The IVF update I’m sure you’ve all been waiting for: Part 2

My apologies for the delay in posting the second part of the update. I’ve been super busy being unemployed and not contributing anything meaningful to society (read: finding a job is hard).

I believe we last left off right at the end of the stimming phase. If you need a refresher you can read all about it here. Basically, after 13 days of hormonal injections I was ready for my egg retrieval … or as Andrew jokingly called it, “The Harvest.” I’ll back track a little and restart my account from the morning of the 13th day of stimming.

Saturday morning I went in for my daily monitoring. I had 20-something follicles all measuring 18-19mm or above and was told I would probably trigger that evening. I met with a nurse to go over the trigger and egg retrieval (ER) protocols. The trigger helps mature the follicles and it causes ovulation in 36 hours, which helps the RE time retrieval for the most optimal moment. That evening I was called with my trigger instructions (0.8 mL lupron injection subq at 1am), and told to return for blood work Sunday morning & that my retrieval was scheduled for Monday at 1pm.

Sunday morning I went in for blood work to check my progesterone level. I was called in the evening with my results, though I don’t remember what the number was. Apparently the nurse who called was supposed to tell me my progesterone was high & what that entailed but she missed that important detail. I took 1g of azithromycin around 9:30pm with some food, and then didn’t have anything by mouth after midnight (water, gum, candy, anything).

Anyway, Monday morning I got up around 9:30 to shower & get ready to go … Which didn’t take long because they ask you not to wear jewelry, makeup, lotion, or perfume. They asked us to collect the sperm at home so that happenened we headed out since we had to be at the clinic by 11:30.

Once there we checked in and were taken back to the pre-op/recovery area after a short wait. I changed into a gown and signed a consent form. Someone from the lab came took our sperm sample after verifying both our identities. Shortly after that the nurse anesthetist came to introduce herself, go over any pertinent medical history, go over what type of sedation would be administered (propofol, fentanyl, and something else), and start an IV bolus of normal saline. At this point I told her I usually get really queasy & was worried about the long ride home, so she made a note to push dexamethasone and zofran through the IV once the procedure was over.

After the IV was started I still had a bit of a wait and eventually my RE came and talked to us about the plan. At this point he said “As you know, your progesterone is high so I’d like to freeze all the embryos and try a frozen embryo transfer (FET) in January instead of doing a fresh transfer today. Your progesterone will affect implantation and reduce your chances of conceiving this cycle by about 50%.” Well, that was news to us since, like I mentioned earlier, the nurse didn’t say anything about my progesterone level being too high when she called with my results on Sunday. We were kind of in shock and I started crying even though I was trying my damnedest not to! But we signed the paperwork and the RE assured me that Andrew and I could still think about things and call if we changed our minds (we did).

After the RE left it wasn’t much longer before a nurse came and got me. I emptied my bladder and then walked to the OR while husband stayed in the pre-op/recovery area. The set up was much like getting a pelvic exam: sat at the edge of the table and put my legs in stirrups. At this point the nurse anesthetist pushed some sedative IV, then the nurses applied a pulse ox, heart monitors, and nasal cannula to administer oxygen. Then the anesthetist said nighty night (and I said “see you on the other side” because I love bad jokes) and that’s the last I remember.

ER

This is what was going on while I was out cold.

I came to in the recovery area drinking a cup of water. Apparently I’d been having a conversation with the nurse about recently passing my boards for some time, but the IV sedation has powerful amnesiac qualities so I remember none of that. The first few minutes after coming to are still fuzzy — I guess I kept asking the same questions over and over again because I couldn’t remember I’d already asked, and I kept insisting that I really wanted to get into women’s health and skip working in med/surge all together. My nurse must have thought I was great (note: sarcasm). I also vaguely remember the RE coming around to let us know he retrieved 35 eggs & that that was great number.

I was in a moderate amount of pain (5/10) so the nurse pushed some pain meds and let me wake up a little more. After a while we did a “sobriety test” to make sure I was stable to walk, the nurse took out my IV, I changed back into my clothes, and we headed home. We were on our way out of the building by 3.

I took it easy at home for the rest of that day and the next. I experienced minimal pain/discomfort, but not anything bad enough to require the narcotics I was sent home with. A heating pad provided enough relief. I certainly didn’t have any complications associated with the high amount of eggs that were retrieved (like Ovarian Hyperstimulation Syndrome), and I credit that to my consumption of gatorade, coconut water, and extra protein to help prevent fluid accumulation in my ovaries.

On Tuesday morning, the day after my retrieval, I got an email with an update on the status of my embryos. Out of 35 eggs retrieved, 21 were mature, and 20 fertilized. We had 20 embryos of our own! Those were exceptional numbers and we were over the moon. Over the next few days we got almost daily fertilization reports & our numbers stayed pretty great. We were scheduled for a Day 5 fresh transfer (meaning an embryo transfer occurring 5 days after retrieval). I’ll write about that experience in my next and final update.

I know this was a really long post — thanks for sticking around!

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The IVF update I’m sure you’ve all been waiting for: Part 1

So a few months ago I had my gallbladder taken out, and though recovery was more difficult than I imagined, I still managed not to fail nursing school or the NCLEX (with the help & support of my amazing husband, family, and friends). I’m now officially a registered nurse & school already seems like a distant memory.

My first round of IVF is also starting to feel like a distant memory — it feels like it was all so long ago even though it’s really only been a few weeks. And let me tell you, those weeks were rough and, again, I really couldn’t have done it without my husband. He’s been my rock.

Anyway, since IVF is a process — that’s an understatement — I thought I’d break it down into a few different phases & this post will cover phase 1: ovarian stimulation (“stimming”).

Before I started stimming I had to be on birth control for 19 days for the purpose of “calming” my reproductive system. The day after my last birth control pill I went to the clinic for a “baseline” appointment that involved an ultrasound to check out my uterine lining and ovaries, and blood work to check hormone levels and make sure I wasn’t miraculously already pregnant. Everything looked good at my baseline so 4 days after my last pill I started hormone injections to stimulate my ovaries into producing a lot of eggs. My protocol was “low and slow,” meaning I took lower levels of hormones for a longer period of time in order to avoid hyperstimulating my ovaries, which comes with it’s own set of problems.

I gave myself two injections a day for seven days (Monday – Sunday) and during that time went in for 2 monitoring appointments to check out follicle (egg) development and estrogen levels. After those 7 days I added a third injection to the protocol and continued stimming for 6 more days (Monday – Saturday), with daily monitoring appointments. On the final day of stimming I gave myself an injection, called a trigger, that causes ovulation to happen in 36 hours and I made an appointment for my egg retrieval at that time (that’ll be covered in phase 2).

So it all sounds simple enough, except that the injections stung and left bruises all over my stomach. And the hormones made me feel tired and hot and cranky and starving and weepy and a whole bunch of other not fun things. And I had a headache the entire 2 weeks I was stimming. And by the end of it my ovaries were so enlarged that they were touching — hint: ovaries are not supposed to touch — and it hurt to walk, go to the bathroom, laugh, breath, or pretty much do anything. AND I had a cold the entire time.

It was totally glamorous and, though I can (and do) complain about it a lot, it was actually a really cool experience. Every time I had an ultrasound and saw how my body was responding and changing, it gave me hope that one day I’d have a family. Every time I saw that my ovaries were producing big, beautiful follicles, I couldn’t help but marvel at the fact that I was looking at what will one day be part of the baby I’ll be holding in my arms. It really helped remind me what a miracle life is and it helped rekindle hope for a future with the family I’ve always wanted.