Today is a New Day 1

It hurts to move.

I woke up a couple time last night to visit the bathroom and relieve the pressure on my ovaries. My body is not happy with me.

I am grateful that I am giving myself good nutrients to heal and space for my body to repair itself.

With light spotting of blood, I’m reminded that the doctor pierced through my lining into my ovaries and it will be more than just getting the hormones out of my system.

At 2:30am, I am awake. WIDE awake.

I spend some time reading and praying, thinking and praying and around 4am I drift back asleep.

With a slow start to my morning, I give myself permission to hunch over and shuffle.

We wait for the call from Dr. O’Brien to know the progress of our little ones.

Today is day 1– Fertilization check day

Approximately 16-20 hours after the insemination process takes place the embryologist will check to see if fertilization has occurred. The embryologist is looking for evidence of 2 nuclei (pn) – one from the egg and one from the sperm. This is how the embryologist determines if normal fertilization has occurred. Any more or any fewer nuclei present and the embryo is considered abnormally fertilized and is not kept in culture. Once normally fertilized, the embryos are placed back into the incubator and are not disturbed until day 3. The embryos are grown in a specially designed culture dish which contains a small drop of culture medium overlaid with oil. 2pn.jpg

This embryo culture medium contains the proteins, amino acids, and enzymes that mimic the fluid found in the fallopian tubes essential for embryo development. One factor (of many) that contributes to successful embryo development is the constant maintenance of temperature and pH level of this embryo culture medium. The temperature and culture medium pH level is dependent upon the CO2 environment and the heat that is provided by the incubators. Since the embryos are grown in a very small drop of culture medium it does not take long for the temperature to drop and the pH level to change in that drop containing the embryo once the dish is removed from the incubator’s environment. Severe changes in the temperature and pH level of the culture medium can have potentially detrimental effects on the embryos. The embryologists are very protective of the embryos in the lab and this is the reason why the embryologists do not like to disturb the embryos too much and will not look at the embryos on a daily basis.*

We get a call from Dr. O’Brien around 9am, of the 20 eggs retrieved, 13 of them were mature. This is a little less than was expected but MORE than what we saw on the monitoring screen a few days ago (which was 8).

Of the 13 mature eggs, 12 of them were fertilized!!

Yippee! The statistic is that 75% of mature eggs will fertilize, we had a 92% fertilization rate!

This means we go into the next 4 days of waiting knowing we have 12 potentials for a baby (or babies) to grow.

Dr. O’Brien keeps my expectations low as she mentions it’s typical to have 1/3 or 1/2 of the eggs survive the next 4 days. She would expect for us to have 4-6 blastocysts on Day 5. Although she cannot see the future or know the strength of our little growing cells, I can trust in her experience and let 4-6 be a success.

Here’s to a weekend of waiting, healing, and praying!

*Information from Fertility Smarts

Egg Harvest Day!

Today is the day! We have been waiting a long time for this opportunity to come and here it is.

Since I will be going under anesthesia, I am not able to have anything for breakfast. So instead, I shower, pack my luggage, and we drive to the clinic around 10:15am for our 10:30am report time.

I am nervous. My stomach feels less bloated today and I fear that the trigger shot already forced ovulation to occur and my eggs flushed out of me.

Oh, the mind games I play.

We are quickly taken back to room 11 where I redress with my blue smock and booties. The bruised vein gets one more prick and the saline begins to drip into my body. It takes an hour before it’s my turn to go into the operating room. At 12 noon, I kiss Hubby goodbye and shuffle into the OR.

It’s cold and the bench I lay on is short, just long enough for my head and torso. I lift my legs into the leg rests and I feel the vulnerability overwhelm me. The nurse straps my legs into the rests and asks me to move down to practically hanging off the edge of the bench.

I mention the chill and Steve, my anesthesiologist, quickly responds with, “let me give you a hot totty to warm you up”. He hooks me up to the ‘goods’ and the nurse flips my blue gown up over my stomach. Complete vulnerability. Pure humiliation.

That was my last thought.

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The IVF process is pretty amazing. We are still in the first part of it all as we need to get the eggs and put the sperm inside and then let the cells grow.

In order to get the eggs, they need to drain the liquid from the follicles. The eggs will come with the liquid into the doctors care. They will pierce the vagina wall and go through the ovaries. I am going into this procedure with just over 20 follicles (that were seen on the monitoring screen).

UNADJUSTEDNONRAW_thumb_8705.jpgI wake up about 12:45 in a drugged haze. I am in and out of coherent thought and I am crying. I’m so happy this part is over and so scared there were no eggs to retrieve. Hubby handles the blubbering sentiments and random thoughts like a champ. I even asked if Hubby could go into the OR and take a picture so we had a memory of it. (not an option).

 

Dr. O’Brien was by my side and shared they were able to harvest 20 eggs from my body!

Oh, what a joy! Great work body, I’m so grateful!

She was very pleased with the outcome and warned me of how sore I would feel. I could already feel the tenderness in my stomach.

Before I am released, I walk up and down the hall with a nurse. I can barely pull my legs out of bed before I feel a shooting pain up my bum.

I comment to the nurse and she says this is a normal pain as my ovaries are so enlarged. I get home and do some googling. This is what I find out:

It’s normal to feel this way since my ovaries were so enlarged that they could be pushing against my rectum.  Apparently, the more eggs they retrieve, the more uncomfortable you feel.  The reason is that they remove the eggs from the follicles, but the follicles still remain inside you and fill up with fluid after the retrieval, hence the bloating and my engorged ovaries.

Today is day 0Retrieval day

After I am released, 4-6 hours following the time of the egg retrieval the embryologist will initiate the fertilization process of the eggs. Fertilization is attempted using one of two methods, standard insemination or ICSI.

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Standard insemination involves placing a required number of washed, motile sperm into the culture drop containing an egg. Although many may decide to do this, modern science has progressed to the ability to insert a single sperm into a single egg.

 

ICSI is a more involved process where the embryologist uses a specialized needle and microscope to catch a single sperm to inject directly into the cytoplasm of the mature egg.

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Once insemination or ICSI occurs the eggs are placed back into the incubator to allow time for fertilization to occur.

We decided to do the ICSI.

 

For the remainder of the evening, I rest and move gingerly, giving my body enough space to heal. We will learn more about how many of the 20 eggs were mature and fertilized tomorrow.

 

 

 

The Future Begins Tomorrow

Day 14- The final prick of my arm to see if the trigger medications worked. I check out of the clinic and am grateful to not need to make another monitoring appointment.

Nope, the next time I step into the clinic will be for egg ‘harvesting’.

I like that word better than retrieval. Time to gather all these wonderful, healthy, vibrant, abundant eggs!

My final acupuncture appointment focuses on balancing my body and rejuvenating my system. It’s time to love on my body and let the eggs release as they are supposed to.

I spend the rest of the day enjoying this process and relishing the growth of these wonderful follicles.

The sunshine greets us as we enjoy a brisk walk around our ‘home’. I feel as though I’m waddling and anxious to have this pressure released from my body.

Dr. O’Brien said the bloated feeling may last up to a week after the ‘harvest’ because of the trigger shots, but I’m hopeful my body will flush these toxins (is that what there are?) out of my system and I’ll be able to return to a normal body.

  • When will I be able to move without feeling this pressure?
  • When will I be able to work out my body again?

Only time will tell.

For today, I am focusing on giving my body good healthy nutrients.

I took the final medication tonight at dinner. It will be my last meal until after the ‘harvest’ tomorrow at noon.

I’m scared of what the ‘harvest’ will be like for my body.

  • What will the aftermath feel like?
  • Will I bleed?
  • How will I be able to walk?
  • What will the flight be like back home?

The only way to know these answers is to walk through this night… and tomorrow morning… and walk into the clinic at 10:30am and put my trust in the doctors…. And God.

See you on the other side!download.jpg

Add the Trigger Meds!

Day 13– Waking up to what feels like a bowling ball resting on my stomach. Is this what it’s like to be pregnant and have to pee every 30-minutes?

The weight of carrying these full follicles is getting heavier and it’s as though gravity is pulling my belly button down to the ground.

My right ovary seems non-existent in my body as I move around but my left is as though there are water balloons squished up in there.

Is today the day we will pull the trigger?

It’s possible and yet I don’t want it to be too early if there is a chance the little ones will still grow to 17 or 18mm. Remember, 18mm is mature and anything smaller may not produce a healthy, viable egg.

I get a pinching prick into my arm. My poor vein is so yellow and bruised.

Into room 3 I go for another monitoring.

As the nurse closes the door for me to undress, I fall to my knees. “God, I surrender this outcome to you. Help me be calm and accepting of what you are doing inside my body.”

A delightful sonographer joins me in the room and we begin.

Sure enough, we have big black circles on the screen. She measures 11 follicles ranging from 9.6mm to 24.8mm, wahoo!! Then comes the left, a little smaller but that is not new information. Eleven follicles there too, measuring from 11mm to 20mm, yippee!

I have 22 follicles measured total with 8 follicles being of mature range (above 18mm).

There are 7 that are either 15-16mm and they ‘might’ grow to be 18mm by the time we retrieve, or they might just be too shy.

I give those over as I can’t do anything about it.

Ok, I’ll be honest, I really want to stick myself with some of the drugs I have at home, even just a little bit just to give that extra boost.

I tell on myself to Hubby so that I can see how insane that would be.

I’m not the doctor, I have never been through this before, and I don’t know what I’m talking about.

I just have to trust. Sit back and trust.

I bet we trigger tonight, so I’ll wait for the call from our nurse to confirm.

Oh my goodness… Thank you body for responding so well to these medications. I don’t know what the quality of my eggs is in there, but I have done everything I can to help them be healthy.

I’m so grateful to be at this point in this journey!

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6 hours later

We receive a call from Nurse Christine. Wonderful news as she confirms 21 follicles with at least 15 of them being a mature size, yippee!!

Tonight, we will trigger!

She has our instructions for the medications.

Stopping all Gonal F, Menopur, and Cetrotide we turn towards the trigger shots.

Since I don’t have a period without medical intervention, Dr. O’Brien decides to use a dual trigger method. I will inject myself with Lupron and hCG tonight and visit the clinic in the morning for blood work to make sure it’s all absorbed and properly ‘triggering’.

There is a hesitation of using the hCG because it could cause the ovarian hyperstimulation syndrome (OHSS).

Dr. O’Brien decides to go with a small dose of hCG and will add more tomorrow if my blood work shows my body is not responding.

After a quick tutorial of how to mix the sterile water with the white powder medication, change the needles and draw just the exact amount prescribed, we say our goodbye.

We spend the next 2 hours waiting to hear from the scheduler to know what time to give the trigger shots tonight (which will be 36 hours from the retrieval time).

Trigger shot at midnight TONIGHT for a retrieval of noon in 2 days.

On we go!

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I fall asleep to help the time pass and wake up at 11:55pm to get ready for the shots. Hubby stayed up and mixed the solutions for me so all I have to do is prick and return to bed.  (What a great Hubby, such support.)

The hormones rush through my body and it takes me an hour to fall back asleep. Finally, I do, one day closer.

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Let the tears fall

Dr. O’Brien pushed our egg harvest (retrieval) by two days since my body started off with low estrogen. Typically, day 12 is when we prepare for the trigger shot to force ovulation, but today is another monitoring day.

Hubby comes with me so he can see the beautiful follicles we are growing.

My stomach region is more sensitive and I feel the pressure mounting as I move.

Thankful, I give praises and I know the follicles are growing.

Another prick of my bruised veins and then into the monitoring room.

This is Hubby’s first time to see and I’m excited for him to experience this.

Sure enough, we have pretty black circles and round shapes front and center on the monitor. The right side is showing off with follicles measuring from 14-22mm. The left is still a bit shy with the majority of follicles measuring around 14mm.

Our nurse explains that although women are born with all the eggs they will ever have, they still need to mature. The maturation process happens within the follicles. Mature eggs are said to be in follicles that measure between 18-22mm.

Although we count at least 15 measurable follicles, only 5 of them are mature.

My heart drops.

We will most likely go one more day to give the smaller ones time to grow.

I pray that we go one more day as it seems too early to trigger now.

Tears begin to fill my eyes as I fear we won’t have enough mature eggs to move through the next steps of the process.

I am scared that we have done all of this and we won’t end up with a good harvest.

My emotions take over and I let the tears fall. I know I am on major hormones but these tears seem so raw and real. tears.png

God, what are you doing?

What else can I do to help these to grow?

How can I ensure they are all healthy, vibrant eggs ready to meet their partner in creating a baby?

I can’t do anything more than what I’m already doing.

I feel helpless.

I have no control what my body will do.

Although modern science is incredible to get us to this point, this is where God shows his stuff.

God, I surrender. I am so scared that we have done all this and we won’t end up with a single viable embryo.

Even more scary to me is that we do all this and we end up with one embryo and we miscarry or we have a full-term pregnancy and then we don’t have any additional embryos for later children.

My mind is full of what-if’s and I don’t wanna’s and me, me, me.

During the acupuncture appointment, I rest my mind.

Allowing myself just to be in this space of pity and sorrow.

Sometimes I just have to give myself permission to wallow. It’s easy to push the feelings aside and get into the positive or the ‘all will be well’ mindset, but it doesn’t honor my emotional reaction to information.

Allow me to be sad and scared.

I don’t stay there much longer as Hubby and I talk and we see that this is God’s plan, as are all children.

This journey is not mine to write. I just get to be along for the ride.

The nurse calls and gives us our medication instructions. Increase the Gonal F, keep everything else the same.

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God, I trust you. I know that although IVF is a medical process, becoming pregnant and delivering a child is a miraculous gift from you.

May I be open to receive what you have to give.

Gonal F- 175IU
Menopur- 225 IU
Cetrotide- .25mg