The day we were given to take a pregnancy test was 13 days past transfer (13dp5dt). I wondered whether I'd want to test early, and around days 5-7 I did have some days of wanting to test, but then I figured it was an opportunity to practise patience - and that if I was pregnant, I'd have plenty more opportunity to practise that, as I waited for scans and so forth, so it would be a good skill to develop!!! After that, I had no trouble waiting, and actually I could have waited longer, but that was probably because I was so nervous about testing. The pregnancy test is a huge deal after going through so much in a cycle, and I definitely felt the pressure of it.
I was really lucky though, as thanks to the OHSS I had a fairly good idea it would be positive. I also had a lot of hope as we had a hatching blast. I also had a fair few symptoms during the 2WW and some mild nausea started on 10dp5dt. When I got the nausea I was so happy - I just felt so blissed out and so pregnant! I had this feeling really deep down inside that something new, strange, and exciting was going on down below.
I couldn't sleep for excitement the night before the test, not a wink of anxiety (very unlike me!). I got up at 6am to take the test, couldn't hold out any more. We'd been given a test by the clinic and I'd bought some tests as well, so I did three. I peed in a little pot given us by the clinic and we stuck the tests in, set a timer, and lay on the bed for three minutes. I then had to get hubby to check the result, I was so nervous. He seemed to take an age to respond and then he said... 'Mrs, you're pregnant!'
I text his mum and sister right away (they asked us to!), and my mum at 8am. Hubby's mum and dad had a little cry, it was lovely. It was so precious telling my mum as well, she made a noise I'd never heard before - "OoohOOOOHoooh!" - and said she'd learn to knit!!!
I didn't feel like sharing the news with others after that, I wish we could have kept it to ourselves for a bit, but we had other friends waiting for the result. Overall I feel so blessed to have so many people rooting for us that I don't mind sharing - it's just my fears of something going wrong or it not being 'real' that makes me cautious. I wish I could let go of that fear and enjoy the moment!
The whole rest of test day I felt shattered and in shock. I didn't sleep well that night either, or the next night! It's now a few days later (I back-dated this post) and I still have no idea how to adjust to news like this!!!
I phoned the clinic that afternoon to give them our result and our 8 week scan was booked for December 14th.
Tuesday, 20 November 2012
Monday, 19 November 2012
Answered Prayer, OHSS, and the 2WW
So on the second day after embryo transfer (2dp5dt) my stomach swelled up like a little pregnant belly and I was diagnosed with mild OHSS following a scan and blood test at the clinic that afternoon. My ovaries had grown 1cm each since embryo transfer (from 6cm to 7cm) and a little fluid had collected on my belly.
After this the clinic phoned to monitor my belly measurements and symptoms every day for a week and a half. After about a week of this they stopped being concerned, I guess it became clear it was staying mild.
A week after embryo transfer (7dp5dt) I had a TERRIBLE night; pain like a ring of fire around my middle (front and back) which Paracetamol didn't touch and therefore no sleep. It was like the worst AF cramps ever and I spent the whole night terrified I was about to start bleeding and the cycle would be over. In the morning my ovaries were throbbing and felt really tender, and the clinic said such pain was normal with OHSS. At this point I felt VERY blessed only to have OHSS so mildly! Aside from that night, my stomach blew up and down a little bit over the days, and I had cramps in my ovaries on and off, but nothing Paracetamol wouldn't take care of. The clinic had me on 'rest', so I spent most of this week on the sofa watching costume dramas. The nurses said that the severity of OHSS can be directly related to the preventative measures women take - e.g. resting, drinking water, and eating protein with every meal (which I did).
Developing OHSS after the embryo transfer made me so happy - in fact, I actually prayed specifically that I would get mild OHSS post-transfer!!! This is because the nurses had told us that OHSS developing post-transfer means pregnancy. So I felt hugely optimistic and loved by God throughout the 2WW, although I felt sick... I'd been terrified of the dreaded 2WW, but actually I found it a lovely, peaceful, and calm time... I 'felt' pregnant during the whole waiting period, from the time the embryo was popped back in.
The Lord has answered some really specific prayers during the IVF process. Here are some of the prayers He has answered:
After this the clinic phoned to monitor my belly measurements and symptoms every day for a week and a half. After about a week of this they stopped being concerned, I guess it became clear it was staying mild.
A week after embryo transfer (7dp5dt) I had a TERRIBLE night; pain like a ring of fire around my middle (front and back) which Paracetamol didn't touch and therefore no sleep. It was like the worst AF cramps ever and I spent the whole night terrified I was about to start bleeding and the cycle would be over. In the morning my ovaries were throbbing and felt really tender, and the clinic said such pain was normal with OHSS. At this point I felt VERY blessed only to have OHSS so mildly! Aside from that night, my stomach blew up and down a little bit over the days, and I had cramps in my ovaries on and off, but nothing Paracetamol wouldn't take care of. The clinic had me on 'rest', so I spent most of this week on the sofa watching costume dramas. The nurses said that the severity of OHSS can be directly related to the preventative measures women take - e.g. resting, drinking water, and eating protein with every meal (which I did).
Developing OHSS after the embryo transfer made me so happy - in fact, I actually prayed specifically that I would get mild OHSS post-transfer!!! This is because the nurses had told us that OHSS developing post-transfer means pregnancy. So I felt hugely optimistic and loved by God throughout the 2WW, although I felt sick... I'd been terrified of the dreaded 2WW, but actually I found it a lovely, peaceful, and calm time... I 'felt' pregnant during the whole waiting period, from the time the embryo was popped back in.
The Lord has answered some really specific prayers during the IVF process. Here are some of the prayers He has answered:
- During the stims process I prayed for just the right number of eggs - not too many and not too few, for optimum quality. We had 13 mature, 11 fertilised, and all survived to biopsy. A pretty amazing result!
- I prayed for Maha, our consultant, to perform the egg collection procedure... And she did!
- I prayed that the sedative would knock me out and I'd sleep through the whole egg collection procedure... And I did!
- I prayed for mild OHSS after transfer, for encouragement, and it came at 2dp5dt.
In fact, the Lord answered ALL my specific (and non-specific!) prayers throughout the whole procedure... And He also looked after some needs I didn't know I had. He delayed my CRB so that I couldn't start my new job until after the clinic had OK'd me to stop resting for OHSS prevention. He gave me the mentor I specifically wanted (out of 8) when I did then start my job. During my first work training session (during the stims phase) the trainer revealed that she'd had IVF treatment - although I didn't reveal to anyone we were having treatment for another few weeks! My friend also prayed that when I started my job, I would make a connection with someone who was a Christian. I did make a connection with one particular person... But I didn't learn for a few weeks that they are in fact a Christian!
The Lord is awesome, and He has really showed His might through this process!!! It is so humbling for someone who has had many doubts about the efficacy of prayer.
Wednesday, 7 November 2012
Embryo Transfer
Embryo transfer was a most exciting and surreal experience!
So we arrived at our clinic for embryo transfer at 2pm; the actual procedure was scheduled for 2.30pm but we were asked to arrive half an hour early (as with egg collection) to prepare.
We had to use our sexy ID card (printed for egg collection) to gain access to the 'hospital' area of the clinic. I also had a wristband printed with a barcode on it (as with egg collection) that was scanned when I got into theatre.
Hubby was allowed into theatre with me for embryo transfer. We both donned some really attractive scrubs. I lay on the theatre bed and put my legs in stirrups. A speculum was inserted, and then the really nice consultant busied himself with 'cleaning' my cervix. This was the most uncomfortable part of the whole procedure, it seemed to go on for ages. This is because it felt like a really uncomfortable smear and smears make me feel really squeamish!!! A catheter was then inserted into my cervix and the embryo gently guided into place. I was worried about this part being painful, but I couldn't feel it at all. We did watch it happening on the ultrasound scan, which was amazing. Hubby said my uterus looked like a 'mouse'!
I had been asked to drink a glass of water an hour before, so the scan would show a clear water, but I think some of the extra anti-OHSS water was also hanging around as my bladder was very, very full - which meant the consultant got a really good clear picture. He said my ovaries aren't looking enlarged at the moment, which was great news! And he said that the 'passage' for the embryo was really easy and clear, which he was also really pleased with.
We were shown a picture of the embryo prior to transfer; the consultant and embryologist told us how pleased they were with it. It was a grade 1/2 (grade 1 being the best at our clinic) hatching blastocyst - the nucleus being grade 1 and the surrounding area being grade 2. Apparently our second healthy good quality embryo is exactly the same; the clinic like to use the best quality embryo on the fresh cycle but they couldn't choose between them! So we have another top quality hatching blast in the freezer!!!
The whole thing was over and done with in 10 minutes. I then lay in recovery for 20 minutes - while the nurse went through some 'Two Week Window Do's and Don't's' with us (no sex! no shark meat!) - before we walked back to the little ward to get changed and leave.
Afterwards I felt elated and very emotional. It was such a relief to get to this point and I feel so very, very blessed it overwhelms me. Having so many emotions running around was a roller coaster - I went out for Chinese that night, and had to jog across one lane of the road as the traffic lights changed, and was then in floods of tears when I got in again, convinced I'd ruined our little embryo's chances (even though our clinic does not advise rest). After a good cry I realised I was being pretty silly, but I had so many emotions built up after all the tense weeks of waiting, with more weeks of waiting ahead of us.
So we arrived at our clinic for embryo transfer at 2pm; the actual procedure was scheduled for 2.30pm but we were asked to arrive half an hour early (as with egg collection) to prepare.
We had to use our sexy ID card (printed for egg collection) to gain access to the 'hospital' area of the clinic. I also had a wristband printed with a barcode on it (as with egg collection) that was scanned when I got into theatre.
Hubby was allowed into theatre with me for embryo transfer. We both donned some really attractive scrubs. I lay on the theatre bed and put my legs in stirrups. A speculum was inserted, and then the really nice consultant busied himself with 'cleaning' my cervix. This was the most uncomfortable part of the whole procedure, it seemed to go on for ages. This is because it felt like a really uncomfortable smear and smears make me feel really squeamish!!! A catheter was then inserted into my cervix and the embryo gently guided into place. I was worried about this part being painful, but I couldn't feel it at all. We did watch it happening on the ultrasound scan, which was amazing. Hubby said my uterus looked like a 'mouse'!
I had been asked to drink a glass of water an hour before, so the scan would show a clear water, but I think some of the extra anti-OHSS water was also hanging around as my bladder was very, very full - which meant the consultant got a really good clear picture. He said my ovaries aren't looking enlarged at the moment, which was great news! And he said that the 'passage' for the embryo was really easy and clear, which he was also really pleased with.
We were shown a picture of the embryo prior to transfer; the consultant and embryologist told us how pleased they were with it. It was a grade 1/2 (grade 1 being the best at our clinic) hatching blastocyst - the nucleus being grade 1 and the surrounding area being grade 2. Apparently our second healthy good quality embryo is exactly the same; the clinic like to use the best quality embryo on the fresh cycle but they couldn't choose between them! So we have another top quality hatching blast in the freezer!!!
The whole thing was over and done with in 10 minutes. I then lay in recovery for 20 minutes - while the nurse went through some 'Two Week Window Do's and Don't's' with us (no sex! no shark meat!) - before we walked back to the little ward to get changed and leave.
Afterwards I felt elated and very emotional. It was such a relief to get to this point and I feel so very, very blessed it overwhelms me. Having so many emotions running around was a roller coaster - I went out for Chinese that night, and had to jog across one lane of the road as the traffic lights changed, and was then in floods of tears when I got in again, convinced I'd ruined our little embryo's chances (even though our clinic does not advise rest). After a good cry I realised I was being pretty silly, but I had so many emotions built up after all the tense weeks of waiting, with more weeks of waiting ahead of us.
Waiting - Fertilisation to Biopsy Results
Our clinic do PGD using arrayCGH testing (they actually had the first aCGH baby in the world!). They do the testing on day 3 and the transfer usually on day 5, but occasionally on day 6.
Day 1 - Fertilisation Report
On the morning following egg collection, I had a call to say 'Good news!' Of my 23 eggs, 13 were mature, and 11 had fertilised.
To be honest, 23 to 11 seemed like a big drop and I felt pretty deflated and disappointed following this conversation. However, looking back, I can see that God answered a very particular prayer I had been praying throughout the stimulation phase - that I would have the RIGHT amount of eggs, and not too few (giving anxiety over the testing phase) or too many (leading to OHSS or decreased egg quality). In retrospect, 13 was indeed the perfect number - and it is indeed a very good number of mature eggs and had someone told me at the start of the process that I would have 13, I would have been very pleased - but it worried me at the time.
Day 2 - Embryo Development
The next day I was very nervous about the call as the day before's hadn't gone as I had hoped. I needn't have worried! The embryologist reported that ALL ELEVEN fertilised eggs were now embryos, and all on track for this stage. We had one 3-cell grade 3, and the other 10 an even split of grade 1 and 2 (our clinic grades 1 as the best quality). We were completely over the moon, I had never expected so many to keep growing or to be of such good quality. The embryologists were very pleased indeed with how things were going. A wonderful day.
Day 3 - Biopsy
On the afternoon of day 3, I had the call I was most nervous about thus far: to tell us how many embryos had been able to be biopsied. ArrayCGH does not just screen embryos for a known genetic condition (i.e. translocation), but for a range of chromosomal abnormalities. This is really good news as even younger women (under 35) have up to 40% of embryos developing spontaneous chromosomal abnormalities, and chromosomal abnormalities are reckoned to be the biggest cause of miscarriage, so it is great to know that the embryo put back inside you has such an increased chance at health and life. However, when one factors into account a genetic condition as well, this leads to a high number of unviable embryos. For me, the translocation affects 50%, but the clinic expect around 80% to be unusable, due to spontaneous abnormalities. So I was really really hoping that at least 8 of our embryos would have survived to biopsy; I know from other peoples' PGD journeys that 8 would be a great number to have.
Imagine my shock, therefore, when the embryologist tells me that ALL ELEVEN were able to be biopsied!!! One was sadly lost (stuck in a pipette) during the biopsy, so we were waiting on the results of 10 embryos, and I knew this was a really great position to be in. However, with PGD, there are no guarantees and sometimes even high numbers of embryos are all affected, so waiting for the biopsy results was the hardest time for me of this whole procedure (so far! imagine the day before pregnancy test won't be great!).
Day 4 - Booking the Transfer
Our clinic don't check the embryos on day 4. They check them on the morning of day 5 and update the patients after that, with the biopsy results (I know some clinics give biopsy results on day 4, lucky patients!). So we were booked in for transfer the following day, without anyone knowing whether we'd have an embryo to transfer, as the clinic were at pains to inform me!
Day 5 - Biopsy Results and Embryo Update
On the morning of day 5, I had a work training session, so hubby took the call and I had to wait until midday to find out! It was absolute torture, especially as the training session overran. I ran from work to the car to meet my hubby, trying to judge his facial expressions as I approached...
We had 3 viable embryos!!! We were both so ecstatic! 2 of these were really good quality, meaning we could transfer 1 and freeze the other, but the third was not looking good quality so the clinic weren't going to freeze it. (They did leave it until day 6 and checked it again, but it hadn't improved.) Another wonderful day!
And so now onto the best part so far, the holy grail of embryo transfer...
Day 1 - Fertilisation Report
On the morning following egg collection, I had a call to say 'Good news!' Of my 23 eggs, 13 were mature, and 11 had fertilised.
To be honest, 23 to 11 seemed like a big drop and I felt pretty deflated and disappointed following this conversation. However, looking back, I can see that God answered a very particular prayer I had been praying throughout the stimulation phase - that I would have the RIGHT amount of eggs, and not too few (giving anxiety over the testing phase) or too many (leading to OHSS or decreased egg quality). In retrospect, 13 was indeed the perfect number - and it is indeed a very good number of mature eggs and had someone told me at the start of the process that I would have 13, I would have been very pleased - but it worried me at the time.
Day 2 - Embryo Development
The next day I was very nervous about the call as the day before's hadn't gone as I had hoped. I needn't have worried! The embryologist reported that ALL ELEVEN fertilised eggs were now embryos, and all on track for this stage. We had one 3-cell grade 3, and the other 10 an even split of grade 1 and 2 (our clinic grades 1 as the best quality). We were completely over the moon, I had never expected so many to keep growing or to be of such good quality. The embryologists were very pleased indeed with how things were going. A wonderful day.
Day 3 - Biopsy
On the afternoon of day 3, I had the call I was most nervous about thus far: to tell us how many embryos had been able to be biopsied. ArrayCGH does not just screen embryos for a known genetic condition (i.e. translocation), but for a range of chromosomal abnormalities. This is really good news as even younger women (under 35) have up to 40% of embryos developing spontaneous chromosomal abnormalities, and chromosomal abnormalities are reckoned to be the biggest cause of miscarriage, so it is great to know that the embryo put back inside you has such an increased chance at health and life. However, when one factors into account a genetic condition as well, this leads to a high number of unviable embryos. For me, the translocation affects 50%, but the clinic expect around 80% to be unusable, due to spontaneous abnormalities. So I was really really hoping that at least 8 of our embryos would have survived to biopsy; I know from other peoples' PGD journeys that 8 would be a great number to have.
Imagine my shock, therefore, when the embryologist tells me that ALL ELEVEN were able to be biopsied!!! One was sadly lost (stuck in a pipette) during the biopsy, so we were waiting on the results of 10 embryos, and I knew this was a really great position to be in. However, with PGD, there are no guarantees and sometimes even high numbers of embryos are all affected, so waiting for the biopsy results was the hardest time for me of this whole procedure (so far! imagine the day before pregnancy test won't be great!).
Day 4 - Booking the Transfer
Our clinic don't check the embryos on day 4. They check them on the morning of day 5 and update the patients after that, with the biopsy results (I know some clinics give biopsy results on day 4, lucky patients!). So we were booked in for transfer the following day, without anyone knowing whether we'd have an embryo to transfer, as the clinic were at pains to inform me!
Day 5 - Biopsy Results and Embryo Update
On the morning of day 5, I had a work training session, so hubby took the call and I had to wait until midday to find out! It was absolute torture, especially as the training session overran. I ran from work to the car to meet my hubby, trying to judge his facial expressions as I approached...
We had 3 viable embryos!!! We were both so ecstatic! 2 of these were really good quality, meaning we could transfer 1 and freeze the other, but the third was not looking good quality so the clinic weren't going to freeze it. (They did leave it until day 6 and checked it again, but it hadn't improved.) Another wonderful day!
And so now onto the best part so far, the holy grail of embryo transfer...
Friday, 2 November 2012
Egg Collection
So on the Friday (what would have been day 11 of stims) I had what is known as "oocyte capture" or "ovum retrieval" - egg collection in layman's terms!
The consultant retrieves the artificially stimulated eggs by passing a fine needle through the vaginal wall and into each follicle in turn. Some UK clinics perform this under general anaesthetic but most under sedation. It also varies as to whether this procedure is performed in theatre or not, I believe.
At Care, egg collection is performed under sedation in theatre. We were booked in to start at 8:30am and needed to arrive at 8:00am to prepare. I didn't get a wink of sleep the night before; I felt physically sick with nerves, it was horrible. So much of our chance of success at IVF depended on the outcome of this procedure and how many and what good quality eggs were removed. At 4am I gave up trying to sleep and came to watch TV downstairs with the dog!
Our clinic ask the patient not to wear perfume, not to eat after midnight, and not to drink after 5am. I was asked to bring a dressing gown and socks as theatre can get cold. I think the dressing gown is more to protect the ladies' modesty as it is removed in theatre and a blanket is given instead.
Hubby and I arrived early and had an identity card produced - with cheesy mugshots! - that allows us onto the ward area. We were shown into a small private room containing a small cupboard and two chairs and I was asked to change into a hospital gown. I've never worn a hospital gown before, it was quite exciting (despite the nerves)! A nurse went through various questions - what I am allergic to and so on - and then collected me and we walked into theatre. Hubby was left behind and collected to produce his 'sample' once egg collection was underway.
The next bit is a bit of a lovely blur due to the sedation... I lay down and was arranged on the bed. The various members of staff - nurse, ODP, embryologist, anaesthetist, and consultant (who was the only consultant at the clinic we already knew, thank goodness - I had prayed specifically for her). The anaesthetist then inserted a canular into my hand, he was a very nice man. He explained to me about the medication and said I might fall asleep or fall in and out of sleep, and that if I had any discomfort, to let him know and he'd increase the dose. He then said, 'You will start to feel sleepy over the next couple of minutes.' I looked around, and that is the last thing I remember before waking up in recovery.
I was vey nervous about the idea of sedation and had prayed I would sleep through the whole thing... Praise God this happened; I slept deeply according to the nurse and was not best pleased when she woke me up! I think my lack of sleep the previous two nights helped achieve this :D. Waking up was the worst part (in fact the only uncomfortable part of the whole thing); I was in a lot of pain. The nurse said, "Do you want to know how many? You've had 23 eggs removed!!" I was overjoyed. She then explained that this is why I was in so much pain - the higher the number of eggs, the more the pain. Paracetamol had already been given through the canular while I was asleep but she said they could give me more drugs and to let her know when I wanted them. She was the nicest nurse (the same nurse who saw me through the whole thing and then again through embryo transfer).
I was wheeled on the bed back to the little private room and there was my lovely hubby. He was very tender and protective of me, it was really sweet. The nurse left us alone and I told him how many eggs, he was amazed too and we shared our joy! Another nurse then returned (equally lovely) and offered me a choice of Codeine or a painkiller that goes in a pessary up the bum (sorry TMI and I forget the name). Anyway she recommended the latter so I went for that and it worked like a dream, in about 20 minutes all the pain had gone. I had low blood pressure from the sedation and couldn't go to the loo for about an hour; this was not good as I was immediately given lots of sweet tea and water by the lovely nurses!!! Had a scary moment when I first tried to go to the loo - the room span and I felt sick - but half an hour later it was ok and I was able to relieve myself.
Both the embryologist and the consultant who performed the procedure visited us in our private room after egg collection. The embryologist told us that hubby's sperm sample was great! The consultant said I would feel very sore as she had not only retrieved 23 eggs, but also 'popped' all my smaller follies not containing eggs in order to prevent OHSS. She also said that due to my large number of follies, she felt unsure as to whether we should go ahead with transfer this cycle or freeze the embryos for transfer at a later date, but she said she was happy to monitor me over the next few days and see how things go before making any decisions. She said that during EC my ovaries had shown no signs of OHSS (i.e. there was not excess fluid), despite the large number of follies. (I had a nurse phone every day between EC and ET to check how I was doing with OHSS symptoms. Luckily I never had any more than very, very mild symptoms - a small amount of bloating, abdominal discomfort, and nausea... And we were able to do the transfer this cycle.)
We drove home and I rested on the sofa the rest of the day. Pain wasn't too bad at all and although we had bought some Co-Codomol in preparation, I didn't need to take more than Paracetamol once I got home, and I took Paracetamol for four days following egg collection. I felt pretty nauseous so treated myself to some favourite foods. It was quite sore to wee, but I didn't have any bleeding or spotting after I left the hospital (there was quite a bit of bleeding immediately after egg collection that went onto the clinic pad, I think they're called Chux pads). And I still haven't had any bleeding or spotting from egg collection and this is now 3dp5dt.
So that was it, my egg collection experience... It was an amazing experience full of answer to prayer - I had prayed for sleeping through the procedure and no signs of OHSS. Next came the really hard part - waiting.
The consultant retrieves the artificially stimulated eggs by passing a fine needle through the vaginal wall and into each follicle in turn. Some UK clinics perform this under general anaesthetic but most under sedation. It also varies as to whether this procedure is performed in theatre or not, I believe.
At Care, egg collection is performed under sedation in theatre. We were booked in to start at 8:30am and needed to arrive at 8:00am to prepare. I didn't get a wink of sleep the night before; I felt physically sick with nerves, it was horrible. So much of our chance of success at IVF depended on the outcome of this procedure and how many and what good quality eggs were removed. At 4am I gave up trying to sleep and came to watch TV downstairs with the dog!
Our clinic ask the patient not to wear perfume, not to eat after midnight, and not to drink after 5am. I was asked to bring a dressing gown and socks as theatre can get cold. I think the dressing gown is more to protect the ladies' modesty as it is removed in theatre and a blanket is given instead.
Hubby and I arrived early and had an identity card produced - with cheesy mugshots! - that allows us onto the ward area. We were shown into a small private room containing a small cupboard and two chairs and I was asked to change into a hospital gown. I've never worn a hospital gown before, it was quite exciting (despite the nerves)! A nurse went through various questions - what I am allergic to and so on - and then collected me and we walked into theatre. Hubby was left behind and collected to produce his 'sample' once egg collection was underway.
The next bit is a bit of a lovely blur due to the sedation... I lay down and was arranged on the bed. The various members of staff - nurse, ODP, embryologist, anaesthetist, and consultant (who was the only consultant at the clinic we already knew, thank goodness - I had prayed specifically for her). The anaesthetist then inserted a canular into my hand, he was a very nice man. He explained to me about the medication and said I might fall asleep or fall in and out of sleep, and that if I had any discomfort, to let him know and he'd increase the dose. He then said, 'You will start to feel sleepy over the next couple of minutes.' I looked around, and that is the last thing I remember before waking up in recovery.
I was vey nervous about the idea of sedation and had prayed I would sleep through the whole thing... Praise God this happened; I slept deeply according to the nurse and was not best pleased when she woke me up! I think my lack of sleep the previous two nights helped achieve this :D. Waking up was the worst part (in fact the only uncomfortable part of the whole thing); I was in a lot of pain. The nurse said, "Do you want to know how many? You've had 23 eggs removed!!" I was overjoyed. She then explained that this is why I was in so much pain - the higher the number of eggs, the more the pain. Paracetamol had already been given through the canular while I was asleep but she said they could give me more drugs and to let her know when I wanted them. She was the nicest nurse (the same nurse who saw me through the whole thing and then again through embryo transfer).
I was wheeled on the bed back to the little private room and there was my lovely hubby. He was very tender and protective of me, it was really sweet. The nurse left us alone and I told him how many eggs, he was amazed too and we shared our joy! Another nurse then returned (equally lovely) and offered me a choice of Codeine or a painkiller that goes in a pessary up the bum (sorry TMI and I forget the name). Anyway she recommended the latter so I went for that and it worked like a dream, in about 20 minutes all the pain had gone. I had low blood pressure from the sedation and couldn't go to the loo for about an hour; this was not good as I was immediately given lots of sweet tea and water by the lovely nurses!!! Had a scary moment when I first tried to go to the loo - the room span and I felt sick - but half an hour later it was ok and I was able to relieve myself.
Both the embryologist and the consultant who performed the procedure visited us in our private room after egg collection. The embryologist told us that hubby's sperm sample was great! The consultant said I would feel very sore as she had not only retrieved 23 eggs, but also 'popped' all my smaller follies not containing eggs in order to prevent OHSS. She also said that due to my large number of follies, she felt unsure as to whether we should go ahead with transfer this cycle or freeze the embryos for transfer at a later date, but she said she was happy to monitor me over the next few days and see how things go before making any decisions. She said that during EC my ovaries had shown no signs of OHSS (i.e. there was not excess fluid), despite the large number of follies. (I had a nurse phone every day between EC and ET to check how I was doing with OHSS symptoms. Luckily I never had any more than very, very mild symptoms - a small amount of bloating, abdominal discomfort, and nausea... And we were able to do the transfer this cycle.)
We drove home and I rested on the sofa the rest of the day. Pain wasn't too bad at all and although we had bought some Co-Codomol in preparation, I didn't need to take more than Paracetamol once I got home, and I took Paracetamol for four days following egg collection. I felt pretty nauseous so treated myself to some favourite foods. It was quite sore to wee, but I didn't have any bleeding or spotting after I left the hospital (there was quite a bit of bleeding immediately after egg collection that went onto the clinic pad, I think they're called Chux pads). And I still haven't had any bleeding or spotting from egg collection and this is now 3dp5dt.
So that was it, my egg collection experience... It was an amazing experience full of answer to prayer - I had prayed for sleeping through the procedure and no signs of OHSS. Next came the really hard part - waiting.
Thursday, 1 November 2012
Stimulation Injections and Monitoring Scans
Stimulation Injections
My protocol for this cycle was Menopur 150iu daily and Cetrotide O.25mg daily (Cetrotide started on day 5 and is to help prevent ovulation).
Through this cycle I have discovered that I much prefer injections in the leg to injections in the tummy :). Didn't mind the leg ones at all; something creeps me out about having a needle pointed at the stomach though, it's such delicate and tender skin. Everyone's different, some people prefer the tummy.
First Monitoring Scan
On day 6 of the stimulation injections we had our first early morning scan and blood test. The scans are done internally - ie vaginally. At the first scan, 17 follicles measuring between 8-12mm were counted and I was over the moon! Hubby and I went to a local country park to walk the dog afterwards, I wasn't feeling too uncomfortable at that point and just had a stitch-like feeling from the follies growing. It was a beautiful day and full of peace, we just floated around all over the place!!! The clinic called at 2pm and told us to continue medication as before (my blood test results were normal - the clinic are looking for risk of OHSS) and to come back for another scan in two days.
Second Monitoring Scan
On day 8 of the stimulation injections we had our second monitoring scan and blood test. It's not normal to have so many blood tests, but due to having PCOS, being under 35 and slim, and having lots of follies responding I am a high OHSS risk.
At this scan I had 19 follies over 8mm, but I was quite disappointed as they didn't seem to have grown much in size, and one was miles ahead of the others in size at 16mm. It was at this point that I learned that clinics look for 3 follicles of 17-22mm in size for egg collection, and I felt really disheartened as we seemed miles away from that (little did I know!).
The clinic called in the afternoon and told me to drop the Menopur from 150iu to 112.5iu that night. Cetrotide stayed the same. Blood work was normal.
I was very sore this day; it was the sorest day. I could physically feel the follies stretching and growing inside, it felt like a burning. Walking began to hurt. I had a training day for new job and it was very unpleasant!
Third Monitoring Scan
On day 9 of the stims we had third scan and blood test. Felt relieved and overjoyed when my lovely original follies had grown lots and lots more, an incredible amount (guess that's what the pain was!). I had 30 follies over 8mm and we had two ready for egg collection at this point. Blood work had increased fairly dramatically but not enough to worry them. After this scan, a lovely nurse (all the staff at Care Nottingham have been so lovely) took us into a private room and told us that our egg collection was likely to be Friday and that my trigger shot would likely be changed from Gonasi (containing HcG) to Buserilin (which doesn't contain HcG). The reason for this is that HcG triggers OHSS.
I was not so sore this day, although this scan was the first to hurt (I guess as my ovaries were taking up a lot more room!). Hubby and I were 'intimate' this night in preparation for EC (sorry TMI!); we were told to be intimate 2-5 days before egg collection, and it was quite sore for me.
When the clinic phoned us in the afternoon, they told us to drop the Menopur from 150iu to 75iu that night. I became very anxious as I was worried that we wouldn't have very many follies ready for collection by Friday, and I couldn't feel them stretching and growing any more.
Fourth Monitoring Scan
On day 10 of stims (our trigger shot day) we had our fourth and final monitoring scan and blood test. The blood work determined whether egg collection would be Friday or Saturday - if it showed me to be at risk of ovulation it would be Friday, but otherwise they would leave it 'til Saturday to give the little follies time to grow. At this scan I was again thrilled and overjoyed as the follies had grown lots and lots.
We saw a nurse after scan and blood test who taught us how to do the Buserilin trigger and prescribed me some Cabergoline to prevent OHSS. She warned me that this would likely make me feel very poorly - in her words, 'not many ladies tolerate it'. This made me feel very nervous - what was I letting myself in for? She predicted that if we did egg collection on Friday I would have 17 eggs and I was OVER THE MOON!!! It felt like God specifically and personally addressing my concerns.
That afternoon the clinic phoned and confirmed that egg collection would be Friday and I should do trigger shot and start Cabergoline that night. I didn't have Cabergoline side effects that night (phew!!) but Buserilin gave me heart palpitations and hot flushes and I only slept about two hours that night.
Luckily I had no warning signs of OHSS - the clinic said that my blood work was at the higher end but not abnormal or dangerous, and my stomach was no more bloated than before a period. However, I spent most of this week on the sofa as walking was sore, and the clinic told me to rest as an OHSS preventative measure.
My protocol for this cycle was Menopur 150iu daily and Cetrotide O.25mg daily (Cetrotide started on day 5 and is to help prevent ovulation).
Through this cycle I have discovered that I much prefer injections in the leg to injections in the tummy :). Didn't mind the leg ones at all; something creeps me out about having a needle pointed at the stomach though, it's such delicate and tender skin. Everyone's different, some people prefer the tummy.
First Monitoring Scan
On day 6 of the stimulation injections we had our first early morning scan and blood test. The scans are done internally - ie vaginally. At the first scan, 17 follicles measuring between 8-12mm were counted and I was over the moon! Hubby and I went to a local country park to walk the dog afterwards, I wasn't feeling too uncomfortable at that point and just had a stitch-like feeling from the follies growing. It was a beautiful day and full of peace, we just floated around all over the place!!! The clinic called at 2pm and told us to continue medication as before (my blood test results were normal - the clinic are looking for risk of OHSS) and to come back for another scan in two days.
Second Monitoring Scan
On day 8 of the stimulation injections we had our second monitoring scan and blood test. It's not normal to have so many blood tests, but due to having PCOS, being under 35 and slim, and having lots of follies responding I am a high OHSS risk.
At this scan I had 19 follies over 8mm, but I was quite disappointed as they didn't seem to have grown much in size, and one was miles ahead of the others in size at 16mm. It was at this point that I learned that clinics look for 3 follicles of 17-22mm in size for egg collection, and I felt really disheartened as we seemed miles away from that (little did I know!).
The clinic called in the afternoon and told me to drop the Menopur from 150iu to 112.5iu that night. Cetrotide stayed the same. Blood work was normal.
I was very sore this day; it was the sorest day. I could physically feel the follies stretching and growing inside, it felt like a burning. Walking began to hurt. I had a training day for new job and it was very unpleasant!
Third Monitoring Scan
On day 9 of the stims we had third scan and blood test. Felt relieved and overjoyed when my lovely original follies had grown lots and lots more, an incredible amount (guess that's what the pain was!). I had 30 follies over 8mm and we had two ready for egg collection at this point. Blood work had increased fairly dramatically but not enough to worry them. After this scan, a lovely nurse (all the staff at Care Nottingham have been so lovely) took us into a private room and told us that our egg collection was likely to be Friday and that my trigger shot would likely be changed from Gonasi (containing HcG) to Buserilin (which doesn't contain HcG). The reason for this is that HcG triggers OHSS.
I was not so sore this day, although this scan was the first to hurt (I guess as my ovaries were taking up a lot more room!). Hubby and I were 'intimate' this night in preparation for EC (sorry TMI!); we were told to be intimate 2-5 days before egg collection, and it was quite sore for me.
When the clinic phoned us in the afternoon, they told us to drop the Menopur from 150iu to 75iu that night. I became very anxious as I was worried that we wouldn't have very many follies ready for collection by Friday, and I couldn't feel them stretching and growing any more.
Fourth Monitoring Scan
On day 10 of stims (our trigger shot day) we had our fourth and final monitoring scan and blood test. The blood work determined whether egg collection would be Friday or Saturday - if it showed me to be at risk of ovulation it would be Friday, but otherwise they would leave it 'til Saturday to give the little follies time to grow. At this scan I was again thrilled and overjoyed as the follies had grown lots and lots.
We saw a nurse after scan and blood test who taught us how to do the Buserilin trigger and prescribed me some Cabergoline to prevent OHSS. She warned me that this would likely make me feel very poorly - in her words, 'not many ladies tolerate it'. This made me feel very nervous - what was I letting myself in for? She predicted that if we did egg collection on Friday I would have 17 eggs and I was OVER THE MOON!!! It felt like God specifically and personally addressing my concerns.
That afternoon the clinic phoned and confirmed that egg collection would be Friday and I should do trigger shot and start Cabergoline that night. I didn't have Cabergoline side effects that night (phew!!) but Buserilin gave me heart palpitations and hot flushes and I only slept about two hours that night.
Luckily I had no warning signs of OHSS - the clinic said that my blood work was at the higher end but not abnormal or dangerous, and my stomach was no more bloated than before a period. However, I spent most of this week on the sofa as walking was sore, and the clinic told me to rest as an OHSS preventative measure.
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