Retrieval 2 and Embryo Update

Disclaimer: Long read ahead with details you likely will not understand or necessarily care about, but this is my journal to look back on. I have already forgotten things about cycle 1, so I know this will be truly beneficial down the road. Thanks in advance for your time!! I will do my best to recap the last 5 days. I should have written sooner, but my mind has been elsewhere. I think, subconsciously, I find it harder to write about the not so great news versus the happy, totally positive, awesome news.

On a happy note today is our MEET-IVERSARY 🙂 November 13, 2011 was the day Chris and I met on that great Southwest Airlines flight from San Diego to Phoenix! I am forever thankful he chose the seat next to me! I cannot imagine going through this life with anyone but him!

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Before diving in, if any of you desire, feel free to take a look at this IVF video. I found it super helpful, intriguing, and uncomfortable all at the same time.

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On our way to SDFC. No make up, no filter, hence the “sunglasses tan.”

Monday November 9th

We arrived to SDFC on time at 7a, but found all doors to be locked. Chris knocked, but no answer. I was hoping I had the time correct. Finally, nurse Marybeth opened the door around 7:10a. I was quickly given my sexy surgery garb to change into, hairnet and all. I was seated in a massage chair and the waiting began. I wanted to throw up. My pulse rate and blood pressure were unusually high, and I had a slightly elevated temp as well. We answered questions, signed consents, etc.

Locked out.

Something quite bothersome – We were behind a curtain and couldn’t see the nurses station, but Marybeth asked unknown nurse how her weekend was. Unknown nurse answers, “I became an Auntie again! My sister had her baby this weekend. 9lbs 5oz, all natural, no epidural, nothing. I don’t know how she did it. So precious….” Blah blah blah.

I mean COME ON!!!!! CLEARLY it is no secret why I am in for surgery, and you couldn’t have a LITTLE more decency?

Despite this, Marybeth was one of my heroes that day. Although she struggled a bit with the IV, she got it on her first try, unlike the 5 attempts it took last time. I was squeezing Chris’ hand, looking away, and trying to stay distracted. Hate this part of it. I began sweating and felt like I could faint. I had to fan myself with a magazine and take deep breaths all while telling myself, I was ok. I was incredibly thirsty, but obviously couldn’t drink.

Waiting…nervously and impatiently.

Dr. F checked on us. I asked for 8 mature eggs. She said, “I don’t know about that, but I will do my best and get all that I can. You will do great! The hardest part (IV) is already behind you!” She changed into her scrubs and was ready to go!

The anesthesiologist came by to ask questions and review info. He let me know I would be put to sleep within seconds of going in the operating room. Last time I had a light sedation while the prepped me, and then they put me to sleep. This time, it would happen right away. He also let us know, dependent upon my breathing, they may place a tube in my mouth/throat to open the airway, and if so, my throat would likely be sore.

My calm, patient, supportive husband.

I gave Chris a kiss and hug goodbye. He thought he was heading to the waiting room, but was escorted to his appointment, which took place in the exam/ultrasound room where I was seen on Friday and Saturday.

In my massage chair, all ready to go!

Around 8:02a, I walked with total jello legs the 30 or so feet to the OR, laid on the table, and within seconds monitoring sensors were placed on me. I asked the anesthesiologist if he had started the meds. He said I would feel the effects in about 10 seconds and likely be able to taste it. Yep, surely a metallic type taste entered my mouth. So bizarre to me that I could taste something going in my arm/bloodstream. And I was out cold. Literally freezing too.

The first thing I remember when waking up was Dr. F asking, “How do you feel about 10 eggs?!” I don’t think I was able to comprehend since I was so out of it, and I kept asking what time it was. 8:27a was the answer. It began and was over in no time.

Chris walked next door for coffee, and within moments of him sitting down in the waiting room, Dr. F came out to let him know the news.

Marybeth got me water, and was going to grab Chris to bring him back. I felt really loopy and out of it. She got another bag of fluids for my IV, I went through two. I asked if I was given pain meds through the IV during surgery, like last time. The answer was no, which would explain the VERY intense cramping and shooting pains I was feeling in my lower stomach area. It was extremely uncomfortable, and I don’t recall this from retrieval 1. She then added some Tylenol to the IV. I don’t think it helped. My throat was also sore, and I asked about the breathing tube. Sure enough, they did have to use one on me.

After retrieval. Shocked! 10 eggs!

Dr. F wanted to be the one to deliver the exciting news…that out of the 10 retrieved eggs, 8 were mature! This was FAR better than we thought. On the car ride down, Chris and I said we would be happy with 6 retrieved. I could tell she was SUPER happy with this!

Day 0 (Monday) Report – Immediately following retrieval:

• 10 eggs retrieved, 8 mature

I was in recovery longer than we had anticipated. The beeping from all the machines was driving me insane. On the other side of the curtain was another girl who just had a retrieval completed by Dr. F. They couldn’t find her husband in the waiting room, called his phone with no answer, etc. I felt so bad for her!

Sarah (I think), from embryology, came by to update us with the results and review what the next few days would look like. She was maybe 25 years old, and really, really nice. I told her to work her magic and take phenomenal care of my eggs/embryos.

Marybeth removed all my monitors and IV, brought me my clothes, and got me a wheelchair. Once changed, I gingerly walked to the restroom, still severe jello legs. A sweet nurse, Cory, wheeled me to the entrance, and Chris grabbed the car.

We were out the door by 9:45a, and headed to Honey’s in Encinitas to pick up some breakfast. Once home, I was couch bound with a heating pad and my puppy, and in a decent amount of pain, so I popped a Tylenol with codeine and hoped that would help. I was chugging water, as it is SO important to be hydrated after this. I couldn’t sleep, and was loving the rainy weather. Chris worked from home the rest of the day.

Puppy snuggles while recovering.

As the afternoon and evening went on, the discomfort I was experiencing intensified. Turns out it wasn’t pain from the surgery, but stomach issues. No further detail needed. Comparatively speaking, I felt like a million bucks the next morning.

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Although I wasn’t taking the day off work entirely, I didn’t set an alarm, and was not going to rush myself. I would just see how I felt. I woke up to a call from “No Caller ID.” Holy heart attack. It was Laura, I think, on the line. I wasn’t sure if she was the one who would deliver the fertilization report, or checking to see how I was feeling. Turns out, both. After letting her know my pain level, she delivered the report.

Our previous clinic only did updates on Days 1, 3, 5, and 6 with very basic, minimal information. SDFC provides extensive detail with their daily calls. I will say the anticipation of these calls is extremely tough on me. The worrying and waiting game seems to be never ending in this journey, and I know the hardest part is yet to come.

Embryo growth and development chart Days 0 through 6.

Day 1 (Tuesday) Call – Maturity and Fertilization Report:

• Of the 10 retrieved, 8 were mature. The other 2 did not end up reaching maturity.
• Of the 8 mature, 6 were fertilized with ICSI.
• For reference, last time we had 12 retrieved, 10 mature, and all 10 fertilized.

So as you can imagine. I wasn’t over the moon with this news. Although it is normal/average, I wanted to be ahead of the game. At this point, I became dead set in my mind and heart that a third cycle would be needed to achieve our embryo goal.

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Day 2 (Wednesday) Call – Growth, Quality, and Fragmentation Report:

Embryos should be 2-4 cells. We had:

• 5 that are 4-cell
• 1 that is 2-cell

Lab grades good, fair, or poor based on appearance of particular cells:

• 2 good (4-cell)
• 3 fair (4-cell)
• 1 poor (2-cell)

Lab looks for minimal to no fragmentation:

• All present minimal to no fragmentation.

Good call for the most part.

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I was staring at my phone ALL morning Thursday. I walked away momentarily, and had a missed call from “No Caller ID.” I called back right away and spoke with Shannon.

Day 3 (Thursday) Call – Growth, Quality, and Fragmentation Report:

Embryos should be 4-8 cells. The more cells, the better, but we wouldn’t want them to be growing too quickly. We had:

• 2 9-cell (strongest embryos)
• 1 7-cell
• 2 6-cell
• 1 5-cell

Lab grades good, fair, or poor based on appearance of particular cells:

• 6 fair

Lab looks for minimal to no fragmentation:

• All present no fragmentation.

I asked if this was good, great, just ok?? Shannon let me know this was average for today, and we are on track. In the mean time Jennifer had left me a voicemail, and I listened to that for a repeat of the update.

Assisted hatching was being performed on the embryos on Day 3. This puts a tiny hole in the embryo, so cells will start growing on the exterior of the embryo. Those are the cells that will be biopsied on Day 5/6 for testing.

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Day 4 (Friday) Call – Growth and Quality Report:

Lindsey from the lab just called. They expect to see the embryos move into an advanced stage of development. Embryos should begin compacting and forming Morulae. Individual cells are not as distinctive. They need to see them complete compacted before reaching blastocyst stage. Anything multicellular with 8 cells or above still has potential to grow, but isn’t as likely. We have:

• 1 at Morula Stage
• 1 at Compacting
• 1 12-cell
• 3 8-cell

They like to see the cell number doubling every 24 hours. Since the embryos are cultured together, and not kept separately, they do not know how many cells each specific embryo had the previous day. All 6 have gained cells, and continued to grow and divide.

The Morula embryo has a 50% chance of being biopsied tomorrow, and the Compacting embryo has a 25% chance. If not, hopefully Sunday/Day 6. We hope and pray to see the others catch up to reach this stage to be ready for biopsy and freeze come Sunday.

When I asked Lindsey how this report was, she said it was OK, as we do not expect all to reach blastocyst stage. Typically there is a 50% fall off between Day 3/4 and 5/6. Lord help me. This was not the most wonderful update. I will get another call tomorrow.

Once biopsied, the embryos remain in the lab, but the cells will be sent to New Jersey for genetic testing. We will have the genetically normal/abnormal results on or around Thanksgiving Day. I hope to be celebrating in style with family and friends in STL.

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I am meeting with the financial ladies on Wednesday to discuss what a 3^rd cycle would look like for us. I NEVER thought this would be US. Although IVF isn’t fun or enjoyable for anyone, we sure haven’t had the easiest go around. Many have 1 cycle, 1 retrieval, 1 transfer, and are then pregnant. Many have insurance coverage. Not us. We like to do IVF the hard way it seems.

Although Dr. F said to take it one step at a time, I am a VERY forward thinker and believe a 3rd cycle is totally necessary. It pains me to think of the financial, emotional, and physical hardships this would bring. A transfer and subsequent pregnancy would be delayed by about 2.5 months. Again, worth it! I know we are closer to the finish line than the start, but my gosh, I just want this so badly.

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Chris is a groomsman in his good friend’s wedding this weekend. I sincerely hope to receive the best news possible, as to not destroy my mood and manner for Jordan and Martina’s celebration.

Thanks for the love and prayers during this time. Have a lovely weekend ! Xo

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Sometimes the best thing you can do is not think, not wonder, not imagine, not obsess. Just breathe, and have faith that everything will work out for the best. – Robert Tew