Adoption Info Meeting Update

I have been meaning to post this update.  Sorry, I've been away from the blogsphere for a few days.

So we went to the adoption information meeting last Tuesday.  Not surprisingly, most of the people there were interested in domestic infant adoption.

I have to say that I did not learn too much more than I didn't already know, but I DID find out the following:

• There is a waiting list to start the domestic infant adoption (DIA) program.  This is due to two reasons.  First, there is a Profile Book that birth mothers look at for selecting potential adoptive families.  Only 60 families are allowed in the book at a time.  This makes sense so birth mothers are not overwhelmed at the number of families.  Also, this increases the chance of families being selected and reduces that wait times of families already in the book. Second, one of the larger adoption agencies here in MN discontinued their DIA program last year, so families already in the process were scrambling to find another agency to go with to complete their adoptions.  Many families moved their profiles to this agency, and they are also on the waiting list.  So, if we were interested in the DIA program, it would be another few months, at the very least, before we would be invited to start our application with the program.
• However, if we were to pursue DIA doing our own outreach, meaning we don't go into the Profile Book (which by the way costs $5,000), we would be able to start on the DIA program.  Doing our own outreach means we would have to be creative and do our own "marketing".  Some examples the presenter gave us were webpages, advertisements, Face.book pages, sending letters to friends and families, business cards, etc.  One couple even had t-shirts printed with information about their desire to adopt and wore those to the State Fair.  The cool thing is this agency actually provides outreach training. 
• I also found out that we are allowed to go dual track - meaning we could be on the international and domestic infant adoption programs as the same time.  Up to a certain point, I'm sure.

After the information meeting, Babe and I went to a late dinner and discussed what we had learned.  What the heck, if we can be on dual tracks, let do it!  We are already on the Marshall Island program waiting list, so let's get ourselves on the DIA program as well.  I also asked Babe, what about embryo adoption, would he be open to that?  He said, oh well.... might as well.  So we may also be doing embryo donation!!

The next day, I emailed the adoption agency requesting to be put on the DIA with our own outreach as well.  I also contacted the National Embryo Donation Center (NEDC) in Knoxville, TN.  NEDC does embryo adoption which requires a homestudy, just like a regular adoption.  Their website mentioned going through Bethany Christian Services for the homestudy.  One of my reluctance about doing embryo adoption was having to go through another adoption agency for the homestudy.  It would be great if we could do everything at one place.  So, I left a message with NEDC asking if we are required to go through Bethany for the homestudy, of if any homestudy would suffice.  I received a voicemail from the patient coordinator the next day stating that any homestudy would suffice, and does not need to be from Bethany.  I'm excited!  We could do one homestudy and could possibly go through domestic, international or embryo adoption!

Our next step if we were to pursue embryo adoption is to register online, but would need to pay a $300 non-refundable fee.  I'm not sure if I want to spend the $300 right now.  I emailed the patient coordinator at NEDC again asking if NEDC had Asian/Caucasian embryos available to adopt, since we are a bi-racial couple.  The answer is yes, there are, but it is a smaller pool as they are not donated as often.  But NEDC reserves those embryos for that ethnic group.  So, that is a relief.

So the point is, no matter which adoption route we take - Marshall Island, domestic, or embryo (unless we miraculously get pregnant), we need our homestudy done.  Now we really need to get in gear and work on those adoption application materials.  There is so much paper work!  I'll write about those in another post.

Embryo Adoption

At the Patiently Waiting Infertility support group on Tuesday, I met a girl named Katie.   She is pursuing embryo adoption.

Yeah, embryo adoption.

When I first heard about her from K (Patiently Waiting also has an adoption group) I thought wow, that's so cool.  Then when I met her on Tuesday, my heart jumped a little.

I'm not sure what this means yet, but the thought of embryo adoption is exciting.  If IVF does not work for us, and if we decided to pursue adoption, this is an option.  I heard about embryo adoption on Focus on the Family a few years ago.  At that time, we were just starting our fertility treatments, and it never even occurred to me that we would have considered IVF.  So I didn't even consider it.  But now, embryo adoption seems like a possible option. Though Babe and I have not talked about this, I did "casually" mention Katie to him.  Couldn't really tell how he felt about it though.

With embryo adoption, we would have to go through the regular adoption process.  Unlike regular adoption, I would actually be able experience pregnancy and childbirth, which would be a big plus!  There is also no risk of a failed adoption where a birthparent decides to parent or reclaim a child.  Plus, since we have gone through IVF, we can relate to the pain and heartache of infertility, and we know how much the biological parents wanted and desired to have children.

It is estimated that there are around 500,000 human embryos in cryopreservation in the US.  Because some parents that have gone through IVF have extra embryos, but have decided that their families are complete, they are faced with a dilemma: donate the embryos to research, thaw them and let them die, or donate them to couples that cannot conceive.  With embryo adoption, we would be adopting these donated embryos, a decision that is life honoring for both the biological parents and the adoptive parents.

Like I said earlier, I don't really know what this all means for us yet as we are planning on another round of IVF.  I haven't taken time to research any of this but I'll probably meet up with Katie sometime in the future just to chat.  Still, it's exciting just to think about it.

Have adopted an embryo?  Have/Would you ever considered it?

Tick Tock

We met up with Dr. Hopeful for our post-IVF conference yesterday.  Overall it was a good meeting.  There wasn't anything shockingly new that I didn't expect already.  Overall, Dr. Hopeful thinks the reason why this cycle failed was due to egg quality issue.

Surprise, surprise.... NOT.

(image from http://www.stupid.com/fun/BCLK.html)

Tick tock, tick tock ..... can you hear the biological clock ticking?

See this earlier post for a recap of this cycle, and some answers I was looking for at this post-IVF conference.

This is what I found out from Dr. Hopeful at our meeting:

• Dr. Hopeful was surprised that no one had mentioned about my right ovary being in a difficult position.  It is high and posterior (behind) my uterus, or other organ.  It would have required a needle to go through the uterine cavity to access it for egg retrieval.  She thinks the location of the ovary will remain and will not change in the future.
• It is possible to fix the ovary but it would require surgery to fix or retrieve eggs from it.  Did you know that in the past, laparoscopic surgery was used to retrieve eggs for IVF?  Dr. Hopeful does not recommend surgery to fix this.  She thinks that based on my body's response to the meds, I should be able to produce a decent amount of eggs in the left ovary.  However, this also means that I probably will only have ONE ovary to work with in the future.
• A day-3 transfer was not considered since my embryos were not at a 7 or 8 cell stage.  If there were, they would have a day-3 transfer.  My embryos arrested at 2-cells and 4-cells stage on day-5.
• Assisted hatching is only done for day-3 embryo transfers, and are not done for day-5 blastocyst transfers.
• There were no issues with my Babe's sperm numbers.
• There were an increased number of vacuoles (fluid or bubbles) in my eggs/embryos, indicating that they may not be healthy (signs of post maturity or degeneration).
• ICSI could be an option in the future.  However, ICSI does not help a compromised (low quality) egg.  She would rather not do ICSI if there is an egg issue.  Performing ICSI is performing surgery on an egg, so she would rather not do it.
• It is an option to do half ICSI and half natural fertilization, or all ICSI in the future, assuming egg quality is not a factor.
• I asked Dr. Hopeful if one year would make that much of a difference in the quality of eggs.  She said no one really knows, but she doubts it.
• If we did a future cycle (which we will), we will switch our protocol and do an Antagonist protocol, meaning I won't be using any Lu.pron.
• I asked about additional testing and Dr. Hopeful suggested doing Karotype testing for me to determine if there are any issues with chromosomes.  It will check for 46XX chromosomes, to see if there would be issues with chromosome imbalance in my embryos (not me).  I still have to research more about this.  She will test me first since she suspects the issue is with my eggs.  Karotype testing is not cheap, about $900 a pop!  I will have to find out if our insurance will cover at least part of it.  It will take about a month for the results to come back.
• According to Dr. Hopeful, there is an 8% chance of chromosomal imbalance.  The other 92% chance is egg quality, i.e. my biological clock is ticking.  If the test comes back and I fall into the 8% chromosome imbalance, then she would suggest donor eggs (my Babe and I have never even discussed DEs yet) since it would mean that our embryos would arrest, fail to implant or we would miscarry.  If we do not have chromosomal imbalance, then it is a matter of finding good quality eggs.  
• Based on my hormone levels this cycle, it looks like I do not have diminished ovarian reserve, i.e. I still have some eggs to work with.  We just have to find the good ones!
• Dr. Hopeful wants to try again. My uterus was "perfect".  I responded well to the meds.
• If I wish, Dr. Hopeful would consult with one of her other RE partners about my case and see if there is something else that she missed, or something different that could be done for the next cycle.
• I will be scheduling a phone consultation with the IVF lab director to go over the outcome of this cycle.  Hopefully this will give me an idea about what happened to my eggs/embryos.  

Overall, we had a good discussion at this meeting.  I think Dr. Hopeful was impressed with the questions  we had for her, and we had a good hour long discussion.  She took her time and read through my list of typed up questions to make sure we got everything answered (she did that the last time too).

She said when we were ready, we should take the Karotype test, and then come back for another try when the test results were in.  Before we left, Babe and I decided that we would take the test anyway, so I had my blood drawn for the Karotype test before I left the clinic.  Since the results won't come back for a month, it would probably be June before anything else happens.

So now we wait.  Again.

Obviously, we hope the Karotype test come back normal so we can try again.  If not, we will need to have a discussion about donor eggs. I don't think we will do donor eggs, but we have never even considered it or discussed it.  We'll have to at least talk about it.  We'll have to see how things go.

We've all heard the cliche of the biological clock ticking.  Well it's ticking REALLY LOUDLY for me.  With each tick, it feel like my eggs are getting crappier and crappier.  With less than 4 months to my 37th birthday, it feels like a time bomb!

Today

Today.

Today would have been my embryo transfer day.

Today I would have been PUPO - pregnant until proven otherwise, a term used for women waiting to find out if their IVF cycle worked.

Today, I would have been on bedrest, relaxing, laying around on our bed or the couch reading, watching movies, or catching up on people's blogs.

Instead, today the lab called to confirm what we already know, that my only 2 embryos have arrested.

Because Dr. Hopeful is currently on vacation, one of her partners, Dr. K called today to follow-up with me.  There wasn't too much more information he could offer me from this cycle.  I will need to follow up with Dr. Hopeful when she gets back from vacation on April 5th.  I will have to leave all my questions I have until I see her face-to-face.

Of course the first available appointment to see her is over a month away on May 5th.  But the receptionist said she would leave a message for Dr. Hopeful and they will try to squeeze me in as soon as possible.   More waiting ahead.

Also, I was told to continue my Endome.trin suppositories for a total of 10 days.  Then I should expect AF to show up within 3 to 5 days of stopping.  Just in time for Easter.  Great.  Such a waste of meds  and effort for nothing.

My sister reminded me last night that around this time a year ago we had been dealing with the disappointment of the BFN from my first IVF.  I looked back at last year's calendar.

March 19th 2009, I found out that we had a BFN from my first IVF.

March 19th 2010, I had my egg retrieval for my second IVF.  It was also the day I found out we could retrieve eggs from the left ovary only.  From there on, things kept going downhill.

I know this may sound silly, but I want to remember today.

Today, March 24th 2010, would have been the day we transfered my embryos back.  It is not to be.

But I want to remember today anyways.  I don't want to forget.

Fertilization Update 3/22

First of all, I want to thank everyone that has left me all those wonderful comments from yesterday's post.  I am humbled that so many of you have prayed or have offered to keep praying for me through these few days.  This has been the hardest few days for me, even worse than the dreaded 2 week wait.  Thank you from the bottom of my heart.

I called the clinic today and talked to a nurse.  It sounds like the doctors normally do a day-3 or day-5 transfer only.  Plus I realized last night that today would already be day-3.  I asked the nurse if the doctor would do day 4 transfers, and the answer is no.   They try leave the embryos alone as much as possible to give the embryos a chance to grow as much as possible without disturbance.  The nurse said she would talk to the doctor or the lab and see what she can find out.

Well Teresa, the nurse from the embryology lab just called me back.  I have bad news and possibly good news.

The bad news:  It looks like Little Embie have not grown since yesterday.  It was at a 3 blast stage yesterday, and it is still at 3 today.  I am saddened by this, but they will continue to monitor closely.

The (possibly) good news:  It looks like an egg that did not fertilize yesterday seems to have fertilized today.  It now has 2 cells.  It is a day late and is slower in growth.  I am naming him/her Tiny.  This give me new hope!

Teresa was telling me that this is really weird, that an egg would fertilized this late.  It is not something they see every day.  I'd like to think of it as a miracle!  They will continue to monitor the embryos closely.  Teresa even gave me the number to the direct line of the embryology lab so I can call tomorrow if I wanted to.

I am feeling a mixture of emotions right now.  Disappointed that Little Embie possibly did not make it, and hope that Tiny may now be in the picture.

So now we wait some more.  The clinic will call me tomorrow with more information, about what time the transfer will be on Wednesday, or if the transfer will be cancelled.  Obviously, I'm hoping that both Little Embie and Tiny makes it tomorrow, and we would be able to continue with a transfer on Wednesday.

Please continue to pray that both Little Embie and Tiny will continue to multiply and grow strong and healthy.

I so want these embies back inside me!

Fascinating Facts: Eggs + Sperm

I have to confess that I have only gotten about half way though my book that I am re-reading up on IVF.

In doing so, I  would like to share some very fascinating facts about the egg and sperm.  Some of this is common knowledge, that even fertiles probably know about, but some are oh so very interesting.

Hello Egg, meet Sperm

• About the size of a grain of sand, the human egg is the largest cell in the human body.
• A woman develops all the eggs she will ever have at the fetal age of 12 weeks.
• A female baby starts off with about 7 million eggs when she is in her mother's womb.
• Her ovaries contain about 700,000 eggs by the time she reaches puberty
• A woman uses about 300,000 of these eggs during the approximately 400 ovulations that occur during her reproductive life span.
• In contrast to the egg, sperm are the smallest cells in the body.
• The man's testicles generate a new complement of sperm every 100 days.
• Eggs and sperm are called gametes until fertilization.
• A fertilized egg is called a zygote until it begins to divide
• From initial cell division through the first 8 weeks of gestation, it is known as an embryo.
• From the 9th week of gestation until delivery, it is called a fetus.

Swim boys, swim!

• Out of the millions of sperm ejaculated the vagina, only a few hundred  to a few thousand make successfully complete the journey to the waiting egg in the fallopian tube.
• Fertilization process occurs near the middle of the fallopian tube, not in the uterus
• The journey from the cervix to the fallopian tubes is about 4 inches.  For a cell the size of a sperm to travel this distance is equivalent to an adult human swimming the Pacific Ocean from Los Angeles to Tahiti - I was most fascinated by this.  

Can you imagine swimming from LA to Tahiti? Do you even know where Tahiti is?  It's in the middle of the Pacific Ocean!!  

That's approximately 4,000 miles or 6,500 km, or 8 hours flight time.

SWIM BOYS, SWIM!!