ivf cycle one reflection

As I sit here 9dp5dt (or, 9 days past 5 day transfer) I have a lot to reflect on from the past 4 weeks. 

For those of you who have been following, this was our very first IVF cycle after 3 failed attempts at IUI. Early in my cycle I felt really good. It was a lot more meds to handle but it seemed my body was adjusting well. I had my first scan on CD7 (cycle day 7) and of the 27 follicles we saw at my CD3 scan, 9 were maturing nicely. What does that mean? Well, typically they like to see follicles over 1.0 cm as a starting point but around the time of egg retrieval they want the follicles to be around 1.8-2.0 cm. It was around this time I started noticing some slight bloating and the Menopur headaches had fully kicked back in. You see, the average woman only has one follicle per month and I already had 9. By CD10 we had 3 more follicles maturing (to make an even 12) and the nurses let me know that it looked like we would be having our egg retrieval by the end of the week. We continued with the meds and I went back for another scan on CD11. Progress was still good but later that day I started becoming increasingly more uncomfortable. I noticed quite a bit of bloating on the right side and shortly after lunch I owned my first pair of maternity dress pants. I am not joking. I was in a meeting and could barely breathe in my pants (that I had just worn the week before perfectly fine). It was then I knew I was getting close and that I would continue to be uncountable for the next 2-4 days when they got the darn eggs out of me. On CD12, I officially started working from home as the discomfort was starting to be too much. That morning I also had another scan where we discovered 9 new follicles over 1.0 cm in my right ovary! That explained a lot. We knew at that point that those follicles likely wouldn’t mature in time for retrieval but they were there. It was also at that time that my trigger protocol was changed (the trigger shot is the last shot you take in advance of your egg retrieval). Originally I was to take a HCG trigger but with these late invaders I was now at risk for something called OHSS (Ovarian Hyperstimulation Syndrome). I went on a strict Gatorade and salt diet to try to prevent full-blown OHSS. They also decided to give me a trigger shot called Lupron. While Lupron is effective at preventing OHSS, my nurse also informed me that there was the potential that we would not be able to have our fresh transfer. Unfortunately, we wouldn’t know until after my egg retrieval if we would be doing a fresh or frozen transfer. I obviously did not want to put off our transfer for another cycle or two but I also wanted my body to be in the best place it could be to receive our little embaby. 

Fast forward to egg retrieval day. I was now feeling like the size of a house and moving around very uncomfortably. We left the house at 5:10 a.m. for our 5:45 a.m. pre-op appointment. I was exhausted but also ready for these eggs to get out. Shawn was there right up until the wheeled me away for my retrieval. They don’t allow partners in the operating room for egg retrieval, only for the embryo transfer later in the cycle. I was given a couple of doses of the good stuff in my IV and the next 20 minutes I went in and out of remembering things. I was consciously sedated meaning I wasn’t fully out but I couldn’t feel anything. I do recall feeling exactly two pokes though. Not bad considering the doctor must have gone in to at least 12 follicles. I also remember hearing numbers.. 1-2-3-4. It was the embryologist counting how many eggs she was getting from the tubes. It was a fairly short procedure (about 20 minutes) and after I was taken back to recovery where I had a very nice nap. We still didn’t know if we would. Be able to have a fresh transfer or not but I did know that if the nurse administered my HCG trigger, that likely meant we were good to go. We were also told at that time that we had 8 mature eggs retrieved and they were off to get fertilized. Oh ya, while I was having my follicles drained, Shawn was dropping off his sample in another room so our eggs could be ICSI’d right away. We got home where I immediately went back to sleep. Shawn then spent most of the day bringing me Gatorade and anything else I could stomach (mostly plain potato chips). I went in and out of sleep for the rest of the day and was fully recovered 2 days later. On the Saturday afternoon we found out that out of our 8 mature eggs, 4 fertilized and that we would find our more on Monday. I went back to work that Monday and was able to wear proper pants once again. That afternoon we found out that our 4 embryos were still dividing nicely and we would have our final report on Wednesday morning – the day of our fresh transfer. 

Transfer day was much easier than retrieval day. It was basically like an IUI but with a full bladder. Ok, I will admit the full bladder was super uncomfortable especially since I over drank the water that day. Our embryologist met with us before my transfer to give us a breakdown of where our embryos were at. The good news, of the 4 we had on day 3, we had one fresh 4AA blast to transfer that day. The bad news, one of our embryos arrested (meaning it didn’t make it to day 5) and the other two were questionable. I was quite upset. Not that I wasn’t thankful for the perfect little embaby that was being transferred back inside me that day, but because at that exact moment I had no backup plan if our little seed didn’t grow. I knew we still had one day to see if our other two embryos would make it to blast so I decided to stay calm and wait. I think the scariest thought for me was if our little embaby didn’t stick, I’d have to go through the stim + retrieval stage all over again which was particularly difficult for me. 

Shawn and I were able to watch the whole transfer together which was pretty neat. He named our embaby Poppy as it’s basically the size of poppy seed. Now we are just in a period of waiting. The day after our transfer we also found out that one of the two remaining embryos made it to freeze so we have one additional embaby in case this one doesn’t work (or for Poppy’s future sibling). 

Overall this process has been the most physically, mentally and emotionally draining thing I think I have ever been though but with a strong husband and an excellent support system, we have made it through and we are hopefully one step closer on our Long road to baby. 

XO

IVFML

A couple of weeks of weeks back I listened to this awesome Huffpost podcast called IVFML and while I wasn’t sure if I’d actually make it to this stage, I sure am glad I gave it a listen. So far my IVF experience hasn’t been much different from my IUI cycles as I already had exposure to injectable medication. The difference has mainly been the dosage of my meds, the number of injections I’m doing daily and the associated side effects.

I have been on a Menopur 150 + Puregon 150 since Monday. For IUI I was only on Menopur 75 so I’m on about 4 times the dose of meds I was for my IUI cycles. I am starting to bloat which is pretty uncomfortable and I look pregnant. BAGGY SHIRTS FOR LIFE. I also have an uncontrollable appetite. Maybe not uncontrollable but I am eating more frequently and while I’m trying to keep it healthy, I find it easy to snack on junk sometimes though which probably isn’t best.

I know I explained the IUI process a couple of posts ago so I thought I’d break down the IVF process because most of this was news to me too!

Our IVF cycle in its entirety looks something like this:

• Superovulation – basically Saturday was CD1. On CD3 I went for my baseline scan at the Procrea clinic in Maple where I later go the go ahead to start my injections. These injections will help me to mass produces some eggies to increase the chance of later producing a viable embryo
• Ultrasound and blood monitoring – I am now on CD7 and just had my first follicle scan this morning. I have 9 mature follicles which is a great number so here’s to hoping they keep on growing. I anticipate I’ll add a third injection to the roster tonight (Orgulatran) which effectively stops me from ovulating too soon.
• Egg retrieval – I imagine that I will stay on stims for another 4-6 days and eventually will take a HCG (trigger) shot to force me to ovulate. 36 hours after the trigger, I will have my egg retrieval. I have been told I will be consciously sedated for this procedure which means I won’t feel a thing but I’ll be awake. Weird. The doctor will use an internal ultrasound wand (I often refer to her as Wanda) with a needle on the end and will suck out each egg from each follicle individually.
• Sample production – Shawn will be there the day of my egg retrieval and will provide the swimmers so after my egg retrieval, they can get working on fertilization
• Fertilization using ICSI – we are using an insemination technique referred to as ICSI (Intra-Cytoplasmic Sperm Injection). Sounds fancy, huh? This is used usually with there is a male factor infertility issue. In our case, Shawn’s motility is low due to a rare testicular disease he was diagnosed with a few months back called testicular microlithiasis.  An individual sperm will be selected and injected directly in to each viable egg. CRAZY. We then wait one day and will get a call about how many eggs fertilized.
• Embryo watch – I don’t think it’s actually called this but the embryologist will keep an eye on these little guys for 3-5 days until we are ready to transfer one back in on day 5 (which is the blastocyst stage).
• Embryo transfer – once they pick the winning embryo, I’ll go back in for a transfer which is pretty simple from what I’ve been told. Not much different from my IUI where they will use a catheter to deposit our little embaby in to my uterus. If there are additional embryo’s the will be frozen for transfer at a later date if needed.
• THEN WE WAIT

It’s actually quite crazy how quickly this is all creeping up yet I AM SO FREAKING EXCITED. My little sci-fi babe should be nestled up inside me in the next TWO WEEKS. Whatttttttttt?!

For now, I’m trying to get rest, practice yoga and meditation as often as I can and relax.

We’ll see how good I do at sitting still the next little while. I’m not tuned that way.

Thanks for keeping me sane through this all! I don’t know what I’d do without all of you (I swear I could say this a million times and mean it every single time).

XO