Our Roller Coaster Week & Egg Collection Update

A few days ago we were absolutely ecstatic that my egg collection this month was going ahead. My follicles had grown quite a bit and things were looking great!

The same day I received the good news, I began to feel rather ill, I had a severe case of diarrhoea that I honestly didn’t think much of until I woke up the next day and still felt rather shocking. I googled “diarrhoea” with “Gonal-F” and also “Orgalutran” and both searches came up the same. “If you experience diarrhoea this may be a symptom of Ovarian Hyperstimulation Syndrome, call your specialist immediately”. So I did what Dr Google told me to, and called the specialist first thing that morning just to be sure. I left a message with the receptionist and the Doctor called back shortly after. He told me that the Diarrhoea was indeed a bit abnormal but to consume lots of water and try to avoid food for a while to see if it sorts itself out.  He then said he was about to call me that morning anyway because he had some news about my blood test.

Apparently my progesterone levels were rising (this is the hormone that is released post ovulation). He explained that this means my body is a bit out of sync and hence the conditions are not ideal for Embryo transfer. Why body, WHY? The Embryo Transfer may need to be postponed until next month, but will be dependent on many varying factors (whether the embryos will be strong enough to freeze, whether we will have enough embryos to give it a go this month).

This was quite the letdown to Scott and I, as we were eager to have everything done this month. Still, it wasn’t the end of the world, the past weeks of injections hadn’t been completely fruitless because egg collection was still proceeding. Plus it would also mean that I would have the opportunity to further focus on looking after myself so that I could be in tip top condition for the embryo transfer next month.

I did what the doc said and I avoided food for many hours and drank plenty of water. I was relieved when the diarrhoea sorted itself out. That day I continued with injections (the final ones Yeehaaaa!) And finished the day with my Trigger Shot (Ovidrel EpiPen) at 10pm. 37 hours later I would be going into surgery, it was exciting!!!

The next day, (DAY 14 – the day before egg collection) no drugs are taken at all. I felt kind of bloated and a little crampy but not too bad overall.

DAY 15 – EGG COLLECTION DAY

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A diagram of the Egg collection procedure

This was the day we were anxiously awaiting, finally there would be some definite answers on how many mature eggs I have hiding in those follicles. We were hoping for 10!

I was very excited about the surgery and surprisingly not too nervous, mainly just anxious to find out the results.

At 4:30am I got up, and although I wasn’t hungry at all then, I had a banana and drank 1 litre of water (this was because I wouldn’t be able to consume anything for 6 hrs prior to surgery due to the anaesthetic requirements). I knew I would be super starving and thirsty if I didn’t get up before 5am to eat and drink! That morning, I was feeling fairly uncomfortable with bloating and cramping.

We were due at the hospital at 9:30am with all our paperwork ready and Scott’s jar of you-know-what!

Shortly after we paid the fees for the surgery a nurse came and interviewed Scott and I to check that she had all the information she required. Then she took me up to the forth floor where the theatres were.

I stripped off and got changed into some very attractive getup, complete with blue paper booties and a nice papery shower cap (I truly apologise for the fact that there is no photo of me in this, I left my phone with Scott unfortunately so couldn’t document it). Then armed with my white garbage bag of possessions, I proceeded to a waiting room with 4 other women just chilling together in our striped gowns and no undies.

The hour wait felt pretty long to be honest, not just because daytime telly is appalling, but because it was obvious that the other ladies were quite nervous. One poor lady was even having bad cramps, I really felt for her, she couldn’t even sit up straight.

Then finally my Specialist was there in the doorway and it was such a relief to see him – I have a lot of trust in this man! He took me through to another waiting room where the anaesthetist came to meet me. The anaesthetist was sooo lovely, I can’t speak more highly of him. He had such a lovely manner about him, he spoke very calmly and I immediately felt at ease. He told me about the risks with the procedure but assured me he would be there the entire time to look after me.

Then I was off to the theatre and the atmosphere was far different to what I anticipated. There were about 7 in the room all up, including my specialist and the anaesthetist. They were all super lovely and very jovial. They were cracking jokes with one another and once again, I felt any anxiety I had been feeling subside.

One of the nurses came and untied my smock so that my bum was on display for all to see (yep there ain’t nothing glamorous about this I’m afraid). Then I hopped onto the bed, awkwardly with my booties slipping off and my butt exposed. I lay down under the blanket and the anaesthetist came to put the drip in my arm. He had quite a bit of trouble getting the needle in and was extremely apologetic. The specialist came and held my hand and told me not to look (he mustn’t have got my memo – I am Ash conqueror of needles, HEAR ME ROAR).

Then I woke up. And a lovely nurse was right there beside me with her smiling face telling me everything went really well and my doc will be there shortly to see me. I  felt really great, surprisingly alert with what felt like mild period pain.

My doctor came in and said they had gotten 17 eggs. SEVENTEEN!!! I felt like I had won the lotto. He told me that the sperm was on the low side so we would be doing ICSI for all eggs (where they take a single sperm and inject into the egg).

I stayed lying down in the bed for a good half hour or so, with the nurses checking on me frequently to offer heat packs and pain killers and to check my pad (yep that’s right). I actually didn’t feel bad pain at all so I declined the pain killers.

I felt extremely lucky as I watched the other women in the ward feeling dizzy and in pain. One patient was helped up by the nurses and then almost passed out, so was put back to bed. I felt rather guilty when I was released and walked past all the women that had gone into surgery before me, still restricted to their beds.

Scotto was there to pick me up. So I told him the good news! 17 Eggs!! WOOHOO!!!

The nurse came and gave me instructions on Ovarian Hyperstimulation which apparently I am still at risk of due to the number of eggs I produced. Told me that I may spot for a few days but if there is any heavier bleeding to seek medical help. I was advised to eat plenty of protein (I assume to assist with the healing) and keep my fluids up. All the advice seemed pretty straight forward.

Later that afternoon the pain hit me and the bloating was incredibly uncomfortable. It was a very uncomfortable evening because every little movement gave me a sharp pain in my abdomen. I took some panadol and it did nothing, the heat pack was much more effective so Scott carried out heat pack duty for the evening.

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Still feeling bloated and very uncomfortable the morning following egg collection

We were given instructions to phone the specialist the following morning at 10am to find out how many were mature and how many were fertilised.

This morning we made that phone call and it wasn’t a very good outcome unfortunately. Of the 17 eggs, 11 were mature (which is good) however only 2 of the 11 were fertilised. This was a complete shock and devastating news. Usually 60% of mature eggs will fertilise. Our specialist can’t give any explanation as to why this happened to us, he said that we may never know what the reason was. I knew that even fertilised eggs can drop quickly in the coming days, so I asked him what the chances were that these two would survive. He didn’t have an answer for us (which I kind of already knew) and he said that maybe these two eggs were meant to be, maybe they will stick it out.

Tomorrow night we will ring the specialist again to find out if they made it to day 3.

I had a big cry and Scott is very upset and frustrated. It’s horrible not knowing what went wrong and an incredibly emotional time as we wait anxiously to see if we have to make the same financial and emotional investment to do it all again next month. It’s human nature to want to fix things, and it is extremely hard dealing with so much of the unknown along this journey.

Processed with MOLDIV

After I had my big cry today, we went to the markets to buy some flowers. I picked 3 beautiful bunches in muted tones and we headed home. I arranged the flowers in the nursery (the room that we have called the nursery for over 3 years now).

I made two small vases in honour of the two eggs that made it overnight. Then I made one big bunch to represent all the hope we are sending them and stuck it in the middle. I also painted a pot plant and moved it to the nursery. It was an odd little ritual that somehow made me feel better about today.

Come what may tomorrow, it’s still going to be our year. I know it.

 

 

 

 

 

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My IVF cycle – The Technical stuff

 

I’ve spoken about emotions a lot on this blog so far but I haven’t really touched much on all the scientific stuff. I’m currently on Day 16 and finished my injections a couple of days ago, so I thought it may be useful to do a post about my specific cycle and give a rundown on any side effects I experienced.

Firstly, it’s important to note that each IVF cycle will vary slightly from person to person. This will be dependent on the circumstance as well as the specialist’s informed opinions and preferences.

There are different protocols for IVF treatments.

The protocol I’m doing for this cycle is what is know as ‘IVF Antagonist’ (sounds fancy right?)

There are two main types of drugs involved in this Antagonist cycle.

1.Follicle Stimulating Hormone (FSH/ Stims)

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Scott armed with the Gonal-F EpiPen for my very first injection – would you trust this man?

WHAT IT DOES: Stimulates the ovaries to produce many follicles (which hopefully contain healthy eggs)

WHAT I’M TAKING: GONAL-F (125IU)- In the form of an EpiPen (subcutaneous injection into the lower abdomen)

HOW SCARY IS IT REALLY: Not scary at all!!! I could inject this one myself after Scott did the first injection (I will reiterate that I am not good with needles at all- if I can do this anyone can!) It honestly doesn’t hurt at all, it’s super easy to insert because it’s such a fine needle. Sometimes you may bleed a teenie tiny bit (1 tiny drop). Also, I bruise easily yet never got a bruise from this one.

SIDE EFFECTS: Hardly anything significant at all – woooohooo! Just a little bit of bloat going on, nothing terrible. Some mild hot flashes.

2. Gonadotrophin Releasing Hormone (GnRH)

WHAT IT DOES: This is where the antagonist part comes into play, as it prevents the pituitary gland from producing Luteinising Hormone (in a normal cycle this is the hormone responsible for releasing an egg).

WHAT I’M TAKING: ORGALUTRAN – In the form of a single use needle (subcutaneous injection into the lower abdomen). Must be taken at exactly the same time each day!

 

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Orgalutran – a teenie tiny needle that had me terrified for no reason

HOW SCARY IS IT REALLY: How on earth can this tiny little needle strike so much fear in me? They should have just encased it in gigantic white plastic cylinder, so you can’t see the syringe part (like the EpiPen) because for some strange reason that plastic cylinder makes everything seem ok. So the nurses kind of had me freaked out about this little guy right from the start. They kept saying that it’s a slightly thicker needle, so a bit harder to go in. So I spent the first few days being a total chicken and forcing my mum-in-law to inject me haha!

Once I got to the point that I could watch it go in, I started thinking “hmmm, I think I can actually do this”. One morning as I was trying to psych myself up to do it, my mum-in-law messaged saying “Am I doing your injection today?” I took that as a sign and decided that I would be really brave and do it myself. I didn’t do a very good job to be honest because I was really shaky and the air bubble was not really in the right place inside the needle, so I could kind of feel it which felt a tiny bit strange. But the sense of accomplishment afterwards was pretty damn good! And I definitely got better at it after that. I only got one tiny little bruise from this guy.

SIDE EFFECTS: Immediate side effects at site of injection, nothing dramatic, just a tiny rash, a little bit of stinging and itchiness. It all subsides within 2 hours.

I was also getting a bit more bloated after taking Orgalutran but I can’t distinguish whether that was due to Orgalutran or Gonal-F. My boobs were super dooper sore and massive too (well massive for me haha), once again not sure which injection is the culprit for this or whether it was a joint effort from the two.

Other drugs involved are:

  • MELATONIN – in the form of a tablet – YAY it’s not another needle!! (apparently a powerful antioxidant to improve egg quality)
  • OVIDREL (which is ‘Human Choriogonadotrophin Alfa Hormone’ or ‘HCG’ – thank goodness there is an abbreviation!) In the form of an EpiPen (subcutaneous injection into lower abdomen) This is the Trigger Shot (to complete egg maturation and to release the eggs, taken very specifically at exactly 37 hrs prior to egg collection surgery, the eggs will release at 38hrs. Yes it is that specific – isn’t the human body amazing!!)
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Ovidrel – My final injection to release my eggies!

Below is a calendar of what my IVF cycle looks like:

DAY 1 (of cycle/period) – Advise clinic, collect drugs & learn how to administer them with the nurses at the fertility centre.

DAY 2

  • Blood Test first thing in morning – 7am
  • Await instructions from Specialist as to whether you can start injections.
  • Take 1st FSH injection of Gonal-F (125IU in my case)
  • Take 5mg of Melatonin at night (tablet)

DAYS 3, 4 & 5 

  • Daily FSH injection of Gonal-F (125IU)
  • 5mg of Melatonin at night

DAY 6  & 7

  • Continue FSH injection of Gonal-F. Continue Melatonin
  • DAY 6 – Commence Orgalutran injections (must be done at exact same time every day)

DAY 8

  • Transvaginal Ultrasound & Blood test to determine whether dose of FSH needs to be increased/ decreased or cycle cancelled.
  • Gonal – F was increased in my case to 200IU as my follicles weren’t the right size (too small)

DAY 9, 10, 11

  • Continue Gonal-F, Orgalutran & Melatonin

DAY 12

  • Return for additional ultrasound and blood test to determine if we proceed to egg collection.
  • Follicles have increased in size. Egg collection booked for day 15
  • Continue FSH, Orgalutran and Melatonin

DAY 13

  • Last day of Injections – Continue FSH, Orgalutran and Melatonin
  • Take trigger shot at 10pm (this is 37hrs prior to egg collection surgery on DAY 15

DAY 14

No injections today!

DAY 15 

  • Egg collection
  • Arrive at Day Hospital at 9:30
  • Semen sample to be provided to hospital
  • 11am Surgery
  • Release from Hospital 2-3hrs post surgery time
  • The scientist will take any eggs that are mature and inject them each with a single sperm (they will select the best sperm of the bunch to do this). This process is called ICSI and is different to IVF. ICSI is used when the sperm sample is not as strong.

Next step is waiting to see which eggs fertilise (this happens overnight)

Then to wait and see if any fertilised eggs divide to form Embryos

If everything is full steam ahead you will commence taking further drugs to support your lining and to encourage the embryo to embed.

Embryo Transfer usually occurs within 2-5 days if you have some healthy Embryos and your hormone levels are sufficient.

In my instance we will only be transferring a single embryo. This is because multiples actually increase your risk of many issues throughout your pregnancy.

So there it is, the technical stuff so far, I’m sure there will be more to come!