooooond, so I'm actually a bit happy to have a darker haired donor) There are some other differenecs and I realize as I read on another blog, she doesn't look exactly like me and I need to just deal with that. As my husband keeps pointing out, we were open to adoptiong a biracial/transracial child, so "like me" is really far down on the list of priorities in this process.

Our neighbors came over for dinner last night and although they don't know exactly what we are doing, they shared the story of a latino friend of theirs who has dark hair, dark eyes and dark skin who had a blond, blue eyed, pale son. Traditional parental genetics don't mean as much as one might think! Sarah Vowell is a twin born of a Swede and a Native American and she and her twin look very different!

So, in any case, we're rematched. I'm excited. There are things I really like about this donor, but I'm a bit more apprehensive than I was. I don't know if it's because I've already been disappointed by losing our first donor or because I'm tapping into some as-yet-unidentified thing that bothers me about this donor.

I need to fall back in love (affection? appreciation?) with this donor like I had with the first one.

Unmatched

Crappity Crap.

Our golden donor has decided to withdraw from the program. That is fine. Really. Part of the ethics of my career involves fully informing people of their ability to withdraw from participating in events. Nonetheless, I thought our clinic had gotten a verbal affirmation of her participation last week and apparently they did not.

That makes me cranky.

Also, our #2 choice has pulled out which is ok. I was having reservations about her. Our #3-5 choices are still in. None of them have my hair. Two are tall and one is not (at all!). One looks a lot like DE Daddy and one looks a bit more like me. Well, at least she has my ethnicities. The one who looks a lot like DE Daddy is very smart and very athletic. The one who looks (more) like me is available when we'll be in California.

Ugh.

Matched!!

We're officially matched with our preferred donor!! I'm really excited. And I know it's foolish to believe this, but I believe with all my heart that we're going to have another baby! Even if it doesn't happen with fresh embryos, I believe we'll have enough frosties to successfully try again. (Did I mention the 70% success rate the clinic has with frosties?)

I'm really not stressed about this. We'll have another child. I know it. Those children who have been trying to get to us will finally make it through.

Narrowing in on a Donor

We've spent the weekend updating our Excel spreadsheet of potential donors. I have a few friends around here (ok, one) who knows what is going on and after speaking with her, we loosened up our criteria for who to choose. I am tall and I have been only considering tall donors. My friend is taller and said that although tall is nice, she reminded me that it wasn't much fun being the giantess we were in high school.

I also appreciated her comments (and yours) that proven is really the key thing. So of the 26 proven donors in our clinic's database (over 5'1"---there's short and then there's short! DE Daddy is 6'4" and I am over 5'8"), 16 are available in August. I printed out all of their information and DE Daddy took the first swipe and found 4 that he really liked. I really liked 3 of the 4, too, so we're starting with them.

We can't be officially matched until they get all our bloodwork and we're waiting for the final results. But we've let them know about our donor. I'm getting really invested in her so I hope she's willing to do just one more cycle! She's 5'4" (the same height as my Mom who had a 6'3 boy and a 5'8 girl), in a good university with a rigorous major, althletic, plays a musical instrument, pretty, with close to my hair, and, most importantly, she's had 8 cycles with 7 pregnancies. The one cycle without a pg ended up with 10 frosties, so that still sounds pretty good to me. (Yes, this clinic does let donors participate in more than 5 cycles, but at this point, that is a plus for me, not a minus.)

I actually hope that tomorrow we'll get the bloodwork in and they can make the match. And she's willing to do one more!!! NowI'm second guessing myself in that I should have called the coordinator to get a feel for this donor's likelihood to do another cycle. (8 seems like a lot to me!)

But the good news is that we have 3 more donors we'd "prefer" and about 5 or more donors who would be just fine. So, I guess I ought not get really worked up about this. It's going to happen, I think.

Yikes!

Choosing the Donor

Well, most of our medical records have been sent from our old clinic to the new clinic and the new clinic is ordering up some additional tests--mainly blood work to meet California's stricter donor laws.

Because we are officially in the clinic now, we can officially be matched with our donor.

YIKES!

There are certain characteristics that we would like the donor to have, mainly because they are characteristics of mine. So we are mainly evaluating donors as how they compare with a tall runner with curly hair. The first donor we were interested in ran track, was 5'8" and had very curly hair. However, she has not responded to the clinic's repeated requests for additional pictures and since I'd argue conscientiousness is one of the best predictors for donor success, I am no longer interested.

There are two other donors that are tall (6'0 and 5'9) and athletic (including one who has run a 5 minute mile----that's FAST) but neither have curly hair. Still the 5'9" one looks a bit like me with the same facial features with self-reported wavy hair. Considering how much people comment on my son's curly hair, curl is still a real issue with me. Additionally 6'0 is proven and 5'9" is unproven. We want to have another child so "proven" is an important thing.

Of course, then we go back to the fact that we have been pretty far down the adoption path and would have happily engaged in a transracial or biracial adoption. So does it really matter if the donor looks like me?

I don't know. I've had too much coffee to think right now. And certainly too much to make any big decisions.

Clay Aiken

I never, ever thought I'd blog about Clay Aiken. But when he and a 50 year old woman conceive a child, I, for one, know that woman used Donor Eggs. So did he want a child so badly that he is having this friend of his carry a DE child or did she want a child so badly that she used DE and asked him to contribute.

I honestly don't care about any of that except that she is OBVIOUSLY using Donor Eggs and everyone else thinks she just got really lucky with IVF.

Excited and Closure

Well, although we continue Mission: Kill The Rats at our house, we do have some more appropriate DE news.

First, we met with our old clinic for the post-mortem for the failed thawing of the frozen eggs. The one thing I did NOT want to happen is for them to say "Well, this sort of thing just happens and successfully thawing frozen eggs is not very likely anyway." Therefore, I went in with the stats from the donating clinic and a couple of articles from Fertility & Sterility and Science.

Although they did imply that "this sort of thing just happens", they did indirectly admit that they had had a learning curve on freezing and thawing embryos and that likely this was the same sort of thing. No one said that directly (God forbid!), but there was an undercurrent of that sentiment. Also, both the RE and the embryologist seemed surprised and upset that this happened. Actually, the embyrologist seemed upset. The RE seemed more "circumspect."

I really, really didn't want to go in and be all "YOU'RE INCOMPETENT!" but clearly mistakes were made. The RE tried hard to close ranks saying "this sort of thing happens" and "maybe there was a difference in the water purification", but the embryologist seemed more upset that this was a complete and abject failure. We tried to tell them that we could have handled not getting pg, but not even getting a try was not cool.

In any case, the bottom line is that we are being refunded the all the money for the embryologist and transfer part of the cycle. We won't get our money back for the services already provided (HSG, trial transfer, medications, etc), but that seems absolutely fine. That refund turns out to be a significant chunk of change and will really help for this next cycle.

Which we are doing elsewhere. I've already mentioned which clinic we're using, but I think I'm going to refrain from doing it again, just to give everyone a little bit more privacy. That said, I've already had a phone meeting with the RE and the DE coordinator. I have everyone's email addresses and private phone numbers. (WOW!) I also have assurances that they are going to make sure I have a baby to take home with me.

Let me reiterate the stats: 80-85% success rates on DE with an 80% chance of two blastocysts and frosties with each cycle. Their FET success rates are also about 70%! That's higher than even my current clinic's fresh cycle success rates.

So here is an example that makes me feel like this is the right place for us to be: every single person, from the original intake person to the RE to the DE coordinator knows about us and the frozen egg debacle. Everyone brought it up first and said something kind about it. Every. Single. Person. At the old clinic, I had to correct everyone I dealt with (except my RE and his main nurse) that I was NOT doing frozen embryo but frozen eggs. Even the doctors at my monitoring visits looked at me with a blank face when I tried to tell explain what I was doing.

I also feel like at this new clinic their main goal is to make sure I have a baby. And they really think they can do it. I told the DE coordinator today that I would love to have twins and she said "Well, let's just see if we can get you twins." That statement would never be allowed at my old clinic.

Onward and upward and closer to bringing our child(ren) home.

Excited!

Besides remembering that yesterday was the day I planned to use a HPT with this cycle, I am very excited. I had my meeting with my new doc at the new clinic and I'm actually ....YIKES!!!.... I just saw a rat run through my garden. I must go now.

Unsettling

Last week, I emailed the clinic where the eggs were frozen. I wanted to let them know about the dismal outcome of the eggs. They emailed back today that they usually have a 85% thaw rate, a 66% fertilization rate, they implant 3 eggs and there is a 25% pregnancy rate. They told me there is a learning curve for this procedure and they were sorry my clinic didn't have more experience.

Although this was exactly what I wanted to know , it has made me so sad. We should have had a chance with these frozen eggs.

I'm not sure I properly grieved not getting a chance with this first cycle. I moved so quickly to the DE cycle 2, that I haven't fully let out how angry, disappointed and sad I really am about the crappy thawing. This dude should not have undertaken the procedure if he was not qualified to do so.

My jaw is really tight lately. I think this grief is going to get out of me one way or another.

One Week In

Exactly a week ago is when we found out that only 4 eggs made it through the thaw and it was my first clue that things were not going to go the way I thought.

I hate that I keep saying to myself "I'm supposed to be on bedrest right now. I'm supposed to be wondering if my sore boobs are due to a pg and not the prometrium to make my period appear. I'm supposed to be watching a lot of TV and not working this week."

Nonetheless, a friend commented that I clearly don't let the grass grow under my feet.

I hate feeling as awful as I did on Monday. Whether it's healthy or not, I cannot stay in that place and wallow in the pain. I'm really glad we have a plan for another try and I know in the deepest part of my heart that if *this* one doesn't work, we are completely done.

A *week* ago. A *week* ago we were completely in another place. It seems like a whole other place. Oh, BTW, any advice for choosing a donor is welcome.

We looked over our financial estimate for this last cycle. They charged us $5200 for ICSI on 11 or more eggs. In actuality, they only did ICSI on 4, but I imagine some of that money also went for the thaw. We are planning on asking for most of that money back (along with the $700 for the transfer we paid for and didn't do). We were their guinea pigs and they messed up. Does that happen? Do you get money back when it's a failed event and they haven't done the procedures we paid for?

It's a lot of money, but it seems like years ago that they paid it. I just want to go forward now and have another real try again. For the first time.

What A Difference a Plan Makes

I am still upset. In fact, things got a lot worse as they days have rolled by. There are few things in this world as dreadful for me as the absence of hope. There are some theologians who argue that "heaven" and "hell" are places on earth; they are not different dimensions that we go to after we die, but a state of being while we are alive here. (There are some people who believe the Gospel of Thomas makes exactly this claim.) In any case, I know for a fact that life without hope is hell for me.

So on Monday, I made a call to the San Diego Fertility Center. For those of you who don't know, at over 80%, SDFC has the highest DE success rate in the US, if not the world. I am going to be in Irvine, CA in August for business reasons and it seems like it would be the perfect opportunity for us to work with them. Our initial appointments start next week and we've already been looking through the donor database for potential matches. Considering that our main criterion is success as a donor (defined as having participated in a DE cycle with a pg), we have a lot of donors to choose from.

When I spoke to the intake counselor, I realized how much I miss California. I shared that I had had three clinical miscarriages and 5 chemical pregnancies. I asked if that would disqualify me from being one of their clients. She assured me that they take everyone. She also said that the soul of my next child must have been working so hard to get to me. She hoped that this would be the path for us to finally be together.

I, of course, sobbed. But it's exactly what I was thinking. I don't have the one-child gene. I know my other child is waiting for me to find him or her. And I want to give it my best shot to break down whatever barrier is there.

Which is why, even if the curent clinic does offer, I don't think we are likely to participate in their DE program. If they have a donor who is proven, I might consider it. But honestly, we have money for one shot. I want the odds to be as high as they can possibly be.

The thought of using SDFC gives me hope, at least for today. Everything may change after we have our meeting with our current RE and the idiot embryologist. But at least, right now, at the beginning of this day, I think it will still all work out and we'll finally find our next child.

Stages of Ick

I didn't realize how numb I felt yesterday until this morning when I woke up very sad. Feeling sad highlights the differences from feeling numb.

I'm also starting to flirt with feeling "angry." It appears that my progress through Kubler-Ross's stages of grief are not going linearly. I am particularly angry at the embryologist at our clinic for doing such a crap ass job. Clearly he did not research the best method to defrost our eggs. I have yet to see any number in the scientific that doesn't say that 70-80% of the eggs should survive defrost. It makes me very, very angry to think that his thaw rate was about the opposite of that.

The lesson I'm learning from this is that I should have trusted my gut. I have done a good deal of research into frozen donor eggs. I know that USC has an infertility program that has done extensive research with frozen donor eggs and deems it to be a viable alternative. I should have gotten over my fear of offending them and sent all the information I had to them to make sure they knew what I know. But if *I* know that, why didn't they? Wouldn't I look like a neurotic patient/client?

Well, I am a neurotic patient/clinic. And I'm not taking the blame here, but I'm mad at myself for not doing that. And more angry for them not to have done a little bit of research themselves.

In any case, I'm also feeling empty and sad. These were good eggs and they fucked them up. And now we have nothing.

I'm assuming they are going to credit us with some of the money we've paid up front but didn't receive for services. In addition, I assume that they are going to put us up front immediately on their fresh DE list. My problem remains with trust. They have a 65% success rate, whereas other places have a much higher rate. Why is their rate so much worse and should we continue to trust them? At this point, I'm only going to trust them if we get a proven donor with multiple successful donations.

Ok. So, considering the conversation I just had in my head, I am definitely in State 2 of the Kubler-Ross model of grief: Anger.

Zero

Nobody made it until this morning. I start prometrium tonight and reduce my estrogen so that I will get my period in about a week.

We'll be setting up a meeting with my RE and the embryologist to discuss what happened. I guess then I can share all the research I was hording trying to not offend their knowledge.

Part of going through this is saying that we "tried" even if we don't end up with a baby. However, this feels like it shouldn't count. We didn't get to "try". I want a do over.

And to my dear friend who has been so worried about me and as anxious as I have been about this cycle, the one who gave me her extra eggs, it's ok. You were such a generous person to have thought of sharing your bounty of joy with me. That is so kind. It's sad it didn't work out, but I'm left with the knowledge that there are truly kind people in this world.

Not Good

Only 4 eggs survived the thaw. The embryologist used the other clinic's protocol and only 1 out of 6 survived that. then he switched protocols and 3 of the remaining 9 survived. I should have sent the information I found and told him to contact USC which has a much better success rate.

He hasn't even checked to see if the eggs that survived have their spindles or whatever. So these four may be complete crap.

And we don't even know if they will fertilize.

Although I know I've been saying that everything will work out the way it's supposed to, I'm very upset right now.

Waiting for Godot

Or good eggs, which ever comes first.

Everything starts tomorrow! DE Daddy goes in to "do his thing" at 11:30. My last lupron is tonight and then I start all the other meds (doxycillan, medrol, PIO and still continuing the estrogen patches).

I'm clearly excited as the wake-every-other-hour insomnia has hit, yet I'm not sleepy or upset.

There are two types of stress: distress and eustress. I'm voting that I having eustress right now. Why not be happy while I can? It's going to work out anyway, whatever happens.

I'm ready to get going!

I'll be back tomorrow with an update on how many thawed. For me, that's the biggie.

Freaking Out a Wee Bit

With the thaw coming up on Friday, I'm getting a bit more anxious. And doing exactly what I should not be doing by googling any new academic information (or otherwise) on the success rates of frozen donor eggs. I know we've already bought the lottery ticket. Nonetheless, I'm still calculating the odds of winning.

There was a recent article in Science on improvements the success rates from frozen eggs. As Science is not too shabby of a journal, I got the article. The main gist of this article is that eggs have been frozen since about 1986, but until the advent of ICSI , it was simply not viable. The egg's membrane gets a little tough after being frozen so it's harder for the sperm to enter. ICSI changed all that so the REs became more interested in using donor eggs.

There's also a new technique for freezing eggs called vitrification versus the old way of doing it, called slow freeze (or the roll-off-your-tongue formal name gamete cryopresevation). From what I can gather, virtification is a quick-freeze, dip in some liquid or another whereas slow-freeze takes up to 1.5 hours of slowly freezing the eggs. And the gist of the debate is that vitrification yeilds more usable eggs at thaw than slow freeze. Like, a lot better in both quantity and quality. In fact, some REs say that vitrification yeilds about the same result as fresh eggs. However, there have only been 100 births ever from vitritifed eggs and about 300-500 births per year world-wide for slow-freeze eggs. With those sorts of numbers it's hard to argue that one is really better than the other. (100 total is a really small sample size) Nonetheless, the 95% survival rate for vitrified eggs is impressive as the Science article above says.

Guess which one our clinic used?

How about "Not Virtification." In fact the clinic got all cranky when I asked which one they used saying that the research was not yet conclusive. Considering that yes, doctor's are likely to exaggerate their success rates and also that this clinic has a Really High donor egg success rate, I'm not going to get completely freaked out, just a little.

However, the Science article says that one needs about 50 slow-freeze eggs for a viable pregnancy whereas one only needs 21-25 eggs for a successful vitrified pregnancy.

That's when I start freaking out. We have 15 slow freeze eggs. ((gulp)) I start twittering and I don't mean updating my friends.

But then I go back to this peer reviewed article in Fertility and Sterility reporting a pretty signficant success rate (about 30%) for frozen DONOR eggs. That's a whole different ballgame than regular frozen eggs. Most women freeze their eggs in their 30s not their 20s. Their success rate is already lower. And I know that our donor was a true fertile Myrtle (as opposed to me, being somewhat of a fertile turtle). So then I reassure myself because I honestly believe that if 75% of these eggs can make it through the thaw stage, we'll have a decent chance.

And last night as I was getting all dramatic on myself thinking "If we don't get pregnant, this will be the worst thing ever" I had to stop and say "Ummmm, no it won't. It won't even be close." I've had a lot worse things happen than not getting pregnant on an IVF cycle. I will undoubtedly be sad. But it will not be the Worst Thing Ever.

I still don't know if I would be ready to give up if it doesn't work. (DE Daddy and I are in the midst of debating about this.) I'm still getting anxious. But this certainly will not be the Worst Thing to Ever happen to me.

Thawing Set

The nurse called late Friday afternoon with the update. First, she says my lining looks perfect. (yay!) However, they are going to wait to thaw out the eggs until Friday not Monday as we originally thought. The embryologist doesn't want to thaw them Saturday-Weds (vacation, I'm imagining) and my RE will not be in the office next Monday so they are working all around their schedules. Apparently, the embryologist and my RE are very keen on being very involved in this process; I think that is good news.

They are aiming for a 5 day transfer which would be May 14. From what I've seen in the literature, frozen eggies often go at a 3 day transfer, although some do make it to 5 days. I don't know if for those who do 3 days it's because the embryos looks so crappy or if that's the clinic's policy. I am still surprised to hear of places that still routinely do 3 day transfers because I was under the impression that 5 days are much, much better.

So we're on the way. And I'm excited to be going forward but trying very hard not to become to invested in one outcome or the other. I want to go ahead and have the answer. But then I also want the best shot we can have for this.

Trip to the Doctor's

I went in today for my bloodwork and an ultrasound. I'm waiting to hear the results, but my uterine lining looked good. He said my stripe was "9". I thought I was looking for a triple stripe, sort of in my mind like Neopolitan ice cream. Does any one have any info or should I go play Dr. Google.

I'm thinking we'll start defrosting the eggies on Monday.

I'm really anxious to hear when everything is going to start up, and to make sure they don't forget about my heparin and prednisone for the (potential) auto-immune problems.

More later if I hear anything.

Wind Out of My Sails

Wow. I have to say I am still so relieved to find these other DE bloggers. I have been so worked up since our last meeting with Dr. Thera Pissed and our preference for disclosure and her obvious bias that we will eff up our child(ren) by doing so. However, reading all the DE blogs, disclosure (or not) just doesn't seem to be at the front of anyone else's mind going through the process. Instead it's happiness at being pregnant or being a new mom or even just starting the process. Perhaps I haven't delved into these new blogs enough, but I just don't see the trauma my Dr. Pissed has implied.

What a relief.

And what a relief, too, about the finances of this. DE Daddy just got a teaching job for the first part of the summer. That, plus some of my additional consulting money means that we will be able to about pay for this by the end of June. On the one hand, one may interpret this as a "sign" that it's going to work out because this new money has fallen into our laps at exactly the right time. Surely, that means it was meant to be. On the other hand, one may also interpret this to mean that it won't work out but we won't be in debt for "nothing." It will essentially be a wash financially; we won't be ahead , but we won't be in a hole either.

In fact, I could easily choose to see my last 6 months as having plenty of signs that this is going to work out: these frozen eggs fell in our lap, a major health scare that could have led to a miscarriage or worse was resolved before we started, we found money to pay for it without going into debt, we are going to a doctor who (unusually) understands auto-immune problems in recurrent miscarriages, other life worries have come to a happy conclusion.

I could see the events as predicting that what we want to happen will happen. Instead, what I see is more evidence that whatever happens, I will look back and say, "That was the right thing to occur."

I really feel the need to protect myself in this process even while I continue to feel positive and excited that we will end up with a child.

We go Friday to have my lining checked and learn the doctor's decision on when they will thaw the eggs.

!!!!!!!

More People Out There**

Over the weekend, I finally found some DE blogs. I've been googling like crazy but did not find these folks that way. In fact, I don't know how I found the first one, but I've been moving between them and trying to find out their histories. (Herstories, actually)

On the one hand, I'm really glad to not feel so lonely in this. On the other, I'm learning about stories in which the DE doesn't work and that sort of freaks me out considering that we're going in with frozen eggies and those are much less likely to succeed.

THAT SAID, these eggies come from a super donor so of all the people out there using frozen eggies, these are the most likely to work.

And the Magic Eight ball has repeatedly told me that we're going to get pregnant and it's going to be a boy and a girl. So there. The Eight ball always knows, right?

Also, I have no idea why it excites me so, but I'm now up to 3 estrogen patches and then tomorrow I go to 4. It feels like I'm doing something to help, even though I'm just putting hormonal stickers on myself.

We go in Friday to check my lining and make a decision about the thaw. Last week, that seemed like a long time away.

**I realized after I wrote the title, that there are more people out there doing donor egg. But I'm thinking the number of people using frozen donor eggs is only in the hundreds, at most.

Passing

After figuring out that Dr. Thera Pissed was talking out of her asshat, I decided to do a little investigation on my own to determine the pros and cons about disclosure to DE children. To be honest, there is not a lot of academic research out there and I have not had a chance to really evaluate it.

However, I did find an interesting article on "resemblance talk" and DE families. Resemblance talk the normal chit-chat from people when they see a new baby with his/her family ("She has your nose! He has your eyes!"). This, obviously, can be quite stressful for parents of DE babies, but for the mothers in particular.

I realized that after reading this article that I had always assumed we (or at least I) would always let the child(ren) "pass" should strangers say to me "Oh! She/he looks just like you!" My thoughts have been that if someone notes that we share the same chin, well, honestly, I believe there are only a finite amount of chins in this world and why as a matter of fact, we DO share the same chin. But there will also be talk about "Oh! His/her personality is just like yours!" and that is much more murky.

So after reading the previous article, what has come first to my mind is what comes from the donor, what is shared between the real mother (me) and DE child and what is really important. First, physical characteristics are most definitely inherited. Height, eye color, hair and bones are inherited. However, we know from current cloning studies is that clones don't look alike. That is, identical twins gestating in different mothers are born looking differently. One thought is that the gestating mother influences what genes are turned on or off during the pregnancy thus having some influence on the child's appearance.

But physical inheritance is one thing. It is important and we know about tons of research that shows that how people look affects how they develop (particularly for attractive people). But what about "personality?"

Well, to be honest, personality does have some genetic roots, but it's much less than people think. The same is true with intelligence. For example, psychologists think that the most inherited personality characteristic is extroversion and that, at most, 50% of extroversion from the genes. What kills me is that people get soooooo excited that extroversion can be explained by 50% of the genes. Great! Yippee!! Guess what?! The exact same amount, 50%, comes from the environment! That's the MOST inherited personality trait and its 50:50 nature vs. nurture!!

Even more so, in our case, of the 50% inherited, 50% of that is from dad's genes and 50% are from the donor's genes (which I will influence having inside of me).

So, back to the original issue here, Dad will account for (at most) 75% of the child's personality trait of extroversion and I will account for at least 50% of the personality traits. I say "at most" and "at least" because psychologists believe that mom's have more influence on the home environment than dad's do. I also want to point out that the 50% estimate is the minimum amount of influence that mom has on the DE child's personality because most personality characteristics are caused more by the environment and less by genetics than extroversion. For example, it is believed that intelligence is 30% inherited. You can do the math yourself, but to me, it says that the donor's genes has a less than a 15% role in the "intelligence" of a DE child. (There's even new research on adopted kids that shows a very strong relationship between adopted parents' intelligence and their children's intelligence. That really challenges the genetic links of intelligence.)

So I really don't believe it's "passing" when someone is going to tell me "Oh! Your child acts just like you!" It's more than likely the absolute truth! I don't think our child(ren) will inherit my hair nor my feet (THANK GOD!), but I do think they will inherit the core me, the inside me, my way of being and thinking. Oh, and I guess DE Daddy, too. I guess he does play some role in all this... :-)

And I don't think that's rationalization. I think it's the truth based on what we know about know about personality. And I think that's just fine.