IVF 8: Egg retrieval

We woke up at an absurd hour to get in at the time they told us: 6:00 AM. We waited nearly an hour in the waiting room before they took me back. I'd like to think that there was a reason for asking us to get there so early, like maybe they can't set up the OR until the patient arrives or something.

Because we arrived so early they wanted my husband to produce at the lab instead of at home. That was one of a few differences in the the new clinic vs the old clinic. The other difference was that we were the only retrieval scheduled for the day. They don't batch their patients like the last clinic so it's based on people's natural cycles - when you're ready, you're ready.

At my scheduled time they wheeled my bed toward the OR. At the doorway they had me walk over to the bed and started setting me up. They put on an oxygen mask and I was out within three breaths. I came out of anesthesia back in the prep room about 40 min later (they let me wear my watch). The pain was not that bad and I wondered how much pain killers they gave me.

Shortly after the nurse came in to tell me how many eggs they got and I realized why I'm not as bloated. They got 13 eggs. In the past they've gotten nearly 30. To say I was disappointed is an understatement. I couldn't stop sobbing. So much so that they went to get the doctor to come explain things to me. I wasn't confused, just so sad. I felt like there's so much attrition to our numbers that starting out with thirteen was basically telling me our cycle is doomed.

They tried to make me feel better telling me that I was on a low dosage to get quality over quantity, and that the embryologist had already looked at the eggs and determined that they were "great," whatever that means. I tried to reel in the tears -- at least when I cry at home no one bothers me. I didn't want them to waste time trying to make me feel better, nothing they said was going to help. It wasn't just the disappointment of the fewer number of eggs; it was the whole summer and everything we've gone through, plus all the hormones just making me feel like a complete mess.

I managed to hold back my tears to get recovery instructions, get dressed, and be discharged. When we got home I spent some energy alternating between crying fits and yelling at my husband. After eating something I passed out for like 4 hours and woke up a different person. I'm a lot calmer. Logic seems to make sense again. I know a lot of people would be thrilled with thirteen eggs; I shouldn't let our past failures bring me down before anything even happens. At this point it's too soon to know and it really can go either way.

Other than my parents no one has checked in. I've mentioned that we're in the middle of a cycle to friends and other family members, and a lot knew that today is surgery day. Nearly everyone I know is traveling or at the beach or on vacation, getting a few last minutes of summer before school starts. It feels like everyone is kinda sick of hearing about ivf that maybe it's easier to ignore and forget about it.

Pain is at a 3 out of ten. So far I haven't taken any meds - I have ibuprofen and some of the good prescription stuff but just don't feel like I need it yet. I have eaten a ton of junk food though. No regrets.

IVF 7: Egg Retrieval

For the seventh time in my life, I went through an egg retrieval. I've been there so often that the OR staff already knows me. The anesthesiologist already knew my tricky veins. It was uneventful for the most part. The azithro wreaked havoc on my system as expected. My weight and vitals were fine. It felt like they were running late (waited in the waiting room 40 min, then waited for the IV to get started almost 30 min) but they ended up taking us back early and I was home sooner than expected. We made a trip to the store on the way home to pick up doughnuts and latkes for Shabbat.

They got 21 eggs. I tried really hard not to be disappointed with that number. I was expecting high-20s results, especially since my E2 was at 2988 on day 14. I totally thought I'd get 29-30. Part of this game is managing expectations and I let mine run away. I know disappointment isn't the right response; not at this stage anyway.

While I can hope they're all mature and all fertilize, I know that's unrealistic. So now the waiting game begins to see how many make it to blast.

I was worried about retrieval and going under so I'm glad the cycle on my end is over and I can work on recovery and putting this behind me, dare I hope maybe even for the last time.

Shabbat shalom and Happy Chanukah!

IVF 6: Egg Retrieval

TL;DR version: 28 eggs. Stories in chronological order from Friday to Sunday.

There was a situation on Friday where there was stress for a bit because my follicles were large and there was a chance I'd need to trigger with Lupron, but they needed to see the blood levels before confirming. A Lupron trigger meant not only did I need to run to the pharmacy before they closed on Friday, but I'd also have to arrange for a ride on Shabbat to get bloodwork to see if it absorbed right. I waited on pins and needles all day and emailed my nurse around 1pm. She replied saying there was a machine issue and the bloods needed to be sent to another location (over an hour away) for processing so they won't get info until after 3pm. I got news around 4 pm that trigger will be with HCG so no need to run to the pharmacy and no need to come in on Saturday for bloodwork. Whew.

Trigger went fine on Friday night. The next step was Saturday meds. The antibiotic they usually prescribe is azithromycin which is one dose night before retrieval to help prevent infection. In the past, I've had severe GI issues with it (at first I called it the nervous-shits but then we discovered it was actually from the meds). So this time, I thought I was being clever by asking for a different antibiotic. Enter doxycycline. It's twice a day for five days. Supposedly a more mild medication and less intense on the GI tract. It had been a rough several weeks with the diet and shots - I was already nauseous. But as soon as I took the doxy the nausea reached a whole new level. On Saturday, I took the first dose of doxy in the morning and felt off the entire day. I threw up my coffee. I couldn't even keep water down. My appetite was non-existent but I knew I needed to get something in my system. I tried eating some dry crispix and kept it down for about 20 min but it came back up. Toward evening I tried having an apple and it stayed. I thought maybe the worst had past because I hadn't connected the dots with the doxy. Then I took the evening dose of doxy and it was an immediate reaction. I was again nauseous and so miserable. I thought maybe having some tea and crackers might help. I was willing to try anything and I knew I'd be skipping breakfast the next day. It was Saturday night and I didn't want to take another doxy on an empty stomach in the morning right before retrieval. I called the after-hours line for help. I told the nurse who called back that I have the azithro and that I just can't tolerate the doxy. I didn't want to overmedicate or have a weird combo reaction. She advised taking the azithro and if it comes back up, it comes back. She said they can give me anti-nausea meds in the IV in the morning.

So instead of fighting the nausea, I went to get rid of the night dose of doxy which I knew was going to bother me until it came up, and I didn't want to throw up the azithro. The apple and crackers came back up and, since there was nothing left, I was left dry-heaving on the toilet.  I felt a tiny bit better almost immediately. I was worried about taking the azithro on an empty stomach and I mean completely empty. My husband brought me some dry crispix and I ate a handful. It stayed down for 10 minutes so I took the azithro and hoped for the best.

I woke up several times in the night with my stomach churning in hunger. I was uncomfortable because of the azithro wreaking havoc on my system and I was still nauseous. I got dizzy in the shower and started dry-heaving again. Nothing came out. It took effort to gather myself long enough to take a few deep breaths and pull myself together. By the time I got to the retrieval I was ready for drugs. Pain killers, anti-nausea, whatever they were offering I was accepting. This is from someone who reconsiders Tylenol for a headache. The meds were heavenly. I didn't even care that the IV was bothering me. It was such a relief not to be nauseous.

Retrieval was uneventful and surprisingly smooth. Maybe I'm just used to the drill by now. There was no issue with my weight. I'd lost 6 lbs since baseline. My diet had a lot to do with it but it was also aided along by the nausea. I'm sure I gained some weight from the bloating so it may even be more. I was ready to do the retrieval without anesthesia - there was no way I was canceling the cycle for that but I'm very glad it didn't come down to that! Tomorrow we find out how many eggs were mature and fertilized.

Overall the cycle passed pretty quickly. I hope the wait to results passes quickly too.

Recovery

Tiramisu

The first time I had an egg retrieval, my family put together a care package with fun socks, nail polish and snacks. It was totally unnecessary but so thoughtful. They made a fuss over me and I appreciated it.

By cycle 5, it's already old news. While I wasn't expecting visitors or a fuss, I was feeling a little sorry for myself that everyone is out enjoying the beautiful weather doing fun family things and I was stuck at home yet again due to this never-ending cycle of treatment. While I was grateful I didn't have to take off any work for it this time, I was also feeling miffed that I had to waste my vacation feeling crappy because of the retrieval. It also wasn't until the late afternoon that anyone checked in via text. I get that not everyone was off work yesterday and obviously I'm not the only thing on their mind, but I was feeling a little forgotten.

Which is why when an amazing angel dropped off flowers and a tiramisu, it completely blew my mind. My sister with the premie baby, who clearly has her plate full and other things to do, took the time to shop for ingredients, make the tiramisu, and deliver it so that I could have a treat. It took away all the feeling-sorrys and forgotten feelings.

My husband has also been wonderful during this recovery time. In general being my go-to guy for things I need, running my heating pad to and from the microwave, and letting me take control of the remote for the most part. On Sunday when we got home from the operating room, he got me my prescription meds, some lunch, and a card, which wasn't just hilarious but also so sweet and had such a thoughtful message in it.

 

IVF 5: Embryo update

Of the 15 eggs retrieved yesterday, 11 were mature, and 7 fertilized.

This ties for lowest amount to fertilize in cycle 2. In that cycle we started out with 7 fertilized eggs after retrieving 12, and only 1 survived to biopsy (which turned out to be non-transferrable after PGD testing). Like I said in an earlier post, I know this is a cycle in a bubble and previous results have no impact at all on what happens now. We're working on staying positive - it is what it is.

Recovery is going well. I'm allowed pain killers every 4-6 hours and was careful about taking them every 5 hours to control the pain throughout the day yesterday. I drank a LOT to the point that I barely ate because there was no room. I was reminded how much it hurts to pee after a retrieval but thankfully that's getting better too the more I drink. I was up at 2:00 AM to pee and stayed up for about 3.5 hours just unable to fall back asleep. I took my pain killer and wasted time online. I stayed away from fertility stuff - I focused on window shopping and browsing Amazon.

I fell asleep again around 6 and slept until 8. I could take my next dose at 8:30 but figured I'll hold off until I need it. So now I have Tylenol and the prescription pain meds on standby for later as needed. So far so good. I remember from previous cycles that I tend to feel better in the morning, over do it, and then crash in the afternoon so I'm trying to rest. I couldn't resist doing the dishes and a load of laundry but other than that I'm hanging out in bed with my heat pad and endless fluids: water, seltzer, ginger ale, gatorade, and the splurge on a cup of coffee this morning.


I called IviGen to update my payment info so that when they get a shipment to biopsy later this week they will be able to process it without delay. I have to also contact my nurse to schedule the FET from the last embryo from our previous cycle and get the financial counselor to start the process with insurance.

I need to remember not to take any of the embryos for granted. As much as I'm being pulled to a disappointed mindset, I have to remember to take it one day at a time and continue to hope for the best. Right now we have 7 embryos growing. To hope they all make it to biopsy day may be unrealistic and we understand that. Even so, we are hoping for the best possible outcome, whatever that may be.

IVF 5: Egg retrieval

I decided to do the regular antibiotic (Zithro) instead of the 5-day version. It did cause a little bit of upset stomach but overall I'm glad I had that choice because I didn't want to have to remember to take anything for several days. 

Things went smoothly this morning. Taking Uber was a great idea - there was no issues with traffic or parking. Very glad we didn't need to rely on anyone to give us a ride. 

It was a bit of a controlled chaos when we got there. For some reason there were FETs happening this morning. Usually my clinic has egg retrievals in the morning and transfers in the afternoon, yet there were several couples doing transfers checking in at the same time. Someone explained to us that there were some transfers from yesterday that got delayed and they needed to happen before the retrievals.I didn't quite get the reason why. They forgot to check my husband's ID when he dropped off his contribution and he had to remind them. They took me back about 20 min later than my original check in time. 

We got called back to our cubicle room, separated by curtains from the other cubicles The nurse started taking my vitals, but I asked to use the bathroom first. In the few minutes while I was away the original nurse got called to a transfer and another nurse had taken over. It was fine, but they missed a few things (checking my ID and forgetting my temp). Throughout this whole thing none of it bothered me because they gave me a bracelet with info and kept double checking it with any form or whatever that I needed to sign so I wasn't concerned. Eventually I asked my nurse if they need any of that stuff and she took care of it. I wasn't trying to get anyone in trouble but I didn't want any of this to come back to bite me in the butt later on. The original nurse came back and apologized - she's like I know you guys but I still should've checked. I was so not mad and was totally fine with it. It was cute she felt the need to apologize. I got the IV put in easily and then it was a waiting game. My husband and I kept each other entertained. He had the suggestion to go around to the curtain cubicles and wish everyone good luck which we both found hilarious. My suggestion was to yell out "Room Service" to get the nurse's attention and then ask about the in flight movie options. I'm glad he was with me, and not only because he was my Designated Adult taking me home.

They were running a bit behind schedule and took the person in cubicle 2 at 9:25. I was up next but my appointment was for 9:30 and I was worried about the time -- they make it very clear that trigger needs to be exactly 36 hours before retrieval. So I asked and they said it's fine because they build in a cushion of time. Whether or not that's true, it was the reality of what was happening. I did a final bladder check and got ready to go. They called me back at 9:45. I was back in my cubicle at 10:11. As soon as I was alert I started to cry. I remember this from last time too. I wasn't so much in pain but I was upset. At what? I'm not sure. I assumed it was the pain and asked for medication and an extra heat pad. I wasn't sobbing, my eyes just kept filling up with tears. Maybe I was just feeling sorry for myself that we have to go through this again. 

The doc came in to give us the number: 15 eggs. We thanked him and when he left I started a fresh batch of tears. Last time we got 27 eggs. I know that it depends on how many fertilize/grow, etc., but I also know that the more you start off with the better the chances are that there will be some good ones at the end of the very long road with attrition at every step. 

The lady in room 2 on our right got 9 eggs. Lady in room 4 on our left got two eggs, and an additional surprise diagnosis of endometriosis (they originally though it was another follicle and poked it but ended up not being what they thought). We weren't trying to be nosy but it was impossible not to hear the conversation through the mesh curtains. I know we can't compare our journey to anyone else, but it kind of made me realize I can't take my 15 for granted. I wish both those ladies so much luck and success on their journey. 

I didn't sleep well because I was so worried about today. I was worried there would be a complication or for some reason the surgery would get canceled. Anything from my husband not being able to produce a sample or it not being good enough, to getting into an accident on the way to the clinic and missing our appointment, to my blood pressure or weight being astronomical and them canceling the cycle, or something crazy happening during the surgery and having to get further intervention.... I guess now that I type it all out I believe my tears were just relief that it was over. 

I had some ginger ale and water in recovery. My blood pressure was awesome - I'd like to think the exercise I've been doing helped that. I walked in a straight line on the first try and was released to go. Again Uber was awesome and arrived within minutes. When we got home my husband got me settled in bed with drinks and heating pad and went to go pick up my pain meds. He came home with a really funny, thoughtful, sweet card that made me tear up again for different reasons this time.

Regardless of what happens with today's embryos we sill have one in the freezer from the last retrieval. I haven't given up on them, of course not - by any stretch of the imagination, and I'm hoping we'll have some good news throughout the week. But regardless, we're planning to schedule for a transfer in April. It really helps puts things in perspective. 

The weather today is absolutely gorgeous. It's keeping my spirits up and putting my in a great mood. I'm also secretly happy I don't feel any pressure to go out and do something because I'm recovering and it hurts to move around. 

That's my rambling, drug-induced, unedited update. I haven't even reread it so if there are some inconsistencies or  random phrases off the back of the cheerios box inserted throughout, blame the meds #sorrynotsorry

IVF 5: Day 9

Monitoring went surprisingly well this morning. There's usually a long wait time at weekend appointments since this is the clinic for the other branches that are closed over the weekend. I was prepared to hunker down for the long haul, but this morning they had adequate staff for the overflow of patients and things were moving smoothly.

My 7:45 AM appointment got called back for blood after a few minutes wait - only one stick. She was weekend staff and didn't know me but followed directions to the one vein and got it working immediately. I was back in the waiting room at 7:55 AM to wait for the ultrasound. I got called back and at 8:10 AM the ultrasound tech came in, followed a few min by the doctor in charge. There was a little hiccup when the inexperienced tech pushed a little too hard, and then again when switching from right to left ovary. I jumped at the pain and she apologized, but overall it was fine.

They measured the lining at 10.3 which is great but we're not doing a transfer so a little pointless. They counted the largest follicle at 13.5 so we're moving along, with 14 follicles counted. I've already learned that just because they retrieve a lot of eggs doesn't mean they're all going to become embryos. In the past I've had 11-12 mature eggs regardless of how many eggs were retrieved (max was 27 in cycle 4).

More importantly, I've been trying to figure out when trigger will be in case we have another Saturday retrieval. Based on info from the past cycles, retrieval will be either on day 13 or day 14 (I've had two of each), which puts retrieval at Saturday or Sunday.

I have enough Menopur to last through Monday. Even though I have refills at Freedom, I asked my nurse to call in the prescription at the local specialty pharmacy. Freedom is annoying to deal with and you can't send back returns. Blood work results came in this afternoon and I need to start the third shot tonight, cetrotide. That one burns but at least that means progress.

My husband and I had a conversation about goals. Apparently, there's a statistic that if you write down your goals, there's an 80% chance that you'll accomplish them. Only about 2% of people actually write down their goals. I don't know the source for those stats, they were presented at a meeting last week and sounded true. So we decided to write down our goals for the week. He has his and I have mine. Mine is to research itinerary and fun things to do in Boston for a possible trip in March. It's no Israel or Miami, but hopefully it will still be fun. If nothing else it will be a nice change of scenery and a new place to explore.

IVF 4: Egg retrieval

I'm so relieved that's behind us. To sum up what I assume is going to be a really long post, IVF 4's egg retrieval resulted in 27 eggs - wow! It's more than double the amount of eggs we had last cycle (12 eggs).

We both went in on Friday morning to sign all the paperwork. Something I forgot to mention in the previous post as part of the "So much news!" was that I told my supervisor about fertility treatment - whaaaaat! I know. Big news for me. I was emotional because I realized it was the end of my compartmentalization between work and home. I had to do it though, because if retrieval would have been on Friday I would have missed a big day at work. She could not have been more lovely about it. If it had to happen, I'm glad it was with this supervisor. So back to Friday, we both went in to the clinic to sign all the paperwork we didn't want to sign on Saturday. I needed to be back at work by 9:30 AM but the doc needed to go over a specific page with us and she was tied up until 9:00 AM. I made it, but it was a close call.

We got to the hotel on Friday evening around 6:30 PM. Because of Shabbat, I reserved two nights at the hotel and figured we'll just stay the second night, may as well. Since the door was activated by an electronic key, we were basically holed up in the room since if we left we'd either need to leave one person behind or have hotel staff help by opening the door for us. It sounds ridiculous when I say it out loud, but I don't make the rules!

I brought light meals and we had a lovely dinner. I took the antibiotic they had prescribed right around dinner time because I was told it would mess with my stomach less if I took it with food. It was better than last time, but I still had an unhappy tummy. It had been a long day and I was out by 9:30 PM. We got up early on Saturday morning and got ready to walk next door to the clinic. We got there by 9:15 AM, right at our appointment time. Our nurses were great and there were no issues getting vitals or the IV in. Since everything was already signed and done the day before, there was nothing to do but wait for my turn.

We waited in those hospital cubicles, separated by curtains. There were two other people having treatment, with the times staggered depending on when they triggered. We could, of course, hear everything. One patient got the most awful news. She was told that they were unable to get any of the follicles for some reason. The doctor was reassuring her that it wasn't her fault and there was nothing she could have done differently, but that didn't help the sobs coming from this poor woman. She had to go through two weeks of stims, and will have to go through the full recovery of the retrieval but without anything to show for it. I felt so, so bad for her.

When it was my turn, I was taken to the Operating Room and they took my glasses away. I leaned back and was told to take a deep breath... next thing I know I was back in recovery and it was 30 min later. The nurses took great care of me and my husband was there keeping me comfortable and entertained. My eyelids felt like they weighed 1000 lbs each, even though I felt clear headed. The doc came in to tell me the news that they were able to retrieve 27 eggs. It's such an impressive number, but I can't help buy worry about how many are actually mature? How many will fertilize? How many will make it to blast? It's obviously better to start with more, but I know that in the end it really doesn't matter how many you start with but rather what you end up with.

Our hotel stay left much to be desired. I mentioned some of this to the hotel staff when we checked out but not all of it because I didn't want to seem like I was just complaining to get something back (discount, points, etc.) - these were all legit complaints. So here is the full list: For starters, there was noise the entire time. Not just regular noise like plumbing and people walking in the hallway. There were doors slamming all night long. People yelling in the hallways at all hours. We could hear the TV playing next door and the guy peeing upstairs. During the day time, after the procedure, I was trying to nap in the afternoon while housekeeping crew was on our floor. They were shouting at each other for 45 minutes to the point where I got out of bed and asked them very politely if they could keep it down, to which the response was that she spoke no English. Beside all that, there was a loose metal sheet on the pavement right outside our window and traffic kept running over it at all hours. In addition, we had a small fridge in our room that kept ticking and shuttering loudly every time it cycled on. I am sensitive to noise in general, but this was completely over the top.

Beside for the noise, the room felt shabby. The mattresses weren't young. They were soft and were ripped at the seams. The door to the bathroom was warped and swollen to the point that it didn't shut all the way. It had patches of flaked plaster on it. There was an updated TV in the room, but no one had bothered to move the painting behind the TV when it was upgraded to a larger side, so it just looked neglected and out of place. There was also a stale smell in the air without the option to open a window.

The things that bothered me most was the two things I asked for when checking in that was totally within their control. When we checked in and got to our room, I saw there was only one chair near the desk. We were planning to eat our meals in the room, so I called the front desk and requested a second chair - any chair would do, I said even a basic folding chair was fine. Not only did they not bring us a chair at all, but they didn't even bother to let us know that one wasn't coming. They basically completely ignored this request. It wasn't like I was asking for the moon. They have a conference hall with folding chairs on the floor right beneath us, they could have found a spare chair.

The second request was for a specific wake up call. We needed to be at the clinic by 9:15 AM. I knew I would wake up in time but I couldn't just leave it to chance and miss the appointment so I asked for a wake up call at 8:00 AM for them to call, let it ring twice, and hang up. They asked if I want a second courtesy call (snoozer?) and I said specifically that I do not want any calls other than the original one because I will not be answering the phone. Of course I'm up by 6:00 AM this morning and there was no reason for the call at all. As expected the wake up call comes at 8:00 AM and rings for 5 times. A few too many, I think, but ok. Five minutes later they call again. At 8:10 AM they call a third time and I'm starting to get really annoyed. We're not answering the phone because it's shabbat, and either this is a persistent employee or an automated system. When it rings again at 8:15 AM and then again at 8:18 AM I've had enough and make my way down the stairs to the front desk. I tell the lady there that we asked for only one ring but that the phone hasn't stopped since 8:00 AM. She asked if we tried unplugging the phone. That's not the point, lady!!! Tell your people to stop calling! I go back to the room and it's finally quiet..... until 8:45 AM at which point the phone rings again. The message button lights up and the ringing stops. After shabbat I checked our messages and it was from a lady in Guest Services saying she doesn't want us to be late to whereever we are.

The mistake was the miscommunication from the person at the front who took the message to give us a wakeup call without letting them know the specific instructions, but there was also an error on the employee's part that she didn't bother checking with anyone before calling 6 times! It's not even like this was a Motel 8 where these things were to be expected. This was a four start Sheraton hotel in a ritzy neighborhood for several hundred dollars a night. It was unacceptable and we decided to check out early. Even though we had the room until tomorrow at noon, we checked out as soon as Shabbat was over and hauled ass out of there. I am not ungrateful that it was there when we needed it. But for the amount of money we spent on the accommodations you'd think they'd put in a little extra effort.

Staying in hotels really makes me appreciate my house more. It's also the reason I prefer to use HomeAway when traveling. The conditions are always so much better than hotels.

So that was our stay. The clinic was great about the whole shabbat thing and really made us as comfortable as possible. We even had a nurse escort us back to our room so we didn't have to worry about electronic doors or eruv. Now we wait to hear about fertilization progress over the next few days. 

IVF 4: Day 14

So much news!

I have been in the clinic nearly every day this week. Everything progressed as expected. On Wednesday a miracle happened and I was in and out of the clinic within 14 minutes. I came in for a 7:45 AM appointment and by 8:00 AM I was already back in my car. That was the first and only time that has ever happened! The prior record was 36 minutes which at the time I thought was thrilling. At the Wednesday appointment they said things look good but that I need one more day, which meant no trigger that night, which meant no Friday retrieval.

This morning I came in and they said things look ready but they need to wait for the bloodwork to confirm. I was told there is "a lot of activity" and just by looking at the follicles they were unsure that I had the right trigger. I learned today that if your estrodial is over 3000 it indicates a chance for over 20 mature follicles and therefore they trigger with Lupron instead of HCG. They said for sure trigger is tonight but they will let me know which trigger to use, depending on bloodwork. I got a prescription for the Lupron and filled it just in case.

I got the call and my E = 2785 so triggering tonight with HCG. Trigger tonight means a Saturday morning retrieval. It had to happen at some point. We knew it was a possibility and are prepared for it. I told my nurse what we can and cannot do on Saturday because of Shabbat. To sum it up, basically anything done to me by someone else (blood pressure, IV, etc.) is fine, but I can't do things to break Shabbat (like stepping on the scale to get my weight, or signing forms). I told her we're not bringing anything other than our IDs. They've done this before and they know how to deal with it, but I'm sure they think we're completely bonkers. Whatever, I can't worry about that. We're going in tomorrow morning before work to get all the paperwork signed ahead of time, and I'll get briefed on the anesthesia protocol so that I can sign it.

I reserved the hotel nearby for two nights. Even though we only need it for 24 hours from Fri night to Sat night, checkout is at noon so I got two nights and we'll have the option on Sat night to either stay or go home depending on how I feel.

I requested a fridge for the room but I'm wondering how much food it can actually hold. When we go in tomorrow to sign the paperwork I'll pop into the hotel and ask some questions. I bet they've had religious people stay with them also so they might have some suggestions.

My cleaning help is coming on Sunday morning at 8:00 AM so that will be a big help. I'll plan to hang out somewhere else so that we're not in the way.

I tried to do as many errands for Pesach prep as I can until now, but at this point it's the last minute stuff that will do me in. I can't buy any of the fruits/veg/dairy until next week. I also can't flip my kitchen until the cleaning help is done. I just hope I bounce back quickly from this one because I have stuff to get done.

Regardless, first seder is in a week from tomorrow night. Ready or not, here it comes!

Tips and Suggestions

Before starting my first IVF, I googled symptoms and things to know. I found blogs, articles, youtube videos, and countless message boards that had a plethora of information. Many, many women have gone through this before and they were all happy to share their experiences so that it may help someone else.

 

Helpful things that were suggested included Gatorade and heat packs for after the egg retrieval; expecting discharge after the trigger shot; staying off Google; not being afraid to ask questions; common symptoms; and much more. 

 

To add to those, here are a few things I now know after going through three IVF cycles and two FETs


IVF tips:

• Write things down during stim stage/monitoring: dosage, time, where injected, bloodwork results if available. This will come in handy in keeping track of injections and appointments. It was also helpful for comparison in future cycles.
• Stim shots aren't so bad.  Stay calm, find a routine, keep track of your meds to reorder as necessary.
• Have the nurse draw circles on your upper-butt for the trigger. Take a mental (or real, if you're into that) picture so that you can refer back to it for PIO shots later on. After a while the person injecting knows the area, but for the first few times when you're nervous and hyper-focused on everything, it helps to have a visual aid.
• Under normal circumstances, bloating after egg retrieval starts to feel better after about 2 - 5 days. Take the day off for egg retrieval and the day after. It's worth the rest.
• Invest in a heating pad for after the egg retrieval. Heat helps relieve some of the discomfort.
• Don't be a hero: take the pain meds if you're uncomfortable after the egg retrieval.
• Don't lie on your right side after egg retrieval for first 36 hrs. After lying on my right side in an earlier cycle, my shoulder hurt for a week. I don't quite get it, I just know it happened and the doc said it's normal. The next time I avoided lying on my right side and it didn't happen.
• Gatorade helps with getting electrolytes and sodium, but some people get stomach issues from it. Once I figured out this was what was giving me issues, I limited Gatorade to less than one 20 oz bottle per day. Instead I substituted lots of homemade chicken soup which was prepped and frozen in advance.
• Drink lots and lots of water, especially the first two days after egg retrieval.  It will make you have to pee a lot, and peeing is so uncomfortable after the retrieval, but do it anyway. It will flush out whatever crap you have in your system and help you feel better sooner. Drink! I aimed for 70 oz the days following retrieval, beside for the Gatorade/soup. It really helps.
• Message boards online can be really helpful, but don't get sucked in.
• Waiting is hard; prepare for it
• Have a strong support system - find a friend or family member for the tough days you need a shoulder.

Tips for FET:

• PIO shots are uncomfortable, but a lot more efficient than the inserts. I've never used the inserts but general consensus says they're messy and icky, so I've opted for the shots both times.
• Warm up the PIO in your hands or bra for a min or two before injecting. This helps make it more viscous and easier to inject.
• Have someone else do your shots if possible. My husband is the most squeamish person when it comes to blood, but he sucked it up and did his part. Since IVF is mainly all about her, this was a good way for him to be involved in a helpful way.
• Rotate the injection spot! My husband gave me the injections and we found a comfortable rhythm in injecting the right side with me lying on my stomach on the couch and taking all the weigh off the side being injected. We would do 3 rights to every 1 left. Pretty soon, the right side started feeling weird and numb - I didn't like it at all! It took 8 weeks after the negative beta to get back to almost full feeling.  So, make sure to rotate.
• Once you inject, massage. Really deep tissue circles. It was uncomfortable for a minute but it prevented those lumps everyone talks about. I noticed the difference on days we got lazy and skipped the massage.
• I didn't ice or heat the spot and injections were fine.  In my mind, icing the area defeated the purpose of warming up the oil. Going in to a cold muscle might make it congeal and leave a bump. I don't know the science behind it, but that was my thought process.
• Technically, you can inject yourself, but they say if you're doing it on your own to do it on your thigh (specifically in your quads). Getting the right angle in your own upper-butt is hard enough, but once you inject you also have to draw out slightly to check for blood and make sure you didn't hit a vein (if there's blood, you have to pull out entirely, change needles, and try again). Unless you're super flexible, that's pretty hard to do, and if you get the angle wrong it hurts more the next day. 
• In addition to the awkward angle, injecting yourself with a big-ass needle is hard!  My husband was out of town one night during our 2ww and I needed to take my shot. I did it in my thigh and not only did it take FOREVER for me to work up my nerves to stick myself with that enormous needle, but it huuuuuuurt so much. I felt it go in the muscle and nearly gagged. It was a numbing/pain that became soreness in the next hour and settled in for a two days.
• Del Estrogen shots weren't so bad - I did those myself in the thigh. Luckily it was only every third day so I'd throw a tiny dance party right after, knowing it's the longest possible time until I needed to do that again.
•  It's so hard to wait. Be prepared for it: fill up your queue with good TV, set up outings with friends, find an engrossing hobby, do your best to keep your mind off of it.
• For the times that distraction doesn't work, try to manage your expectations. I was never good at this.
• As hard as it is to wait, it's even harder to avoid taking home pregnancy tests. I've never been able to avoid it, but I want to say that next time I won't test (yeah, right).  It was so hard to keep doing the shots when I didn't see any results in the pregnancy tests.  I had a meltdown after FET #2, sobbing that it didn't work because there was nothing on the pregnancy tests. It was still a week before the beta and there was no guarantee that it did or didn't work, but I worked myself up and I'm sure the stress didn't help anything. 
• Stay positive and be nice to yourself!

IVF #3: Embryo update

Of the twelve eggs retrieved yesterday, eleven were mature. Seven were fertilized and survived to today.  We want to stay positive but can't help feeling disappointed and worried about the low number.


IVF #1 we had 20 eggs > 9 fertilized > 4 survived to biopsy and PGD testing > 2 healthy embryos
(one transferred at FET #1, negative beta; the other transferred at FET #2, also negative beta)


IVF #2 we got 23 eggs > 13 fertilized > 6 survived to biopsy > 0 healthy to transfer


Logically, I know that it doesn't matter how many eggs are retrieved, rather what matters is how many come back from PGD testing as having tested healthy.


As for recovery, I'm doing ok from the egg retrieval.  I felt sore as expected but not nearly as bad as previous times.  Is it possible because I was expecting what was to come? Maybe because they retrieved less eggs so less poking down there? Maybe because we had Chinese food for dinner and all that sodium helped?  Maybe the massage the night before?  Maybe because I'm used to drinking so much water that it helped to flush things out? Who knows. 


Whatever the reason, I'm happy recovery seems to be going smoothly.  I'm not a fan of drug side effects so I try to avoid them, but in previous cycles I used one or two of the prescribed pain meds and then followed up with a day of round the clock Tylenol. This time I haven't even needed the Tylenol.


At this point we're discussing whether it might be better to "batch" the embryos and do another fresh cycle before sending them off for testing. To clarify, I want to discuss it and my husband prefers to wait and see what happens. I like discussing the what if's and he likes to deal with facts, so we agreed to table it until we hear back on day 5.

Egg Retrieval

There were a few bumps along the way this morning (sample collection from him, transportation to clinic, etc.) but luckily nothing too bad. We arrived on time, got checked in, signed paperwork, and everything was going ok.  Moment of truth when they checked my blood pressure and it was totally normal. I get high readings in doctors offices so it always skews the numbers, but I'd like to believe yesterday's massage may have helped relax me.


The anesthesiologist tried to be a hero and attempted a different vein even after I told him there's only one that cooperates.  Of course the first place he tried didn't work. He went back to The Vein they've been bleeding dry for the past two weeks and it worked on the first try. He was good natured and knew what he was doing. At one point my doctor came in while they were getting the IV set up and they were joking with us and each other - my cube became a party.


I love that the clinic is so efficient. They got me set up and ready to go. Seconds later, or what felt like it, I was back in recovery. As soon as I woke up I felt sharp stabbing pain I hadn't had the first two times. I couldn't help it and started tearing up. My nurse gave me pain meds and more heating pads which helped make it better almost immediately.


They retrieved 12 eggs. More tears.
Just 12?
Last time it was 23.
I knew the bloodwork was low.
Would it have been different if we waited a day? Doc said no. 


My husband made me feel better by saying that it only takes one, which is true. He also reminded me that last time we may have had 23 eggs retrieved but none to transfer, so what does that number matter anyway. Truth.


What's meant to be will be.  If I have to do it again, so be it.