Wednesday 31 October 2012

FET Results In

Not sure how to start this post as there are many thoughts running through my mind. There's disappointing news. There's a glimmer of hope. There's a sense of déjà vu for me as well. In the end, I remain grounded and will hang on for the next couple of days.

What am I talking about? Results are in from my first FET at SCI and it's a low beta HCG value of 41, which SCI categorizes as a "weak positive". So the words "weak positive" are disappointing for sure. However, as many of you know, 41 is just a number and it's what happens to that value in the next couple of days that will tell the tale.

Why déjà vu? Well, when my first surrogate was pregnant with my son, our first beta HCG value was 42 on a Thursday. I remember being so excited when she told me the number. I don't recall being disappointed at all, which is supported by past entries in my first blog. Anyway, that beta value grew to 393 a few days later on Monday during our second beta HCG test.

However, with baby #2, our first beta was 299 - that's much higher than 41. So I can see why 41 is considered a "weak positive". For some reason, I am being affected by the recency effect, meaning more recent events are having more influence over me than the less recent events. Given this, I don't have a good feeling overall. Of course, initial beta values can vary significantly from pregnancy to pregnancy. Betabase is evidence of that!

So as you can tell, I'm not exactly sure how to feel. "Weak positive" has a sad tone while my beta numbers from my first child suggest it's not over until "the fat lady sings". So I'm hoping for a true déjà vu and see that 41 double, double, and double in the next few days. One thing is for sure though - I still believe what's meant to be, will be. Perhaps it's a way to protect myself from negative and sad news but I also know I cannot force things to happen that I do not have control over.

Happy Halloween!

Thank you for letting me share this part of my world with you! 

Monday 29 October 2012

Declaration of Parentage

This post focuses on declarations of parentage on home soil as my second child will be born here in Canada. My apologies for those expecting a post on this process in India. I should note this process varies from province to province so the following process applies to the province where my daughter will be born. You must choose a lawyer in the same province where your child will be born.

As we approach the third trimester, it is time for my lawyer to start preparing all the documents for the court application, which she will immediately bring after the birth. My lawyer will obtain the consent of my surrogate to act for all of us and will provide her with detailed instructions about what to have her physician record in the chart.

Immediately after the birth (or within a day if it is a c-section), the lawyer will send someone to the hospital to obtain the sworn evidence that she requires for the court application. That person will also assist in filling out the hospital forms, which will have me as the father and the surrogate as the mother (or other "parent" as it is known in other provinces). At that point, I will be free to leave the hospital with my baby and return to my province (subject to medical approval) - although I plan on staying a week or so before flying back. Vehicle is an option but the winters in the birth province are legendary so the sky is safer than the roads.

Within a day or so of the birth, the lawyer will bring the court application, the purpose of which is to have the surrogate removed as the "mother" on the birth registration form and to replace the form with only me as my child's parent. Once the lawyer has the court order (normally in about 2-3 days), she will send it to Vital Statistics, who will be expecting it and who will not have registered the form, which states that my surrogate is the mother. They will register the new form (which I will have signed in the hospital in front of my lawyer's assistant) and once she has confirmation that has been done, I will order a birth certificate and be shown as the only parent of the child on that document.

Thank you for letting me share this part of my world with you!

Thursday 25 October 2012

Diaper Pails

For those of you who are planning on using disposable diapers, there are many diaper pail options out there in the market such as the Diaper Genie, Diaper Champ, and Diaper Dekor just to name a few. Of course, you can use a plain pail with lid or even your regular trash can.

Personally, I really like the Diaper Champ. I used it with my son and still have it. I am planning on getting the pink one for downstairs. I'm hoping to find the original model and not the newer "deluxe" model because I read that the newer model is slightly smaller. The main reason for loving the Diaper Champ is the fact that you can use regular garbage bags (or any other bags really) and do not need to buy refill bags (that cost more than garbage bags), which is the case for the Diaper Genie.

I also read some reviews stating that the smell is still there. I don't know any diaper pail, no matter what is being claimed, that eliminates the smell from dirty diapers that have been sitting there for some time. When you leave any pee or poop diapers too long in any container, it will eventually stink. I usually place the pee diapers in the Diaper Champ and poop diapers in the regular kitchen trash, knowing I will discard it into the outside trash can later in the evening.

At the end of the day, it is all about your time, energy, and tolerance for smells. If you have the time and energy to empty your diaper pail or kitchen garbage on a nightly basis then great. If you have a low tolerance for pee and poop smells then it's wise to empty your diaper pail or kitchen garbage more frequently. For me, it really made sense to go with a diaper pail that I could use regular or my own bags versus buying refills that cost more than regular garbage bags. You will spend enough on diapers, diaper wipes, and formula.

Too bad I cannot take my Diaper Champ with me to India for baby pick-up! By the way, don't forget to bring your own garbage bags to India for baby pick-up. I can't speak for other places but the Svelte has no bags in their garbage bins. You'll want those dirty diapers in bags to ensure your garbage bins stay as clean and odour-free as possible.

Thank you for letting me share this part of my world with you!

Saturday 20 October 2012

FET Report & Grading

First of all, I received an email from SCI advising me that the frozen embryo transfer (FET) went well on October 20. Four embryos were thawed and all for survived the thaw. Embryos transferred included 2 blasts with 3AA and 3BB grade (explained later), Grade 3 morula, and Grade 4 with > 16 cells. There are a lot of stats out there but in the end, my blasts have the best chances. Morula transfers can be successful while I don't put much hope on the Grade 4 embryo that was transferred but you never know!

The pregnancy test is scheduled for October 31 - Halloween! So given the stage of the embryos transferred, instead of the 2ww, I have 10 days before the beta HCG pregnancy test... aka 10dw. With the time difference between Delhi and Vancouver, I'm hoping to wake up to wonderful news on October 31! I'm sure my surrogate is also hoping for the same result - I hope to meet here in 9 months or so!

Halloween is one of my favourite days of the year so hopefully that is a good sign! I found these "monster embryos" online - cute but not something I would purchase. LOL!

Secondly, for those of you wondering what is in the FET Treatment Summary Report, here's what it contains:

General Information
  • Name of patient (me)
  • Date of birth (my DOB)
  • Date of FET

Embryo Information
  • Embryos thawed
  • Embryos survived thaw
  • Embryos cultured to day 5
  • Embryos transferred
  • Details of embryos transferred (i.e., cell stage and grade of each embryo transferred)
  • Whether laser assisted hatching was completed

Embryo Transfer Details
  • Position (doral versus lithotomy)
  • Vaginal discharge (normal versus abnormal)
  • Cervix (healthy versus cervicitis)
  • Transfer Grade (I - no holding cervix, II - cervix held, III - dilater used)
  • Transfer (easy versus difficult)
  • Type of catheter
  • Mucus on catheter (yes or no)
  • Blood on catheter (yes or no)
  • Re-insertion of catheter
  • Date of beta HCG testing (aka pregnancy test)

Finally, some of you are experts with embryo grading given your previous experiences with fertility treatments; however, for those who are new to the embryo grading (which can vary from clinic to clinic), I thought I would provide a basic summary.

It appears SCI grades their embryos from 1 to 4 with Grade 1 being the best. Grade 1 embryos are "morphologically perfect, with round, symmetrical cells. They have the appropriate number of cells for their stage of development. Cell division is even, and there is no visible fragmentation. Only 20% of embryos receive the highest grade. Most embryos have slight imperfections, and this is normal and expected." Grade 2 embryos have "the correct number of cells for their developmental stage, and usually have even cell division. They might have slight unevenness of blastomere sizes and/or a small amount of fragmentation (<20%). Grade 3 embryos have "uneven cell division and moderate fragmentation (>30%), or are behind in their development, or have similar irregularities. Finally, Grade 4 embryos have "uneven cell division and extensive fragmentation (>50%). They may have few viable cells or be completely fragmented."

Generally, lower grades are associated with poorer chances for a viable pregnancy. Two of my embryos transferred were graded 3 and 4. However, keep in mind that success does occur with lower grades albeit a lower chance of success. You may just be one of those individuals who are in that minority of success with lower grade embryos. Plus there are other factors that will determine success.

SCI also grades with a number and two letters. "The number refers to the amount of expansion, the first letter to the quality of the inner cell mass that will develop into a baby, and the second letter to the quality of the outer cell mass that will become the placenta." My blasts are 3AA and 3BB - depending on the grading scale used, 3AA would be excellent to good while 3BB would be good to fair. Again, in the end, percentages and other factors aside, you just need one to make it to the finish line.

Thank you for letting me share this part of my world with you!

Friday 19 October 2012

Just In Time

We are back from Disneyland - 39 different rides, 63 times in total on rides. My 4-year-old is such an awesome boy, trying different things and waiting patiently in the lines. Of course, I planned things out so he wouldn't have to wait to long in the lines - 20 minutes at most of those were usually in the morning gate line-ups. We went on the Tower of Terror 5 times and 4 times on Big Thunder, Grizzly River Run, Splash Mountain, and Soarin' Over California.

We return just in time for the frozen embryo transfer on Saturday, October 20. Then the 2ww begins again - hopefully with some good news once the 2ww is over. I can only hope and wish for the best like everyone else. Work-wise, the next two weeks (and pretty much until the end of the year) will be super-busy so time will fly by very quickly. Please keep me in your thoughts and prayers in the next two weeks.

Thank you for letting me share this part of my world with you!

Wednesday 17 October 2012

Deja Vu

Deja vu - similar to my first transfer, there has been a last minute change to my FET surrogate. I trust Dr. S to do what is right for me but hope that this will end in a different result this time around and get me a BFP!

My new surrogate, M, is 30, married, and has two of her own children. Again, looks good to me - both the surrogates I've worked with (on home soil) are 30 plus.

Here's to a successful transfer, pregnancy, and birth!

Thank you for letting me share this part of my world with you!

Monday 15 October 2012

FET Surrogate Chosen

While my son (my brave little man) and I were waiting in line in Disneyland - specifically his favourite ride, the Tower of Terror - I received an email from the clinic. Dr. S has selected my surrogate for the upcoming FET. I have to admit that although it was great news, my anxiety levels lining up for the Tower of Terror did not allow me to get fully excited at that time! LOL! We are going back to the Tower of Terror tonight for a third time on this trip :)

Anyway, my surrogate, B, is 26 years old, married, and has two girls of her own, 3 and 6. I know and preach, what's meant to be will be... but I really do wish and pray that this first FET works out. I know Dr. S and her staff are behind me 100%, and will do their best to help this happen. Until then, my son and I still have a few more days here in Disneyland. We arrived here Saturday afternoon and are leaving Thursday afternoon.

Hope everyone is doing well!

Thank you for letting me share this part of my world with you!

Friday 12 October 2012

Disneyland

Growing up, we travelled more frequently than most families I knew. Whether it was a road trip or a flight across the globe, I have very fond memories and photo-memories of our family time. Because of this, I have taken my son to various destinations around the world - starting when he was just 3 months old - to start creating our own memories and photo-memories.

One comment that I got and sometimes I still hear but ignore is, "Is he too young to remember anything?" It's an odd question to ask in my opinion. For one, the travel is not just for him but for me too. Secondly, the real-time experience of being together and having fun is as valuable if not more valuable than the future memory. Also, who says we can't vacation there again and again and again for many years to come? Finally there is a precious window when our kids will want to vacation with us so take advantage of those years as much as we can!

I do understand why some may ask this question based on their own experiences and views on vacationing. For me, showing my children the world and sharing that with them as long as they will allow me, is a priority of mine. I now just need to win the lottery so I can have unlimited time to travel! I will say, I envy my European friends - although I make time and ensure I have a healthy vacation budget, I wish I could visit several countries and cultures in a shorter period of time and for a greater bang for the buck, like they can. Sure I have North America and I have my favourite places to visit but I assume there are more diverse cultures in Europe versus North America.

After saying that, I am off to Disneyland  tomorrow (Saturday). It's our second trip to Disneyland this year but this time around, Carsland is opened and it's a final trip for us boys before a little lady comes into our life in early 2013. It's been a crazy week at work so looking forward to our one-week adventure. I just need to finish up the packing tonight. I will be refreshed when I return next week - the final few months before baby #2 arrives will be extremely busy at work. Next week, I will also be returning just in time for my first frozen embryo transfer! So wishing that it works this time around!

Thank you for letting me share this part of my world with you!

Tuesday 9 October 2012

FET Success Rate

So the first and hopefully last frozen embryo transfer (FET) is planned for next week. I'm really hoping that I get a BFP so crossing everything starting right now! Feel free to back up your truck load of baby dust into my baby yard too!

When it comes to the success rates of our beloved totcicles (i.e., frozen embryos), there's a lot of research and statistics out there. My current pregnancy on home soil is a result of 5-year-old totcicles. Approaching the FET, I had the typical questions. I have not asked Dr. S these questions because given my previous FET experience, I feel good about the upcoming transfer. But here were my typical questions about FETs.

1. How long can embryos be frozen and still be viable? Embryos frozen as long as twelve years have resulted in successful pregnancy. Again, mine was 5 years. With freezing and thawing protocols continuing to improve, embryos frozen more recently may have better outcomes.

2. What is the thaw rate of totcicles? This depends on the freezing and thawing protocols, and the quality of embryos before freezing. Embryos graded higher before freezing tend to be more resilient to freezing and thawing. With my current pregnancy on home soil, I had two final totcicles - although they were good quality, they were the lowest quality of the bunch. They both thawed successfully - I remember giving a big sigh of relief because if none had survive, it would have been a wasted cycle.

Survival rate is also influenced by the stage of development at which your embryos were frozen. Some argue that embryos frozen at earlier stages of development survive freezing better because "they are simpler in structure and still have an intact nuclear membrane" while others argue that blastocysts may survive better because "they have more cells, and therefore can recoup easier from the loss of some of them." The best practice appears to depend on what works best for the clinic and their protocols.

Embryos with an even number of cells also appear to have a higher survival rate (5-10% higher) versus odd number of cells. Finally, embryos created with donor eggs also appear to freeze better than embryos of the same grade created with infertility patient's eggs with a 2-5% higher survival rate.

Focusing on the numbers, typical embryo thaw rates range from 50 to 80% depending on the clinic.

3. Does a success thaw mean all totcicles will be transferred? Some surviving embryos will not be transferred because they will have no surviving cells. Many embryos will be partial survivors with some cell damage. Although the extent of the damage may influence subsequent pregnancy rates, embryos that have been damaged often recover and can still capable of resulting in a live birth. The highest quality embryos are those that survive with 100% of their cells intact. Some have suggested that these embryos are essentially as viable as if they had never been frozen.

4. Is there a lower probability that thawed frozen embryos will produce a pregnancy versus fresh embryos? In general, the success rates of FETs are usually lower than those for fresh embryo transfers. This makes sense because damage may occur during freezing and also because higher-graded embryos are usually transferred fresh.

Summary: In the end, these are "just" percentages. The transfer will either be successful or not. Focus on the positive and plan for the negative but believe in the dream.

Thank you for letting me share this part of my world with you!

Saturday 6 October 2012

Dressing Baby 101

There are so many cute baby clothes out there - actually, "so many" is an understatement. I have to admit that I was one of those first-time parents that bought several cute (but functional) outfits for my son when he was just a baby. In fact, one of his first outfits was a Santa Claus outfit - he was born in mid-December so when he was just two weeks old, he was in his first costume. Plus you will have friends and family who will add to the "style pile" with their contributions. In reality, they don't wear these cute outfits too often. I am not discouraging any parent from buying them but just to keep in mind the amount of use each outfit will get over time.

In my humble opinion, there are three basic considerations for baby clothing. Very simply, the first consideration is that your baby will spend most of his or her time lying down so keep the back of the clothing free of anything that might make your baby uncomfortable. Secondly, especially as a single parent with only two sets of hands, I rarely bought or used clothing that required the baby's head to go through a hole, large or small. Although it was not brain surgery, you can imagine trying to put on a t-shirt or closed-front onesie over a baby's head and then slot their arms through the arm holes. It obviously can be accomplished with two people or while the baby is lying on his or her back with some effort. Some babies also do not like having their head and arms squished through an opening - perhaps memories of birth? :)

Finally, linked to my second point, think about location, location, location... of the buttons, snaps, zippers, etc. Of course, you want easy access to the diaper but it is also easier to dress your baby while they are lying down so anything that has a full opening (length of the garment) at the front similar to the photos is ideal. You open up the piece of clothing, place baby on top, slide in two little arms, and then snap everything up.

As mentioned, I'm not suggesting that you avoid buying the clothing with the cute sayings, trendy logos, or cool/adorable look. Just keep in mind that for your baby's daily wear, keeping these tips in mind will make things easier for you and your baby!

Thank you for letting me share this part of my world with you!

Thursday 4 October 2012

Baby Name Decision

As each week passes with baby #2 on her way (on home soil), I get more and more questions about her future name. It's normal for people to ask whether you have a name selected and whether you are sharing it. Some prefer to keep it to themselves - to avoid hearing others' opinions and minimizing the possibility of someone else taking their baby's name. I chuckle when I hear the latter - yes, I have had people use names that I have mentioned but baby names are not copyrighted. Some have no problems sharing like myself. It's not a guarantee and I do not call her this at this time - and will not until she is born - but there's a good chance her name will be...

 Thank you for letting me share this part of my world with you!