Maybe this isn’t true for everyone, but for me, going into IVF felt like walking into a dark room with absolutely no information. This remained true even on my first day getting baseline values. So, in effort to give others some clarity, and to share my feelings throughout the process, I’m going to provide a timeline of our journey.
Day 0 (03/2021) – On day 2 of the last cycle before you are to start your IVF cycle, you start taking birth control. You take this daily until you’re told to stop which will correlate with the next steps.
There’s not a whole lot to say here. It seems slightly odd to be on birth control when that’s the exact opposite of what you want, but when you consider that you’re trying to chemically control and dictate what your body does…it makes sense. I was more responsible about taking it at this time than I was when I was younger. Granted, when I was younger, I wasn’t using it to prevent birth, I was using it for horrendous cramping. This time around, I didn’t know how important being exact was, so I set an alarm to take it at the same time everyday. No real changes here.
Day 1 (4/20/2021) – this is your baseline day. On your baseline day you go in for two things, a vaginal ultrasound and blood work.
During the ultrasound (which at this point, if you’re going through IVF, you’ve had many for the same reasons) they are assessing the lining of your uterus, the size of your ovaries, and counting your follicles.
I don’t remember all of my measurements but I know I had 14 follicles on one side and 17 on the other, providing me with 31 follicles. This is a high number, or so I’m told. There are pros and cons to this. The pro being, more follicles, more chances. The cons? I’m a higher risk for a couple of issues. Ovarian hyper-stimulation syndrome (OHSS) which can also lead to ovarian torsion. OHSS is a possibility with any woman, but usually those undergoing fertility treatment. To reduce the risk of this, I’m on activity restrictions – basically I can’t do anything. I’m being dramatic, but I’m not supposed to run, bike, swim, do things that will engage my core (which is basically everything).
The lab work is simple (unless you read my blog about IVF and the government effect). They take 1 vial of blood and send you on your way. Easy.
Day 2 (4/23/2021) – this occurred for me 3 days after baseline. This is when I started taking stimulation drugs. In the EVENING (I set an alarm for 2000), I am to be injected with Gonal-f (a follicle stimulating hormone) and Menopur (gonadotropins).
I could inject these myself but to keep Mike in the loop, he does it for me! This is our nightly routine until we are told to stop, so I’ll let you know what day that is.
The first night, Mike stabbed me 3 times. I flinched a little during the second injection and so he took the needle out and stabbed me again. The second night, he only stabbed me twice, but this time there was some blood and it hurt a little.
About the drugs – The Gonal-f is fool proof. It comes in a pen that you have to dial to your prescribed dose and then inject it subcutaneously. The Menopur on the other hand feels a little like a chemistry class. You get a vial with sodium chloride, one with the Menopur, a Q-cap blister a syringe, and a needle. Mike and I choose to set everything out at the start and then start prepping. You have to take the plastic caps off of the two vials, unseal the Q-cap, then without touching the top of the vial or the Q-cap (sterility after alcohol wiping), you flip the Q-cap over onto the vial with the sodium chloride and puncture the top. Then you prep the syringe by pulling it back to the desired dosage (1mL) and twist it onto the Q-cap. Flip everything upside down (making the vial the top), push the air out of the syringe and then draw up the sodium chloride to the prescribed amount. Now, pull of the syringe and Q-cap and put it on the vial with the Menopur (pushing down to puncture the top). Push the fluid out of the syringe into the Menopur and make sure the solution dissolves. Then draw the solution back up into the syringe, untwist the syringe from the vial and Q-cap. Now you’re ready to attach the needle to the syringe and prep your injection site. That’s it.
No really, it sounds like a lot and the first time it is a lot, but by the second night Mike and I had a really good rhythm and it all took no time at all.
Day 4 (4/26/2021) – was a lab day. I went in for that one vial of blood work. Still a crazy wait time but not much I can do about that.
Day 6 (4/28/2021) – Mike and I have continued to shoot me up with drugs every night. Today we had an ultrasound appointment and lab work (FYI, I pulled my ticket for lab work before Mike pulled his but he got called back already. The perks of being the active duty service member I guess)
The ultrasound went well. It looks like have 23 follicles maturing (slightly down from the baseline of 31, but still really good). I actually have to start another medication today – antagon. It’s to prevent ovulation. My body is one confused chem lab right now. While I start the antagon I will be increasing the menopur from 1 vial to 2 tonight.
So everything looks to be on track, maybe a little ahead of schedule, we will know more when we repeat this process on Friday. I may have the joys of getting my first COVID test on Friday as well. Despite not being exposed, presenting with no symptoms and being fully vaccinated it’s still required to have a negative COVID test before undergoing anesthesia. Safety first. Logic never.
Day 8 (4/30/2021) – At this point I’ve had another ultrasound and more bloodwork. They never talk about the labs – no news is good news I suppose. I have used the patient portal and looked at the lab results and couldn’t tell you anything from that.
At the ultrasound today, the doctor counted 18 “large” follicles (size 9-17 mm ea) plus a bunch of other little guys. Still not sure if we will trigger Sunday for Tuesday or Monday for Wednesday. I get to go back for more labs and another ultrasound on Sunday.
I got the privilege of taking my first (hopefully only) COVID test today. It really wasn’t that bad. It was the up your nose one. I’ve had to go through letting someone put a nasopharyngeal airway in before, so that was worse. Really, if you focus on breathing it’s fine. I just think it’s dumb that I have to have a negative COVID test when I’ve never had, never had symptoms, and am fully vaccinated. By the way, the results are in….I do NOT have COVID.
Some mild frustrations:
1. Reporting on Sunday for another appointment. I have battle assembly this weekend, so now, last minute, I get to work out arriving late on Sunday.
2. The last minute aspect of the retrieval day is interfering with my work and therefore negatively affecting my coworkers and patients. As of today, I will have to report for another appointment on Monday. My schedule was already full for Monday, so I had to ask coworkers to cover my patients, call my patients and reschedule, etc. I’m fine taking the inconvenience for myself, I hate that it affects others.
Day 10 (5/2/2021) – I went for another ultrasound and lab work. It’s go time. This time I counted them counting 19 good sized follicles…it’ll be interesting to see what they come up with on TUESDAY!! So everything looks good and ready so I’ll trigger tonight.
They had to wait for the lab work to come back before they decided a couple of things and then called and told me what to do. First, they had to see what my hormone levels were to ensure I wasn’t at even higher risk for OHSS. If I was I would have had to use a different trigger other than the HCG. I forget what’s called, but I didn’t have to take it. Second, they had to compare my results with all the other people going through this and put us in a list of priority per our results. That would determine what time I would take my HCG.
I guess I got a little lucky, my HCG trigger was at 2330. I guess it can be anywhere from 2130 to in the early morning hours. So Mike and I set an alarm for 2315, mixed the vial of saline and HCG and Mike stabbed me in the butt. It was an intramuscular injection this time.
Day 11 (5/3/2021) – More lab work. It’s was a little faster but still a 35 minute wait.
Tomorrow I go in for the retrieval. I don’t really know what all this entails. I do know that it requires anesthesia. And I should wear loose fitting, comfortable clothes. So, more on this process later!!
Day 12 (5/4/2021) – May the fourth be with you! I laid my eggs today!! they were able to get 16, we will hear tomorrow how many are viable to move forward after insemination!
We had to arrive at 0700 but I didn’t go back to the OR until 1030. When we got there, we were greeted by some AWESOME nurses. I wasn’t anxious or uneasy, but if I had been, these nurses would have squashed that! We did the standard vitals stuff and got an IV started and just waited.
The nurse prepped us for the visits from a lot of other medical people and gave us a heads up on what they would be telling us. I thought this was super awesome because it gave me time to think and figure out if I understood or had any questions. Then we were visited by the nurse anesthetist, the sperm doc, and the OR doc.
Mike left to do his thing but was back before I went anywhere.
The OR. I was transported about 50 feet in the hospital bed but when we got to the OR I had to get up and walk in and to the “nest” (table/bed for the procedure). The nest has a hole in it where they want your butt to hang off. The nurse (a different one from earlier), put compression sleeves on my legs and lifted them into some pretty intense stirrups. Hips and knees bent to 90 degrees and the abducted a good amount. These stirrups support your whole lower leg (calf/shin region) and they strap them in. Shortly after that I was out.
Per the clock, about a half hour later I was done and back in the first room. I had some mild discomfort, I wouldn’t have called it pain yet. It got a little worse with time but nothing more than a 1-2/10. The nurse took my vitals and gave me grape juice and graham crackers (I hadn’t eaten or drank since dinner the night before). Just had to wait for our number of eggs and then I was required to urinate before we could leave.
We got our number – 16- pretty quick, but I wasn’t going to the bathroom. 2 liters of IV fluid and 16 ounces of grape juice wasn’t enough to make me have to go….but I started getting nauseous. After about 45 minutes of nausea and a dose medicine to reduce the nausea, I vomited. Then I was better. I still didn’t HAVE to go to the bathroom, but I was able to make myself go. Now I could get dressed and head home!
I vomited again in the car – they had given us a bag for that just in case. We got home, and I slept for 3 hours or so.
My list of meds and routine has changed now. I have an antibiotic that I take tonight and then twice a day for the next 2 days. I have oxy for pain relief – taken as needed.
The important stuff though, I have progresterone suppositories that I have to take 3 times a day every 8 hours starting tomorrow until someone says stop. I also have estrace, it’s a pill I start tomorrow as well. 1 tomorrow, 2 the next day, and 3 the subsequent days, until told to stop.
That’s probably all the update until, I think, Sunday, when we transfer.
Well guys, it’s Tuesday. I left you hanging on Sunday. I’m going to be honest, it wasn’t the day we had hoped for, so it was full of raw, confused emotion. The day after the retrieval, they called at let us know that of the 16 harvested eggs, 14 were mature. Good news. Then they said that only 8 fertilized. Ok news. Sunday, only 2 fertilized, and 1 was questionable. That hit hard. We had approached this day so optimistically and hopeful that we’d get to transfer a really strong blastocyst and then freeze 3-5 more. Now, we were left with a good blastocyst and a questionable one.
Yes, we were/are grateful for the 1 we had. Yes, we are blessed. Yes, we are hopeful this one takes and turns into a pregnancy. But, so much can be unpacked from the information of only 2 out of 8 surviving. And yet, we still don’t know what or why we can’t do this on our own.
Also, now that we’ve made it this far, and have this much information (that still amounts to no information), why am I the one that has to carry the diagnosis of unexplained infertility? We know nothing, but in that, we don’t know that this issue lies within me.
Fast forward to today, Tuesday, May 11, 2021. I received a phone call stating that our questionable embryo was good enough to be frozen. I don’t know the grade yet, also can’t tell you what that would me right now either, but maybe later. In the next few days, I may receive a phone call with the grade. Don’t really know what that means.
The next steps. On Tuesday, May 18, 2021 I have to go to Walter Reed and get blood draw for a pregnancy test. I’ll leave and sometime later that day, I’ll get a phone call letting me know if it was positive or negative. The catch here, even if it’s positive, we still won’t be sure. I’ll have to go back to the lab two days later and do the blood work again.
Continuing to be honest with you, because these are my feelings, and you may relate, you may not, but if you’re reading this, I think you’re trying to understand your own struggle, so it may be helpful to know, you aren’t alone in feeling alone and worried.
I hope Tuesday is positive. I hope Thursday is positive. But I’m still scared. Last time, it was natural and unassisted, but it didn’t work. Maybe I’ll feel safe after the first trimester, that’s what I’m telling myself anyway. But it may not feel safe to be happy until there’s a baby here. I don’t really know.
home 