News Article: Why Women's Eggs Don't Last

A human oocyte.FLICKR, ED UTHMAN

It's late and I'm tired, but I've been meaning to post about this since last week. My BFF sent it to me the same day we got our twins u/s report and I wasn't ready to share our news with him yet. Will have to have a talk with him at sometime to explain "timing" and how it relates to "appropriateness", but fortunately our u/s went well. Anyhow - since I wasn't in anguish over my old-ass eggs that day, I was able to read the article as it was intended.

The article is a very interesting read regarding how egg quality declines as women age. Too tired to go into my analysis of it so I will just give you the link outright. :-)

http://www.the-scientist.com//?articles.view/articleNo/34375/title/Why-Women-s-Eggs-Don-t-Last/

This really doesn't help me that much because of my age, but I do think it has great potential for others 10+ years from now, with a hope of pharmaceutical help to all ages of women. That would be freaking fantastic. 

6 Embies

We have 6 embryos. We will see how many continue. (4 of the eggs were immature). The embryologist said if they do well, then they might consider doing a 5 day transfer instead. We told her that we are not sure if we want to take that risk and to have the doctor call us tomorrow when we know more on how they are doing. 

Pros of going to 5 day: out of the embryos that survive, you can choose the very best ones to implant, resulting in a higher rate of pregnancy.

Cons of going to 5 day: embryos that could result in a pregnancy may not make it to 5 day outside of the womb. We could lose them all and have nothing to transfer. 

Trying to get less excited. It's hard. 

Money, Get Away

"Money, get away
Get a good job with more pay
And you're OK."

Clearly The Pink never went for infertility treatment. Which is weirdly funny given their nickname.

We are entering our third and final cycle with my eggs and with a person close to us doing the surrogacy (without charge). Approximate cost: 35-40K. That's not a typo. That's how much it will cost us out of pocket. Paid in full by months end. In addition to all we have already spent.

And now, all of a sudden, a little voice inside me is very scared. To spend this much money and use my long shot eggs. Actually I'm quite terrified.

Weekly Update: A Job, Land of IF, Being a Proud Parent

So many things, so many things. I've forgotten half of them already. Let's just hit the highlights and see what else I can remember.

Hi Ho, Hi Ho, It's off to Work I Go.
Had to go back to work. Money is just too tight right now. Me not working for 8 months has finally taken a toll on our finances and if we want to continue in this Land of IF, then we can't do without my paycheck.

My first week of job hunting was really me just talking to recruiters. I figured I had put enough off during my travels to India, that now was the time to dig deep. That's always an adventure, but by week 2 I had a job - fortunately my area of expertise has an extremely low unemployment rate. It's a contract to perm position in IT, doing what I have over a decades experience experience in. I will be making over 10% more than what I did at my last job and for a company that has a big name all over the world.

What about my dreams to do some sort of humanitarian thing in the non-profit industry? Selfishly, our dreams of a family rates higher on the scale, thus I had to give up on a career choice that would pay just over 1/3 -1/2 of my current salary. All is not completely lost as the project I am working on helps people from 9/11. At least I can believe in the project. Some of the companies that wanted me to interview were BLECH. (Have had enough of soul sucking from my last job thank you very much!)

Speaking of Land of IF...
1.) Just starting reading the book Navigating the Land of IF: Understanding Infertility and Exploring Your Options by Melissa Ford of Stirrup Queens fame. Only on chapter 3 (have had to study for work - <sad face>), but it is pretty awesome. Have my own mini-collection of IF books, but this is the one that most interests me right now. Probably because it's not all doom and gloom fact based. Melissa does an excellent job of making the reader far more relaxed over a very NON-RELAXING subject and everyone is included. It's a hard road and the recurring theme is that we are not alone. And that it's ok to be all emotional. I'll write a full review when I'm finished.


2.) Our friend and her husband who offered to do surrogacy for us are "both feet in". YAY!!! That's the first hurdle. We've consulted with our local clinic and there are a couple of things we have to address, almost all of which we expected. Then there is the insurance issue. We don't know yet if her insurance has a surrogacy clause. Trying to find that out without sending up red flags. They aren't known nationally to cover these things...One step forward, two steps back.

The item I had not thought about was that my doctor wants to retest my FSH. It was high last january (12.4) and with the decrease in my AMH, she wants to make sure that it hasn't shot up to the high teens. I know, I know, it's a Big If. Wish me luck. If it comes back too high, then we could be in holding pattern for years for the DE as I've previously mentioned here and in other places.

Proud Parent
Some of you might remember that I have a 20 year old son. What I don't think I have ever mentioned is that he is in seminary school. Which is perfectly natural since his father is Jewish, my husband is an ex-Hindu, and I have had a lifetime of "trying to figure it all out". (Try not to laugh.) Anyhow, my son has a religious podcast now and I am very happy to see him do something he enjoys so much! Of course as the proud mama I had to listen to it right away and I was tickled in doing so. He was great! Very few people in life get to have the career that they absolutely love and I think he will be one of the lucky few. We have the best discussions and I'm thrilled that not only am I his mother, but also his friend. He dives into projects where he can bring help to those who need it and I am so incredibly proud of him.

-------------------------------------------------
Well, that's all I can remember right now. Still recovering from the flu, which is interesting with starting a new job. I'm exhausted.

You have questions...We have answers

Actually I need your answers, so if any of this sounds familiar please post your experience/knowledge in the comment section.

On Tuesday night, I attended a seminar at my old clinic ACRM, here in Atlanta. I described some of it here and also pinky-swear promised to post the questions I posed to the new doctor during the Q&A session. (Ok, I didn't really pinky-swear, but I wrote I would, which is almost like the same thing.)

So here are the questions I asked.

1.) Can endometriosis affect the outcome of an IVF cycle if the woman is using a surrogate?
A.) Yes it is possible. [Sadly I have forgotten the reason behind it. I believe she did mention that there could be an effect on the eggs in a follicle and thus less eggs retrieved, but for the life of me I can't remember if she said certain things or if I am confusing it with stuff I have read.]

2.) Besides cost, what are some of the downsides of using ICSI?
A.) There have been studies done of the offspring conceived by ICSI and it was noted that the male children had a higher rate of sperm problems. Whether this is a cause of the ICSI or due to genetics (ie, the father having sperm issues thus ICSI was used) is unknown. 

[This one I already knew the answer to, but I wanted to make sure there wasn't anything else I didn't know about. Primarily because our clinic in India uses ICSI as a default with no extra charge (unlike here in the States).]


3.) How long after a laparoscopy, do you need to wait to start an IVF cycle?
A.) Generally the recovery time is short and we like to do the next cycle as soon as possible. Especially if the woman is older.
[I know they can't do it the same month as IVF, so I'm guessing that means you just have to wait until the next month.]

I'm getting conflicting statements about #1 and I'm a little concerned about it. Everything I read regarding endometriosis and IVF revolves around the woman carrying the baby, there is very little info for women using a surrogate.

My new OB/GYN did not seem to think that endometriosis would be a problem for me (with regards to lowering my IVF success rates) since we weren't using my uterus. In fact he thought there was a low likelihood that I had it since some of my symptoms were relieved with my cryoablation. He advised for me to find out if the cyst I had aspirated during my first IVF cycle was a chocolate cyst. He did mention at the end of our lengthy consultation that he did not specialize in reproductive endocrinology, so I'm guessing that was his out if he was wrong. The only surrogate cases he probably has is if someone walked into his office who IS a surrogate and already pregnant. Also this WAS before they locked me in the bathroom.

Conversely, Dr. GS on SIRM's forum indicated endometriosis could cause a problem in my case, but it was hard to tell if he understood that I would not be CARRYING the child. Even though I definitely mentioned it. (I am awaiting on a response for that clarification.) He mostly pointed me to articles that either talked about the problems in the woman's lining (and toxins activated in it) or in one case a long article he wrote with one tiny sentence that suggested a gestational surrogate would be a better option. That seemed to contradict his reply to me. Anyhow, I've awaiting clarification.  [UPDATE: Dr. GS did reply and state he missed the part about gestational surrogacy. He said that in the case of immunologic implantation dysfunction, it wouldn't apply to me, but an endometriotic cyst would affect egg quality.]

The REASON I'm even asking is because I don't know if I should be tested for it. We have decided to cycle again, but this may be my last one and I want to optimize my chances. If endometriosis can affect my eggs pre-aspiration, then it seems like a good idea to be tested and get any problems fixed. On the FLIP side, scheduling and doing a laparoscopy  plus recovery time could add a couple of months to the process - thus lowering our chances. PLUS some doctors advise against laparoscopic surgery for poor responders as it can further lower your ovarian reserve and raise FSH levels.

What to do, what to do. Time to go have a real one-on-one with our ACRM doctors again.

As I said at the beginning, feel free to chime in. 

New Advances in Infertility

Each of these mouse pups was born from an egg scientists created using embryonic stem cells. 

On thursday, NPR had a fascinating story on a breakthrough discovery for infertility. Even more fascinating  they did it with induced pluripotent stem cells (as opposed to the controversial embryonic stem cells). If they can do it for women, then not only will it reduce/eliminate the biological clock worry, but also provide a solution for the dreaded "unexplained infertility" diagnosis that plagues so many women. This will be a game changer for future generations of infertile women. There are even great implications for men with sperm issues, as well  as the many hurdles faced by the LGBT community.

Alas, this will not apply to many of us currently in the throes of infertility. All is not lost. Many doctors are currently working on various cell technologies that apply to infertility. Autologous Endometrial Coculture is one example of a technology promising encouraging results. What does all that fancy wording mean? The short of is that they take cells from the lining of a woman's uterus and use them as a more natural environment for fertilized eggs than the previous methods. Studies have shown that in certain cases embryo development is improved, as are IVF success rates.

Dr. Patel's clinic in India is working with a similar concept: certain clients can qualify for the case study in which natural cells from the IVF patient are used to surround the egg pre-fertilization. They are seeing an increase in fertilized eggs and while it's too early to determine if this results in actual healthy babies born, I can say I was very impressed to learn that 3 out of 4 of my eggs were fertilized with this method. There is more to this method than I am [purposely] describing, but that is better left to the professionals or perhaps, when I can be less emotionally attached to the subject matter.

I have no idea if this will help the quality of my eggs/embryos in the long run, but it is still very exciting. My first cycle ended up with 2 eggs and only 1 of those fertilized. That 1 egg took over 24 hours to fertilize. On my second cycle (with the new protocol) I had 4 eggs extracted and out of those 3 fertilized. Like my first cycle, one of those was a late bloomer, but maybe it's the one implanted now and thus causing a lower hcg. Apparently my case is not an anomaly as the Akanksha Infertility Clinic is seeing really encouraging results with women that qualify for the case study. Even if it doesn't work for me, I will be really excited if this helps improve success rates for women in general.

Science is so cool. 

Egg total = 4

Less than I thought for 12 good follicles, but still twice as many as last time.

Today we go and see if they fertilized. Already my stomach is a tad in knots. 

Day 9: 12 are good to go!

12 follicles are between 16-21mm and 1 is at 14mm. YAY YAY YAY. This is so much better than last time (and with the original 5 we thought we were starting with). I'm still on the antagonist protocol, but with extra meds that Dr. P says has recently shown really good results in poor responders. Now let's just hope everything else goes well and that the follicles are filled with good eggs, that make good embryos, that make BABIES. It would really suck to feel so positive this time to have it all go to crap.

We are going to retrieve on Thursday. My husband has switched his travel plans and it taking an earlier flight into Vadodora, where the hotel car will be waiting for him. We nixed the train idea. That should shave a few hours off his time, so maybe he will make it before I go under. I hope so.

My husband wanted me to ask the doctor if we could do the retrieval in the afternoon, but she said she doesn't want to take the chance and compromise everything. I knew that would be the case. If we don't time things exactly right, then we could miss our window, especially with my larger follicles.

So Thursday it is. Right now my husband should arrive around 8:30AM and I am scheduled for retrieval at 9:30am. With any luck he will be there to hold my hand before I have to go under. Hoping that Dr. P is able to retrieve many and that they are good.

While we are waiting, here are some pics of a small local temple nearby.

Day 8: Yay! and try not to freak out.

Had another sonogram today, more shots, met the surrogate, and went over some preliminary paperwork.

Sonogram showed 13 follicles (yay!). 5 really good size, 6 average, and 2 small. Hopefully we will get some good eggs and then embryos out of these. Right now we plan on extracting on Thursday, but Dr. P said she will confirm after my sonogram tomorrow. 

Starting to get a little worried with the timing of my husband's arrival. I recall when we were planning this trip that I commented we didn't have much buffer room for mess-up (time wise), but I didn't think much more of it. Don't think I even thought of the timing for HIS arrival at all. Saturday I realized how short we were cutting it with his arrival. He gets here on Thursday - right now I'm tentatively scheduled for egg retrieval that day. That means he will not be there when I go under, something I am NOT happy about. Think "scared" is more the word I am feeling around for. In case of emergency, we do have 2 backup samples from last time, which is  good to know, but still don't like the idea of possibly having to use them if ANYTHING goes wrong with his travel. 

Try not to freak out, Try not to freak out. 

Last time we had to go a day earlier than expected. We expected 10 days of shots (not including the trigger) and ended up with only 9. If I go on Thursday, this will mean that I only had 8 days. I think the average person goes 9-12 days. I'm hormonal and irritable at my husband right now. Even more at myself for not looking at his schedule more closely and insisting on better buffers. 

Try not to freak out. Try not to freak out. 

Ok, got that out of my system for now.

On a different note: met the surrogate today. The surrogate is 28 years old, 121 lbs and 5'3 (I think she's 5'2 1/2). She has a brightness to her eyes and is ready with a smile. Sadly, she is going through a divorce and wishes to have enough money to get her own house and have some left over to go towards her son's education. 

When people talk about exploiting the poor, I really wonder if they think of things like this. Many months ago I looked up Gujarat house/flat prices and I remember being amazed how low they were. A surrogate in the USA could NEVER buy a house for what a woman could here in India. Sure, it may be a small house/flat compared to what we are used to, but so are most of the homes I have been to here. Even in very well to do homes. A woman could not earn the equivalent of 10+ years salary for surrogacy in the USA and they could not have left over funds to educate their children. When you see the lives here that have had such a positive impact due to Dr. Patel and surrogacy, it's easy to see why she does not let her critics affect her. 

Ok, got that out of my system for now.

Please let this take this time. I don't think we could come back again for another try with my eggs. Please please please. 

Hopefully this cow gave me her blessings. I gave her and a baby cow some of my leftover Malai Kofta and rice. Actually I gave it to the calf, but then she came and took it over. I'm ok with that. Maybe I'll get double blessings. 

Boss cow

Baby cow eating bushes after a few bites of delivery

Days are flying by: Day 6 - Part deux

Good and bad.

The bad was the AMH results, but for reasons I will not go into right now, I don't have absolute confidence in the results from the blood peeps. That could be a preserving mechanism, could be erroneous results, maybe my cyst threw it off, or maybe the results were simply wrong. Whatever. I'm not going to focus on that either way. PLUS, from what I understand, AMH is a direct reflection of follicle/egg count and if that's the case then it doesn't make sense that....


MY FOLLICLES ARE WAY UP! I have 11 that are growing. 7 of them are good sized. The 4 smaller ones can always potentially catch up, but I'm very happy about the 7 follicles. That's much better than last time.

(pic my send friend sent me during my 1st cycle)

I realize that 11 follicles isn't earth shattering news for some, but it's great news for me. Let's just hope that they have good eggs inside and that will grow into great embryos. 

Special Lady Cocktails

When I first was swept up by the internet infertility tornado, I remember reading forum posts from other hopeful women. Falling on a theme (as I often do), I obsessed over the ridiculousness of women taking all kinds of crazy pills - usually without having a doctor recommend them. OMG! DO YOU JUST TAKE ANYTHING YOU FIND ON THE INTERNET??? Some posts swore by the helpfulness while others confessed that they worried it may have hurt. Once discovered, some doctors gave full-on lectures how it was not appropriate for the poster's situation, only to find out that someone else (usually another doctor) in their clinic had told them to take it. Truthfully, I was personally affronted that such naivety and desperateness could drive women to arbitrarily take anything in an attempt to conceive.

The picture above is from MY house. That's right, Ms. Holier-than-thou is ...well, the same as everyone else.

At first it started small. My first pill was THE PILL, and I was told I would have to take it by my Indian doctor to make sure I was synced properly for my IVF treatment. Fair enough. I called my OB/GYN and promptly got a prescription. Let me mention here that I do not like taking birth control pills (bcp) as not only does it make me gain weight and experience occasional nauseousness, but sometimes I experience additional glum side effects (depending on the brand). Fine - whatever - I set my alarm on my phone to give me a daily reminder; particularly because my history of remembering to take medicine on a daily basis is pretty dismal. Especially BCP. Our local IVF doctor also advised to add a pre-natal vitamin (another item bound to make me nauseous) and I immediately relented as I ran to our local Publix.

Baby aspirin and acupuncture were added to the regime - the latter being something I normally would have scoffed at a year earlier. Doctor semi-recommend it and so I shelled out the cash. My husband gave me the big-eye, but I'm guessing he recognized my fervent look and said nothing. 100 bucks a pop for 6 weeks = not cheap. What can I say except I wanted no regrets.

IVF treatment #1 was dismal. 2 eggs retrieved, only 1 fertilized. Even that 1 took a damn long time to fertilize.

Now I am prepping for treatment #2. In typical fashion, I have been obsessively researching similar cases. Not just blog posts, but academic papers and any type of current research I can lay my grubby little eyes on. A clinic in India recommended 25mg of DHEA for 3 months. I rush to pull up the scientific documentation and realized all of the research is really based on a tiny Tel Aviv study. The study showed a significant difference in live birth rates with women who were poor responders and took 75mg of DHEA for 40 days vs women who did not. A follow-up study had additional encouraging results. Screw the 25mgs -I only had about 40 days till cycle, I was going to go full boat - 75mgs it is! [I would like to make a note here that I was not able to take the full 75mg initially because of side effects. I had to build up and even now I have minor side effects.]

Next I read how melatonin could also help woman with poor ovarian reserve and immediately I was hunting down more articles and recommended amounts. 3mgs seemed to be the magical number, but that amount knocked me on my butt. Still 1-2mg was doable and thus it was added. Combining it with the DHEA means I sleep really well, but I'm groggy as all get-out when I wake up. Heaven help me if I don't get a full 8-9 hours. Oddly enough, my friend says she takes 10mg all the time and it barely helps her sleep. What can I say? I'm a lightweight.

Did I stop there? Heck no! I was on a search that day and after reading some articles (which I can not find at the moment) regarding myo-inositol, my amazon shopping cart increased. Among other things, myo-inositol was suppose to help women with cyst issues and a giant cyst almost caused a no-go last cycle. My OB/GYN found a cyst last year and I began to wonder if some of the pain issues I had felt over the last year were cyst related. GIVE ME MYO-INOSITOL NOW!!!

There were a few other things on the list, but these 3 new items had good scientific data to back them up and they applied to women with similar (if not exact) conditions. The other pills I noticed my fellow women-at-arms were taking were either less scientifically regarded or didn't apply to me. Besides, as I mentioned before, I'm a light weight and I wanted to see how I was going to handle this new concoction.

Which brings me to last week. I'm not quite sure HOW I ended up at the Rainbow (read: hippie) Grocery store - but all of a sudden I found myself at the cashier's stand with CoQ10, some fancy fish oil supplements, and yes even some Royal Jelly that was well hidden in a jar of honey. And some awesome low-sugar dried mango. And a yummy nut mix. And Activated Charcoal that I told myself would be good to have on hand if my dogs ever get into something they shouldn't. Somehow I think my subconscious was trying for an easy excuse to get some for me. You know. Just in case.

"Just a spoon full of sugar..." (or honey) 

"Assume" makes an...

When I first started reading IVF blogs, I came across an elegantly written piece about why adoption was not the choice for everyone and how the poster was sick of people suggesting it. It was long post, and I wish I remembered who wrote it, but it was good. Really, really good. The post outlined perfectly why not only was it not an option for them and the reasons why it was not an option for many, but also how the constant mention added hurt to an already very difficult time.

That's what I felt like yesterday with yet another hint that we should consider donor eggs. 

I'm sure it wasn't intentional, the person probably thought they were being helpful - they weren't. At this time, egg donation is not an option for us. Period. Maybe that will change if I have additional failed cycles and other things fall into place, but 1 failed cycle does not = go straight to donor eggs for us. 1 failed cycle that I may add, produced a high grade embryo. I may not have responded as well as we had hoped, but that's what 1st cycles are all about - right? Learn how you respond and adjust.

Both my husband and I are educated people and we know exactly where we stand with odds. We are fortunate enough to have access to published information that is reserved for academics in the field, are avid researchers, and even have access to data that very few others are privy to. If anything, one can say I have analyzed data to death as data is my field of expertise. We do not even look at data the way a layperson does because we have a statistical and data background that let's us read beyond sheer numbers. We are well aware of EXACTLY where we stand. 

Besides the warm and fuzzy of having your own genetic child, we have bigger issues on why it's not an option: my husband is not a US citizen. We live in the US. An egg donor means our child would not be a US citizen and we could run into some very serious issues of not being able to return to the US or a child visa expiring while we are in the US. There are 20 things that could go wrong and quite frankly the added cost of it all (me not being able to work while this thing sorts out) is too much of a limbo for us. To badly paraphrase the great Jack Nicholas, "Go sell limbo somewhere else, we're all stocked up here". 

We could wait for my husband to become a citizen, but that can take a lot of time and his international travel could be limited during the process. That may or may not cause issues with his work and it would certainly cut out travel to India, something we would prefer not to do at the moment given his parents are elderly, have had health issues, and live in India. 

There are a TON more issues of WHY we choose to try to use my eggs right now and quite frankly I don't feel like listing them all at the moment. Between a baby shower and a email yesterday, I'm spent. The email was from a popular clinic and even though I have never worked with them before and have only had 1 failed IVF, there was a blatant suggestion that I consider the egg donor route. I'm sure it wasn't meant this way, but it felt the same way that all of us IVF'ers do when someone suggests that we quit being selfish and go adopt a needy child. It's not one of our current options and people shouldn't assume that it is. 

I seriously thought my tears were going to flow in front of everyone when I naively and happily opened that email from the clinic. In the middle of the baby shower no less. Let me clarify that I think the egg donor route is an excellent option for many people and I fully support that decision, - but for now it is not for us. 

Things you should not read during 2WW (I mean it!)

From  http://www.fertilitynation.com

Ugh.

Supposed to get the news tomorrow, but I wouldn't be surprised if we don't hear from them till the 11th.

Looks like I need to pull out a yoga video and read my new "Mindfulness" book. 

Eggs in a basket

For some reason our daily fruit package from our hotel in India always reminded me of a uterus. Don't judge, I have a great imagination and my thoughts were consumed with my lady parts already. You can even see where I pressed the cling wrap with my thumbs to try and get a better look and some tiny round fruit beneath the bananas whose name escapes me now. I'll call them the ovary fruit. (Thank goodness my Fallopian tubes don't look like that!)

With wandering thoughts today (and because it has been mentioned to me more than one at my precious age of 40), I looked up some egg donor info today. Not because I'm worried, just to prepare myself with some info should I need it.

Holy. Crap. 

According the American Pregnancy Association, the costs for just the egg donation is another 15-20K. If we do it here in the US, then costs for egg donation + surrogacy + all the other expenses that go with it run around 120K (and that's ONLY if the IVF cycle is successful!) If we do it in India, the costs are much less, but the complications are way more. If I want an egg with my ancestry, then it gets SUPER complicated. 

Do the process in the USA where it costs more and you chance a lower success rate by using frozen embryos or find an egg donor that is willing to travel to India (and probably go through a huge culture shock.) If we use an egg donor in India, then I have zero chances of having an egg donor with similar traits to me. In India we also run into the problem of my husband not being a US citizen and thus our child would not be. Getting the baby a visa with the HOPES that the US would approve me for adoption (and then citizenship for child) is a nightmare that might test me more than I am able to handle. (What happens if they say no after the fact???) Alternatively I can dash all hopes of any remote resemblance and we wait for the long process of US citizenship for my husband. 

Crap. 

Come on little embryo! You're the only prior egg left in my basket. 

Some news is good news

Yesterday I began to prepare myself for the worst. My husband was affected especially hard by our news of no fertilization (and by the evasiveness of the embryologist to my specific question) and I knew I had to be tough. There was no way he could take the news and deal with an emotional wreck of a wife. We barely spoke the rest of the day and only ate what was around our hotel room (i.e. snacks). I didn't even want to discuss next steps yet.

Today we were able to talk more on our walk to the clinic. Misc things revolving around IVF. Typical things that I think most couples go through including questioning some of the way things were handled. Think most couples go through that when faced with bad news; stages of loss and what-not.

Once we arrived in the clinic, rather then wait for Dr. Patel (which we knew would take awhile - yesterday's doctor strike caused double duty today), my husband asked if we could go straight up to the embryologist's office. The lady in the office told us to wait and after a few minutes went into the lab. She returned shortly and I assumed she informed the embryologist that we were here.

We waited. And waited. The seconds felt like minutes. After awhile, I knew the news would be bad. If she had good news, wouldn't she rush to tell us? I tell myself that maybe she is in the middle of an ICSI procedure and can't, but the other lady looked pretty forlorn. I suspect she already knows the bad news we are waiting for.

Finally the embryologist comes out. Her expression is not one of good news. She sits and starts speaking to my husband in Hindi.

All of a sudden I hear the Hindi word for "1" twice. I perk up. Then I hear "4-6 cells"! The conversation goes on and on and I don't want to interrupt for fear something might be missed, but I'm dying to know if I am right, and if so, the quality of the embryo. (It's amazing how much information you can get with only knowing a VERY limited amount of Hindi.)

Finally there is a pause in the conversation. I'm right! My husband asks if I want to see images. We are given surgical hair covers and face masks as we head into the lab. On the computer monitor I see the one egg unfertilized and next to it one booming with smooth edged cells. No fragmentation. It's 6-7 cells now; transfer is planned for this afternoon.

Holy crap.

I'm still not going to get overly excited, there are still many hurdles, but I will allow myself to be happy for today.

No news is probably not good news

2 mature eggs retrieved.
24 hours later neither have fertilized, but neither have degenerated.
ICSI was performed.
We are asked to check again tomorrow. Can take up to 48 hours. Embryologist will not answer the question of what is the longest she has seen take.
Husband can barely speak.

India is getting a egg-sperm-embryo bank!

Another great article from Times of India - Ahmedabad

Gujarat to have India's first egg-sperm-embryo bank

http://timesofindia.indiatimes.com/city/ahmedabad/Gujarat-to-have-Indias-first-egg-sperm-embryo-bank/articleshow/12643028.cms

I'm going to be how old? GAH!

Art by Ken Keirns.
http://fab.com/inspiration/aging-gracefully-16x22

It hit me yesterday. Wasn't fair. Truly I was minding my own business having a fun shopping day in my old hangout Little 5 Points (I can not BEGIN to tell you how cool we were hanging out there back in the day) when I had the sincere misfortune of catching a quick glimpse of my own reflection.

It wasn't pretty.

Apparently the boho look I was sporting (and do on occasion since my youth), does not actually look that good when surrounded by actual, modern, young bohemians (on 4/20 no less.) 

My initial reaction was "Holy crap - somebody get that girl some botox stat!" Oh wait, I'm fairly certain that botox would fall under the "what the hell were you thinking" category. Especially if I'm trying to limit stuff like caffeine, medicine, alcohol, and oh, I don't know, toxins that may cause botulism. Damn it. Ok fine. Just DON'T MAKE ANY EXPRESSIONS AGAIN EVER. And get more than 5 hours sleep. And DO SOMETHING with your hair for God's sake. 

Then another marvelous thought occurred to me: I'm turning 40 next week. Holy Christ in a Winnebago - when the hell did that happen? Can I protest or something? Occupy 30's anyone? My 30's have been some of my best years, but now that it dawns on me, the impeding 40's seem scary. 

I don't look 40; usually I gleefully tell people my age because of the confused looks I get. I don't feel 40; well maybe I do feel a tinsy-bit 40, but I've felt that way since I was 20. I definitely don't WANT to be 40. How is it I am already referring to myself as 40??? I have an entire 5 days left!

Most importantly, 40 is the age that egg stats really start to trail off (or at least that's how it is in my mind.) I've been able to deal with my new worry over the last few months about how my eggs will be - technically had not hit the big 4-0 mark - but now what? Crap, if I had known about this whole  older eggs thing, we would have started right away. But noooooo, I wanted to enjoy the whole "romantic, we've just been married" thing. They should give PSA's on this stuff: "girls, either freeze your eggs by 35 or screw a bunch of feminist things that take longer than 30 seconds to rant about. Fo realze". Then flash this chart the remaining 25 seconds.

If we don't succeed the first time, which statistically is expected, then our chances really decrease. Essentially I will need to put myself through as many IVF cycles as possible, in as short of period as possible. The stats for a 41 year old are downright "OMFG". Don't even get me started about 42. How will we even begin to afford this? If we can't use my eggs, then things get really complicated for us.

Is turning 40 going to be my new obsession? I'm not 30 anymore, and need to take better care of myself. Don't get me wrong, it's not like I think I'm 20 still and party like a rock star, but there are improvements I can make. I've started most of them with my "let's get this egg party started!" of late; hopefully they will become easier with habit. Hope so.

40. Ugh. It's going to be a long week. I wasn't even thinking about it until I saw my stupid, tired-looking reflection. Mental note 1: get plenty of sleep. Mental note 2: slap any one that says "age is just a number" on your birthday. 

If I were a fertility clinic, I would...

buy a billboard. Or a commercial. Or maybe both. And explain to anyone who would listen:
"if you are a woman over 30 that wants the chance of pregnancy - freeze those eggs baby".  Seriously. Why don't they tell us how DRASTICALLY our odds decrease as we women age? They'd make more money if they did.

Sure, sure, sure, we hear about "our biological clock ticketing", but I never even thought of what that meant. I've spent most of my adult life trying to make sure I didn't GET pregnant. When people talk about a woman's biological clock, they don't even put an age with it. I though it meant there was some internal biological EMOTIONAL clock that tells childless women they want babies as they age. Had no idea it meant "your eggs will turn craptastic with every passing month."

I swear if we are lucky enough to have a baby, I'm going to post those age egg charts all over facebook and google + as a PSA. Normally I wouldn't because I don't like people knowing my biz, but this is serious. Wish someone had done it years ago when I was first married.

We're going to have a meeting about the meeting and get back to you.

The nurse called today and initially told me what I thought she would: "The doctors had their meeting and your doctor wants to schedule a consult with you to discuss the results. Wait what? Earliest we have available is next week. How will that work for you?" GAAAAAHHHHHH!

Seriously? I have long thought that doctors operate in a different world where test results are just little things on pieces of paper that get moved around and talked about while sipping tea. No rush. Take your time. One lump or two?  It's not like we are waiting for each minute to tick by. The internet feeding our fear like a hypochondriac on WebMD. This confirmed my tea theory and it took me all of second to decide that I was NOT going to wait another 6 days.

"So what does it all mean? Are we still ok to use my eggs?" Nurse: "oh yes, it just means the doctor will probably want to give you more fertility meds and you should think about freezing some embryos now. It could take months before we find a gestational carrier." And there it was. We were still a go with my eggs and of course, my husbands gametes. (Is it weird that I don't want to post the S word?) I didn't have the heart to tell her we were going to India instead.

Now we just wait for our meeting about their meeting about our test results. Where they tell me "TIME IS OF THE ESSENCE!!!" As if I didn't already know that. Hopefully I will have a zillion more questions by then. Wait....that's my hopeful? I may need to schedule a meeting with my hubby to discuss this...