Our Fertility Journey: IVF Part 1, Stimulation and Retrieval
On March 23rd, we left California with a Uhaul trailer full of my gym equipment, clothes, and miscellaneous items I had collected over the course of the past 9 months there. Tucker, of course, had the whole back seat to himself, because he's a damn prince. He stays with me, because he's a Mama's boy, and because he is 100% my emotional support animal. Honestly, the traveling for Shawn’s work deserves its own post, and I will get to that one day. In the past year, we have packed our shit up 7 times, if you count the 4 rental houses we moved between while in the Palm Desert area. LOL. We are professional movers, really. But don't call me for moving help, because I'm over it. Kidding. But honestly, don't.
So, once again, we made our way back across the country. It should be noted that, in keeping with this year’s theme of being anything but easy, Shawn decided that we take the route across I-40 instead of the more southerly route using I-10. It was slightly longer, and I was immediately against it. He, however, wanted us to “enjoy the views” of the more scenic route. In hindsight, I would like to punch him in the throat. It should also be noted for the record, that I literally asked him to check the weather before we committed to the more northern route. “It’s the end of March,” he said, “We’ll be fine!”
Fast forward to the first night when the first snow flakes started hitting our windshield and I watched as the temperature kept getting lower and lower. Can you imagine the looks I was shooting over at him in the driver’s seat? I was not happy.
We woke up the next morning to a fresh blanket of snow on the ground with a fucking trailer attached to the truck, mind you, also covered in snow. The day before we left, I was sitting outside on a lawn chair, enjoying the 85 degree heat and the sunshine on my skin. Today I was contemplating murdering my husband, shivering to death, and wondering if we were going to crash the vehicle on the icy highway. What the actual fuck?
I can’t make this shit up y’all. We were driving along the interstate, it was snowing pretty hard, and visibility was not great. Traffic was actually pretty heavy. Why people wanted to drive in this is fucking beyond me, but there were a lot of people doing it like it wasn’t no thing. Anyways, the interstate is covered in snow and we are all driving along everyone else’s tracks. Suddenly, people start slamming on their brakes. Perfect. Shawn starts to slam his brakes also, but we have a freaking TRAILER attached to the back of us and it ain’t happening. Especially in the snow and ice. So the choice was either hit the guy in front of us, or veer off the road into the median and pray to God we don’t flip, bust a tire, get stuck in a ditch, hit something else, whatever. Somehow, this asshole (my husband), manages to drive us along through the median (which is grass covered in several inches of snow, mind you), parallel to the interstate, and merge back into traffic a couple hundred yards ahead without getting stuck or hitting anyone. That, I’m pretty positive, was an act of God. I think he was like, “Damn, I’m really putting this bitch through a lot this year, maybe I’ll cut her a small break.” That’s what happened. We survived, and kept trucking along through the snow and eventually made it to Georgia a couple days later.
Needless to say, I am never trusting Shawn to choose our route without looking at the weather first again. Here's something though, if you really want to give your relationship a test, drive across the country with your significant other. If you can survive that, you can survive anything. We've done it about 4 or 5 times now, so if that's not a testament to the strength of our relationship, I'm not sure what is.
Happier times ^^ haha. After 4 days of travel, we had made it to Georgia, alive, and we took the weekend to get me settled in. On Monday morning, Shawn gave his sperm sample to the fertility center to freeze and have on hand for our egg retrieval down the road. Talk about a gear switch! I needed to get that story in there, though, 1. because Shawn wanted me to put it in here, and 2. because it truly helps demonstrate what a fucking time we’ve had throughout this process, and 3. because what a perfect metaphor for the journey I was about to embark on.
The next step in this whole process is to wait for my cycle to start. Everything in fertility medicine is based around your cycle. All the protocols you get during IVF have to begin with the first day of your period. So we wait. And wait some more, and after you feel like you’ve finally made it, then you’re waiting again for the next thing. And again, and again until you think you’ve become a psycho person. So buckle up and prepare yourself for that. A friend gave me this advice: don’t glue yourself to a specific timeline. This is very important, because I can almost promise that whatever timeline you think you’re on, will surely be fucked right up as soon as you think it’s going well. I had to cross shit out on my planner more times than I can count. If you're planning a cycle of IVF, get yourself some white out. That's good advice right there.
I started my period on April 2nd, which was actually right on time, can you believe it? That day, I called into the fertility center and let them know, and I was sent a protocol for the stimulation phase of IVF. For anyone new to all these fertility terms, here is an abbreviated explanation of what the hell IVF even is (which by the way, let me preface by saying I am, by no means, any sort of medical professional or expert on any of this, I am simply speaking through experience and letting you know what I have have learned through all this. So don’t freak out on me if I accidentally misspeak or there is something factually wrong with what I’m saying. PREESH): IVF stands for In-Vitro Fertilization. Test tube babies if you will. It’s the process where they stimulate a woman’s ovaries to produce as many mature eggs as possible in a given cycle, harvest them in an egg-retrieval surgery, fertilize them in a lab with sperm taken from the spouse, partner, or donor, allow the fertilized eggs to grow for a given amount of time (in our case for 6 days), then transfer the embryo back into the woman’s uterus via tiny catheter through the cervix. Then, you’re pregnant, hopefully!
The process is separated into two main phases. You pay for these phases separately, because nothing is ever guaranteed, and you may end up on the other side of this first phase with zero embryos. If that happens, you start from scratch. The first phase is SIGNIFICANTLY more expensive that the second (which is the transfer phase), because you are dealing with multiple daily injections, an actual surgery where you have to be put under anesthesia, more monitoring and bloodwork appointments, etc. It’s a lot. It’s all a lot, really, but the stimulation phase can be a real bitch and time stealer.
The first two weeks of my cycle, my protocol had me taking birth control. This helps control the timing of the cycle. After those two weeks, you start the shots. I am the type of person that struggles to allow myself to even take a couple of ibuprofen when I have a migraine. I hate taking medicine. I just don’t like putting crap into my body. It’s just how I am. When the box of meds showed up on the front porch, I felt like I was in over my head. I mean, this box was FULL of needles, vials, powders, swabs, containers, drugs on drugs on drugs. My head was spinning. Also, how in the fuck do normal people do this on the day-to-day. Luckily, I was living with a nurse. What about people, like me, that don’t have a damn clue about what any of this is? What do they think; what do they do? This shit is bonkers! I watched the tutorials of how to mix the drugs, how to draw up medication, and how to inject yourself, and it’s a lot. It’s intimidating as shit. I can only imagine had I been completely alone in this, how many questions I would have had, how many times I would have watched those videos, how much time I would have spent trying to psych myself up for that first shot.
It’s honestly not that bad.
First of all, the needles are teeny tiny. Had I known in advance, how big the needles for the progesterone shots later on would be, I would have laughed at the first needles. They are babies. From that standpoint, do not even fret. The only thing that sucked about the stim shots was that, for me, one of the shots (I think it was the Menopur, but to tell you the truth, I can’t even remember at this point), stung really bad when it was first injected. It only lasts a few minutes, and then it’s fine. The rest of them were easy peasy. Really, the most intimidating thing for me was the mixing aspect of it. Some of the drugs require you to measure out the saline solution into a syringe and squirt it into another vial of powder, swirl it around, then draw out however much of the drug you need to inject. That part was a lot to me. And I get nervous that I’m not measuring right, or that I’ll accidentally draw out too much or not enough. Some of the drugs come pre-measured, which is the best. And some drugs have fewer steps than others, so once you get the hang of it, it’s really not that bad. I’ve also heard that there is always a nurse on call, so if you have questions, freaking ask them. And to tell you the truth, had my Mom not been there to help me with all the mixing and measuring and keeping things straight, I probably would have been best friends with the on-call nurses, because I need to make sure I’m doing shit right.
These shots go on daily for somewhere between 8 days and two weeks. To tell you the truth, I was riding a high of like here we fucking go. We’re in this, we’re doing it, I’m ready to make a baby. It helped me take on the shots like a champ. My thought process every day was, "Alright, shoot me up!" If it’s one step closer to pregnancy, then bring it on, baby! Each day I would cross off a day on my protocol feeling just a tiny bit closer to the goal each time. If you approach it that way, it makes it so much easier. I also had very few side effects, so that could have been working in my favor. I felt some fatigue, but I don’t feel like it affected my emotions, and it definitely didn’t make me feel sick in any way. I could feel my ovaries swelling up, and it’s not always the most comfortable thing, but small sacrifices for that end goal, am I right?
I did stimulation shots for 8 days, then did trigger shots for 2 days, and then it was time for my egg retrieval surgery. During stimulation, they have you come in for multiple monitoring appointments where they do a vaginal ultrasound to check how your ovaries are responding to the medication. They also to do bloodwork to check your hormone levels. On the ninth day of my stimulation, they decided that I was ready to begin the trigger shots. That night, instead of my usual injections, I had two different medications (that I had to pick up from a special pharmacy in Atlanta, since it was a Sunday and was technically closed...figures). Then the next morning, I had one more trigger shot injection in preparation for my egg retrieval surgery the next day.
I should mention that during the medicated part of this cycle, your ovaries feel like they are growing into softballs inside your body. They tell you to limit your exercise during this time, because there is a risk for OHSS- ovarian hyper stimulation syndrome, which is where your ovaries swell so much that they start leaking fluids into your body. If it’s serious enough, it can delay your egg retrieval, cause them to cancel it altogether, require medication or surgery to correct it, etc. So for people who were wondering if I was still doing my lifting or CrossFit during this time, the answer is hell to the fucking nah man. OHSS is not for me. I did continue to walk, do yoga (aside from any twisting stretches or poses or really anything that caused me discomfort in my pelvic area), and use my stationary bike during those ten days. Movement for me made me feel better, and helps with blood flow, which my doctor said is super important. I used my heart rate as a gauge during this time and tried to stay below 130.
On April 27, my dad drove me to the fertility clinic for my egg retrieval surgery. To tell you the truth, surgery was a fucking breeze. The worst part for me was getting the initial IV put in, because I was dehydrated again. The whole not drinking water after midnight the night before really crushes me. I’m typically a very hydrated person, and it is always easy for nurses to get to my veins. Both times now that I’ve gone in for surgery, however, we’ve had a fucking time trying to get the IV in. Anyways, we got it done. The OR nurse was really the sweetest person, and she did a great job of getting me comfortable, and explaining how everything would go down. Once she left, the embryologist came in to talk about what happens with my eggs after surgery. They would be in the operating room, place the eggs into tubes, take them to the lab, and fertilize them with Shawn’s sperm that same day. Someone would be in touch with me the next day to let me know how many were mature, and how many fertilized. Then the anesthetist came in, gave me some of the good drugs and had me feeling RIGHT, then we were on our way to the operating table. I got in there, saw the doctor come in and then I was out like a light. Next thing I know, I’m waking up and chatting with the nurse across from me. She told me she was impressed by my heart rate (it was 45bpm) and I must be a runner. I said thank you, I haven’t run in about a year. Lol. I took it as a real sign last summer when I got injured AGAIN from running on a regular basis, that I’m just not meant to be a runner. Plus, my doctor told me to cut out long distance running while we were going through treatment. I DIGRESS. Moral of the story is: I’m still fit-ish, so WINNING. After a little bit of time, the doctor came in to let me know they got TWENTY-TWO eggs. She said this is great, because they normally only get between 10-15, so I was ecstatic.
Dad was there to pick me up after surgery and drive me back to my Mom’s. I felt fine really. A bit tired, but zero pain aside from maybe a little dull cramping. In hindsight, I think it was the drugs making me feel fine, but whatever. I was feeling good. I got home, plopped my butt on the couch, and relaxed for the day. I did manage to get up later that afternoon, put makeup on, and record a vlog talking about how good I felt and how excited I was that we had gotten 22 eggs, so that goes to show how much the drugs were masking what I was about to go through.
The next day I woke up feel like I got hit by a train. My abdomen felt like it had a brick inside it, and I had these constipation pains going on…does that make sense? Y’all know what I’m getting at? Like you have gas trapped up in there that won’t come out. Freaking miserable. Eating that day was awful. I would eat the smallest thing and feel like my stomach had expanded to triple its size. I stepped on the scale and was up 10 pounds from the previous week. I was puffy, and bloated, and feeling like absolute trash. I know that all of that was fluid from the drugs and the surgery, but it is NOT a good feeling in the least. I also read that even though they have taken the eggs out of your ovaries, they are still filled with fluid, so they remain quite enlarged for up to a week post-surgery. COOL! The nurse called to check in on me, and I let her know how I was feeling. Her advice was to eat lots of salty foods and drink tons of electrolyte based fluids over the next couple of days to help flush out the fluid. I did that, and I moved. I had to force myself to go on a walk that day, feeling like I did, but it was worth it. The movement made me feel so much better. Over the next couple of days, I eased back into exercise, even adding back in some light weight training, until I got back to my pre-stim routine a couple of weeks later. Three days after surgery, I was back to my pre-egg retrieval weight. That fluid retention is just the worst. Once you get past that, things get better.
Later that day following surgery, I got a call from the embryologist with an update. Of the twenty-two eggs they had harvested, only twelve had been mature enough to fertilize. However, all twelve of those fertilized, and were currently growing in the lab. It was kind of a mix of emotions with this news. I expected less of a drop off from the eggs that were mature, so that sucked, but on the other hand, I was pumped that they all fertilized, and twelve was a still a good number! I felt pretty good about that, and wasn’t too worried, despite being a tad disappointed in the drop-off. They told me I would receive an update in a week with how many embryos had matured to the blastocyst phase (these are the ones that grow enough in the lab to have a good chance of implanting). Since we had decided to do PGS (Pre-implantation genetic screening) testing on our embryos, the matured embryos would then be biopsied and frozen while we waited on the results to come back from that. That testing would tell us whether or not our embryos were genetically normal, and therefore have the best chance for implanting. The embryos themselves would never leave the lab. They do the biopsy, and that sample is sent off to Denver for the testing. It takes about two weeks to get the results back. So we wait again.
In the meantime, I would have to wait for my period to start again, and then we would start the protocol for the transfer phase. The stim phase had been relatively fast paced. I had been to several appointments, I was having regular acupuncture, I had been administering injections on a nightly basis, there was a lot going on. The worst part about the transfer phase, for me, was that it took for FUCKING ever! Maybe that's not everyone's experience, but it was absolutely mine. Again, right when you feel like everything is going right, and you are on track with your timeline, here comes something to fuck it right on up. Tune in tomorrow, friends.