I finally got a call today with our results from the ODWU-
Me:
1)communicables- negative :)
2)AMH- 2.5 (should be above 1)
DH:
1)Sperm chromatin <16% (<=15% indicates excellent sperm DNA integrity)
2)morphology 1% (should be 3% or greater) IMSI is recommended for this result
3)motility- 26% (should be >39%)
4)count- 18.5 million (should be at least 20 million)
5)sperm antibodies- negative
6)culture- negative
Still waiting for the genetic testing (fragile X and SMA)
DH's sperm results seem better although the previous SAs were at a different lab. His motility was previously 18% and count was 10 million. Morphology was previously 2% but on a different scale so not sure if we can compare. DH is on fertility blend for men and antioxidants... maybe it has helped :) I am encouraging him to continue taking his vitamins.....sometimes he complains about them!- Ughh! If he only had to go thru what I have to!! Needles, tons of meds and side effects, hot flashes, vaginal ultrasounds- taking a few pills twice a day is nothing!
I am doing OPKs to get an idea of when cycle day 2/3 testing will be. Hope to ovulate soon!!
Thursday, May 27, 2010
Wednesday, May 26, 2010
Next Steps
Still waiting for results from the ODWU. I thought they would have called regarding the AMH and SA results by now. I called yesterday and left a message and still haven't heard back yet! It's certainly not urgent, so I will bug them again next week if I don't hear by then.
The next steps are:
1)Get results back- AMH, communicables, SA and chromatin results, genetic results (SMA,fragile X)
2) May 28th- go back to my OB to have them listen to my heart and lungs (they didn't do this for my physical!) also have them send the pathology report from my pap smear. FYI- CCRM does not accept the report that says "pap is normal" they want the pathology report.
3)Send day 3 blood work around June 14ish
4)Consult with Dr Schoolcraft mid June to review all results and discuss protocol
The next steps are:
1)Get results back- AMH, communicables, SA and chromatin results, genetic results (SMA,fragile X)
2) May 28th- go back to my OB to have them listen to my heart and lungs (they didn't do this for my physical!) also have them send the pathology report from my pap smear. FYI- CCRM does not accept the report that says "pap is normal" they want the pathology report.
3)Send day 3 blood work around June 14ish
4)Consult with Dr Schoolcraft mid June to review all results and discuss protocol
Saturday, May 22, 2010
Immunology????
If anyone is reading...what do you all think about the conflicting opinions for immunology- specifically NK cells? SIRM, my previous RE (Dr Zouves), the popular Beer Clinic and other clinic believes in NK cells. Dr Schoolcraft says it is "hocus pocus". I am not sure what to do about my cycle with CCRM. Should I just trust Dr Sch and erase it from my mind?
Here's my history with immunology- my first two failed cycles I was not tested for any immunology or clotting issues and both cycles failed. (but we also had low fert rates and slow growing embryos) At the second clinic, for our third IVF, my RE did extensive immune testing, that's what he is known for. I was treated for a slight elevation in NKcells but our embryos also were much better quality. We did get a BFP and had a successful outcome. I was only treated for NKs with one infusion IVIG, my NK cells were monitored after positive pregnancy and were within normal limits.
For our frozen transfer a couple years later we did a natural FET...which is supposed to be much easier on the immune system than a fresh cycle and I did not have any immune treatment. 4 were transferred, but only two that were growing well. We got a positive beta and it doubled, NKs were checked at that time and were normal. There was no heartbeat at our first u/s despite doubling betas. My RE thought it was probably a chromosomal loss not immune. But d&c results showed 46XY. At that point, the NKs were retested and were elevated. Did the NKs attack my baby? Is this why we lost it?
For our next fresh cycle we wanted to be proactive about the NK cells and were treated for them as a preventative measure. We did get a positive beta and I had intralipid inufusions every 3 weeks. But we lost the baby at 8wks. I freaked out and thought it was an immune cause and went to the Alan E Beer Clinic for a further immunology work-up. The d&c ended up showing that the loss was chromosomal (monosomy X).
The work-up at the Beer Clinic showed I had other clotting issues (but I had been treated with lovenox anyway since my third cycle), it also showed I have low levels of blocking antibodies so I did an IVIG infusion to bring up these levels before another fresh cycle. This fresh cycle ended in a negative despite the immunology treatment of 2 IVIG infusions. I don't think this recent failure was due to immunology...our embryos were slow growing and not the best quality. Although, we spent a lot of extra money, I am glad I did rule out an immune cause by doing the treatment.
I am not sure what to do about our upcoming cycle at CCRM. If we happen to get some CCS normals, I just don't want to take any chances. I may just have my NKcells treated as a preventative measure just in case through the Beer Clinic. I just keep thinking back to my first miscarriage.... but who knows if the NKs were really the cause of the loss. CCRM has better success rates than Zouves and SIRM and doesn't treat killer cells. I don't know what to do. Anyone else dealing with a similar dilemma or had this decision to make at CCRM? I sort of wish I never knew about the immune issues.
I don't know what to do????
Here's my history with immunology- my first two failed cycles I was not tested for any immunology or clotting issues and both cycles failed. (but we also had low fert rates and slow growing embryos) At the second clinic, for our third IVF, my RE did extensive immune testing, that's what he is known for. I was treated for a slight elevation in NKcells but our embryos also were much better quality. We did get a BFP and had a successful outcome. I was only treated for NKs with one infusion IVIG, my NK cells were monitored after positive pregnancy and were within normal limits.
For our frozen transfer a couple years later we did a natural FET...which is supposed to be much easier on the immune system than a fresh cycle and I did not have any immune treatment. 4 were transferred, but only two that were growing well. We got a positive beta and it doubled, NKs were checked at that time and were normal. There was no heartbeat at our first u/s despite doubling betas. My RE thought it was probably a chromosomal loss not immune. But d&c results showed 46XY. At that point, the NKs were retested and were elevated. Did the NKs attack my baby? Is this why we lost it?
For our next fresh cycle we wanted to be proactive about the NK cells and were treated for them as a preventative measure. We did get a positive beta and I had intralipid inufusions every 3 weeks. But we lost the baby at 8wks. I freaked out and thought it was an immune cause and went to the Alan E Beer Clinic for a further immunology work-up. The d&c ended up showing that the loss was chromosomal (monosomy X).
The work-up at the Beer Clinic showed I had other clotting issues (but I had been treated with lovenox anyway since my third cycle), it also showed I have low levels of blocking antibodies so I did an IVIG infusion to bring up these levels before another fresh cycle. This fresh cycle ended in a negative despite the immunology treatment of 2 IVIG infusions. I don't think this recent failure was due to immunology...our embryos were slow growing and not the best quality. Although, we spent a lot of extra money, I am glad I did rule out an immune cause by doing the treatment.
I am not sure what to do about our upcoming cycle at CCRM. If we happen to get some CCS normals, I just don't want to take any chances. I may just have my NKcells treated as a preventative measure just in case through the Beer Clinic. I just keep thinking back to my first miscarriage.... but who knows if the NKs were really the cause of the loss. CCRM has better success rates than Zouves and SIRM and doesn't treat killer cells. I don't know what to do. Anyone else dealing with a similar dilemma or had this decision to make at CCRM? I sort of wish I never knew about the immune issues.
I don't know what to do????
Tuesday, May 18, 2010
ODWU update
Here's the update on my ODWU!!
We arrived at CCRM at 1000am for our first appt as the schedule stated, but found out we missed our first appointment at 9am!!! I was never contacted about the change on our schedule! (when I arrived home I found a message on my home phone) They were very accommodating and said they would squeeze everything in. Our first appointment was supposed to be a medication review with the nurse.
At 1000am my DH went to submit his sperm sample while I had my doppler ultrasound and antral follicle count. My AFC was approximately 17 and my ovaries looked good :) The uterine blood flow to my ovaries were normal.... no resistance. Yay! My next appointment was with Schoolcraft for a hysteroscopy. I was so nervous to meet him! I have to say...I did not really like his bedside manner on the phone for my first consult with him in January. I have also heard he isn't the most warm and friendly guy. Fortunately, he had a smile and was friendly and chatted with me during the procedure. What a relief! The hysteroscopy was so quick and painless....my uterus looked good!
After that, we met with Dr Schoolcraft in his office...he said my uterus looks great and we aren't dealing with uterine issues. He thought it was great I have lots of eggs and seemed positive. We talked about our failures/history. I gave him my most recent cycle records (since I had another fresh cycle locally after our consult with him in January). He reviewed the records... he thinks that the protocol I was on for the last cycle (MDL) was too aggressive for me and may have affected the quality of my eggs. Although I did tell him I did like getting a lot of eggs (we got 27!!) but agreed that we want quality over quantity. We had done PGD for our most recent failure- he said PGD results aren't acccurate (based on a study he referred to) and it can also lower implantation rates. Ughh! What a waste of almost $4000!! and possibly the reason we had a failure!! Our day 5 embryos on our last two cycles have been slow growing. So we're hoping the lab will help us. We asked him if we should do CCS- and he thought it would be a good idea since we've had quite a few failures. I asked if we could plan for a freeze all - and he thought for sure to plan for that... so that was promising to hear. Dr Schoolcraft also thought that we have a good chance for success especially since we already have had a child via IVF. I was relieved that he was so positive. My worry though, is that every RE we've been with is positive about us and we tend to get just okay results. I just hope that doesn't happen at CCRM!!!
After our consult, we met with our nurse, Cathy. She was very nice, thorough and knowledgeable. We liked her. We spent about an hour going over all the info in the IVF binder....some of it we skipped over since we are vets at this stuff. She said we could probably get started sooner than I thought. But I think we will wait so that my retrieval is in August to give us time to plan for travel and so that I can continue to rest and prepare my body. It's so crazy for me to say this because I am usually wanting to get going ASAP.
Next, we had our blood drawn- the required communicables, two genetic tests for me (SMA and Fragile X), and AMH for me. I am curious to find out the AMH results since I have never had this test done. I picked up my day 3 kit to take home with me :) Thanks to my blogger friends who gave the tip :)
Lastly, we signed our consents and met with finance. I think my husband had sticker shock from the ODWU (spent about $3000) and the costs of the IVF cycle especially if we end up doing CCS testing which their prices increased to 6850!! Yikes. Definitely makes us reconsider CCS testing. We will probably do it, but only if we get a good number of blasts. I am not sure if you can make the decision last minute. I hope you can.... I will have to ask more about this. I think the CCS testing has lots of advantages and the success rates are amazing. I don't think I can handle another BFN or miscarriage.... this has got to work this time. And if we happen to get no normals at least it would make more sense to move on from this. It would also be nice to know if we end up having frozens if they are normal and worth going back for.
We were done by about 2pm (although we didn't break for lunch- maybe b/c we had to catch up since we missed our 9am appt). When we were done we headed to lunch at Cheescake Factory and talked. DH is in agreement that this is our best option. Overall, we both felt encouraged by the consult with Schoolcraft. I hear he tends to underestimate your chances so it's hopeful that he was positive for us. He said he thought we had a better chance than most that travel out of state :)
I was so happy and positive the day of the work up. But today I started having all of these doubts. I am scared. Even though Schoolcraft is positive doesn't mean it will work. I am sure it would work if we could do a few more cycles, but this is probably our last shot. I hope he gets the protocol right! I hope our fert rates improve, I hope our embryos thrive. It's not a guarantee. The rollercoaster of emotions are happening and will continue for months....I am dreading this...especially as the cycle gets started. Even if we make it to CCS testing- the wait will be excruciating. And even if we transfer normals it will still be nerve racking. I tend to over worry about everything! Every number, every test, every result, every decision, just everything! UGHHHH! It goes back and forth between positivity and negativity the whole way thru.
I should try to enjoy our next two months off it's gonna be one wild ride!!
We arrived at CCRM at 1000am for our first appt as the schedule stated, but found out we missed our first appointment at 9am!!! I was never contacted about the change on our schedule! (when I arrived home I found a message on my home phone) They were very accommodating and said they would squeeze everything in. Our first appointment was supposed to be a medication review with the nurse.
At 1000am my DH went to submit his sperm sample while I had my doppler ultrasound and antral follicle count. My AFC was approximately 17 and my ovaries looked good :) The uterine blood flow to my ovaries were normal.... no resistance. Yay! My next appointment was with Schoolcraft for a hysteroscopy. I was so nervous to meet him! I have to say...I did not really like his bedside manner on the phone for my first consult with him in January. I have also heard he isn't the most warm and friendly guy. Fortunately, he had a smile and was friendly and chatted with me during the procedure. What a relief! The hysteroscopy was so quick and painless....my uterus looked good!
After that, we met with Dr Schoolcraft in his office...he said my uterus looks great and we aren't dealing with uterine issues. He thought it was great I have lots of eggs and seemed positive. We talked about our failures/history. I gave him my most recent cycle records (since I had another fresh cycle locally after our consult with him in January). He reviewed the records... he thinks that the protocol I was on for the last cycle (MDL) was too aggressive for me and may have affected the quality of my eggs. Although I did tell him I did like getting a lot of eggs (we got 27!!) but agreed that we want quality over quantity. We had done PGD for our most recent failure- he said PGD results aren't acccurate (based on a study he referred to) and it can also lower implantation rates. Ughh! What a waste of almost $4000!! and possibly the reason we had a failure!! Our day 5 embryos on our last two cycles have been slow growing. So we're hoping the lab will help us. We asked him if we should do CCS- and he thought it would be a good idea since we've had quite a few failures. I asked if we could plan for a freeze all - and he thought for sure to plan for that... so that was promising to hear. Dr Schoolcraft also thought that we have a good chance for success especially since we already have had a child via IVF. I was relieved that he was so positive. My worry though, is that every RE we've been with is positive about us and we tend to get just okay results. I just hope that doesn't happen at CCRM!!!
After our consult, we met with our nurse, Cathy. She was very nice, thorough and knowledgeable. We liked her. We spent about an hour going over all the info in the IVF binder....some of it we skipped over since we are vets at this stuff. She said we could probably get started sooner than I thought. But I think we will wait so that my retrieval is in August to give us time to plan for travel and so that I can continue to rest and prepare my body. It's so crazy for me to say this because I am usually wanting to get going ASAP.
Next, we had our blood drawn- the required communicables, two genetic tests for me (SMA and Fragile X), and AMH for me. I am curious to find out the AMH results since I have never had this test done. I picked up my day 3 kit to take home with me :) Thanks to my blogger friends who gave the tip :)
Lastly, we signed our consents and met with finance. I think my husband had sticker shock from the ODWU (spent about $3000) and the costs of the IVF cycle especially if we end up doing CCS testing which their prices increased to 6850!! Yikes. Definitely makes us reconsider CCS testing. We will probably do it, but only if we get a good number of blasts. I am not sure if you can make the decision last minute. I hope you can.... I will have to ask more about this. I think the CCS testing has lots of advantages and the success rates are amazing. I don't think I can handle another BFN or miscarriage.... this has got to work this time. And if we happen to get no normals at least it would make more sense to move on from this. It would also be nice to know if we end up having frozens if they are normal and worth going back for.
We were done by about 2pm (although we didn't break for lunch- maybe b/c we had to catch up since we missed our 9am appt). When we were done we headed to lunch at Cheescake Factory and talked. DH is in agreement that this is our best option. Overall, we both felt encouraged by the consult with Schoolcraft. I hear he tends to underestimate your chances so it's hopeful that he was positive for us. He said he thought we had a better chance than most that travel out of state :)
I was so happy and positive the day of the work up. But today I started having all of these doubts. I am scared. Even though Schoolcraft is positive doesn't mean it will work. I am sure it would work if we could do a few more cycles, but this is probably our last shot. I hope he gets the protocol right! I hope our fert rates improve, I hope our embryos thrive. It's not a guarantee. The rollercoaster of emotions are happening and will continue for months....I am dreading this...especially as the cycle gets started. Even if we make it to CCS testing- the wait will be excruciating. And even if we transfer normals it will still be nerve racking. I tend to over worry about everything! Every number, every test, every result, every decision, just everything! UGHHHH! It goes back and forth between positivity and negativity the whole way thru.
I should try to enjoy our next two months off it's gonna be one wild ride!!
Tuesday, May 11, 2010
Wahoo! We're going to Colorado!
Wahoo! AF finally showed very late this evening! Thank goodness.. it needed to show by Thursday and I was starting to get nervous. So thankful we can keep our plans!! I am so excited to get moving at CCRM. I can't believe we are actually going. I am excited but also anxious about what they have to say for us. When I had my consult with Schooly back in January I was in a totally different frame of mind.... I was mainly just calling for a second opinion (he didn't say much- so it wasn't much help) and did not plan on going there. But now I have tons of questions and am so interested to hear what he has to say for us! It will be great to finally be an "official" patient and get this process going!
Monday, May 10, 2010
Test results
I have Hashimoto's Thyroiditis...so I have to keep an eye on my TSH levels. Every pregnancy I've had this summer has brought up my TSH level even while on synthroid. I was up to 100mcg. My most recent TSH level is now too low at .1 (it was 2.6 in March)! So my thyroid dose is now adjusted to 75mcg. Up, up, up and down. This thyroid stuff is a pain. I guess I will have to deal with it for the rest of my life. Ughh!
The other test I had done was a karyotype. My husband had his done at the very beginning even before we started IVF, probably since we had male factor (his is normal) I was a little nervous to hear the results....but thankfully I am a "normal female"!! Yay!
My pap results came back the other day- normal too! Wahoo!
Still waiting for AF! I feel like it's coming, I have a headache tonight, I'm emotional (cried at my acupuncture appt for no apparent reason today), my lower back is achy and I am crampy. AF has got to be around the corner! I hope so.
The other test I had done was a karyotype. My husband had his done at the very beginning even before we started IVF, probably since we had male factor (his is normal) I was a little nervous to hear the results....but thankfully I am a "normal female"!! Yay!
My pap results came back the other day- normal too! Wahoo!
Still waiting for AF! I feel like it's coming, I have a headache tonight, I'm emotional (cried at my acupuncture appt for no apparent reason today), my lower back is achy and I am crampy. AF has got to be around the corner! I hope so.
Thursday, May 6, 2010
Please come AF!!
AF is due in the next few days. I hope it comes on time or I will have to change our ODWU plans. I already made flights and my husband is flying out a few days before to visit his best friend who lives in Colorado. I am planning on flying out Sunday night and our workup is on Monday. AF needs to arrive by May 13th for me to be on cycle day 5 on the 17th. I hope it all works out.. I am really looking forward to going and don't want to have to change our plans!!! Please come AF!!! Please!!!
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