Dr. Angel

May 16, 2021May 6, 2021 / Hilary / Leave a comment

The sun is shining.
I look for the good in the day, knowing it will be a long day.

Turning to Hubby I say, “Can I just sleep all day today and then when I wake up it will be egg retrieval time?”

He laughs. I’m sort of serious.

My drive to Shady Grove is full of fear and I call a friend who reminds me that I don’t have all the information and to just stay in the day.

My stomach doesn’t have the same uncomfortable bloated feeling as it does a few days ago and I fear it’s because I lost the follicles.

My arm is pricked for what I truly hope is the last time.

Upon my arrival, I see the friendly, caring eyes (I’m sure she is smiling under her mask) of Dr. B.

She greets me and asks how I’m feeling.

Doctor Angel High Res Stock Images | Shutterstock

She listens.

I share with her my fears and am wondering if it’s possible that I’ve lost some follicles.

She assures me that my hormone levels were too low for ovulation to have occurred and then offered to have me do one more ultrasound monitoring to see.

I gladly accept.

She cares for me and my feelings. How refreshing to be seen and heard by a doctor.

In minutes, I’m looking at 8 beautiful black circles in my right ovary and 8 beautiful black circles in my left ovary.

They are all there.

We don’t know the egg quality yet but I can see that everything that was there a few days ago is still there with just a little more growth.

I am at ease.

Dr. B calls with the results from my bloodwork and all looks good and we are ready to go!

I will pack up, rest up, and be ready for the retrieval tomorrow at 8:45am.

Thank you, God.

Medication Day 17

Medication: Azithromycin (2 tabs)

Follicles: 28, 25.3, 21.9, 20.9, 20.3, 20.2, 19.3, 18.9, 18, 16.9, 16.7, 16.6, 16.5, 15.7, 14.9, 13.8

Slow growing ’round here

May 12, 2021May 6, 2021 / Hilary / Leave a comment

Medication day 10

It’s slower going these days. I thought for sure that starting off on the highest dose of meds would grow these follicles so fast my head would spin.

Okay, maybe not that fast, but I did think I would at least be on track for a ‘normal’ follicle stim cycle.

I’m not.

They are growing, just not fast enough.

I had my appointment yesterday and instead of starting to go to my monitoring appointments every day, meaning that I’m getting closer. I’m still at every other day.

I am not disappointed because this time I’m not surprised.

I’m just scared that there won’t be many more follicles and the ones that we do have won’t grow.

I’m scared to face the possibility that we won’t have another biological child.

That the maternity clothes that I have loaned out to expecting friends won’t need to be returned.

The excitement of news for other friends who share in this exciting journey toward parenting, won’t have a reason to be reciprocated.

My thoughts grow dark as I begin to think that I am not a good enough mom to be gifted with a second.

Or even darker, that Hubby and I are not capable of having a healthy family with another child and that God is protecting us from a future where our marriage is on the rocks.

Either way, my thoughts lead me to “I’m not good enough”, “I’m not deserving”.

I’m glad to know today that these are dark and not true thoughts.

They are just fears mixed with emotion.

Instead of wallowing with these thoughts, I pick up the needles and vials of medicine, click the Gonal-F pen until the number for the correct dose pops up and proceed to do my 1% in this whole process which is to give myself the medicine and relax.

God- help me look to you when my thoughts grow heavy and dim.

Cetrotide: .25mg

Gonal F: 375IU

Menopur: 225IU

Follicles: 14, (12, 11, 11, 10, 10, 9, 9)

Medication day 11

Oh, how I cried on the way home from the appointment today.

I could not stop the tears.

I knew I needed to let myself flow with sadness and fear.

What if we won’t get a healthy, viable embryo?

I am not ready to accept that we won’t get pregnant again.

You may be wondering what caused the flood of emotion?

During the ultrasound, today, I only saw 4 noteworthy follicles on my right side.

There were only four there two days ago… and on top of that, they are the same size as they were two days ago.

I can’t believe my body is not responding to the medications.

I feel as though my body is making a line in the sand saying, “I won’t make any more follicles”.

Is my body rebelling against me?

The foods I eat, the supplements I take, the acupuncture, the naps, the walks…

Nothing is working and I feel as though my body is shutting down from making any more follicles.

I get the call from my medical team and they are happy with the overall progress, counting 15 follicles total right now.

My left side is really stepping in it seems.

I feel so defeated, so tired and yet not ready to let go.

This is my last effort for a baby, come on body, keep working, keep pushing!

Cetrotide: .25mg

Gonal F: 375IU

Menopur: 225IU

Follicles: 17, 16, 15, 13, 13, (11, 11, 11, 10, 10, 9, 9, 9, 7)

Medication day 12

Another day where I feel like crying, but there are no more tears in there.

I spent some time with God this morning and really surrendered my grip about the number of follicles and the number of eggs and the number this and the number that.

I don’t want to place stock in the numbers, the data, the science.

I already did that last time around and came up empty handed with a lot of heartache.

Every time I go to the doctors I don’t want to focus on the numbers.

I hear this small voice say “I’ve got something better”.

What does that mean?

I feel the doom of dark clouds roll over my thoughts and my heart sink.

In my life, I have learned how I hear best from God.

It’s in these still moments that this little voice of peace comes over me. He’s here, I think.

God is with me.

I try not to argue and instead leave my heart open to receive.

Many times, I’ll hear God answer with one of three responses:

Yes
Not now
I have something better for you

I’m not always in love with the second or third response and yet I know that is a call for me to practice obedience in my ability to trust that God’s plan and ways are always so much better than mine.

I’m not sure if ‘something better” means He is about to give us multiple healthy wonderful embryos or if this IVF round won’t be successful and something better means an adopted child or even bigger “something better” might mean I will get pregnant all on my own without all of this medication.

Either way- I want to receive this word as a way to feel peace.

God is in these details and I may not know how it will all work out but I can sit back and watch as He does his miracle work.

Nurse Emily calls and I am to do one more night of medication and come in for a final monitoring appointment tomorrow. We are getting closer and depending on how some of these grow tonight, we might be close to triggering for an egg retrieval.

Lord, your will be done.

One win for me: I did not have the same expectations as I did last time around. I am not surprised that my body is taking a little longer to respond and that the follicles are s.l.o.w.l.y. growing. Getting the call from Nurse Emily today to say that we might have another day is no surprise and if anything, I welcome it because it means more time for those littler follicles to grow and potentially become our ONE (or more) babies!

Cetrotide: .25mg

Gonal F: 300IU

Menopur: 300IU (4 vials)

Follicles: 20, 19, 17, 15, 15, 15, 14, (13, 12, 12, 11, 11, 10, 10)

Medication day 13

We continue to do the do… morning shot of Cetrotide, blood work, ultrasound, wait to hear from Nurse Emily and two shots at night.

It’s become such a routine and yet I am so grateful that I get to go through this each day.

By me giving myself shots and driving to the appointments means I’m in the game.

We are still in this!

Today, I got to meet Dr. Brahma in person.

She is absolutely lovely.

Her door was open and she was sitting at her desk as I walked by.

I introduced myself and she invited me in with a warm disposition.

We talked about this cycle and how she is liking what she is seeing with the growth.

This was comforting.

She also adjusted my thinking (again) with the fact that she is looking to get a little over 10 really solid good eggs, thinking between last cycle and this cycle we will have one wonderful embryo.

I do have the same hope.

With a spring in my step after meeting such a caring doctor, I returned home with another night of medications to give my follicles more nutrients to grow!

Cetrotide: .25mg

Gonal F: 375IU

Menopur: 225IU

Follicles: 22, 21, 19, 17, 16, 16, 15, 14, 14, 14, 14, 13, 13, 11

Medication day 14

It’s a drizzly day here and it pretty much reflects my mood.

I woke up feeling as though this seems to be dragging on, and yet I also welcome the opportunity for a few more follicles to grow in there to help the chances of a successful outcome.

I give myself the Cetrotide shot, eat my breakfast and head off to another monitoring appointment.

It’s possible that we will ‘trigger’ the ovulation process tonight and schedule the egg retrieval for 2 days from now… or we will do another night of mediations.

I want to stay open… and I also want to return home to sleep in my own bed.

It’s been wonderful to be with family and yet I am ready to return to my normal routine in the comforts of my home.

I remind myself that this could be the last effort for a baby and one more day is worth a lifetime of having a child.

As I lay there on the monitoring table with the ultrasound wand taking pictures of all the beautiful follicles inside of me, I have to praise God for this amazing gift of creating life and surrender what He will end up doing with these follicles.

The sonographer is new and I have to block-out any fear that she doesn’t know what she is doing.

Nurse Emily talks with me briefly after the appointment. She thinks it’s just too close to call and has a slight suspicion that Dr. B will go one more night on the meds.

An inconvenience to use and our desires to return and yet worth the extra 24 hours if that will make all the difference in our future.

At 2pm on the dot she calls.

One more night of medications with a certain trigger tomorrow night.

We adjust all our plans to fit this additional day and look at the good in this opportunity.

Cetrotide: .25mg

Gonal F: 375 IU

Menopur: 225 IU

Follicles: 25, 23, 20, 27, 28, 27, 16, 16, 15, 15, 15, 12, 12, 12, 11, 11, 10

Bio Lesson: Cells the Grow into Human

January 5, 2019November 1, 2018 / Hilary / 2 Comments

Here’s what will be happening with our little cells while we wait:

*Day 2 in the IVF Lab – Embryo Divides

On Day 2 the embryos start to divide and should have 2-4 cells. The embryo itself does not grow bigger; the single cell that was the fertilized egg divides to become 2 cells and then 4 cells with each cell being half the size of its predecessor.

They can start to see slight variations between the embryos in the group and they could be graded at this stage. Most clinics do not look at the embryos on this day but it is possible to do an embryo transfer or freeze the embryos if that is the clinic’s policy. It is usually better to wait as long as possible for transfer and freezing as this allows more diversity within the group and enables the embryologist to more easily select the best embryos. The splitting of cells to create identical twins happens on day 2 or 4.

Day 3 in the IVF Lab – Embryo Grading and Potential Transfer

On Day 3 the embryos should be around 8 cells. This is the day when some clinics move them into a new Petri dish with different media (solution to support growth) that is similar to uterine fluid for their next stage of growth. They grade the embryos but still do not know how many will continue to grow to the blastocyst stage (Day 5 and 6).

Some clinics perform embryo transfers and freezing on Day 3 and some clinics wait until Day 5. This depends on the number and quality of embryos that you have available and also the clinic policy. From what I understand, Shady Grove does not touch the cells until day 5 to let them grow in a healthy, untouched environment.

On Day 3 we know:

How many cells the embryos have
If the embryos are of good appearance up to this point
An average of 95% of fertilized eggs will grow to the Day 3 stage
The appearance on Day 3 does not tell us how many embryos will continue to grow

Day 4 in the IVF Lab – From Cleavage Stage to Blastocyst

Day 4 is a transformation day where the embryos are in between the cleavage stage and blastocyst stage.

What is a blastocyst?

A blastocyst is a fertilized egg that has developed for five to six days and contains 3 distinct features. These features include a fluid-filled cavity and two distinct types of cells:
- Trophectoderm (T) cells – T cells consist of a single layer of cells around the circumference of the embryo that become the placenta and embryonic sac.
- Inner cell mass (ICM) – The ICM is a distinct clump of cells that form the actual baby

The clinic usually does not look at the embryos on this day, but if they did they would see that some of them would be making the transition from a multi-celled embryo with clear cell outlines to what is called a morula which is the stage before an embryo becomes a blastocyst. Sometimes embryos do not reach the morula stage until Day 5.

*Information from Fertility Smarts

Egg Harvest Day!

January 2, 2019January 2, 2019 / Hilary / 2 Comments

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.

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).

I 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 0– Retrieval 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.

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.

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

January 1, 2019January 1, 2019 / Hilary / Leave a comment

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!