IVF#2: Day 1 Fertilization Report

So remember my post about fertilizing our eggs via conventional IVF vs. ICSI? Well last year, we had 19 mature eggs, and opted for 1/3 IVF and 2/3 ICSI. Last year we had 14 fertilize.

Today I got a call that out of our 21 eggs collected, 13 were mature, and all 13 fertilized via ICSI.

Now I’m a little upset that only 13 of the 21 were mature. I was hoping for more. However, I am so glad that I posted my dilemma about IVF vs. ICSI, and that with your support and sharing of experiences, DW and I decided to go all ICSI.

I am also glad that I spoke to the embryologist yesterday, and asked her how they select when eggs get IVF’d and which ones get ICSI’d. Apparently, they can only do ICSI on mature eggs, but immature eggs can be fertilized via IVF. So if you choose to do a “split” of ICSI and IVF, they choose the mature ones first for the numbers you’ve designated for ICSI, and the remaining (including immature eggs) are used for IVF. So if you choose to do a split, you may have a greater yield of fertilization because they can utilize those immature eggs, which are still capable of fertilizing. However, if you choose to do all ICSI, you can’t use those immature eggs at all.

OHSS update:

Weight: same as yesterday
Circumference at umbilicus: same as yesterday

I have been in progressively more pain as time passes since the retrieval. I have been popping extra strength Tylenol every four hours, which works, but wears off after about three hours. I woke up in the middle of the night with searing abdominal pain (meds wore off), and had to pee, which hurt like hell. I have been asked by the clinic to track my liquid intake and output, which has been very difficult for me. We have a measuring cup in the bathroom for that, and I always forget at the time I start to pee. Plus, the perfectionist part of me hates not having a very accurate system for measuring liquid from things like vegetables. I also dislike how I’m measuring my intake in millilitres, and my output in cups. I know it’s a simple conversion, but it still bugs me.

Things that hurt: walking (a bit), rolling over in bed, changing position, twisting, putting on pants, putting on socks.

Things that really hurt: coughing, sneezing, peeing, pooping.

So far, it just feels like my ovaries are inflamed from having holes poked in them. However, thankfully, my belly isn’t more distended than on retrieval day. From what I remember though, the OHSS didn’t really show until a couple of days after the retrieval.

Anyways, more salty snacks and soup for me!

IVF#2: Egg Retrieval Part II

So I laid 21 eggs today! At least, that’s how many the RE collected from me this morning.

The procedure went much better this time around. I pretty much told every nurse and the RE about how quickly I metabolize anaesthetic, and they gave me an extra dose at the beginning of the procedure. I felt my head get heavy, the room started to look blurry, and while I was aware of what was going on at a very superficial level. I didn’t feel any pain, which was really nice.

After the procedure, I recovered in the lounge with apple juice and the snacks that we packed: coconut water and homemade cornbread muffins. Since I had been fasting since 7pm the night before, I was ravenous. I basically stuffed my face as the nurse was trying to explain the discharge items to me. I felt a bit dazed, but then we had a chance to see one of the embryologists, as I wanted to discuss our choice of fertilization method.

We have decided to do 100% ICSI.

They will start the ICSI tonight and then we will get a fertilization report tomorrow.

After that, DW went to grab the car and came to pick me up from the front door of the clinic. I was feeling woozy getting into the car, and started to salivate. In that moment, I knew I was gonna puke, so I opened the door, leaned out, and puked all over the sidewalk in front of the clinic. DW hung onto me by the back of my jacket, and I was so glad my dreads were tied up, because I had four good barfs before I was empty. Goodbye apple juice, coconut water, cornbread muffins, and water!

On our way home, we make two stops. One at Whole Foods because all I could stomach was soup. Another at Walmart to grab some Tylenol for the post-retrieval pain as well as some Gravol because the Dostinex makes me so nauseous.

I’ve spent the rest of the afternoon lounging on the couch, binge watching Broadchurch on Netflix. DW has been taking very good care of me- unlimited fetches, making food, bringing me meds. She also took the dogs out while I vegged on the couch.

The anaesthetic wore off by the time we got home, as I have some pain with moving, but much worse with peeing. I haven’t pooped all day, and I dread having to do it. I finally pooped and while it was moderately painful, I survived. There may have been some whimpers coming from the bathroom.

I have been taking Extra Strength Tylenol every 4 hours, which has taken the edge off and made the pain quite mild. But from what I remember, the OHSS came on with a vengeance a few days after the retrieval, so the worst is yet to come.

Since we had so many eggs retrieved, they’ve already got us booked for a five-day transfer. We transfer on Wednesday! I am hoping and praying that we get a lot of good quality blastocysts over the next couple of days. I’ll post their progress along the way.

Thank you everyone for your kind words and well wishes. I appreciate all of your support. I don’t know how I would have gotten through the past two years without you all.

For now, here’s a picture of two of my cutest girls:

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Juno (the big dog) saved Clementine (the little dog) and I from a coyote that was stalking us two days ago. We were walking on a path on the side of a hill, when a coyote cut us off about 30 feet ahead. Juno chased it down the hill and across a valley, probably about 0.75 of a kilometre long. Luckily, she is bigger than the coyotes, so they are afraid of her and run away. It’s one of the major dangers of taking the dogs to this conservation area. There are deer, coyotes, beavers, and other native wildlife. We always try to go during the day time because the coyotes are more active in the evening. I feel so grateful for Juno’s protection, even though she is generally a super suck 99.9% of the time.

Anyhow, fertilization report tomorrow!

IVF#2: After 12 Days of Stims… We Trigger Tonight!

Well here we are, after 12 days of Gonal-F doses ranging from 200IU to 250IU, finally, we trigger tonight!

Yesterday I waited by the phone, self-soothing with spoonfuls of coconut butter (you must try coconut butter- not oil- it is so rich and creamy and delicious. It’s the only food I could really taste yesterday), for a phone call that never came. This morning I went to my monitoring appointment, had more blood drawn (so many holes in my arms now), and went for my daily meditative dildo-wanding.

These are my stats:

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As you can see, it was a good call for my RE to have me stim for one more day. A good amount of growth happened, and some of the mid-sized follicles have grown to potential maturation size. The ultrasound technician says that in her experience, the follicles 16mm and greater will probably be mature by egg retrieval. The 15mm ones are iffy, and anything smaller is unlikely to yield a mature egg by egg collection. So right now, we’re looking at 18 or so potentially mature eggs, which is great. Obviously, you never know until egg retrieval, but I love to speculate. TTC had made me a master speculator. I have self-diagnosed a whole shit tonne of things already, most of which has actually been correct.

Anyways, there’s a lot of snow around here, and I’m dying to take the dogs out, but the conservation area doesn’t get plowed, and the snow is knee-height. Juno killed and ate 90% of a raccoon a couple of days ago (we lost her in the conservation park and then found her laying in a mess of fur and blood, so we speculate (see master speculator!) that it must’ve been a small raccoon based on the fur). She has been crapping fur poops, which can’t be fun. I might throw on my gators and go for a jaunt with her. Oh, that dog… Eating things she shouldn’t eat.

Speaking of eating, I have been feeling quite a bit less bloated in the belly lately. I believe that it is due to some changes that I’ve made to my diet:

1. Cut down my carb intake a bit. Because of the amount I was working out before stims, I was eating 40-50g of carbs with each meal (so 4-5 times a day). I’ve cut that down to 20-30g of carbs with each meal, sometimes less, depending on the meal. I always feel a bit better eating less carbs. It’s not a weight loss thing, it’s an overall homeostasis thing.

2. I’m force-feeding myself protein with each meal, even with snacks. I ate a lot of protein before (at least 35g per meal x 4-5 times a day), but feeling like crap doesn’t make you want to cook or eat things that require a knife.

3. I’m consuming a lot more salt than usual. I usually consume very little salt, but thanks to some advice from this lovely blogger at Plan B Chronicles, I’m eating way more salty foods. I’m adding salt to my soups, eating more salty snacks, etc.

4. Metamucil is my friend. I’m taking two scoops of the Orange flavoured powder once a day. DW says it makes her poops “nice and fluffy”, which makes me giggle. I don’t think my poops are ever fluffy, but I’m crapping at least once a day right now, which makes me happy.

Having so many follicles, I’m aware that OHSS is quite likely on the horizon. All of the above mentioned efforts are also to prevent it. Last year’s IVF had 36 growing follicles, 19 of which were mature. I felt super shitty for 6 days after egg retrieval, and then started to feel a lot better. All in all, it took 2 weeks for me to be able to take a dump without crying alone in the bathroom (due to enlarged ovaries). I was bloated and in pain, but didn’t have nausea or troubles breathing like some women do. I definitely had ascites, and got to practice some diagnostic tests that I had learned in professional school.

Lindsey at Awaiting Autumn also mentioned taking Dostinex (Cabergoline) for OHSS, and I’ve sent an email to my primary nurse asking about being prescribed some. This study shows that it doesn’t negatively affect egg maturation, implantation rates, or pregnancy rates.

So yeah, we trigger tonight, and egg retrieval is on Friday, though I’m still waiting for a call from the nurse to find out the exact time for both events.

Last year I said that I’d never do this again (because of the pain and trauma to my insides), and here we are, doing it again. I hope that we finally get some babies out of this.

IVF#2: After 11 Days of Stims… Almost There!

I must confess that I’ve been napping lately. After lunch, I fall into some sort of food coma, and nap on the couch with the dog, or retreat to the comfort of our bedroom. I just feel so tired. I’m not sure how much energy goes into growing and developing 32 follicles, but hot damn it’s draining me. And I’m doing pretty much no exercise right now because of the wobbly wobbly going on in my abdomen. I needed assistance from my wife last night to get my underwear on after a shower. I’m sure she loved the view, but when you can’t lift your knee up and balance on one leg because it squishes your ovaries, well, it just sucks.

My breasts and nipples are super sore, and have been for three days now. Looking at my bloodwork, it seems that my LH and progesterone have increased a bit, probably because of all the mature follicles. I have read that increased progesterone levels near trigger can yield a poor prognosis for implantation in a fresh cycle, but if a woman has high follicle counts, these levels are to be expected. I am trying not to think about this too much, lest my anxiety start to soar again.

I have also lost my appetite. I’m hungry, yes, but nothing appeals to me. Our local Costco sells organic free-range whole chickens, so I bought some last week and have been eating them for almost 5 days straight, and am so sick of chicken right now. Everything tastes bland and flavourless to me. Yesterday, I polished off a bag of HardBite chips because I needed to eat, wanted the salt, but didn’t enjoy them that much. Being a person very much ruled by my stomach (and on a whole whack of injectable hormones), you can imagine the kind of existential crisis I am experiencing right now.

Today’s monitoring went well. My favourite phlebotomy nurse took my blood, I joked around lots with the reception ladies, and my favourite ultrasound technician dildo-wanded me. She even printed off a photo of my right ovary because it was pretty:

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I’ve actually begun to find the dildo-wanding rooms to be relaxing. The lights are low, it’s always warm, there’s a place to take off your clothes and lie down. There’s someone else there, but they don’t talk to you. You just lay there in silence. It’s almost meditative. I just focus on breathing in, and breathing out.

Anyways, apparently lazing around all day yesterday was good for my follicle growth. Here are today’s stats:

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As you can see, I have a total of 32 follicles (last year was 36). Of those, 17 are 15mm or larger (last year at trigger there were 18). My estrogen levels from yesterday are higher than those on a comparable day last IVF. I think trigger may be tonight, but I’m waiting to hear from the nurse. If we trigger tonight, egg retrieval will be on Thursday, which will mean a very early appointment (like 4 or 5am), because my RE has a standing OR day on Thursdays at the Hospital (he’s actually an OB-GYN so he does operations every Thursday).

So by the phone I will wait, all day. I will post again if we trigger tonight!

IVF#2: After 10 Days of Stims

Goodness! It’s been 10 days already, and we’re still not trigger-ready.

Today has been an exciting day however. At 6am, I awoke to my wife’s ecstatic giggles, as she exclaimed “It’s a SNOW day!!” Our school board cancelled all buses and closed all schools for the day, due to the terrible weather.

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As teachers, this means we do not have to come into work. It’s a safety thing really. Last year, an Ontario school board kept schools open during one of the worst snow storms, and a teacher had a fatal accident while commuting to school due to the terrible road conditions. School boards rarely call a snow day unless it’s projected to be really necessary, as they have to pay back the government for the lost teaching day.

But we woke up to our front door being snowed in. I had to go out the side door, and shovel and brush it clear to walk through. The snow was also at least three times as tall as Clementine (the dog), so DW had to shovel a path for her from the side door to an appropriate “bathroom spot” in the yard. Juno (the big dog) just loves this weather. She sat on a mound of snow in our front yard, while DW and I brushed off the cars and shovelled our driveway. We wouldn’t have been able to get to my monitoring appointment without doing so. I love shovelling. I like the physicality of doing it. But today, I got some sharp pains in my left ovary after tossing numerous shovels of snow. I guess when your ovaries are the size of oranges, you shouldn’t be twisting like that. DW made me stop, and finished off the driveway on her own.

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By the time we were done, it was time to leave for my monitoring appointment. I was hoping that my follicles would be ready to trigger today, as my beta (if we do a five-day transfer) would land on DW’s birthday, but alas, it seems we may have to wait one or two more days. I don’t know why my follicles take so long to grow. I have so many of them, but they just take their sweet ass time. I’m already half-way through my third 900IU Gonal-F pen, which costs about the same as one of my paychecks!

Anyways enough of my complaining. Here are today’s stats:

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So, we’re getting there… One or two more days until trigger.

IVF#2: After 9 Days of Stims

DW and I had a nice date night yesterday. We started off the evening at Whole Foods (always a delight), and then headed to my favourite Thai place. This restaurant is 100% authentic Thai. The women who own it are sisters, and actually purchase most of their spices from Thailand themselves because for some reason, a lot of Thai products aren’t approved for import into Canada. My favourite dishes are their made-from-scratch (and not from a powder) tom yum soup:

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And their tilapia keang som, which is a non-coconut milk based curry. It has a base of tamarind paste:

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DW tried a new dish, called Pad Ped Pla:

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The dishes were served with jasmine rice, and were sooo delicious. We saved some for the next day’s lunch, but by 10pm the same night, we inhaled the leftovers.

After dinner, we hit the movie theatre to watch the new Johnny Depp movie, Mortdecai. We enjoy Depp’s silly humour, and kind of picked this movie without knowing much else about it. However, we were quite pleasantly surprised by how enjoyable it was. Several times I found myself literally laughing out loud. We got home in time for my nighttime Gonal-f injection, and a couple of episodes of the Walking Dead, which we are catching up on on our PVR.

Today, I had monitoring this morning.
Here are today’s stats:

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The ultrasound tech was funny today, saying, “uh oh, Dr. ______ isn’t going to like this- so many follicles!”. Ahh such is my life.

She was right. This afternoon one of the nurses called, and I’m supposed to lower my dose of Gonal-f again tonight, down to 200 units.

Monitoring again tomorrow!

IVF#2: After 7 Days of Stims

So I’m at that point of bloatedness now where it hurts to pee and poop. My ovaries are each packing in 10 follicles that are on average, a centimetre in diameter each. In the morning, the bloat isn’t so bad, but by the night time, I feel like someone has pumped my belly full of air, creating a very high-pressure system. It hurts to twist or turn too quickly, and rolling over in bed has to be done very carefully. It takes me forever to empty my bladder, because bearing down feels like I’m squishing my ovaries. Pooping, well, you can imagine how difficult pooping is too.

I had monitoring again today, and have a lead follicle at 14mm, so I start coming in daily now for blood work and ultrasound. I hope things progress fast, because my cervix is getting very sensitive to the poking around, I’m running out of veins, and just had to buy another 900IU of Gonal-f and vial of Lupron. These drugs aren’t cheap!

Plus, stimming for 14 days last time nearly killed me- both the wait, but also the amount of monitoring and the OHSS. 36 follicles was just crazy!

So here are today’s stats:

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Those follicles are growing, and more importantly, they are growing all within the same range of sizes. I hope all 20 make it to a good diameter so that they’re all mature. Last time, even though I had 36 follicles, only 19 were mature enough.

What I’m really enjoying right now is comparing my stats from this IVF to those from last year: after 13 days of stims, and after 14 days of stims.

Judging from how things progressed last year, I predict that I’ll be triggering on Tuesday, and retrieving on Thursday. That seems so far away, and a long time feeling so bloated, so of course I’d be thrilled if things progressed quicker this time around.

Another update tomorrow!

IVF#2: After 5 Days of Stims

Just a quickie today, but I wanted to update y’all after today’s monitoring appointment.

Yesterday, I went in for my intralipid infusion, which took about two hours, and involved me being hooked up via IV to a bag of what DW calls the “special mayonnaise”. At $750 a pop, out of pocket, it is also an expensive mayonnaise. I have very few superficial veins, and it took the nurses four tries to tap a live one. They eventually had to go for one in my hand, which hurt a lot, and with the Aspirin that I’m taking, bled a lot afterwards.

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Yesterday, I also noticed globs of egg white cervical mucus, which tells me my estrogen levels are high. Each of the little follicles in my ovaries release estrogen as they mature, contributing to the clusterglobs in my underpants. I anticipate that it is bound to get messier by the day. Lucky for you, I did not take pictures of this, as I might have been tempted to post them.

Today, I ran from appointment to appointment. I had really bad insomnia last night (probably due to high estrogen levels, which messes up my sleep every cycle), and took 50mg of diphenhydramine hydrochloride (Benedryl) at 11pm. Benedryl makes me super groggy and I was laying in bed like a zombie this morning, almost missing my monitoring appointment at the fertility clinic. Over the course of 15 minutes, I managed to shower and dress, set up the crockpot for pulled pork, fry some eggs (sunny side up), butter some gluten-free toast, and make myself a protein shake. I also made it to my appointment only 4 minutes late. Phew!

At the clinic, I had blood work and ultrasound done, which revealed 10 follicles on each side (20 in total!), 4 of which are 10mm or larger. They still have a ways to grow, so I go back in on Friday for my next monitoring.

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I’m happy with this number, and now just want them to grow into big fat juicy follicles. Last IVF, I ended up with 36 follicles, with only 19 being mature. This time, since we are doing a fresh transfer back into me, I hope I am not overstimulated, but still have a good number of mature eggs to make good quality embryos. *Fingers and toes crossed*

After monitoring, I rushed downtown to my acupuncture appointment. I’ve got a whole bunch of herbs that I need to take to increase my kidney yang, as my pulse was a bit slow and weak. I also had an acupuncture treatment, which was nice. My TCM doc is a bit of an odd duck, so it’s always an interesting treatment.

Next update on Friday!

What I’m Doing to Prevent OHSS- Day One

The last 28 hours have been less than fun, given that there are holes in my vagina and ovaries. We have been doing our best to stave off ovarian hyper stimulation syndrome (OHSS), which has felt like a full-time job.

Things that we are doing to prevent OHSS:

– I have been downing coconut water, which is a good electrolyte
– I have been eating salty things like soup
– I made myself a big pot of congee (a savoury Chinese rice porridge), which is salty and very easy on the digestive system
– I am trying to maintain my protein consumption at every meal even though I don’t feel like eating it when I’m not feeling well
– I am not exercising, even though it usually makes me feel better when I’m feeling gross
– I am weighing myself and measuring my abdominal girth daily
– I am doing acupuncture on myself (I have advanced training in this) to prevent ascites
– I am trying to relax and enjoy my 2 days off at home

So far, most of my discomfort has to do with any movements that engage my pelvic floor: getting up/down from sitting/standing, rolling over or changing position on the couch/bed, coughing (still have that damn cold from my MIL!), urinating, defecating, sitting.

This morning, the acetaminophen had worn off and I had major problems trying to pee. I could not bear down, and could only “open the flood gates” and let the natural pressure differential aid in excretion. I sat there for minutes as my urine “drip drip drip drip dripped….”. It was frustrating and sad as DW stood there and stared, feeling helpless and sorry for me.

However, I’m not feeling overly bloated. Just a little maybe. I have read that the bloating gets worse with time, which scares the shit out of me because I was hoping to play hockey on Monday, and am playing in a tournament during the weekend of the 30th.

We’ll see how it goes. Will update more on this as things progress.

Egg Retrieval!

So at 5:35am, we rolled into the clinic parking lot, Black Eyed Peas blaring in the car, us bouncing to “Pump It Harder”.

We were immediately escorted downstairs to the recovery room, where I was asked to change into a gown and undress from my waist down. I was also given little disposable slippers and a hair net that didn’t fit over my dread bun.

Then the nurse asked me some questions and put an IV in my arm. The doctor was running late, so we just waited for a bit. Below is a picture of DW in her outfit for the retrieval, as well as the recovery area:

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We were then led to the treatment room, where I was asked to lie down and place my legs in a strange contraption. DW was in the room with me, as were two nurses and one of my favourite ultrasound technicians.

Three different drugs, which the nurse kept referring to as the “cocktail” were injected into my IV line, and within a few minutes my body started feeling heavy. The doctor came in just as the drugs were starting to set in. He inserted a speculum, ‘prepared’ my vagina, and then began the retrieval.

I felt the needle as it poked through each ovary, and as it was maneuvered to access each follicle. I got to watch it in the tv in the room as well. It was over just as quickly as it began, and I don’t remember about two-thirds of it presumably because if the drugs (at some point the doctor asked the nurse to give me another dose of the “cocktail”).

In no time, it was over. It took about an hour and a half for the drugs to wear off though. In that hour, I was very sleepy, we hit a grocery store, and I puked in the car (thank goodness for doggie poop bags in the glove compartment).

Once we were home, DW pampered me with unlimited fetches, and hit up three more grocery stores to get things that I wanted/needed.

The pain has been on and off since we’ve been home. Mostly a stabbing pain that comes on randomly, but it also hurts a lot when I pee and poop. Sudden movements are risky as well. So today, I’ve been a couch potato, and have run out of PVR’d shows to watch.

Here are today’s stats:

21 mature eggs were retrieved (they didn’t bother with the smaller ones).

7 will be used for old-school fertilization (put egg and sperm in a room and see if they hit it off)
12 will be used for ICSI (intracytoplasmic sperm injection)
2 were deemed low quality

Tomorrow we find out how many fertilized!