Egg retrieval
Friday night before my egg retrieval surgery Jared and I
headed down to King of Prussia…we had an amazing meal at The Cheesecake Factory
and then headed back to our hotel to veg out (and eat cheesecake and try not to
freak out about what was happening tomorrow!).
Yummy!
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Bright and early on Saturday we
were up and we headed over to the office (literally almost across the street)
at 7:00. Almost immediately I was whisked away by a nurse. In retrospect, I
wish I would have kissed or hugged Jared goodbye at this point – I didn’t know
I wasn’t going to be seeing him again until after! The nurse had me change into
a hospital gown, silly grippy standard issue blue socks, and the glamorous
surgery hair net thing. I was so nervous - I peed twice even though I hadn’t
had anything to eat or drink since about 10:00 the night before! She asked me
some questions and checked my vitals. Then the doc stopped in to say hello,
presumably having just finished the procedure before me. I had met him before –
he had done a scan or 2 for me before Dr. Nguyen came to Mechanicsburg and he
was actually the doc that did my last IUI. He asked if I was nervous…I told him
yes but that I was trying not to think about it and so far I was just doing
what each person was telling me to do! The best thing about this wait is that
they cover you with a blanket that has been kept in this amazing blanket hot
box device (note to self: must research getting one of these for the house). If
I was going to be scared out of my mind, at least I was warm and cozy!
I was then moved to the next room where I met with the
anesthesiologist. He asked me a litany of questions and checked my vitals
again. As he was trying to jam a needle into my hand, he was trying to
“distract” me by asking me about where I was from and all that. I had no
interest, haha…I was trying so hard to be sociably but IT HURT! Apparently
things did not go as expected because soon he was after the vein in my arm.
That one hurt, but not nearly as bad as the hand. At this point, I started to
panic. As I sat there, in pain, with a needle in my arm, with surgical garb on,
surrounded by strangers in a fluorescent lit room at 7:15 in the morning, I
just had a flash of a friend who had announced on Facebook the previous day
that she was pregnant…AGAIN. In one overwhelming moment, I was just angry and
sad and scared. Of course, the anesthesiologist thought I was having a panic
attack and just tried to get me to breathe. Soon he was pumping me with fluids
and I sat there…just trying to breathe in and out.
Before I knew it, it was time to go and they walked me into
the operating room – it was huge and in the center was a chair-like thing with
padded stirrups that held almost your whole leg. As I sat down I looked up and
saw one of those big round surgical lights with the handle in the middle and I
remember thinking that it was just like on Grey’s Anatomy. I literally said to
the nurse and anesthesiologist, “wow, this just got real.” In a flutter of
activity, they were moving me and strapping me, and hooking me up to stuff –
terrifying. One of the last things I remember is getting an oxygen tube stuck
up my nose and telling them I could feel something in the back of my
throat…then I felt the meds kick in and it was lights out.
Of course, the first thing I said when I woke up was, “Is it
over?” I was so happy with that fact alone. The first few minutes are fuzzy but
I remember them wheeling me into recovery and hearing the most amazing words –
“33 eggs”. Let me clarify that the average IVF egg retrieval results in 8-15
eggs. We knew there were going to be a lot but WOW. I immediately asked for
Jared and was so relieved when I saw him. I cried when I told him the egg
number. At this point, I was definitely in some pain but it was really not bad
at all considered that they had just poked holes in my ovaries. It felt like
period cramps but not even like the worst period cramps I’ve ever had. We sat
there and hung out for about an hour. Jared was texting friends and family that
all went well and they were periodically checking my vitals and going over what
meds I was to start taking and other post-op instructions. When I was ready
they gave me some orange juice and graham crackers – yum! When I was cleared to
go, I just changed and it was off to Mifflintown for a day of R&R!
Hanging out in recovery - so happy it's over!
Embryos week
The next morning I felt much better – a little
pain/tenderness and a little bloating. As we were eating breakfast in the
kitchen, the embryologist called – 26 of the 33 eggs had fertilized! I cried. I
think at each step I had been prepared for something crazy and rare to come
along…the follicles would be empty…the eggs would reject the sperm and not
fertilize... The average fertilization rate is 50-70% so we were officially
above average. Jared and I just didn’t know what to do with all this good news.
Looking back on those 2 days – it was like everything was going perfect. Too
perfect.
Monday morning the embryologist called again. Right away I
panicked because I could sense a tone in her voice – like someone preparing to
deliver bad news. She said that 10 of the embryos failed to “cleave” (i.e. cells
didn’t divide) which she thought was odd. She commented that this might even be
the cause of my infertility. (I am thinking – “oh great, just add it to the
list!) Of the 16 remaining, she said she was happy with the morphology (or
quality) of about half. Then she said she would call early Tuesday in the event
they decided I need to come in for a day 3 transfer. (Day 3 transfers occur
when the embryos are not doing well vs. a transfer on day 5 which is the goal.)
I was shocked! Plus, there was the idea of having to stop everything and drive
to KOP the next day (the embryologist was quite shocked when I told her we were
3 hours away…I was thinking ”guess what,
lady – we don’t all live in Philadelphia!”) Everything seemed so hasty and
uncertain. I felt upset and confused after the call. I waited all day hoping my
doc or nurse would call to talk about the potential for a day 3 transfer. Finally
after Jared called them, I got a call from my nurse. She said according to the
notes, there were 16 ongoing embryos and even from as many eggs as we had, this
was normal. (I really felt that if the same info had been delivered in a more
positive way, I would not have been so upset.) She was very surprised to hear
they mentioned a day 3 transfer and she didn’t know anything about it. She told
me Dr. N was going to call to touch base with me.
Another question that was raised by all this was whether we
were going to be doing a transfer at all. Last we knew, it was very probable
that we would be freezing everything due to my hyperstim risk. However, except
for a pretty severe case of constipation, I had been feeling pretty good. I was
consistently the same weight every morning and my bloating and soreness seemed
reasonable to me. I began to hope that we would be able to do a day 5 transfer
after all.
Tuesday morning, Dr. N called. She started the report with
“ok, are you ready?” I really felt she was going to tell us there was nothing
left or that what was left was not good enough quality to be transferred. What
she did say was that of the 16 embryos remaining, 7 had stopped developing or
were not healthy. That left us with 9 embryos. In terms of quality,
unfortunately, we had no A+s, a few As, and mostly Bs. UGG. However, the
embryologist feels that there are a few that are healthy enough to make it to
day 5. YES. But, because of my soaring estrogen levels and risk for
hyperstimulating, they wanted to freeze everything that’s left at day 5 and
delay the transfer until next month. UGG.
What a roller coaster of emotions. In 2 days, how did we go
from 26 embryos to 9?! She said we might end up with only 2! The thought of
this seriously concerned me because there is not a 100% survival rate when it
comes to thawing embryos. Our fear was that if we freeze 2, we could end up
with nothing. However, she made sure to make it known that if we would do the
fresh transfer and I would get pregnant (and hyperstimulate), I would be very
sick for a long time. We left it that she would discuss our concerns with the
other doctors and go from there. However, the more I thought about it, the more
I realized that fighting the doctors was one of the things that was making us
stressed – it was feeling that we had to make decisions. Jared and I talked
about it and later I emailed the doc and told her that we would concede to do whatever
the team thought was best.
We spoke to her briefly on Wednesday and all the embryos
were still growing but they aren’t graded on day 4 so we really got no new
information. Although we did get the official decision to freeze and I got the
go-ahead to stop my progesterone (used to prep my uterus for implantation and
pregnancy) and Medrol (a steroid given to suppress the immune system so it
doesn’t attack the embryo at transfer) since there would be no transfer this
month. I should expect my period in a week or 2 and then they would start
prepping me for next month. From my understanding it will just be oral meds and
estrogen patches (no injections, I was assured!).
Thursday morning Dr. N called with what I thought was going
to be the final pre-freezing report. She informed me that 4 embryos were
continuing to grow. Somehow I was not surprised by this number and was even a
little relieved – I felt like so scared that none of them would make it.
All 4 were in the very early “blastocyst” stage – the blastocyst is the
developmental goal for a day 5 transfer embryo. She stated that because they
were so early in this stage, the lab will wait to make the final decision on
what to freeze and do the actual freeze on Friday. I didn’t ask any questions
about the grading of the 4 – I think, at least for the moment, I preferred
ignorant bliss to the risk of getting more negative news.
In addition to all this bad news, my body was suffering from what I believe to be the effects of mild ovarian hyperstimulation
and/or the excessive hormones. My belly was still bloated and my ovaries were very
sore. I was nauseous every day and had terrible heartburn. I had aversions to
foods I normally love and became obsessed with certain foods (I think the week
was officially dubbed “Tuna melt Week”!!). I was just a mess.
Friday was all about waiting…waiting waiting waiting…for the
final call. In my head, I think I was allowing myself to hope that since the 4
embryos were all early blastocysts that they would all make it to freezing. I
missed the call while Jared and I were at his grandfather’s viewing. We stepped
out quickly before the service to return the call. After being on hold for what
seemed like forever, Dr. N got on the line and delivered the blow. Only 1
embryo had been frozen. It felt like someone stabbed me in the gut. I didn’t
even know what to say. 33 eggs and we got ONE embryo. 14 injection days, all the running to
Harrisburg, a trip to KOP, anesthesia, surgery, plus the exhausting effect the
hyperstimulation had on my body and not to mention thousands of dollars
stripped from our insurance funding – and we got ONE embryo. I was sick.
She then proceeded to tell me that we have 2 options from
here – proceed with the transfer of the single embryo next month or do a whole
new round of IVF to try to get more embryos. I managed to ask her if she knew
why things had gone so poorly. Her answer still rings in my ears: “It’s an egg
quality issue.” She went on to tell me other things about the eggs and how they
develop but it was all gobbledeegook at that point. All could hear in my head
was – not only can you not ovulate, your
eggs are defective.
To say that the events of this week sent me into a tailspin
is definitely an understatement. Walking away from our first IVF cycle with only
one embryo is heartbreaking – in addition to learning about my egg quality
issue. I think that after we got so many eggs and so many fertilized, I allowed
a little hope to creep in. But as I have learned over and over and over again,
nothing is a guarantee. And now, I think more than ever before, I feel the need
to mentally prepare for the distinct possibility that Jared and I will never
have children.
We have a sit-down scheduled with Dr. N tomorrow to go over
everything. I am hoping to get some more detailed answers about the egg quality
problem and how severely this impacts our overall chances of ever having a baby. At this point, unless she has some amazing
pitch prepared for going right into another round of IVF, we are probably going
to transfer our one embryo next month and pray for a miracle.
I feel very torn in this moment in time between "beating this horse til it's dead" - i.e. doing everything in our physical and financial power to have a child, OR taking to heart "If God shuts a door, stop banging on it. Trust that what's behind it is not for you." I've said it a thousand times - should it be this hard? We just seem to be met with obstacles at every turn. Every time we begin to have an ounce of hope, our hearts get shattered all over again. I met with a counselor for the first time yesterday. It really hit me hard when she said that, other than the loss of an infant or a small child, what we are going through is as bad as it gets. We are grieving the loss of the children we will never have.
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