Category Archives: Donor

Surprise! (written 5th March 2015)

It is officially the longest morning of my life. I’m slightly nauseous as I wake but can’t decide if it’s from lack of sleep, anxiety about today, or morning sickness. I’m awake early which doesn’t help, but even the last hour from 9:15am until we leave for the clinic seems to take a lifetime. I can’t find enough to keep me occupied and spend a good deal of time swinging on one of the barstools in the kitchen telepathically sending messages to the clock to tick faster.

Eventually it’s time to leave. My hubby’s excited but I’m more nervous than I’ve ever been and on the verge of tears. We only live 5 minutes’ drive away from our clinic so before long we’re pulling into the carpark and heading up in the lift. It’s only a short wait before our doctor comes out to get us and with shaking legs I follow him into his office. He knows I’m nervous so doesn’t delay, “scan first, then we’ll talk” he says.

It’s still early days so it’s an internal ultrasound this time rather than the gel on the tummy number. One final date with dildocam (I hope). I lie there with my pants off waiting for the machine to start up and praying to the universe for a good result. Finally it’s time. The ultrasound wand goes in and my doctor exclaims “Well straight away I can tell you that there are two sacs.” I gulp, please let there be a heartbeat in at least one of them.

He has a closer look. “Yes, there’s the first heartbeat” he says, and I look at my tiny Bumble’s heart flickering away like a little moth on the screen. I’m trying hard not to cry. My baby is alive. It’s amazing, exciting, fear-inducing and surreal all at the same time. “Now let’s see if we can find the other one. It seems ‘the other one’ is a little trickier with the sac tucked right up in the uterus where it’s hard for the ultrasound wand to reach. A moment later he’s found it though and there’s little Bee’s heart fluttering away as well. We’re having twins.

My husband is supposed to be filming this but he’s so caught up in the moment that I have to frantically gesture to him to capture at least some of it on his phone. Our doctor takes a few screen shots, including one with both our babies in the frame, and then it’s done. Hubs and the doctor leave and I get dressed with shaking hands then head out to chat.

We get the usual warnings that it’s still early days, that things are riskier with twins, about vanishing twin syndrome. However our doctor does add that with such a young donor (21), and the good condition the embryos and sacs appear to be in, that our chances of carrying them right the way through to somewhere near a twins full-term (38 weeks) is good. Our chances of miscarriage have now theoretically dropped to 5-10% per embryo. My fingers are crossed.

I’m still in total shock. Our doctor is asking me questions about the medication I’m on and how many embryos we have left in the States and I’m struggling to answer. I feel as though I’m moving in slow motion. We collect information booklets from the nurse and then we’re off home to let the news sink in and start sharing the news with our family and close friends.

My mum squeals then bursts into tears, my hubby’s mum has more of a philosophical approach to it, my siblings are somewhat disbelieving and excited. I tell the friends that ask, sending them just two baby face emoticons in a text. Everyone is stoked and so are we, although we’re both still in daze of amazement. We have heartbeats. Plural.

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Give a little

To all our gorgeous friends and family who contributed to our Give-A-Little fund (you know who you are),

Thank you so much for contributing to our treatment in San Diego. As many of you know we were a bit hesitant about the whole Give-A-Little thing, knowing that you all have your own things to pay for and deal with, but we truly are so grateful to you for helping us out. The money raised covered the cost of our donor, which is just amazing! We’re so lucky to have such fantastic friends and family who care so much about us. Fingers crossed for a happy outcome!

Thank you so much once again. We love you all.

xx


The Process (written 30th January 2015)

After a few random questions on what we’re going through this cycle I’ve decided to write a post on the different stages we’ve completed and what is yet to come. Assuming we’ve contacted the clinic, chosen our donor, passed all pre-work (which we have) this is what is happening from start to finish of our cycle. Here goes.

  • Suppressing my cycle. Just after the period I have following my evaluation cycle, I start on birth control pills (seems totally contrary to what we’re trying to achieve right?!?). Just over a month later, on the 5th of January, I inject myself with Lucrin (known as Lupron in other parts of the world), another drug designed to suppress my cycle. I’ve previously nicknamed this drug “Lucky Dip Lucrin” as when taking the daily injections in my 2nd IVF cycle it was a lucky dip as to what side effects I’d have each day. Luckily this is the monthly dose, which I don’t seem to have as much of a problem with.
  • Supplements: I begin (or in some cases continue) a range of supplements, which assist my body get into the best shape possible for our cycle. These include a pre-natal multivitamin (exceedingly hard to find in New Zealand so I have to opt for a ‘pregnancy & breast-feeding’ one, and boy do I feel like a fraud taking that!), folic acid, iodine, and a low-dose aspirin.
  • Blood test and ultrasound #1: This is a baseline scan that essentially checks the starting point for our cycle. They measure the thickness of my uterine lining and make sure my ovaries have been suppressed by the last few weeks of drugs so that they aren’t producing any egg-containing follicles. For us this occurs on January 12th.
  • Estrogen substitutes: I start taking Progynova (estradiol valerate) on the 13th of January and will continue taking this (hopefully) until my 12th week of pregnancy. Beginning with a low dose (one pill in the evening) I slowly build up my dosage until I am taking five tablets a day. This drug helps to grow my uterine lining to a decent thickness (anything greater than 8mm) so that it is ready to receive our embryos when we get to that point.
  • Donor scan and meds: Our donor has her own baseline scan and blood-work done in San Diego on the 15th of January and is all set to start her medication on Saturday January 17th. We’re not informed of what drugs she’ll be taking but assume that it will be similar to the ones I’ve taken in previous cycles – some kind of follicle stimulation drug (Gonal-F or Follistim for example) to encourage her ovaries to produce a multitude of egg-bearing follicles; and not long after, a lutenizing hormone antagonist (e.g. Cetrotide) to stop her body from ovulating before we need it to.
  • Blood test and ultrasound #2: Another blood test and internal ultrasound to make sure my uterine lining is developing and that everything is on track for our cycle. Both bloods/ultrasound #1 and #2 occur at our clinic in New Zealand. #2 occurs for us on the 20th of January.
  • 23rd of January: We head to The States! I inject Clexane, an anticoagulant, three hours before we fly, to help prevent blood clotting issues such as deep vein thrombosis. Not only does flying increase the risk of such problems but the estrogen substitute I’ve been taking also adds to the chance of such issues arising.
  • Final blood test and ultrasound: A final set of bloods are done and yet another date with ‘dildocam’, this time at the clinic in San Diego ensure that my lining has reached an acceptable thickness (it needs to be 8mm and mine is 7.6mm, but not to worry, they round it up to 8mm, phew!). 27th of January and we’re good to go! Our donor also has an ultrasound today and from this the clinic determine the dates for egg retrieval and embryo transfer. At the point in time of this ultrasound our donor is showing between 35 and 40 follicles, which will hopefully result in anywhere between 24 and 32 eggs (they expect to retrieve eggs from 70-80% of follicles).
  • Donor trigger: Once the clinic has assessed our donors scan results they decide that egg retrieval will occur on Thursday 29th In order for this to happen our donor needs to ‘trigger’. This mean she injects herself with a human chorionic gonadotropin (hCG) product (e.g. Ovidrel) to instruct her body to put the finishing touches to the maturation of the eggs, and to begin the process of ovulation. Our donor won’t actually ovulate normally as the clinic will extract the eggs before this can occur. However, by setting ovulation in motion, it becomes easier for the clinic to retrieve our donor’s eggs and allows for their final maturation process.
  • Egg retrieval: Just what it says. Our donor heads into the clinic and the docs there remove all the lovely eggs she’s been growing for us. As mentioned above, this happens for us on the 29th of January.
  • Sperm collection: At the same time our donor is having her eggs collected, my husband drops his sperm sample at the clinic so that it can be ‘washed’ and ready for the fertilisation process.
  • The first set of numbers: Later on the day of egg retrieval the clinic contacts us to let us know the number of eggs collected during the morning procedure. This is our first anxious wait, hoping for the best result possible. It’s good, we have 27 eggs collected and of those 26 are mature (able to be fertilised) with the final one having the potential to mature in the couple of hours before insemination.
  • Insemination: Once both the eggs and sperm have been washed (cleared of any excess debris not actually related to the sperm or egg). The lab fertilise our donor’s eggs with the sperm my hubby has provided. There are different ways to do this. The simplest and possibly most common way is to introduce multiple sperm into the petri dish the egg is contained in and let them fight it out, much as they would if the embryo was conceived ‘normally’. For our cycle we’re doing things a bit differently and are using a process called intra-cytoplasmic sperm injection or ICSI. In this process a single sperm is selected and manually inserted into the egg. This of course has its pros and cons. It makes the fertilisation rate much higher but it also increases the risk of the embryo or child having something wrong with it as it’s not necessarily the strongest sperm making it to the egg. The increase is very small though, so in the interests of getting the best possible result overall we’ve agreed to go with this option. The day of egg retrieval/insemination is known as ‘Day 0’.
  • Fertilisation report: The day after egg retrieval/insemination (January 30th for us) we receive a fertilisation report from the lab to let us know how many of our eggs have fertilised into embryos. For me this was one of the most harrowing times of the process so far, I think perhaps because this is where everything has gone wrong in our other cycles. The news this time is good and 24 out of the 27 (yes our last little egg that was lagging behind in maturity caught up) have fertilised. At this stage, day 1, the embryos are only a single cell. Tomorrow they will start to divide and we will begin to see differences in their development and quality.
  • The daily updates (this is currently the stage we are up to as I write this): From now until transfer day we will receive daily updates as to how our embryos are doing. On day 2, the second day after egg retrieval/insemination the embryologists begin grading our wee embryos. They look at the number of cells each embryo has, the quality of the embryo (poor, fair, or good – a call dependant on various factors such as the graininess/transparency of the embryo, the symmetry etc.), and finally the amount of fragmentation the embryo has (this is the amount of excess waste generated by the dividing embryo. A heavily fragmented embryo, much like our embie in our first IVF cycle, will have a lot of this waste trapped within the embryo itself rather than excreted and expelled).
  • Pre-implantation genetic screening (PGS): Most normal IVF couples would proceed with the daily updates until it was decided the embryo/s were ready for transfer. Again, we’re doing things slightly differently and have elected to pay extra to get pre-implantation genetic screening, or PGS, done on our embryos. This is more insurance for us, having travelled so far, that the embryos we implant are chromosomally correct. This will hopefully reduce the chance of miscarriage further down the track should we be lucky enough to fall pregnant. The testing, which for us will occur on day 5 (the 3rd of February), involves taking a few cells from each of the embryos chosen for assessment. These cells are then examined under a microscope to determine whether they have the correct number and arrangement of chromosomes, and any abnormal embryos are discounted. Abnormal embryos might result in a pregnancy (although pregnancy is less likely) but are far more prone to miscarry before full term. The standard number of embryos tested is 8 but, due to the number of embryos we currently have at day 2 we’ve decided to pay to get a further 4 examined. We’re not going to get this chance again and figure it will give us peace of mind that any embryos we’re able to freeze for future use will be chromosomally normal.  It’s also at this stage that you can find out the sex of your embryos and can choose whether you want girls/boys/one-of-each transferred into you.  We’re opting to go for the two best-looking/highest quality embryos and leave they sex of them to chance, we want that to be a surprise further down the track.
  • Egg transfer: This is it, day 6 (4th February). Decisions are made on the best quality embryos and we head into the clinic for egg transfer. Finally I get to play my part in this process. Because we’ve selected the success guarantee program (essentially, “we guarantee you a baby or your money back”) I am to have two embryos transferred into me.   Basically I rock on up to the clinic, pop my legs in the stirrups and have two little embryos inserted into my uterus via a catheter. Having been at this stage twice before (with less than ideal embryos) I have some idea what to expect. Every clinic is different though so there may be some slight disparities in what I expect and what will actually occur. I know of one already. Back home in New Zealand, our clinic performs this transfer with a full bladder. I consume 750ml-1 litre of water an hour before transfer so that by the time I get in there I’m desperate for a pee. It’s horrendous for the patient but helps the doctor with both ultrasound visibility and with the uterus’ position. Thankfully our San Diego clinic is able to perform the egg transfer without the exceptionally uncomfortable full bladder, so I am one happy camper!
  • Home time: A couple of days of relaxation then it’s time to head home. On the 6th of February we’ll drive back to LA and hop on a plane bound for New Zealand, hopefully with two very precious cargo still on board. Another shot of Clexane 3 hours before the flight and away we go!
  • Test time: The nerve-wracking two-week-wait (2ww) and pregnancy test. A couple of weeks after we arrive home I’ll have a blood test to determine whether all this has worked or not. It’s an excruciating wait, not helped by the fact that our test day will be delayed due to the San Diego/New Zealand time difference, and clinic hours. I hope the wait will be worth it. Wish us luck!

F-Day (written 30th January 2015)

D-day yet again…or should I say F-day as it’s the day we get our fertilisation report. I’m awake early, unable to sleep in anticipation of the news we are yet to receive. I try to keep busy, making tea and coffee and breakfast but even still I’m checking my emails every few minutes for an update.

By 10:30am we decide we need to get out of the house, we’re both going crazy with the stress of waiting for an update. We opt to head back to the Gaslamp Quarter as I’ve got my heart set of some yellow (bumble coloured) slippers to ward off the cold of these tile floors. Just as we’re about to hop into the car a text from a DEIVF-experienced friend arrives hoping we’ve received good news this morning. It’s just before 11am, should we have received news by now? Thinking back to our other cycles it’s seems that we should have, that can only mean bad news right? Or maybe not because we received early news in our other cycles and THEY were bad. My panic shifts into overdrive. Emails are checked nearly every minute as we cruise down the freeway. Why aren’t they emailing us?!? Should I have opted for a phone call? Do they prioritise the calls first then get to those who have selected to receive their news via email?

I think I’m officially nuts, but looking over at my husband I see the stress written all over his face too. It’s a quiet car ride, no talking, no music, neither of us can bear it. We clutch each other’s hands and steal frantic yet supportive glances at each other. Then we reach our destination. I check emails again but the number in my inbox hasn’t increased. “Refresh! Refresh!” says hubs urgently…and there it is. ‘Day 1 update.’ My stomach drops out as I open the email, I think I am going to be sick. “Yesterday we retrieved 27 eggs. Of those, 27 eggs were mature” (YES! Our little eggy lagging behind caught up!)…yada yada yada…..”We inseminated 27 mature eggs yesterday and today 24 have fertilised”

Twenty-four! Oh my god, that’s amazing! That’s an 88% fertilisation rate. I’m stunned. WE’RE stunned. I feel a sense of relief. I’m smiling yet kind of numb. Then a minute or so later it actually sinks in. We have 24 embryos. I feel the tears start to stream down my face and look over at my husband to see the tears in his eyes too. A text to our friend in San Diego who had messaged earlier and soon she has tears welling in her eyes also. We’re both shaking and I feel some of the stress leave my body. There’s still a fair bit of tension there, we’ve still a long way to go, but we’ve crossed a major hurdle. Now to hope that our potential little Bumbles develop normally, survive their PGS testing, and make it to transfer/cryopreservation.


A trip to the hen-house (written 29th January 2015)

It’s been a day of ups and downs. Egg collection occurred this morning and I’ve had butterflies from the moment we dropped the ‘other half of the equation’ at the clinic at 10am. We’ve been trying once again to distract ourselves – wandering through the Gaslamp Quarter of San Diego, and having lunch at the magnificent Stone Brewery. Still, the wait to find out our egg numbers is hard. I’m constantly checking my emails, doubly disheartening because not only is there no email from the clinic, it’s also my work email address so I’m reminded of all the shit waiting for me back home when we return. Argh.

The email comes just before we sit down to lunch. My heart is hammering in my chest as I skim the email to get to the juicy stuff. It’s good news. They’ve retrieved 27 eggs from our beautiful donor. Better still, 26 are mature and there’s a hope that the 27th one will mature in the next couple of hours before insemination. Wow. That’s an awesome number. Twenty-seven! That’s 4 more eggs than our previous three cycles combined, and if you’re talking mature eggs, a whopping 18 more! Amazing. I spend most of lunch messaging various people to tell them the good news, a little rude but we’re both just so excited.

A couple of hours later and the dread starts to sink in. Like a drug, the high doesn’t last, and we start panicking about the fertilisation report. It’s that point in most of our other cycles that the major bad news has arrived. The butterflies are back but this time they’re worse than ever. I feel ill, my body can’t decide if it wants to cry, yet I try to convince myself that it’s all going to be ok. Hubs is slightly more positive, as always, but secretly I think he’s pretty nervous too. Unable to concentrate on much we opt for a quiet afternoon back at the house.

6pm and I’m absolutely shitting myself. Two days ago I was on cloud 9, browsing the baby sections of the local shops, now I’m completely and irrationally paranoid that this won’t work and that tomorrow we’ll get similar news to what we’ve received in other cycles, “few have fertilised normally”. I know it’s stupid, we’re trying something new now, but there’s part of me that just feels as though I’m cursed, that we’re destined never to have children. It’s a dark tugging hole deep down in my stomach, a black pit that sucks out all the rational thoughts and feelings, leaving only a hollow emptiness. I hope more than anything that it’s just me being crazy, because I struggle to imagine my future without kids.

A tense evening ensues but on the plus side I’m so exhausted from worrying I manage to fight back a little at the insomnia that’s plagued me for the last three nights. I by no means sleep normally but do manage about 5-6 broken hours so to me that’s a win. If only my dreams were of little Bumbles and a successful DEIVF instead of boats and sharks and drowning and nightmares.

 


This is it (written 27th January 2015)

After a few days in LA, hanging with my brother-in-law, we’re now in San Diego. I’m not big fan of LA as a city but it was nice chilling with my brother-in-law and seeing some of the nicer parts of the place. I was able to distract myself from our upcoming DEIVF with shopping, a theme park, and sightseeing, not to mention all the eating! It almost seemed like a holiday.

The holiday falters as we exit the city on the two and a quarter hour drive to San Diego and the reality of what we are about to undertake sinks in. Of course I’d thought about this a lot before, but this momentous step in our USA DEIVF journey, travelling to the city where our baby will hopefully be made, hits home like no other. I have a wee meltdown as we enter the city limits. I’m scared, excited, nervous, pleading. I’m not a religious person but I’ve prayed like the most religious person alive to every person, object, thing, or higher being that there could ever possibly be that this treatment works for us. I have so many butterflies I think I might be sick.

After a few minor hiccups with our accommodation (the Air BnB host gave us the wrong apartment – there’s a set of four of them – then the wifi wasn’t working) we settle in. I’m trying my hardest to think of this as a holiday with additional tasks, but it’s a pretty hard ask when those ‘additional tasks’ hold the key to one potential future.

10am the following day and we’re at the San Diego Fertility Clinic for my final bloods and ultrasound, and an appointment to chat through the rest of the process. It’s pretty cool to finally meet all the staff we’ve been dealing with via phone and email for the last few months. The nurse gives us a big hug, and the doc chats to us about the time he’s spent in New Zealand. It’s all very surreal.

The ultrasound goes well, 8mm lining which is good, and I can now say I’ve dated dildocam internationally. A quick blood draw before we head into a little consultation room to get bombarded with information. Our donor was seen earlier that morning and has between 35 and 40 follicles which should result in somewhere between 24 and 32 eggs, fantastic! It’s likely egg collection will be Thursday but they’ll confirm later in the day. We get handed a bag of drugs and told all about when to take them. My hubby gets warned about progesterone and how I will probably think it’s the end of the world sometime just before my test date, and how he needs to be supportive through that. Then we’re done and it’s time to go. Roll on the progesterone fun!

We spend the rest of the day cruising around, on a high, stocking up the house with food etc. I can’t help but look at the baby section in Walmart despite that being waaaaay ahead of where we’re at. I don’t care. For once I feel good about something related to IVF and I’m going to make the most of it!

 


First boarding call (written 23rd January 2015)

We’re currently sitting in the airline lounge. Sitting in the airline lounge awaiting our flight to San Diego. OMFG we’re actually doing this. We’re on our way! This week has been one big whirlwind of stress, work, and socialising. Barely a moment to stop and think, or pack. Work has been flat out and we’ve been out just about every night spending time with friends and family before we head off on what we both desperately hope will be a life-changing trip. My hormones are amped up and I’m teetering on a knife-edge between sanity and bawling wreck.

Despite the hectic week, there’s been good news. The first report from our clinic tells us that our donor is all good to go to start her drugs, and that her baseline scan (before she starts injecting stims) shows 20 follicles. WOW! Even on our best cycle we only had 8, and that was AFTER stims. They anticipate getting approximately 70-80% of the follicle number in mature eggs, so we’re off to a good start.

My baseline scan is good too (despite having just got my period 30 minutes before the scan, DISGUSTING! Thanks Body!), nothing happening in my ovaries and a good lining measurement for baseline. I start my Progynova (estradiol valerate/estrogen) and away we go. My next scan a week later is a go-er too, and the departure gates are open for us to go to San Diego. With just one more scan and blood test to go when we get there I’m hopeful that my side of the treatment should go to plan.

The next update on our donor brings even more good news. My heart is beating so fast as I read the email from the clinic. With our track record I’m sure that after the “Hi, hope you’re well. As you know your egg donor was seen today for her first ultrasound and blood work…” they’re going to tell us she’s not responding, and call the cycle off. It’s about this time in all our other cycles that we’ve started to receive bad news so it’s hard not to automatically proceed down that track. But no, the news is good, great even. Our donor is now showing 30 follicles. Thirty! 3.0. I can’t get over it and, sitting at my work desk in front of my computer, I am so close to tears I can hardly talk. The girls I work with tell me to breathe and I manage to squeeze out “I can’t, if I breathe I’ll cry.” I’m in total shock. 30 is more than we have ever hoped for. I only pray the news rolling in continues to be so good.

There have been other good moments this week as well. We’ve started telling our friends about the trip and why we’re going. Rather than broadcast it to the world I decided to just tell people as they asked or as I chatted to them and thought they should know.

I started with one of the girls at work who was asking about the necklace we’ve bought our donor, and her reaction was amazing, possibly the best reaction we’ve had. She was soooo excited! Next I told some close friends I was out to dinner with, their response was similar and they ended up shouting not only a bottle of champagne but dinner as well – “we’re celebrating!” I have to say I was a little seedy the next day! A couple more work friends are told and finally another close friend who texts not long before we leave for the airport. “Would love to catch up with you for dinner but it will need to be in a few weeks as we’re off to San Diego in 3 hours” I reply. Again her reaction was fantastic. It’s just so wonderful having such fabulous friends and family who are so supportive of us and follow us on our journey. It truly warms my heart and I love you all.

So here we are sitting at the airport waiting for our plane. My emotions are jumping from nervous to excited to ill to feeling chilled-out about our ‘holiday’, and back again. But as much as I want this to be a holiday as well I can’t help but wish we were at the point where we already knew the outcome.


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