Fertility Report

On Tuesday June 30th we got the call from the IVF lab with our fertility report. Out of the 34 eggs they pulled out, 21 of them were mature. After doing ICSI to 20 of them, 15 fertilized! Yeah 15! Holy cow... that is ALOT!!! Now they will watch them grow for a few days and then call us back and give us the grading scale. They also saved the 5 that didn't visibly fertilize and will watch to see if by chance they missed something.

They were also able to take what was left of Johnny's sperm sample and freeze that for possible future use.

We got an update on our embryos at the cleavage stage which is day 3, Thursday, July 2.............What they are looking for at this stage is the embryos that have the least amount of fragmentation. Out of the 15 good ones that were fertilized 10 of those have a great to good rating which means they have the least amount of fragments. The other 5 were given a low grade, which means they are 1-2 stages behind the other 10. One of the 5 embryos that did not show signs of fertilization after retrieval started to fertilize and the other 4 were thrown out. So as of now we have 16 embryos in the lab. They will all be watched for a few more days and we will get the grade scale of each at the next stage of the embryos life.  :)

Sunday July 5th I went in for another blood draw to check on my levels to see if they have started to decrease since starting back on the cetrotide. Well while I was getting my blood draw the nurse went in and got my nerve which shot a shooting pain down my forearm and also made my hand go numb and get all tingly. I literally almost came out of the chair because it hurt so damn bad.

Later that day we got the final report from the lab. Out of the 16 embryos from the Cleavage stage only 9 made it to the Blastocyst stage. Details on this stage are that an embryo has developed and it has 2 distinct cell types and a central cavity filled with fluid called blastocoel cavity, The surface cells around the cavity are called the trophectoderm and will later develop into the placenta. The inner cell mass is what will become the fetus.

And the fee for freezing all embryos is $975.00.

Since my body is not ready for transfer we will be put on hold for a while to let it get back to normal. Hopefully this wont take too long but they say it could be a few months before everything is back to normal. So sit tight and I will update when things get back going!

So just a recap on the amount of money we have put out just this year $28,460.00, and yet we are still far away from baby Cashmore. 

I thank each of you that have donated to our fund, but am asking if there is anyone out there that is willing to donate please do so. Your donation big or small is so much appreciated. It looks like our journey is still far from over and I am sure we will encounter many more bills.

Here is the link to our site again.
http://www.gofundme.com/Jessica-JohnnyIVF

Egg Retrieval

On Monday the 29th I had my egg retrieval scheduled. We got to the clinic about 8:00, check in was at 8:45am and surgery was scheduled for 9:45am. As they were checking me in the nurse let me know that my estrogen levels were over 10,000 which is ridiculously high. She also let me know that I was "an overachiever" with the amount of follicles I have. They got me all set up with my IV and had me sign all my consent forms and then it was time to go back. All I remember was them hooking oxygen up and asking me to scoot down and that's all. I woke up in recovery with a nice warm blanket.

While waiting in recovery the nurse came to let me know that they were able to retrieve 34 eggs!! Holy Cow that is a lot of eggs. Next, the embryologist came to let us know that Johnny's sample they got the day before wasn't as good as they hoped but that there were about 6-7 little strong swimmers they could use for ICSI (Intra-cytoplasmic sperm injection). ICSI is where embryologist selects a single sperm to be injected directly into an egg, instead of fertilization taking place in a dish where many sperm are placed near an egg. They would do ICSI later that day and we would get a call the following day with out Fertility report.

The nurses went over my discharge paperwork and let me know that I would need to start back on the Cetrotide that evening and also go get the other script for the additional 4 nights. I also needed to take the antibiotic for prevention of infection, and to come back in a few days to make sure that everything is looking good. I still have to take it easy, meaning no exercise, no baths or submerging myself in water, must drink LOTS and LOTS of fluids and continue to eat salty foods! Johnny so kindly went to pick up my additional Cetrotide, which cost $418.00.

That day was pretty non eventful just laid around, still was really bloated and uncomfortable. I went back to work the next day and again was extremely uncomfortable and bloated. I really could of used a wheelchair because it was a jaunt to the restroom and believe me with all the fluids I was drinking I was in there every 30 minutes, and walking was even painful! But things are moving forward so I am happy!! :)

Here is a look at what my stomach looked like even after I was done with the first round of shots before starting the Cetrotide again.

Johnny's Surgery

Since my follicles were getting to be the size for retrieval they went ahead and scheduled his sperm extraction for Sunday June 28, at 7:00 am. Whew that was early for a Sunday.... we got to the surgery center about 6:20 because check in was at 6:30. Well being a little ahead of the game didn't do us any good because no one shows up until 6:30, so we had to wait and didn't get upstairs and checked in until 6:40 am. Once we got up to the check in room it was like rush rush because they needed to start on time! The nurse kinda sucked at giving Johnny his IV, which she should of had no problems because he has HUGE veins, but they had to stick him 3 times before getting it to work. He signed all his consents and started anesthesia and was off to the OR.

Johnny Oh So Excited for Surgery

I had to go get labs drawn for the last time to check on my levels again just to see about that OHSS. Well apparently all the nurses must of been sleepy because my nurse had to stick me twice before getting a good vein.... She told me that they normally wont call with results with this draw so no news is good news.

Johnny got out of surgery about 8:00 am, quick and easy! Dr. Mills came out to tell me that he did very well. The aspirated all sperm from his right side and gave him a small stitch, he asked Johnny how he was doing and well good since he didn't remember anything from getting the IV on. They gave him his discharge instructions, an ice pack, pain meds and we left about 9:00. Doctor said we would get the report most likely the next day.

Just a little loopy

On another note.... I got a call later in the day from the nurse saying that my levels were still super high and that after my egg retrieval I would need to continue the Cetrotide injections for 5 days to minimize the chances of OHSS. It usually occurs after the retrieval because the follicle pockets will continue to fill up with fluid after the eggs are retrieved and the fluids could leak and spread to my heart and lungs. So because I only had one Cetrotide kit left she was needing to call in another prescription.

Daily Ultrasounds

On Wednesday June 24th I went in for my ultrasound and labs. The ultrasound again measures my lining as well as all the follicles in each of my ovaries. I have been very very bloated and so loose baggy clothing are my BFF right now! Since I am so bloated and my ovaries are growing very fast this ultrasound was pretty uncomfortable. The ultrasound showed that in my left ovary I have about 7-9 that are growing pretty large, and the biggest one is 16mm. In my right ovary I have about 7-11 growing and the biggest one is 17mm. Which is great considering that two days before the biggest ones were 11 and 13mm. They still have some growing to do until they are able to come out. They also saw in my left ovary that I had a free fluid pocket. This is normal in people that have so many growing follicles but I have to really take it easy and not be on my feet so much so the fluid doesn't increase. I was able to get some pictures of what the growing follicles look like.

The little black dots are the follicles.

Here is the list of the measurements they took of each follicle. In the column that says CM is actually the MM measurements.

I got the day off on Thursday the 25th (that was super exciting for me), so my next appointment to check on the follicles and get my blood drawn was on Friday the 26th.

Friday when I went in they told me that everything was still looking good but that my Estrogen and Progesterone levels were really elevated. This is to be expected because I am pumping in all these extra hormones and I am pretty young to begin with. The only concern with this is that if the levels get too high then there would be a concern for ovarian hyper stimulation syndrome. This is where your ovaries become swollen and fill up with fluid which causes a lot of pain. It could also cause severe problems and make it to where the IVF cycle will have to be put on hold after egg retrieval. The doctor said he would know more after my labs came back later that afternoon. He would call me to tell me my next dosage of medications and what the future plans were. During my ultrasound they found at least 15 growing follicles in my left ovary, with the biggest one being 20mm. In my right I had 13 growing with the biggest one being 25mm. Things were looking very good and close to getting these things pulled out!! Thank Goodness because at this point even walking was pretty painful. 

Later that afternoon I got a call from the nurse stating I did not need to take my night shot of Follistim but to continue my morning shots on Saturday and to come in for what would hopefully be my last appointment for labs and ultrasound. She also gave me the bad news that we will not be able to have a fresh transfer due to my ovaries being a little too big and my levels being highly elevated. Its upsetting but better to play it safe and not put my body through anymore strain right away. 

A look at what my stomach looks like on the last morning of shots.

Saturday the 27th I went in for my labs and ultrasound and they found about 24 actively growing in my left with the largest few at 24, 22 , 21, and 20.5 mm. In my right they could see at least 20 active and the largest ones were 26.5, 24.5, 23.5, and 20 mm. All looks good because the goal is to have the majority of the growing follicles need to be at least 20 mm before they will remove them.  

This picture shows both ovaries touching each other and all of the growing follicles inside both. 

After the doctor looked at my results of the growing follicles he was happy with the size they were and gave me the OK to give myself the trigger shot. I did not have to take my follistim any longer just the dexamethasone. I also was instructed to take my Lupron shot at 11:45 pm and then again at 11:45 am on Sunday for an egg retrieval date of Monday. I was instructed to take .8 ML of the Lupron, which requires two shots!! One with the syringe filled to 50 units and another filled to 30 units..... WOWZA that is A LOT of medication. 

Just some info on what exactly the trigger shot does.... Lupron injection induces a surge of LH and FSH hormones from the pituitary gland that works to induce proper maturation of the eggs. 

Here is my Trigger shot supplies

Appointment Check In

On Monday June 22 I went in for my first Lab and Ultrasound appointment after starting the medication. They were checking to see how well my follicles were responding to the stimulation medication. After the ultrasound the nurse told me that in my right ovary there are about 30 active follicles and the largest is 11 mm, and in my left there are about 20 active and the largest is 13 mm. Things are looking great from the ultrasound and I need to increase my salt intake a little to make me thirsty and also drink lots and lots of water or Gatorade.

Later in the afternoon the nurse called and let me know what doses take for the next couple of days. I have to add an additional injection of Cetrotide to my morning routine. Cetrotide is a medicine that helps prevent early ovulation. It blocks the hormone that causes the eggs to be released.

So just imagine all of these follicles growing in my ovaries and them not being able to release... lets just say I was over bloated!

Menopur and Cetrotide

The aftermath of the Cetrotide injection

Tuesday the 23rd I had to go in for my IVF Physical. This was just to go over some consent forms, check in with my height, weight, lungs, and the whole nine yards. Johnny also got his extraction paid for so we should be all good to go for the procedures when the time is right.