Thursday, July 19, 2018

A Little Embryonic Education

So here we are...48 hours into our fertilization process!  I should be hearing from our nurse here in a few hours.  She will tell me how many of our FOURTEEN embryos are continuing to grow and mature, what their "grades" are, and when our transfer will be scheduled.  As we have been going through this process, I've been so honored to offer a little education on this process.  SO many people have no idea what IVF entails, so I'm happy to be the sounding board and offer a little insight.  As our egg retrieval and subsequent fertilized embryos have become a reality, I've had LOTS of questions about what it all means.  So I thought I would do a quick Q&A with y'all to give you a little more information and help you understand what all of this crazy IVF talk means:

So they retrieved 20 eggs??  Does that mean you'll have 20 babies??

Ha!  Definitely not.  To give you some perspective, when we did this process with Greysen they retrieved 11 eggs.  Of those 11, 9 were fully mature.  Of the 9 fully mature eggs, 7 were successfully fertilized.  Of the 7 successfully fertilized, 3 were viable embryos.  1 of those embryos was a strongly graded one (I'll talk about the grading here shortly), and the other two were "marginal".  We transferred 2 embryos, and ended up with our sweet baby Greysen! We froze the remaining embryo.  So this time, we had a shocking 20 eggs retrieved, and 15 of those 20 were fully mature.  Of the 15 fully mature, 14 of them fertilized successfully (which is a CRAZY amazing result!).  Today I will find out how many we have that are viable, but more than likely we are probably looking at around half of the fertilized eggs will go on to be "gradeable" viable embryos...

Why didn't you use your frozen embryo?

The technology has changed SO much in the last 4 years since we did this and got pregnant with Greysen.  4 years ago, the freezing technology wasn't what it is today.  So our little embryo was a marginal embryo (B/B-, 3/5) and it was frozen with old technology.  Our doctor agreed that our best chance for success was with a fresh transfer.  Eventually, that little frozen embryo WILL be transferred if it survives the thawing process, but for now, at my age, it made more sense to go ahead with another fresh transfer for the best chances of success...

Are you going to have multiples??  Quadruplets??

The chances of a multiple pregnancy *are* higher with an IVF pregnancy than with a natural pregnancy.  However, my doctor and the practice at OU is VERY ethical and they rarely transfer more than 2 embryos at a time unless there is documentable reason to.  Dr. Hansen is an incredibly ethical doctor, so you will never hear of an "octomom" coming from his practice.  As a matter of fact, I think there are less than 10 total women who have gone on to have 3 or more babies at a time at the OU practice...ever.  The only way I would end up with 4 babies at once would be if each of my 2 embryos split into two sets of identical twins.  That is VERY unlikely. The chance of twins in a natural pregnancy is about 3%.  With an IVF pregnancy it's about 32%.  So...much higher, but still not more likely than a singleton pregnancy.  In all likelihood, we will end up with a single baby even if we transfer 2 embryos...

What do they mean by a "non-viable" embryo?

This is an answer I have been DYING to give.  Coming from the perspective of a woman who has suffered 2 miscarriages and had YEARS of trying unsuccessfully to get pregnant, I think SO many people don't understand what the process of "getting pregnant" entails.  Did you know that in any given cycle, it's possible for your released egg to fertilize and still not result in a pregnancy?  You might never know you had a fertilized egg because you'd go on to have a normal period.  A home pregnancy test is only going to show up positive once the egg has implanted and hCG is present in your system.  So no, not every fertilized egg goes on to become a viable embryo.  Sometimes they fertilize and then they stop growing.  That is a normal, natural process both in IVF AND in natural cycles.  Don't panic...

What do you mean by "embryo grading"?

Each embryo is graded on it's propensity for continued growth and it's uniformity (which is a way to evaluate its viability).  Embryos are transferred on either day 3 or day 5 after fertilization.  So check out this picture of our two embryos that we transferred last time:


You can see, somewhat, that there are small divisions within each of the eggs.  The more uniform the divisions, the stronger the embryo is graded.  Can you tell which of these two is graded higher?  The top one is the A/A-, 4/5 embryo, and the bottom is the B/B-, 3/5 embryo.  The top one is more uniform and symmetrical.  It had the highest propensity for continued growth, and more than likely was the embryo that resulted in our Greysen!  Did you know that embryos actually hatch??  They do!  You can clearly see the shells on these two embryos.  On day 5-6 they actually hatch and that's when they burrow into the uterine wall and become a true pregnancy.  A perfect embryo is an A+/A+, 5/5.  There are hardly ever embryos graded that high.  Most viable embryos have at least one A in the letter grade, and at least a 4/5 on the number grade.

What happens to the ones that are graded poorly?  

They watch our little embabies like a hawk, so they do not discard any embryo that has even the tiniest chance of continuing on into a normal pregnancy.  They don't make final decisions on viability until A) the embryo actually stops growing, or 2) after 7-8 days of growing they aren't dividing and maturing normally or have considerably slowed down.  These embryologists know what they're doing!  They take a whole lot of pride in cultivating normal, viable embryos.  They are emotionally invested in their success!  They take it hard when seemingly normal embryos don't continue growing.  While there is LOTS of science to this, these scientists are invested in this process and they want to see these little embabies succeed as much as we do...

What if you decide not to use all your embryos?  Where do they go?

We have to fill out paperwork before we even start this process that is like 20+ pages of consents.  Right now today, we are saying that however many viable embryos we have, we will be transferring at some point.  Of course, life happens and that could change.  In the event that we come to the end of our child bearing time and we still have frozen embryos, we have decided to adopt them out to couples who need them.  I don't anticipate that will be our end result, however we have thought and prayed a lot about that scenario and that is where we feel the most peace.  Of course, there are a lot of factors involved in that decision.  We do not take lightly at ALL that these little embryos are little lives.  They are not "discardable" to us.  They are OURS!  So trust that we will never make rash decisions about the lives of our embryos...

And as an end note, don't believe everything you read on the internet about IVF or fertility treatments.  While there *are* women out there who seek out doctors who will "pump them full of babies" because they want the publicity, that's not the majority of us.  Dr. Hansen, as I said before, is an incredibly ethical man.  He would never knowingly put me and my children at risk.  He has my best interest at heart and he has the lives of my future babies in the forefront of his mind.  Me and my babies are his top priority.  He is not interested in the fame!  Our end goal here is healthy babies and humane treatment of them from the absolute outset.  I know for a fact that OU has that same goal in mind.  That's why we are their patients!

In conclusion, if you have questions...PLEASE ASK!  I would rather you ask a seemingly "awkward" question rather than assume something incorrect or just go on not understanding.  I don't mind answering questions at all!  I hope some of these answers clear up at least some of your confusion if you had any...




Monday, July 16, 2018

To My Littlest Little Ones...

My Sweet Little Embabies,

Tonight I lay my head down for the last time before you exist in this world.  Tomorrow...everything changes, my loves. Tomorrow, life will be breathed into you.  I have watched my body grow and change this week creating vital parts of YOU.  We have counted eggs and measured follicles for 9 days now...knowing that ultimately, those eggs and follicles could potentially contain 50% of one of YOU!

We are SO extremely excited to hear of your growth.  How I wish I could see you grow and change minute by minute!  For now, though, I will trust your care and your progress to the expert embryologists.  The guys in the lab who know exactly what they're doing.  I know they will take excellent care of you until you and I can connect and the responsibility of guarding your life and caring for your little growing self can be my responsibility.  How I LONG for that responsibility!  How we have prayed for you, our sweet little miracle angels.  You have such a huge army of people rooting for you...praying for your arrival!  We hope and pray that one day soon we will get to introduce you to at least some of the mighty prayer warriors that have been lifting you up for months now!

I have no way of knowing how tomorrow will go.  I don't know how many of you there will be...how you will grow...what you will be like.  But I know each of you will be beautifully unique, and I can't help but hope with every ounce of my being that I will get to hold and know you here on earth.  But no matter what happens tomorrow...I want you to know how much you are LOVED.  How you are cherished, our sweet little babies.  You have a Mommy and a Daddy who are invested wholeheartedly in YOU and we have been since before we even knew each other.  We love you so much that we couldn't possibly put it into words.  Just the thought of your sweet perfection is overwhelmingly exciting...

So grow, grow, grow my little miracles.  I am SO ready to know each of you!

See you Soon!
Mommy


Thursday, July 12, 2018

Something Beautiful...

Tonight I took my regular 3 shots in the belly.  Right now we are holding at 150 iu of Follistim and the regular 1 ampule of Menopur and 5 iu of Lupron.  Tomorrow we go in for what *might* be our last monitoring appointment.  Depending on how my follicular count looks, we may have one more appointment scheduled this weekend.  But we will most likely take our trigger shot either Sunday night or Monday night to do our retrieval Monday or Tuesday morning.  Eek!!

This week has FLOWN by...I knew it would...but I've tried to take some time to kind of soak it all in.  I've let myself take naps when I would otherwise just push through.  I've made myself stop working at 9:00 when I take these shots and I spend a few minutes in my glider after I take them just to woosah for a minute.  Greysen has taken to "helping Daddy" give Mommy shots.  We give him a little empty syringe plunger without the sharp.  He wipes an alcohol wipe on my belly and says "Right here Mommy?" and then he says "It make noise again Mommy, but you feel better."  Then he pats the place he gave me a "shot".  It is not lost on me what a beautiful picture that is.  My little living, breathing miracle playing a role in this process.  His little tiny fingers gently caring for me, and his tender little heart being concerned about me.  I saw him when his entire "self" could fit on the head of a pin.  And now here he is being a part of every step of the same process that brought him to us.   It's really just...beautiful...

Tonight I got to looking at my lower belly where I've been getting at least one injection a night for 3 weeks now.  There are little "poke holes" in my belly and some tiny little bruises.  That's to be expected in a process like this.  My body kind of goes through the gauntlet on the way to a hopeful pregnancy.  It's worth every stick and every discomfort, though, and I would do this 10 times if it meant I could have a miracle even half as incredible as my Greysen is.  But tonight I noticed that those expected "poke holes" are interspersed among my tiny little stretch marks from pregnancy.  Evidence of the beautiful life I carried in my belly for 37 1/2 weeks.  Evidence that this process has worked.  Evidence that God has been faithful.  It was a little reminder that there is more to this than a few uncomfortable pokes and procedures for a few weeks.  It was a beautifully poignant picture of my strength and my vulnerability all intermingled together.  The body is incredible.  The things that God designed it to do are just awe inspiring.  And I am not at all unaware of what a GIFT it is that I get to see this process step by tiny step.  While there was a time that I felt resentful of the fact that we were going to have to go through this process again if we wanted to further grow our family, tonight I was reminded what a true BLESSING that is.  I can tell my babies that I saw them when they were so microscopic you couldn't see them without a specialized microscope.  I knew the MINUTE they were embryos and I saw the EXACT MOMENT that they were placed inside my body.  It's miraculous y'all...no way around it.  It's truly something beautiful...



Thursday, July 5, 2018

This Strange Peace...

About this time 4 years ago, we were right at the beginning of this IVF process for the very first time.  I remember feeling anxious and nervous and excited.  Every time I thought about the "next step" I would get a major adrenaline rush followed by a jittery excitement.  The process consumed my life and my thoughts and my time.  That's not to say that peace wasn't being prayed for by me and on my behalf.  That's not to say I wasn't hyper aware of God's presence and His provisions then.  But there was most definitely a different emotional vibe to that first process than there is this time around...

And I frequently find myself thinking, "Ok...how should I feel about the fact that I'm NOT constantly worrying or fretting or getting those adrenaline rushes all the time?"  It's as though my heart and soul are at complete serenity about this process, but my mind keeps second guessing this strange peace I feel.  My mind says "Maybe you feel this way because it's not going to work"...and then my heart says "Nope Rach...don't go there."  I know beyond a shadow of a doubt that no matter what happens with this cycle...even if it DOESN'T end in the pregnancy we are hoping and dreaming and praying for...I know I can trust my God.  I can trust Him to be the Master of the details and I can just be the beloved daughter of the King of the World...

When I close my eyes and picture what my relationship with my Lord would look like if He were living and breathing and physically here on this earth with me, I picture His mighty arm looped through mine.  I hear Him saying, "We got this girl.  Come on!".  I feel His unfailing strength and love and provision and I KNOW He has an incredible plan that is only just now beginning to unfold.  I know He is near.  So close, in fact, that He is speaking audibly to me through His Word and through my "tribe" of people. Through YOU!  Many of you probably have no idea, but on a daily basis I hear from at least one of you  about this IVF process and your words are a sweet balm to my heart a soul.  They are a reminder that my God and Savior loves me, He is present, and HE CARES!  I haven't even had a moment to fret about the "what ifs" because He keeps providing those frequent oases through your words of love and encouragement.  Goodness how He loves me and how precious my sweet relationships with YOU are!  My cup runs over...

So as we barrel right into this weekend and this next week of monitoring, I feel peace and serenity.  At my core, I feel a complete composed calmness about this cycle.  I am praying that that serenity translates to beautiful and healthy Womack Embabies.  And of course we pray fervently...we plead...that we would have the great privilege of holding and raising and KNOWING at least one of those sweet embabies on this earth.  But no matter what, I trust my God completely.  He will never leave me or forsake me.  He has a plan to prosper me and not to harm me.  He intends to answer my prayers and fulfill the desires of my heart.  And I KNOW He wants the absolute best life has to offer us.  So I'm resting on His promises, His provisions, and His wholly REAL presence...

Wait with us.  Pray with us.  Hope with us!