Wednesday, September 11, 2013

IVF Abroad - Week Two

            On the day of fertilization (the day after the egg retrieval) Jill and I left to travel northwest to Berlin, Germany for the duration of our embryonic development.  At that time our job was done for a few days except for the continuation of drugs Jill has to consume, and a shot of Progesterone in oil every night in the upper buttock for two weeks.  She thought the ovarian stimulation shots were a pain in rear until I had to stick a 3-inch needle in her rear.  Of course the first time was painful for her and I realized you literally had to stab her abruptly with this almost lethal weapon to deliver the drug intramuscularly.   WTF?  Though after the first time I became pretty good at it with almost no pain at all.  Jill is also taking an estrogen supplement three times a day as well as her prednisolone and folic acid daily.

            However, we were given a chance to see the beautiful and historic city that Jill and I both missed our last time we were in Europe.  Finally a city with a normal infrastructure for easier navigation and sight seeing, and with three days to explore this colossal city, we took to Berlin.  On our first day we visited the Pergamon and Neues museums on museum island.  Followed by the astounding Berlin Cathedral.  After lunch we spent some time around Brandenburg Gate and the Reichstag Building.  The next day we went to the superb Berlin Zoo, rated the best zoo in the world.  We spent about four hours documenting our travels wandering through the park.  We took about 600 pictures of everything we saw to have a plethora of animal pictures to choose from for our future baby’s room.  On the way back we stopped at an intriguing street market and of course, bought souvenirs.  The following day we sought out and found our limited edition German beer stein with a piece of the Berlin Wall on the stein’s cover, and then headed back down to Brno for the final stages of IVF.

            At Reprogenesis the next day was the egg transfer and there was good news and bad news but the good news is great.  First, the bad news, of our six embryos only three made it.  Apparently this is quite common as the jump from morula to blastocyst is quite a huge developmental hurdle.  Two of the embryos just simply stopped growing.  The third had no inner cellular mass although it became a blast.  At the blast stage the cells divide into two groups - the outer which will become the placenta and sac and the inner, which becomes the baby.  With no inner cells our embryo could only form an empty sac with no baby.

            On to the good news!!!  All three of the remaining embryos made it to become a blastocyst and are AA quality - the best rating they can get.  Two of them were hatching - meaning getting ready for implantation and the best possible stage for IVF.  The third is an AA expanded blast, meaning it is great quality and about to hatch.  We had the transfer on 9/9/2013 and all went well.  They put the two hatching AA blasts into Jill’s uterus via catheter and we had the third blast cryogenically frozen and will come back for it later.  We briefly considered using all three for IVF, but because they are all AA it would be pretty risky to do so and the embryologist was definitely against it.  So our doctor impregnated Jill with our fertilized blastocysts as I sat next to my wife with her hand in mine as we silently prayed for our two little blasts to implant and grow.  Jill is now taking it very easy with mostly bed rest on the 10th and 11th, and then also pretty easy for the next couple weeks as well. 
            To end week two when Jill was off of bed rest we drove a half an hour northeast to the Moravian Krast and the Punkva Cave to take a boat ride on a under ground river the runs through the largest cave system in Europe.  A little adventure and fresh air for us after two days lying around in our hotel room was well needed.  Not to mention our 2nd anniversary on the 10th was spent eating doner kebab and watching BBC World News.  Though we keep on telling ourselves, “it will be totally worth it,” and now that our IVF cycle is complete we are in the two week wait to find out our results.  However, I apologize to my readers, but our results (positive or negative) won’t be announced until 12 weeks after IVF because we fall under the category of a high-risk pregnancy, and we prefer to keep a certain amount of privacy concerning the actual results.  Only our parents will be informed when we find out.

            In the upcoming week 3 of our IVF journey abroad, we built in 6 extra days for any mishaps or miscalculations during our trip.  Since everything actually went according to plan, well actually, we were one day ahead of schedule; we will spend the rest of our time in Europe in Vienna, Austria and Prague, Czech Republic starting tomorrow (9/12/2013).  Now that the IVF portion of the trip is over and went very well, my last blog post will be the results of our hard work and due diligence.  Thank you for reading and please keep praying for our success with our IVF journey abroad. 

Friday, September 6, 2013

IVF Abroad - Week One

            We flew over the Atlantic to arrive in Prague where we drove to Brno to check into our hotel in less than 24 hours from departure.  A feat that would seem impossible less than a century ago, yet in the course of our travel I was never really that uncomfortable.   Fatigued, sure, but having made this trip six years prior for a backpacking adventure through Europe, I felt prepared enough to ready myself for the stress of travel; and stressful it is.  With calamity lurking at every corner in a airport, one must rely on a certain amount of luck to navigate the ever pending doom of delayed flights, canceled flights, or if you are even going to see your luggage 5,500 miles away from where it was entrusted.  Luck would have it we had a four hour delayed flight in Cincinnati, Ohio due to weather in New York, and would indeed cease any chances of making our Prague flight.  (We were not made aware of the delay until one hour before our departure.)  Luckily, a fellow international traveler sitting behind us on the flight from Denver intelligently found another commuter flight to New York a few gates down as soon as she landed.  Having heard of our travels from the inquisition I’d endured from the woman sitting next to me, she actively sought us out to relay this information.  She literally saved the day, and with her the help we were able to switch flights and obtain the last two out of three tickets available on the plane.  Once we arrived in New York we found our gate and made sure our Prague flight was on time, and just less than two hours later we boarded our international flight and nestled in for our last leg of travel to Europe.  The flight was actually decent, except for the knees in my back all the way to Europe.  Though we loved the on demand movies with plentiful choices but didn’t love doing an injection mid-air so much.

            Once we arrived in Prague, Czech Republic we rented a light blue 4-door 5 speed manual transmission Skoda.  A very economical European car with minimal amenities, or as I see it, a stripped down Corolla.  Nonetheless, it does its job nicely, and armed with our Skoda, IPod, European Garmin, and utter excitement to lie in bed at our hotel, we traveled to Brno.  The next day we had our first appointment at Reprogenesis, and Jill received her ultrasound to determine the exact time for egg retrieval and any medication adjustments.  Our doctor, Tomas Vrana, conducted the study in his office (which is in a older mansion that’s been rehabbed into a state of the art fertility clinic) and determined that Jill responded really well to stimulation drugs with a count of 16 follicles.  10 on the right ovary and 6 on the left with every other measurement taken produced good results too.  So he felt that there was no need for a second ultrasound and we reserved the date of 9/4/13 for the egg retrieval at 8:00AM.   Only being August 30th at the time, we were allowed some time to experience Brno, and Jill continued her stimulation injections up until the day before transfer. 
So I put my Pumas to the pavers, and walked the cobblestone pathways that led to such marvelous sights such as Spilberk Castle, Cathedral of Saint Peter and Paul, and old town square.  We happen to stumble upon a folk music festival where we witnessed the actors on stage dressed in presumably traditional Czech attire, slaughter a women dressed as a giant pink pig.  We had no idea what was going on.  Then had the pleasure of listening to the best xylophone exhibition Jill and I have ever encountered.  Quite a treat really, considering the beautiful courtyard that held the show was riddled with Romanesque sculptures and marble slabs and columns at every turn.  The next day we experienced Brno once more and on our stroll we found ourselves at the Moravska Galerie (the Moravian museum).  With high hopes of seeing something ancient and interesting we entered enthusiastically, but only to find bitter faces and bad attitudes.  We started walking through the museum with the hickory wooden floor weaved in the basket formation crackling with every step we take.  Which then alerts the hound dogs that follow us through the museum watching every movement we made, as if we were casing the place.  I tried to reassure the museum attendants that I came only to be enlightened by the exhibit with a smile to show my intent.  Though, to no avail, we were just silently followed around by dour older women with frowns on their faces.  Creepy, to say the least.

            On Sept. 1st we traveled to Bratislava to stay in the Marrol’s hotel, a very charming upscale hotel just down the street from the main square.  Jill and I fell in love with this area with its street markets and delicious food and sight seeing.  We traveled up to the Bratislava castle and walked into beautiful cathedrals.  We bought souvenirs at a local artisan fair and here we decided to buy a decorative beer stein in all the cities that we enjoy the most.  The next day we traveled into Poland and stayed at the Piramida hotel (a hotel that is fashion after the pyramid of Giza), a pyramid in Poland.  I know, right?  It would be weird if we didn’t stay there.  However, we were only in Poland for one reason, to visit Auschwitz concentration camp.  We felt that it was important to remember those who tragically lost their lives, and honor people like my grandfather who fought against the Nazis for freedom.  We also need to remind ourselves that it can never happen again, because, as they say history repeats itself.
            We drove back to Brno that Tuesday for the embryo retrieval and stayed at the Holiday Inn due to their reviews of having the best beds in Brno.  We haven’t had much luck with a comfortable bed thus far, though to our surprise they did indeed have the best beds in Brno.   And best of everything else too, but of course, everything seemed to be a surcharge and very expensive.  Totally worth it though, because up until then I had been suffering from a mild case of insomnia.  The next day Jill underwent the egg retrieval under general anesthesia for approximately 10 minutes.  During the procedure our doctor was able to aspirate 11 eggs (oocytes). 
The next day, the clinic informed us that 9 of the 11 eggs were mature and suitable for attempted fertilization.  They work on fertilizing these 9 eggs with first using a procedure called PICSI to collect the best of the best of my little guys and then used ICSI (intracytoplasmic sperm injection) to fertilize the eggs, and 7 of the eggs did indeed fertilize and became embryos.  On Friday, day 2, we received another update on our embryos. (Embryos that are developing properly should have 2-4 cells by the second day and continue to multiply from there.)  Of our 7, one stopped developing.  Though 5 of the remaining embryos have 4 cells and one has 3 cells.  So they are all potentially viable!

            Each day until we do the embryo transfer we will get an email of an update on our little guys, or girls.  The clinic actually uses embryo monitoring to visually inspect the stages embryonic development, and we get a DVD copy once completed.  Tomorrow will be day 3 and our embryos should have 6-8 cells to complete week 1 of IVF journey abroad.  Week 2 will have the exciting conclusion of the embryonic development and the adventures that come along with doing IVF abroad.