IVF Retrieval through the 6-Day-Wait!

I feel like so much has happened since the last time that I posted a new blog update! This post will take you through the week of IVF Retrieval and the dreaded 6 day wait! 

5/15 Monday, Shots day 7: Half Dose Cetrotide, 75 ui Gonal F

 

Example of ovary filled w/follicles

Today I went in for my ‘Cycle Day 9’ lab and ultrasound appointment. This is the first time we got to see what the medication is doing to my ovaries!  

Labs:

PROGESTERONE: 1.22 ng/ml

LH: 12.92 mIU/ml

ESTRADIOL: 4665 pg/ml

Ultrasound:

Left Ovary

Follicles:              17mm, 12mm, 14mm, 12mm, 15mm, 14mm, 16mm, 12mm, 20mm, 13mm

Right Ovary

Follicles:              14mm, 10mm, 19mm, 10mm, 17mm, 15mm, 15mm, 12mm, 15mm, 17mm

Endo Thickness 14.2

So the follicles looked great but my labs were a bit alarming! The estrogen (Estradiol) was very high and the LH was showing signs that my body was getting ready to ovulate…which isn’t supposed to happen! Cetrotide is supposed to suppress ovulation, because if you ovulate early in IVF, you could lose ALL of your eggs before they are ready for retrieval. They told me to take an extra half dose of Cetrotide right away and then to take another full dose in the evening and to come back for another ultrasound and more blood work first thing tomorrow.

By this point I am terrified, I’m upset, I’m so bloated and crampy and emotional that I’m sure that everything is going to go wrong. I’m pretty sure I cried myself to sleep. 

5/16 Tuesday, Full dose of Cetrotide before exam 

Today I went back to the clinic for more blood work and another ultrasound to see if we stopped my body from ovulating. I got into the ultrasound room and was so nervous. When my doctor looked at the ultrasound and told me that I had NOT ovulated I about cried! I wasn’t completely out of the woods since we needed to see if my blood work matched the ultrasound, but I was very happy!

A few hours later my blood work came back:

LH: 0.847 mIU/ml

PROGESTERONE: 0.537 ng/ml

ESTRADIOL: 2750 pg/ml

Ultrasound:

Left Ovary

Follicles:              17mm, 12mm, 11mm, 20mm, 13mm, 15mm, 12mm, 16mm, 15mm, 19mm

Right Ovary

Follicles:              17mm, 14mm, 22mm, 16mm, 14mm, 11mm, 20mm, 18mm, 16mm, 21mm

General Observations

Endo Thickness 10.9

Even I could see that we were able to severely lower the estradiol and the LH numbers! My doctor said she was very optimistic that we caught it in time and that I would not ovulate before retrieval…which was now officially scheduled for Thursday morning at 7:30am. 

I was told to do  Gonal F 75 units right away, start my  Z-Pak 250 mg (to help prevent infections from retrieval and to do my trigger shots at 7:30pm! The trigger shots are what helps the eggs mature and prep for retrieval. You have to do this exactly 36 hours prior to retrieval. Too late and you won’t be ready by your time slot or too early and you might already ovulate prior to your appointment.

My trigger shots were HCG 1500 units and Lupron 80 units.

5/17 Wednesday, Take z-pack

Today I felt like my stomach was being pushed into my throat and my stomach was swollen to the size of a basketball. The anesthesiologist for tomorrow called to introduce himself and to get payment ($500). He also let me know that today I was not allowed to eat or drink after midnight since you are completely under anesthesia for the retrieval process. I went to bed early. 

5/18 Thursday- RETRIEVAL DAY!!!

Today I felt like CRAP! I was waddling, I slept like crap, I had cramps! Honestly, I was glad I was not able to eat or drink that morning because I’m not sure I would have been able to fit any food or drink in my stomach. I’m pretty sure my stomach was literally in my throat because my ovaries were taking up too much space!!!

Giant bruise after retrieval

We arrived to the clinic at 7am (like we were supposed to). Steven went into his little room to ‘do his business’ while I changed into a hospital gown. We then go into the procedure room where I am met with the anesthesiologist. The next 30 minutes is spent with two nurses and the anesthesiologist trying to find a vein. I warned them that my veins hide if I do not eat or drink, and boy did they hide. I was poked a totally of 5 times. My left arm was so bruised from the past two times they took blood that they didn’t want to risk it so they tried my right arm…no luck. They tried my right wrist…no luck. They tried the middle of my left arm…no luck and OMG OUCH! They tried my left wrist…no luck. Finally they decided to risk it and try the left arm in the normal space and after some digging…luck! They finally got it!!! 

As they were hooking me up to all the machines and fluids my doctor came in to do one last ultrasound to make sure I had not ovulated…I hadn’t! Then I slowly drifted to sleep.

When I woke up (all of this is me in a semi couscous state) they told me that they had gotten 31 eggs! So 11 eggs were hiding from the ultrasound each time I had come in. That’s a lot of eggs!! For that reason they wanted me to come in again in a week to do a follow up to make sure I didn’t overstimulate and develop Ovarian Hyper Stimulation Syndrome. Ovarian hyperstimulation syndrome (OHSS) is a medical condition affecting the ovaries of some women who take fertility medication to stimulate egg growth. Most cases are mild, but rarely the condition is severe and can lead to serious illness or death.

Once we were able to put my pants on…yes, Steven literally had to help me pull my pants up because I felt like a drunk person…they released us. They told us they would call tomorrow to let us know how many fertilized and then one day 6 (day zero being retrieval day) to let us know how many grew to Day 5! 

When we got home, I had to do two full doses of Cetrotide. This helps to calm the ovaries after retrieval. I'm a little worried that even while 'drunk on meds' I was able to draw up and inject myself with medication.

5/19 Friday, Day 1 after Retrieval

Today I felt like crap. I’m swollen, bloated, its hard to breath because ovaries are so large. I do nothing but sleep. I do another two doses of Cetrotide in between naps.

We got the call that afternoon that out of the 31 retrieved, 29 were mature (this means they were full size eggs that could potentially fertilize) and out of that 19 fertilized! I was very happy with those numbers. Remember, based on the previous ultrasounds it only looked like I had 20 eggs, so having 19 fertilize was great! Most of the time you lose about 30-50% each step (retrieval, fertilization, grow to day 5, etc.) 

5/20 Saturday, Day 2 after Retrieval

Ditto to yesterday. I e-mailed my coordinator to tell her I was having trouble breathing and she asked me to come in immediately for an ultrasound. I went in, and they saw everything looked normal. I was just suffering from extremely swollen ovaries due to retrieving so many eggs. I go home, I sleep.

5/21 Sunday, Day 3 after Retrieval 

Ditto to the past two days. I stay in bed and sleep.

5/22 Monday, Day 4 after Retrieval

Today is my first day back at work, since I took Thursday and Friday as sick days, and I’m still not feeling great. I end up taking a half sick day.

5/23 Tuesday, Day 5 after Retrieval

Today I wake up and feel a little better…YAY! I go to my follow up appointment and the doctor says that it looks good. My ovaries are still swollen, 8cm each (normal ovaries are 4cm each). But that it is to be expected with the amount of eggs that we had. It will take the next few weeks for them to slowly shrink down to normal. I have a little bit of free standing fluid in my body but nothing to be concerned about. That should go away on its own. 

Today (a day early*) we received a call from the clinic to let us know that as of right now 9 embryos have made it to day 5 blastocysts and they are watching 2 more. They called early because they wanted to check to make sure we wanted all genetically tested. This is because the package that we bought (for $2050) only included 8 embryos. Since we had more than 8 to send they wanted to check to make sure it was alright. (I'm assuming that if we wanted to only send 8 they would have sent the best 8 we already had.) It will be an additional $250 per embryo sent. Luckily Steven and I had discussed it ahead of time and decided that we would send up to 12 if we had that many make it. 

Looks like will have at least 9 to send to testing!We find out tomorrow if the other two made it or not. 

*Can I just say how terrifying it is to get a call a day early?! I saw the number and I was sure it meant that none of them made it and they were calling early to tell me the bad news. No point in waiting the extra day to call if none made it...but whew, I'm glad I was wrong!

5/24 Wednesday, Day 6 after Retrieval

So we got the call this morning that the other 2 did not make it to full grown- but we have 9 that look great and have been biopsied, frozen, and the biopsy will be sent out for genetic testing. It will take 7-10 days to get back from testing!!! Keep your fingers crossed for some healthy embabies! 

We also learned what grade the embryos were: 

1 was 4bb
2 were 5bc
1 was 5bb
5 were 5ab

6AA would be highest grade, 1CC would be lowest grade. While it is nice to know the grades, it will really come down to the genetic testing. Sometimes the best quality embryos are abnormal where the lower quality ones are normal and the best option for implanting. We shall see!

Journey to Becoming a Mother

On this Mother’s day I want to update everyone on my journey to becoming a mother.

I am very thankful for my mother during this whole time (and all the times). She has been there for me a lot lately. She has been coming over once a week or so since Gadget passed since I've been in a major funk. She has been there for me through phone calls and emotional support. She has been amazing. If all of this IVF stuff works out I know that my future child will have a wonderful grandmother waiting for him/her. I cannot express the amount of gratitude and love that I have for her. Happy Mother's Day.

This week I started doing injections on my journey to become a mother. 

Monday, Shots Day 1: 225 ui of Gonal F: 

This was the first shot! All shots, up until the trigger shot (which helps induce ovulation before retrieval), are given through subcutaneous injection in the stomach around the belly button. This means it is a shot given into the fat layer between the skin and muscle. Gonal F comes in a pre-filled pen where you dial the amount you need, insert the needle, and press. This one was pretty easy, however, I accidentally had to poke myself twice since I withdrew the needle thinking I got everything out, when I hadn’t. So other than having to give myself the shot ‘twice’, it went off without a hitch.  

 Tuesday, Shots Day 2: 225 ui of Gonal F: 

Today was my last acupuncture appointment before retrieval. We finally got all my levels down to normal so I won’t have to go in again until after retrieval when we work on thickening the uterus lining. 

 The shot this afternoon was the same as Monday. I started to feel a little bloated today. Hopefully this means there are lots of eggs being produced and growing!

This afternoon our AC went out- not sure if medication caused hot flashes or if it was just hot as hell in our house, but I'm thinking it was just hot!

Wednesday, Shots Day 3: 225 ui of Gonal F:

Today I was definitely feeling a little more bloated. I also have a ‘full’ feeling in my stomach.

The AC was fixed today- however I almost murdered Steven at the same time. This is its own story, but he accidentally had the AC guy fix a piece that my dad could have fixed for $30 and instead he had the AC guy fix it for $400!!! Again, maybe the medication is making my hormonal, but Steven almost died tonight. He's lucky I need his swimmers to do IVF lol!

Thursday, Shots Day 4: 150 ui of Gonal F:

Very bloated today and I fell super ‘full’. Like after you eat thanksgiving dinner and you are full up to your throat. 

Friday, Shots Day 5: 150 ui of Gonal F:

I had an appointment at the fertility clinic today to check my blood levels to see how we need to adjust my medication. Results came back shortly that afternoon and things seems to be on track. We adjusted and added some medication to start the next day. 

Saturday, Shots Day 6: Morning, ½ dose Cetrotide; Evening, 75 ui Gonal F, full dose Menopur:

Cetrotide is used to prevent premature ovulation. With all of the other medication your body is being stimulated to grow eggs and preparing to ovulate, but we do not want to ovulate before the eggs are ready to be retrieved or else they are gone and cannot be used during IVF. Menopur helps with the growth and quality of the eggs. We want to make sure that we have the eggs grow to maturity before retrieval. 

Cetrotide is the worst so far! I injected it and right away it started to itch like a horrible mosquito bit. It started getting red and swollen. The redness and swollenness when down in an hour or so, but the itchiness continued for a few hours and then final went away. 

Menopur can be bad as well, but luckily I had learned from others that it is best to inject this one slowly. Very slowly. If you go too fast this one can burn very badly. Even injecting it slowly made it burn a little, but it went away pretty quickly.

Sunday, Shots Day 7: Morning, ½ dose Cetrotide; Evening, 75 ui Gonal F, full dose Menopur:

Today I have been very tired. I had the same reaction with the Cetrotide as I did yesterday with the swelling, redness, and itchiness. 

Tomorrow I go back to the infertility clinic to do an ultrasound and more blood work to see how the eggs are growing.

*This week started off with getting the phone call that Gadget’s ashes were ready to be picked up. We had requested him to be cremated on his own so we could get his ashes back. We also requested a clay foot print be made. So Monday afternoon Steven picked up Steven’s ashes while I got a wooden box ready for his ashes. I lined the box with one of his favorite fleece blankets, one of his favorite toys, and a few other items. When Steven brought him home we placed his bag of ashes in the box and had a good long cry. While I know the sadness isn’t going to go away anytime soon, I felt some comfort having what we can of him home with us.  I believe that he knew how much I wanted him to be with me for all of the injections so fate worked out so he would be home by then.

The Storm before the Storms

This past week and a half has been one of the hardest times I’ve ever experience.

Last Monday, April 24^th we lost my (fur)baby boy, Gadget. I came home from work and he was having trouble breathing. He has been suffering with severe asthma for the past three years. Right before we moved to Wentzville (May 2016) we took him to the vet for an asthma flare up and he told us that Gadget probably had 1 year left, or one more major asthma attack, whichever came first. When we were settled into Wentzville we took him to a new vet and she had been working with him from May-December. In December he has a small attack and we took him in. She checked out his lungs and said they looked pretty bad. She prescribed us some injectibles for him to take (which were strong steroids that came with major possible side effects). She told us that after these injectibles there was nothing more that they would be able to do. Since the drive to the vet stressed Gadget out she told us that she did not want to see him in office anymore. We had all of the tools (oxygen tank, inhaler, medication, etc.) that we needed if anything ‘fixable’ went wrong.

I was honestly surprised that we came home with him that day. She told us that we would know when it was ‘time’ and that he would tell us. From that day there were a few other scares, but each time I’d look at him and ask him if it was time. And each time I was met with these eyes that were full of life. Sadly, on Monday that was not the case. The past few weeks he had been losing weight, which at first we thought was a side effect of the medication (and it probably was, or it could have been a ‘complication’ from the medication), but it was starting to get noticeable. We also noticed that he needed to use the oxygen tank more over the past few days. His nose would turn this purplish shade, but when we put the oxygen tank up to him he would perk right up and the rest of the day would be fine. On Monday we tried oxygen and he would perk up for about a minute and then his nose would turn purple again. At one point he started coughing (asthma fit) and he kept coughing so hard he had to slowly lay himself down. He had never done that before. I looked at him in the eyes and asked him if it was time. I was met with some very sad, tired eyes. 

 I told Steven that it might be time. I had one test left to see if this might be it. Gadget absolutely loved to drink from the bathroom tub faucet. So I said that if I brought him upstairs and he jumped into the bathtub for water that it wasn’t time yet. I brought him into the bathroom and sat him next to the bath tub and he just sat there. I turned on the water just a little so it dripped down…nothing. I even went as far as picking him up to put him in the bathtub. He just sat there. A minute passed and he jumped out of the bathtub and walked into the walk-in closet and went behind the door and under the pants hanging on the bottom rack in the corner, in the dark, and sat down. I knew he was telling us that it was time.

That night I said goodbye to my best friend, my couch snuggling buddy, but confidant, my therapist, my baby. Since then I have had so many emotions overwhelm me. Steven and I adapted our lives around taking care of Gadget. I woke up every morning and gave him his medicine. We kept him separated from our other cats at night so he wouldn’t get worked up, so early afternoon we would go into his room (which is also my office), pick him up and carry him downstairs so he could lay on the couch with me. At night, Steven would pick him up off the couch and bring him back upstairs and do his night time medicine. This is how our day would go. We were not able to go out of town for longer than a night since that would mean him missing more than one dose of medicine. We would come home early and spend time with him because we never knew how much longer he would have. We ordered medicine every month and refilled his oxygen tank every few months. He was the center of our world. 

Now that he is gone it has been very difficult finding a routine. I miss him all the time. He was such a fighter. I know that our vet told us that he had about a year left, which would be one year this very month, but he fought so hard and had so many scares previously that I kept thinking that he would beat the odds. I know that he is no longer in pain, but not having him with me has been hard.

We went to our medication class on Wednesday evening last week to learn about all of the fertility medications. It was hard to stay focused. I was looking forward to giving Gadget his injection in the mornings and then giving myself injections. We were going to be shot buddies. We talked about side effects or discomfort from the medication or the retrieval. I had been excited to get some extra time off while I was feeling lousy to lay on the couch with Gadget in my lap and binge watch Netflix. I had made so many plans in my head that it was hard thinking that I would have to change those thoughts. 

One last piece before I dive into where our fertility journey has taken us over the past two weeks; if

you do not believe that pets are part of the family, you may not understand any of what I just wrote. That is alright, that is your choice. But to me they are part of my family. For a long time they were the only family I had with me. Gizmo and Gadget were with me for 10 years while I was living 4 hours away from home and while I was living on my own. They have been with me when I was single, engaged, and married. They were adopted when I was told I may not be able to have human children of my own. To me they will always be my first babies. I will always love them.

Now that I’ve cried my eyes out, I guess I should let you know where we are in #journeytobabykneeland. As I mentioned previously, we had our medication class this past week. We also received all of our medication and needles. $4,600 worth of medication!!! Luckily we were able to save almost 50% with a program called compassionate care. Our grand total from the pharmacy was $2,500, but luckily a few lovely ladies who have gone through IVF at the same clinic helped us to get the total down to around $1,700. I am so grateful for their help! 

Earlier this week I was contacted by, Genesis Genetics, the clinic that will do genetic testing on any embryos that make it to Day 6. I had to fill out all of the paperwork and submit it back to them so that when the clinic sends the embryo biopsies they will be able to do PGS testing.

Today I had my ‘baseline’ appointment at the clinic so they could check to make sure everything looks good to start the IVF cycle. I had an internal ultrasound so they could check to make sure there

were no cysts and to make sure the follicles in my ovaries looked ready to produce some eggs. She said all looked good and that she thinks we should be able to get a good number of eggs this cycle! She counted 29 follicles on the left and 25 on the right, so lots of chances for eggs. I also had blood work done to make sure my levels all look normal. It was pretty early in the morning when I was getting blood work done so I hadn’t eaten or drank too much that morning. I should know better than that! When I do not eat or drink enough my veins like to play hide and seek, with an emphasis on ‘hide’. They poked my right arm and dug around for a while with no luck. They brought in another nurse and she felt around and then decided to try my left hand. She poked and dug around and finally got a small vein…that then clotted as soon as she hit it. She then went back to my right arm and found a vein that was very small and hiding way low, but she was going to try it. She hit it first try that time.

So now I’m a little bruised from the numerous pokes and wiggling, but all done with the first checkup. We got our results back this afternoon for the blood work and we got a thumbs up, everything looks good. Tonight I take my last birth control pill and Monday I start my medication.

*I apologize for any spelling or grammar errors in this post. I did not proofread this post as it was emotionally draining just writing it and I did not want to have to read it all over again.