CD 15: Embryo Transfer day! 0dp3dt

Our Day 3 embryo transfer went perfectly. I am now - dare I even type it? - PUPO!

Since our appointment was at 11.10am, we didn't rush getting up. I woke at about 7.30am and made us both tea and toast (I am on caffeine free tea, but not being terribly strict about it).

We packed up the motel room and drove down to the lake for a walk. Since it's spring here in NZ, there are just loads of cute baby animals all around. Awww! I saw 3 baby pukekoes and a bunch of ducklings. In case you have never heard of a pukeko, here is a pic:

Source. These rather prehistoric looking creatures have enormous feet and live in fields and wetlands.

And that is not counting all the baby lambs and calves, and kid-goats and piglets I saw out the window on the car on the drive up!

Focus. Ok, so it went really well. When we got to the clinic I was busting, since they needed me to drink lots of water for the external ultrasound. We were shown to a room where I could get changed into the beautiful hospital gown moo-moo. Once again I clipped my insulin pump to the neckline, and we then found I'd cleverly left the Dexcom receiver down in the car! Poor Hubby had to race back down to get it. The embryologist and Dr G both came to see us, and nurse M gave us a gently-toned lecture about keeping my core body temperature after the procedure, and using the progesterone pessaries until told to stop.

We were led through to the OR with the spaceship door, and I had to walk right around the bed and climb on. The lovely nurse D was helping setup the bed with stirrups and towels and stuff, and Hubby took a seat to the left of my head. The ultrasound screen was, as before, to the right of my legs and then - I looked more to the right, past the hatch to the lab - I saw our one little embryo on screen!!!! The photo had been take yesterday when it was just a 6-cell, although the embryologist, M, had said it was now a great looking 8-cell. We only get to transfer 1 embryo since this is a publicly funded cycle, and even then I don't think anyone would be in a hurry to risk multiples in a Type 1 Diabetic woman.

Hubby and I were both shocked at this tiny little thing. Granted, it was magnified to be about 10cm wide on screen (only 125 microns in real life, we later learned) but it was amazing. I am hoping to receive a copy of the pic soon, will share when I get it!

Nurse D squeezed gel on my tummy and used the ultrasound thing to show us my (full) badder and uterus-squashed-flattish-under-said-bladder. She showed us where to look. Then Dr G came in and both of them laughed about how no one had told the lab that we were in here, and how there was some mild role-reversal going on with doc making the call to the lab and nurse working the ultrasound!

The doctor inserted the speculum and did something else, advising me I would feel some "mild tugging" on my cervix. Now, how am I supposed to know what that should feel like, eh? Anyway, to me it felt like a catheter being inserted - I could feel it go the length of the, um, journey into my cervix and there was some mild stingy/cold (very mild), mainly tickley sensations. Not unpleasant at all. Just weird as it was novel. This was not the real deal yet, so I'm now entirely sure what Dr G was doing, a test run maybe?

Next thing they were checking my name and date of birth again, Dr G checked the name matched the petri dish on the shelf at the lab-hatch. The lab tech then loaded up the catheter from the petri dish. I could see her peering under the microscope and taking her time/having a devil of a job scooping up the embryo into the catheter. She passed it carefully through the hatch to the doctor, I made sure to watch the screen and take a deep breath.

Of course, I was looking in the wrong place. I caught the "bright spot" out the corner of my eye right in the centre of the screen, but Hubby saw it no worries. It stayed bright for the time the ultrasound was trained on it, and Dr G told us that it was the bubble of liquid around the embryo that we could see.

And then it was over. I wasn't asked to lie down for an hour. I could get up right away and make my way back to the first room. Cue a stream of nurses all telling me to avoid raising my core body temperature, again. Nurse H, Nurse D, and Dr G all wished us best of luck and that they hoped it would work for us.

So that is that. We drove home this afternoon. I had a horrendous high blood sugar caused by a not so brilliant lunch choice, and that damn progesterone. Seriously, that stuff is an absolute nightmare for a diabetic, let alone one who is now supposed to be watching her blood sugars like a hawk! I am having to set a 20% basal increase for 2hrs every time I have the progesterone, although unlike an injection I never know when it's going to "kick in"! Arrgh!

Apart from that it's all good. Surreal, but good. I don't feel any different and it will be nice just to be calm for a while with no trips back to Hamilton planned for the near future.

p.s. So, you are wondering about the other embryos eh? Well, yesterday the second-best one was a 5-cell and had grown to a 6-cell today. They will culture it on and if it gets to blastocyst stage, then it will go into the freezer. The other one stopped growing at 3-cells. I kinda wished we had at least one more to freeze, knowing that we have had a pretty consistent 40% attrition rate all along this journey. Maybe my stim meds were not strong enough? Oh well. For now, I will wait and see what happens at the end of the 2ww.

p.p.s. Dr G said I have a small polyp on my cervix. Looks benign, but that sux.

CD 8 + 9: A Scan and a Mega Road Trip

Wow. What a way to spend a Tuesday. We have just returned from the clinic where we did the first ultrasound scan to check this IVF cycle is on track.

Results: Yes, all good.

Lining = 7.9 mm

Left side: 12, 16, 14, and 13 mm follicles

Right side: 16, 16, and 14 mm follicles

Total of 7, although the nurse said at this stage only 6 of them will probably be useful.

My scribbly notes from the meeting post-scan with the nurse.

The scan itself was the only part of the day that went well.

We started off getting up nice and early, and realising we had forgotten to pack any breakfast and wouldn't have time to get to our favourite cafe. I was due to have a FSH and Oestradiol blood test early enough to get the results in to the clinic. Got over to the path lab at 8.05am and I walked in while Hubby waited in the car. The waiting room was about a third full, and I started the-first-of-the-things-to-go-wrong! It took over 35 mins for the technician to call my name, which was plenty of time for Hubby to get worried and come looking for me.

We hurried out of there, and had 20 mins so we skipped around the corner to a cafe and got a quick bite of quiche lorraine and a cuppa tea.

In the clinic doors and up to the reception. The clinic is arranged with two wings, I like to call them the "office" and "doctor" wings. I was expecting us to be led through to the office wing to have the scan, like last time, but instead we were given a slip of paper and told to go across to the doctor wing. The doctor wing has no reception, and you have to just wait, in limbo, in the waiting room for the locked doctor-doors to open. Sometimes someone in the office will take pity and come and check on you, but most of the time we get left there for ages staring at the horrid crart (craft-art).

The nurse associated with our old Dr R came out to see us, and informed us that we were terribly early. To which I said, no, you are 6 mins late! She then pointed to the slip of paper and it did indeed say 10.22am. We had been told 9.10am!!! "Oh! But so-and-so called you yesterday and left a message!" I said no, I got no messages and no phone calls. I have asked them who-knows how many times to EMAIL ME. How hard is that? This nurse gets super-defensive very quickly, and sure enough she was intimating that I didn't know how to work my phone, or Hubby his phone, or either of us our home phone!! Grrr. Long story short we had another hours wait, so we took off and drove to a mall. I was wanting a bit of walk and it was raining, so a mall seemed like a semi-tolerable option. Of course, as soon as we got there it was time to turn around and come back. Red lights all the way back to the clinic.

When we strode into the doctor side for the second time, there were two other couples (?) in the waiting room. One of them had a toddler (! Why would you do this??? To the other patients? I mean really? You brought your CHILD to a fertility clinic. Words fail me.) and when a passing nurse asked who we were and what time our appointment was for, I said "9.10" this patient-with-toddler snidely commented "9.10!!" because we were now a tad late. Grr. Anyway we were hurried through the locked doors and I was asked to go for a wee then join Hubby and the doc in the scan room.

A new nurse, a new doc. Just whoever was on-call. I don't know their names. "Just take your bottom-things off" I nearly cracked up. Damn, should not have worn skin-tight skinny jeans! Doh! I was just hopping up on the exam table when the doc whipped back the curtain and at the very same moment my knee went through a hole in the table! Turns out it is a fancy pants table/bed and most people do not get on it knee first. lol.

Ice broken.

The scan went well, no pain at all. See the good scan results above. 7 follies. Definitely no over stimulation. Whew.

Pants on, go next door to get more drugs and talk to the nurse.

Turns out the egg retrieval will be this Friday (3 days away CD 12). I have one more stim injection of Puregon which I have given myself tonight (Tues CD 9). Tomorrow morning (Weds CD 10) I have the last Orgalutran injection, and in the afternoon the clinic will call to tell me what time to give the trigger Ovidrel injection. It has to be given exactly 36hrs prior to the egg collection procedure.

We asked what that procedure would be like, and the nurse said it was done under sedation (hyponovel and fentanyl) and should take about 10 - 15 mins in theatre. I asked to have a dextrose IV ready, and Hubby asked to have the IV cannula inserted as early as possible because we have learnt from prior surgery that a diabetic hypo + collapsed veins = no fun. The nurse agreed that this was all a good idea, and then said "so are you what, type 1 diabetic?" This was after telling her directly that I was type 1 diabetic, and showing her my dexcom and insulin pump prior to the scan to check it wouldn't interfere with the ultrasound. So she finally understood (at one point she thought it was Hubby who was the diabetic one! Read the medical notes PLEASE) and went to check with another doc if the egg retrieval procedure could be scheduled as late as possible so that I could still eat breakfast on Friday morning. This was after telling her not to worry, and that I would prefer the first appointment actually, and that I could miss a meal now that I am on the pump. People hear what they want to hear, not what you tell them sometimes.

She gave us these drugs:

Puregon Pen and needles.

My dosage for tonight is 150 more units of stimulation using the drug Puregon this time.

Puregon (Tuesday night, 150 units) (for the record, I had an unexpected low blood sugar 30 mins after injection. Don't know if it's related or not.)

Orgalutran (for tomorrow morning, this one is to prevent premature ovulation)

Ovidrel (this one is the trigger injection and is to be given 36 hrs before egg collection)

It was a bit hilarious being taught how to use the puregon pen, considering I had been doing multiple daily injections for diabetes since I was 5. Still good to watch and just make sure there was nothing new to see.

We got out of there are started the drive home knowing that a major storm had just thrashed the north island and the road south was currently closed.

The trip should consist of 3 hrs in the car going across one mountain.

It ended up taking us 9.5 hrs, and we went to 3 cities, tried to get over 1 mountain, went around 2 other mountains, across a gazillion rivers, through a million puddles, past a trillion slips and goats, and got turned back back sorry-for-themselves looking road workers in orange jackets telling us "the bridge has been washed away" "there is severe flooding" "you will have to go back" "the road is closed".

We were trying to go from a northern region to the south-western region. We ended up having to go south-east, then more south, then more east, then very south, to come right around and enter the western region from the south instead of the north! It was the longest road trip of my life and it is the only occasion that I have physically been unable to get to my homeland. At one point, I considered how it would have been easier to fly to Australia and back in, rather than drive!

But we are finally home. Everything went wrong except for the scan!

Oh, and I have to go in for a blood test tomorrow morning, do an infusion site change, and teach a class. Oh and re-book the motel for Friday. I need a nap.

p.s. If you're wondering what happened to CD 8: I went to work and taught class in the morning, then we drove up to Hamilton and checked into the motel. I had my Orgalutran injection in the morning and did a +20% temp basal increase for 4 hours which worked great guns.