Testing dilemmas

To pee or not to pee, that is the question.

For the record, I hate POASing.  For an infertility veteran (yes I think I've earned the right to call myself this by now) I've peed on a remarkably small number of sticks.  One after my first IVF, three during my chemical pregnancy, and one waaaaaay back when I first went off the pill and my period didn't come back.  Five times.  I can literally count the number of pee sticks I've used in my life on one hand.

I'm usually a strong believer in waiting until at least 8 or 9 days past transfer to pee on anything.  The idea of squinting and tearing a test apart in search of a second line just seems like it would only make my anxiety over testing even worse.  I'll take a clear positive or negative, thank you very much.

Except this time I'm fighting really hard not to pee early.  Today is 6dp5dt, and I very nearly tested yesterday afternoon on the basis of a lot of Googling and forum chats where people got faint positives as early as 5dp5dt.  Part of me just feels like, if this worked and it's a healthy pregnancy, there has got to be a detectable (though small) amount of HCG in my system by now.  The only thing stopping me is the crippling fear of finding out that it didn't work.  Because, my friends, as usual The Little Voice has reared its ugly head and is telling me that this whole thing is a bust.

Fitting, don't you think?

Here's the added wrinkle this time: on Friday M and I leave town again to go to Vancouver for a friend's wedding.  We decided to take advantage of the fact that we're flying out west to tack on a few days of vacation, so we've booked a cottage and are planning on doing some more surf lessons since we had such a blast in Mexico last year.

So the dilemma is that if I test before the wedding and it's negative, I'm going to be pretty damn depressed for our whole trip.  On the plus side, I can drink my face off at the wedding and get in the hot tub at the cottage.  And do I honestly think that I can wait until our vacation is over to test?  That will be something like 17dp5dt.  I'll go insane well before then.  Or M will kill me because I'm really annoying to be around right now.

The other snag is that, because I didn't do this cycle through my Toronto clinic, there's no beta date in my future.  I've thought about calling them up if I get a positive HPT and I'm pretty sure they'll book one for me, but I obviously can't do that if I'm in Vancouver.  So I could get a positive pee stick but then have absolutely no idea how pregnant I am or if I'm staying that way this time.  I'd basically just have to wait until I got home and go for a blood test like a ... gasp ... normal fertile woman.

Eep!

I don't know what to do.  Tell me what to do, internet!!

Czech-ing out

I can't believe it's over already.  Today was our last day in Prague.  In the wee hours of the morning we'll be heading to the airport and back to Toronto.  I can't help but feel a little melancholy.  We've had such a wonderful time here, above and beyond how well our donor egg cycle has gone so far.  I was a little worried before we came that, if I didn't wind up pregnant, I'd feel like we had wasted our time and money in coming here.  But we've had such an amazing vacation on top of things that I know that even in the face of a BFN, that won't be the case.  We needed this.  We deserved this.

We took it easy the day of the transfer and stayed at the hotel, apart from a quick jaunt to a nearby restaurant for dinner.  The next day we headed to the National Gallery of Prague to check out its exhibits of 19th and 20th century Czech and European art.  Imagine how I felt when we walked in the front door and this was the very first thing we saw:

There was no placard or anything nearby (these were in the lobby) to tell us who the artist was or what the piece was titled, but its meaning was obvious.  I'd love to take it as a sign of some kind, but then again we all know I don't believe in that sort of stuff.  Right?

One of the other really cool things we did was take a dinner cruise on the Vltava River at sunset.  There was a small band playing jazz and swing while we ate, and the only thing that would have made the meal better would have been if I could have had wine.  Sad trombone.  It also gave us an opportunity to take some awesome nighttime photos of the city from the river.

What can I say, I like me some dramatic moon shots.

As of right now I'm 3dp5dt and feeling nada.  Not like I ever do, or even should.  I know that.  I'm also trying really hard not to think about how I'm going to be feeling a week from now, because every time I even remotely contemplate peeing on a stick my heart starts to pound and my stomach clenches and I want to crawl into bed and curl into a ball.

If only I could stay here for the rest of my two week wait.  I think that might help.  Oh well.  At least I'll be seeing this little face pretty soon:

Missed this guy!

And now for something completely different

Today we transferred one hatching blastocyst graded 5AA.  We have four more blasts in the freezer.  FOUR!

Never had one of these pics to post before!!

We arrived at the clinic well in advance of our noon transfer time and had a quick meeting with the embryologist, who filled us in on our blasts.  In addition to the one we transferred, we had another top quality hatching blast and three more worthy of freezing.  For someone who's constantly been worried about having ONE left to transfer, five blasts seems like an embarrassment of riches.

The transfer went smoothly, although the one down side was that they didn't allow M in the room during the procedure.  I got to see our blast on a TV screen in the procedure room before the embryologist loaded it up, then the catheter went in and I saw the familiar but always breathtaking flash of light appear inside my uterus.  Mentally, I thanked the donor again and welcomed our embryo home.

The nurse wheeled me into the recovery room, where I was the only patient.  I lay in the quiet, darkened room, closed my eyes and tried my best to communicate with the tiny little ball of cells inside me.  I told it how much it was wanted.  I sent it mental images of its grandparents, its cousin, and M.  I wished he could be there with me, but the nurse had already left and I had no way to get him without getting up myself.  I just lay there and tried to send relaxing, calming, implant-y thoughts.  After about half an hour, I got up and got dressed, then M and I came back to the hotel where we've spent the afternoon chilling out and watching TV.

I want so much to believe that this time things will be different.  So far it has been.  Everything about this cycle has so completely exceeded my expectations that it almost feels like it has to work.  And when you have obvious egg quality issues like me, it's hard not to fall into the trap of thinking that you've fixed the problem by using donor eggs and therefore success is guaranteed.  It's not.  Far from it.  I've read enough of your donor egg stories to know that most definitely isn't the case.  The odds are better, sure, but they're still not even close to 100%.  I'm trying my best to be prepared for that.

And yet, I want to enjoy this optimism.  Because there's a reason to!  We transferred a top quality donor blastocyst made from 27 year old eggs today.  Also, while I don't put a whole lot of stock in this stuff, I've had so many people tell me that they have a really good feeling about this cycle.  That this is the one that will stick.  I want to believe that they know something I don't.  I want to believe they're right!

The eve of transfer

First things first: an embryo update.  As of yesterday (Day 3) we were told that we had "8 high quality embryos".  Full stop.  I have no idea if the other three arrested or are just poor quality, nor do I know what cell division stage the remaining 8 are at.  That's all the information I got.  I'm starting to get used to the Czech brevity in delivering medical info, and in a way I'm kind of digging it.  They're not giving me enough to obsess over or Google, and the almost nonchalant way I get my updates makes me feel like they're pretty confident that we'll have lots of good blastocysts tomorrow.  They're already talking about freezing leftovers, so that's clearly a good sign.

In the meantime, we've been keeping ourselves so busy with sightseeing and activities that I've really hardly had time to worry.  I highly recommend this method of distraction!  Over the last couple of days we've walked over what feels like every square foot of Prague, and yet I know there's tons we've missed down all the crooked little streets.  Some of the cool stuff:

A gun concealed in a cigarette holder at the KGB Museum

Mock interrogation room at the Museum of Communism

One of the coolest things at the Museum of Communism was watching film footage of protesters and soldiers during the Velvet Revolution, the series of protests in 1989 that ultimately resulted in the overthrow of the Soviet-backed government and the institution of democracy in Czechoslovakia.  Wenceslas Square was the hub of the protests, and is now a huge tourist shopping destination lined with things like restaurants, casinos and clothing retailers.  We've walked through it several times already, but seeing it how it was in 1989 was a whole different story.  It's hard to believe I was just 13 years old back then, and didn't really know what has happening at the time.  So much change in just a few short decades.

Another day, we took a sweaty hike in the hot sun up to the top of Petrin Hill, which is a huge park complex overlooking the city.  It's gorgeous up there, and instead of being filled with tourists it also had a lot of locals just enjoying the sunshine or sitting in the shade under the trees eating ice cream.

Petrin Hill lookout tower

One of the many rose gardens on Petrin Hill

We've also paid a visit to Vysehrad, which is Prague's second smaller castle complex that is apparently often overlooked by tourists.  It's a 5-minute walk from our hotel, so today we hiked on up and took in some more amazing views of the city.  There's also another beautiful cathedral there and a very cool cemetery.

Cathedral as seen from cemetery at Vysehrad

 

Vltava River from the top of Vysehrad

Me being artsy with my camera at the cemetery

So now we just wait for tomorrow to find out how many blasts we have.  Thanks to everyone for your comments on my last post asking advice about how many to transfer.  Right now we're leaning towards one, based both on the assumption that they'll be of high quality as well as how difficult we think it would be for us to manage twins on our own without any family within screaming distance to help us out.  We'll see what the RE and embryologists have to say, though.

Yikes.  I can't believe this day is almost here.  And that I'm not looking at it with total pessimism like I have in my past cycles.  I wouldn't say I'm 100% planning on it working, but I'm definitely preparing for the possibility.  What's happening to me??  WHO AM I?? 

Drum roll, please...

The fertilization report is in, and with it comes what seems to be an answer to our previous crappy fertilization rates.

It was my shitty eggs the whole time.  11 out of our 12 donor eggs fertilized!!

Yet again, this is even more than I dared to hope for.  We were shooting for 8, which would have been a solid 75%.  To have more than that...well, it puts me in the scary position of actually starting to feel an emotion I haven't had in a while: hope.  The pessimistic part of me keeps intruding into my happy thoughts, saying that things have been going so well up to now that the other shoe is bound to drop sometime.  I've been doing my best to shut it up with sightseeing and beer.

This development also means that M and I may have to do some serious talking over the next few days on a subject that hasn't been an issue for us in the past: whether we transfer one or two embryos.  I have to admit that the idea of having our family all in one go is sort of appealing, especially at the ripe old age of 38.  But I've read about enough twin experiences from my fellow bloggers to know that there's almost always some sort of complication, and while things have almost always worked out well in the end, it can make for some scary times.  A single embryo transfer would avoid that, and we could always come back for a sibling later if we have anything to freeze.  I'm open to input here, so have at it in the comments.  Especially you twin moms.  Would you do it again if you had the choice?

After getting our fert report, M and I headed out for some more Prague exploring.  We thought we'd try some shopping in Wenceslas Square, but discovered it to be very touristy and cheap there so we wandered through and kept on going to Josefov (the Jewish Quarter) where we window shopped the fancy stores (Gucci, Prada, and the like) and picked up a few small souvenirs.  I had the best traditional Czech meal of our trip so far, roast duck leg (pečená kachna) with braised red cabbage and potato dumplings, then we strolled back along the river to our hotel.  Right now we're pretty exhausted, so to finish off I'll post a few pics of some of the sights we've seen the past few days.

Prague castle

St. Vitus' Cathedral (facade under renovation)

View of Prague from the castle grounds

National Museum building, also under renovation

Spanish Synagogue in the Jewish Quarter

The Old-New Synagogue, also in the Jewish Quarter

 

Retrieval

Don't worry, I'm not going to keep you in suspense.  Unlike what the clinic did to us this morning!  But I'll get to that in a sec.

Our donor gave us 12 eggs.  All 12 are mature.

Join me in my happy dance!

12 eggs is beyond my wildest expectations.  As I think I've mentioned before, most Czech clinics use a lower dose of stimulation than in North America and will only guarantee you between 6 to 8 eggs from your donor.  I was hoping for the upper limit, and thought that maybe we'd be lucky enough to get one or two more, but 12 wasn't a number I even allowed myself to entertain.  It's incredible.

The experience at our Czech clinic today was nothing but positive.  They sent a taxi to pick us up for our appointment, and we were greeted by the clinic rep that I've been emailing incessantly over the past several months.  I had seen her picture before on the clinic website, so I knew she was young (early 20s) and cute, but I definitely wasn't prepared for what I saw this morning.  This girl was smoking hot, with long dark hair, perfect skin, a pert little nose and a body that made me want to cry, clad in a white tank minidress that left nothing to the imagination (i.e. I think I know where she buys her thongs).  Attire aside, she was utterly professional and got us settled in to fill out our paperwork while also inquiring about our vacation plans in Prague and giving us recommendations of things to do.  She informed us that our donor's retrieval had already been completed and that she was resting, and I asked her to pass on our sincerest thanks to the donor for what she had just done for us.  The rep also hinted that the retrieval had gone "very well" but said she didn't know the exact number of eggs retrieved.

Once we'd signed our consents and waivers, we met the RE with whom we'd previously had our Skype consult.  He went over my medication protocol for the coming few weeks and did a quick ultrasound to check my lining (still 8mm, still triple stripe), and told us that we'd be meeting with the embryologist next to discuss how many eggs had been retrieved and what the plan was.  This was new territory for me; in Canada I've never dealt with anyone but my RE and always got all my information through her.  The RE did however hint that there had been "a high amount" of eggs collected so by this point I was getting super curious.

After our meeting with the RE, M was whisked off to the collection room to give his sperm sample.  I figured that our new friend the clinic rep might have been conjured during his efforts, and I can't even blame him. 

Unspeakable things happen behind this cute little sign.

They also took some blood from him for some updated STD checks.  Then, finally, we met the embryologist.  He gave us the number of eggs collected, and then told us about M's sperm quality.  Unfortunately, it wasn't his best showing.  His count was good (81 million) but motility was pretty low at 18% (it should be around 40%).  However, the embryologist didn't seem concerned.  He told us that of those 18%, 25% had normal morphology and he had more than enough to work with.  He recommended ICSI (which we'd been planning on anyway), and then also suggested a new technology that allows for time-lapse photography of the developing embryos.  Though it costs a few hundred euros extra, he suggested doing it for at least the first 3 days since the rate at which the embryos are dividing can give an idea of which ones are the best for transfer.  We thought it through and decided that we'd come this far, we might as well try it to give ourselves the best possible chance.

And then we were done!  In and out in under 2 hours.  We spent the rest of the day exploring the grounds of the Prague Castle and the area known as Malá Strana (Lesser Town).  It was sunny and hot, and we worked up quite a sweat climbing the hill up to the castle.  We saw the changing of the guard at noon, ate ridiculously large sausages from a street vendor, and then wandered back along the river to our hotel.

So now we wait.  This, to me, is the second worst part of the whole process after the two week wait.  Up to now our best fertilization rate has been 50%, which we've mostly attributed to my poor egg quality.  The million dollar question is: what about the contribution of sperm quality?  M was noticeably disappointed in the report on his sperm quality this morning, and I think we're both more than a little worried that we're about to find out something we're really hoping not to.  We've held off making any firm decisions on how many embryos to transfer until we get this crucial piece of information.  That said, even if we only have 50% fertilize that still leaves us with 6 embryos, which is more than we've ever been able to make with my craptastic eggs.  But I'd be lying if I said I'd be happy with that.

Guess we'll find out soon enough! 

Czech-ing in

Greetings from beautiful Prague!

Walking towards Charles Bridge from our hotel

Our travel here went off without a hitch.  We left Toronto on Wednesday about midday, had a quick stopover in the US and then took an overnight transatlantic flight to Amsterdam.  Well, it was technically overnight.  We left around 4pm and the flight was just about 7 hours, meaning that by the time we landed it was barely 11pm Wednesday for us even though it was 5am Thursday morning in the Netherlands (+6 hour time difference).  Unfortunately that meant that despite our best efforts, we didn't sleep a wink on the flight because we just weren't tired enough.  By the time we arrived in Prague at 9am (3am in Toronto) the lack of sleep was starting to catch up to us.  We allowed ourselves a quick catnap upon checking in to our hotel (which blissfully had a room available instead of making us wait until proper check-in time at 3pm) but then forced ourselves to get up and go out so that we'd stay awake and start to get our bodies on the proper schedule.

We basically just spent the day wandering around some of the main areas of Prague to get a feel for the place, interspersed with extended periods of time sitting on restaurant terraces eating and pumping ourselves full of caffeine.  We made the rookie mistake of stopping at a pretty touristy spot on the river for lunch, which was fine but incredibly overpriced for some wraps and salad.  We subsequently discovered some awesome spots frequented by locals in the residential area around our hotel that are a million times more reasonable.  For dinner I tried a traditional Czech dish called svíčková na smetaně (sirloin medallions and bread dumplings served in a cream sauce).  I know it looks like something that belongs on my new favourite Tumblr, Someone Ate This, but it was actually really tasty.

I swear there's meat under there somewhere.

We're now back at the hotel and will probably be going to bed pretty soon, since tomorrow is retrieval day!  We are getting picked up to be at the clinic bright and early so M can do his thing.   If I'm being honest, I don't think it's really hit me yet that we're finally here and this is actually happening.  It feels like I've been worrying about it and organizing it for so long, and yet it's still this abstract event that hasn't quite taken shape in my mind.  It's a bit weird to think that M and the donor will be the ones doing all the work tomorrow.  It's even more weird to think that there's this perfect stranger out there somewhere who's going to be giving us possibly the greatest gift of our lives tomorrow, and that we'll never get to know who she is or thank her properly.  More than once I caught myself looking at various women today and wondering, "Are you her?" when I saw someone I thought matched our donor's characteristics.  

I guess I'm realizing that there's a big difference between theoretically thinking about having an anonymous egg donor and being less than 12 hours away from having it actually happen.  When M and I got married, I didn't have wedding jitters, but I imagine this is maybe how it would have felt.  This is something I really really want, and I'm not in any way having second thoughts...but I also can't help freaking out a little bit about what a huge deal we've actually gotten ourselves into.

Gulp.