What is an embryo transfer?

"The patient returns to the clinic to have the embryos transferred. Anesthesia is often not necessary, although a sedative may be used. An ultrasoundmay be used to help guide the physician as he transfers the embryos. A predetermined number of embryos are loaded into a fine transfer catheter that passes through the vagina and cervix, into the uterus.

The embryos are deposited from the catheter into the uterus. Following this procedure, the patient usually remains in a recovery room resting on her back and is discharged 4-6 hours after the procedure. The couple will then wait and optimistically watch for early pregnancy symptoms."

www.americanpregnancy.org

#1 IVF update on our embryos

  Yesterday they were able to retrieve 8 eggs. Today they reported that only 7 fertilized because one egg wasnt mature enough to fertilize. But 7 out of 8 is a great number!
  We offically have 7 embryos! Because our fertlization report came back so good and they don't appear to be struggling they are waiting to transfer on day 5. By waiting until day 5 they will be able to weed out the weakest embryo's because they will start falling off. The surviving embryos will be examined and they will transfer one and freeze whats left (if by day 5 there is some left). They will not be checked on from now until transfer day. On Wednesday they will call us if something horrible happens but if not we will be in Rockford on Wednesday at 1:40 to place our embaby back home.

Trmbaby.com

"The laboratory is a critical part of the IVF process. The eggs that are harvested are placed into dishes where they will be counted and evaluated.

Approximately six hours after egg retrieval, fertilization is accomplished by placing a small concentration of sperm onto each egg, or by ICSI (where a single sperm is injected into an egg.) Approximately 18 hours after retrieval (the day after egg retrieval) we will evaluate fertilization of the eggs.

Fertilized eggs (zygotes) have two pronuclei. One pronucleus is a packet containing half of the female’s DNA. The other pronucleus contains half of the male’s DNA. This genetic material will unite to form the full complement of genetic material that will make an embryo.

The embryos are cultured (or grown) in incubators with an environment designed to mimic the human fallopian tube. A careful balance of carbon dioxide, oxygen, and nutrients are maintained at the correct pH (acid content) to promote embryo growth.

Embryos destined to result in pregnancy will progress through several well-defined stages including zygote, cleavage and blastocyst stages. Only normally fertilized eggs are kept in culture. Not all embryos will grow in culture. Some of them will be genetically abnormal, while others cease to grow for unknown reasons.

Cleavage-stage embryos are those that are dividing into progressively smaller cells. Two days after fertilization, normal embryos are between two and six cells. Three days after fertilization, most normal embryos are between seven and nine cells.

Four days after fertilization, most normal embryos have reached the morula stage (too many cells to reliably count with a microscope).

Blastocysts are embryos that are nearly ready to implant. Blastocysts have developed three distinct regions:

• An inner cell mass, which becomes the baby
• The trophectoderm, which becomes the placenta
• The fluid-filled cavity, which will form a structure called the yolk sac

Embryo transfer

Your physician and embryologist will determine the ideal day for your embryo transfer.

The very best embryos will be selected for embryo transfer. The number of embryos transferred will depend on several factors, including your preference, the quality of the embryos and the ASRM Embryo Transfer Guidelines.

If you have other embryos that are suitable for freezing, they can be frozen (cryopreserved).

It is critical to understand that morphology scoring of the embryos does not evaluate the genetic potential of the embryo (e.g., will the baby have a normal number of chromosomes) or the potential health of a baby that grows from the embryo.

While pre-implantation genetic testing can investigate the chromosome number of the embryo, no test can guarantee a healthy baby after IVF."

What is a Egg retrieval?

What are they doing today??

Egg retrieval

Egg retrieval can be done in your doctor's office or a clinic 34 to 36 hours after the final injection and before ovulation.

• During egg retrieval, you'll be sedated and given pain medication.
• Transvaginal ultrasound aspiration is the usual retrieval method. An ultrasound probe is inserted into your vagina to identify follicles. Then a thin needle is inserted into an ultrasound guide to go through the vagina and into the follicles to retrieve the eggs.
• If your ovaries aren't accessible through transvaginal ultrasound, an abdominal surgery or laparoscopy — a procedure in which a tiny incision is made near your navel and a slender viewing instrument (laparoscope) is inserted — may be used to guide the needle.
• The eggs are removed from the follicles through a needle connected to a suction device. Multiple eggs can be removed in about 20 minutes.
• After egg retrieval, you may experience cramping and feelings of fullness or pressure.
• Mature eggs are placed in a nutritive liquid (culture medium) and incubated. Eggs that appear healthy and mature will be mixed with sperm to attempt to create embryos. However, not all eggs may be successfully fertilized.

After they retrieve my eggs they will attempt to fertilize them:

Fertilization

Fertilization can be attempted using two common methods:

• Insemination. During insemination, healthy sperm and mature eggs are mixed and incubated overnight.
• Intracytoplasmic sperm injection (ICSI). In ICSI, a single healthy sperm is injected directly into each mature egg. ICSI is often used when semen quality or number is a problem or if fertilization attempts during prior IVF cycles failed.

In 1-2 days we will get the fertilization report and find out if they are transfering our embryo on Monday or Wednesday. Fingers crossed we get several eggs and after fertilization we have enough to freeze after transfering one (or two). 

www.mayoclinic.com 

#1 IVF 4th Scan

  Today I got my final ultrasound of my ovaries for my upcoming IVF procedure. I lost count of the follicles he was counting but I believe they are all still there. I was scared of them somehow disappearing. They are big though! The smallest was a 17mm and the largest was a 25mm. This worries me because I still have a couple days until my retrieval and they could continue to grow.

 I asked him if there was a such thing as too big and he told me "uhhh not really. We like to see them between 18mm-20mm." but personally I've heard stories of eggs not fertilizing because they were too mature. He told me that everything looks good so I'm just going to take his word for it.

The plan is to trigger ovulation tonight at 10:45 PM and my egg retrieval is scheduled for Friday at 9:45 AM. I am looking forward to it! I'm in so much pain from all the activity in my ovaries... I will update after we gather our eggs and let you know how many they were able to get!

IVF #1 third scan

  At my last scan I had 6 follicles today I have 15! They are all sizes 11-19mm. Thats potentially 15 eggs we could retrieve! Thats great news! The doc made me a little nervous because he called the IVF nurse and told her I may be "growing too fast" but I'm trying not to worry. Its hard for me to stay positive and not stress over every detail. I have my last scan in a couple of days and we head to Rockford Thursday night!

Symptoms: I am in pain when I move wrong one way or the other. I have little appetite and feel like I am carrying around 15 bowling balls.

IVF #1 second scan

  I went and saw my doctor today and so far I have been stimulating my ovaries for 6 days and my left ovary has 6 follicles between the sizes of 11mm and 13mm. My right side has several small ones but they were to small to measure. I am on a shot to help keep me from ovulating those 6 follicles when they reach maturity (about 18-20mm).
  I asked the doctor if this is where I should be at this point and he said my left side is doing well but my right needs more time to grow. He said he is optimistic and I have plenty of time. Fingers crossed those babies grow! (Hehe babies) .

IVF #1 first scan

I don't really have any updates. My ovaries have follicles and doc didn't say anything was wrong. This doc doesn't give me much feedback and I was too nervous to ask questions. I believe there are less then 10 all together but I will know more Friday.


Can you spot my follicles?

 This is just the ultrasound machine

First day of IVF cycle 1

First IVF shot taken. I will give myself another in 12 hours. They are both to help stimulate follicle growth. Check up with doc in a couple days to check on growth. My schedule is all planned out but things can change at any moment. It all depends on how my body reacts. Here we go! IVF cycle 1 has officially begun.

Update on pathology report

I talked to my doctor today. Pathology came back negative for any abnormal cells. I am still cancer free and have no signs of the abnormal cells returning!  I am to proceed on to IVF and start meds Sunday! It gives me a little hope that we may just have a baby Pickett!

4/18/17 D&C update

 Hello friends, I'm awake and decided to update you officially on my blog. According to Kevin doctor didn't have enough room to check my uterus properly in the office and was wrong. It appears I don't have any scar tissue or polyps like he first speculated. He seems to think the pathology report will come back normal and he wants me to continue IVF as planned in May.
 I had convinced myself we wouldn't continue but after hearing the good news from Dr.S I feel a tad bit better about continuing on. Kevin is 100% on board for continuing as well.
 Dr. S did take a sample of a small part of my uterus and sent it in but he isn't concerned just by looking at it.
  Nothing is 100% until pathology comes back but I am in a better place then I was before the surgery. I have my get up and go attitude back!
  Thanks to everyone who private messaged me, sent me texts and went out of their way to let me know they care. The sweet nurse at the surgery center wiped my tears away while waking up from surgery and told me I will be a good mom one day. It made my heart swell with love.

Update 4/12/17 hyperplasia???

Ok...some of you may remember that I have a history of complex hyperplasia with atypia in my uterus. Basically pre cancer cells which is why I have ongoing appointments with a oncologist. At my last appointment my oncologist gave me the OK to proceed with IVF. That was in Feb.
 At this appointment with my reproductive endo. he took a look at my uterus (with a camera) to determine if my uterus looks good enough for implantation. What he found today were a few polyps near my right tube and my lining is so thick it was either blocking the view of my right tube or there is a build up of scar tissue.
 Next Tuesday I have to go in for my 4th or 5th D&C (I've lost track). Its a surgery that  I will be put to sleep for. They will take a sample of my lining and have it sent off to pathology to see if those pre cancer cells are back. If they are I will not be able to move forward. If not and its just a build up of lining then we can continue as planned.
  If my pre cancer cells are back (or worse its cancer now) I will go in for a hysterectomy. I say that because my health is priority over everything else. Hoping I can stay in a positive head space... I can't afford to let this take over my soul again. Please everyone positive vibes that its nothing! I love you all!

IVF consultation 4-7-17

Hello all, sorry this took so long to write. I  currently don't have a computer so this has to be written out on my phone.
 Last Friday I had my first IVF appointment. We had to meet with our doctor (the same doctor I worked with for my IUIs). Dr. G went over the IVF process and answered the few questions I had.
 Then we met with an IVF nurse and went over all the medications. I am currently taking birth control (BC) to help suppress my ovaries. After another 10 days or so I will start on stimulating meds. My cycle is going to be controlled with medications.
 During this appointment we went over all the financial obligations (OMG its so costly! Without insurance this would cost us over 13k for ONE CYCLE!).
 After that Kevin gave a semen sample and the lab tech looked at it under a microscope and gave them a set of tests (haha) to determine how many sperm were there, active and moving right. In the past from our IUI samples they were estimating he had 5-10 million sperms but this time he had 21 million! So we dug deep in our pockets and forked out $275 to freeze those sperms just in case his IVF sample isn't as good. It's a "back up".
 I got the results from my blood test a couple weeks ago and all hormones look perfect and I have plenty of eggs left in storage (haha) and I do not look anywhere near menopause! Thats all great news!
 I will be on 2 injections a day for about 10 days (could be more or less) with ultrasound monitoring every other day. There is a huge chance of over stimulation of my ovaries which will make me sick and will cancel the IVF cycle. So its very important that I be closely monitored.
 The first medication is Gonal F it will stimulate my ovaries to grow follicles. The second daily medication is menopur and it works with gonal f to do the same thing. When there are many follicles big enough to extract I will stop meds and take a shot of HCG (trigger). I have to take the trigger shot to help loosen the eggs so they are easier to take out.
 For the egg retrieval I will be put to sleep and Kevin and I will have to stay the night in Rockford. Kevin will have to give me the trigger exactly 36 hours before my retrieval so I don't ovulate before the procedure.
  After they take my eggs they will count how many they have and tell me. We are hoping for 10-15. The lab tech's will then see out of those eggs how many are ok to continue. They will then take one single sperm and inject it into my eggs. They will freeze most and keep a few in an incubator. After 3 days they will check on them and see how many are progressing. If they look like they are struggling they will transfer one back into my uterus because its the best environment for a embryo to thrive. If they seem to be doing OK they will wait a couple more days to transfer one back in on day 5. I asked Dr. G if he will consider transferring two he said because of my age he will only transfer one but if I only have two eggs in the end then he will just transfer both instead of freezing the one extra. There are laws that doctors have to abide by and that means because of my age (for my safety) he can only transfer up to two embryos.
 Then...I wait...for two weeks! It will be the longest... 2 weeks...of...my....life...! But hopefully it all ends with a positive! Its a long and very detailed process but we both agree it's worth the money and the emotional roller coaster.
 If this first IVF cycle is a success we will hopefully (if all tests come back OK by the FDA) donate our embroys to other couples in need. IVF is expensive and not all have coverage by insurance. I would love to help remove one burden off their shoulders. Those embryos would literally be a child of ours and the couple would have to adopt our embryos but we are ok with that. We would be honored.
 If all goes as planned embryo transfer is set for May 8-10th but things can change depending on how I respond.
 Fingers crossed this all works out! I will keep you updated along the way!

Start of IVF journey

  Hello, I hope everyone is doing well! This blog is just a start to many more IVF blogs! First of all I am completing a blood panel at the end of today to measure some of my hormones so the docs can kind of know where to start me with meds. Then two weeks later we are going to Rockford, IL (3 hour drive) to have a complete and very informational semen analysis done. We are doing another analysis in Rockford because there is a state of the art lab there. Having that done gives us a little more insight on how many sperm K has and they will be able to determine their motility and morphology with more accuracy. If he has a good number we will freeze the sperm and use it as a back up during IVF. We can't count on his samples being good every time and the last couple of IUIs his numbers have decreased each time. He is on a strict daily vitamin regimen and he is TRYING to eat healthy and well balanced.
  During that appointment we will also meet with the IVF nurse, the doctor (should be Dr. G) and we will be given a medication schedule. A couple of weeks after our first IVF appointment I will have to go to Peoria for a procedure on my uterus (Hysteroscopy) to make sure there isn't any polyps or anything else abnormal that could prevent a embryo from implanting. Depending on the results of that test we will either continue with medications and IVF as soon as possible or we will have to have surgery on my uterus and put IVF on hold again. I am hoping of course, that nothing abnormal is going on in my uterus and we can continue as planned.
  This Thursday I start Birth Control to help suppress my ovaries before all the hormone injections. During IVF we completely take charge of my body's process and time everything just right. And to start that we have to stop my ovaries and then when the time is right help stimulate them via medications while being closely monitored by ultrasounds.   
  At this time, that is all the information I have. We are getting closer! Hopefully we won't have any road blocks and we can start in May
If not we will have to wait until July to start. Fingers Crossed and GOOD VIBES NEEDED!

("Sperm motility is an important part of the semen analysis-male fertility. The three main components of a semen analysis are: Count (concentration), Motility percentage. Morphology - The percentage of "normal forms"...the most commonly used cutoff for normal sperm motility is greater than or equal to 50%...  The lower the motility percentage, the less likely any treatments other than in vitro with ICSI will result in pregnancy...extremely low motility percentages such as less than 25% motility we rarely see pregnancies without the use of ICSI." www.advancefertility.com  ICSI: when a single sperm is injected straight into an egg for fertilization.)

(Hyerstoscopy: ... a narrow tube with a telescope at the end is passed through the vagina and cervix into the uterine cavity, which is sometimes filled with fluid or gas. The images are viewed on a screen and recorded. The surgeon can then check for fibroids, polyps scar tissue, septa, and other malformations. If any are spotted, they can usually be sorted out." www.yourivfjourney.com)

End of IUI Cycles and the beginning of IVF

So I just talked to my doctor after work and found out what I was expecting that my pregnancy test came back negative but we started the conversation about IVF and I can potentially start in May. But only if my pre-approval from my insurance company comes back in time and only if I start bleeding on time. Otherwise due to calendar issues and the fact that they only do IVF Cycles every other month I'll have to wait until July. We do have an appointment in Rockford Illinois on April 7th to go through a detailed semen analysis with potentially freezing his sperm for the IVF cycle. We will also be getting our plan of action that day and meeting with the doctor. So to summarize hopefully my period starts on time and my pre-authorization comes back in time and we can start IVF in may otherwise we will have to wait until July. I will update you as I know more.
Many people don't know what IVF is: below is the steps involved. (http://attainfertility.com/article/get-pregnant)
in vitro fertilization (IVF) 

"Step 1: Ovulation inductionBefore and during the in vitro fertilization process, your fertility specialist will monitor your ovaries and the timing of the egg release. The doctor will make sure that your ovaries are producing eggs, and that your hormone levels are normal, among other procedures.

Most women take fertility medicines or hormones at this time to stimulate the ovaries to produce one or more eggs. Having several eggs available for IVF will increase the chances that you will get pregnant.

If you cannot produce any eggs, talk to your doctor about donor eggs for the IVF process.

Step 2: Egg retrievalDuring this step in the IVF process, pain medication is given to reduce any discomfort. Then a very thin needle is passed through the upper vaginal wall. With the use of vaginal ultrasound, fluid is removed from the follicles under gentle suction.

Immediately after aspiration of the follicle, the oocyte (egg) is isolated from the follicular fluid. The egg is placed in a culture dish containing nutrient media and then transferred to the incubator.

Step 3: FertilizationThe next step of the IVF process is the fertilization of the egg. A sperm sample is secured, either from your partner or a donor, and the most active sperm is mixed with the egg in a special chamber. Sometimes the sperm is directly injected into the egg. Then, the sperm and egg are placed in an incubator and monitored to make sure that a healthy embryo develops.

Step 4: Embryo transfer and ImplantationThe final step of the IVF process is the embryo transfer. First, the embryos are examined to select the healthiest ones for transfer. To transfer the embryo(s), a speculum is placed into your vagina and the embryo(s) are transferred via a small plastic tube placed through the cervix into the uterine cavity.  After the IVF process is complete, bed rest is often advised for around 24 hours."

3rd IUI completed

Today was our 3rd IUI and we didn't get the greatest news. Our chances to conceive this month may only be 5%. Thats the lowest so far. Dr G my normal RE wasn't there today but another RE stepped up in his place. He gave us the option to deny the IUI process but we both agreed to do it anyway. You never know... He said he's seen it happen before so fingers crossed! This doctor agrees that IVF may be our only option now. Kevin's numbers have been on the low side recently and that combined with my issues...you get the point. But good news is there is some sperm so IVF will give us a good chance! I asked if there was anything we could do to increase his number and he said "not really". He doesn't drink or smoke so the only answer we have for his low count is the fact hes a welder and the heat impacts his sperm production. Good news is we may get to start IVF in May! If thats so then we wont have to wait long to get started. Lets hope this IUI is a success and we don't have to worry about it! In 2 weeks we will talk pregnancy tests so stay tuned!

Update IUI #3

 Today I found out I have two follicles on my left side one is at a 15 and the other one is at a 17 therefore we're triggering ovulation  tomorrow and hoping that I ovulate both follicles for IUI on Friday. This is the first time I had 2 follicles ready to finish maturing so that gives me a little hope!

Update IUI #3

Well, not really bad news but not good either. I have several little follicles but none really measurable. I am to continuing stimulating my ovaries and hope next time I have some growth.

5 days on 200iu gonal f

Only a couple more days until I get a follicle check and I will be really surprised if I don't have more then one follicle. I am literally feeling the pressure! Fingers crossed!

Update on 3rd and final IUI

Today I start my 3rd IUI meds. This is my final IUI before I move on to IVF. I am ready! They upped my gonal f to 200 (from 150) and switched my trigger to a intra-muscular which will hopefully work the 2nd IUI was a total fail. I didn't ovulate and had to wait twice as long for my period. Much baby dust needed!

Family

As most of you know at 14 years old my father sent me 2,000 miles away to live with my grandparents (his parents) and all ties between me, him and my siblings were cut. I felt abandoned and lonely. I had a journal where I logged all my feelings towards my father the good,  bad and ugly. At 18 I asked my grandma to send it to my dad. She told me she would but I later found out she did not. She always protects my dad even though he cut ties with her a long time before and only contacted her when he needed something.  She thought she was protecting me too so I kind of understand why... Anyway, I have no father. He bailed on me and every life event I have gone through. Graduations, marriages and soon new additions to the family (birth or adoption). I don't have many family members  physically  around me. I have a few that stick by me every way possible and some of my moms family that I talk to via e-mail and Facebook. I do talk to my mom and have a great relationship with her. My relationship with my siblings are always being repaired. We lost many years as kids and each of us have made our own individual lives. We don't keep up with each other as often as we should. I am also blessed to have a great family that I've married into. But I  want to point out how  lucky I am to have friends...who support me! Some of them I work with and some I have found on Facebook. Friends who reach out to me on the phone and in person to ask how I am doing and give me hugs of support. Family is more then a blood line... Family is a bond and unconditional love. Thanks for being my family. Before my grandparents, Kevin and the friendships I've made as an adult I didn't know what "family" was!  Much love to you all!

Update Dr.Byler-Dann

Everything looked perfect my uterus was of normal size and lining was only at 1mm (at the time of my ultrasound). I am to followup in another 6 months if I am not pregnant by then. No concerns.

Feelings entry: I am grateful

I just wanted to take the time to say I'm sorry for complaining lately. You have to understand the emotional roller coaster that this journey takes couples on. Especially when they have more than just infertility to worry about.  I had many obstacles to overcome before I could actually start  fertility treatments and when I finally got the chance to start I was only able to complete one full treatment cycle the second one failed. So I've been waiting to start the third cycle and the setback has just been emotionally overwhelming. I also have a lot on my mind which includes insurance and being able to afford IVF. IVF takes a lot of time and everything is calculated a certain way and with it already being February I also have to look at how this is going to affect the way it's billed to my insurance so basically there's just a lot on my mind and when doctors offices don't listen to me and don't take the time to talk to me it just gets very frustrating. Not to mention I don't know how much time I have left to do treatments. It's been a year and I've only had one successful cycle. I'm grateful that I have a group of friends and family members who take the time to try and understand what I'm going through and help to give me the encouragement I need to continue. I'm trying to take a grateful approach to things and this to We Shall Overcome.

Thanks for helping us by donating

I just wanted stop and write a quick blog post for people who have donated and for those who might in the future.
It truly means everything to Kevin and I when someone donates to our cause. Kevin and I dont have a lot of money and we know in these hard times how it can be a stretch to donate so we thank every single person who has donated cash and ordered blankets! The money and the fear is what has kept us from trying to build a family before and we are so grateful for our friends and the new ones we have met along the way.
If we do end up having a child they will know how loved they are and if we don't at least we know we had everyones blessing and we tried with everything we have!
Our goal no matter what is to eventually foster and adopt a child (or more) so we know no matter what we will have the completed family we so desire!
Coming up Feb 18th is our fundraiser by Sarah S and Lularoe! Looking forward to meeting new people!
Please read old posts explaining more of our journey! If you have any questions feel free to message me! If your also suffering from infertility and need a friend I am here for you.
Thank you!

-In Vitro Fertilization is assisted reproductive technology (ART) commonly referred to as IVF. IVF is the process of fertilization by manually combining an egg and sperm in a laboratory dish, and then transferring the embryo to the uterus.
- On average, nationally, a “fresh” IVF cycle costs $12,000, before medications, which typically run another $3,000 to $5,000. 

Update on late period

Went to the doctor today for a ultrasound and found out that I didn't ovulate last cycle. Which would explain why I didn't have a period. I also have a twenty-something MM cyst on one of my ovaries. Since I didn't have a period this month I'm going to have to take an injection in the butt delivered by my lovely husband with a needle as long as my index finger and of course because it's in the muscle it will hurt but we are upping the dose of my medication and going through with my next IUI following my period fingers crossed the third does the trick! I also have a appointment with my oncologist to update her on how things are going. hopefully she thinks my uterus looks ok to continue doing what we're doing it's always up to her.

Not sure whats going on!

So, today is 23 days past IUI and big fat negative pregnancy result at 14 days past trigger (13 past iui). I expected my period to start no later then 10 days after that test. We are there now (or a day or two from it). I still don't have a period! I spotted some black stuff on Monday of this week and thought it was starting but I haven't had anything since!  I called my RE yesterday and he said it was odd and wondering why I haven't started. It could be I didn't ovulate (even with a trigger shot), or my hyperplasia is coming into play. I hope it's that I didn't ovulate because if its my hyperplasia then that makes me worry! Endo hyperplasia is abnormal thickening of my lining (which is where the pre cancer cells were a few months back). I don't see my oncologist until Feb so my RE is having me come in for an ultrasound to see how my uterus looks. I am worried something is wrong... More updates as they come!