Retrieval Keeps Things Interesting

My retrieval was scheduled for yesterday (Monday) at 1:30 P.M. I've never had a retrieval that late in the day, so I figured I would be very hungry and thirsty leading up to it. The cutoff for food and drink was midnight Sunday night. 

On Sunday afternoon we headed to Queens to stay at an empty apartment owned by our friends. They are in the process of selling it but are waiting to close. We arrived around 9:00 and found the place easily. The apartment was really nice and spacious, but quite empty. Apart from the bed there wasn't much else. Unfortunately, we weren't able to pick up on any wireless networks so watched Net.flix from W's i.Phone. Not the biggest screen ever, but it worked. 

We slept in Monday morning and took our time as we showered and got ready. We left the apartment around 11:00 to head into Manhattan where the retrieval would take place. We found a cheap parking garage nearby and left our car for a few hours. 

From there we had over an hour to kill so decided to walk around some. I do not recommend walking around Manhattan around lunch time when you haven't eaten in twelve hours and are super hungry. I have to say though that the good and bad smells would waver from one step to the next, and one block to the next. There were certainly tons of restaurants to admire as we walked. There was even a guy who stood outside a place and offered free hot soup samples. Soup is my absolute favorite so it was a bit torturous to walk past and not take a delicious sample. 

We went into a few stores and made a few small purchases to kill the time. We then headed to the clinic with plenty of time to spare.  The staff was not overly communicative about anything. There was another couple there scheduled to go before me and the husband was not being cooperative. He refused to sign any consents without things being thoroughly explained to him. He also came to the front desk to complain that it was 1:05 and his wife's procedure time was supposed to be 1:00. I'm not sure if it was their first time or what, but they were making things much more difficult than they needed to be. 

Dr. Br.averman has a contract with this office. They only perform procedures and don't actually treat any patients. I would not see Dr. B during this procedure. 

I got changed and waited in the smallest recovery room ever. As I changed the other woman was taken into the procedure room. The recovery room I waited in contained three beds with a curtain between each one. They had me wait in the bed closest to the wall with the procedure room on the other side of that wall. There was a sliding door between the rooms.

As I waited a nurse came in and told me W had gone to give his sample. At one point the RE came in to explain the procedure and risks to me. He asked me if I had any questions and I asked about what kind of anesthesia would be used. For my last retrieval there was a shortage of Pro.pofol and I was in a lot of pain and remembered most of the procedure. Luckily the RE said they had Pro.pofol and joked I had done my last retrieval in Mexico. 

After what seemed like a little while the sliding door opened and I heard hysterical crying. I guess the woman who went before me did not wake up in a good place. They wheeled a bed from the recovery room into the procedure room and I heard them giving her instructions to transfer into that bed. The whole time she was hysterical and I heard it all. I'm not going to lie, this definitely made my heart start to beat a bit faster. 

After they wheeled her into the recovery room and had her cry in the bed next to me they told me it was my turn. I walked into the adjacent room and was immediately asked by the nurse if it was my first retrieval. When I told her it wasn't she was relieved because she didn't want the other patient to freak me out. 

The next bit was a complete whirlwind. The RE came in and instructed me to scoot down the bed while lots of other people moved around the room. I guessed who the anesthesiologist was and finally asked. He started the IV and asked me literally three questions, two of which were the same. It wasn't exactly the confidence I desired. Next things I knew I looked up to see am empty syringe in the anesthesiologists hand and heard him say, "things are underway." I felt a slight burning in my throat and was asleep quickly. 

I woke up and the nurses asked me to walk back to the recovery room. I was super lightheaded and felt  lots of cramps. They had me lie in the same bed I was in previously and all I wanted to do was curl up into a ball and sleep a little more. 

I guess they had other plans for me. They continued to bother me as I just wanted to be left alone to nap. The one nurse offered me a drink and I had zero interest in it. The anesthesiologist and RE came in numerous times. They put a blood pressure cuff on each of my arms. The anesthesiologist at one point lifted my legs and held them in the air for a few minutes. He kept straightening my arm for the IV and asked me to lie on my back rather than my side. They asked me if I was in pain to which I replied yes. They gave me something for the pain but it didn't really help. Most of this time was mostly a blur. 

Eventually I realized they were concerned about my blood pressure. When they asked me what my systolic pressure typically ran I said around 120-130. I then asked what it was. They replied that it was in the 70's! 

I remember seeing W as he hung back a bit and that I felt really cold. The RE came back (apparently he had left) and grabbed my hand to talk to me. I told him his hand was really cold. He decided he wanted to do an ultrasound since my blood pressure was so low and I was in pain. 

They wheeled me back into the room and did a trans-abdominal ultrasound. There wasn't any fluid there so they just continued to pump fluids into me through my IV and brought me back into the recovery room. 

Slowly my blood pressure came back up. The RE said he didn't want us to leave that night and told us it would be best to stay another night. He gave W his cell phone number, his secretary's number, and the hospital info for the one he had rights to. He said he thought I would be fine but it was just good to have that info and keep and eye on things. He said my blood pressure likely got so low due to the fact that I was so dehydrated. I guess that's what happens when you can't have anything to eat or drink for 13 hours. 

Once things were under control and I was more conscious I asked about how many eggs we got. The nurses disappeared for a few minutes and came back to give me some seriously disappointing news. 

They retrieved twelve eggs, only twelve. I know I had at least twenty follicles and felt a bit blindsided by this information. I started to ask questions and they brought in the embryologist. She explained that many of the follicles did not contain eggs. I was completely heartbroken. I am used to egg counts in the high teens or twenties and I knew we had a LOT of follicles. 

I know a lot of people would be thrilled with that many eggs but I was just caught off guard. I really had expected a much higher number. 

I had been instructed by Dr. B's office to take a HCG booster shot of 1,500 IU's after retrieval. I was completely confused about how to do this, so called his office to speak to a nurse. She talked me through it and then I asked about the empty follicles. She said she would ask Dr. B and put me on hold. 

Then Dr. B got on the phone and asked me what was up. I told him what I was told and how disappointed I was. He listened and replied with true concern and compassion. He said no one really knows why empty follicles occur but they likely aren't really empty. The eggs instead stick to the wall of the follicle and then the egg does not come free easily. He said likely it was an egg quality issue with those eggs but that it said nothing about the eggs that were retrieved. He told me it was way too early to get disappointed and that anything over 10 eggs was still good.  He said it could have been the stimulation protocol but there was no way to know that at the time. I honestly felt on the verge of tears. I was glad I was able to talk to Dr. B, and he seemed so positive, but I still felt pretty low. 

W tried to reassure me that we still got a bunch of eggs and that the embryologist said the eggs we got looked really great. 

We left around 4:30 and headed to get some food. My friend had recommended a mac & cheese restaurant so we ate there. As we sat and ate I wanted to cry multiple times. Between the blood pressure fiasco and empty follicles I was feeling really low. W continued to try to reassure me, but I just needed to process everything. From there we headed to a frozen yogurt place a few blocks away and I treated myself to as many delicious toppings as appealed to me. 

We headed back to the apartment in Queens and I napped for a bit in bed. After an hour or two I woke up and wanted to get some fresh air and go for a walk. I was a little hungry so we decided to look for a place to eat. We stopped at some kind of South American restaurant and had some delicious homemade soup. W and I both joked after we left that being in that restaurant was like being in another country. I was convinced I wanted to take the train into Manhattan to see a late night movie, but W was a little more guarded. He didn't think it was a good idea and I realized he was probably right when the cramping returned. 

We went back and watched a little more Net.flix on the i.Phone before we fell asleep. We did my PIO shot and I slapped some estrogen patches on my stomach. I still felt pretty sore and had a lot of cramps. 

I dreamt last night that I was looking for a place to hide and bawl my eyes out. I didn't want W to be there, so found some place and curled up in a chair with one of my dogs. I'm sure it reflects the disappointment I felt. 

I woke up this morning and felt much better. My stomach seemed to have gone done in size and I had gotten up a few times in the night to pee out some of the fluid they pumped me full of. 

We walked to get some breakfast and had another foreign country-like experience. After, we got back in the car ready to head home and I felt SO bloated and full. I reclined for most of the ride and things were quite uneventful as we drove. 

Around 3:00 I emailed Dr. B to get the fertilization report. He responded in literally two minutes to tell me of the twelve eggs retrieved 8 were mature. They performed ICSI on all 8 and... ALL EIGHT FERTILIZED!! This really helped to perk me up a lot.  Our first IVF we had a 55% fertilization rate, #2 we had 80%, #3 we had 61%, and #4 we had 68%. 100% really is great! I asked about In-Virto Maturation and he said they would try with the other 3 eggs. 

So, as much as I was disappointed by the number of eggs retrieved and overwhelmed by the whole blood pressure thing, I was happy to hear about the fertilization. 

We got home this evening around 5:00 and my MiL brought our dogs home to us and joined us for dinner. I still feel pretty full and uncomfortable and am sure I have at least a little OHSS, but I am okay. I'm going to try to work tomorrow but will see how I feel when I get up/as the day progresses. I really need to make some money and work since I have taken off so much time lately. 

I joked to W that I've had two near death experiences (sliding off the road in the snow and really low blood pressure after retrieval) already this cycle. Hopefully everything else will be smooth sailing from this point forward.

My transfer is still scheduled for Saturday at this point and we will head down Friday night and possibility stay the weekend in the city now that we have our own apartment to stay in. 

Tomorrow I will hear again how things are progressing and hopefully it will be more good news. Things have definitely been crazy this time, but I know it will all be worth it if we end up pregnant. Either way, there nothing else we can do but hold on and try to enjoy the ride. 

IVF #4 CD 16- Fertilization Report

So I got the call this morning from my clinic. Of our 23 eggs they were able to ICSI 19 of them. Of those 19, 13 fertilized (68%). I'm elated that we have 13 lucky little embryos growing. I know that more could still fertilize because it happened last time, so we will see. 

They told me I won't hear again about them unless I want to call. They will freeze the embryos on day 5/6 and I can call if I want to get more information from the embryologist at that time. 

I'm feeling much better today than I was last night. I didn't sleep great because I was super uncomfortable. I weighed myself before bed and was up 4 pounds from the clinic. I can't say my scale is the same as theirs, but my stomach was definitely distended. I weighed myself again this morning and was down 3 pounds. I feel much better. The lupron trigger shot is amazing in comparison!! I can't believe how much better I feel this time around. I almost feel like I could have gone to work today, but I'm glad to be home relaxing and taking it easy.

I'm glad we have the next few weeks to relax and not worry about anything IVF related. I can get my body back to normal and start feeling better before we transfer any embryos. 

Keep growing little ones! I have such a good feeling about this cycle.

Hello again disappointment

The nurse called today and said we will not be able to do the FET this cycle. My RE wants me to come in for another ultrasound when I stop bleeding. He wants to be sure the fluid is gone. I guess if I were to start the estrogen and start building up my lining it could mask the fluid. If the fluid is still there he wants to do a biopsy.

The ultrasound tech is on vacation next week and I don't have an appointment until August 8th.

 I am frustrated to say the least.

Now the debate is whether to wait another 7+ weeks to do the FET (my cycles unmedicated are about 35 days), or whether to start another fresh IVF. I was willing to do the FET this cycle because it would give me closure on our cycle. I didn't have a ton of hope in the fact that the embryos that were frozen were as follows: 1 6-celled embryo graded 4+, 3 4-celled embryos graded 4, and one fertilized egg that hadn't started to divide. It was always very clear they were slow to develop.

So I'm working on a pro's and con's list of IVF and FET.

FET

Pros:

The only cost is the meds (estrogen)

It may work and we could get pregnant for the cost of one IVF cycle

It gives me closure on our cycle and allows me to say we completed an IVF cycle

Cons:

The chances of success aren't great

Our embryos are not as many cells as they should be for day 3 embryos

We have to wait 7+ weeks

The best embryo may not survive the thaw and we would be left with only 4-celled embryos to transfer

IVF

Pros: Doing one cycle prior lets us know that we need to ICSI all eggs and may result in more embryos

We could be transferring fresh embryos in about 7 weeks

The chances of success are higher

We have all the meds we need

We can start this cycle (I think)

Cons:

$$$$

Our embryos could be slow to develop again

Fluid could return since we didn't know what caused it

I really can't make any decisions until the ultrasound to know whether the fluid is gone. Today W and I had a conversation about where to go from here, how much disappointment this has all been, how far we are willing to go with fertility treatments, and how this will all (hopefully) be worth it. Needless to say, the disappointment continues.

IVF #1 CD 15 (updates)

So I waited around all day with my phone glued to me. Finally, at 7:10 my RE called with the update. He apologized for being so late in calling but said there was an emergency in the OR he was dealing with. 

Of our 5 fertilized eggs, 4 are still going. 1 of them is still at 2 cells, so isn't doing great. 3 of them are at least 4 cells, one of which is at 5 cells. The only ones that are dividing are the ones we did ICSI on. My RE said the 4 cells is about what he would expect at this stage, maybe a little slow, but nothing to worry about. 

He is hoping they are at 6-8 cells tomorrow. I am scheduled for a my transfer tomorrow at 10:30. My MIL is my chauffeur and will drive me to acupuncture before and after the transfer as well as be there for support during the transfer. I told her everything tonight and she was super excited and optimistic. 

W and I talked and we will probably put all 3 back tomorrow. I don't think they will all implant and it seems like my RE would be on board for transferring 3. I wish we had more to choose from, but you get what you get. Hopefully they will be at 6-8 cells tomorrow. Thinking good thoughts for my embryos this evening. 

Wish me luck and send some positive vibes towards my embryos!

IVF #1 CD 14 (fertilization report)

So I finally got the call at 5:45 from my RE with the update. Of our 11 eggs, they performed ICSI on 6. Of those 6, 4 fertilized. 5 of the eggs they did not perform ICSI on, and 1 fertilized. There is one other egg that may be mature enough to perform rescue ICSI on, but we will see.

So, all together we have 5 fertilized eggs. There are 4 others they are keeping cultured to see if they mature. Of our 5 fertilized eggs, 1 is 2-celled and starting to divide.

Looks like we will be doing a Friday transfer and all I can do at this point is keep my fingers and toes crossed. I am a bit disappointed by the fertilization report, but there isn't much use in feeling down about what didn't happen. I have to feel positive about what we do have. Here's hoping those 5 do well and continue to divide.

My RE said of the eggs they performed ICSI on, the outer shell of the eggs was very thick. We may be looking at assisted hatching based on how they do.

It is hard to be overwhelmingly excited and optimistic with only 5 fertilized eggs, but I am trying. I will hear more tomorrow and get a time for the transfer.

IVF #1 CD 13 (Successful Retrieval)

So I have been home lounging in bed with the AC on all afternoon. I haven't had much pain or discomfort and am feeling pretty well. 

We arrived early, got the IV going, and I was feeling SUPER nervous. The only experience I have with surgery/IV's are my laparoscopies, and those weren't exactly a walk in the park. They had me put on a gown and go to the bathroom prior. They then took me into the retrieval room and got me situated with the full-leg comfy stirrups. They gave me the anesthesia but it didn't kick in for a few minutes. They definitely started the procedure before I was asleep, but it didn't hurt much. In the room there were 2 nurses, my RE, the anesthesiologist, and a resident doctor. The embryologist was in an attached room with a little window between. 

The next thing, I was waking up in the recovery room. I quickly learned that there were 11 eggs which is great! My RE was super positive but did say we will probably end up doing a 3 day transfer since we want to be sure we are able to get to transfer. The embryologist said W's sample looked great, but my RE and the embryologist agreed to ICSI half of the eggs. 

I had some minor cramping and went home and slept for a few hours. I am feeling fine now and will probably work tomorrow. 

I am happy about the 11 eggs and glad to be moving forward to the next step... transfer! I have been corresponding with another girl I met at yoga who has her retrieval tomorrow. It is nice to have someone so close to me in her cycle and location who is able to relate to the IVF craziness. 

Oh, and my pedicure didn't get much attention since I had to wear these sterile booty things. The nurse did compliment them when she was helping me into the wheelchair to leave, so I'm glad they did get noticed.