Day 4 Post Retrieval

We are back home now.

It is a relief.

I have been attempting to take it easy but life with a toddler and job outside of the home lends to more go-go-go then I would like during this recovery period.

To sleep in my own bed has been a gift.

My body relaxes as the pain continues to throb in my lower abdominal areas.

I feel bloated.

There is not much room down there and much of this reminds me of being pregnant.

The full tension of my insides pressing up against my skin.

My stomach is swollen and my ovaries are not very happy with me.

I get a massage and am grateful for my masseuse who is trained in abdominal massage.

She helps the blood flow and circulation to give my abdomen and ovaries some support.

The pings of sharp pain come only when I move too quickly or when I am resting.

The busy schedule I have this week is helpful.

There is not much time for me to obsess about the little multicell embryos (meaning day 2-5 after fertilization). They are in the cleavage stage, meaning the cells inside the egg are dividing or cleaving but the embryo itself is not growing.  

The first 5 days of an Embryo - Simply Fertility
Days 1-5 of the fertilized egg

When I do think about the multicells, I wonder how they are growing? How many of them are playing nice with each other and multiplying? How many of them are fighting and persevering to continue to do what they want so badly to do? It’s what they are designed for.

I pray for them to be healthy and to be strong. I pray for God to be protecting them as they are so far away from me. I pray that God will guide them and be working in each cell to form as it is supposed to, as He designed each cell to form.

Today these multicell embryos are in the morula stage and tomorrow they will reach the coveted blastocyst.

Tomorrow is day 5 and the multicells will be about 70-100 cells, this is when they have reached blastocyst.

Tomorrow we will receive a call from Nurse Emily.

She will share with us how many of our 7 multicell embryos survived and thrived to day 5 blastocysts.

The wait continues and I am full of excitement.

The Blastocyst Report

We got the call.

Dr. Brahma was short and to the point. From the seven that were fertilized, one made it to day 5.

My heart sunk a little bit as I was hoping for at least 2.

What is Blastocyst Culture in IVF | Advantages of Blastocyst Culture

I am grateful for the one though.

She mentioned how she was pleasantly surprised with the one because of our numbers that we were working with. I recall the previous conversation with her where she mentioned our attrition rates are much higher than the norm.

Our first retrieval in 2018, we had 12 fertilized and two make it to this stage. Today, we had seven fertilized and one make it.

I learned that ‘normal’ attrition is 50%.

So she seemed hopeful because this particular blastocyst is a high grade- even higher than the one we had in our first retrieval (which is now our daughter).

We jump off the phone, glad to hear to report.

We begin the two week wait for the chromosome testing (pre genetic screening- PGS/PGT-A) to see if everything is normal for us to transfer this little blastocyst back in me for a pregnancy.

In the meantime, I wait expectantly for my period to come.

I had so many hormones in my system for that stim cycle that I can feel the heat in my body.

I need to get these hormones out of me.

I have night sweats that wake me up.

Drenched in sweat, I feel the hormones racing throughout my body.

Once I get my period, I pray all of this will be washed out of me.

Hubby and I decide that since the report was so good with the grade of the blastocyst that we are going to begin the Frozen Embryo Transfer (FET) process as soon as I start my period.

I am anxious.

The feeling of wanting so much for this to be the plan.

Do you ever have that sense that you have an idea and timeline that makes sense and when it falls into place you think, “cool, so glad it worked out the way I thought it would”?

Well, I have that all the time.

I have the tendency to plan the future out with all the details that seems right to me.

For example: I look at my calendar and like to add things and estimate when other things will happen and I find myself in a calmer state when I have a perceived sense of control over what will happen.

The downside of this is my level of disappointment when what I had so perfectly plans doesn’t work out.

Same is true today.

I look at the calendar and plan out when I hope to get these icky hormones out of my system and what that would mean for our little one blastocyst that we hope will be our baby.

It’s not healthy thinking and it sets me up for let down. So I check myself.

Stay in the day, be present with the moment and turn off that ‘future-tripping’ brain that wants to figure everything out.

Egg Retrieval Day!

7:30am, I arrive at Shady Grove Fertility, Atlanta ready to release these precious follicles to the care of my medical team.

I was the first patient this morning so everything went incredibly smooth.

Hubby was not able to come because of the COVID restrictions, so I asked God to be with me as I walked down the familiar hall and into the intriguing door on the left marked “IVF Suite” I had seen so many times in the days prior.

I undressed and weighed myself, put on my hair net and booties and nestled into the medical bed that was draped with a thick white blanket.

Within a matter of 15 minutes, I had met my nurse, the doctor performing the retrieval and my anesthesiologist.

I signed, dated paperwork and got the deep poke of an IV into my left-hand vein.

Wheeled on the gurney down the chilly, white walled hallway into the OR room where I felt only cold air surround my vulnerable body.

Looking over at the all too familiar retrieval table, flashbacks for my first retrieval came to mind.

Fear of that exposed space, I asked God for a lot of help and support as I stood up and shuffled ever so gently over to the table, with my IV in tow.

The table was long enough for the trunk of my body and my head. I had to sit at the very edge (almost as though I was falling off) and lay back. I then lifted my legs into two platform like cushions, and although comfortable in theory, incredibly unguarded and exposing.

I was grateful for the warm, white blanket that comforted me and covered the top part of my body until the burning anesthesia entered my veins.

I was out.

As I came to, I was back in the recovery room, foggy in thought and yet comfortable.

I learned that from the estimated 16 follicles, 10 eggs were retrieved.

I began to cry with sadness.

“Will that be enough?”, I feared.

I am so sad, my heart drops.

“What if we are not able to have a viable embryo from these 10?”

The first retrieval 20 eggs were retrieved.

My heart feels heavy.

I am so scared.

I just want to have another baby. What does this mean for us?

Hubby is not there to hold my hand. Tears run down my face. I feel so defeated.

I try and turn my thoughts to the positive because there is a lot that can happen with 10 eggs.

I just want to go home, to my real home.

I will have to settle for my in-laws house and am glad that all I need to do is rest and recover for the rest of the day.

What am I grateful for? I have to shift my mind.

  • Grateful to not be as sore as I was the first time around.
  • Grateful to have been given this chance in the first place.
  • Grateful my body responded with these eggs.

Sleep, water, Tylenol.

We will wait the phone call that will come tomorrow from nurse Emily where we will learn how many of the 10 were mature eggs and how many were successfully fertilized.

“Lord, I know you are in control.”

I know you know the desires of our hearts and I know this is an opportunity to trust you and have faith in what I cannot see.  

——–

The next day-

The phone rings at the perfect time.

I answer.

It’s Nurse Emily and she is happy to report that out of the 10 eggs that were retrieved, 7 of them reached a mature size.

Not bad… I have to keep thinking and looking for the good in this.

“Hilary, this retrieval is different than the first, it’s not helpful to compare”.

Seven is wonderful, that means only three of the eggs were not large enough and that is a much better ratio than I had the first round.

Then she gave me this gift… all seven of those mature eggs fertilized!!

Wahoo! 100%, can’t get better than that.

With this news, we pack up our bags and head to the airport. It’s time to head home and begin the recovery week… and more waiting.

The Final Push

I just returned from my monitoring appointment and I am waiting to hear if tonight we will trigger the HcG for us to our retrieval in 2 days… or if we will do one more day of medications to give those littler follicles time to grow to maturity.

I am at peace. Whatever your will is, God. I will accept it.

24, 20, 20, 18, 17, 16, 15, 15, 15, 15, 13, 12, 12, 12, 10
12 follicles above 12.5
We had 17 follicles there were 12.5 and above with the first IVF cycle.

——

We just heard from our nurse. One more night of medications to give those smaller ones a little extra time to grow.

We are tired. We just want to go home.

We also know that one more day here could make the difference between a whole other cycle so we are willing to be patient and just be here for the time that is required.

We change our flight (again), I assess our food to make sure we have enough, and we readjust our mind to the inconveniences this change in plan means for us being able to get back home and settle in to our regular days.

Medication:
Cetrotide: .25
Gonal F- 400 IU (use all the remaining pens!)
Medication day 14, cycle day 16

———

I went in for the ultrasound today and it looks like we are ready to trigger!

24, 24, 21, 21, 20, 19, 19, 17, 17, 17, 15, 15, 14, 14, 14, 9

Ovidrel and Trigger Shots for Fertility Treatment

Dual Trigger Instructions at exactly 8pm tonight:
– Leuprolide- 80 units into the belly
– HcG (Chorionic)- 1 ml solution into powder… mix… and inject the mixture into the hip/butt

Tomorrow:
– Morning blood work to confirm my hormone levels are where they need to be
– Take Azithromycin (2 pills) at dinner

The following day:
– Retrieval is scheduled for 8am. I need to arrive there at 7:30am
– The usual pre-surgery instructions: nothing to eat or drink after midnight- brush teeth only
– We will need to get the sperm collect prior to coming in anytime between 5:30am-7am (Good morning to Hubby!)
– After the retrieval, I am expected to be picked up around 9:30 in the office
– Recovery after the retrieval is to rest. It’s expected to feel groggy until meds get out of my system. Common to experience cramping and abdominal pain, Tylenol is recommended.

We will hear how many eggs were fertilized from the physician on the day of the retrieval.

The following day, we will hear from the nurse how many of the eggs were fertilized.

Five days after that, we will learn how many of them made it to day 5 blastocysts and were biopsied. The PGS biopsy results will come back two weeks after the biopsy.  

Expectations = Disappointment

Dr. Bhrama calls. What a lovely voice she has!

This is the first time we have spoken and I find her to be such a delight.

The COVID-19 pandemic has really thrown things off for us to meet in person, so I welcome her call.

We discuss how things have been going this cycle and before I know it, I am having to swallow the biggest upset to date in this process.

We might not have a viable embryo at the end of this cycle.

*Sigh*

Disappointed HD Stock Images | Shutterstock

There are a few things that have tipped her to say this.

  1. My age (approaching 38) is 3 years older than the first cycle
  2. The slow start to the medications. She explained that the first few days of a cycle is the most important because that is when the ‘cohort’ of follicles develops. These are the follicles that will be growing throughout the course of the stim and although more will grow, they will be behind this first cohort. It’s like the cohort is the senior class and the freshmen may be in the same school, but they will never be seniors at the same time as the current senior class. She said that my estrogen was extremely low at the beginning and that if she would have known this, she would have started me with a higher dose of Menopur from the beginning.
  3. The number of follicles we have today is about half from the last time. Our % of blastocysts to eggs retrieved was drastically lower than the average in the first cycle so if we have the same %’s we most likely won’t have an embryo.

My heart drops.

I knew there would be a potential for us to do a 2nd retrieval, but I can’t help but think… I don’t wanna! Like a kid throwing herself on the ground throwing a temper-tantrum.

The upside to doing another cycle is that we would be able to:

  •  start off from the beginning with a higher dose of medication and that would give us the chance for a better follicle growth and count.
  • Meet our new nephew who is due to arrive in 6 weeks from now
  • Be vaccinated from the COVID-19 virus before pregnancy
  • Use the Shared Risk program for how it is designed and feel like the higher price tag was worth it
  • Visit with family another time this year

Dr B also said that my body would be ‘prepped’ for this next cycle because of all the medications I currently have in my system. She said that if we did another stim cycle 1 to 2 months after this current cycle, my body would reap the benefits of it.

Lord, help me remain open to your will and what you are doing for us in the season.

Dr. B also said that she is 75% sure we will trigger tomorrow night… but there is a 25% chance we will go one more day.

*Sigh* oh, Lord, help me release my timing over to you.