Tag Archives: Egg Retrieval

Another Egg Retrieval, Another Fertilization Report

08 Thursday Mar 2018

Posted by in IVF #6 with Fresh 3-day Transfer

≈ 3 Comments

Tags

, ,

natalie-rhea-riggs-359448-unsplashEgg retrieval was yesterday and full of surprises. It started off great because I saw that my favorite anesthesiologist was there for my procedure. Yes, I have a favorite anesthesiologist since I’ve done this, and had other fertility related surgeries, so many times. It’s always a relief to see him because I know I’m in good, capable hands. But then my RE came into the room as I was laying there getting hooked up for monitoring. He asked if everything went okay with my trigger shot. Odd question, I thought.

I told him that it had gone well. To my surprise, and horror, he said that my HCG test that I took that morning  was negative – since the trigger shot I take is HCG it should be positive which tells them it’s in my system correctly. The trigger is a vital step in the process because it signals to the eggs to begin making their final maturation preparations, and it begins to loosen the eggs inside the follicles so that they can be retrieved just in time before they are ovulated. If this doesn’t happen, then eggs are stuck and they cannot retrieve them. My RE was concerned. He said that he’s had this happen before – sometimes it turned out fine and other times it didn’t. I was shocked. I’d had such a great response to meds this round, I had about 12 perfectly sized follicles, and I really though this would be my last round – and now this. Was my perfect cycle about to be ruined?

My RE exited the room. I was left with the anesthesiologist and my husband, who was nervously rubbing my feet. The anesthesiologist turned to me and told me not to worry. He said that everything would be okay and that he has a good feeling about this. He said that in his line of work it’s very important to trust your intuition because sometimes it lets you know things that the monitors do not. And intuition was telling him that everything was okay. His kind words and comments on intuition helped me. I believed him without logical reason. Shortly thereafter, my RE poked his head in the door again and happily announced, “the test turned positive – it was just slow.”

And so I drifted off to sleep with a smile on my face. Upon awakening the anesthesiologist and a nurse were the only ones in the room. He asked me if I’d heard how many eggs they’d gotten. With one eye open I said, “no.” He said, “18! But don’t tell the doc I told you – act surprised because he’s going to want to be the one to give you the good news.” I couldn’t believe it.

After I had woken up a bit more, my RE came in to tell me the great news. I seriously don’t know how he manages to get more eggs than we expect. He’s amazing. Of the 18 eggs, 13 were completely mature, 3 were almost mature and they were going to try to mature them in the lab, and only 2 were not yet ripe. This is by far my best response and I feel grateful.

Today I waited for the fertilization report, unsure of what to expect. Last cycle we had an astonishing 100% fertilization rate (the same as my first IVF 4 years ago), but in the 3 cycles before that we had a 50% rate at best. Finally the call came. Of the 13 mature eggs, 6 fertilized normally with ICSI. Another 3 fertilized but were showing significant cleavage, indicating they were not growing well. Nevertheless, the embryologist wanted to give them some more time to see if they corrected. The other 4 arrested after fertilization. The 3 eggs that they tried to mature in the lab did not make it. So there it is – in just one day I went from 18 eggs retrieved to 6 embryos growing with a hope of 3 more. Not the fertilization rate I was hoping for, but still glad to have these.

In my last cycle I had 7 fertilize normally but by day 3 there were only 3 still growing well. The others had significant cleavage and eventually arrested. So that’s why I’m a bit thrown off. With so many eggs retrieved, I actually started thinking that I may have some left over after my transfer to freeze. While it’s still possible, I’m adjusting my expectations. I’m going to continue to meditate, pray, and send reiki energy to these 9 embryos. I hope they grow well and I have a healthy looking bunch on Saturday for my 3-day transfer. And if I have any left over, and if they make it to day 5, I’ll be happy to have a bonus embryo or two to freeze.

I desperately hope that my baby is in this batch. It’s crazy how fast numbers can change, and how moods can shift during this journey. They don’t call infertility treatment a roller coaster ride for nothing.

Another Egg Retrieval & Surprising Results

08 Monday Jan 2018

Posted by in IVF #5

≈ 3 Comments

Tags

, ,

Another egg retrieval down. My husband and I arrived bright and early at 7:30 am last Friday for the procedure. As per protocol, I had to give a urine sample. When they buzzed me into the back I saw my favorite anesthesiologist was there and shouted a welcome down the hall. The fact that I’ve been through enough infertility procedures to actually have a “favorite anesthesiologist” I find almost comical. Almost.  But it was great to know that I would be well taken care of, and as always, my RE and the nurses made me laugh and feel comfortable. The retrieval went well. We got 8 eggs, 6 of which were mature and they were going to try to mature the other 2 in the lab. Yep, that’s a thing. My RE was really pleased, and so was I.

That happy post-egg retrieval feeling typically only lasts one day until I get the fertilization report. Unfortunately, my fertilization rate has been really poor since beginning this process this time around. The best we’ve ever gotten was a 50% fertilization rate, which doesn’t leave you with many eggs when you begin with so few. This is a huge difference from my 100% fertilization rate at age 36. When the call came it was the embryologist on the phone. That was a huge surprise. He has never called me over the course of 5 egg retrievals. I paused and expected the worst. Was he calling because none had fertilized and he wanted to give me an explanation?

He told me that 7 ended up being mature…and all 7 fertilized! Wait, what?? I was shocked. I literally couldn’t believe it. He was very pleased and I cried. This means that this batch of eggs is of better quality than what we had been getting. In previous rounds, the eggs had a tendency of immediately dying when the sperm was injected, which is a sure sign of poor egg quality. Now I know we are far from being out of the woods. We still need to get some of these embryos to make it all the was to blastocyst. And since we are doing PGS testing, we will need to see if any come back normal, which is always a nerve wracking prospect since the results are based on a small sample of cells and there could be error. So there are many hurdles yet to pass. But this is a big win and sets us up for a fighting chance.

I am so beyond thankful for this chance. This is truly a synergy of science and miracles at its finest. Did we find the golden egg? We shall see, but I am hopeful. And now another wait begins.

But my body had other plans…

11 Monday Dec 2017

Posted by in IVF #4

≈ 2 Comments

Tags

, , , ,

My mini IVF cycle was really off to a great start. I responded excellent to the meds and at my first ultrasound I had 7 follicles. Even my left ovary, which tends to be sleepy, was producing well. It felt like this might be the protocol to do it. Each ultrasound was good and my follicles grew well and consistently. We got to last Thursday, did an ultrasound and labs to make the final decision of whether we would trigger on Friday or Saturday. My nurse called and based on my estrogen level it was decided that we would go one more day for optimal growth – trigger on Friday and retrieval on Sunday. I was right on schedule with my predicted calendar.

And then I got a second call late in the afternoon. Apparently they measured by LH in addition to my estrogen and to everyone’s surprise my LH was high – like ovulation peak high. Wait, what?! Despite the antagonist I was injecting daily, which blocks your brain from releasing LH, my brain decided to do it’s own thing. I was about to ovulate. Just two days before, my LH was low as they would expect. I was informed that my retrieval would be the next morning. I was stunned.

I spoke with my RE in the morning before the procedure. He said this happens in about 1% of the cases with antagonists. Of course I’m in that 1%. He told me of the one other patient he’s had where this happened. He waited 36 hours after the high LH reading to do the egg retrieval and ended up missing all the eggs because she had already ovulated. So, this time he’s doing it earlier – about 24 hours – in hopes of getting the eggs. Of course, the problem is you really don’t know when the surge began so there is guess work.

After waking from retrieval, I was informed that he got 2 eggs. I was devastated. And angry. Such great potential with this cycle – wasted. The issue wasn’t that I had already ovulated, rather my eggs weren’t fully detached from the fibers that hold them in the follicles. He scrapped, trying to release them, but only got 2. So we ended up being a little early. He told me to have sex since I have potentially 5 eggs that are about to be released, but I know that my chances for a natural conception are low, especially with my shotty fallopian tubes. We decided to not waste any time, since I don’t have much, and go straight into another stim cycle when my period starts in about 2 weeks. Is there a possibility that one of these 2 eggs could be the golden egg? Sure. But with stats like I’ve had, I’m not holding my breath.

This all feels surreal, as does most of the IVF process. How do we go from such a great start to this? Part of me is angry, but part of me just feels numb. And I go through the motions because what else am I going to do? After the epic failure of my last cycle, where none of my 9 eggs made it to blastocysts, this simply feels like par for the course. The fertilization report came the next day. One egg fertilized and is growing. In general, you’d expect a 50% drop off from fertilization to blastocyst. Humm, 50% of 1 isn’t looking too good. And if it did make it, would it be chromosomally normal? It’s a long shot. People have told me to have hope – that it only takes one. I get it, really I do. People want you to feel better. And they want to have hope too. But I’m getting tired. I had so much hope and optimism during these last 2 cycles and all the way up to retrieval on this 3rd. Each time I though that THIS was the one that would get me that baby. I really believed it. And all the hope and belief didn’t make it so.  I know I’m sounding really pessimistic here. But at some point, I feel like I have to protect myself from the pain. I don’t feel hopeless. I don’t feel like I’ve come to the end of my road. And neither does my RE. But right now, I need to feel neutral. I need to feel okay with a negative outcome so I don’t drown in it.

Today, I have no idea if this is going to work. I don’t know if I’ll ever have another baby. If my daughter will ever be the big sister that she so desperately wants to be. But I do know that at the end, whether I’m pregnant or not, I will have given it my best. I will have tried everything. And that’s the best that I can do.

For the next cycle we are going back to my original high dose protocol. It’s the same protocol that brought me my PGS normal embryo, as well as the failed cycle that ended in zero blasts. This will answer the question of whether that failed cycle was simply “a bad batch” or if it truly reflected a fast decline in my egg quality. My RE said that after 3 cycles of no good blasts, that’s when we would say that this isn’t going to work. I’ve had one cycle like that. I’m not counting this cycle that we just had, regardless of the outcome, because we were not able to do the egg retrieval at the right time. So I guess there is an end in sight. I truly hope there is a happy ending to this story. I’m not ready to think about the alternative.

The Numbers So Far: Stims & Egg Retrieval

14 Tuesday Nov 2017

Posted by in IVF #3

≈ Leave a comment

Tags

, , ,

I held off on writing about my follicle count during stims because I know how quickly it can change. But unlike last cycle, this one held pretty consistent. At each ultrasound I had 4 to 5 good size follicles and a few smaller ones. I kept hoping that the smaller ones would catch up. At my last ultrasound before egg retrieval, I had a solid 5 with 1 or 2 that might catch up in time, but I was told to not bank on those. I was actually okay with that going in and thought that perhaps my body was just putting in all the effort to grow these few high quality eggs, especially since we added in human growth hormone (HGH) for 6 days during stims to help with egg quality. Plus I’ve been on my egg quality cocktail of supplements – oh how I wish it was an actual cocktail – for so much longer at the time of retrieval. So I was ready for retrieval.

The anesthesiologist, however, was not. I sat there in the retrieval room, draped in paper gowns, and waited for this person to show up to my very important, and time sensitive, event. And then I waited some more. The RE assured me that I wouldn’t ovulate before retrieval because they calculate an extra couple of hours into scheduling specifically for uncontrollable events like this. Apparently there was a mix up with the anesthesiologists, or mine overslept – I’m not exactly sure. In an effort to get everything ready and save time while waiting on this person, a nurse came in to start my IV. She joked and said, “It’s okay, I’ve watch YouTube videos.” But then reassured me that she used to be a paramedic and I’m in good hands. Well I think dinosaurs must have roamed the earth back when she was a paramedic because the first attempt she hit a wall  and the second and third attempts were blow outs. My husband intervened and told her not to try again and that we’d like to wait for the anesthesiologist.

I got a little break, then my RE came in and told me that he had a “plan B” – if the anesthesiologist is much later, they will give me “lots of pain meds and a little something to forget”. Now, I know he meant well, and honestly I’d do anything to get the eggs, but I couldn’t help but have a few tears start to fall. I was scared. I know some women do egg retrievals awake, but I’ve never heard a good story about it. It would hurt and I’m getting a little tired of all the pain involved in this process. This was not going how I expected! The RE also said that either way, we need to get the IV started. In came a different nurse who was able to get the IV going on the first try, though not without some struggle. And let me just mention that I have great veins. I’ve never experienced anything like this. To my relief, the anesthesiologist finally arrived in the nick of time and we didn’t need to revert to the dreaded plan B.

I was shocked to find that they retrieved 10 eggs! Some of my follicles contained 2 eggs (bonus!) and I guess some of the smaller follicles caught up. It was great news. My RE said he was hoping to get 5 or 6 embryos growing from these. Ahh, if only. As last cycle, my excitement only lasted a day until I got the fertilization report. The good news was that 9 of my eggs were mature, but the bad news was that only 3 fertilized with ICSI. And I was crushed. Again. I just don’t get it. How can my fertilization rate be so poor? I’ve been taking so many supplements, as recommended by my RE and consistent with the book, “It Starts with the Egg,” and we used HGH. What went wrong? This fertilization rate seems lower than would be expected for my age, and a drastic reduction from the 100% fertilization rate (natural – not ICSI) that I had at age 36. I know I’m 40 now, but that really does seem a bit much. I want to know why, but I’m trying to not focus on that right now, and hopefully I won’t ever have to.

Now I have 3 embryos growing. One of them has to be my golden egg. It only takes one. I focus on that, but it is so easy to get pulled back into the numbers game of probabilities and percentages. That’s a scary game. So I’m putting all my energy, prayers, and intention out to these little 3. Coincidentally, or not, I happened to have 3 egg shaped bees wax candles left from the bunch I bought when I started this journey. Bedazzled with green glitter, rose essential oil, symbols for protection and blessing, and sprinkled with the herbal mix I created when I set my intentions for this cycle, which you can find here, I mindfully light these three candles nightly to send this love and energy to my embryos. Tomorrow I will find out how they fared.

3 embryos