Showing posts with label egg retrieval. Show all posts
Showing posts with label egg retrieval. Show all posts
May 21, 2012
cycle update
10 eggs retrieved (much better than we expected), 7 eggs mature (a little better than we expected), 5 fertilized by ICSI (we'll take it). Big decisions to be made still re: transfer and lots of different considerations to take into account (though we are pretty steadfastly committed to SET, so that is not one of the major considerations). I am exhausted so more to come later, but I just wanted to check in.
May 18, 2012
in which my body made the choice for me...
This round of IVF has become somewhat of a disaster. My right ovary is on vacation, not responding at all. The ultrasound technician says there is something on that ovary, probably a cyst. My E2 was very low at baseline so whatever it is, it seemed unlikely to be functional and interfere with things, but it is now the only explanation of why my right ovary won't do anything. I am now on 2x my usual dose of stims trying to max out what the left side can produce.
None of that in of itself is so terrible, but yesterday my progesterone more than doubled. In short, this means the environment is no longer supportive of implantation, so the plan is to cut the cycle short, do retrieval on Sunday, and then likely freeze whatever we can get in terms of embryos. If we get 3-6 eggs, I don't think we will have much in the way of embryos, but things don't look good for a fresh transfer this month.
The other problem is my uterus. When I had my follow-up scan after the operative hysteroscopy, there was still a small amount of residual "stuff." The gynecologist wanted to wait until I had a good bleed and do another scan at the beginning of my cycle herself to see how things look and then send me for another diagnostic hysteroscopy if things still didn't look good. Then I got the crazy idea that I wanted to do another IVF before we leave for Y's fellowship. And I got lazy. If I needed to get a baseline scan at the fertility clinic anyway at the start of my cycle, I didn't want to also trudge back to her for a baseline scan as well. She said that was up to me, I should just let her know how everything goes.
The baseline scan at the fertility clinic wasn't perfect, but it was good enough for them and I explained to the ultrasound technician the context, so she knew what she was looking for. She said my lining was very thick for the beginning of the cycle and that there was a small echogenic area which could be something or nothing, but at any rate, it was probably on its way out with my period. My next two scans were both with different technicians and they both said my uterus now looked fine. Cue major sigh of relief.
Yesterday was yet another technician. She said there was a small amount of fluid in the uterus (never a good thing) and that there is still an echogenic area with blood flow (not good at all). Also, my lining is inexplicably getting thinner instead of thicker. I don't even know how that is possible. Now my RE says he will take a look at the uterus as well when he does my ER but a fresh transfer is likely off the table anyway due to the rising progesterone.
I guess my body decided for me that it is not ready to make and carry another baby yet. I am quite sad and frustrated because I don't know when our next opportunity will be to cycle again since we are leaving for a year. I know it was wishful thinking to have a smooth and successful IVF so soon after losing the twins and I know I have been a lot less emotionally involved in this cycle than I usually am, but honestly, I am still not at peace with this and it makes me so sad. I come back to it every time - I will never understand why this has to be so so hard.
None of that in of itself is so terrible, but yesterday my progesterone more than doubled. In short, this means the environment is no longer supportive of implantation, so the plan is to cut the cycle short, do retrieval on Sunday, and then likely freeze whatever we can get in terms of embryos. If we get 3-6 eggs, I don't think we will have much in the way of embryos, but things don't look good for a fresh transfer this month.
The other problem is my uterus. When I had my follow-up scan after the operative hysteroscopy, there was still a small amount of residual "stuff." The gynecologist wanted to wait until I had a good bleed and do another scan at the beginning of my cycle herself to see how things look and then send me for another diagnostic hysteroscopy if things still didn't look good. Then I got the crazy idea that I wanted to do another IVF before we leave for Y's fellowship. And I got lazy. If I needed to get a baseline scan at the fertility clinic anyway at the start of my cycle, I didn't want to also trudge back to her for a baseline scan as well. She said that was up to me, I should just let her know how everything goes.
The baseline scan at the fertility clinic wasn't perfect, but it was good enough for them and I explained to the ultrasound technician the context, so she knew what she was looking for. She said my lining was very thick for the beginning of the cycle and that there was a small echogenic area which could be something or nothing, but at any rate, it was probably on its way out with my period. My next two scans were both with different technicians and they both said my uterus now looked fine. Cue major sigh of relief.
Yesterday was yet another technician. She said there was a small amount of fluid in the uterus (never a good thing) and that there is still an echogenic area with blood flow (not good at all). Also, my lining is inexplicably getting thinner instead of thicker. I don't even know how that is possible. Now my RE says he will take a look at the uterus as well when he does my ER but a fresh transfer is likely off the table anyway due to the rising progesterone.
I guess my body decided for me that it is not ready to make and carry another baby yet. I am quite sad and frustrated because I don't know when our next opportunity will be to cycle again since we are leaving for a year. I know it was wishful thinking to have a smooth and successful IVF so soon after losing the twins and I know I have been a lot less emotionally involved in this cycle than I usually am, but honestly, I am still not at peace with this and it makes me so sad. I come back to it every time - I will never understand why this has to be so so hard.
Nov 6, 2011
retrieval and fertilization report
First thing Friday morning we went in for our retrieval. The experience at the small private hospital was much more pleasant than the experience at the large university hospital. No waiting around forever...it was amazing! We got there at 7:30am and got to leave by 9:30 (it's true we were really pushing it - Y HATES waiting around hospitals which is ironic given his profession and also his place of employment...he was ready to take out my IV himself). For comparison, at my previous clinic I got there at 8am for retrieval and wasn't able to leave until 3pm, mostly because it took hours for a doctor to come and sign off on my chart.
I also had a much, much easier time recovering from the retrieval this time around which also made it a much more positive experience and as I mentioned previously, my friend T (who was the one who actually recommended my current RE) had retrieval immediately after me, so it was really great to have a comrade in all of this (as I have said to her, I like to imagine our embryos hanging out in the incubator together becoming friendly in their pre-life :) ).
This time around we got 10 eggs, which is two less than last time. It is about what we were expecting. I had 13 follies at my last monitoring appointment, but of those 13, four were still just barely measurable, so it would seem that one of those little guys was able to catch up and the other three weren't. I do think I had a slightly smoother stimulation this time than during my last fresh cycle. Last night we found out the 8 fertilized, and as of today, we still have 8 embryos. Last fresh cycle we also had 8 embryos, but coming from 12 eggs, so this was a higher fertilization rate. Like last time, we did a split-batch of 1/2 ICSI 1/2 regular IVF. I am still not sure what proportion of eggs fertilized via ICSI vs. natural fertilization, but I will be interested to know.
The decision of whether to try to grow the embryos to blastocyst or not was much more agonizing than I thought. Dr. T. basically left it up to us to decide. He did suggest the possibility of transferring 1 embryo on day 3 and then attempting to grow the rest to blastocyst with the option of transferring another embryo on day 5. I guess the idea is that this would be a sort of insurance policy if none of the remaining embryos made it to blast. Another consideration is that the lab is apparently not super adept at freezing and thawing blastocysts, even with vitrification, so by attempting to do a day 5 transfer, we might be limiting our possibilities with pursuing frozen transfers from this cycle.
I guess the thing that nags at me most is that all the doctors agree that the reason we are probably not getting pregnant is due to a very high proportion of genetically incompetent embryos, even if they morphologically look nice on day 3. If this is true, it seems to me that our most efficient strategy is probably to eliminate as many abnormal embryos as possible and not even bother transferring them and growing to blastocyst gives us a better selection device than we have had in the past to accomplish this (ultimately, CGH testing would probably be the best selection device, but it's not really an option for us here in Israel right now).
Soooo....in the end we decided to try to grow the embryos to blastocyst. I just know I need to be emotionally prepared to lose all of our embies and/or pursue another fresh cycle in a few weeks if it doesn't work. I still must say I am feeling better about this cycle than our previous ones and I am quite happy we switched clinics and grateful for our RE, who allows us to be much more involved in the process than our previous clinic.
I also had a much, much easier time recovering from the retrieval this time around which also made it a much more positive experience and as I mentioned previously, my friend T (who was the one who actually recommended my current RE) had retrieval immediately after me, so it was really great to have a comrade in all of this (as I have said to her, I like to imagine our embryos hanging out in the incubator together becoming friendly in their pre-life :) ).
This time around we got 10 eggs, which is two less than last time. It is about what we were expecting. I had 13 follies at my last monitoring appointment, but of those 13, four were still just barely measurable, so it would seem that one of those little guys was able to catch up and the other three weren't. I do think I had a slightly smoother stimulation this time than during my last fresh cycle. Last night we found out the 8 fertilized, and as of today, we still have 8 embryos. Last fresh cycle we also had 8 embryos, but coming from 12 eggs, so this was a higher fertilization rate. Like last time, we did a split-batch of 1/2 ICSI 1/2 regular IVF. I am still not sure what proportion of eggs fertilized via ICSI vs. natural fertilization, but I will be interested to know.
The decision of whether to try to grow the embryos to blastocyst or not was much more agonizing than I thought. Dr. T. basically left it up to us to decide. He did suggest the possibility of transferring 1 embryo on day 3 and then attempting to grow the rest to blastocyst with the option of transferring another embryo on day 5. I guess the idea is that this would be a sort of insurance policy if none of the remaining embryos made it to blast. Another consideration is that the lab is apparently not super adept at freezing and thawing blastocysts, even with vitrification, so by attempting to do a day 5 transfer, we might be limiting our possibilities with pursuing frozen transfers from this cycle.
I guess the thing that nags at me most is that all the doctors agree that the reason we are probably not getting pregnant is due to a very high proportion of genetically incompetent embryos, even if they morphologically look nice on day 3. If this is true, it seems to me that our most efficient strategy is probably to eliminate as many abnormal embryos as possible and not even bother transferring them and growing to blastocyst gives us a better selection device than we have had in the past to accomplish this (ultimately, CGH testing would probably be the best selection device, but it's not really an option for us here in Israel right now).
Soooo....in the end we decided to try to grow the embryos to blastocyst. I just know I need to be emotionally prepared to lose all of our embies and/or pursue another fresh cycle in a few weeks if it doesn't work. I still must say I am feeling better about this cycle than our previous ones and I am quite happy we switched clinics and grateful for our RE, who allows us to be much more involved in the process than our previous clinic.
Nov 3, 2011
retrieval tomorrow
Tomorrow I go in for my ER bright & early. I am really a bundle of nerves - so many what-ifs running through my brain as usual. I started off this cycle so optimistic. I was really making a conscious effort to stay as positive and calm as possible. I am still trying, but as the cycle unfolds and I have more & more information available, it becomes so hard!
I know in every cycle previously I constantly adjusted and managed my expectations as the cycle progressed, and this has been a splendid defense mechanism to prevent me from ever being surprised or caught off-guard by a negative beta, but on the other hand, I really would like to be able to keep up some positive energy and I just want so, so badly for this to be the time things are different.
We are in a new Jewish calendar year, we are at a new clinic with a new doctor - I have just been so ready for a change of luck. My pragmatic side realizes that just feeling ready for a change in luck or any sense of entitlement that I really *deserve* this for all of the crap I have been through, doesn't really make it any more likely to happen; I mean if this was about what is fair, I like to believe I would have had a screaming baby in my arms quite some time ago. But please G-d, still, can't this time be different?
The truth is that even with the tweaks in my protocol, this cycle is eerily reminiscent of my last fresh cycle, right down to the E2 that initially rises nicely but then stalls such that my E2 and my follicle growth become somewhat inconsistent with each other and right down to the 2 dominant follicles (I often wonder if these 2 big guys are sequestering all of the drugs for themselves and not playing nice with their friendly ovarian compatriots? :) ). In a way it is humbling how even with changes to my protocol, it seems my body is just going to do what it's going to do despite our best efforts to steer it a little differently.
I don't mean to be all gloom and doom - I still did get a respectable number of eggs last time (though this time it seems like there may be less), but it is so difficult for me not to let all those familiar doubts come rushing back in. My friend T will also be doing ER with me tomorrow morning - companionship that I feel very lucky for. I really hope next time I write I will have some good news to report!
I know in every cycle previously I constantly adjusted and managed my expectations as the cycle progressed, and this has been a splendid defense mechanism to prevent me from ever being surprised or caught off-guard by a negative beta, but on the other hand, I really would like to be able to keep up some positive energy and I just want so, so badly for this to be the time things are different.
We are in a new Jewish calendar year, we are at a new clinic with a new doctor - I have just been so ready for a change of luck. My pragmatic side realizes that just feeling ready for a change in luck or any sense of entitlement that I really *deserve* this for all of the crap I have been through, doesn't really make it any more likely to happen; I mean if this was about what is fair, I like to believe I would have had a screaming baby in my arms quite some time ago. But please G-d, still, can't this time be different?
The truth is that even with the tweaks in my protocol, this cycle is eerily reminiscent of my last fresh cycle, right down to the E2 that initially rises nicely but then stalls such that my E2 and my follicle growth become somewhat inconsistent with each other and right down to the 2 dominant follicles (I often wonder if these 2 big guys are sequestering all of the drugs for themselves and not playing nice with their friendly ovarian compatriots? :) ). In a way it is humbling how even with changes to my protocol, it seems my body is just going to do what it's going to do despite our best efforts to steer it a little differently.
I don't mean to be all gloom and doom - I still did get a respectable number of eggs last time (though this time it seems like there may be less), but it is so difficult for me not to let all those familiar doubts come rushing back in. My friend T will also be doing ER with me tomorrow morning - companionship that I feel very lucky for. I really hope next time I write I will have some good news to report!
Jun 19, 2011
12 eggs!
My egg retrieval was this morning. In the end, we got 12 eggs. No great surprises, but that's just about as good as we could reasonably expect so I am happy. I also had an irrational fear that I would have already ovulated, so I was so relieved to hear there were actual eggs in there:) The whole experience was very surreal, probably thanks to the anesthesia.
We checked in to the day surgery department at 8am. The nurses took my vitals and I got my uber fashionable gown and hospital pj pants. Y went to to hand in The Sample and I listened to my Anji pre-retrieval meditation track on my iPhone one last time:) After 30 minutes or so, they brought me down to the OR. They brought us into a smaller inner waiting area off of the ORs. There was another couple there when we arrived. After about 20 minutes, they were called in and a few minutes later, another couple arrived. This couple, who we would spend most of the rest of the day next to, was on their 5th IVF. I so very much hope that they are successful this round! Once they arrived, we waited a full hour before the nurse called me back! This was definitely the most nerve-wracking part of our morning, and the other couple was getting pretty anxious and antsy, too.
Finally, I was off to the OR. The anesthesiologist arrived and asked me questions about my health and anesthesia history. Since the REs in the clinic do the ERs on a rotating basis, I had no idea who I would be getting. I was really relieved and happy to get my favorite RE. He did my hysteroscopy as well and I know that he is very gentle.
He asked me how many eggs I was expecting and when I told him just around 10, he surprised me by asking whether I wanted local anesthesia instead of general and whether I have good pain tolerance. I know Y also prefers operating under local anesthesia whenever it's possible since it means fewer risks and a quicker recovery for the patient, but I wasn't too thrilled with this idea. The thing that's funny is that a few years ago, I probably would have said yes, seeing it as some opportunity to prove myself. However, I really didn't feel like I needed to prove anything so I told him the truth, which was that I wasn't so afraid of pain but that I didn't want to remember a thing!
Anyhow, the anesthesiologist put in my IV. I asked him if he had started pushing the drugs yet and he said no. Then he said he would start slowly and that the anesthesia would be progressive. The next thing I know the RE was telling me he got 12 eggs. The funny thing is that I don't remember seeing him or having my eyes open. What seemed like only a minute later, I was in the recovery room and Y was there. Y said a full hour had passed since the time that we parted ways - amazing, because to me it could have been just 10 minutes. After about 30 minutes, the pulse oximeter and EKG leads came off and an orderly arrived and I was on my way!
They brought me back up to the day surgery unit, hooked my IV back up, and then I was able to drink some tea. The whole thing was kind of a production - I thought I would be out of there by noon but the day wore on. First, they wanted me to eat something after my tea. Then, they wanted me to pee. I spent most of the afternoon napping. Finally, around 2:30 a RE (a different one) came around and went over instructions with us and discharged me. I was so ready to get out of there and go home!
Unfortunately, because of where Y parked the car, we had to walk through the medical school (where my lab is located) in order to get out of there. I was sooooo cranky and I didn't want to be seen by anyone because I knew I looked like crap and I prefer to keep my treatments as private as possible. I kept seeing people I know, averting my eyes, and whining to Y. It was pretty embarrassing.
I asked Y to get me a giant fruit smoothie on our way home, which I consumed in about 3 minutes. I was so happy to be home, take more Optalgin (awesome OTC pain medication in Israel that is illegal in the states), and sleep! I was quite uncomfortable and groggy for a while, but now it is 10:30pm and I am awake and feeling better and more with it - just sore and crampy. Hopefully, I will be able to go to work tomorrow - we'll see.
Tomorrow is another big day for us - we should get the fert report around 10am. I am hoping and praying that across town tonight, my eggs and Y's sperm are playing nice, giving rise to some beautiful, healthy embryos!
We checked in to the day surgery department at 8am. The nurses took my vitals and I got my uber fashionable gown and hospital pj pants. Y went to to hand in The Sample and I listened to my Anji pre-retrieval meditation track on my iPhone one last time:) After 30 minutes or so, they brought me down to the OR. They brought us into a smaller inner waiting area off of the ORs. There was another couple there when we arrived. After about 20 minutes, they were called in and a few minutes later, another couple arrived. This couple, who we would spend most of the rest of the day next to, was on their 5th IVF. I so very much hope that they are successful this round! Once they arrived, we waited a full hour before the nurse called me back! This was definitely the most nerve-wracking part of our morning, and the other couple was getting pretty anxious and antsy, too.
Finally, I was off to the OR. The anesthesiologist arrived and asked me questions about my health and anesthesia history. Since the REs in the clinic do the ERs on a rotating basis, I had no idea who I would be getting. I was really relieved and happy to get my favorite RE. He did my hysteroscopy as well and I know that he is very gentle.
He asked me how many eggs I was expecting and when I told him just around 10, he surprised me by asking whether I wanted local anesthesia instead of general and whether I have good pain tolerance. I know Y also prefers operating under local anesthesia whenever it's possible since it means fewer risks and a quicker recovery for the patient, but I wasn't too thrilled with this idea. The thing that's funny is that a few years ago, I probably would have said yes, seeing it as some opportunity to prove myself. However, I really didn't feel like I needed to prove anything so I told him the truth, which was that I wasn't so afraid of pain but that I didn't want to remember a thing!
Anyhow, the anesthesiologist put in my IV. I asked him if he had started pushing the drugs yet and he said no. Then he said he would start slowly and that the anesthesia would be progressive. The next thing I know the RE was telling me he got 12 eggs. The funny thing is that I don't remember seeing him or having my eyes open. What seemed like only a minute later, I was in the recovery room and Y was there. Y said a full hour had passed since the time that we parted ways - amazing, because to me it could have been just 10 minutes. After about 30 minutes, the pulse oximeter and EKG leads came off and an orderly arrived and I was on my way!
They brought me back up to the day surgery unit, hooked my IV back up, and then I was able to drink some tea. The whole thing was kind of a production - I thought I would be out of there by noon but the day wore on. First, they wanted me to eat something after my tea. Then, they wanted me to pee. I spent most of the afternoon napping. Finally, around 2:30 a RE (a different one) came around and went over instructions with us and discharged me. I was so ready to get out of there and go home!
Unfortunately, because of where Y parked the car, we had to walk through the medical school (where my lab is located) in order to get out of there. I was sooooo cranky and I didn't want to be seen by anyone because I knew I looked like crap and I prefer to keep my treatments as private as possible. I kept seeing people I know, averting my eyes, and whining to Y. It was pretty embarrassing.
I asked Y to get me a giant fruit smoothie on our way home, which I consumed in about 3 minutes. I was so happy to be home, take more Optalgin (awesome OTC pain medication in Israel that is illegal in the states), and sleep! I was quite uncomfortable and groggy for a while, but now it is 10:30pm and I am awake and feeling better and more with it - just sore and crampy. Hopefully, I will be able to go to work tomorrow - we'll see.
Tomorrow is another big day for us - we should get the fert report around 10am. I am hoping and praying that across town tonight, my eggs and Y's sperm are playing nice, giving rise to some beautiful, healthy embryos!
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