Egg Retrieval Day

DH and I arrived at 8:45am for my pickup at 9:30am. I was a little nervous but the staff in the OR were really friendly and nice to be around. Once I had my dressing gown on, we felt like we were in a receiving line of sorts...first came the nurse, then came the embryologist, then the anaesthetist, and finally, Dr Awesome. I can't begin to tell how how much his presence relaxes me, and after he shook my hand, he walked me to the theatre. There, in the centre of the room were the dreaded stirrups, oh the indignity! DH was seated next to me when the happy juice was injected, and off I went into the land of nod....

I awoke some time later (it seemed like hours but in actual fact in was on 20 minutes) and my sweet, smiling husband was looking at me....and what did I say?...

Me: "did you manage to um.....", 

Him: "um...yes", 

Me: "oh...good on you"

Me: "how many eggs did they get?"

Him & Nurse: "15....you know you've already asked us this 6 times!"

Me: "um.........ok"

The wonders of sedatives!

After I got fed some toast and juice, I got dressed and Dr Awesome popped in to say "You've done fantastic". I think he expected not to get that many eggs with my history of endo, as us gals can be poor responders. I felt like I was back in grade school getting a gold star ;-)

So off we went home...DH and I treated ourselves to a coffee on the way out, I had been off caffeine whilst stimming, and I suddenly felt like throwing one down the hatch....and it was great!!

Now came the wait to see how many of our eggs would make embryos, and we would find that out tomorrow. At least the difficult part of the stim cycle was over and done with, and we had some promising early results.

Did our eggs & sperm like each other?

Although I felt pretty ok after the retrieval, boy was I sore the next day! Apparently what happens is those follies keep producing fluid once the eggs have been harvested. This fluid then drains in the abdominal cavity and can make you very bloated and sore. Because I had 15 eggs retrieved and my estrogen was high, I was at a higher risk for OHSS, or Ovarian Hyperstimulation Syndrome, you can read more about it Here.

The clinic said to keep pushing the water through, as in, drink 2-3 litres every day. Not only is this difficult to do with an already bloated tummy, but I found that I was having massive salt cravings, probably due to my sodium levels getting diluted from all the extra water. The actual sites of the surgery for the retrieval hurt as well, but nothing too awful at this point.

On a brighter note, we learned that out of the 15 eggs, 10 were mature and were able to be ICSI'd, and overnight, 9 had fertilised! So with a little scientific poking and prodding, our sperm and eggs really did like each other after all!! Now we had to wait and see if the relationship would be just a fling, or a lasting love affair, and for this, we had to wait for the Day 3 embryology report.

Itchy Trigger Finger

On my 10th day of stimming, the nurse rang to say that I'd be giving myself the trigger injection that night. My trigger shot was 250 units of Ovidrel, a drug containing HCG, designed to mature the eggs in my follicles in readiness for my egg collection 36 hours later. I was to take the trigger at 9:30pm Wednesday night and my collection was at precisely 9:30am on Friday. Giving myself the injection was a piece of cake, and it was such a nice moment to know that it was the last shot for this cycle....hooray!!

Then came a niggly little thought..."what if I ovulate before my egg collection?"...a small thought at first, and then like everything in my bad neighbourhood of a brain, it gained momentum, FAST! Off I went to Dr Google and found story after story of angry women who had ovulated before the egg pickups, only to have their procedures cancelled, or the retrieval of eggs which had past their prime. 

BUT!

For every one of these stories I read, there were so many more women who had commented that all their eggs made it to their pickup without incident, and based on the information given by IVF clinics, it is a well-researched phenomenon that egg pickups are ideally done between 35-37 hours after the trigger. So I decided to do something I find difficult at the best of times, I decided to trust in the process, and more importantly, trust my body. Lo and behold, the world didn't end AND I didn't ovulate before egg collection. 

Ready, Set, Inject!

I started this blog about 10 days into my very first IVF cycle. In writing this, I have the benefit of retrospection, as I know how my cycle has turned out, but for the purposes of chronological perfection, I'm going to outline the steps I had to undertake in my cycle. Your treatment protocol will determine how long you will cycle for. The two most common ones are a Short/Antagonist and a Long/Agonist, the main difference being that the long cycle involves some suppression or down-regulation of your own cycle for up to two weeks before the stimulation phase. The short cycle begins with the stimulation phase when your natural cycle starts. Here were my steps.

On the first day of my period (or as we in the TTC community call Aunt Flow, AF for short) I was instructed to call my clinic to let them know that the witch had shown up and they told me to go for some bloodwork. This is a baseline blood test usually done within 1-3 days of AF to make sure all the hormone levels are where they should be. The nurse called in the afternoon to tell me we were a go for launch for me to start injections on day 4 of my cycle. IVF cycle days are numbered differently to your natural cycle, so henceforth, all day numbers are in reference to when I started my injections.

Day 1: Inject thyself! I was to inject 150 units of Gonal-F at 7 am every morning for the next 10 days. Gonal-F is a drug containing follicle stimulating hormone (FSH) and it acts on the follicles of the ovaries to grow.

Day 5: Blood test and a follicle tracking ultrasound.

Day 5: Injection party! The clinic told me to start the antagonist drug to stop me from ovulating and wasting all those lovely eggs. I was to inject 250 units of Orgalutran (Ganirelix) in addition to the Gonal-F every morning. Whilst the FSH shots didn't bother me that much, the Orgalutran stung like a mofo! I'd recommend icing the area beforehand. I continued these injections until day 10. 

Day 8: Blood test and a follicle tracking ultrasound. By this time, I had a good number of follies growing on each ovary.

Day 10: Blood test and a follicle tracking ultrasound. Now this ultrasound was uncomfortable! There were about 11 measurable follicles on my right ovary, and 6 on my left. They were all between 13-18mm at this stage. Later that day I got a call from the nurse to say I had to take the trigger shot at 9pm that night and my egg retrieval was scheduled exactly 36 hours later. My trigger was a one-off injection called Ovidrel, which helps to mature the eggs in time for retrieval.

So all in all, I stimmed for 10 days and there was a good response happening from my ovaries. The only issue at this stage was that I had probably over-stimmed, as my estrogen levels were over 15000. This put me at risk for Ovarian Hyperstimulation Syndrome (OHSS), and I was told to rest and drink loads of water to flush some of the hormones out of my system. Bring on retrieval day sailor!

What to expect when you're not expecting...

Image courtesy of Growing Our Own Garden

So what was I to expect from the thought that I would have to go through IVF to conceive? Uncertainty, hope, drugs, and more uncertainty were my initial emotions. how would I cope with the daily injections? Would I remember the correct shot at the right time? Who would I tell and how much? How much time off work would I need? Would I start to feel resentful towards DH for having the "easy"part? And lastly...would I be able to take home a baby one day?

It may be glaringly apparent that there have been many "I's" and not a whole lot of "we's", however, I'd like to confirm at this point that this was exactly how things were playing out in our relationship. Even in cases with male factor infertility, it's the woman who still has the harder slog in my opinion. It's her body that gets rented out to the fertility specialist, and it is she who has the heavier burden of knowing that there are so many more reasons that things may not work out once there is an embryo aboard the mothership.

Pessimistic huh?

Not all the time...

It's more like this:

Our Journey to This Point

Image courtesy of Pinterest

How did we find ourselves on the rabbly brick road of assisted conception? To give any sort of decent answer to that I must colour in a bit of backstory. When I was 21, I had my first surgery of endometriosis. When I was 25, I had my second surgery for endo, and when I was 31, I had my third trip to the surgical suite. During those years, I guess I couldn't really entertain the prospect of having children because it seemed like such a distant possibility. The 2nd and 3rd surgeries were performed by an expert surgeon, lets call him Dr Awesome, in the field of endo, with excellent results, and he is responsible for igniting the flame of hope in me, that I would be able to have the courage to, at the very least, start down the journey of trying to conceive. 

Fast forward to 9 months ago, I was 33 and excited about finally trying for a baby with Dear Husband (DH) and although I knew in the back of my mind that our way would not be the natural way, I secretly hoped that I would be the exception to the rule for gals who had endo. 

About 6 months into it, nothing was happening, so we went to see Dr Awesome and he referred us for bloods and DH for a sperm analysis. Well well well! It turns our that DH's morphology was 0% ...am I allowed to say at this point that I felt a huge wave of relief wash over me? I hope so....because I did. Suddenly I felt as if the burden was being shared, as in, it wasn't all me. We were told that the only way would be IVF with ICSI (Intra Cytoplasmic Sperm Injection), whereby the sperm is injected directly into the egg in the hope that it will fertilise.

So we left it for about 3 months to try and wrap our heads around the fact that we would be heading down this road. IVF was such a big nebulous thing in the future, and we were about to jump in. We hoped the water was fine....