In September 1st my period came again and we started with a wonderful new clinic. I was nervous to make the switch. It meant new blood work, scans and building a new relationship with a new team (let’s be real though, there wasn’t much of one at the last clinic). I’m not sure I would have had the energy to keep going with the first one anyhow. It’s like kicking a relationship until it’s last breath. It felt like it was just time to call it. I felt like I deserved better. 

I called the clinic on cycle day one and we discussed then and there what our next steps would/should be. Did I want to forge ahead with a retrieval and get moving asap? Absolutely! But we decided before we made any more attempts that it would be smarter to do some further testing. 

We started with my AMH levels, last tested in April of 2022. My initial levels were 9.6 pmol/L, but now in September 2023 they had dropped significantly to 5.1 (for those on the ng/mL scale, it went from about 1.34 to .78). This officially put me in DOR (diminished ovarian reserve) territory. Scary stuff. Your AMH can fluctuate but I took this seriously. Going ahead, and looking back, it was becoming harder to get quality eggs and embryos. Our time was running out and the embryos we could get were becoming rare and precious. 

We decided with our new doctor (who is wonderful BTW) to do a mock cycle before doing another retrieval. This would delay our retrieval by 2-4 months but it would be instrumental in ruling out and identifying any barriers to carrying a healthy pregnancy.

Mock cycles are often debated in the fertility community. Some doctors are all for them, and the myriad of biopsies that can go alongside them. There is mixed evidence, or maybe just not enough evidence to convince all doctors of the value of these tests, but I wanted to take the kitchen sink approach. We were still very much in unexplained infertility territory, so anything that could explain what was happening was welcome.(I’ll link to some relevant studies below in case you want to read them)

Four endometrial biopsy tests were recommended as options with one strongly urged over the others. I decided to do all of them. 

EndomeTrio (3 tests)

ERA (Endometrial Receptivity Analysis)

The ERA test checks the receptivity of the uterine lining to find out if it is lining is receptive to embryo implantation at the time of a normal transfer. The test could indicate a different amount of progesterone in preparation for future embryo transfers. (The ERA test resulted in a 73% pregnancy rate in patients with implantation failure) 

(https://www.igenomix.co.uk/genetic-solutions/endometrio-clinics/#:~:text=The%20ERA%20test%20evaluates%20the,personalised%20embryo%20transfer%20(pET).)

ALICE (Analysis of Infectious Chronic Endometritis) 

ALICE detects the bacteria causing chronic endometritis (CE) and identifies the most common bacteria causing it and helps clinicians to recommend appropriate antibiotic and probiotic treatments.

EMMA (Endometrial Microbiome Metagenomic Analysis) 

EMMA evaluates the uterine environment at the microbiological level by analyzing it’s  microbiome. It can indicate whether the uterus has the optimal microbiome for embryo implantation.

UTIMPRO (strongly encouraged by our doctor)

UtimPro is a biopsy that analyzes the immune profile of your uterine environment and response to foreign cells (embryos, etc). It tests for natural killer cells and it can indicate a very specific customized protocol for individual patients. 

To do a mock cycle, you basically proceed as if you’re planning on doing a frozen embryo transfer. I started on Estradiol on day one, and similar to a FET, my lining was monitored throughout my cycle. I did 5 appointments with my friend Wanda, and it took a little while to get to the needed 7.5mm minimum uterine lining thickness required for the biopsy. I introduced progesterone on day 28 (pretty normal for me as I struggle with thin lining issues) – both as suppositories and intramuscular injections. My biopsy finally took place 6 days later on October 3rd. 

I’ll stop here to say, by this time I had met with my actual doctor either on zoom or in person 5 times in one month. He was also the one to personally do my scans and my biopsy. Seeing that smiling familiar face made all the difference. Technically the appointments were the same, but patient care was worlds ahead with the new clinic. From the receptionists and nurses to the clinic itself and their professionalism and timeliness. It made the experience better many times over. 

The biopsy was…. Not fun. Not going to sugar coat it. Because of the things being tested, the biopsy only allows you to take Tylenol as a pain killer and is fully unmedicated otherwise. I managed to convince them to give me a Ativan to take as I tend to have a sensitive cervix. The procedure requires them to use the speculum, and sometimes a cervical clamp, and insert a tool into the uterus to scrape the lining. It’s as gross as it sounds. The doctor told me it would hurt and I prepared myself. He told me I could swear at him if I needed to, that it would last 10-15 seconds and I’d have some severe cramping. The nurse offered to hold my hand.

They went in with the pipette (the tool for the biopsy scrape), and I was surprised it didn’t hurt more to be honest. It did suck, very much. But I tolerated it and they applauded me for handling it better than most do. Once the procedure ended, the cramping stopped. It turned to mild tenderness, and I spotted a tiny bit following the procedure. After that, I was good to go.

The test results take 2-3 weeks on average for the EndomeTRIO and 4-6 weeks for the UTIMPRO.

The doctor put me on Estradiol again for 5 days, but I began bleeding 3 days later for my next period. All in all, I think it was worthwhile. The overall cost was around $3400 CAD including meds, the time it took was 33 days for the cycle, and the recovery was almost immediate.

Now, we wait for those juicy results.

Studies on the above mentioned tests:

The Uterine Immune Profile May Help Women With Repeated Unexplained Embryo Implantation Failure After In Vitro Fertilization (2016)

Comparison of the Effectiveness of Endometrial Receptivity Analysis (ERA) to Guide Personalized Embryo Transfer with Conventional Frozen Embryo Transfer in 281 Chinese Women with Recurrent Implantation Failure

Is Endometrial Receptivity Assay (ERA) Useful in Patients with
Repeated Implantation Failure Undergoing Single, Autologous Euploid
Embryo Transfer?

The Endometrial Microbiome and Its Impact on Human Conception

Characterization of the Endometrial Microbiome in Patients with Recurrent Implantation Failure

The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology

The effect of chronic endometritis and treatment on patients with unexplained infertility

The post The Biopsies appeared first on .

I went into stims with enthusiasm and I brought that same vibe to my second egg retrieval. I basically hopped and skipped into that procedure, knowing what to expect now. I had the same number of follicles as last time, similar sizes and I was on a so-called miracle drug called saizen/omnitrope which I was sure would bode well for us given our previous outcome). We just needed a bit better quality and we’d be golden.

As before, my husband dropped me off, waiting with me until it was my turn to go into the procedure area. He stuck around for his part, did the job and left. I took my ativan since I’d be having another IV placed. I was in a nice daze as I awaited the okay to head into the operating room. Things were light and easy this time. My nerves were low, and we chatted about the hoopla of the Taylor Swift Eras tour, even getting the doctor in on the chatter. It was another doctor I hadn’t met before. But all was well. I was ready to do the damn thing.

I faded out a bit – didn’t quite fall asleep, but remember time warping slightly and we were done (thanks meds!). They walked me out and the embryologist came shortly after to give me my news.

We had 13 eggs retrieved (same as last time!), 12 were mature and would be fertilized using ICSI. I was over the moon.

I received a call the next day at 8am sharp. Out of the 12 mature eggs, 10 fertilized normally.

Looking back, I felt a little sad about this. Our first cycle just 9 months earlier was:

13 retrieved, 13 mature, 13 fertilized, 7 made it to blast on day 5/6. I was still super hopeful. Quality over quantity I kept saying! Our first cycle yielded just the two normal embryos after testing, so I wanted this cycle to be better quality even if it meant fewer embryos.

The wait until day 4 after transfer was painful, but we had friends visiting and I took every opportunity to enjoy myself. We went to a music festival two days after my retrieval. We celebrated my best friends birthday. We came home and I caught up on work. Doing a retrieval mid wedding season is no joke!

Day 4 I got a call. We had embryos!!! I’d be heading back for a fresh transfer that next day. I booked the ferry, we left at 6am and we’re ready to meet our embryos! This time we had planned to transfer two, in lieu of testing. Due to the added cost, we didn’t want to bother and discard anything. We decided each untested transfer would be a double transfer.

I arrived at the clinic with so much excitement. I was so damn ready. So damn positive. My husband donned his hazmat suit and I changed into my hospital attire. We were sent to the little waiting room we’d been in countless times before and we sat for a bit and waited for the embryologist to come give us a report before we did the transfer.

After about ten minutes she entered. She was so hard to understand, with a very thick Eastern European accent. I had to clarify a few things because it was hard to hear every word. She told us we were ready to go, and we’d be transferring 2 embryos – a 3BA and a 2AB….

Say what? I was confused. Last time we had a myriad of 4-5s (further along basically I’m growth with more cells), and some AAs. These were the two they wanted to transfer? She said yes, and proceeded to tell us how the others were doing. I barely understood her, but from what I gathered, a few were growing normally, just behind, and the others were trying to catch up.

Okay… so we had two, and that’s all we knew so far. Last time we had 6 full on blastocysts by this stage on day 5. I was worried.

While my legs were splayed and my drapery open, I asked the doctor if we should transfer two after all given this news. What if they were our only shot? She assured me that embryos do much better in our bodies than in the lab, so yes we should! (I found out later that the 2BA was something they wouldn’t even normally freeze, so this is likely why she urged us to transfer).

We went ahead with the transfer but the mood had changed. I was scared. Another 20 thousand dollars was on the line. I was told to stay hopeful, to keep positive. We had two embryos on board and that’s all that mattered. We travelled home immediately after the transfer – went to the ferry early and waited. I had a slice of pizza and an egg salad sandwich for dinner.

The next morning at around 9am I got the final call. Day 6 report. None of our embryos had made it. None. Not one. It was the same embryologist who delivered the news the day before. Her bedside manner was lacking, the way the news that we lost everything except the two embryos in me came across was appalling to be honest. She said “they are all discarded, ok? Anything else?” when I asked for clarification. I held back tears.

I hung up the phone and texted my husband from bed. I couldn’t handle speaking the words out loud. He came rushing into the bedroom and found me sobbing in a puddle of tears. I was hysterical. I couldn’t stop crying. My world stopped in that moment. Hearing every single embryo had either arrested or was such poor quality that they couldn’t be frozen was one of the most upsetting moments in my life to date. This moment was harder than the miscarriage news. It was almost as hard as hearing my little sister died in a car crash, over the phone nearly ten years prior (that one takes the cake). It broke me in some deep way. All the hope. All the positivity. All the parts of my that had convinced myself that I deserved a family of my own were fractured into a million shards. I began to spiral, and I wondered why me. Why the hell couldn’t I just have anything without fighting so damn hard for it and suffering so much over it.

I’d love to say this had some silver lining, but for once it just didn’t. Maybe that’s why it hurt so unimaginably.

People kept saying “but you still have two!”, “be positive for those embryos inside you!”. I couldn’t. I was convinced it was over.

We waited 8 more days until our beta test. To be honest though, I tested every damn day from my transfer onward. I did a HCG trigger again, like the first retrieval. So my tests were positive for many days. I wanted to test that trigger out. The tests got lighter almost every day, until they didn’t. They kind of went stagnant, with a faint little pink line for about 4 days straight. It was beta time and I actually thought, despite my pessimism that I might be pregnant. That they were slow to grow and probably slow to implant. I went for my beta and I got my results.

<1. I was not pregnant.

20k. 8 weeks of my life. Pain. Bloating. Excruciating waiting. For nothing. Absolutely nothing.

It was September 2. We had been trying for 1 year and 9 months with nothing but heartache and loss.

I called my clinic to make a follow up appointment with my doctor to find out how, why… they couldn’t get me in for a phone call for 6 weeks. 6 WEEKS. 6 weeks to ponder my failure, 6 weeks in the dark. 6 weeks of doing nothing to move forward. They didn’t seem to see the problem with this. They had made their money and that’s all that mattered to them.

I made a very crucial decision that day. I decided to leave my clinic. The clinic where I only ever spoke to my doctor 4 times in over a year. The clinic that screwed up and gave me someone else’s PGTA results and all their personal information. The clinic who I had to babysit at every damn turn. We only have two clinics regionally where we live, and I decided I was burning the bridge and jumping ship. Nothing can change if you do the same old things over and over. I wasn’t about to risk more money down the drain, it was mother effing go time. I wasn’t getting any younger.

Exactly 3 months before my 39th birthday I got my period and I got myself a new doctor.

The post Egg Retrieval #2 appeared first on .

Now, imagine doing that with a day job, trying to hide the procedure and diagnosis or fact that you’re even trying to conceive from your judgy employer. Nope nope nope.

I booked my last transfer and NYC trip around my 3 month probation at my day job. That job I got so I could get maternity leave like any other normal human Canadian being. Those of you who don’t know me personally, I’m a wedding and portrait photographer. Self employment isn’t kind to pregnancy or leave.

I arrived in NYC and stewed in my thoughts for a few days, while trying to be peppy and make the most of my trip at the same time. IVF has taught me that it’s entirely possible to feel multiple conflicting emotions at the same time. Excitement and disappointment. Happiness and bitterness. Joy and sorrow. You almost start to compartmentalize it in a way. Observing the feelings from the outside. Like when your best friends get pregnant with twins on their first cycle while you’ve had losses upon losses. You feel ecstatic for them. But you also love hate them a little bit too. It’s entirely possible to feel the emotions at the same time and to genuinely be happy for others while grieving yourself.

A few days into my trip I decided that dealing with an incompetent boss who pushed professional boundaries about asking about medical stuff wasn’t worth the stress it was bringing to my situation. Maternity leave or not. Who the hell knew when we’d have success again. I couldn’t stick it out with no end in sight. What seemed like a hopeful career path and dream job for working my way up in a new field turned into feeling stuck, stagnant and bitter. I emailed my boss and told him I wouldn’t be returning. I emailed his bosses and told them why. I felt free for the first time in a long time. Free from the burdens of IVF and from the burdens of a job I hated. Free to live in the moment for the first time in ages.

This trip rejuvenated me in a way. It gave me the space and time to decide on our next steps.

When we started IVF we said we’d only do one cycle. Whatever we got, we got. Then we’d look at alternate options. Like many things in life, we didn’t know how we’d feel until we were faced with the decision of what came next. It wasn’t our last cycle.

We got home and due to my job as a wedding photographer I looked at the calendar. My job is one that I can’t just call in sick to, or allow life to just happen around. I plan my life 12-18 months in advance, down to the day. It was June and if we did another cycle, and another transfer (always the “what if this time it sticks?!”) it would put me being due in May – the beginning of my summer season the following year. I had already booked a few gigs for 2024 and I needed to do what I could to pay the bills – keeping my age in mind.

I assumed we’d have the same success the second time as the first. We’d have a few embryos to work with, so if we waited until August (when I had a lull in my schedule) for our cycle start, we’d surely be set up for a 2024 baby that wouldn’t interfere with my job. So we decided. We’d wait until my July cycle start to begin our protocol again. Same clinic, same protocol as cycle 1 with the addition of Saizen/Omnitrope as a primer alongside birth control.

We tried naturally that in between cycle with timed intercourse but alas it did not work. My cycle came and we were once again on our way. This time with no burden of a day job, with a month and a half break under our belt, some relaxation (see guys, I relaxed, it didn’t work!), and with fresh hope.

On August 3rd, 2023 I started my stim injections once again. I had a AFC (Amtrak follicle count, a pre count of your follicles before stims) taken prior, with 6-7 follicles visible (the same as last cycle). I started taking Gonal F 300, Menopur 150, Orgalutran .25, plus Saizen .1ml a day. Daily injections, taken around 10pm at night. This time, there was no fear of the needles. Every part of my being wanted to get shit done. I was ready for this. Readier than I have ever been. Each night I eagerly did my stims awaiting the day of our next ultrasound.

After 3 ultrasounds I was told my follicles were slow growing. My first cycle, I stimmed for 11 days total. When 11 days neared. They kept pushing me further. My follicles were growing, steadily, but slowly. This meant more meds, more money (about $650 a day per extra day), and more appointments. On day 13 they finally told me I was ready. I’d trigger on day 14, and my retrieval would be on August 18.

I took my HCG trigger at 8:30pm, 36 hours before my retrieval, this time 10,000 IU instead of the 7500 IU last cycle. I scrambled to book ferries and hotels. We had planned for every possible date within the 3-4 dates they quoted originally, booking countless ferry reservations and hotels, but with my delay we had to cancel them all and struggled to find a ferry that would get us there in time. Summer ferries are no joke. We had friends in town so had to shift accommodations as well to fit us all. This stuff just never goes as planned.

I waddled my way into the Airbnb around 10pm the night before the retrieval, the earliest we could get there. I tucked myself into the hardest bed I’ve ever slept on and tried to rest up for my procedure the next day. I could barely roll over I was so bloated. I didn’t know, but during stimulation your ovaries can grow to the size of grapefruits and beyond. I didn’t even have a large number of follicles – pretty average actually around 14. I couldn’t wait to get these eggies out and fertilized and to get back to being able to wear actual pants and not just leggings.

The things we do for love.

The post Never say never appeared first on .

When you have repeat failure to conceive there are lots of weird things that start to become triggers – and now that I’ve been through it, rightfully so. Here are a few things to never say to someone struggling with infertility or loss:

⁃ “But at least…” – sure, there are silver linings. It’s easy to want to look for them when talking to someone about infertility, but nothing fills the void in your heart that not having a wanted child of your own does.

⁃ “Just relax…” – followed by anecdotes about how xyz person got pregnant only when they stopped trying. (Here’s a secret, you never truly stop trying, or thinking about it every time you await your period). If relaxing was the cure for this medical condition, doctors would be out of work.

⁃ “Try to enjoy the process…” – especially during trying to conceive the old fashioned way. Nothing kills your libido and the mood more than timed intercourse and the pressure that comes with that. It’s the last thing you want to do when you’ve been timing it for 15 months+.

⁃ “Your time will come” – I sure frickin hope so! But it’s not guaranteed whatsoever.

⁃ “Congrats on doing IVF!” – the number of people who have congratulated me on my infertility journey and the need to spend tens of thousands of dollars on treatment is astounding.

⁃ Following miscarriage, “at least you know you can get pregnant!”… sure, but it’s not working. Something is clearly not working and I might never carry a baby to live birth.

I’ve had a close friend tell me that they really don’t know what the proper thing TO say to me is, as I experience the ups and downs over and over again. And to be honest, there isn’t really anything right to say. It’s a crapshoot that I wouldn’t wish on my worse enemy.

What helps me, is knowing I still have people in my corner. Still being invited to things, despite sometimes having to bail due to IVF commitments or a medication schedule. Having people simply ask how I’m doing and being open to a potential not so great response. Hearing me out when I need someone to talk to about how much the process sucks or hurts or is unfair. Just don’t stop checking in with your people. Don’t leave them to suffer through it alone. I’ve had a number of friends disappear through this journey and it’s hard. People stopped inviting us out, asking how life is going, shooting the shit. But I have also had people I never expected come out of the woodwork to pick me up and help me keep going when it feels like the universe is not on my side. A big thank you to all of you. We don’t feel like ourselves when we go through the rollercoaster of infertility. It’s not easy to be our support. But we will remember your kindness for a lifetime.

This third transfer preparation was aided by some gracious humans who offered to transport donated meds and who drove miles and miles to make it happen, who offered a place to stay or a ride to and from the ferry if we needed it. My heart felt full going into the FET prep.

Transfers after a miscarriage are a bit of a pain. You have to wait for your cycle to come and go, so it’s about a month waiting from your loss until your next cycle day 1. From March 10 until April 16. Then, priming began. More Estradiol, more visits with Wanda. More progesterone up the hooha.

Lots of things can happen in a frozen transfer to delay your cycle. From ovulating through the meds to thin endometrial lining issues. I suffer from the latter, and every time I try to grow my lining using medication, it takes its sweet time. More delays. Woohoo.

The first baseline ultrasound happens generally 2-3 weeks following priming beginning. Mine was May 5 on CD20. Too thin. I went a few more times around 2-3 days apart, and then finally on May 12, cycle day 27, I was finally ready.

They ask for a minimum lining thickness of 7-8mm before proceeding. Sometimes, you don’t get there and the cycle gets cancelled. But I got there. My frozen transfer would be scheduled a week later on May 19. We would finally get to meet our last normal embryo.

May long weekend was chaos for travelling from our island to our clinic – they had recently stopped offering transfers at our local clinic, so now we’d have to travel for any procedure larger than monitoring. Booking a ferry was nearly impossible and I had to work the following day, but we somehow managed to get on it that very morning at 7am. We anxiously anticipated our last shot from this retrieval.

The transfer went as expected, short and sweet. A new doctor we hadn’t met did the procedure (no meds this time whatsoever but no pain), and we were sent off again to suffer through the two week wait (9 days for us technically). That very day I had mild cramps, and in the days to follow they continued. My fingers and toes were crossed. The symptom spotting ramped up. Nausea, headache, back ache, fatigue, twinges, tender breasts. The whole gamut. I was 95% sure this was it for us. I had a feeling in my gut, again.

Earlier that month we decided to take a vacation – it had been about a year since we got the chance to relax and explore. Yolo. Especially during fertility treatment when so much gets pushed to the back burner – both time wise, mentally and financially. We booked a 9 day trip to NYC and we couldn’t be more excited.

Our significant transfer delays due to my lining were unexpected, so my beta tests fell on the days I’d be out of the country. Because of this I decided to test on May 26. 7 days post transfer, or 12dpo. This would give us a fairly definitive result. We left for the ferry and drive to the city where we’d overnight until our morning flight the next day. So I could test that day and the morning before we departed (8dpt by then). I packed all my injection meds, suppositories and supplies just in case. Then I took the pregnancy test.

It was negative.

I tested the next morning in a frenzy. It had to be wrong. Too early. Something. Stark white.

Our last normal embryo failed to implant. My body failed me. My symptoms failed me (I read into this further and apparently the high doses of progesterone I was on can mimic pregnancy symptoms 100%, great to know). I was angry, and I’d be stuck on a plane for 6 hours to stew in my thoughts. The idea of a relaxing vacation was out the window. Now WTF were we going to do? By this point, 30k in the hole with nothing but pain and suffering to show for it. A failed egg retrieval cycle, 3 failed transfers of 2 normal embryos. 7 total embryos gone.

I heard those phrases I knew all too well echoing in my mind. “Try to relax”, “At least…”, “your time will come…”. All I wanted to do was cry on that plane.

Lost was an understatement – but damn was I glad I had 8000 distractions in NY to take my mind off of it. At least to an extent.

We had the trip of our lives. I connected with family randomly in NYC that I hadn’t seen in many years (they just happened to be there the same week as us from the UAE). We ate at a 3 Michelin star restaurant, we saw Ray Ramano perform at the comedy cellar, we went to two wonderful broadway shows.

All I can say is book the damn vacation. Nothing is guaranteed. Life is too short. We can always make more money, but time is finite. Living our lives, finally, was the best medicine for the loss we felt deep in our hearts. It brought back our connection we felt got buried during all the trauma and all the loss. It healed us just enough to keep moving forward.

The post “Just relax” – The last euploid embryo appeared first on .

Since going through this I have become a FIERCE advocate for women’s rights and abortion rights. I always was pro-choice, because I truly believe women aren’t out there in droves trying to abort babies late in pregnancy. I never thought I’d have an “abortion”, but that’s what a medicated miscarriage is classified as.

I didn’t mention this in my past post, but let me lay out how that week went.

On February 22, 2023 I started a full-time job. I am a photographer full-time, but knowing we wanted a baby, knowing the costs of IVF and how fixated I was on fertility, I wanted a distraction. I also wanted maternity leave one day. I applied for jobs and took on this job before I knew I was pregnant, but hopeful it would happen. By the time I started I knew I was pregnant.

My first day I went into the office to meet everyone in person. My interviews had been on zoom, so this would be the first time. That day was the first day I started bleeding. While I was trying to focus on the job, I was panicked about whether I was losing this baby.

As time went on, juggling a new role that was more challenging than it ought to be and juggling a guarded pregnancy was hard. At the time, was a solely remote position, at the very least so I got to work from home. I found out on Friday, March 10th that we had no heartbeat. Before starting work for the day at 8am. I came home, told my boss I got some bad news, he pressed a bit about what, and I told him family stuff. He told me to take it easy that day, I’d continue to work at my own discretion but I may not be all there.

I called my clinic and they had the doctor call me back to discuss “options”.

I had 3 options.

1. A natural miscarriage, which may or may not occur – if it did not, I’d have to consider option 2/3 anyway. It could take a while, it might not happen at all. We already knew our baby was gone for a week at that stage, so infection was also a risk the longer the tissue stayed in my body.
2. A medicated miscarriage – I’d take one medication day 1, a second medication day 2, and the miscarriage process would begin ideally within 12-24 hours.
3. A D&C (surgical removal of the pregnancy). More invasive, more concrete.

I decided on option 2. The determining factor for me was speed, I wanted it gone. I didn’t want to be pregnant anymore. I would have to wait for a D&C, until there was time in the surgeon’s schedule. It could be with very little notice. If I took medication one immediately that day, I could start the miscarriage on Saturday, with hope it would be finished by Monday so I could work again.

The clinic sent me to a very specific pharmacy in my area. This is where we learn about reproductive rights…

Abortion is legal in Canada. We are VERY lucky to be given the choice. Did I want an abortion? No. Did I need an abortion? Likely yes. Whether the baby was already gone, or whether a defect would cause them suffering, I would have chosen to forgo the natural miscarriage. In any miscarriage/abortion, it’s possible for tissue to be retained by the body, and it can cause all kinds of issues. Option 2/3 both are the most helpful at removing all the tissue. Option 1 often requires 2/3 anyway to remove it all. Sometimes 2 or 3 don’t get it all either, and another method has to be used.

Despite being legal, very few pharmacies stock the medication. Mifepristone, when used together with another medicine called Misoprostol, are used to end a pregnancy through 9-10 weeks gestation on average. It’s controversial. I had NO IDEA how hard it was to acquire, even with the doctor’s prescription and sign off. We learn new things every day.

My husband went and picked up the medication for me while I finished work for the day, and as soon as he came home I started the process.

My medicated abortion experience was hard, but predictable (thank baby jeebus). It was both the worst pain of my life and the biggest relief of my life.

Trigger warning again – graphic descriptions/loss.

I took day 1’s dose. This medication is a progesterone blocker. It stops supporting the pregnancy, in preparation for a clearing of the uterus. That was all good.

On Saturday, day 2, I took Misoprostol. I had read stories of people’s experiences on Reddit and online forums. I was scared but ready. I surrounded myself with the essentials:

• Heating pad
• Advil
• Tylenol
• Snacks
• Gatorade
• Netflix
• Adult diapers
• Bucket for vomit

I took the pill and within around 4 hours I started cramping, as expected. The cramps built up over the next two hours. Tolerable still. But medication helped. I kept a hot pack on my abdomen to ease the discomfort.

I put on the adult diaper just in case.

About 7 hours after the medication it began. Cramps continued to build into what I’ll describe as borderline contractions. I started bleeding slightly and kept checking to see if anything major was happening. Bleeding got heavier, but nothing much greater than a period.

For some, the first dose doesn’t work, and they have to take a second dose after 24 hours. I was ‘lucky’ this wasn’t the case. At 7.5 hours or so, I started having excruciating cramps/contractions. Keep in mind, I am popping advil and tylenol on regular intervals at the max dose. Let’s just say it did not take the edge off.

I went into what I assume were full on contractions. I was sweating, I couldn’t wear clothes, I put a mat down on the bathroom floor but all my body felt like it wanted to do was sit on the toilet and poop out my insides. Nothing came besides liquid blood.

I sat on the floor again, for about 45 minutes. It ramped up. It was the worst pain I have ever felt in my entire life. Worse than the banana bike seat up the hooha at age 12, worse than a dental abscess that triggered my trigeminal nerve, worse than any IVF injection, any skinned knees or any period I have ever had. Worse than the car accidents and sprains. I sat doing cat-cow on the floor for what seemed like eternity, mooing like a damn cow (seriously). I pushed and pushed and nothing came, until suddenly I felt a gush, a release. The contractions returned to cramps, and there it was.

That thing I fought so hard to grow. That 30 thousand dollar piece of tissue. The visible gestational sac, about 3 inches long. Luckily, no fetus was visible, but I assume it was present in a few pieces of the tissue that were expelled (a few different things came out with different consistencies/colour). I knew from reading about the process, and what parts needed to be accounted for, that my miscarriage was done.

I went to bed, kept popping the pills and applying the heat. The next day I recovered in bed, my body was exhausted, like I had run a marathon. The hormones were FIERCE. Coming off the high hormones of pregnancy, and slowly losing them over the coming weeks was a trip. I felt waves of depression, which almost seemed like postpartum depression in hindsight, comparing this to what my mama friends have told me post birth.

I returned to work on Tuesday, taking Monday off because I just didn’t care anymore.

Slowly my thoughts began to look forward at what was next. We still had a normal embryo on ice, so all was not lost. The fighter could continue to fight when the time was right. We still had a shot.

The post Medicated Miscarriage appeared first on .

Pregnancy after loss is a beast, even if the loss was barely after finding out you’re pregnancy in the first place. My previous loss was so early that I didn’t really know it was happening, had it not been for my beta bloodwork telling me so.

When I got this positive, the feeling was not exactly excitement. It was a flurry of tests over and over until I felt confident it wasn’t going to to fade or disappear. I tested for maybe 10 straight days to watch the line get darker. After a while, it’s natural for the tests not to be able to accommodate the levels of HCG your body is producing, so you get the illusion of a lighter test. To combat this, there’s a theory that if you dilute your urine again, it will be more easily picked up by the pregnancy test. This was the case for me at a certain period – I can’t recall when, but I am guessing around 20dpo or so.

I would every now and again catch myself thinking, when we have this baby in 9 months, wondering what they would be like, who they would look like more. I wouldn’t let myself buy anything this time around though. It’s just different when you know how fragile pregnancies can be (god, I envy those people who never have a loss or significant struggle to conceive).

I am going to get really real and candid for a second. I have only shared this with 1-2 friends during this process. Many people who know me know that I have always been a bit of a black sheep. If you read my earlier posts, there’s a slight indication of that. But it runs deep.

Much of my ‘history’ has been pieced together through stories my family have told me – family I trust – and I didn’t know this until I was very much an adult in my 30s. My mom had me after having what I can only assume was an affair with someone while she was married. She wanted a baby, so I am told. Why I don’t know. I learned from a very young age that it likely wasn’t the “baby” she wanted, but the stability and security of a ‘normal’ relationship. My biological father enjoyed drinking. They weren’t super young, 26/28 when I was born. Technically, the divorce from my mom’s husband happened late, right around when I was born. I found this out through a divorce certificate I discovered in a box a number of years ago. Some drama went down, no doubt. My bio father wasn’t looking to have a baby. I believe there was deception involved, and I also believe abuse was a factor in my not really knowing him until I was an older child.

When I was around 2, I was “lucky” enough to have had my mother’s boyfriend take an interest in raising me. I spent a lot of time with my grandmother while my mom was off being a 20 something year old. But when I was 3, my “Dad” started to raise me more full time. His family took me in like their own, and to this day they are my primary supports.

I say all this because as much as I was “wanted”, I wasn’t. I was planned, but I wasn’t. My entire childhood, and life, I couldn’t picture growing up with a stable and secure life, with the nuclear family and with the ease that comes with secure attachments (a really good book on this is Attached, for anyone curious about the impacts of infant and childhood attachment). Nothing I have ever done has been achieved without taking the hard road.

I was moved around every 3-5 years of my childhood/teen years. I never had a “group” of friends, always lurking on the outside. I had lots of friends, but never truly fit in any one place. I couldn’t go to university when my peers did because my bio parents made too much money but refused to help me out, so I didn’t qualify for loans until I was 24. I never made university friends because I was 7 years + older than everyone else. I didn’t learn to drive until my mid 20s because nobody would take the time to teach me (my now ex bf graciously offered when I was 24). I’ve never been on a “family vacation”. Nothing has come without a fight, a wait, a challenge. This “fight” is a part of my soul.

When we got pregnant, I couldn’t believe it would be this easy. This simple. And in true me fashion, it wasn’t.

Trigger warning ahead: graphic descriptions.

At 5 weeks and 4 days I started bleeding. My periods are usually light, so this was scary. I passed some heavy tissue/clots. I was sure I was miscarrying this pregnancy and had passed it. I had some intense but brief cramping. I googled it, naturally. Cramps and blood isn’t good in combo. I called my clinic and I got in for an emergency ultrasound at the hospital the next day to verify whether it was gone. It wasn’t. The sac was there, measuring correctly. Why was I bleeding?

The doctors chalked it up to what they call a SCH (Subchorionic Hematoma), a collection of blood in the uterus that eventually releases. It can be harmless, or harmful. It depends on the type.

My clinic told me to go home, take it easy, and continue my meds (progesterone injections, those huge gross ones, and oral/vaginal meds). I did just that. I continued to bleed lightly, but it tapered off slightly.

My next ultrasound was scheduled for 6w2d. I did not have high hopes. They wanted to monitor me closely, even though the norma was to do the first scan around 7 weeks. Two days before I started bleeding heavily again. More tissue and clots. I went to my ultrasound and I said to the doctor, “I’m prepared for bad news, so please be real”. He said, “we’re you prepared for a heartbeat?”

Holy effing shite. This threw me. I was floored. My heart skipped a beat. A HEARTBEAT? IT HAS A HEARTBEAT?

He explained that I was measuring a couple of days behind, which in itself is not a huge deal. But the heartbeat was slower than he’d like. He called it a “guarded pregnancy”. We’d want to be cautiously optimistic. It could go either way.

Nothing comes without a fight, I told myself.

I left the clinic elated that it was still hanging on. I was still pregnant. We could do this. If I could fight so could this baby.

The week passed, I passed more blood. Less bright coloured (a good thing indicating older blood vs. a new bleed). I was still scared to death.

We went together for my 7 week ultrasound as planned.

I listened to Tara Lapinski’s podcast, Unexpecting, recently and she put words to feelings and experiences I hadn’t been able to describe. In her podtcast she reiterates how in all her scans, she noticed the technician “seeking” before giving bad news. This was what I experienced.

Seeking. Measuring. Seeking. Seeking. Measuring.

The baby was there. It was measuring 6w2d (at 7w, not good). She said “theres no FHR”.

Ok, but what? What is FHR… then, my brain put the pieces together. Fetal Heart Rate. There was no fetal heart rate. (are you crying yet? Because I am…).

How the f&%! I held the tears back then, I don’t know. She said she was sorry. She left the room. I had no pants on. My husband was staring at me with sad puppy eyes. Unsure what to do or say. I told him to look away, I couldn’t handle being nude and having him stare at me with those eyes.

I got dressed, still holding it together. Doing that thing we as women are taught to do. “Stop crying”.

I walked out of the room in a daze. Walk through the waiting room. Get to the door I told myself. Just get to the damn door.

I opened the door and emotionally I collapsed. I cried and cried and couldn’t stop crying. I have never cried so much in my entire life. All of the feelings of black sheepery, having a hard go all the damn time, never getting a break, came flooding to me. All the hope was washed away by my tears. I got in the car, I had to get my husband to drive because I couldn’t keep my eyes open and dry. I cried the 25 minutes home. I sat on the bathroom floor and cried when I got home. For days, I continued to cry.

The flicker was gone. The hope was gone. Our baby was gone.

The post A flicker of hope – Pt 2 appeared first on .

The hardest part of IVF is the waiting game. The complete unknown and it feels like every appointment is one where you’ll hold your breath. Maybe for 10 mins, maybe for 2 weeks. The lack of control you have over your actual body and its responses can be very frustrating and discouraging. It takes a lot of getting used to, especially for control freak me.

We went into the clinic locally this time. And this was the first time until now that we had actually seen our doctor’s face. We had only spoken to him twice in 6 months. A different doctor did the last transfer and our retrieval.

The local clinic where we live is lacklustre. For how much money you toss into IVF out of pocket, you’d expect more from the digs. It felt like going into an abandoned office building when we ventured into this part of our clinic. Until now, I had only been in the monitoring rooms – also lacklustre but pretty generic with dim lighting so not as shocking.

This transfer threw me for a loop initially. We walked into a waiting area, and I had asked for Ativan again because I didn’t know how my body would react to the catheter. Better safe than risking major uterus cramping. I went in early like they asked but they never passed the message along that I was waiting to take the medication in office (thanks receptionist). So they pushed our transfer back 20 minutes and bumped the next person into our spot. The kicker… they had the same birthday as me. Flash back to the 800 times they verify your embryo is yours using the birthday. Well, I got super worried they’d mix us up due to the schedule change, and the same birthday. Stress isn’t fun when you’re about to meet your embryo. I reiterated that I was worried about a mix up to every single person I spoke to after that. All I can say is speak up! Advocate, advocate, advocate.

The meds kicked in and I got changed into my pantsless getup while my husband donned his white space suit and we were escorted into the transfer room. This time, instead of an operating room it was a cramped clinic office with barely any room to roll the equipment around. The radio was playing in the background. We met the doctor and in no time it was done. I didn’t feel much besides the speculum. We got our little ultrasound photo, I got dressed and we departed.

My husband went back to work for the day and I took it easy. It was February 1, 2023.

I’ll get into more about chronic testing and testing culture one day, but let’s just say until now I was more than slightly OCD about testing. February marked 13 months of trying. 13 months of two week waits, testing, disappointment. It had been 9 months since my chemical pregnancy. Since my last positive test. I don’t know how I did it, but I managed to wait SEVEN days before I caved and got the urge to test.

On day 6 I started feeling some stuff, but after so many failed months of trying and ghost symptoms for absolutely no reason, I learned I couldn’t trust my body to indicate either way. I did get some pretty awful back pain on day 6, which would be the equivalent of 11dpo for those trying unassisted. The pain persisted and I had a gut feeling. I couldn’t wait any longer. Not even the two days until my beta blood work.

It was positive!!!! And not super faintly positive squinter like before. It was actually positive. I was soooo very cautious because I knew how much my heart broke last time around. I probably took 10 tests that day. All. Were. Positive. I was pregnant. It worked.

My beta blood work was scheduled for day 9, but I couldn’t wait so I went on day 8. It was within the minimum levels they had hoped for (they look for 50 on day 9, I was 46 on day 8). I went back two days after that and it had more than doubled to 108. Heck yessss!

I continued testing a couple of times a day, eventually upgrading from my crappy Amazon pee sticks to the fancy first response tests. I tracked my progression day to day to make sure my levels were getting darker, and they did continually.

I was so cautious. Could this really be happening? My brain and heart couldn’t believe it but my eyes were seeing it. I got a “dye stealer” on day 12 after transfer (when the test line is darker than the control line). This eased my mind substantially.

Now, the hardest wait of all – the 7 week ultrasound. 3 weeks of torture were ahead of us. I repeated cheesy mantras such as “my body accepts this pregnancy”, kept my feet warm and stopped eating foods I wasn’t allowed in pregnancy. I reminded myself every hour of every day that I was still pregnant and we were so very lucky. I stocked up on pregnancy books, just in case. I ordered a pregnancy pillow and welcomed my first small bouts of nausea. I also got to continue those wonderful suppositories and PIO injections.

This was finally happening.

The post A flicker of hope – part 1 appeared first on .

My period came on Dec 20, right before their closure, but due to the holiday slow down, I had to go on birth control until Dec 27. This basically delays your cycle, forces another light bleed, and you can begin cycle day 1 again.

We were waiting to begin a new Frozen Embryo Transfer (FET) with one of our Euploid embryos.

FET prep varies depending on the clinic, but most of the protocols I have seen involve Estradiol (Estrace, Lupin Estradiol, etc.) for a number of days, basically shutting down your ovaries for that month. You take that for a couple of weeks or more, and they bring you in for a baseline ultrasound (we meet again, Wanda).

You become intimately familiar with this machine and it’s phallic ultrasound wand. For a FET you may go in for internal ultrasounds upwards of 4-5 times in a two week span. Early AM appointments usually beginning around 7am. You get really used to people being up in your business. It’s much like a pap smear, minus the speculum (I hate the speculum). It can be a bit uncomfortable if they have trouble locating your uterus or getting the right picture.

For the FET they are checking for uterine lining thickness, which is juiced up by all the meds you’re on. You eventually add progesterone suppositories into the mix, and for me I was lucky to have to take them 3x a day up the hooha for almost 4 weeks.

Along with many other people I know, I suffer with thin endometrial lining, so it takes a while to build it to the thickness they require for the transfer. Our clinic looked for 7mm and it wasn’t without difficulty getting there. If it takes too long, you’re at risk for a cancelled cycle, and you have to begin again on your next period start. It’s not an exact science, but it’s close.

In addition to the suppositories and the oral medication, a FET differs from a fresh transfer in one other way…

Progesterone in Oil – the bane of my existence. (PIO)

This was my first experience with PIO. Before this, I had to brave my fear of needles with subcutaneous injections – these are done around the bellybutton area and the needles are 1/2″ in length, and quite thin (27 gauge if you are curious). Scary for someone beginning to inject on their own, but all in all tolerable. Not completely void of pain, but I’d classify it as a mild and brief discomfort.

PIO was a whole other ballgame. PIO is thick, as it’s actually oil, so it requires a thicker needle. The kicker with PIO is that it is injected intramuscularly. This means the needle is also longer. 3x longer to be exact. 1.5″ of thick, scary pokiness. You inject PIO into the upper butt, almost on your lower back, directly into the muscle. Because of the location, I had to let go of my control-freak tendencies and let my husband help me. I’ll include my PIO workflow at the bottom in case anyone is curious and scared for their first poke.

My protocol involved taking 2 Prometrium suppositories 3x a day, 2-5 Estradiol orally a day (depended on time in cycle), and PIO every 3 days at a certain point in my cycle after thickness reached it’s minimum.

It took a while for me to get to the 7.5mm required, I was 5mm on CD20, and finally bulked up to 11.3 by CD27. I was ready to roll. They started me on PIO and my FET was scheduled, this time in my home city, 6 days later on Feb 19, 2023.

PIO for Beginners

For anyone staring PIO in the face, I HIGHLY recommend using an auto injector device. This was recommended on a couple of threads I read, and I am SO glad I ordered it. The shipping was fast and I got it in time to start my injections. It also helps if there’s a chance you might not have someone there to inject for you. Takes the guesswork out of needle depth, angle, etc. The injector I used can be found here: https://unionmedico.com/90-super-grip/. It’s not cheap and I felt sketchy ordering something from Europe, but it works like a charm. See photo at the bottom.

Drawing it up/pre-injection:

• Lay out all your stuff (needle, syringe, alcohol swab, tissue, injector if you have one, sharps container)
• Turn on a heating pad, or warm up your hot pack
• Wash your hands
• Swab the top of your PIO vial
• Swab anything else (end of syringe, needle attachment, etc.)
• Attach the needle to the syringe, ensure it’s secure.
• Pull back the syringe to your dose line (mine was 1ML) with air
• Pierce the top of the vial, inject the air into the vial
• Tip upside down, and draw back your dose of PIO. (I always take more than I need, give it a few flicks to remove air bubbles, and plunge the access/air into the vial)
• Remove the needle from the vial
• Re-wipe the top of the vial with the alcohol wipe
• Heat the area you’ll be injecting into for 10 minutes approximately (see image below for ideal placement – check with your clinic if you’re told otherwise or not sure. Some clinics recommend using the upper thigh, but I have heard this hurts more).
• I also put the syringe somewhere warm to warm the oil, like an area below the heating pad, in my bra, etc. It shouldn’t be too hot, but warm enough to reduce viscosity.

• After 10 minutes, I swab the area to inject with the alcohol pad
• I get any remaining air out of the syringe, and load it into the injector
• We steady ourselves to ensure no movement occurs, and inject the needle at a 90 degree angle to the skin.
• PIO takes a little while to plunge due to it’s thickness, go slow and it will hurt less. Avoiding movement or shaking also hurts less.
• When the plunger has been fully plunged, pull the needle out and wipe the area with a tissue or swab.
• IMPORTANT: Massage the area for approximately 2 minutes vigorously, down into the muscle. This helps distribute the PIO and will prevent pain in the days to come.
• Heat for another few minutes, then stretch those muscles for 2-5 mins to further distribute the meds.
• Discard your needle in the sharps container.
• Voila, you’ve been jabbed successfully.

The post Frozen Embryo Transfers appeared first on .

On day 6 the clinic called to tell us that they had biopsied and frozen 6 embryos, in addition to the one 4AA they inserted into my uterus. I jumped for frigging joy. 6 embryos out of 13 eggs retrieved is unheard of. There were others, too, but they didn’t meat the grading requirements to freeze. Every lab is a bit different on how they grade and what they believe it’s worth keeping. 6 was amazing. They biopsied them and mailed the samples off to Igenomix, a genetics lab that tests for chromosomal abnormalities.

PGT-A Chromosomal testing is helpful in some ways. The unfortunate thing is that most clinics make you decide whether to PGTA test before you even begin your cycle. There’s an increased cost to set this up, so if you don’t get embryos you’re out that money. In addition to this, for each embryo you send out, you pay a testing fee per embryo. At the time, ours was $550 per embryo, so an addition $3300 after our cycle. It’s not chump change.

PGT-A testing doesn’t find everything though. It tests for the most common genetic abnormalities, such as common trisomies. There other types of PGT tests too, but this is the most common. Skip the next section if you don’t care to read about the specifics…

– Preimplantation genetic testing for aneuploidy (PGT-A): This type of PGT screens embryos for certain chromosome abnormalities. Human embryos typically have 23 pairs of chromosomes (46 total) in each cell.  One chromosome in each pair is contributed by the egg, and the other is contributed by the sperm.  It is common for embryos to have random chromosome abnormalities such as a missing or extra chromosome, which is called aneuploidy.  In the majority of cases, these chromosome abnormalities happen by chance and are not inherited from a parent or donor.  Embryos with aneuploidy are more likely to result in miscarriage or a failed transfer.  Some types of aneuploidy may result in the birth of a baby with a chromosome condition such as Down syndrome or Turner syndrome.
– Preimplantation genetic testing for monogenic disorders (PGT-M): This type of PGT is performed when a patient has an increased risk for a specific genetic condition to occur in their embryos.  PGT-M is appropriate when an individual is affected with a genetic condition that could be passed on to their children, for individuals who are carriers for an X-linked condition, or when an individual and their partner or donor are both carriers for the same autosomal recessive condition.
– Preimplantation genetic testing for structural rearrangements (PGT-SR): This type of PGT is performed when a patient or their partner has a rearrangement of their own chromosomes such as a translocation or inversion.  A person with a translocation or inversion is at increased risk to produce embryos with missing or extra pieces of chromosomes.  Embryos with missing or extra pieces of chromosomes are more likely to result in miscarriage, stillbirth, or a child with serious health issues.
(Source)

If you have suspected monogenic disorders, sometimes they will send you for IVF not because of infertility, but so they can test for these disorders. For PGT-A, its for people who have a need to do IVF otherwise, and it gives them peace of mind. The results can come back either Euploid, Aneuploid, Mosaic, or No Data.

I’ll also note, when testing for chromosomal abnormalities in blastocysts, it is done by taking a miniscule sample from the embryo. This sample will ideally contain all the data needed to say whether the inner and outer portions of the embyro are chromosomally normal, however the data is taken from the outer portions which will eventually form the placenta (not the fetus). The inside portion will form the fetus and is usually left untouched.

Euploid Embryos are embryos with normal chromosomes. People often say your fertility shits the bed at 35 and it drops off a cliff. For some it does, but Euploidy and Aneuploidy are the reason they state this. You may be able to make lots of eggs and fertilize those eggs, and they may make it to blasts, but they might all be aneuploid.

Here’s a chart showing the probability of Euploidy at different ages:

Aneuploidy is when an embryo comes back with one or more extra or missing chromosomes. This can result in either a nonviable pregnancy, babies that may not survive after birth, or a surviving newborn with congenital birth defects and functional abnormalities. Most aneuploid embryos won’t implant, but at times they do, and it can be the main cause of early miscarriage. When getting pregnant ‘the old fashioned way’, we have know way of knowing whether our embryos are euploid or aneuploid, and this can sometimes be why a cycle isn’t working.

Mosaic results are a different beast. No tests are perfect. A mosaic outcome *could* result in a live birth – it’s heavily debated in the fertility community, so some clinics will implant Mosaics while others will not. In PGT-A, mosaicism is defined as a mixture of 20% to 80% aneuploid and euploid DNA content, with some euploid content.

No Data embryos occur when there is not enough genetic material in the biopsied sample to provide a picture of the genetic makeup of the embryo. These are often given the option to retest, or to transfer blindly. Re-testing requires thawing the embryo, re-biopsying it, refreezing it and sending it off again. This can damage the embryo so some people choose to forgo additional testing.

PGT-A testing can help you select the embryo that is most likely to end in a successful pregnancy/live birth. However, having a PGT-A normal embryo does not guarantee a successful transfer cycle.

The 3 embryo rule
Many doctors will say it takes 3 Euploid tested embryos to achieve a 95% chance of pregnancy in most individuals. Many first transfers of PGTA-Normal embryos will result in a pregnancy. Those who take more than 3 transfers likely have other underlying issues at play which may or may not be evident.

Now that you’ve had a science lesson!

We sent out embryos off for testing and waited a painful two weeks over Christmas 2022 for our results.

In the meantime, I was still PUPO. They encourage you not to test at home during IVF due to a variety of factors. You go in for your beta bloodwork usually 9-14 days after your transfer, depending on the clinic. I went on day 9. I was feeling good until a few days before. We had a bunch of embryos and so much hope. I caved and tested at home.

Stark White.

I went for my betas on December 19, and the result came back as <1, which means you are not pregnant. Our first perfect little embryo (pictured in the last post) didn’t make it. I was sad. But I was still hopeful.

On December 26 I got a call and voicemail with my PGT-A results. Then logged into my portal – the portal is where they keep all of your communications, docs, med schedule and results. It’s like a beast of a database from the year 2000. I logged in and the embryologist had sent me SOMEONE ELSES RESULTS. I was super confused. Not to mention the concern I had that someone also got my results, and all of my personal information to boot.

I tried to reach the embryologist but as the clinic wasn’t open officially until Jan 3, I was left in the dark. The results in the voicemail differed from the results in my portal for the other couple. So I went with what was in the voicemail (which turned out to be correct).

13 Eggs Collected
13 Eggs Mature
13 Eggs Fertilized
7 Blasts (6 tested, 1 failed transfer)
We found out 2/6 were Euploid, 2 were Aneuploid and 2 were No Data.

I was pretty happy, considering we had been lucky with attrition at that time. 2 Euploids meant two more shots at this thing. and 2 No Data could be more hope!

I’ll fast forward to February, when we decided we’d retest the No Data embryos. We thought for sure one would be Euploid. Tragically, neither embryo survived the thaw. We lost 5/7 embryos in two months due to attrition, aneuploidy and failed implantation.

Our goal was one child, and we felt pretty damn positive about our two normal embryos and got to work on preparing for another embryo transfer.

The post The little blobs that could, and couldn’t appeared first on .

After the egg retrieval, you begin to play a new waiting game. You’ve done your part, and now it’s time for the eggs and sperm to do their’s.

Immediately after the retrieval, they look at how many eggs are mature. We got lucky and 13/13 were mature. Usually the attrition for this is around 60-80%, meaning on average, people with 13 eggs would end up with 8-11 mature eggs.

From there, the eggs are fertilized. They use one of two methods (there are other methods that are much less common), either standard IVF or ICSI (I described this in an earlier post, but in short standard lets the sperm decide to fertilize, and ICSI is an injection of sperm INTO the egg itself). On day 1 post retrieval, so the day after, you get your fertilization results.

Usual attrition for fertilization is also 60-80%. By now, most people will have 5-8 fertilized eggs. We miraculously got 13.

The next part is the hardest wait so far. If you’re doing a fresh transfer, you find out on 4 days post transfer whether any embryos made it to the blastocyst stage. The blastocyst stage requires a certain number of cells and for the cells to arrange in a particular way. We were lucky to have all embryos growing as hoped on day 4, so we got scheduled to come back for our embryo transfer the next day on day 5. We were hoping to PGT-A test our remaining embryos for genetic abnormalities (an additional cost, and involving a biopsy on day 5-6 before freezing).

From here, the wait can get tangly. Lots of embryos make it to day 3-4. We in the infertility community fittingly call the next few days the hunger games.

We went in for our embryo transfer feeling so very hopeful. We got a photo of our little embryo that would be transferred and it was so cool to see a picture of it. It was of one of the highest possible grades (grading takes into account the ‘look’ of the embryo, and in lieu of genetic testing it is the one marker they use to decide which embryos to keep and which to discard).

The transfer itself is a lot easier than the retrieval. Following the retrieval you immediately switch gears and start on progesterone suppositories (in my protocol anyhow), and you come back on day 5 for the transfer. This involved another trip across on the ferry for us and another night in hotel that same night. You really don’t get much notice, but for us it was the ‘off-season’ from tourist season so not too difficult to find a spot affordably or to get on the ferry.

We arrived and usually the transfers themselves are completely unmedicated. They had me take Ativan one more time just to ease my muscles in case I reacted to the catheter due to some cervical pain/cramping I had previously with my Saline Sonohistogram.

This appointment was a piece of cake. I donned my hospital attire, and my husband was allowed to be present for this procedure so he donned his own set of whites over his clothes. I wore my socks again for good measure. He, of course didn’t even have to take off his shoes. He just put some booties over them and went on his way.

They walked me into the same OR I had my retrieval in, and it was just sheer luck that it was the same doctor (I still had never met my own RE doctor at this point. More on that later.). I laid on the same bed, had the nurses lift my gown – and my husband got a wonderful show.

This is where I point out that I am NOT comfortable with my body. We joke that I am a never nude like Tobias on Arrested Development. I have always had issues with body confidence and being comfortable in front of others. I changed under my bed coverings until I was 10 years old (no abuse, just paranoia), I refused to change for gym class with other classmates for many many years, often going so far as to leaving my clothes at home and getting detention because I was uncooperative. I wouldn’t shower when we went swimming unless there was a private shower stall. This was never addressed in a healthy way, because teachers and parents don’t talk about that stuff. Not in our generation anyway (Millennials). After some tragic experiences as a teen regarding consent, I reverted even further into my cave of discomfort with my body.

Let’s just say the IVF journey has taken all the fear and dignity I have when it comes to my body. There is was, out there for a room full of strangers and my husband to see. Not to mention his first experience seeing people poke and prod between my legs. I can only imagine how uncomfortable that is for a partner. He had never been present for my other exams, and there were many, so by this point I was used to it. It got to a point where I didn’t even try to cover myself anymore. What was the frigging point.

The transfer went off without a hitch. The catheter and the speculum didn’t hurt, and when they inserted the embryo into my uterus, a little flicker showed up on the ultrasound screen. This is NOT the embryo, but an air bubble that accompanies the embryo to confirm placement. An embryo at this stage is microscopic (.1-.2mm), but they print off a little picture of your “flicker” for you to hold on to.

It was done in a flash and I walked out with the strangest feeling. I was now Pregnant unless Proven Otherwise (PUPO! – I’ll note that the fertility community says “Pregnant until proven otherwise” which I don’t love, because there’s almost an expectation of it being proven otherwise, so I prefer my saying).

Now the next most excruciating wait of my life was to come. The “Two Week Wait”. This is a bit of a misnomer for IVF though because technically the two weeks starts the day after your retrieval. At this point on day 5, I was already 5 days into that wait. So we awaited our bloodwork 9 days after retrieval to tell us if this little blob decided to stick around or not.

The only solace we got in that time was that we would be getting our final blast update on day 6-7, telling us how many made it to biopsy & freezing.

All in all these 9 days have tended to be THE most hopeful and ignorantly blissful part of IVF. We got to pretend we were pregnant, we got to feel all the myriad of emotions that come with maybe having a baby. We got to imagine a future with our little 4AA embryo. Finally we had hope.

The post Embryo Attrition and Our First Transfer appeared first on .