Good Morning! :) I'll provide a more detailed report after church - but wanted you to know that we got a great report from the lab. We are back to having 13 embryos still progressing and dividing!
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2 Cell, 3 Cell, & 4 Cell Embryos Good Afternoon! We received our update from the lab this morning shortly after 9AM from Kelly, one of the embryologists that we remember working with during our previous cycle. She reminded us that at this point, we just want the embryos to have divided to 2-4 cells. On Day 2, they also start grading the embryos on a rating scale of 1-5 with 1 being the highest/best quality. The great news is that we have 12 embryos left that are still fighting for the chance to be transferred (or frozen):
Kelly did tell us about the other 2 embryos from the original 14. One of them is still in the 2 pronuclei state - which they said is rare, because most cells either continue to divide or lose the 2 nucuclei state. For that embryo, they are going to keep monitoring it to see what happens. So it's not completely out of the game, but she said not to get our hopes up too much about it at this point. The other embryo actually had 3 pronuclei - which is considered an abnormal embryo that cannot result in a live pregnancy. I found a link that has more information about it - but it sounds like this abnormality can be caused by the egg being fertilized by more than one sperm. Since it only happened to one of our embryos, I'm guessing it was just a one-off thing. But that embryo has been disposed of and is officially out of the running to be Baby Johnston. Why is there no Day 4 transfer? We have been asked by many family members and friends why there's only a Day 3 or Day 5 transfer. My husband and I have come up with some pretty good explanations - but we got the real answer from Kelly this morning. I'm so glad my husband thought to ask her before we got off the phone with her. :) The reason that they don't do any Day 4 transfers is because on Day 4 the embryos are in a stage of development (called "morula") - where the embryologists can't grade them and determine which ones are the best to transfer. This makes sense because in reading my blog posts from 2011, they didn't give us a lab report the day before our embryo transfer (which was Day 4). So on Day 3 and Day 5, the embryos are in a stage of development where embryologists can make decisions on which ones to transfer. My husband asked her if they've ever done a Day 4 transfer and she did say that she recalls one time that they did it on the patient's request because they wanted their doctor to do the transfer. Seem kinda silly to argue with the lab's best practices - but you gotta do what you think is best, I guess. Since we have so many embryos and they seem to be doing well so far, we will have the Day 5 transfer on Tuesday. And they did tell us on Thursday that Dr. Williams will do the transfer if it's on Tuesday. The lab will call us tomorrow with our Day 3 update. Oh, and I did ask her how many dishes our embryos are in and she said they are all in 3 dishes - in case you're wondering. I hope they're all behaving and getting along well. :) Continued prayers that our little embryos continue to divide! What our embryos look like at this stage Good Morning! :) We got some wonderful news from the lab this morning around 9:30AM. Dean (one of the embryologists) told us that of our 20 eggs - 18 were mature. And of those 18 mature eggs, 14 of them fertilized - so we have 14 embryos! We were ecstatic to hear that we have 14 Johnston embryos in the lab. There's no guarantee that fertilization will happen - so we are so thankful that we have 14 embryos. He also said that we are definitely looking like a Tuesday (Day 5) transfer at this point because we have so many embryos. But they will call us with updates tomorrow and on Sunday to let us know how the 14 are developing.
We were a little thrown off (as I'm sure you may be as well) about his initial comment about our "20 eggs." When we left the office yesterday, they told us we had 18. I asked Dean about that and he said that although initially 18 were counted - they did end up finding 2 more after we left. I guess it's better that they under-counted vs. over-counted, right? Either way - we are so happy to still have 14 little embryos in the running. As long as most of them continue to divide/develop - it looks like we should have enough embryos for both transfers and maybe even some to freeze as well. Yay! So far, so good. :) I would like to shout-out a "HAPPY BIRTHDAY" (Frosty the Snowman style) to Elphie! Welcome to the 33 year old club, OLB!! And thanks for using all of your birthday wishes on us. Card from my sister & her family :) Good Evening! Our Valentine's Day could not have gone any better. :) I woke up around 5AM and checked the clock - not sure if I was nervous that we would oversleep and miss our appointment or what. But as always, I was able to quickly go back to sleep. I took the whole day off of work and my husband took the morning off - so we got to sleep in. My sister stopped by on her way to work to give us hugs and drop off a cute card from her family. It was nice to see her smiling face this morning. :) Our morning was pretty relaxed, I took my Xanax pill at 8:20AM and we were out the door around 8:30AM. I was pretty thirsty and a little hungry - but nothing to eat/drink for me! During our drive this morning, my husband was joking about how relaxed I was and how it must be the Xanax. I'm normally pretty calm, so it's hard to tell if it was affecting me or not. But I did feel calm and relaxed! :) Avela Pharmacy: Since Teri (one of the nurses) didn't know that we wanted to do a double transfer when she ordered our meds, she had given me a prescription for Medrol and Progesterone in Oil. I told Chris on Tuesday that I was planning to just fill both prescriptions on Thursday - but she mentioned that she had some Progesterone in Oil that we could just have. Very nice of them to just give us that for free. The Avela Pharmacy is in the same building as ORM, so we just stopped in there to get my Medrol pills. The purpose of these pills are to weaken my immune system so that my body doesn't try to attack the embryo when they are transferred back in. My sister and I will both take these for 6 days - 1 pill every night, starting with tonight. Stopping by the lab 9:05AM @ the Lab: After swinging by Avela Pharmacy, we had a little time to spare - so we hung out in our car and played a few iPhone games to pass the time. Promptly at 9:05AM, we headed into the lab. The guy that greeted us seemed to be expecting us as he took us right into the office to fill out the paperwork. We had to provide IDs - which he copied onto the bottom of our embryo form. And he had us verify the information listed for both of us. We also had to sign some paperwork saying that we want them to thaw my husband's sperm that's been pre-tested, that we understand there could be extra fees, and that we want them to freeze any extra embryos that aren't transferred. We also made sure that he was aware that we wanted to transfer embryos into both my sister and me. He knew we were considering it but seemed to think we were still undecided. So we clarified that as long as we have enough embryos for both of us - we wanted to move forward with the double transfer. The embryo form that is used for the transfer had my sister listed as the recipient of the embryo. I asked him if they would need to create another version of that form for the transfer of any embryos that may go into me. He said they'd have to figure that out. My husband joked with him and said, "Oh, you don't have this scenario everyday?" And the guy said that he thinks they've had it once before. I think my hubby was a little disappointed that we weren't the first. ;) He did say that it all depends on how things go, but that we may not have any extra embryos to freeze if we're both getting the transfer. 9:30AM ORM: Even though we were a little early, we headed straight over to ORM to check in for the actual egg retrieval. The waiting room was empty! I'm thinking that they do all of the ultrasound/lab work in the 8 o'clock hour, the artificial inseminations in the 9 o'clock hour, the retrievals in the 10 o'clock hour, and the transfers in the 11 o'clock hour. After a short wait, Chris came to take us back. Last time we did a retrieval (two years ago) - they took us to back room to do some of the prep work since the room wasn't quite ready yet. But this time she took us straight to the room where the egg retrieval would take place - it's also the same room that I had my ultrasound in earlier this week. First, she asked me to tell her when we took the trigger shot. I told her it was on Tuesday night and then started to say "eight..." but then corrected myself with "10:20pm." I think I had the 8:20am Xanax thing on my mind. I gave her my empty Ovidrel syringes that they asked us to bring in. After that, it was time for me to get ready for the retrieval. Chris told me to use the restroom and then use the 3 obstetric wipes (front to back) afterwards. I remembered that from last time - guess we want to make sure everything is nice and clean. :) There is a restroom connected to that room, which is convenient. I peeked back in the room and Chris was giving Joby the post-retrieval and pre-transfer instructions. I asked her if I should undress now and she said that I should. Ready for the Retreival! :) So just like the other appointments, I undressed from the waist down and headed back into the room. I had a seat on the exam table and had the lovely sheet across my lap. For retrievals, they have a pillow for us to use and Chris brought in a red blanket that was nice and toasty. She told us that Amy would be in shortly to give me the narcotic injection. While we waited for Amy, we talked about how many eggs we thought we would get. My husband was thinking 15 and I was thinking maybe 12 would be good. We also talked about how the embryologist said we probably wouldn't have any embryos to freeze - I mean, doesn't he know that we had 6 embryos to freeze last time? :) Next, Amy came back in to continue with my pre-retrieval prep work. She came in and checked my pulse and took my blood pressure. They need to monitor my blood pressure after the narcotic and after the retrieval - to make sure there wasn't any sudden changes in it. She also gave me the narcotic injection around 10 o'clock. I just had to lay on my side and she gave me the injection - just a little poke, no big deal. She asked if I had nausea with it last time and I told her that I didn't. She said that the narcotic does dry things up - so that my mouth would probably feel dry for the next couple of hours. And that I shouldn't walk unassisted for the next couple of hours or drive (or operate heavy farm machinery) for the rest of the day. She pretty much made my morning when she told us that we were welcome to play any music (if we brought any) while we waited. My husband and I had Pandora playing within seconds - at first I had it on the "NKOTB" station, but then thought the "Carrie Underwood" station might be best. She came in a few more times to check in on me and make sure I was still doing alright. The shot made me feel a little groggy - but I was still alert and aware of what was going on. While we waited for Dr. Williams and team to come back for the egg retrieval, we chatted about which room we would make the baby room if we had one or two or more babies. My husband doesn't normally like to talk too much about future baby plans - so it was nice to just talk through the "what if" scenarios. We also got a few texts from friends/family during our wait, so we took some time to respond to them as well. Retrieval Room - note the little door that connects to the lab! :) Egg Hunting Time: Sometime after 10:20am, Dr. Williams and Chris came back into the room for the egg retrieval. And around that time, the little door in the wall was opened by our embryologist. (The patient rooms on the one side of the office share a wall with the lab that is next-door. These rooms have a little doors within those connecting walls so that the nurse can pass the tubes to the embryologists during the retrieval. Pretty smart!) There was a sign on the inside of the door listing my name and date of birth - which the embryologist had me confirm. Dr. Williams also made sure that the embryologist knew that we were using my sister and that we wanted to put the best embryos into her. He also asked how she was doing with all of the shots, I told him that she was doing great - but that now that she's onto the progesterone shots, she's missing the Lupron shots. We also had a little small talk about Valentine's Day and Dr. Williams commented on my pink/green froggy socks. He also said his wife asked if he was wearing red because of it. Turns out he was really wearing it for the OSU b-ball game tonight - so we talked about how my parents and sister's family were going to the game tonight. During this time, I think he gave me a couple shots of local anesthetics down in my southern girl parts - but besides a couple pokes, it didn't really hurt. I'm guessing I have the narcotic shot to thank for that. :) Somehow we also started talking about the # of eggs and I think Dr. Williams was trying to level-set our expectations about our 18 eggs from last cycle. I told him that we had talked to Penny and how she said not to expect 18 again. Nice of them to look out for us - but little did we all know that they would be able to get 18 again! For the actual retrieval, Dr. Williams uses the normal ultrasound wand to see what he's doing in there and a REALLY long needle to drain each of the follicles. Each follicle has fluid in it - along with a stalk that has the egg attached to it. My husband told me that Dr. Williams had a pedal that he was using to trigger the contents of the follicle to be sucked out through the needle. The needle is connected to a long tube that Chris was using to fill up test tubes with the fluid. As the test tubes would get filled up, she would pass them through the little door to the embryologist. Dr. Williams told us that the embryologist was then filtering the fluid to find the eggs within each of the tubes. While Dr. Williams was draining the follicles, my music was still playing on Pandora - which I loved. I also asked him when the follicles would've released the eggs had we not done the retrieval. He said probably within the next 20 minutes or so - which explains why the timing of everything is so critical for this part of the cycle. It is quite fascinating to watch this all happen on the ultrasound screen. We could watch Dr. Williams search around for the follicles, poke each one with the needle, and drain it. He started on the left ovary - which had more follicles. Then he moved to the right ovary - draining the follicles one-by-one. It's kinda weird to be watching it on the ultrasound as it happened inside of me - it wasn't painful, but I could definitely feel some pressure each time a follicle was poked. After he got done with the right ovary, Dr. Williams checked both ovaries one last time to make sure had had gotten all of the follicles and then he was done! The whole thing took just about 10 minutes! The embryologist was calling out counts as he counted the embryos. Even though he was a little behind Dr. Williams in the process, the last number I heard him call out was 8. So based on that, I thought we would be lucky to get 10 at that point. Dr. Williams told us that they would give us the official count before we left, told us that the retrieval went great, shook our hands, and told us that Amy would be back with us shortly. We were glad that the retrieval part went so well and were just anxious to find out how many we got. Amy came back in and gave me a little cup of water to sip on. She checked my blood pressure again and it had remained stable throughout. Turns out she's a country music fan, so she was enjoying our Pandora music. She checked under my hood to make sure there wasn't any excessive bleeding going on down there and cleaned me up. She told us that I could get dressed now and just asked that my husband help me - since I would probably still be a little woozy. She left and we got me dressed again - the hardest part was getting my tennis shoes back on. ;) When Amy came back, she asked how I was feeling and had me sit up on the side of the exam table. She also reminded me that I would feel bloated/full after the procedure - because all of the follicles are going to fill back up with fluid/blood. But that it's really important for me to drink lots of fluids and to monitor any sudden weight gain. Starting tomorrow, they need me to drink a minimum of 64 ounces and keep track of it to make sure I'm drinking enough. I'm also supposed to weigh myself in the morning as a baseline and let them know if I gain more than 2 lbs overnight. At the end, she asked if we had received our official count yet and we told her that we had not. So she left to go get that information for us. When she got back, she opened the door and just said "Eighteen!" I think my response was, "Really?!?! Wow...." We were shocked and happily surprised. My husband told me in the car that he thought he had heard the embryologist say "eighteen" through the wall when Amy was checking on me - but he figured maybe he misheard him or it was for another couple. Just seems so unbelievable that they would get 18 eggs from me again! Guess I still got it after all - YAY! :) Connie the Conception Frog Relaxing at Home: We got home by 11:30AM this morning - which seems so long ago. I was escorted to bed and pretty much spent the rest of the morning/afternoon in bed. For awhile, I was texting friends back and talking on the phone to my parents and my sister. My husband called his parents on our drive home. He also gave me some cute Valentine's Day gifts - an adorable frog card, a little froggy stuffed animal, and some Mike & Ike candy. :) Since today is conception day for our babies - we decided to name the frog, "Connie the Conception Frog" - or just "Connie," for short. I listened to Pandora on my phone and napped off/on until about 2:30PM. My husband brought me lunch-in-bed, which was so nice. I wasn't on strict bedrest today or anything - they just told me to take it easy. So it was sweet of him to wait on me! Later in the afternoon I watched some shows and caught up on a few cards I'd been meaning to send out. My parents stopped by when they got into town for the OSU b-ball game - so nice to see them. After my husband logged off of work, we watched "Survivor" and then headed downstairs to heat up some leftovers for dinner. We played a couple rounds of Sequence (Thanks, OU Oh Yeah!) while watching the OSU b-ball game. He beat me twice! :) And then I came up to blog and here I am. :) Minocin, Progesterone, & Medrol - Oh My! Earlier in the day, I could definitely tell that something had been done to me - but no sharp pains or major discomfort. I felt some cramping throughout the day - but nothing really painful. Right now I'm just feeling very full/bloated - I even passed on ice cream after dinner. Amy did tell me that I would feel full and probably wouldn't feel like drinking anything but that I need to make sure I do. I've done my best to drink lots of fluids today and will start tracking my ounces tomorrow. Me & My GC: Now that the retrieval has occurred, me and my GC have some changes to our medications. Tonight I had my first progesterone in oil shot - it definitely isn't as smooth as the subcutaneous shots, but I survived. The soreness from these shots seems to linger longer as my sister found out when she started them on Wednesday. I believe her progesterone shot is every morning, where my progesterone shot is at night. She's also still continuing the estrogen shots on Mondays and Thursdays. But I don't have any other shots besides the progesterone to take. We also both started taking the Medrol pill tonight and will take that in the evening for the next 5 nights. And I took the Minocin pills at 5pm & 9pm today and will finish them up tomorrow with a pill at 9am, 1pm, 5pm and 9pm. The Minocin is to prevent me from getting an infection from today's egg retrieval. ICSI Diagram 2-14-2013 - Conception Day: After the retrieval, all of our 18 eggs were attempted to be fertilized in the lab. That's right, we will know that our babies were conceived on Valentine's Day in a lab. How romantic! ;) There are two ways that the embryologists could attempt to fertilize the eggs in the lab. One method is to just put a bunch of sperm and some eggs in a dish and let the sperm fertilize the eggs naturally. But our eggs will actually be fertilized via another method called Intracytoplasmic Sperm Injection (aka ICSI). The diagram to the left shows how this is done. They basically inject a single sperm directly into the egg - talk about needing to have a steady hand! :) Doing ICSI definitely increases the chance of fertilization and costs more to do, but doesn't guarantee that the egg will be fertilized. We figure anything that increases our chances of getting embryos is well worth the money. As we've mentioned before, it's pretty much a numbers game at this point. Not all eggs will get fertilized and not all fertilized eggs (or embryos) will continue to develop as they should. So we are absolutely thrilled that we're able to start with a high number like 18 - because the number will continue to go down after each round. Back in 2011, we had 18 eggs (just like today). Of those 18 eggs, 12 developed into embryos after fertilization. And of those 12, we had 8 that were viable embryos - 2 we transferred fresh and 6 that were frozen. For this cycle, we will just have to take it day-by-day and I will definitely keep you all posted! We can't thank you enough for your love, support, and prayers throughout this cycle! We know a lot of you have been following us for the past 5 years and appreciate your dedication. :) I would like to shout-out a prayer of thanks for Mr. Reyen's open heart surgery going well today! And tonight, I will leave you with the song "Then" by one of our favorite country artists, "Then." Hope you all had a wonderful Valentine's Day!! :) Everything went so amazingly well this morning - we were so shocked & thrilled when they told us we got 18 eggs again!!! I'm feeling groggy, so I'm going to take a nap. But I will post later today with more details. :) Thanks for all the prayers and texts this morning - we were totally feeling the love.
Good Evening! So today I had to take the home pregnancy test this morning and 4 Minocin pills throughout the day (to prevent an infection from the egg retrieval) - but I didn't have any shots today. Kinda nice to get a break from shots for a day. Unfortunately, my dedicated GC didn't get a break from the shots - she actually had her first shot of progesterone in oil shot this morning. It's another intra-muscular shot that her hubby will give her. I talked to her tonight and she said that she can still feel where the shot was this morning and that it's a little sore. I do remember the progesterone shots being a little tougher than others and will be soon joining her in the progesterone shot club.
Tomorrow is our big day and I will definitely make-up for my lack of shots today. I know that the nurses will give me a shot of some narcotic prior to the procedure. And in reading my blog from our 2011 egg retrieval, I was reminded that Dr. Williams is going to give me some Novacaine shots down there - lovely! And then tomorrow night, I will start the progesterone in oil shots. Some doctor's offices actually treat the egg retrieval as an outpatient surgery and knock patients out. But ORM does them right in the office. They offer the outpatient option - but it's more expensive, so back in 2011 we went with the in-office procedure and it was fine. :) I will take the Xanax pill 2 hours before the procedure, then get the narcotic shot before the procedure, and the local anesthetic down yonder right before Dr. Williams begins his egg hunting. Here is the timeline of our Valentine's Day agenda leading up to the egg retrieval at 10:20AM...
We are definitely excited for tomorrow. Since we've done it before, we kinda know what to expect. Hopefully, we will get lots of mature eggs retrieved. Thanks again for all of the prayers, cute emails, sweet texts, and positive thoughts t Baby Wilcox arrived this afternoon and much to everyone's surprise - she's a girl!! Her 3 older brothers were all thinking they were getting another brother - but I have no doubt they will absolutely adore their baby sister. :) Congrats to the Wilcox family - party of 6! We love you!!
Chris (from the IVF dept) called in my Xanax prescription this morning and I went to pick it up at lunch. Crisis averted... :)
This morning I collected my urine sample in a cup - a red Solo cup to be exact. ;) I did this just in case I wanted to try a 2nd test. The first test did appear to be positive, but the first line was super faint. They say faint is okay, but I took a digital one to be sure and it was definitely positive. Yay!! It looks like my nurse hubby administered the Ovidrel shots perfectly. :) I will call the IVF department to share the good news. And we will get the missing Xanax medication taken care of as well.
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