Couldn't Resist

So, online you can write a question and have it answered by a well known RE. This one happens to be an RE in Sacramento.
This is IVF #3, and wow what a difference a protocol can make. For the first time we made it to day 5 (at Stanford). We transferred two 4AA blasts and froze 5 more. Amazing accomplishment for us! Anyways, we have been trying since 2004 are thrilled that we got pregnant!

13dpo = 130 progesterone 45 (high numbers from what I read)
15dpo = 224

So, as you can see they did NOT double within 48 hrs. More like 60, I know people say as long as it doubles within 72 you "should" be okay. My RE was fine with the number, she said they look for an increase of 60% and mine was 72%. She was so fine that she didn't even schedule another beta, but instead an u/s for 2/12/09.

I think I am in need of some reassurance. Can I go off the 60% rule, is anything less than 72 hours okay? I think hearing from another RE would put my mind at ease until the 12th. We worked so hard to get here, and I really want to enjoy it.

This post has been edited by tiffne86: Today, 06:31 AM

Robert Greene, MD
Post #2
Group: ModeratorsPosts: 2,976Joined: 10-July 07From: Sacramento, CaliforniaMember No.: 8,575

Dear Tiffany,
Congratulations! Sounds like all is going real well for you. You should continue to be pleased and optimistic. This issue of the "doubling" has gone from being a scientific average intended to be a loose guide to a misguided legend among patients. Biology does not follow the laws of mathematics. The "average" is a doublins which means that oftentimes it will more than double and other times it will rise by less. I fully agree with your doctor that a 60% or greater rise is cause for celebration. That said, I always encourage cautious optimism until you're able to see cardiac activity on the ultrasound; at which time the miscarriage rate drops below 15%.
Best thoughts,
So, I am DONE worrying and researching. It is what it is, my research is not going to help lil' pumpkin, but instead my stress may harm him. I trust my RE, she got me here. If I don't trust her, what am I paying her the big bucks for? She is fine with it, and I am fine with it. LP grew so fast in the beginning that now, he slowed down a bit, and that is okay.

I also couldn't resist sharing a comment I got on my last post from Stacy G. "Please, please don't worry. You're doing great. At your stage, my doubling time was exactly 59 hours as well, so I just had to write a comment. I, too, was overcome with worry, spending a good portion of the work day calculating and recalculating the numbers. Not so long after that we saw our baby's first heartbeat, and I am now 35 weeks pregnant with a very healthy baby boy. It is all going to be great - you are right on target! As my husband said to me at the time, there is nothing wrong with being somewhere in the "middle" of the good range. It's not a beta contest!!"

I am pregnant and I am going to enjoy it! All I can do is hope, pray, and encourage my little one. Please pray for LP, he/she is so loved and so wanted.


2nd Beta Results

2nd beta HCG results are in, and it is 224. We were looking for a doubling time of between 48 - 72 hours. Ideally 48 is usually better and mine is 59 hours. This nurse and my RE were fine with it, however I am VERY nervous about it. The nurse told me that they look for at least a 60% increase in 48 hours, and mine was beyond that. They were so fine with it that they didn't even schedule a repeat, but instead scheduled my ultra sound for Thursday February 12th. Even still, here I am worried. Oh how I wish I wasn't worried, oh how I wish I wasn't worried.

We have decided to begin to call our little one Lil' Pumpkin or LP for short. Mommy and Daddy love you so so so much, and we hope you continue to grow strong and healthy so we can meet you in early October. Please stick around LP and stop worrying your Mommy. Can't wait to see you on the 12th along with your strong heartbeat.

What is Beta HCG?


Q: What if my HCG levels aren't doubling every two to three days from a quantitative blood test?

A: It doesn't necessarily mean something is wrong, but it warrants further exploration including an early ultrasound (6 weeks LMP, 4 weeks after ovulation). Slow-rising hCG can be related to impending miscarriage or ectopic pregnancy. One important thing to remember is that on average hCG levels double approximately every two days from 4-6 weeks LMP, then doubles every 3 days when the level is 1600-6000, then the doubling slows to every 4 days or so. Levels peak a week or two before end of the first trimester (14 weeks LMP) before declining in the second trimester.

Q: If I am pregnant, how long will my doctor monitor hCG levels.

A: Many doctors will do two or three hCG levels to confirm doubling and stop there. Most others will stop after a fetal heartbeat is detected since hCG levels vary greatly and doubling begins slowing down. After a heartbeat is seen or heard, the chance of miscarriage drops to 16% before 6 weeks LMP, 5% from 7-9 weeks, 1-2% after 11 weeks (reference).

The range of HCG levels in the blood during pregnancy is huge; a single value will not indicate a normal pregnancy! in fact a number of values are necessary before making a number of determinations, including how far along the pregnancy is. Consider the following figures (based on days past ovulation (DPO); all HCG levels and ranges are averages):

• DPO, 14. HCG level, 48 mIU/ml. Range: 17-119 mIU/ml.
• DPO, 15. HCG level, 59 mIU/ml. Range: 17-147 mIU/ml.
• DPO, 16. HCG level, 95 mIU/ml. Range: 33-223 mIU/ml.
• DPO, 17. HCG level, 132 mIU/ml. Range: 17-429 mIU/ml.
• DPO, 18. HCG level, 292 mIU/ml. Range: 70-758 mIU/ml.
• DPO, 19. HCG level, 303 mIU/ml. Range: 111-514 mIU/ml.
• DPO, 20. HCG level, 522 mIU/ml. Range: 135-1690 mIU/ml.
• DPO, 21. HCG level, 1061 mIU/ml. Range: 324-4130 mIU/ml.
• DPO, 22. HCG level, 1287 mIU/ml. Range: 185-3279 mIU/ml.
• DPO, 23. HCG level, 2034 mIU/ml. Range: 506-4660 mIU/ml.
• DPO, 24. HCG level, 2637 mIU/ml. Range: 540-10,000 mIU/ml.

Look most closely at progression: during the huge majority of early pregnancies (80-90%), the level will double every couple of days, or 72 hours. As your pregnancy progresses, levels rise and that doubling time increases.

The expected doubling time for HCG levels:
• Under 1200 mIU/ml: 48-72 hours.
• Between 1200 to 6000 mIU/ml: 72-96 hours.
• Over 6000 mIU/ml: more than 96 hours



Beta is in

My clinic was hoping for at least 50, well I just got the call and it was 130. I go back again on Thursday for a re-test. We need for the number to be at least 260. Please pray for a great strong beta over 260 for us. I think once I see it double, I can start to relax a little bit and maybe even begin to believe and enjoy my pregnancy. Wow, did I just say "MY PREGNANCY?"


A Little Show and Tell

My precious babies, taking a much needed nap the day before my ET, wait I was the one that should have been resting, but of course me being me, I wasn't. I was racing around trying to get things ready so that I could rest the next few days. Laundry, grocery shopping, meal planning, cleaning, baths for the pups, bills, etc. etc. etc.

Mr. Memphis showing off his big boy paws.

I love this picture, he is getting SO big.
What a cutie

My boys are SO cute!
I am very, very done with pineapple. I know, I know that it is supposed to make a huge difference, but I am so done with it.
Yesterday, I made a smoothie. My 1/5 of pineapple with core, a banana, a few spoonfuls or organic plain yogurt, OJ, and ice. It made the pineapple very bearable. Today I will eat it over the plain yogurt, then I will be officially done with my 5 days of pineapple.



I was watching American Idol this morning before work (the puppy has me up around 5:30 a.m. lately.) I decided that I am headed to Hollywood. I got the golden ticket! Things have lined up and the stars just MIGHT be shining down on us. With a LOT of hard work we have made it so close. I have never been to Hollywood, I have been in the audition room, but never got that ticket, the ticket that says "you have a VERY good shot." Now little babies please continue to work hard with Mommy in Hollywood to make it to the top 12. I know that it will be hard, but I am pulling for you, and praying for you and so are many other people. We won't talk about winning yet, our next step is making it to the top 12.

One single line today as expected, but at least we know the trigger is gone.


Our Snow Bubs

So here is a run down:

16 eggs
13 mature and ICSIed
12 fertilized
10 made it to blast
2 transferred
5 frozen

Just got off the phone with the embryologist, yesterday we froze 5 and were watching 5 more. Three more made it to blast stage today, but the quality was not good enough for freezing. He was impressed that 10 or our 12 embryos made it to blast stage, and was confident in the two we chose to transfer. I am fine with that, 5 snow babies is GREAT!

I am at home resting today living off pineapple. I will go back to work tomorrow. Please please please please please implant little ones. Huge huge hugs to Polly, my heart is breaking for you. If you have a chance please visit Polly's blog and give her some support. http://in2mesee.blogspot.com/

I am NOT savvy on the layout of the site, but it seems for some reason all my blogs I follow are not showing up, and when I go to that area on the layout it says there is an error. I will be LOST without that and updates from all of you. Any ideas?



We arrived to the clinic, with a mighty full bladder and were faced with good news, after good news.

All 12 embryos were still around, 7 had made it to blastocyst, and a few others were still doing well. We were told that the odds on more than half making it to blast was rare. Hard to remember all the great compliments we got on the embryos, but lets just say the embryologist was impressed with our over achievers. She compared our last set of three dayers to when these guys were three dayers and said it was like "night and day." We had THREE perfect 4AA blasts, and four 4AB's. Today she froze a 4AA, and the four 4AB's. The other five will be watched until tomorrow and if they make it to blast, will be frozen as well.

We went in fully intending to transfer 3 blasts, but the RE was highly against it. She told me over and over that these embryos were different and she didn't want to chance a high risk trip pregnancy. She said with my age and the quality of these embies, that she would normally only transfer one, but allowed us to transfer the two. So, we took her and the embryologists advice and transferred TWO 4AA PERFECT blasts. Now we wait, and hope, and pray. Obviously I am ecstatic at how different this turned out and how many blasts we were able to freeze. We have been blessed, now we wait, pray, and hope.



So, I need input from my girls. How many should I transfer? We are VERY okay with twins, and give my past losses and BFN's, we want to give it our all. How many blasts would you transfer if you were me?

Our Dozen

You read right, we still have one dozen. We have been moved to our first ever five day transfer (5dt). As of this morning all embryos were still alive, some growing slower than others, and one out shinning the rest.

1 - 9 cell
8 - 8 cell
1 - 7 cell
2 - 4 cell

Today the average embryo should be 8 cells. We go in Monday at 10 a.m. for transfer, and will be sure to stop at Mickey D's for my Egg McMuffin (many say that the grease helps the embryos implant).

Funny, Monday will be Martin Luther King Day. IVF #1 we transferred on St. Patty's Day, and our FET we transferred on Labor Day.

Off to buy my pineapple!


Fert Report

RE's office just called and we have 12 embryo's doing well today. Out of the 16, 3 were not mature enough to ICSI, and just one did not fertilize.

They will call again on Saturday with another report. If we have at least four embryos doing well on Saturday, they will push us to a 5 day transfer, otherwise we will transfer Saturday at 10 a.m.

I am pleased with the out come, this is 3x more fertilized than IVF #1.

Please pray for our little guys!


Pinch ME!

Oh my goodness, oh my goodness, oh my goodness! Something must have done the trick! So, on Sunday the RE suspected 16 eggs and GUESS WHAT? We retrieved ALL 16 EGGS!

All were mature and have been ICSIed. We will get our fertilization report tomorrow morning.

I can't believe it, that is more than IVF #1 and #2 combined. Pretty sure it was the lupron trigger than did the trick, but whatever the case Gabe and I are very pleased. Now we pray for a great fert report. If a large number of the eggs fertilize we may be able to have our first ever 5 day transfer.

We are beyond happy, I blogged Sunday asking for ten good eggs to work with, today I am baffled with the amount we got. What makes me the happiest is the fact that I am no longer classified as having Ovarian Dysfunction, it seems we just needed the right cocktail or the right trigger. We went in this morning agreeing that if the empty follicles happened again we would move onto donor eggs and give up on the idea of using my eggs. Looks like donor eggs are out for now. Even if this doesn't work this time, we have found a fix to our empty follicle problem, and are hopefully officially on the right track.

I am not allowing myself to get too far ahead or too excited, but I feel at peace knowing that something went right this time.

I will post as soon as I get the fert report. Please hope and pray for a great one for us. Thank you all for your love, kindness, and support.



A Stripe For Me?

Yes, you read right... that is what I got today. A TRIPLE STRIPE 12 MM LINING... thank you thank you! For those whom are unaware of what that means, it is a prime lining for implantation.

So, all in all things have gone textbook. For the first time ever I have followed my schedule to a tee. Never have I stimmed for the amount of time recommended until #3, never have I had a schedule that I didn't speed ahead of. We WILL be stimming as anticipated and my RE is happy with what we have achieved. I have less follies than previous cycles, but that is sort of the plan. We were trying to stim longer, with less follies to help the quality. I have about 20 follies, but my RE is thinking they will only yield about 15 mature eggs. I WILL TAKE IT! I am good with 10, just give me some good ones to work with, and no FREAKING empty follies.

We are set for a Wednesday a.m. ER, this cycle has been SO different. Not much anticipation or build up. I only had three follie checks and to put it bluntly I am "prepared." I know what to expect and I am not planning on a miracle, I am just "doing it".. not anticipating any miracles or dreams to come true, but also not being pessimistic. Just taking it day by day and not thinking ahead, even today it is hard for me to anticipate an ER, even though I know it is just days away.

This is bitter sweet, as it could very well be out last attempt. We cannot afford to keep throwing $ at IVF if it isn't going to work. We would much rather begin a savings for donor eggs for the next couple of years instead of throwing funds out the window for nothing.

Today I smile because I have hope, today I smile because I have a chance at a biological child, today I smile because my RE is hopeful, today I smile because we followed our schedule, today I smile because I hope that all my follies will yield eggs, today I smile because we had a lot of fun going on a Harley ride upvalley with a large group of friends, today I smile because I know that no matter what everything WILL be okay, today I smile because we WILL be parents somehow!


I am up and about on a Sunday morning getting ready to leave for my follie check, but my heart is aching. This time not just from my own sadness, but from the sadness of those whom I hold close to me heart, those whom know me and my struggle, and those that give me strength when I am weak. It amazes me how truly saddened I am by their news, and how much it is truly affecting my emotions this morning. Erin and Polly, my heart is a aching for you both. WTF? This is not fair and it plain ol' sucks. I pray for a miracle for Polly and her embryo and I pray for strength for Erin to get through a dark time. We know what it is like to feel disappointment, can't we just catch a break?


Moving Along

Another great appointment! I am right on track, my lining was 8.5 and I now have 20 follies ranging from 10 mm to 14mm. I will start my Ganarellix tonight and go back again on Sunday for another check. So far it looks like the ER will be on Wednesday, which means 10 days of stimming! Better than my 7's and 8's in the past! Sure hope that extra stimming does the trick, along with my double trigger shot of lupron and HCG.

We decided to add Assisted Hatching this time, not because we need it, but just because we felt like spending an additional $600. Just kidding, we were told we don't "need it" but it won't hurt, it could only help. Since this may be our last go at this, lets give it our all! So we WILL be doing ICSI and AH, neither because we NEED it, but just because it should give us a better chance. Come on lucky #3, stay away empty follies!

I promise I will start to devote some more attention to this blog, I have been so busy lately. I really got to post some new pictures of Mr. Memphis. Those boys are too cute, and always manage to bring a smile to my face even when I am up at 4 a.m. for a Memphis potty break. Oh, on Sunday night he slept ALL NIGHT, Yahoo! Making progress and almost fully potty trained. Now if he would just stop growing I would be happy. Last weekend he weighed in at 12.3 pounds.



My check went fine. I am moving slower than the last two IVF's and my RE is happy with that. In prior cycles I only stimmed sever days (average is 10 - 11), so we are hoping to stim slower for better quality eggs. My lining was at 5 and I had about 18 follies around and under 10. So, I have a ways to go. This means more appointments, but hopefully a better outcome. I go back again on Friday, with Ganarellix in hand.


Chugging Along

The last two nights of stims have gone off without a hitch. Ol' hat to us at this point. I can say that I can definitely feel something going on already. I sure hope I don't overstim like I did with #1. I don't recall feeling much with #2 this early. My first check is on the 7th.



BCPs - Check
Baseline - Check

My baseline appointment was on the 29th and everything was great, I was full of questions (as usual). I have about 16 antral follies and was told to take my last BCP and then start the stims this Saturday. Here we go again, praying the 3rd time is the charm. Here's to hoping for TWO lines in '09. Good riddance 2008, not sorry to see you go. Now lets bring on a better year.