We completed our first IVF cycle (minus the transfer)! For those are interested, here's an update on how it went.
Stims
I was looking forward to the stimming process, with all the sciency needles and vials. And it was fun for awhile, until my follicles (eggs) started growing. Then it started to get old and very uncomfortable. But I responded so well! For our IUI's, I usually had very little response at the first ultrasound. But for my first IVF ultrasound, I already had a great number of follicles growing with an E2 (estrogen level) of 937! And then things just ballooned. Two days later, I had 27 follicles. Then 39. I triggered with 39 follicles and an E2 of 4540.
One of the reasons they pushed the number of follicles was due to my left ovary, which they were concerned they might not be able to reach for retrieval. For most of the stimming process, it was hidden underneath my uterus. So they wanted to make sure my right had a good amount of mature follicles, and it did. Each mature follicle is about the size of a grape. I had 25 in my right, 14 in my left. So each ovary was like a large bunch of grapes, and I was seriously bloated to the size of a very pregnant woman. Don't believe me? Here you go.
I realized that estrogen is what causes the nausea in early pregnancy. By Day 8 of stims, I felt as gross and nauseous as I had felt during the first trimester with Abbie. I worked in the office that day and was so exhausted, bloated and in pain (I swear I could feel my ovaries stretching out). Thankfully, my dear friend Susan, who just went through a (succesful!) IVF cycle herself brought us dinner that night. It was just one of many of the kind and supportive things she did to care for me during this cycle; I'm so thankful for her!
I triggered on Sunday night. They did a lupron trigger with no hcg, to ward away hyperstimulation of my ovaries. It seemed to work well, because though the first few days post retrieval were verrrrry painful (but oh thank you, Vicodin!), I'm feeling almost back to normal now. Still bloated, but much better than before.
Retrieval
We got there bright and early on Tuesday morning at 7 am. I was a ball of nerves. What if the lupron trigger didn't work and they couldn't get any of the eggs? What if all my eggs were bad? What if they couldn't get the left ovary? The nurse was so kind and cheery, and she led us to the operating area, an area I've never been in all my years at Midwest Fertility! I dressed in the gown and they put in my IV. Thankfully Tom was able to be with me during this, since he is always able to calm me and make me laugh when I am anxious.
Then they took me back and put me to sleep. Unfortunately, the anesthesia didn't seem to work as well as it should have. I supposedly frantically scratched my nose during the whole thing and then started kicking my legs! When I woke up, I told the nurse I had dreamed that they kept telling me to stop moving, and she told me that was not a dream. The doctor said while he was getting the eggs from my left ovary (which was accessible!), he had to wait for me to settle down after each one. He laughed when I told him that Tom often tells me to "sleep like a human" in the middle of the night. Thankfully they were able to move past it and get 29 eggs!
Fertilization/Embryo update
The next day, the lab called at 9 am to tell me that of the 29 eggs, 25 were mature and 14 fertilized with ICSI. That number honestly worried me. I knew that from 29, the number would dwindled down significantly, but I expected more like 20 to fertilize. The embryologist told us that about 30% of our embryos would make it to day 5, so I wanted to start with as many as possible. But my hope was that, since fertilization is our main fertility problem, a healthy number of those that fertilized would make good embryos. There's so much you learn during an IVF cycle that you don't learn during IUI's. And though my tests have always been good, I've felt sure that I contributed to our fertility problem as well over the years. So the wait from Wednesday to Sunday was not the easiest, to say the least. I really wanted enough embryos to have a peace of mind about our future family. We did this with kid #3 in mind as well as kid #2. And of course, just as I would be okay with just having Abbie because she is perfection, I would be okay with only two kids. But I want my options. Infertility doesn't give you many options, and I was so hoping IVF would give us some! That feels greedy, but it is what it is.
Thankfully, the lab called yesterday to let me know that they biopsied and froze 5 perfect embryos! They were all of equal quality, given a grade of 6BB. I asked what was the highest, and she said 6AA but they rarely give that out, so 6BB is pretty much the highest they give. They were still watching 6 more embryos, and I heard today that one of those was also biopsied and frozen, also 6BB. So we have 6 beautiful, frozen embabies! This is a great number! And by next week, we should know which of those are chromosomally normal.
PGS is an optional test that we are paying for ourselves, but it will hopefully save us from the agony that our miscarriage was back in February of 2014. If I never have to go through that hell again, it will be worth the $4k it cost to get there. And as far as costs go, I feel so lucky. The medication was completely free with my insurance. And I've almost met my insurance deductible, so the cycle will be mostly covered. Obviously it would be nice if we could just get pregnant for free, but we are very lucky to be working our way through infertility treatments a second time without any debt.
So now we wait to see how many of our 6 embryos have the right genetic components. And after that, we start prepping for a transfer! This will either be in August or September. I feel way more terrified about this than the retrieval. I knew I could make a lot of eggs from our cancelled IUIs when I made too many eggs, and I guess I should feel good about achieving pregnancy since I've been pregnant twice. But I still feel like my uterus is deficient and will reject the embryo. I will be doing everything I can to make the embryo stick!
So, in summary, here is the crazy math that is IVF:
Stims
I was looking forward to the stimming process, with all the sciency needles and vials. And it was fun for awhile, until my follicles (eggs) started growing. Then it started to get old and very uncomfortable. But I responded so well! For our IUI's, I usually had very little response at the first ultrasound. But for my first IVF ultrasound, I already had a great number of follicles growing with an E2 (estrogen level) of 937! And then things just ballooned. Two days later, I had 27 follicles. Then 39. I triggered with 39 follicles and an E2 of 4540.
One of the reasons they pushed the number of follicles was due to my left ovary, which they were concerned they might not be able to reach for retrieval. For most of the stimming process, it was hidden underneath my uterus. So they wanted to make sure my right had a good amount of mature follicles, and it did. Each mature follicle is about the size of a grape. I had 25 in my right, 14 in my left. So each ovary was like a large bunch of grapes, and I was seriously bloated to the size of a very pregnant woman. Don't believe me? Here you go.
I realized that estrogen is what causes the nausea in early pregnancy. By Day 8 of stims, I felt as gross and nauseous as I had felt during the first trimester with Abbie. I worked in the office that day and was so exhausted, bloated and in pain (I swear I could feel my ovaries stretching out). Thankfully, my dear friend Susan, who just went through a (succesful!) IVF cycle herself brought us dinner that night. It was just one of many of the kind and supportive things she did to care for me during this cycle; I'm so thankful for her!
I triggered on Sunday night. They did a lupron trigger with no hcg, to ward away hyperstimulation of my ovaries. It seemed to work well, because though the first few days post retrieval were verrrrry painful (but oh thank you, Vicodin!), I'm feeling almost back to normal now. Still bloated, but much better than before.
Retrieval
We got there bright and early on Tuesday morning at 7 am. I was a ball of nerves. What if the lupron trigger didn't work and they couldn't get any of the eggs? What if all my eggs were bad? What if they couldn't get the left ovary? The nurse was so kind and cheery, and she led us to the operating area, an area I've never been in all my years at Midwest Fertility! I dressed in the gown and they put in my IV. Thankfully Tom was able to be with me during this, since he is always able to calm me and make me laugh when I am anxious.
Then they took me back and put me to sleep. Unfortunately, the anesthesia didn't seem to work as well as it should have. I supposedly frantically scratched my nose during the whole thing and then started kicking my legs! When I woke up, I told the nurse I had dreamed that they kept telling me to stop moving, and she told me that was not a dream. The doctor said while he was getting the eggs from my left ovary (which was accessible!), he had to wait for me to settle down after each one. He laughed when I told him that Tom often tells me to "sleep like a human" in the middle of the night. Thankfully they were able to move past it and get 29 eggs!
Fertilization/Embryo update
The next day, the lab called at 9 am to tell me that of the 29 eggs, 25 were mature and 14 fertilized with ICSI. That number honestly worried me. I knew that from 29, the number would dwindled down significantly, but I expected more like 20 to fertilize. The embryologist told us that about 30% of our embryos would make it to day 5, so I wanted to start with as many as possible. But my hope was that, since fertilization is our main fertility problem, a healthy number of those that fertilized would make good embryos. There's so much you learn during an IVF cycle that you don't learn during IUI's. And though my tests have always been good, I've felt sure that I contributed to our fertility problem as well over the years. So the wait from Wednesday to Sunday was not the easiest, to say the least. I really wanted enough embryos to have a peace of mind about our future family. We did this with kid #3 in mind as well as kid #2. And of course, just as I would be okay with just having Abbie because she is perfection, I would be okay with only two kids. But I want my options. Infertility doesn't give you many options, and I was so hoping IVF would give us some! That feels greedy, but it is what it is.
Thankfully, the lab called yesterday to let me know that they biopsied and froze 5 perfect embryos! They were all of equal quality, given a grade of 6BB. I asked what was the highest, and she said 6AA but they rarely give that out, so 6BB is pretty much the highest they give. They were still watching 6 more embryos, and I heard today that one of those was also biopsied and frozen, also 6BB. So we have 6 beautiful, frozen embabies! This is a great number! And by next week, we should know which of those are chromosomally normal.
PGS is an optional test that we are paying for ourselves, but it will hopefully save us from the agony that our miscarriage was back in February of 2014. If I never have to go through that hell again, it will be worth the $4k it cost to get there. And as far as costs go, I feel so lucky. The medication was completely free with my insurance. And I've almost met my insurance deductible, so the cycle will be mostly covered. Obviously it would be nice if we could just get pregnant for free, but we are very lucky to be working our way through infertility treatments a second time without any debt.
So now we wait to see how many of our 6 embryos have the right genetic components. And after that, we start prepping for a transfer! This will either be in August or September. I feel way more terrified about this than the retrieval. I knew I could make a lot of eggs from our cancelled IUIs when I made too many eggs, and I guess I should feel good about achieving pregnancy since I've been pregnant twice. But I still feel like my uterus is deficient and will reject the embryo. I will be doing everything I can to make the embryo stick!
So, in summary, here is the crazy math that is IVF:
39 follicles
29 eggs retrieved
25 mature eggs
14 fertilized eggs
6 frozen blastocysts
29 eggs retrieved
25 mature eggs
14 fertilized eggs
6 frozen blastocysts
It's crazy to go have to start with such high numbers to end up with 6, but I am very happy with these 6! May the Lord bless and keep these embabies until they are able to be brought to life :)
Oh wow, that sounds great!! I can't believe how bloated you were before retrieval- that sounds terrible!! Thanks for keeping us updated- the world needs more babies as cute as Abbie, so I am praying for the best for you guys!! :)
ReplyDeleteWOW! I bet your ovaries felt a lot more like a sack of potatoes than a bunch of grapes. I'm so glad you didn't get OHSS! Praying for great results from the PGS testing.
ReplyDelete6 is a great number!! It is crazy though to start out with so many and how fast the numbers drop. I think I started with 11 maybe? which I was so worried about and ended up with 9. We transferred 2 and one split so we started out with twins but only one continued to grow into our Bowen. I can't wait to follow the rest of the process as you continue!
ReplyDelete