IVF – Egg Retrieval {Infertility}

Howdy! Last time I left off, we had just finished stims and were getting ready to administer the Lupron trigger injection to prepare for egg retrieval. The following post contains my account of the egg retrieval procedure. Warning: content is graphic in nature and may be inappropriate for children or squeamish adults.

Our egg retrieval was the morning of Thursday, March 26. As soon as we arrived at the clinic, our nurse (Judy) escorted us to a private waiting room where she took my vitals and asked me a few questions about my medical history, medications, emergency contact, etc. Then she gave me two Valium to help me relax, and this is where things start to get a little fuzzy…

I remember Tim leaving the room to make his “contribution” while I changed into a hospital gown and robe. I sort of remember the IVF coordinator (Jess) starting an IV. By the time Tim came back to our room less than 20 minutes later, I was feeling mighty fine – like I had just chugged two glasses of wine. It was party central.

At some point Dr. C came into the room and talked to us about the procedure. He commented on my bright pink socks and joked that he would have to wear sunglasses while he was performing the retrieval. I, of course, found this hilarious!  He also commented that he had already performed one retrieval that morning, so he was nice and warmed up. (See what I mean? Not only is Dr. C a wonderful doctor, he is also slap-your-knee funny!) Then the nurses had me empty my bladder (thank goodness, because I really had to go!). When I walked out of the bathroom, the other nurses at the clinic asked me to lift up my foot so they could see my pink socks everyone was talking about. I happily obliged. Then I kissed Tim goodbye and the nurses walked me down the hall to the retrieval room.

Egg Retrieval 1

Once I got to the procedure room and situated on the table, the nurses covered me with a warm blanket. Dr. C dimmed the lights, and I vaguely recall music playing. (Tim mentioned later that Dr. C said eggs don’t like light. I must have been in la-la land for that conversation.) I also remember thinking it would be so fun to do one of those Taylor Swift “Shake it Off” lip-syncing videos while I was in there. (I was really enjoying the Valium.)

Anyway, there were three other nurses in the room. One of the nurses (Kelly) sat near my head and helped position the nasal cannula (I just had to look that up) on my nose. She also started pumping pain meds through my IV while Dr. C started to, um, get things ready in the land down under.

For the actual retrieval, Dr. C inserted a needle attached to an internal ultrasound probe into my whoo-ha (trying to keep it PG over here). After locating my ovaries and the follicles on the ultrasound, he punctured each follicle and gently sucked out the egg and fluid within each follicle. I can’t be sure, but I think a long tube ran from the probe to the embryologist waiting in the lab next door. (She waved at me through a small window/opening in the wall next to Dr. C.)

They kept me fairly comfortable throughout the procedure, which lasted less than 20 minutes. I watched most of the retrieval on a small screen next to my bed. I felt mild to moderate menstrual cramps throughout most of the procedure. Toward the end, I started to feel pretty uncomfortable but refused additional pain medication since it negatively affects egg quality. The embryologist kept giving us an updated egg count (“We’re up to six eggs!”), and I remember feeling a small thrill that I did it – I actually made eggs. Dr. C joked that the embryologist was our first “babysitter” since she was busy watching over our eggs in the lab. Once again, I found this absolutely hilarious.

Even though the procedure is performed under light sedation, I was conversational throughout most of it. Here are some rather cringe-worthy snippets of conversation:

  • “Everyone in my family just looks at it and gets pregnant.”
  • “Wow, these stirrups are really nice. They kind of, like, cradle my legs.”
  • “Do you guys watch The Bachelor? Whitney was a fertility nurse, and she and Prince Farming made a baby in the lab. I mean, it wasn’t his baby, but they helped make one with a couple’s sperm and egg.”
  • “You know, twins actually run in Tim’s family. One time, one of them pulled the fire alarm at school”…(I lost my train of thought and never finished the story.)
  • “Do you ever watch the TODAY Show? They did a series not too long ago on IVF. They showed the retrieval, and ICSI, and…” (Once again, I forgot what I was saying.) “Yeah, you should really check it out!”
  • Dr. C also asked me where I grew up. I told him the name of the small town, mentioned the booming population of 4,000, and said everyone was super excited when we got our first stoplight a few years ago. He said, “I think they have an airport. I think it’s an international airport.” (OMG, hilarious!) I said, “You have a plane, right? Wow, that must be so fun.”

While I was busy making small talk, Tim watched the procedure on a television screen in our private waiting room. He said a nurse sat with him for a bit to explain what was happening. The top photo shows an ultrasound of Dr. C inserting a needle into the follicle to draw out the fluid and egg. The bottom photo shows the embryologist examining the fluid and egg in a petri dish in the lab.

Egg Retrieval 2

After completing the procedure, Dr. C and the nurses helped me sit up and take a few steps to a La-Z Boy on wheels. Dr. C then wheeled me down the hall back to Tim. Baby photos line the hallway, and I remember making a mental note to send Dr. C a photo of our baby/babies. Once we got back to the room, Dr. C announced they retrieved 21 eggs! Feeling especially chipper, Tim and I made some comment like, “Overachiever much?!” My boss later called me the Easter Bunny.

Egg Retrieval 3

I sipped on animal crackers and ginger ale while they pumped two bags of fluid into me. Before getting dressed, Judy drew two squares on my butt cheeks so Tim would know where to administer the Progesterone in Oil injections we had to start that night. Judy joked that she was really drawing smiley faces or hearts on my bum. (I was losing it at this point.)

After Tim helped me get dressed, we walked out to the nurse’s station, and they all commented that I didn’t even look like I just came out of surgery. I jokingly fluffed my hair and was like, “Well, you know…”

Once we got out to the reception area, Tammy (one of the nurses) said something like, “See, all your follicles were still there!” At one of our last scans, I told her I was terrified my follicles would just disappear or I would spontaneously ovulate. She had reassured me the follicles would be there waiting for me at retrieval.

On the 20-minute car ride home, Tim stopped at McDonald’s to buy me some fries. I took one bite and started to feel a big queasy. As soon as we walked in the house, I ran to the bathroom and tossed my cookies three times. Party. Over. Tim helped me to the couch, where I slept the rest of the day.

I felt pretty sore and bloated that evening and the following day (Friday), but I was also so relieved that egg retrieval went so well. The nurse called on Friday to say the embryos were doing great, and we were on track for a Day 5 transfer.

As soon as she said the word embryo, I started crying at my desk at work. In our five years of trying to conceive, we have never once gotten pregnant. We have never created anything. So the fact that we now had embryos thriving in a petri dish made my heart happy beyond belief.

If all continues to go well, our embryo transfer will be Tuesday, March 30. Because I over-responded to stims, we had to follow the Lupron trigger protocol to help prevent OHSS. That means I have to take Estradiol pills, vaginal progesterone suppositories (Endometrin), and Progesterone in Oil injections through the first trimester of pregnancy. This is a small price to pay for our little miracle(s).

Next Steps:

  • Embryo transfer on Tuesday, March 30!

IVF – Stims Day 9 & Trigger Shot {Infertility}

We survived stims!

Yesterday was Stims Day 9 (our final day of stims). Our nurse (Tammy) counted 20 follicles on the ultrasound (seven in my left ovary and 13 in my right), including six mature follicles and several in the 10-14 mm range. These numbers changed a bit from Sunday’s ultrasound (nine in my left and 11 in my right), but they still add up to 20. Tammy commented that I had “kissing ovaries,” meaning my ovaries are so large at this point they are nearly touching. It seems the stimulation medication did its job, and all those follicles have made me look about four months pregnant. I rather enjoy my bump!

Trigger Night Collage 2

Tonight Tim gives me a trigger shot (helps with follicle maturation), which is the final step before retrieval. Because I had an increased response to the stimulation medication, we are following the Lupron trigger protocol to reduce my chance of developing Ovarian Hyperstimulation Syndrome. Basically, OHSS = bad.

Next Steps:

  • Egg retrieval on Thursday, March 26!

Wish us luck!

 

IVF – Stims Day 8 {Infertility}

We’re feeling (mostly) great on Day 8!

Stims Day 8

We had another follicle scan bright and early this morning. (Is it weird I now feel totally at home in stirrups? TMI?) Our numbers increased slightly since Friday, with nine follicles in my left ovary and 11 in my right. A few follicles had reached maturity (15 mm), with several follies in the 10-14 mm range. My blood work came back good, and my lining has also thickened. Kelly (our nurse) thinks we will be ready for retrieval on Wednesday (a day ahead of schedule) or Thursday (right on schedule).

Tim was finally able to join me for a scan and see the follicles for himself. He had never seen a transvaginal ultrasound before, so Kelly explained where the embryo(s) would implant and pointed out all the follicles as she measured them.

In terms of medication, we will discontinue the morning Bravelle injection and keep the evening Menopur and Ganirelix Acetate injections until further notice.

How I’m Feeling:

  • Uncomfortable. I feel bloated, crampy, achy, and full. My poor ovaries have never worked this hard in their lives. My Grandma Dottie said my stomach looked pudgy yesterday, which I totally took as a compliment.
  • Excited. The stimulation phase flew by, and this whole process is starting to feel very real. I am especially eager to see how many eggs we get at retrieval (not every mature follicle will have an egg) and pray at least a few eggs fertilize.

Next Steps:

  • Ultrasound and blood work on Monday, March 23

We’re getting close!

IVF – Stims Day 6 {Infertility}

Hello, Day 6!

Stims Day 6

Six days and 15 injections later, my ovaries have produced 15 beautiful follicles. I have six follicles in my left ovary and nine in my right, all measuring between 10-13 mm (15 is mature). I also have several smaller/immeasurable follicles on each side, but I doubt they will catch up in time for retrieval. On Sunday we drop the morning Bravelle injection and keep the evening Menopur and Ganirelix Acetate injections.

In related news, Windsor still expects a treat every time Tim prepares the injections while Tucker runs for the hills.

How I’m Feeling:

  • Bloated. I can no longer button my pants, but the old rubber band trick works like a charm. I also feel super full really quickly when I eat.
  • Calm. I thought stims would transform me into an emotional wreck, but I feel abnormally cool and collected. All side effects seem purely physical (see above).
  • Tired. My Grandma Dottie landed in the hospital this week with chest pain and shortness of breath. I drove straight to the hospital most nights after work, then came home for my injections, and then drove back to the hospital to spend time with my family. To top it off, Windsor picked a fight with a raccoon on Tuesday (the same night Dottie went to the hospital), so Tim had to take him to the vet and nurse his scratches on top of juggling my shots. Luckily, both Dottie and Windsor are doing much better.
  • Hopeful. So far (knock on wood), everything looks great. I feel like we have won the follicle lottery. Now we are crossing our fingers the follicles mature nicely.

Next Steps:

  • Ultrasound and blood work on Sunday, March 22 (On a side note and in my personal opinion, a good clinic opens its doors even on the weekend.)

C’mon, follicles!

IVF – Stims Day 3 {Infertility}

Welcome to day three of stims! So far I have survived five shots in the stomach (see our injection tally sheet below). For some reason, the Bravelle injections hurt a bit more than the Ovidrel injections did during our IUIs. It has become a running joke between us as to which four-letter expletive I will blurt out each time Tim stabs gently pokes me. I totally feel like Steve Carell’s character in The 40-Year-Old Virgin when he gets his chest waxed. “AAAAAAAH KELLY CLARKSON!” Okay, I exaggerate a bit.

Anyway, this morning I had an ultrasound to check for follicles (which contain eggs) and blood work to monitor my hormones. I have about 7-10 follicles in each ovary. The follicles were small/immeasurable, but the nurse (Judy) said at this point they just want to make sure I am responding to the meds. Judy also saw a 10 mm follicle in my right ovary, but I suspect the follicle is actually the cyst they saw on my baseline ultrasound.  (On a side note, a mature follicle usually measures at least 15 mm.)

Tomorrow we begin replacing our evening Bravelle injection with 150 units of Menopur and add Ganirelix Acetate (to prevent me from ovulating) to the nightly rotation. We will continue with 150 units of Bravelle each morning until further notice.

Stims Day 3

How I’m Feeling:

  • Bloated. I have a four-month baby bump. Judy said the medication, along with all the follicles, cause the bloat. She also said my mid-section will continue to expand as the follicles grow. In the meantime, I seriously think I have to buy new pants before the work week is over.
  • Hopeful. Because my body has failed me so much in the past, I half expected my ovaries to either respond super slowly or boycott stims altogether. I was pleasantly surprised to see so many follicles hanging out on my ovaries.
  • Amused. Our yellow lab seems to think each injection is a treat, and he eagerly sits at Tim’s feet as he mixes the medication. Our black lab, on the other hand, runs and hides when he sees the syringe. Puppies are funny.
  • Grateful. Tim has given me every injection, meaning I don’t have to give them to myself. I don’t necessarily fear needles, but I sure appreciate Tim’s help/support/commitment.

Next Steps:

  • Ultrasound and blood work on Friday, March 20

Grow, follies, grow!

IVF – Stimulation Phase {Infertility}

After years of waiting, praying, dreaming, and hoping, it’s finally time to get this IVF show on the road. Tim and I officially started stimming this morning, marking a major milestone in our journey to parenthood. We’re doing it. Really doing it.

Before I talk about the stimulation phase of IVF, here’s a brief calendar of recent events:

  • Down Regulation – I spent Feb. 28 to March 9 down regulating on Norethindrone (a synthetic hormone similar to progesterone). This helped me shed my endometrial lining prior to initiating stimulation medications.
  • Mini Period – I got a light period on Sunday, March 8. If things go well, this will be my last period for a very long time (fingers crossed).
  • Baseline Ultrasound – I had a baseline ultrasound on Friday, March 13. My lining was nice and thin. Unfortunately, I had a 17 mm cyst on my right ovary. While Dr. C normally aspirates any cysts larger than 15 mm, he decided the cyst was still small enough to ignore and instructed us to start stims as scheduled.

Speaking of stimulation, over the next 10 days, Tim will give me twice-daily injections of hormones that stimulate my ovaries to produce multiple eggs. Dr. C and his nurses will monitor my ovaries and hormone levels very closely during this time, giving us specific instructions each step of the way. If everything goes well, my eggs will be ready for retrieval around March 26 to March 28.

Tim rocked the first injection. We set the alarm for 7 a.m., and he mixed the medication and poked me like a pro as I stumbled into the kitchen still half asleep. I have to say, a shot of Bravelle first thing in the morning equals at least two shots of espresso; I suddenly felt wide awake!

First Injection

Next Steps:

  • Ultrasound and blood work on Tuesday, March 17

Cheers to starting stims!

 

Getting Ready for IVF {Infertility}

Well, folks – it’s March. Tim and I start ovarian stimulation (stims) in two weeks, and our home office resembles a mini fertility pharmacy. We have alcohol wipes, syringes, and medications galore. I don’t know if I should feel excited or terrified. Probably both.

I used to think IVF was a relatively simple procedure – an egg, a few sperm, a little TLC (and maybe some romantic music) in the lab, and BAM: you are the proud parents of an embryo! Transfer the embryo, wait two or three months until you hear that miraculous little heartbeat, and then blow up the internet/social media with one of those cheesy “We’re Expecting!” announcements. If only IVF were that simple.

Even though we officially start IVF in mid-March, we actually started preparing back in January. Goodness, I never knew how much testing and paperwork went into making a baby. I may have suffered a slight meltdown on Christmas Eve. Just saying.

Here’s what we have been up to the past two months:

  • Hysterosonogram: Dr. C did a hysterosonogram to check for fibroids and other abnormalities in my uterus. Luckily, my uterus checked out great. In fact, Dr. C said my uterus is beautiful. I totally just blushed.
    Hystersonogram
  • Birth Control: Yes, we infertiles understand the irony of taking birth control to help us get pregnant, but it helps resolve/minimize/prevent any ovarian cysts. Birth control also helps suppress my system to optimize my response to the stimulation medication. I like to picture my ovaries on vacation – maybe sipping a margarita on a sunny beach and resting up before they have to work overtime later this month.
  • Infectious Disease Testing: Both Tim and I were tested for HIV, AIDS, etc. We have a clean bill of health.
  • Embryo Storage: After getting our infectious disease results, we signed a lease with an embryo storage facility. This required a small mountain of paperwork in which we had to answer strange questions like, “In the event of death or divorce, who shall retain ownership of your embryos?” Tim said I could have them. Awe. Who needs diamonds when I could have my very own blastocyst?
  • Blood Work: I had additional blood work to check my hormones. Unfortunately, my estrogen level was a bit high (probably due to two ovarian cysts). Hopefully the cysts disappear before we start stims. If not, Dr. C will aspirate them. I also discovered I have no immunity to chicken pox, which requires signing yet another waiver stating I understand the risks.
  • Back-up Sample: Tim made a special trip to the clinic to provide a security deposit of sorts just in case he is unable to deliver a fresh sample the day of egg retrieval. That poor man still won’t tell me what’s in “the room.”
  • Drugs: After a brief medication discussion with an IVF nurse, we ordered all of our fertility drugs from a specialty pharmacy in Minneapolis. Four bags and $4,100 later, we now own stock in Menopur, Bravelle, and Endometrin.
  • Injection Class: Before Tim can use my bum as a human pincushion, we must first attend training (scheduled for March 3) to learn how to properly fill the syringes and inject the medication. I foresee a lot of ice packs in my very near future.
  • Voicemail: Finally, we set up a voicemail system at the fertility clinic. Basically, a nurse calls us each day to tell us how much of each medication to administer. They will also use this voicemail system to notify us of our beta (blood pregnancy test) results.

Whew! As the weeks leading up to IVF continue to fly by, I have to admit, there are good days and bad days. Some days I feel so incredibly hopeful, and other days I feel crippled by fear. As someone who loathes gambling, I sometimes worry we are just rolling a $20,000 die and hoping things work out in our favor. But, alas – we must simply believe this is going to work. Believe. BELIEVE.

Weekly Walk {v.5}

Ah, the walk that wasn’t.

020115_Calhoun

#iheartpenguins

Sandra and I had the best intentions of walking the entire 3.2 miles around Lake Calhoun this morning, but gale-force winds forced us to abandon ship less than a mile into our normal loop. Practically crawling back to our cars, we stumbled on several snow sculptures left over from this weekend’s City of Lakes Loppet Ski Festival. Despite freezing her face off, Sandy eagerly paused to pose with this giant penguin.

Note to self: check weather forecast before next walk. Ha!

Ciao!

Currently {v.1}

It seems like just yesterday we rang in the New Year, yet next week we flip the calendar to February. You know what they say: Time sure does fly when you’re having fun wishing for spring! Anyway, aside from warding off a serious case of cabin fever, here’s what I have been up to:

  • Watching…way too much trashy reality television. Prince Farming, anyone? Oh, and Parenthood. Week after week, I sob my way through each episode, crossing my fingers Zeek pulls through and Joel and Julia give their marriage another chance.
  • ReadingA Week in Winter by Maeve Binchy. How I would love to own/manage a small bed and breakfast or a quaint, coastal inn. Too bad I can’t cook. And I don’t live near the sea. Nor do I know the first thing about the hospitality industry in general. But hey, I can sure fluff the heck out of those pillows.
  • Listening..to podcasts every chance I get. Tonight, washing dishes and cleaning up the house, I tuned in as Sarah Ruiz discussed her approach to juggling motherhood, hobbies, and her career at NASA on The Lively Show. I love her idea of picking one little word for the year. Her word for 2015 is enough (the idea of not wishing for more…that where she is at and what she is doing is enough). Now I am on a mission to select a word. Perhaps calm? Or hope. Ooh, I know – believe.
  • Pondering…the chicken pox. Our fertility clinic called today with my recent blood work results, and it turns out I have no immunity to chicken pox (which I vividly and uncomfortably recall surviving in kindergarten). Now we have to decide if we should delay our IVF cycle so that I can be immunized, or throw caution to the wind and go ahead with the embryo transfer anyway. I foresee a depressing/terrifying WebMD search in my very near future. More than likely, I will diagnose myself with some rare, incurable form of cancer, and then Tim will spend all night lecturing me on the dangers of online medical advice. Sigh.
  • Photographing…the dogs. Sometimes I sprawl out on the bathroom floor just to watch Windsor nap in the hallway and snap a few photos. He plays along as long as I don’t use a flash.

windsor bw

Cheers!
~Erica

1 2 3 4