Egg Retrieval Day

Thursday, the night before the ultrasound, I was officially off from work and I felt really great. I was somehow confident, excited, eager for what tomorrow might bring. Although I really had no grounds to feel that way. Like I said at this point, there was no point in grieving my losses or how much of a monumental failure IVF felt like or how I felt like at this point. Instead, I tried to stay focused on the good that might come out of this. And that was the opportunity for Robbie and I to become parents.

The egg retrieval process is a surgery. Although you aren’t fully unconscious for it, you are in the twilight zone. In part of the sedation, you obviously can’t drive after the procedure and you are required to take a lorazepam (used commonly to treat anxiety like disorders) the night before of and the day of. Since Robbie was out of the province, my Mom and sister came up to drive and keep me company for the weekend.

My poor Mom drove 5 hours after a full day of work, only to arrive at my house at 11 at night, to be up and ready to drive 2 hours to Ottawa at 6 am.

I held off taking my lorazepam until they both arrived, scared I would be passed out otherwise. Believe it or not (and you probably won’t since all you’ve been reading about in my blogs is all the injections, hormones, and pills I am required to take for IUI’s and IVF) but I really am not a medicine person. I hardly even take a Tylenol, maybe once a year and even then, it’s only in dire situations where I have to be fully alert and can’t be distracted by whatever pain I am in.

So I am not a pill taker. I’m more more likely to change my dietary needs, use essential oils, acupuncture or other needs of pain relief (like baths, hot water bottles) before I cross a pill to my lips.

So that lorezapam (and the drugs from the retrieval itself) really messed me up. But needless to say, I slept really well that night.

At 6 am our alarms went off. I sat in my room, on the floor, taking a few moments to meditate and prepare myself mentally for the day. At this point, I couldn’t eat anything (no food or fluid after midnight) so getting ready was simple.

It was required that I weigh myself that morning, to get a baseline so they can monitor me for OHSS (ovarian hyperstimulation syndrome). OHSS affects women taking injectable hormone medication that stimulates the development of eggs in the ovaries.

Essentially, too much hormone medication can lead to OHSS, in which your ovaries become swollen and painful, and can cause rapid weight gain, abdominal pain, vomiting, shortness of breath etc. In the case you develop OHSS, you have to do a frozen transfer. Which means after your egg retrieval, usually they try to implant the embryo either three or five days later (this is called a fresh transfer).

But if you have symptoms of OHSS, they have to wait until your ovaries become less inflamed and swollen, so after your embryo makes it to day three or five, they will freeze it and plan a transfer usually at least three months later,once they know the inflammation is gone (this is called a frozen transfer). I’ll talk more later about what qualifies an embryo to be day three or day five later in the blog.

The moment I stepped on that scale, I was in shock. I PUT ON 10 LBS OVER THE COURSE OF IVF. I knew I felt bloated and my stomach looked quite distended (I just thought it was swollen and inflamed from being my pin cushion), but I didn’t think I had gained 10 POUNDS.

I’m only estimating what my previous weight was because I don’t weight myself anymore. After years of a really unhealthy obsession with the number on the scale, I sort of gave up weighing myself and instead focused on two things.

  1. Do I eat a healthy diet?
  2. Do I feel good about my body image?

After that, I focused on those, instead of the scale. I also recommend giving up the scale, its highly liberating. But my weight has always stayed relatively the same as I’m pretty good at gauging when it fluctuates.

We were in the car at 6:30 am. I was expected to arrive at 8:30 am, although my egg retrieval wasn’t booked until 9:30 am. I brought my journal along and wrote in the car all that I was feeling that morning. I set an alarm for 7:30 to take my lorazepam and an antibiotic, in case I feel asleep.

But I couldn’t sleep. I was just so excited and so nervous of what the outcome would be of today.

Once we arrived at the clinic, I was sent to pre-op. I changed into a hospital gown and was instructed to only wear the gown and my socks with bootie covers, and sat down in a strange little waiting room. Previously, all my appointments were either upstairs with my RE or on the bottom floor, but to the left side. I felt like I was in a completely different environment coming to the right side.

Me, pre-egg retrieval, just feeling sleepy. I’m only attaching this so you can see the full before and after reality of narcotics.

I reviewed all mine and Robbie’s information, and an RN put my IV in. This was the first time in my life I’ve ever had an IV and she couldn’t get the vein in the back of my hand (thank god, I always think that looks so uncomfortable there) so she put it on the inside of my right wrist. I was anticipating it to feel similar to a blood withdrawal but it felt like my vein was trying to resist it entering.

At this point, the nurse asked if I had anyone waiting for me that I would like to have sent it. I said “both my Mom and sister are waiting, so whoever wins rock-paper-scissors can come visit me.”

Inwards walked the rock-paper-scissor master, my sister. We sat and listened to music (Lauren Daigle’s songs You Say and Rescue), which came highly recommended to me by a friend who also did IVF.

I started to feel a bit drowsy but nothing too extreme. Another RN came in to introduce herself and confirm my information yet again. She kept looking at Sarah until Sarah introduced herself as my sister, but I think she thought she was my partner. We definitely laughed about that, let me tell you.

Finally, it was time to go into the operating room. I had one last washroom visit, as a full bladder can restrict access to the ovaries. One the left side, was a door to the lab where I was explained they would bring my eggs after extraction. On the right side, was a door to the lab where they store the embryos for the day of transfer.

I sat on the operating table, and kept getting asked to scoot down farther on the bed. My gown kept riding up so I kept slowly pulling it down and the nurse laughed and said “no need with fussing with that, we’ll be seeing that in just a few minutes anyways.”And I thought to myself, she is right, this isn’t the place for modesty now.

I put my legs into a new form of stirrups. They were almost comparable to hollowed out parts that trap your thighs/ knees.

On the operating table above me was a small television screen. The RN started to explain that when the egg retrieval begins, the ultrasound of my ovaries will be shown on the screen for me to watch. Once the catheter is inserted vaginally (it has a needle attached to the tip to remove the eggs from the ovary, which is also attached to a little suction device to help pull the eggs and follicle fluid through the catheter tubing), the needle is inserted into the vaginal wall, and then into the ovaries to start removing the follicles.

From here, I will be able to see the needle go into my follicle on the screen. Then as the fluid and egg are drained out, the black cater of the follicle will get smaller on the screen. The fluid and eggs will be drained into a test tube. The test tubes will then be brought to the room on the left, and as they count the eggs, the embryologist will call out which number we are at.

Just a little science behind the follicle/ egg: every follicle should contain an egg, and typically the egg is attached to the wall of the follicle. The follicle is full of fluid, to act sort of as a cushion for the egg to grow. The trigger injections I took on Wednesday to force my body to ovulate, help detach the egg from the wall so that its suspended in the fluid and is easier to extract.

At this point I was so cold. They draped heated blankets over my stomach and sterile surgical blankets over my legs, which made me feel much more cozy. There was an anesthesiologist at my side, and a nurse between my legs. The anesthesiologist said I am just going to give you something to help with the pain (which was Fentanyl and also Dilaudid which I really didn’t enjoy one bit).

Instantly I felt so drowsy and felt like I kept slipping in and out of consciousness. The embryologist came to introduce herself. I don’t remember her name, but I remember struggling to spit out my name, Robbie’s name and our birth dates. I could barely keep my eyes open or form words.

Instantly I felt so lethargic and had a sudden itch. I couldn’t stop scratching my face. It was just so damn itchy. I remember apologizing for the constant scratching and they said its okay and is a common side effect.

At this point, the RN started talking to whoever was between my legs and she kept saying her name but I kept thinking she was saying Daddy. I was so disorientated, I felt so completely out of it that I couldn’t ground myself. I kept looking up at this girl and I started thinking, I’m not supposed to be here. This isn’t the right place. I started to panic a bit thinking this isn’t right. I didn’t feel right. I hated this.

And my face was still so itchy.

Disclaimer: I later found out her name was Danny, I was just super high and out of it.

At this point the RE came in and I said, that’s not my Doctor. I wanted to say that out loud but I couldn’t find the strength. I thought it was going to be my RE. Finally after some talking, the RE said “okay we are going to start and I am going to place the catheter now into the vaginal wall.”

Instantly I felt a super sharp pain down there and I screamed out and tried to move away. But I couldn’t. I didn’t have the strength to move and my legs were caught in the stirrups.

The anesthesiologist said “I just gave her more pain medication” she said to the staff around her. I didn’t want more pain medication. I wanted out.

But the sharp pain stopped almost instantly. For that I was grateful.

I was so nervous that I was in the wrong room and wasn’t actually getting my eggs retrieved. I forced myself to stay alert until I saw the first follicle being drained, and shortly after I heard the faint call of “one” from the next room.

We had one follicle.

I must have blacked out again because I have no memory of follicle two or three. I woke up to watch follicle four being drained. I heard “four.” Then I was out again.

I vaguely remember hearing someone say “five.” and then okay we are all done now so you can sit on the side of the bed and we will get you into the wheelchair.

Did I hear someone say five? Did we get my five?” I slurred. I repeated myself scared no one heard me. The nurse called out to the embryologist and said “was that five?”

“Yeah, number five.”

Yay, we did it. we got my five. From here, the embryologist will mix Robbie’s frozen goods with my eggs using ICSI and hopefully, it will create some future babies for us.

I slowly transferred to a wheelchair with the help of two nurses because I couldn’t hold myself up. I felt so nauseated, so disorientated, so confused. I hate feeling this way. I felt so heavy with sleepiness.

Feeling crampy but at least warm now thanks to the sheets. I could also take my hair net off at this point but in all honesty, I couldn’t even feel that it was still on.

I went back and sat in the little pre-op area I was in before hand. I was covered with more blankets. My eyes felt so heavy, my lips could hardly move. My stomach was so crampy, I thought to myself, I wish I brought my hot water bottle. The nurse asked if I wanted my sister or Mom with me. In my mind, I thought I had said send in whoever wants to come but apparently I really asked for my sister.

Sorry Mom.

I remember asking the nurse if I could still have a matcha green tea latte today and she said, as long as my stomach can handle it, caffeine was okay. She said to pace myself and eat small amount later. (I ended up about an hour later eating a massive tempeh wrap, a huge fruit salad, and a large veggie works fries from New York Fries, in addition to my matcha latte. So much for small amounts).

My mouth was so dry, I was asked if I wanted anything to drink. Water, juice, gingerale? Water. I needed water now.

At this point, my sister, has lovingly been taking videos and pictures of me. I’m oblivious because my eyes are closed and I can’t seem to focus on anything anyways while they were open.

We have two videos that are quite far fetched.

The first video I go on about how the nurses had a pizza in the delivery room, with a thick crust and lots of sauce, and that, it was really weird, but they wanted to put my eggs on the pizza.

The second video, I said “I have this image of my tub overflowing and the handles are broken off.” I later go on to say that my cat Rocco did it.

The crazy thing about both is that in mind mind I actually saw the nurses eating pizza and my tub overflowing. I knew it couldn’t be real but I still saw it. That is the crazy effects that narcotics can have on you.

The nurse at this point came in with my final egg count. 14 eggs.

I instantly said “no, what? No that’s not me, are you sure you have the right person?” She confirmed again, and I instantly started to cry.

I had thought we got the 5, but with the 14, there was a chance that maybe some of my other follicles ended up growing and were also possibly mature.

I looked up at my sister and said “I have 14 eggs, I have to call Robbie.”

I don’t really remember that conversation, other than I was crying when I told Robbie and that I could tell Robbie was so happy to hear that I was so happy. Happy about the results for the first time this whole IVF experience.

Afterwards, I called Jordanne to tell her and at the end of the conversation she said she was so proud of me. I got off the phone and started to cry to Sarah that Jordanne said she was proud of me. I then sent Sarah to get my Mom and made her swear not to tell Mom how many eggs I had.

We both cried when I told her I had 14. I was still skeptical so I made the nurse get my paper work to show that I for sure had 5. I even took a picture, just to be sure so I could look at it when I wasn’t high on drugs.

Proof that they actually got 14 eggs.

At this point, a requirement to leave was to be able to go to the washroom with success. I stumbled to the washroom, with my IV pole in hand, and managed to trip over it in the washroom. But as I stood in front of the mirror, I inched my face closer, trying to stare at myself better. Wooooooow, I look rough, I said to my reflection.

I was all cleared to leave. I started my progesterone suppositories that day. Three times a day to help assist and sustain pregnancy. I had minor cramping the rest of the day when I was too active and had spotting all day. Normal side effects. But otherwise, after a long sleep in the car and another nap when we got home, I felt much better. And I was very relieved to not feel so paranoid.

This is my lovely after photo, right when I was cleared to go home. Also I can’t believe all the water retention in my face and legs!

I was sent home with a chart to monitor my weight, nausea, bloating, etc for the next 7 days and was alerted to call if I experienced any symptoms of OHSS.

Other than some mild cramping, I felt fine again. I was told to drink lots of water, rest, no heavy lifting, and no driving for 24 hours.

The next morning I woke up early to use the washroom and weighted myself. Since yesterday, I had managed to lose six pounds (and I lost another two pounds the following day). I couldn’t believe how quickly I lost the weight but it didn’t surprise me. My body didn’t seem to be holding so much water retention today.

I crawled back into bed with a hot water bottle because I was still quite crampy. I woke up hours later to my phone ringing.

It was the fertility clinic calling with my fertilization report. You see, even though they extracted 14 eggs, that doesn’t mean that all eggs are mature and ready to be used.

Of the 14 eggs, 6 were mature, and only 3 of the 6 fertilized over night with ICSI (the process that injects one single sperm into the egg because of Robbie’s low motility count).

Only one more egg, aside from my original five. I was hoping for more but I was grateful that three fertilized.

Basically, the three that fertilized just mean that they had a successful egg and sperm meeting. From here, we would wait until to hear back if we would do a day three transfer or a day five transfer.

Basically if one of the three fertilized embryos were to die off, I would proceed with a three day transfer just so they wouldn’t risk me losing all my embryos and have nothing to transfer.

If all three continued to grow until the three day mark (egg retrieval day is concerned day zero), we would proceed with a day five transfer (at this point the embryo would be considered to be in blastocyst stage).

If you drop under three embryos, the concern is your remaining embryos might not also make it, so its better to transfer at day three and have a chance it might implant, as opposed to it just dying in a lab petri-dish. Typically day five embryos have a higher success rate of pregnancy, so that is why its most ideal to wait until day five.

I was instructed, if I didn’t hear any updates, there probably wasn’t a change in my embryo status. All I could do was hope that all three of my embabies (embryo babies) would hold tight and keep growing.

I didn’t hear anything on day two so all I could hope for was that all three embabies were alive and that the clinic wasn’t just being tardy with communication, yet again. My Mom and Sarah left today, as I would be able to do the transfer myself, since I wouldn’t be highly medicated this time.

Monday (day three), I got a call from the clinic that all three of my embabies were still alive and dividing (the cells in the embryo divide to become more complex and this is exactly what you want). All was good to proceed with a day five transfer.

I was instructed to come in at 8:30 am on Wednesday, although my transfer wasn’t until 9:30. I was told to drink a liter of water before hand to have a full bladder, I can eat breakfast, and was to put my endometrin (my progesterone suppository) in but to bring another for after the transfer (that would be considered an extra dose for the day).

Things were starting to become real. I might actually have an embryo to transfer. I might actually have the opportunity to become pregnant. But part of my me worried that maybe my embryos would die suddenly and I wouldn’t have the opportunity to transfer them. I tried not to focus on that and instead focus on the good this could bring.

What a surreal moment it is. How fragile an embryo is, how the sudden stop or delay in the cell division could result in my beautiful embryos, ceasing to be no more.

How complex was this. Somewhere in a lab in Ottawa, my possible three future children are microscopic cells that are growing in a petri-dish. Completely out of my body. Without having seen my husband. My future child is growing, outside of my body.

I repeat, we have future children growing in a lab.

Sometimes in life, we don’t get to see the beauty of life as one typically would. Instead, we get dealt another personalized version of reality, and it is so important, in your version of reality, to see the miracles that are growing around you and to see all the beauty that encompasses your life. In whatever form, that may be.

Rebecca

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