Blastocyst Grading

Transfer day!

Have you ever seen the Friends episode where Phoebe becomes a surrogate for her brother?  If you have, you probably remember this moment; her pep talk to the embryos and her plea for them to stick.  Of course, television is grossly inaccurate and there is no way a reputable fertility clinic would allow you to be alone in the room like this, but the feeling, the pleading to work?  That is the real deal.
After what seemed like so much waiting, the transfer day came at me like a freight train.  I went to bed  as cool as a cucumber and woke up feeling as if all the hormones I had been putting into my body hit me at once.  I was a wreck!  What scared me the most was that up to that point, I had been in charge.  I took my meds routinely, ate well, avoided all the things I was supposed to, and followed every instruction I was given.  Once the transfer took place, it was up to nature and science, and I had no control over any of it.  I wanted it to work so badly, and was afraid of letting my intended parents down.  I texted them and they were not only supportive, but grateful for my honesty in sharing my feelings.  Its important to be able to openly share the bad as well as the good and work through it as a team.  I consider myself incredibly lucky to have IP's who are caring and involved in everything I'm doing.  They reminded me that we are in this together, and that made all the difference.  Once we met up with them at the clinic, all my worries vanished.
This is a time when its also important to have a reliable support system.  I put out a call to rally my closest supporters, asking for positive thoughts and boy, they sure delivered!  I received so many reassuring texts, photos and calls that I was again overwhelmed with emotion, but this time, calming and happy!
The waiting room was packed when we arrived at the fertility clinic and it was fun to watch the interactions around us.  I could tell which women were there for transfers, as they were all chugging water as vigorously as I was.  (I was instructed to ingest a large bottle of water upon arrival)  It seemed that they were all surrounded by groups of people, so I assumed that most of them were surrogates as well.  That thought made my heart so happy!

Baby's first photo

The transfer procedure was an indescribable experience.  There was a slight buzz about the room, as we were all a bit nervous, but also excited and optimistic.  We observed as the 5BB+ embryo (you can learn more about the grading scale in the post titled "Blastocyst Grading") was transferred into a catheter, and then on a separate monitor, saw it placed into my uterus.  It was so quick that it literally flashed on the screen and was done.  It was quicker than getting a routine pap, and much less uncomfortable, so much less in fact that I didn't feel a thing.
Now that it's over, we have what is commonly referred to as the two week wait (2ww) before my first blood test to check my HGC (pregnancy hormone) levels.  Never has two weeks seemed like such a long time!

Medications: Phase Three and Four

Since beginning this journey, I've become quite comfortable using words such as uterus and vaginal.  If you're following this blog, you might as well get comfortable as well.  Go ahead and say each one out loud a few times.  I'll wait...

After my second monitoring appointment, my uterine lining wasn't as thick as is preferred, so I was instructed to add a vaginal suppository called Estrace to my daily routine.  Estrace is a little blue pill, a description which makes me giggle every time I use it.  Like the "other" little blue pill on the market, Estrace seems to be a power hitter and after four days, my lining was in prime condition.  Usage isn't exactly ideal, as the size alone makes it a bit tricky to get into place.  It also leaves behind a blue residue, which is a bit strange to see every morning.
Once the Estrace did its job, I got the go ahead for the final round of medications, which dropped the Lupron and started Progesterone in Oil (PIO for short).  The PIO is an intramuscular injection in the upper, outer quadrant of the gluteus maximus.  Let's just say that I'm glad mine has some extra padding!  The needle was intimidating, as was the thought of relinquishing control to my husband, who graciously agreed to help me out.  I made him watch training videos ahead of time, watched him cringe at the sight of the needle, and that in turn made me nervous.  PIO is the only medication which is administered in the morning, and since he gets on the 6:30 train into the city, I've seen some pretty early mornings.  The upside is that we get to enjoy a few minutes of quiet in the mornings now, just the two of us, and I've found the new routine to be a great way to start the day.  The injections aren't nearly as bad as I feared.  I ice the area beforehand while I get everything ready, then once its done, I use a ball roller to massage the area for a minute, then do ten minutes on a heating pad.  I haven't had any crazy muscle aches, as I've read is common in some women, but I do have quite a few bruises back there!  My husband handles it like a professional and I am incredibly lucky to have his full support.
Along with PIO, I added Medrol and Doxycyclin to my daily routine, and also increased to four estrogen patches every 48 hours.  The Medrol is an immuno-suppressor, used to stop my body from fighting off the foreign cells (the embryo) upon transfer.  Its taken four times a day, at very specific times, and I'll be the first to admit that I'm no good at keeping schedules like that.  The alarm feature on my phone is my lifeline to remembering, so between the Medrol alarms and the ones I use to for all my other daily reminders, like getting my son to the bus stop, I had eight alarms going off at different times of the day.  Anything to make sure I'm doing what needs to be done!

Medication-Phase 2

Last week I went in for my baseline appointment at the fertility clinic.  They did a blood draw to check my hormonal levels as well as an ultrasound.  The ultrasound was necessary to check the lining of my uterus, which at this point, they want to be thinned out from the Lupron.  They also checked my ovaries, I am assuming to make sure they've temporarily shut down.  Everything looked as it should, so I got the OK to begin the next phase of medications.  I have dropped the Lupron dosage level to 5 units and have added estrogen patches and baby aspirin to my daily regimen.  The estrogen patches will thicken up my uterine lining, while the baby aspirin very slightly thins out my blood and is believed to help during implantation.
The Lupron shots are quite easy to give and for the first week, I didn't notice any side effects, other than a slight itching at the injection site, which lasted only a few minutes.  I did notice that on days that I didn't itch, I developed a small bruise instead.  A little over a week in, the side effects became more noticeable, mainly fatigue and headaches.  The grossest thing so far has been what is called scaling.  Definition: Abnormal shedding or accumulation of an upper layer of skin" I noticed that my feet were kind of dry and itchy so I put some lotion on in the morning.  The next morning after my shower, the skin was literally hanging off my feet, huge clumps that kind of looked like blisters.  It didn't hurt, just looked really awful.  I went out and bought a pedicure set with a pumice stone and one of those heel grater things, soaked my feet and then gave them a good scrape and they are looking much better.  I'm just glad its still boot weather outside, so I can hide my toes until things are back to normal!

The estrogen patches I'm using are called Estradiol

and are meant to stay on for 48 hours at a time.  I had an issue with adhesion the first day and ended up using bandaids and gauze to keep them in place.  I did some research (thanks Google!) and found that prepping the area first with an alcohol pad works wonders.  The packages seem huge and I was wondering how I was going to comfortably fit two of them (and later on four) on one arm, but as you can see from the photo of me above, the actual patches are much smaller.
Common side effects of estrogen patches include cramping, bloating and headaches.  So far I've felt the headaches but I'm also dealing with seasonal allergies, so I'm not 100% certain its because of the estrogen.  Things are going smoothly and everything has been easy to manage, more so than I ever imagined it would be!