We administered the "trigger" shot (Ovidrel - which helps finalize the maturation of the eggs and will make you ovulate 35-36 hours later) at exactly 7:45:00pm on Sunday evening, January 24, which was timed precisely with my Tuesday morning procedure time slot. The goal is for the RE to extract all the eggs directly from the ovaries just before they would be released by the body.
Sunday night, I had a dream that the trigger shot worked too fast and that all my follicles fell out as I arrived at work Monday morning. They were like little egg-shaped marbles that rolled in all directions across the hard office floor. I was panicked and started chasing them every which way, knowing my RE would be very disappointed if I couldn't find them all after we worked so hard to grow them with all the shots. I woke up feeling silly, but later found out this is the "showed up at school naked" dream of IVF and is a pretty common dream theme amongst those triggering. LOL!
Tuesday, January 26, we arrived at Piney Point Surgical Center around 6am and checked in for my 7:15:00am procedure. It was early, and we were nervous, but excited. The nurse took me to the prep room to change and then brought Michael back to sit with me until the RE could some brief us before the procedure. The IV didn't quite go smoothly...the clip-on tourniquet got stuck on my forearm and ultimately had to be cut off, but not after the IV needle had leaked blood down my hand and fingers. Old me would have panicked, but new needle-fearless me handled it pretty well. The nurse apologized and cleaned me up, and then we were waiting again.
The RE came and walked us through it all. They would bring me into the procedure room, put me under anesthesia, the RE would aspirate the ovaries through my vaginal wall, and suck all the eggs he can from each follicle on each ovary. The embryologist would be in the room, counting what is retrieved, and then shuttling them off to the lab room next door to evaluate how many are mature enough to fertilize. Michael would be on the spot to give his donation while I was under. The lab would take his sperm from there, wash it, and pick the best, healthiest ones to insert into each mature egg. All of this would happen that exact day. We would know how many eggs were retrieved before we went home!
They sent Michael back to the waiting room with his paper bag filled with documentation and a plastic cup, and they guided me to the procedure room. They untied the back of my robe, and I climbed onto the table. My arms spread and secured outward as they converted the table into the stirrups setup, just like the D&C, except I wasn't scared or sad this time. I chatted with the anesthesiologist as they started the medicine that would put me to sleep. The embryologist came in and introduced himself, and I asked him to take good care of my few little eggs. Then my RE was there, and he asked if I was ready, and I was. I don't even remember falling asleep, but I'm pretty sure it was soon after that.
I woke up quickly after they brought me into recovery, and I slowly got dressed while the nurse went to get Michael. Coming out of anesthesia, I'm a bit slow and dizzy, but this was the 3rd time in as many months, so I was pretty capable of getting dressed solo. The nurse had brought me a bottle of water, and helped me into a wheelchair, where I waited first for Michael, then for the RE. When the RE said we got 7 eggs, I was shocked and excited. I was preparing myself for 4 or less, and we got 7?! How exciting! We had to wait until the next day to find out how many fertilized, but 7 was amazing news. Statistically, ~50% of eggs retrieved end up as frozen day 5 embryos, which meant a potential of ~3.5 embryos from this cycle. 50% of those typically implant and produce a baby.
The thought crossed my mind that this may be it...we may have just created all of our children in one go. The average number of eggs retrieved during IVF is somewhere in the 15 egg range...given my low-ovarian reserve issue, that was way to much to hope for, confirmed by how the cycle had progressed up to now...we just weren't likely to be average from the start. The thought that we might have the chance to do this once and be finished was exciting and gave me lots of hope.
We drove home, and despite my dietary restrictions, which had been challenging during the last 10 days, I requested my usual post-anesthesia treat of a chocolate milk shake and a cheeseburger...a day with some cheating was in order! ...which I paid for later with a stomach ache.
The next 6 days were the slowest ever...like waiting for Christmas. The following morning, I got a call from the lab. 6 of the 7 eggs were mature enough to fertilize, and 5 of those were still healthy and surviving after 24 hours. Wow!! 5!! Now to wait for more information on day 3 (Friday, February 5, my brother's birthday!).
On day 3, all 5 were still growing, but there was some divergence in the pack. On day 3, they hope for the embryos to be at least 6-8 cells, >8 is better. We had:
- 1x 4-cell embryo
- 2x 6-cell embryos
- 1x 8-cell embryo
- 1x 10-cell embryo
And then it was the weekend. Day 5 would be Sunday, and we would find out on Monday how many made it all the way to be 100 + cell embryos, sampled for genetic testing, then frozen. I couldn't help but think we would get 3 or 4. Maybe that little 4-cell would catch up? Could 5 be possible? They said they have seen it happen...
The waiting was very hard. I'm not a very patient person in the base case. Plus, coming down off the hormones meant I felt emotionally shaky, and physically, my entire face had decided to break out. Delightful, right? And to top it off, I would be on a business trip to Phoenix on Monday and we would have to find out when we couldn't be together. At least the numbers were good so far!
Monday morning came and I got the call while I was in my hotel room. The voice on the phone said only one made it to blastocyst stage. One. That's it. Just one. It was the 10-cell embryo from Friday. My heart sunk. All that effort for one lonely blastocyst, after having 5 still growing 2 days before...which meant we had to try again. Progressing to transfer this blastocyst to get pregnant, if successful (50% chance on average), would mean only 1 child. Coming back later for more IVF would likely find me out of eggs entirely.
I asked if the sample was successfully taken for testing on the 1, and the line went silent. The lab's paperwork had an error, she said, clicking through her system. It did not show that the genetic testing box had been checked, though that was clearly written in other parts of my file. She said she needed to check if it was too late, and she would call me back. When she did, she told me that the blastocyst had been frozen, stored, and not tested. We wouldn't be able to find out if this one remaining blastocyst was genetically normal. I hung up the phone and burst into tears, sobbing loudly into the damn hotel pillow...what if this one is really none? I was sick to my stomach. All this work, and all the emotional roller coaster of a process we've put ourselves through for one-maybe-none? I felt like such a failure...6 of my 7 eggs failed and the last one is a big question mark.
Later, I got a call from my RE, and he apologized profusely. It was a paperwork issue which resulted in the blastocyst not getting sampled before freezing. They would make it right. When it came time to do our first transfer, they would defrost the blastocyst, sample it immediately, and send the sample for 24-hr turnaround genetic testing (free of charge) before transferring it into me. With a transfer, there is a lead-up protocol of a couple of weeks of medicines to prep the uterus to be at the exact right stage for blastocyst implantation. Just like if the blastocyst had come down the fallopian tube naturally. If that one blastocyst is abnormal, we wouldn't want to waste the opportunity, and we can defrost another (from our potential round #2, which will be tested and confirmed normal), and transfer it instead.
We talked about round #2. Second rounds, he reminded me, are often more productive than the first. He recommended taking a break to give my ovaries a chance to calm down, but said we could go straight into it if we wanted. I told him a break was in order, especially since I would be travelling for the next couple of weeks. When I was back in town, we would go to see the RE and discuss the strategy for round #2. I hung up the phone, feeling very down, but at least moderately satisfied that there was a solution to the "unknown" blastocyst quality issue.
Michael and I agreed that one is better than none, and for now, we should hold out hope that the one is good and normal. Plus, maybe we would get enough from round #2 that the first one can just be a back-up! It was still a bitter pill, and the thought of starting over again was overwhelming. The rest of my business trip was a blur, however I did get to chat with a close friend, who had recently given birth to IVF twins, and she made a very good point. During a normal cycle, you release 1 egg / month. Those 6 failed eggs...that's 6 months of trying naturally that we just got to skip. Potential miscarriages we were able to avoid. The IVF process allows us to go in, find the best chances for success, and skip straight to them. The ones we lose along the way, we should be happy that we aren't wasting our time (months and months of time!) hoping that they will be successful, when they weren't meant to be. While this thought process helped quite a bit, I couldn't help but hope we could do better in round #2 and find a higher percentage of successful eggs / embryos...
Monday morning came and I got the call while I was in my hotel room. The voice on the phone said only one made it to blastocyst stage. One. That's it. Just one. It was the 10-cell embryo from Friday. My heart sunk. All that effort for one lonely blastocyst, after having 5 still growing 2 days before...which meant we had to try again. Progressing to transfer this blastocyst to get pregnant, if successful (50% chance on average), would mean only 1 child. Coming back later for more IVF would likely find me out of eggs entirely.
I asked if the sample was successfully taken for testing on the 1, and the line went silent. The lab's paperwork had an error, she said, clicking through her system. It did not show that the genetic testing box had been checked, though that was clearly written in other parts of my file. She said she needed to check if it was too late, and she would call me back. When she did, she told me that the blastocyst had been frozen, stored, and not tested. We wouldn't be able to find out if this one remaining blastocyst was genetically normal. I hung up the phone and burst into tears, sobbing loudly into the damn hotel pillow...what if this one is really none? I was sick to my stomach. All this work, and all the emotional roller coaster of a process we've put ourselves through for one-maybe-none? I felt like such a failure...6 of my 7 eggs failed and the last one is a big question mark.
Later, I got a call from my RE, and he apologized profusely. It was a paperwork issue which resulted in the blastocyst not getting sampled before freezing. They would make it right. When it came time to do our first transfer, they would defrost the blastocyst, sample it immediately, and send the sample for 24-hr turnaround genetic testing (free of charge) before transferring it into me. With a transfer, there is a lead-up protocol of a couple of weeks of medicines to prep the uterus to be at the exact right stage for blastocyst implantation. Just like if the blastocyst had come down the fallopian tube naturally. If that one blastocyst is abnormal, we wouldn't want to waste the opportunity, and we can defrost another (from our potential round #2, which will be tested and confirmed normal), and transfer it instead.
We talked about round #2. Second rounds, he reminded me, are often more productive than the first. He recommended taking a break to give my ovaries a chance to calm down, but said we could go straight into it if we wanted. I told him a break was in order, especially since I would be travelling for the next couple of weeks. When I was back in town, we would go to see the RE and discuss the strategy for round #2. I hung up the phone, feeling very down, but at least moderately satisfied that there was a solution to the "unknown" blastocyst quality issue.
Michael and I agreed that one is better than none, and for now, we should hold out hope that the one is good and normal. Plus, maybe we would get enough from round #2 that the first one can just be a back-up! It was still a bitter pill, and the thought of starting over again was overwhelming. The rest of my business trip was a blur, however I did get to chat with a close friend, who had recently given birth to IVF twins, and she made a very good point. During a normal cycle, you release 1 egg / month. Those 6 failed eggs...that's 6 months of trying naturally that we just got to skip. Potential miscarriages we were able to avoid. The IVF process allows us to go in, find the best chances for success, and skip straight to them. The ones we lose along the way, we should be happy that we aren't wasting our time (months and months of time!) hoping that they will be successful, when they weren't meant to be. While this thought process helped quite a bit, I couldn't help but hope we could do better in round #2 and find a higher percentage of successful eggs / embryos...
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