Day 3 -- Embryo Update

An interesting thing happened on the way to forum…..or on today’s phone report. First, the nurse told me was had 15 embryos. Ummm, 15? That is an increase from the 13 we had on Saturday. Apparently, two additional eggs matured and were able to be fertilized. So we got two more! Eleven of the fifteen are considered “good.” While the other four are “fair” but still had a healthy cell count. Now, I get to sit and fret for the next four days until the follow-up report. Here’s to wishfully thinking. 

Day 1 – Fertilization Report

Received the call this morning. Out of the 20 eggs retrieved, 14 were mature. Of those fourteen, 13 fertilized normally. Now because we are having the embryos tested, the clinic performed a procedure called ICSI. Which stands for intracytoplasmic sperm injection. It just means the embryologist directly injected the sperm into the egg. Overall, so far, so good at this point. Next report will be on Monday. Grow, little embryos, grow.

I still feel blah. Just can’t get situated enough to sleep well. But, I am getting better. 

The Harvesting ...Updated

As we drive to the clinic my stomach has began to do little summersaults. The anticipation causes my breath to catch. I'm scared about how things will turn out. I responded well, but will my eggs be a good quality? I have my lucky socks on though...

Now that I’m more coherent as the anesthesia wears off, I shall break down today’s events. After checking in, they took J² back for his – ahem – sample. Then a nurse came and grabbed me, went over a few things for ER post procedure, and took me back to the prep area. Prep area – ice box. Same difference. I’m sure there’s a reason for it to be cold, but when you’re stripping down it doesn’t seem to make sense. Also, I realize how much I missed J² because he wasn’t there to tie my gown up. So there I sat on the gurney fashionista style in a thin gown, head cap, and booties (but also got to keep my socks on) waiting to be taken into the OR. My doctor stopped by to brief me about what was going to happen. A few minutes later, a couple of nurses escorted me into the OR. I met the anesthetist, who was very nice. And I was introduced to the lovely embryologist who would be taking care of my little pre-babies and turning them into embryos. And then…….I was out.

Time traveling nearly 30 minutes into the future, I awoke were I started. This time I had J² at my side. It’s always a relief to see him there. He calms me down. The nurse checked on me and then Dr. G came by. They extracted (as J² calls it) 20 eggs. That’s a good amount.

Once I was more alert and fairly steady, we left for home. Remember how I said I was uncomfortable earlier? I taken that back. My abdomen feels extremely bloated, but there’s also some pain. I can’t sit up without it feeling like I’m squashing my insides. Moving around is awkward because, you know, all that work your midsection is involved in. Once I arrived home I planted myself on the couch and have been sleeping on and off. Furthermore, these are my plans for the rest of the weekend.

And now…...more waiting.

Tomorrow, we will be given the fertilization report. How many were mature and of those how many could be fertilized. I’m nervous. I really hope we got some good eggs that will then make good embryos. I don’t know if I could bear to fail again. Some semblance of success to generate a peace that this was a journey worth weathering. The discomfort and tiredness increase my apprehensiveness.

I will resume blood thinners and continue those for about a fortnight. Regarding what actually took place today and the how fragile it all is, everything was over so quick.

IVF Update #5

Stim day 10

Just for reference: my estradiol levels went from 2522.0 pg/ml on Sept 13 to 4189 pg/ml on Sept 14. No shots tonight. My belly is delighted. I would do a jaunty dance, but I can barely move. So I’ll gesture my hands in excitement.

To-morrow, to-morrow. Egg retrieval Is tomorrow. Is that not how the song goes? Well it does now. Bright and freaking early. 8 am. In order to avoid traffic, we have decided to stay in a hotel. Oh, and so I don’t have to wake up extra early. You might gather that I detest mornings.

You would be correct. J² on the other hand:

How annoying is that? Ha ha! He does get a ton of shit done though. As long as I can sleep, no one gets hurt.

Away we go. If you like me; keep your fingers crossed for us. 

IVF Update #4…..Maximum Overload

See that? It’s the finish line to this part of our journey. About 40 little pre-babies have been growing for about a week. Today, my doctor said they are ready. So tonight we trigger with Lupron. I’ve never been so thrilled to be getting just on injection.

Lupron uses LH instead of HCG to trigger ovulation. I’m using this type to help reduce the chance of OHSS. Ovarian Hyperstimulation Syndrome is where the ovaries can swell. If it becomes severe, I could end up in the hospital. Dr. G is trying to prevent this. Drinks with electrolytes and food with protein and salt have been known to help decrease the odds.

Tomorrow, I go in for more blood work to check to make sure the Lupron is doing its job. Which makes Friday -- Egg Retrieval Day. It’s here…...almost. Now to prepare for the days following ER.

IVF Update #3

Welcome to stim day 8. I feel like this:

Just roll me around. Literally.

A beached whale would also be an appropriate metaphor. The copious number of eggs have caused my ovaries to touch. My doctor had difficulty seeing where one ended and the other began. No worries….it’s not dangerous. Sitting is a chore. Stretchy waistbands only. Or dresses. Good news is that I only have a couple more days. The official countdown hasn’t begun, yet. That won’t happen until I get the trigger shot. Here’s what tonight round of meds looked like:

                                 

Side note: See what I have circled in red? I cannot tell you how much I love that little thing. It’s called a Q-Cap. Why is it amazing? Let me bring you into the know. Normally, when you are mixing a solution and a powder medication you use a long needle to draw the liquid from one vial and inject into the powder vial. Then, you withdraw the mixture. Finally, you switch to a smaller needle and complete the injection. The Q-Cap eliminates the first two steps. This way you’re not trying to balance the vial while holding the needle and withdrawing the meds. That cute little cap fits over the top and has a tiny needle to puncture the rubber top. Just turn it upside down and pull down the plunger. Voila! Now, the original way is not as formidable as I make it sound. But, I just got excited that something in this process was made easier. Please, just let me have this. Considering my stomach looks like this right now….

Anyway, back to the main update. I still seem to have a rough estimate of 13 follicles on the left and 20ish on the right. Of these 19 are measuring between 13mm – 22mm. My estradiol came back as 2556.1 pg/ml. Progressing nicely. Even my doctor is kind of excited.

So tomorrow I go back for what might be my final scan. It’s getting close. Wow. I still feel like I am I daze that all this is happening. I think by having the days broken up between scans and blood work make it so it doesn’t feel so overwhelming. Well, that’s from my perspective.

IVF Update #2

Stim day 6, time for more blood work and a follicle check. Estradiol came back as 1478.1 pg/ml. Almost tripling in two days. Next up, the ultrasound. Now, when I mention ultrasounds I am speaking of the transvaginal kind. You’re exposed and uncomfortable. Honestly, at this point, after everything that has occurred, I possess no modicum of embarrassment in stripping waist down and flinging my feet into stirrups. In general, I am a modest person, but no longer in a medical environment. Log that under interesting tidbit of the day.

What did the scan show today? I have amassed roughly 13 follicles in my left ovary and 20 follicles in my right ovary. Of those, from the few my doctor measured, 16 are between 12mm – 16mm in diameter. Not quite mature, but getting very close. Because they don’t want me to ovulate on my own I was given a dose of Cetrotide in office. I will also start this tonight and use it until I trigger. My doctor also decided to drop the Gonal-F injections and just maintain the Menopur at 150 iu.

Next appointment will be on Tuesday. It is possible egg retrieval will happen before Saturday. Which was the original tentative date. This whole process is flying by…..like I can’t catch a breath. We are excited that my body is responding well.

Symptoms: abdomen is bloated (because of the follicles), bruising from the blood thinner, still tired, breast tenderness, and uncomfortableness due to the bloating. 

IVF update #1

Today marks day 4 of stims and my first estradiol, which is estrogen, level check. The results will give the doctor an idea of how my body is reacting. On my first day (CD3) of stims my estradiol level was at 53.3 pg/ml. A good baseline number. This afternoon my levels were at 504.3 pg/ml. The nurse stated that I was responding well. My Gonal-F measurment was dropped to 75 iu. Below is a chart that displays how estrogen levels increase through an IVF cycle.

Source

I will do this for the next two days. On Sunday, or stim day 6, I go in for more blood work and an ultrasound. Here’s a nice picture of what our nightly ritual consists of:

That yellow-labeled package? Well, that is a fun little addition to this protocol: blood thinner. Since several doctors and I concluded that the birth control pills were the (most likely) culprit for my blood clots, I shouldn’t introduce estrogen into my body without taking blood thinners. Why is it so much fun? Lovenox burns for about a minute after injection. Intensity can vary depending on….magical medication gnomes. Honestly, I don’t know. Some days, it’s not so bad. Other times, it’s as if lava was inserted under you skin. See? Fun. J² seems intent on keeping me alive. He did just drop a fortune for me to carry his love child.

Symptoms: slight bloating feel, twinges probably from growing follicles expanding, exhaustion, and nausea.  

The Craziness Begins

My nerves were just chillin’ until I had to go in for my baseline ultrasound. As I drove to the clinic, my gut twisted and my mind reeled with all the things that could ruin the start of this process. I could have a cyst, or multiple ones. My lining might be too thick or too thin. Would my blood work be okay?

Worries abated. Everything looked good. I have a plethora of tiny follicles, due to PCOS, just waiting to grow. So what does this mean? I get to start stims! The IVF process has begun. The wonderful nurse handed me my tentative schedule. She also gave me instructions on how to properly administer the medications. Although, when I was at home trying to mix it up, I still worried about doing it incorrectly.

And what does that mean? Lots of shots, blood draws, and ultrasounds. Which will continue for about the next week and a half. My first three doses will be 150 IUs of Gonal-F and 150 IUs of Menopur. Medication and timing will be adjusted as needed. It is also possible I may transform into a crazy, hormonal monster. Apologies to those near me. Appeasement can be found be leaving chocolate. Or maybe ice cream. Or food in general.

So, tonight was my first shot. And with this being a team effort, J² had the privilege of playing nurse. He’d look good in a sexy nurse costume for Halloween. 

I am excited and nervous. Doing my best to not have expectations beyond reason. We’ll see if stays that way. 

Almost dying....Part 2

Returning home, I set up camp, so to speak, in the living room. When I take ill I usually sleep on the couch. That way I can move around without disturbing J². Although, J² did sleep next to me in a recliner for the first few nights. He was overly worried that I might stop breath. He is my husband and he should be concerned, but there are times when I feel I’m not worthy for such distress. Now settled, I focused on another important task; showering. While I was almost desperate to wash the hospital from me, I ran into a problem. Standing. Not something I could do for very long. Then a thought crossed my oxygen deprived brain and I called J² who was picking up my pills. I had him purchase a shower stool. So helpful. I was all clean and I didn’t fall over. Big win.

I ended up taking three weeks off work. After shuffling back into work, however, I sort of wished I reconsidered. Since I was only there for an extremely short amount of time, I chose to leave my oxygen tank in the car. It was a little heavy and I didn’t want the attention.

Physical recovery basically consisted of rest and slowly introducing exercise. As I felt a little better, I walked a little more. Mentally was more of a deterioration. When I landed in the hospital my brain automatically focused on what was wrong, how to fix it, and healing. After a couple months, when I felt practically normal, the panic and thoughts started creeping in. Besides having my plate full with issues, one more was added during this time that was not only revealing, but also damaging. So everything was compounded into a nice ball of anxiety in the pit of my stomach.

  

At random intervals, thoughts crossed my mind. The kind of dark thoughts you wouldn’t expect of someone who just had a serious health crisis. The accumulation of these thoughts spilled over the day we spoke with our fertility doctor. He didn’t give us bad news, quite the opposite. He still believed her could help us. Later that night, after J² had gone to bed, I felt the weight of everything. I panicked over the time we had lost. I panicked over the time I felt slipping from my grasp. Like, no matter how hard I could run, I would never catch up. Yes, chasing an intangible notion seems very reasonable. But, nevertheless, a relatable way to describe the particular weariness that came with the panic. I started to cry.

Then came the thought that I should have died. Why did I bother going to the hospital? What purpose did saving my life bring? How easy to ignore the symptoms. To clarify, I was not suicidal. I didn’t feel the need to hurt myself, but I just didn’t want to exist. I can’t even do a breakdown right. I understand it was a good thing to not be suicidal. But, the impression I’ve always gotten is that my feelings and experiences are not dire enough to warrant discussion. So it seems foolish mentioning it.

No matter the importance, I still felt like the visceral reaction to seek help was actually the wrong choice. I could provide nothing. I could offer nothing. I felt like I was losing It all. So why was I alive? Plain and simple: Luck. Many people die from pulmonary embolisms. I noticed an issue and looked to solve it. Deserving or not, it’s happenstance. No deeper meaning. Peace was not bestowed. Sorry if you thought I’d have some epiphany. I’m broken. In more ways than one.

Days passed by. Months. And now it’s been over a year.

I’m no longer in that mindset. I’ve accepted certain truths and what not to bother with anymore. We’ve continued fertility treatments. I did what I’ve trained myself to do; deal with it and move on. It’s what happens when you’re an in-between. This post isn’t meant to evoke anyone’s sympathy (not that I would presume it would). It’s better saved for others that need it.

As much as what’s in my head has hurt me, it also has saved me.