Time for an IVF update! We just wrapped up our third egg retrieval cycle and I want to share how it went along with some other things that came up during the cycle.
This retrieval had a very wonky start, to say the least. Typically what happens during a given retrieval cycle for me, which is a two month period, I go in for bloodwork and ultrasound on cycle day 19-21 to confirm ovulation. If ovulation occurred, I will start estrogen priming with estrogen patches and Ganirelix injections. After I get my next period (cycle day 1), I go in between cycle days 2-4 for bloodwork and ultrasound and then begin my stimulating injections. This is where things got weird this cycle. I never got a “full flow” to know when my period was starting. Coincidentally, our first retrieval cycle started very much the same way and I missed the start of my cycle. This time, however, I had a hunch about what was happening so I contacted my nurse, she recommended going in and having bloodwork and ultrasound done, and sure enough, my cycle had started despite never getting an actual period. Crisis averted!
I would be lying to you if I said that how this retrieval started didn’t make me nervous about how it would end up. I worried that something would be wrong with my eggs, or that follicles would grow but they would be empty. I ended up taking my stims for 10 days, and with every day that I did my injections, I could feel my follicles and, in turn, ovaries getting larger. I was experiencing constant cramping and was so bloated none of my pants fit properly. I resorted to using either a belly band or rubber band to keep my pants up, and even just straight up maternity jeans. By the time I went in for my retrieval, I was so bloated that I honestly looked 4 or 5 months pregnant. I also had very high estrogen levels leading up to the retrieval (over 6200) which put me at a higher risk for developing ovarian hyperstimulation syndrome (OHSS) which can be extremely dangerous, possibly even fatal if severe enough. To make things safer for me, my doctor put in an order for a new trigger shot prescription for me to pick up on Friday to be used that evening, which of course was to be picked up at an out of network pharmacy because there wasn’t time to have it shipped (trigger shots force your body to begin the ovulation process, readying your follicles for release).
To add to the fun of this cycle, Kevin had plans with his little brother for Sunday, October 3rd, so when we were planning out this cycle with our doctor, we all agreed we would do our very best to try not to have the retrieval fall on this day. Naturally, my body had other plans. Our retrieval got scheduled for 9am on Sunday, October 3rd. For a retrieval, you are completely knocked out with anesthesia so you have to have someone drive you home (full sedation is necessary because there are a lot of tiny blood vessels within the ovaries, so to avoid one of them getting nicked while your doctor is retrieving the egg follicles, they put you out so that you’re fully relaxed). Mom and dad to the rescue!! Thankfully the in-laws weren’t busy that Sunday so my amazing mother-in-law graciously came with us to the retrieval so she could drive me home, and Kevin could proceed on with his plans with his brother, Kyle.
On Tuesday, I needed to go to the grocery store to pick up some things for dinner on my way home from work. Up until this point, I had been feeling good and didn’t notice any signs or symptoms of OHSS. However, about halfway through my shopping trip, I noticed some discomfort in my lungs. I wasn’t having any shortness of breath, but it was still concerning to me. I ended up calling the after-hours number for my clinic and spoke to my doctor about what was going on. Since I wasn’t experiencing any pain in my legs, she was able to rule out the possibility of a blood clot which would have been reason to go to the ER. She recommended taking one of my leftover doses of Ganirelix, taking it easy, and letting her know in the morning how I was feeling. Thankfully that was enough to help me get back to normal and I was feeling better by the morning. THANK GOODNESS!
Now for the good part: the doctor was able to retrieve 14 follicles, 13 of which had mature eggs. Of the 13, 10 fertilized and 3 went on to develop into blastocysts!! This cycle we decided to send out biopsies of our frozen embryos for PGT-A testing. What this test does, is it looks for the correct number of chromosomes within the embryo. If there are found to be 46 chromosomes (23 pairs), then the embryo will be considered chromosomally normal and will be used for a frozen embryo transfer down the road. If the embryo has too many or not enough chromosomes, it will be considered abnormal and will be discarded. The test takes about 2 weeks to complete, so until then, we will be crossing all of our fingers and toes for chromosomally normal embryos.
But why discard the abnormal embryos?
I know to some people, it might seem crazy to discard any abnormal embryos, especially when one considers that these results are not 100% guaranteed. That being said, the reason we have chosen to discard the abnormal ones is because they would likely not become viable pregnancies even if we tried to transfer one of them. It will be devastating to have to discard them. My body has gone through a lot this cycle, both physically and emotionally, and I will be so incredibly crushed if the results come back abnormal. Unfortunately, that’s the name of the game when it comes to IVF and infertility.
So what else happened during the course of this cycle?
There was a lot of emotional drama that happened in the midst of the chaos that was this retrieval cycle. I want to share what happened, not to shame anyone (I will not be naming names) or to put anyone down, but more so to bring awareness to how this type of situation affects someone going through infertility.
Shortly before we began our retrieval cycle, I received a phone call that I was not emotionally prepared for. Someone very close to us who had just gotten married found out they were pregnant. Now, I want to stop here for a moment to say that I’m happy for them and I hope all goes well with their pregnancy and they have a happy and healthy baby. That being said, delivery is key. The way this news was dropped on me was extremely insensitive to our situation (and before you ask, yes, the couple very much knew about our infertility struggles). It was said to me in a joking way that gave me no space to process what was about to come. I was not okay. I was not okay with how it was told to me and I was not okay hearing that news and knowing how short of a time period this couple had been trying to conceive.
Pregnancy announcements are hard when you’re struggling with infertility. Even when it’s someone within the community, they’re hard. They’re hard because with every pregnancy announcement come feelings of happiness, joy, sadness, anger, jealousy, resentment. You don’t mean to feel this way, but you can’t always help it. I’m here to tell you that, if you are on your own fertility journey and have all of these feelings when someone tells you they’re pregnant, you are not alone and your feelings are incredibly valid!
On the flip side, if you are the one who is pregnant and someone you love reacts with these emotions “toward” you and your pregnancy, please know it is not personal. While we were in the trenches of the cycle and I was already halfway through doing my injections, I had to see this particular couple. What they saw was someone who was very cold towards them, who didn’t even look at or talk to them. What they didn’t know, was the night before, I sobbed gut-wrenching sobs for a good 45 minutes to an hour just thinking about having to be in the same room as them. Day of, I had an emotional breakdown in the moments leading up to being in the same room as them. The amount of jealousy I feel is borderline unbearable, and being a Christian woman, I hate myself for being so jealous. I’m both angry at myself and feel horrible for being so jealous and angry toward their pregnancy, but again, I can’t really help it (not to mention the hormones coursing through my body).
All I can do is ask for grace and space during this time and hope and pray this couple can understand how difficult this time is for me.
So what’s next?
As I mentioned above, we are currently waiting for the results of the PGT-A testing on our embryos to determine our next steps in the process. God-willing we get normal embryo results, we will do a frozen embryo transfer, hopefully before the end of the year. Otherwise, we will try and squeeze one more retrieval in this year and try PGT-A testing again, hoping for better results. In the meantime, I am currently preparing my body for a series of uterine testing called an EndomeTRIO test. Prep for the test consists of doing a mock frozen embryo transfer cycle, except instead of transferring an embryo, they will take a sample of the uterine lining and send it to the lab. This test consists of three different uterine tests (ERA, Emma, and Alice). The ERA will test for the exact number of hours of progesterone my body needs for my endometrial lining to be receptive to an embryo. The Emma test looks for healthy bacteria within the endometrial lining, and the Alice test looks for any infections that could prevent a viable pregnancy. We want to gather as much information as possible before we do our next transfer to give us the best chances of success. Stay tuned to the blog for updates as we receive them!