Blogs that inspire me in this journey

Part of the survival kit for infertility is to look for other people going through infertility and deriving inspiration from them. Here are two of my favorite blogs --

1. A husband and wife team-up :
http://ourmisconception.blogspot.com/

2. A witty ex-marketer, now SAHM living a life totally different from what she envisioned :
http://scrambled-eggs.org/

Enjoy!

Slowly getting better!

Day 5 after LIT -- still two big, angry, insect bite-looking spots with a bit of a rash and a bit of itching left over.

Hopefully it'll be gone by the weekend. Next round in about 9 days' time! 

First immunology treatment

So I just did the first of hopefully only 2 LIT sessions last Sat. The nurse came over at 6am as agreed and extracted 10 vials of blood from a sleepy, groggy Dennis. I'm a bit nervous at this point because I had forgotten to tell Dennis to abstain from alcohol the night before, and he had gone out with friends Friday night and of course had several rounds of scotch. After researching online, I found out that alcohol is counter-indicated because it tends to lower white blood cell count and tends to water down blood - both not good effects we want on our LIT day. 

Oh well. Guess my husband has tons of blood because when we got to Bloodworks at 10:30am, we found out that they were still able to extract the needed amount of white blood cells. 

So Dr Aleta injected me on the left arm, in 2 injection sites to spread the concentration of the "foreign bodies" for better absorption. It hurt a bit - like being stung by a bee - for about 10 seconds, then it burned.... And burned. 

She had to cover it with bandage to cover it from sunlight. 

So this is how it looks like with bandage -

This is how it looks without it. You'll see two very angry shot marks and the beginnings of a bad, itchy rash --

You also see the bruise on the inside of my elbow -- which I have on BOTH arms. Hideous, I know. But a necessary side effect of all the blood draws I need to get on a very frequent basis. 

So now it's been 2 days after the procedure and I'm happy to report I think I reacted sufficiently to the treatment. Hopefully this means it's working and I reach the required minimum 80% level after the second treatment. 

Wish me continued luck!

Embryologist Consult

So we went to see the embryologist and Dr Mendiola today to find out the status of our embryos. Recall that last June 11, I had my egg retrieval procedure which resulted in the ff:
> 2 mature eggs
> 1 semi-mature (called M1) egg
> and, 2 immature eggs that will be subjected to IVM or in vitro maturation, which hopefully results in their upgrading to mature grade

So after 9 days, here are the results:
> Mature Egg 1 was able to be grown into a Day-2 embryo by June 13 and was frozen as the backup embryo to be transferred if all else fails (scary phrase)
> Mature Egg 2 grew to Day 5 but degenerated by the time Day 6 rolled around
> Semi-mature M1 egg grew but very slowly... only 2 cells by Day 2 and compaction-stage by Day 5, whereas normally, embryos should reach blastocyst stage by this time. It finally reached blastocyst stage by Day 7 (two additional days after the average), and was frozen. This will be our priority contender come transfer time.
> The 2 immature eggs did not make it to maturation.

So we have 2 embryos - a blastocyst and a Day-2-er. Funny, I even gave the 'transfer one or two' thing quite a deep think; yet, it turns out I don't even have that as a choice. We'll transfer the blastocyst first, it being the higher-odds of the two, when I'm ready for the transfer. Day-2-er will be the backup for a future cycle.

Dr Mendiola was very patient with our questions and also assured me that the embryos can stay frozen until my immunologist clears me of the auto-immune issues I have. He has heard of LIT therapy and agreed that it's better to get them done and cleared before going for a transfer.

I'm a bit bummed, to be honest, that we only have 1 of each type. I honestly thought one of the immature eggs would catch up, and then hopefully we have 2 or even 3 blastocysts. I guess I'm just an overachiever by nature and by heart and I guess I expected a lot from my embryos as well. Or maybe a part of me felt that I wanted at least a part of this process to be 'perfect', even if the others aren't. I dunno. Dennis is more optimistic than I'm feeling right now.

Ironically, it's the semi-mature egg that made it to blastocyst stage, and the mature one fizzled out right before it reached it. Funny how nature works. This also gave me an idea of what may have happened during our first IVF round -- maybe that embryo is similar to Mature Egg 2... They're both perfect contenders on Day 2 (IVF round 1 embryo was a Day 2 transfer, if you recall) but didn't result into anything at the end.

Funny.

In an unfunny way.

Oh well.

So tomorrow, we're doing our first LIT treatment. I found this provider based in Katipunan that does home service of the husband blood draw, which saves us the trouble of trekking up to Katips at the crack of dawn (FYI, LIT sessions always involve an early-morning blood draw from the husband because it takes about 4 hours to process the blood to isolate only the lymphocytes, before it is ready to be injected into the wife's... forearm! I don't know why they particularly chose the forearm, as it sounds like a painful transfusion site to me... Anyway...) So they'll arrive at our condo at 6am, get Dennis' blood out into 5-6 vials, and then we're supposed to go to their clinic by around 10:30 or so for me to get the lymphocyte transfusion. Then we'll see how my body reacts to it. From my understanding, the more violent the reaction (i.e rashes, boils-looking angry red inflammations, etc), the better. It is supposed to mean that my body is 'reading' Dennis' genetic material and a 'battle' is being waged, hence starting the assimilation process. The objective is for my immune system to read, recognize and accept Dennis' genetic material as non-threats. Very sci-fi, right?

On my way back to the office earlier from Kato, I couldn't help but cry as I talked to our future child in my thought-voice (of course, I was being chauffeured back, so it was just thoughts running through my idle, in-transit head), telling him or her that, see, this is how much mommy and daddy love you. This is how much we are fighting for you -- that we fight even for your conception to happen, for your implantation to happen, for YOU to happen. It's not meant to be compared to people blessed with natural pregnancies. It was just an expression of the magnitude of sacrifice that we're doing --- a level of sacrifice that sometimes overwhelms me beyond comprehension. We love you, advocate for you and fight for you, even when you are simply an idea, a dream, a hope in the hopefully-not-distant future. We sacrifice so much, to the point that we even 'play' with our health, just to have even the smallest chance of YOU happening. Love. That's all this is all about.

Love.

When you do come around, and I believe in my bones that you will (and you're just choosing when to make your grand entrance), boy, will you be the most loved and cherished child that ever graced this world. If I can bottle up all my hopes and dreams for you, all my fears and doubts, all my pain and endurance, I would, if it can remind you everyday just how WANTED you are.

I love you already.

Another unpleasant surprise!

So I mentioned a few weeks ago that I was going to do an immunology workup after the first ivf failed. Partial results came out today and the second part which tests for 1 other condition will come out in 2 weeks. 

Surprise! Of the 4 conditions that my results tested for, I have 3 of them. Wow! Talk about a curveball. Curveball because my OB previously told me he doesn't think I fit the profile of someone with immune issues and because, as Dennis' logic goes, how much odds can a couple really take?

Well, I guess fate had other plans. 

First, I have an autoimmune condition VS my husband's (or any other unrelated person) genetic material. If the last ivf did implant for a while, the uterus becomes a hostile environment for it soon after, because my system reads his DNA (which is half of the embryo) as foreign and should be attacked. The solution for this is to do a LIT treatment - lymphocyte immunology treatment or paternal lymphocyte treatment. It involves getting blood from the husband and washing it to isolate the white blood cells. Then infuse this into the wife so that her system can be taught to accept his DNA as "friendly" and not hostile. The immunologist I saw today says that she thinks I'll reach normal levels after at least 2 sessions. And once I do reach the minimum of 80% on this test, I can proceed with the IVF. 

The treatment cost is quite significant too but I don't wanna dwell on it, simply because we'll do it anyway. No use pining over the money. 

Second, I have autoimmune against... Myself! The manifestation of this is blood clotting -- no wonder my legs often feel painful especially when I get my period. It means my blood coagulates as an autoimmune reaction. The treatment for this will be aspirin and daily heparin shots which I'll administer on myself. 

Third, I have thyroid issues. This needed some deep-diving which led me back to the lab today to get more blood drawn out. At this rate, I think my hemoglobin count must be so low already with all the blood draws!

Another test which I'll get in 2 weeks' time will count by natural killer cell count. This is the mother-fucker autoimmune condition of all -- I pray I don't have it. It makes one not able to be pregnant at all and the treatment entails massive amounts of money -- and that says a lot because in our 3 years of infertility, I think I've grown a tolerance for this kind of spending. I pray I don't have it. Please please please. 

I'm so tired. Seriously. What else is out there for us to conquer before we have a healthy baby in our midst?! Dennis breaks down every time we face a challenge and I myself don't know how much longer I can put up a brave front. The fighting spirit that we wring out painfully from our hearts gets a bad bad beating throughout every cycle that doesn't work and every condition that gets uncovered. This is bordering on traumatic, to be honest. And I don't know how much stronger we can remain to be for long. 

Then again, it must be even more painful to lose hope. So we live to fight another day. LIT session 1 will be this Saturday. Fight!

ER Attempt #2!

So I had my egg retrieval (ER) yesterday morning. We got to Kato before 8am and the experience was a bit different for me now that it's my second time to do the procedure. Things felt faster, I think... Or maybe because I was less apprehensive and nervous and more "in control" due to the sense of familiarity. 

After being prepped, it was my turn at around 8:30am. I was surprised to see it was Dr Mendiola- Kato's head practitioner- who was going to do my procedure that morning. Just like the last time, the OR was filled with doctors (Dr Ong-Jao and Dr Perillo were both observing) and nurses and embryologists. Kato's super professional way was such that every single action and result obtained was checked and validated. It made me feel at ease. 

So after cleaning and administering local anesthesia, Dr Mendiola started the procedure by popping the more visible follicles. This process was much more painful than the first time, mostly because it involved multiple follicles. The sensation is half a sharp pain when the needle would  permeate the follicle and an acute sucking pain when the fluid and egg were being suctioned out. 

Anyway, to spare you the yucky details, I was able to generate 5 eggs -- 2 mature, 1 semi-mature and 2 immature. We initially thought we could harvest 8, but it turned out that one was a cyst disguising as a follicle, another one was a follicle but didn't carry an egg inside it, and the 8th one didn't show up for the party. So 5 is what we have. I was happy to know that Kato did in-vitro maturation, which essentially means lab-controlled maturation of an immature egg. This means that our semi-mature egg has about 80% chance of maturing whereas our 2 immature ones have about 25%. I'd take those odds over zero, which is the case if they didn't do IMSI. 

So the plan recommended by the embryologist is to culture 1 egg to day-2 just like last time and culture the balance 2 eggs (or more if the immature ones catch up) to day-5 blastocyst. While there is a 50% chance of mortality among fertilized embryos cultured to day-5, they are believed to be stronger than day-2s and have better chances of implanting. The reserve day-2 one will be frozen and kept for future use. This method allows us to hinge on both styles and have some eggs in each basket, so to speak. 

Dennis also had a good production level yesterday. So happy!

So there. We're going back on June 20 to find out how many fertilized embryos survived the culture process and freezing. Hoping for 100% rate of survival! Please pray for our little embies!!!

Oh and since embryo transfer will be done next cycle, I have a month (roughly) to decide if I want to transfer 1 or 2 embryos. This is noting that ivf embryos tend to have a higher chance of splitting after implantation, resulting to identical twins. And noting that embryos do not have any dependencies on each other in terms of ability to implant, said Dr Mendiola. What this means is if we have 2 embryos that are likely to implant, they will likely both implant whether they were put in together to share a pregnancy or put in separately to be carried in 2 separate pregnancies. And noting that I have a heart-shaped bicornuate uterus that won't stretch as much as the average oblong ones of other women. But a part of me stubbornly feels 2 is better than 1. Hehe. No logical back-up for that sentiment though, and I know carrying twins (much more triplets if an embryo splits; and I refuse to entertain the idea of quadruplets!) is extremely difficult and carries significant risks for mommy and babies. 

I guess I already know the answer. The only upside of putting in 2 is it increases the chance of that particular cycle (but not the chance of each individual embryo, as I mentioned). This means that I can spare myself (and Dennis) the horrible emotional strain and pain of a failed cycle because the cycle has double the odds. Does that make sense? So it's just emotional self-preservation. Vs physical safety and health. I guess I know which one takes precedence over the other. We've just been carrying so much pain throughout this process I can't help but try to find a way to shield us somehow. 

Pray for us please!

Man's perspective

Rare does a man lend perspective on infertility. Much less a pastor! This is a good read and some parts brought tears to my eyes. A part of me feels that while we will be eternally and deeply grateful once we are blessed with a child, we'll also still carry with us a sense of PTSD over this infertility experience. Yes, as in post-traumatic syndrome. It's indeed so traumatic and the experience so unlike other challenges in life, that I think a part of me will never forget it. 

Anyway, here's the link -

http://natepyle.com/the-disgrace-of-infertility

Update!

My ovaries have cooked the eggs enough -- We have a retrieval schedule! It will be on Wed morning, and we're looking at getting at least 3 eggs up to a maximum of 8! Woohoo!

Praying everything goes well!

Waiting for egg retrieval part 2!

After taking minimal stimulation drugs the past week or so, we're now waiting for the schedule of when we can do egg retrieval. Hopefully we get at least 3 eggs and fertilize them. 

I thought that since we were doing minimal stimulation, there won't be side effects the way that traditional IVF patients report having. Turns out the side effects are definitely still noticeable and still quite substantial, to my surprise. I can't imagine how conventional ivf protocols feel at the stimulation period if I already feel like this under minimal stimulation. I'm so bloated and I feel my ovaries are so heavy. There's a strange heaviness that I carry around all day and the doc says that's because of the multiple eggs growing. I am also more irritable and prone to flaring up -- which if you know me well, you'd know is not my nature. I also feel really warm, which is made worse by not being able to drink cold drinks or eat ice cream, as prescribed by my acupuncturist. 

Oh well. I'm just complaining uselessly. The truth is, all this is acceptable and accepted in our quest for Baby Chan :)

Wish us luck today!

You said it!

This post totally gets my perspective about the lonely world of infertility -

https://medium.com/theli-st-medium/the-saddest-room-on-earth-cb2249250830

Please read it if you have time :)