IVF Update: Egg Retrieval #2 + Starting Transfer Cycle
If you are just starting to read about this 2+ year TTC (trying to conceive) journey that we’ve been on, or if you need/want a recap, here are my previous posts on all of it (buckle up because it’s a lot):
It honestly feels surreal that I’m going through all of this again. It’s almost as though I didn’t have a surgery 3 weeks ago. I did, though!
The stim phase this time around was a blur. By the end of the medications, I was going in to the fertility center in San Francisco every day for ultrasounds and bloodwork. Also, let me note here, in case there was any confusion, the ultrasounds I’m talking about are vaginal. Sorry, but not sorry, if it’s TMI, but people should know. They aren’t just sticking that thing on your stomach people, it’s going up in there. I’m mentioning this, because Shawn had no idea when he came with me to one of my appointments, and he was asking me if that was normal. Yes, every ultrasound. They are looking at my uterine lining, as well as my ovaries to check follicle growth. It’s not a blast, but it’s become so routine that I’m just like, “well, here we go again.” Being the girl is SO fun sometimes.
My Mom came into town with perfect timing, the weekend before my egg retrieval. We got to explore San Francisco, tour Alcatraz, eat some good food, and do a tasting at a winery in Napa. It was a great weekend and a wonderful morale boost (and kept me moving...we walked like 6 miles the day we went to Alcatraz) to have her there. It definitely sent me into surgery feeling refreshed and ready for the next step in our journey.
By the day of the egg retrieval, on September 14th, after 11 days of injections (32 total shots, y’all), I was feeling a bit like the sea lions we saw on Pier 39 in San Fran, I was so puffy and bloated. My ovaries HAD to be the size of softballs at this point. Although I continued CrossFit through ~day 7 of injections, I did tone it back to just walking for those last few days, mostly because I literally felt like I would pop if I did anything else.
On surgery day, I went in at 8:30am (for 9:30am surgery time), which is an awful time slot, because you can’t eat or drink anything before, and I was SO thirsty. The earlier time slots are much better, but I didn’t have an option this time. My nurse came in to give me my hospital gown and socks to change into, and then asked me a bunch of pre-op questions, such as: when was the last time you ate or drank; are you on any medication; and when’s the last time you took ibuprofen? Pretty standard.
The next step was getting my IV placed, which I am so happy to say went much better this time than the past couple times I’ve had to get one. I’d like to attribute it to how hydrated I stayed the day before (ya girl was CHUGGING water all day up until I went to sleep), in anticipation of being dehydrated going into surgery, but I couldn’t see my veins the next morning, so it’s really a toss up. Maybe my nurse was just really good at it for once. Shortly after that, they allowed me to use the bathroom one more time. Then my doctor came in to check on me and let me know he was ready for me, and then I walked back into the operating room.
Even though I’ve had to spread my legs open for countless doctors at this point, and I feel like all my modesty is out the window now, it felt pretty awkward when I got into the OR this time. They immediately started loosening my gown because I had tied it closed, so I felt like everyone in the room got a solid view of my whole ass, not to mention getting into the stirrups and just laying there wide open for what felt like a hundred people in there for the procedure. I don’t remember feeling that way during the first surgery. I think they probably did a better job of keeping me covered and getting me comfortable the first time around. It was a lot. I also remember the oxygen being placed in my nose and feeling super uncomfortable. It has this antiseptic smell to it, and it’s just so much air going straight up your nose holes, it’s just not my fave. Shortly after though, the discomfort goes away, because the anesthesiologist starts their job, and you are out like a light.
I do love that part of it. It’s like the best nap you’ve ever had. You wake up and it’s like nothing even happened. You’re covered in a warm blanket, propped up on pillows, feeling like a princess. They offer you water/juice/snacks right away. I chugged two waters off the bat and grabbed some goldfish for Shawn (LOL). Dr. Kaser came in to let me know they retrieved 16 eggs. Later on, I was a little disappointed, but at the time I was just happy to be done, knowing that I wasn’t going to have to do this again. Shawn and I had come to the decision that, no matter what, we finish this IVF cycle and never do another one. My body has been through enough. So, honestly, my feeling of relief far outweighed my feeling of disappointment. The reasoning behind the disappointment, by the way, was because we retrieved 22 eggs in my first cycle of IVF. I was nervous that with fewer eggs to begin with, we may end up with even fewer embryos, and there was also the possibility of it being a complete failure, where we wind up with zero by the end. I tried to look on the bright side by telling my doctor it really didn’t matter how many we got, what ultimately mattered was the quality by the end. If we ended up with multiple normal embryos in the end, it would still be a success. He agreed.
After you spend about 30 minutes in recovery, you change back into your clothes, and a nurse walks you out to whoever plans on driving you home. Shawn was in the waiting area to pick me up and get me the heck out of there.
I had packed a Perfect Foods Bar (snack size…THE BEST), for my post-surgery snack on the car ride home. My post-surgery meal was a grilled chicken plate with brussel sprouts and cauliflower rice from Urban Plates here in town. It was DELICIOUS. I was way more tired this time around than I was last time, so I spent most of that day alternating between napping on the couch and watching Netflix. Shawn went back to work after I assured him I would be totally fine.
I felt many of the same symptoms I felt the first time around- bloating, light cramping, fatigue. The difference this time around was that I got SEVERELY congested starting that afternoon. I feel like it was from the oxygen in my nose, although I never got a clear answer on that. I HATE taking medicine, but I was so bad off that I said fuck it and took a Nyquil that night, which I truly regret because it made me feel worse when it wore off. The following day, I tried an antihistamine, which did absolutely nothing. Then, I took Sudafed for the congestion, and that was the only thing that made a difference. I took those about every 6-8 hours over the next two days and it worked like a charm.
I started working out again the day after surgery, although I took it easy for the first couple of days. I may have jumped back in a little too hard too fast later in that first week though, because on day 7 following surgery I had some pretty intense cramping. I had done a pretty tough CrossFit workout on day 5 and completed a very difficult 6.5 mile hike on day 7, and I think it was just a little too much, too soon. I took the next day completely off of exercise and felt much better the following day. Again, my philosophy this time around is to listen to my body. My body, at that time, was telling me, “Fuck you, bitch, I’m done,” so I listened and sat my ass down.
Embryology updates come in waves following surgery. The day after surgery, they update you on how many eggs were mature and how many fertilized. Out of the 16 eggs that were retrieved, 11 were mature, and of those 11, nine fertilized. I’ve come to find out that this week following surgery is often referred to as “The Hunger Games,” and it totally makes sense, because you just watch the numbers get lower and lower throughout the week. First cycle, we went from 22 retrieved, to 12 mature and fertilized, down to 6 on day 3, down to 3 remaining embryos by day 7. It was rough. It’s the MOST nerve wracking week, well maybe a three-way tie with waiting for PGS results, and waiting for the pregnancy test. Waiting is the worst.
Anyways, this clinic gives an update on days 5, 6, and 7 following fertilization. During these updates, they let you know how many of the embryos are growing in the lab, and if any have made it to blastocyst, which is the final stage of cell maturity they are looking for before they biopsy them (for the genetic testing) and then freeze them for transfer later. On day 5, we had five early blasts that were progressing well, and it looked like several would be ready for biopsy on day 6. On day 6, we had three quality blasts biopsied and frozen, while four more looked to be early blasts that would be checked on the following day. On day 7, they biopsied one additional embryo that made it to blastocyst, and the others had fallen off and stopped growing. We were a bit disappointed, after feeling like seven embryos had a really good chance of making it, and then only four made it to the final stage. However, in the previous cycle, we only had three embryos make it this far, so at least it was one more than that. If you think this was a roller coaster ride of emotions, it certainly was. And it continues to be.
The shitty thing about having the PGS testing done, is that you have to add an additional 10-14 days of waiting on to the lifetime of waiting you’ve been through thus far. PGS tested embryos have a lower rate of miscarriage, higher rate of implantation success, and is the recommended path for IVF patients today. Especially because we had two embryos come back chromosomally abnormal last cycle, it made the most sense to do this again. If we were to transfer an abnormal embryo, we would basically be throwing $4000 out the window from a transfer cycle, because it would likely either not implant or end up in a miscarriage. For us, it has always seemed worth it to add this additional step, just to be sure, before we start a transfer cycle.
So we waited. In the meantime, I started coaching at Diablo CrossFit, where I had become a member after moving here. The community is wonderful, the programming is great, and it’s really helped me to feel like my old self again. Having CrossFit back in my life, in many ways, has taken so much of the stress and negative thoughts out of this process for me. It is a healthy distraction, a return to normal, and, all-around, just a good damn time. It’s nice to feel fulfilled again, by getting to impact others, face-to-face, and to do what I love to do again. I have really felt an emptiness from not coaching or training much over the past year, and I’m so excited to have that back in my life again.
Coaching and training again has really helped the time between updates move a lot quicker. The nerves really only began to set in a couple days before we heard back from the testing. With the 10th day after fertilization looming, I started to get super anxious about what we would hear. What if we didn’t get ANY normal embryos this time? What if we only got one again, like last time? It’s tough. I felt a lot of pressure to have multiple embryos come back normal this time, because this was our last shot. I know it’s not all on me, but it certainly feels like the weight of the world sometimes. We want this so bad, and to have put in all this effort, not to mention money at this point, for it all to end in nothing, felt like a horrible possibility. I know so many people tell you to never dwell on the negative in this process, but it’s also impossible to never let those seeds of doubt creep in. The thing I had to keep telling myself was that whatever was meant to be would happen. Whether the outcome was good or bad, we would figure it out.
The morning of day 10, I was so anxious, I sent a message to my doctor/nurses over our communication app to see whether or not I should expect results that day or if I should adjust my expectations. Surprisingly, they got back with me pretty quickly to say that they had received our results, and…
WE HAD THREE NORMAL EMBRYOS!
My heart skipped like 7 beats. I was ecstatic. The fourth embryo even came back showing “no result,” which means that it could still be a normal. The testing would just need to be redone in order to yield a result. In order to do this, we would have to thaw it, re-biopsy, send it back to PGS, and then re-freeze the embryo. Because we have three healthy embryos already, and because the embryo is essentially frozen in time and we can redo the testing at any point, even years from now if we wanted, we aren’t feeling compelled to retest at this point. Should we need that embryo at any point in the future, we would have it retested first. The only downside of retesting is that it can, very slightly, decrease the chances of it resulting in a pregnancy. For the time being, I am putting all of that on the back burner, because the thing that truly matters is: WE HAVE THREE PERFECT EMBRYOS!! That means we have three chances to get pregnant!! This is the BEST news I’ve gotten all year.
After only having a single precious embryo, and one chance at pregnancy on the first go-round, this is like hitting the dang jackpot. I’m telling you. I feel embryo rich. You get such few moments of celebration throughout this whole process, so when something good finally happens, it puts you on cloud nine. It’s the greatest feeling. I finally feel like I can let out a breath of pure relief. Like we finally did something right. Attribute it to CrossFit, y’all! Honestly, I can’t tell you, definitively, what made the change, but I will say, feeling more like myself has GREATLY decreased the stress of everything. Maybe that contributed, maybe it didn’t, but I’m so happy that it didn’t affect things in a negative way. Life is good.
A few days before I received the results, my cycle started (12 days following my egg retrieval). My team confirmed with me that I was ready to begin a transfer cycle (which we obviously are. I’ve waited over two years, so the sooner I can be pregnant, the better!). After that confirmation, they started me on a daily progesterone pill (beginning on cycle day 3) to control the timing of my cycle until we could get the PGS results back. I only had to take these for a couple days, since the PGS testing came back on time. Then they scheduled me for a baseline appointment 3 days later.
This is also the time that Shawn and I went on our adventure to Yosemite to hike 17 miles and climb to the top of Half Dome....
At the baseline appointment, I got another ultrasound and bloodwork to confirm that my uterine lining was thin (which it was) and my hormones were all at normal levels (they were). This meant I was ready to get started with the transfer protocol. Since everything looked good, I was ready to start estrogen pills. I am currently on day 4 of estrogen pills, which I take twice daily (AM and PM). I will do this for the next couple of weeks, then I’ll start the wonderful adventure of progesterone in oil injections, which you can read all about here. To be real with you, I look forward to getting to that point, because it puts us SO close to transfer time.
Transfer should happen within the next 3 weeks, because once we start progesterone shots, it’s exactly 6 days to transfer. These are once daily injections, taken every morning, for 6 days. Shawn will get to give me these bad boys, because they go right in the booty. It’s a pretty hard to reach area on your own (although doable, people do it that way too). Then on the sixth day, you go in for transfer.
Since our embryos are PGS tested, and there is such a high risk associated with multiples (for the mom’s health as well as the babies), we have been advised and agreed to only transfer one embryo. That’s the plan. That's also why we have three chances.
We also know the sex of each embryo, thanks to the awesome science of PGS testing, but we plan to keep that a secret until a little later. It’s our one piece of intimacy in this whole process that we’ve decided to keep between us, at least for a little while.
My next steps, at the moment, are to continue taking estrogen pills twice per day leading into my next ultrasound/bloodwork appointment in 5 days. They’ll go back in to check on my lining to make sure it’s growing well, and check my hormones to make sure they’re all good. Then we will most likely continue on for another week before starting progesterone shots. This all means that I have three precious weeks to savor all the fun workouts before I have to chill out for a while and allow the embryo to (hopefully) find its new home for the next nine months and freaking stick this time.
So that’s where we’re at! Hanging out, feeling less stressed than I have throughout this whole year and a half of treatment, pinching myself that we have THREE beautiful embryos and THREE excellent chances to make a baby Wassy, and allowing myself to be happy and live life like I want to, rather than making myself feel guilty or depriving myself of things that I love. We're going to keep on keepin' on, and hopefully head into transfer in a little under three weeks! Updates to come.