Friday Evening - Stims Start
They had put me on birth control pills until everything was approved with insurance, my meds had arrived, and my ovaries/uterus looked good to go after the last IUI/Clomid cycle that was unsuccessful. I went in on Monday morning to make sure everything looked ok. The only slightly off thing was my right ovary had this cyst, but my estrogen was within acceptable range (although a little high on the end) so I got the go ahead. I stopped birth control and then was instructed to start meds Friday evening.
The whole day at work I kept thinking - tonight is the night. Some crazy things happened at the end of the day, so when I got home well past my normal time I had to focus on what needed to happen.
I'm a nurse and was still terrified to go through this process. But I reviewed the instructions 100 times and gave myself a pep talk. Meanwhile my husband stood by and kept our very curious doodle away from the interesting looking things mom was working with. I continued the injections throughout the weekend and went in Monday morning to see how we were doing. Things were definitely growing. I had asked my physician about supplements and while he isn't big on them, he gave me the ok to take 200 mg COQ10 3 times a day. Remember those pills three times a day definitely took a reminder in my phone.
9 Days- Trigger Shot
I continued to do injections and be monitored every 2 days for that week until Saturday. I could continually feel my ovaries expanding, but for the most part it wasn't too bad. I was very conscious about the clothes I was wearing though always stretchy and not too tight.
Every day it got a little bit harder to give myself the injections. But I took a deep breath and did it. I kept thinking about how many times I had stuck a needle in someone and how brave my patients have been. One of the hardest parts outside of the injections was giving up my more intense part of my exercise routine. I was terrified to twist an ovary. But I missed the feeling of taking care of my body and the stress relief it provided. I still stuck with daily walks though.
In general every day was a little bit harder than the one prior. I think the extra hormones and overall process is just exhausting emotionally, physically and mentally.
On day 9, it was a Saturday, I got up early and drove to downtown Chicago for my monitoring appointment. My doctor called that afternoon and we talked through whether to trigger or continue to grow a few more days. We had planned to do a fresh transfer originally. He listened as I thought through the two options - see if we can get 1-2 more follicles or trigger that night and go forward with the fresh transfer. I chose to stick with triggering and the fresh transfer. 1-2 follicles wasn't that convincing to me, they were counting 7-8 good size follicles at this point. I took one last dose of stim meds that day in higher doses than what I had been doing the majority of the time (most days I was taking 75 of each but this day I took 150 of each).
That night at 10:30 PM on Saturday, Jared buckled up to give me the trigger shot (10,000 of hcg) that was deep intramuscular in my butt (1.5 inch needle going straight in). Again, I reminded myself how many pts I have given a shot the same way too and how brave they all were. Honestly though, I was more nervous of him passing out, but he did great. Sunday I went to make sure the trigger shot had taken by blood-work. Thankfully, it did and the next several hours were spent in waiting.
Monday Morning - Egg Retrieval
Bright and early Monday morning we got up and drove downtown for my egg retrieval that happened exactly 36 hours after my trigger shot. Jared had gathered his specimen that morning before we left. So upon arrival, they quickly took him back to verify his identity and take his sperm.
I was taken back and he joined a few minutes later. They went through extensive paperwork with us and then we waited until they were ready for us. They then took me to the egg retrieval room. I apologized to the nurse anesthetist putting in my IV for my bad veins, but he did great. The next thing I remember is "waking up" crying back in the room - I was in wondering why I was crying. Jared said I had actually been awake for some time. I still don't remember any of it. We shortly after got the news they had gotten 10 eggs, which was more than last follicle count so I was pleasantly surprised.
They had me pee then we were quickly on our way home and I slept most of the rest of the day.
The 5 Day Wait - Embryo Growing
If I thought the process of the stims was bad, I had no idea the anxiety and long hours of waiting to hear about our embryos. They gave us a great handout that explained what would happen everyday and when we would get calls. Tuesday was the longest morning as I waited for the call. My head was spinning....
Did we have any mature eggs?
Did any fertilize?
Was there something I forgot to do to help egg quality?
Was there something I did to impact egg quality?
I hope they did ICSI like we had talked about.
I believe the call came in between 1030 and 11. We had 8 mature eggs and all 8 had fertilized - what a relief! That day my physician called around 540 at night. Being who he is, he apologized for calling so late. I'm thankful I have him for a physician, he didn't need to call. But he wanted to call to make sure I understood how well I did. It was reassuring and helped.
But the waiting wasn't over... Wednesday was no call. Thursday we got another call. All 8 had made it to day 3, but I knew over the next 48 hours the biggest drop off was likely to happen. Friday we didn't get an update on our embryos but we did get our transfer time. We were to be there at 7:45 AM with a full bladder.
Saturday - Transfer Day
I am a patient who follows directions (well, most of the time). So at 7:45 I came in with a full bladder. Only to wait another hour for them to call us back. By that time I was busting at the seems. The nurse didn't even need to look for more than a second to see my bladder was full. We then heard we had a beautiful embryo to be transferred. There was a flurry of activity which I couldn't pay attention to because I was just trying not to pee. The physician doing the transfer happened to be one that refers to my office quite frequently so it was a fun little connection.
We got to see our beautiful little embryo and learned we had 3 more still growing. We had decided to PGT-A test any that were left and freeze them.
The embryo was transferred and I then got to pee - phew. I was running to the bathroom as quick as possible and am pretty sure I peed 3 minutes straight. At least the nurse bladder is good for something. We then left and I went to see Karissa, my wonderful acupuncturist. Following that I slept the rest of the weekend.
The Two Week Wait (TWW)
Whether it's naturally trying to conceive, IUI, or IVF the two week wait is the worst. At some point int he process Jared had to start giving me daily butt shots of progesterone (these were just as deep as the hcg shot had been). He got really good at them. I worked Monday and Tuesday that week, but then had the rest of the week off.
I was super tired during this time, fatigued, short of breath, dizzy, night sweats, and all I could do was sleep. I explained it all away by the meds I was on and what my body had just been through. At some point I also started to have change of smell/taste but didn't think much of it at the time because I might be pregnant at that point. Looking back now though, I wonder if I had COVID. Part of me wonders if that is why little embaby didn't stick around. But in honesty, I'll never know and all the side effects were also side effects from all the meds I was on.
Friday morning of that week I woke up with a startle after having a dream all the symptoms I had been having (sore breasts, nausea, enlarged breasts) that would indicate pregnancy were gone. And in reality, they suddenly were. I knew at that point it hadn't taken. I spent most of Christmas sleeping and digesting that it didn't work. But I still kept taking a pregnancy test every morning first thing hoping for a line (yes, I'm that person who cheats).
Tuesday I drove to the clinic, already knowing. Even without the pregnancy tests I knew. Later that day my physician called and I said "I know it's negative". And he said something about how it was, we knew it was a 50% chance, but he still counted this a very successful cycle. He then went on to say he assumed I wanted to get going as quickly as possible again - I responded with he knows how I work. He then went on to work us into his busy schedule for Monday and talked about starting birth control after my period.
Later that night I wrote our physician a thank you e-mail, because although I was sad it didn't work, I am eternally grateful to have him walking us through this journey. His kindness and individualize care truly make a difference. I work closely with 6 physicians, I know how much time it takes to provide the care he provides. I don't take that lightly.
Fertility is a Marathon
I had started spotting the day before my beta, but the full on bleed didn't happen until Friday. I asked my acupuncturist if there was anything she could do to help it, and within a few hours it happened. That was NYE and we took COVID tests (they were negative) before heading to our friends house to spending the evening with them. They were supportive and listening ears and let us be all the emotions we were feeling with them.
We met with our doctor on Monday, but prior to that I had been researching, talking with friends, and processing. We went into it knowing we wanted to do another round of IVF. Our doctor let us know he was ok with a FET or another round of IVF. I asked him the hard questions like "What are the chances we will have to do this for a second child since we are still unexplained?" He said it is unlikely we wouldn't need to do IVF. I also asked if he would only want to do FET transfer, he said no, that unless some number happened during the IVF cycle to make a fresh not an option, he was ok with a fresh.
We went over with him while this was a failed transfer cycle, it wasn't a failed cycle. He was incredibly pleased with the results we came out with. He said while he will increase the meds a little this second cycle, there isn't much he will change because he likes the results we got. It's a really strange thing to process that there is still celebration in the cycle with a failed transfer. One of the biggest things fertility has taught me is how to be both happy and sad at the same time.
After we hung up with our doctor, I called the genetics lab to see where our testing was at. They let me know they hadn't even started it yet. They sent the paperwork that was still needed and we got that finished as quickly as possible, but knew it could still be 15 more days.
Deciding to do another egg retrieval was an easier decision for me than it was for Jared. As soon as I knew the first transfer hadn't worked, I knew I wanted to do another round. Jared and I had to do a lot of talking for us to both be on the same page about this.
I couldn't put into words until just this weekend, the reason I wanted to do another round of IVF first. I knew parts of it. Part of it was just knowing we want to have 2 kids and they suggest 3 PGT normal embryos for every one child you want. Part of it was that we didn't get our PGT test back until just 2 days ago so we didn't even know if we had any normal ones. Part of it is just wanting to not have to do this with a toddler (hopefully we'll get to that point). And part is knowing I still have good quality eggs.
But the biggest reason. I want to focus on one thing at a time, because we've already had two pregnancy losses. I want to be able to focus on getting embryos and knowing we have enough for multiple tries. And then focus on staying pregnant.
The hard thing is, it's not just about getting pregnant for us. It's about staying pregnant.
Our doctor is still hopeful. And to be honest, since we got the PGT-A tests back that we have 2 normal, I am too. But I have my moments of doubt and fear and wondering if it will ever happen.
For someone like me who likes to find the most efficient and quickest ways to get things done, this whole journey has been one big learning process. But I'm also one who wants to do things right. So I'm learning to be patient in the process.
Friday I had my baseline ultrasound and blood work and our second round of meds were delivered. I also received my schedule. I took a rapid COVID (it was negative) Friday night before stopping my birth control. Injections start Wednesday with blood work and ultrasound Saturday. My biggest fear right now? While I'm not looking forward to all the shots again, that's not it. My biggest fear is that COVID will get one of us in the middle of all this and we'll have to stop. So we're being extra cautious and taking it one day at a time. Because in this marathon of an experience, that is really all you can do.
