Hacking Nature - my IVF blog

I am officially past the mid point of the journey because I am in my 22nd week now. As each of the weeks get ticked off the calendar, it feels strange. Everything feels strange, including the wave like movements in my belly which are actually well timed kicks and punches. I used to think these things happen to "other people", but now they are really happening to me. I was not keen on having a baby registry or a baby shower, as those concepts are very alien to me. In India, a baby registry would mean you are asking for gifts and that you are not grateful for whatever gifts your friends/family bring. Baby shower in India is actually a celebration for the mom, not the baby, because you are not supposed to count your chickens...etc. But the baby is American, so things are going according to her plans I guess. We found out the practicality of having a baby registry where you get discounts from Target or Amazon and my friends here explained that people WILL give you something an...

I don't know where to start this article from, because every time I think about this issue I get very angry at the unfair treatment that this doctor, rather scientist received. Dr. Subhash Mukhopadhyay has been the father of IVF in India, delivering a "test tube" baby 67 days after Louise Brown was born in Manchester, UK.  Somewhere around the late 90s, I first came to know of 'Durga', this girl conceived through IVF and a result of a successful experiment by Dr. Mukhopadhyay. I don't remember why this news was reported in the 90s, or in what context, but I remember my family discussing this at the breakfast table. They were upset that the recognition came after so many years and they were also angry at the Government and also at the family for not having the guts to come speak the truth. Especially at it caused the death of the scientist.  Fast forward many more years, I got in the IVF world after being diagnosed with PCOS and my husband having some...

As I mentioned before, it is difficult to rejoice when you are accustomed to the trials and tribulations of infertility. However, with each ultrasound done, and looking at the fetus growing with a good heartbeat, I am feeling the idea slowly sink in. Along with it are the common symptoms of nausea and going to the bathroom what feels like, after every couple of minutes. I am grateful for the symptoms, however uncomfortable they may seem, because the symptoms mean everything is going as it is supposed to. I am at the end of my 11th week now. It felt unbelievable when I went to the OB appointment at 8 weeks because I really didn't think that day would eventually come. It was something way down the road, clouded in uncertainty. Only the lucky ones get to go there, I felt. When my time came and I was handed the brochure, it was like a dream. Even now, when I am telling people that I am coming close to the end of my first trimester, it again feels incredible. Like really? End of t...

Frozen Embryo Transfer take 2. After the ERA test results came, we decided to go ahead with round two of an FET with the second (and only) remaining embryo I had. This is a CB embryo (compared to the last one which was BB), so I was a little concerned, but everyone at the clinic told me not to worry about the grading of the embryos.  With my RE Dr. Rehman in the recovery room after the transfer Anyway, so with the second cycle, I decided to go under anesthesia because there was a lot of poking and prodding going on, including two water ultrasound tests I went through. I know the embryo transfer is a very non-invasive process, but I hate the feeling of the speculum inside me. I need to stop being too hard on myself, I thought. On Saturday, September 15, I had the embryo transfer in the afternoon. The day before, I was at work till a little after 5. In a software company, the entire office is almost gone by 4 on Fridays, so I was practically alone on my side of the flo...

Yes, IVF is a big deal demanding a lot of physical and mental strength, and also significant chunks of finances, but I refuse to make it the central part of my (and Arnab's) life. There are lots of other stuff happening to us and they are good things. I should be enjoying those, which I am happy to report, that I am. For the first part, Arnab got a new job and we decided to buy a new house. This is our second house, we moved and are settling in now. For me, deciding on paint and organizing the house is a big deal. I am doing that with full vigor. Choosing furniture, window treatments, and all the normal stuff a couple with a new house need to do, we are doing those. We got a new cat too. This happened after our beloved May passed away. I promised May that we would keep her legacy alive by providing forever homes to many more cats during our lifetime. Gemini, or now renamed, Alpha Gemini, is the soft furball who we found sleeping in a small cubby at the Seattle Humane Soci...

Endometrial Receptivity Analysis (ERA) is a test that measures whether the uterus is ready to accept the embryo, leading to further implantation. There is an implantation window during which time, if the embryo comes, it gets implanted. However, as a student of statistics, I am not surprised to know that there is a bell curve, with 84% women falling in the +5 days region. The rest 16% have their own window of implantation. I am not a person who really fits in the box, I knew that already. So it is a surprise that I don't fall under the 84%? I need two more days of progesterone, because my implantation window is shifted by 2 days. As for my last transfer, the embryo was sent on day 5, my uterus was not ready to take it. Hence, it was rejected. Generally, if the embryos are healthy and the uterus and uterine lining don't have any problem, but still the embryo fails to implant, this test is done. It is a pretty new test, so this isn't yet done for everyone. But who knows...

I wish I could have had a different title, something like good news at the end of the wait, or anything positive for that matter, but my beta HCG test was done today and there was no pregnancy. My good quality BB embryo had failed to attach. I was thinking before that the embryo had only one job, and this was a 95% viable embryo... anyway nothing can be done about it right now other than preparing for the next cycle. There's a lot going through my head now - what if the second one also fails? What can be our next options? Should we worry about ovarian reserve? Consider embryo adoption? My husband reminded me that this is a process and we must deal with a little detachment if possible. I am trying to stay positive for the next cycle and telling myself that this is just a part of myself. My entire existence is not guided by my uterus!

Now we are approaching the most physically painful part of the process - the progesterone shots. On March 3, I went through a baseline check ultrasound to see how thick the uterine lining was. At this time, as I was on Nuvaring, my lining measured 4 mm which is pretty thin. From March 7, my Delestrogen shots started. They are basically the hormone estrogen that thickens our uterine lining in preparation for a cozy spot for the embryo to snuggle up to. For an embryo transfer, they expect the lining to be around 8-13 mm thick. The way to do that is by the estrogen shots. These intramuscular shots go in the butt and if you were one of those people who was taking the subcutaneous ones by yourself, now you would need someone to give you these ones. These are water soluble injections, so they are not that heavy. Also, I had to give them twice a week.  On March 23, I had another ultrasound to check how my uterine lining has thickened up. In the mean time, I ate normal healthy food...

After the egg retrieval surgery happened and my embryos got frozen, February was my month of resting. I went back to my normal life with no restrictions, I started yoga and went back to swimming. My work life also came to a stable ground with me not taking too much sick time off. There was nothing to do related to the IVF process, and my body got time to heal. Here's where I will discuss the frozen embryo transfer process and compare that with the fresh embryo transfer. There are different medical reasons to choose the frozen process, but from a layman's perspective, and also as one undergoing it, I also prefer the frozen process.  1. The body gets time to heal. If I had to do a fresh transfer, that would be 3 days after my egg retrieval. That means my ovaries were sore, still healing from the process, and I was still EXTREMELY bloated. I could barely walk to the bathroom. Going through another process at that time, that is so much taxing on the uterus and my general ...

From when I started the IVF process, I have found quite a lot of well meaning people saying some pretty strange things. At first I was getting annoyed, especially to things like "just relax, and it will happen" but then I figured out it is mainly because of ignorance that people are saying such stuff. As infertility and general reproduction issues are never discussed in a manner they should, no one really knows what is going on at this front. I decided to shine some light. Why does someone need IVF? A person can decide to go through IVF for many reasons. Generally, if a couple tries to get pregnant but even after trying for a year, they do not, then they are advised to see a doctor. For a woman over 35, it is six months. The Reproductive Endocrinologist (RE) doctor would advise a lot of tests to figure out if they have any issues which is causing them to not have babies or delaying the process. For certain cases in women like Poly Cystic Ovarian Syndrome (PCOS), damag...

I have come to work today, exactly a week after my egg retrieval surgery. After we pulled the trigger shot at 1 AM on Jan 20, exactly 36 hours after that the eggs had to be retrieved. It was nothing different than any surgery under general anesthesia. The problem was I couldn't wrap my head around what was wrong with me. I mean unlike my previous surgeries, I actually had no ailment this time. It was not like my wisdom teeth were bothering me, or the salivary gland stone was hurting. Anyway, I guess this is the first lesson in "this is not just about me". At the clinic, I was put on IV fluids and then taken to the Operation Room in a weird hospital gown (I still don't understand the use of them). I joked with the doctors and nurse as usual. Arnab and I had placed a bet on how many eggs would be retrieved. He had said less than 13, while I said more than 13. The range was 5-19. After talking to the anesthesiologist about my general health, allergies, if I hav...

Today I am done with the stimulation shots and I will take the trigger shot at 1AM. It is hard to believe that the time is slowly coming, I think as I am taking one step at a time, it is getting easier to handle. I am really pleased at how I handled the hormone shots. Or rather, I'd say there was nothing intimidating about the shots. Other than Menopur, neither the Follistim nor Ganirelix hurt. Menopur hurts because of the saline solution and it is very short lived. It is true that I have a higher pain tolerance, so the entire experience was nothing critical. The ultrasound technician is happy with my eggs. She said I have got an A+ in my egg creation. There are in total 34 eggs, 23 on the right and 11 on the left. I do not know why my right ovary is so over-populated (no, it is not because I am right handed). It can mean that there has been some extra blood circulation on the right, but nobody knows for certain. There is a heavy feeling in my ovaries, yes, and with every...

Earlier this week, on Monday, my beloved feisty firebrand cat, May Kitty crossed the Rainbow Bridge. This is so far my first real encounter with death of a beloved soul. It is true I have seen my grandfather moments after he passed away, but to be honest May Kitty's death has impacted me much more than that. It has even touched me more than my own miscarriage. I was wondering what is it about a pet's death that affect us so much. I think it is because how ever old they may get, since we take care of them as our kids, we never really sense that age. To us, they still remain our little kids. May was almost 16, which mean more than 80 in human years. So we should really say that she had quite a long life. Her chronic kidney ailment was under treatment but that is what finally gave in. She withdrew from the world on Saturday, but we still tried to get her back. After 2 days of fight at the ICU when she did not respond to any antibiotic or even human dosage of pain killers, we...

In the software industry, we have a term called "male allies". What it means is that they are that group of men who are supportive of women's rights. As women are a minority in the technical industry, we need a support group of men to stand up for us. (Doesn't mean that we cannot stand up for ourselves, but sometimes you need men to stop other men from road rolling over us.) I have my own set of male allies in my life and I figured out they can be of immense help during the IVF process. To start with, the #1 male ally is Arnab. Yes, he has a big stake in the matter, but that doesn't mean I have to take his support for granted. This is a huge time to test our relationship. A lot of couples go through a very stressful time, infertility causes them to lose temper, blame one another for the "problem" (quotes because it is not a problem as such). We are both very scientific minded, so we are taking this in a practical way. Jokes about the egg retrieval,...

We had been marking days off on our IVF calendar and it looked like we have time before the shots would start. I am totally taking it one step at a time. At the end of December, we tested for any possibilities of infectious diseases, and got training on how to administer injections. On Jan 7, I got my suppression check ultrasound done and removed the Nuvaring that evening. For the only time in my life I had smooth periods (withdrawal bleeding) and the Nuvaring along with Metformin leveled my hormones, so I did not have any breakouts! An amazing feat for me! My doctor was happy with the suppression check ultrasound. Out of what seemed to me like static on the TV screen, he saw my ovaries and uterus, pointed them to me and Arnab. As long as he is happy with what he saw I am fine. Four days after that, means from Jan 11 I started my Follistim and Menopur shots. The dosage is 150 for the Follistim twice a day and 1 vial (75) of Menopur in the evening. And now I will tell you abou...

The IVF process is known to cause a big strain on the health, mind, and even finances, but generally people don't think of the documents one signs during this process and how taxing that can be to the mind as well. Today we sat with a folder full of such documents. Firstly, we had to decide if we want to know the gender of the embryos or want to transfer only the embryos of a certain sex. We decided not to find out the gender, a healthy embryo would be sufficient. Secondly, we had to read all the information about the process and basically learn how many ways it can go wrong. For every statistics I read, I was reading between the lines to see the failure rate. Like for a 70% chance of success, you actually have a 30% chance of failure and that is also quite significant. Once a person goes through a miscarriage, you learn to sense that the rates for failure is not just a number, it is you! The most miserable part was deciding what would happen to the embryos in the case of my ...

Today is Friday, but I am going to work tomorrow. As a software engineer, I really shouldn't complain about work because of the flexible hours and work from home benefits we get. But, like a spoilt employee, I still don't like the thought of working on a Saturday, poring over logs as they trickle down showing (hopefully) a successful transaction. I will get a day off because of it, but still tomorrow I need to work. I have a Nuvaring currently have inserted inside me that is supposed to give my ovaries a break from egg production before they are injected with hormones to create enough eggs to fill up a Costco sized egg carton. That Nuvaring, however, caused some side effects and had me spotting in the middle of my cycle. I have never used any kind of hormonal birth control before, and as my periods come like clockwork, I never saw any mid-cycle bleeding either. So, as you can guess, I was not very happy this evening. On days like this, positivity doesn't come easily. ...

To tell or not to tell, that is the question. Every couple is different, all our journeys are unique, and even within each couple, the people are unique individuals. When anything happens to me, it feels like entire Seattle and the major part of India already knows about it. Some parts of Europe does too. However, about the IVF thing, I was wondering should I tell people or not. Then I decided to go for it. True, it is because of the fact I told people, that I heard the random comments that I could have done without. But as I have the courage to face people and correct them, I feel good to tell people. There is a practical part too. At work, we sometimes need to take turns to work on the weekends, or take care of software releases. If I do not let them know why I cannot be part of the schedule it would be wrong. On the other hand if I do take part in that, it might just over stress me, or at times be just impossible. Like, I could possibly not be the on call engineer on the day o...

Some days are difficult. However much if an optimist you may be, it is difficult to stay happy, or rather, stay sane all the time. The earlier you accept it the better. The medicines are making me upset, just the fact that I have to take so many medicines is not a good feeling either. And the rest of the world doesn't care. However understanding your spouse/partner may be, they are not actually  going through  the process, so they won't get it either. The shots haven't started yet though. Work continues with all its follies, people around you are insensitive, because they know no better. Also, with all the medicines, you are slowly getting more sensitive to the people around you and what they are saying. Some people choose this time to talk in detail about their new babies, the baby troubles rather and explaining in depth their experiences with the birth process. I understand they are so happy that they want to share, but it may not occur to them that firstly, this is...

I am thinking of keeping an IVF journal to write down my thoughts as they come now. I know once the process is done, whether it works or does not, I surely will not be able to bring back these thoughts. I was thinking about my journey so far, and of the journey that lies ahead. In my life, everything has been pretty planned and the results expected (other than my score on the English paper in the Board Exams of class 10). My life generally revolves around studies, career, family, friends, having fun. Bringing a baby in the picture falls in a totally different bucket. After my miscarriage in 2015, I figured out, probably for the first time, that life is unfair and I really have no control over my own life. We took a break from baby planning until the start of 2017. We traveled, attended conferences, did a lot of fun stuff and then this year decided it was time again to chart my ovulations. Nothing happened for the first six months. Working in an industry where a delay of a few mic...