Post Retrieval Aftermath

Its been about 4 days since I had my egg retrieval and things have been going relatively well.
I have developed OHSS, ovarian hyperstimulation syndrome
The Mayo Clinic website has this to say about it:

Ovarian hyperstimulation syndrome (OHSS) usually occurs as a result of taking hormonal medications that stimulate the development of eggs in a woman's ovaries. These  fertility drugs may be prescribed to treat infertility. In ovarian hyperstimulation syndrome, your ovaries become swollen and painful. About one-fourth of women who take injectible fertility drugs get a mild form of ovarian hyperstimulation syndrome, which goes away after about a week.

I have experienced a 5 pound weigh gain in the last 4 days, my belly is incredible swollen and occasionally can be painful depending on the position I'm in.  Since I have this additional weight on my belly, my lower back hurts if I stand for too long. My belly looks like I'm almost 5 months pregnant.  These symptoms are suppose to last about 2 weeks. I still also have very sore boobs. But no more headaches!
Greg keeps telling this is just preparing me for the weight I'll have to deal with when I get pregnant.  But at least that weigh gain will be slower.
So in order to come combat all the fluid that has leaked into my belly from my large ovaries, I have been drinking lots of Gatorade and pedialyte. I am also suppose to be eating lots of protein. Some how that's suppose to help too.
In addition to all that fun stuff, I have started taking progesterone injections.  Greg has to give these to me in the upper butt lower back area.  This injection is particular not fun because its an oil which makes it especially difficult to inject. Take forever to push in.  Also,the first time I got the shot, I became nauseous, like I had morning sickness.  Which seem reasonable considering I still have HCG in my system. HCG and progesterone are 2 very important pregnancy hormones, so my body might be confused. The progesterone shots are a precaution that I'm taking for another few days, in case I needed to do a fresh transfer instead of the frozen transfer I am planning on.  But will the all the possible embryos we have, a fresh transfer seems unlikely. So I just get to suffer a but longer

I went to the Dr. this morning to have a follow up visit.  He told me I look pretty good for being hyperstimulated.  Although my ovaries are still 10cm in size. Which he so nicely put as each of my ovaries are the size of a newborn baby head, awesome.....
My Dr. and I also discussed how many embryos will be biopsied, since we have so many and the genetic testing is expensive.
We do not know the exact number yet for many will even make it to the biopsy stage but with 26 to start with, Greg and I decided that 16 will be biopsied.  That number will of course be less if less make it the biopsy stage.
All embryos even those that will not biopsied will be frozen.  We will then hope that at least 50% of the tested embryos come back with genetically normal results. Which we would should get in about 3 weeks and then we will start the process of the transfer.

Fertilization Results

Called the Dr. office this morning to find out how many of the eggs that got sucked out yesterday fertilized after one of Greg's swimmers was injection into each egg.
And out of the 34 eggs, 29 were good enough have a swimmer injected and of those 29 eggs, 26 fertilized and have started growing.
 The Dr said he is very pleased by this result and I am completely surprised by how many we had to start with and even more by how many have fertilized.
Now we wait till Wednesday, 6 days, to find out how many continue to grow and make it the biopsy stage.
Then I can't wait to find out how many have good quality genetics. That's the true test!

Egg retrieval Day!

As most of you noticed I already posted on Facebook that I had my egg retrieval this morning and it was successful.
But before I get into the details of today I'll give you some updates since Tuesday.
As I mentioned in my last post, Tuesday I had my HCG shot.  Greg was nice enough to poke me in butt with that shot.  It wasn't so bad but side effect of that shot was that my slightly sore boobs became ridiculously sore and tender.  No fun at all! Also on Tuesday, my blood test results came in again with high estrogen levels so I didn't have to do my usual nightly injection.
Wednesday, no more injections! But I did have have to have another blood test to get my HCG levels tested.  Which thankfully came back normal so I didn't have to do another one of those injections.  Wednesday was not a really good day for me, as I started hyper stimulating.  I was working when the pressure in my belly felt like it was pushing up into my stomach and lungs.  Super uncomfortable!  Thankfully a bottle and half of Gatorade later, I felt much better.  I was definitely glad I had bought more Gatorade and pediaylte before I went to work that day.

I realized that many of who read my updates my not fully understand what I have been going through. I'm sure I haven't been the best at explaining. So before I tell you about the retrieval, I wanted to show you some pics. (None of the pics will be mine but it will help visualize what's been going on with me)

First pic is an ultrasound of follicles in an ovary before staring fertility treatment. The little red dots are follicles.















Next pic is and ultrasound with multiple medium to large follicles. The big black circles are the follicles.



















So here's an illustration of of normal female parts and then after follicles have grown.
















Now you kind of see why I've been bloated and uncomfortable for the last few days.

So now on to the part that's really important. Egg retrieval day!
Day started off with Greg going to the dr office to give his part.  Need some good swimmers to fertilize the follicles that got sucked out.  Anyway, then Greg took me to dr office to get my part over with.  Thankfully, I got put under anesthesia and the dr sucked out a combine total of 34 follicles.  Of course not all of them will be good and not all will fertilize. But I figured if even 50% of the follicles fertilize we still have quite a few to work with. Tomorrow, I will be able to call the dr office and get the total number of fertilize eggs. Also, to give you an idea, my Internet research says that between 10-20 follicles is the average.  Since I have PCOS,  they did expect me to have a little more and to hyper stimulate.
Now it's pretty much a waiting game.
Dr did tell me after I woke up and became aware of what's going on, that I am hyper stimulated. Since all the eggs are out, my enlarged ovaries will fill with fluid. So I'm drinking Gatorade like its my job to keep it from getting worse. Also, the dr prescribe me some vaginal suppositories. I know you are all excited to hear about those as I am to take them.  These are suppose to help with the hyper stimulation.   Better to drink the Gatorade and take the suppositories then go to hospital to have fluid drained from my belly and be in pain.
Starting Saturday I have to start progesterone injections for 5 days. More shots in the butt!  These are just a precaution in case we have to do a fresh transfer and not the planned frozen transfer.  Though with so many follicles, problems leading to a fresh transfer seem unlikely. But just in case...
I will have to resume these injections when we do the frozen embryo transfer and then for the entire first trimester.

I will post more updates as I get results from the dr.
But for now the hard part is over!

Thanks for the support and prayers!

Final Ultrasound!

Before I begin with the most recent updates, I thought I would mention that it officially feels like fall here in ABQ.  It's 75 degrees and I feel like I will have to get out sweaters and sweatshirts soon.  Also with it feeling like fall, I am sad because Starbucks has their pumpkin spice lattes out and I CAN'T have one! I have not been able to have any caffeine since starting my injections. : ( No coffee, no teas, and no COKE!  Can't wait till I can enjoy one these beverages again.
So that's my "poor me" pity party for the day, on with the updates. : )

I have still been going to the Dr. every day for ultrasounds and blood work. My arms look more like a heroin addict everyday. I have really great bruises. The lab people even feel bad poking me now.
Since Sunday my follicles have grown to the 17mm-19mm range (there are a few smaller ones, so not sure those will be any good but we will see) and there are still bunches out them! Upwards of 15 follicles still.
I have been giving smaller doses of the medications and have been doing the 3rd injections which prevents ovulation.  But a couple of times now my estrogen levels have been high so I have been skipping my nightly injections.  Not complaining about that! : )
With the smaller doses of meds, my headaches have almost disappeared.  However, the bloated belly and pressure has only gotten bigger and occasionally worse. I was informed today that these symptoms will get worse before they get better, once I have the egg retrieval. yay.....

Egg retrieval is scheduled! Thursday is the big day!  Follicles have seemed to max out in growth and there's a lot, so Dr. said Thursday will be the day. So today, I will be giving myself super low doses of the usual injections but will be adding the dreaded HCG Injection.  This one is dreaded because Greg has to give it to me in the lower back/upper butt area with a needle that is 1.5 inches long, (has to go in the muscle).   Not excited about this at all!  HCG is suppose to trigger the follicles to be ready to be "released". This injection has to be given at a very specific time and that time happens to be 11:45 tonight. another yay......
No shots tomorrow though, unless I happen to need more HCG, which means I to have to get more blood drawn tomorrow to check those levels. But no Dr. visit tomorrow.

Thursday is the all important day! The general procedure for Thursday will be that early in the morning Greg will go the Dr. office to provide a sample of his swimmers,so they can be all ready for the eggs.
Greg will then take me to the Dr. office where the retrieval will take place.  I will be placed under anesthesia and the Dr. will use the internal ultrasound to guide a needle through the uterus wall and into the ovary and suck out all the eggs he can. Repeat for both ovaries.
Behind the scenes, the embryologist, will the hand pick one swimmer for each egg retrieved and fertilize them. He will let each embryo then grow for 6 days, then biopsy any that have made it and grown to the 6 day stage. At that point embryos will then be frozen.
After I recover and such, we will be told how eggs they were able to retrieve. And then the next day I can call to see how many fertilized. And then 5 more days we will know how many grew large enough to be biopsied for the genetic tests and frozen. It will then be 3 weeks until we know the results of the genetic tests and then begin the process of getting ready for the transferring of an embryo.
Hopefully there will be enough good embryos that I will not have to go through this whole retrieval process again!

So wish us lots of luck that everything will go smoothly!
More updates after Thursday!

IVF Weekend Update

I have been getting up very early for the last 5 days to go the Dr. for my daily ultrasounds. The getting up early is my least favorite part of these daily Dr. visits. I am definitely not a morning person.

Anyway, no one really cares about me complaining about getting out bed before 8 am! ; )

So last 3 ultrasounds have showed that the follicles are still growing but they are taking their sweet time. Only growing about 1mm a day. Which isn't necessarily bad, just means I am on my meds longer.  As of today the the majority of the small follicles are in the 13-14mm range and the bigger ones are in the 15-17mm range.

So close! And the Dr and nurse who have been monitoring me have both said that there are lots of follicles in there. Today, the nurse measured 15 of them and that wasn't all of them. The more the better! I'm hoping for 8 that fertilize and grow, since that is the max freezing number unless we pay more money.

Been having my blood drawn for the last 4 days. My arms look like a heroin addict with the puncture wounds and bruises. Been having my estrogen levels tested. Those levels were normal until yesterday, my Dr. called to tell me that it had gotten high so I didn't have to do my nightly injection. He didn't want to risk overstimulating, which I am glad for (and for not having to do one shot yesterday).

Having the estrogen levels tested again today. So I'll find out if I'm on or off the meds again today.

At Saturday's appt, the Dr. was thinking that I would have my retrieval on Tuesday but with the follicles still not quite big enough, retrieval could now be on Wednesday.

Side effects lately are still headaches. they aren't as bad as long as I drink lots of gatorade and water.

My belly has bloated up a little bit.  Looks like I have a constant food baby.

I also have some pressure in my belly and my belly feels heavy and full. I told the nurse I'm running out of room in there for all these big follicles.

Still no weight gain, pretty excited about that! And still feeling general alright.

Back the Dr. again tomorrow!

2nd IVF Update

In my last post, I wrote that I would be going to the Dr. on Tuesday and I did. I also went again this morning.
At Tuesday's appt. I had an ultrasound that showed that there still follicles/eggs in the ovaries and that they were growing but slowly.  The largest follicle was only 6mm.  The follicle needs to be around 20mm to have the retrieval. So my Dr. up the medication to a high dosage for a day and then back down to a medium dosage for yesterday.
Today at my Dr. appt. follicles have doubled in size.  Ranging in size from 10mm-13mm. My Dr. seemed pleased with these results and I am to stay at the medium dosage for my medications.  I also get to start going to the Dr for daily ultrasounds until its time to retrieve the eggs.  I also had my blood drawn today to check my estrogen levels. I know this important to the follicle growth but I cant remember why.
I have yet to start the 3rd medication, since the follicles are not quite big enough yet. Still doing one injection in the morning and one in the evening.
I suppose the good thing about the follicles growing at a relatively normal/slow pace is that I have not been overstimulated. Which I understand makes you feel terrible and puts the retrieval at risk of not happening.
I am still suffering from nearly constant headaches, some bloating and pressure in my belly.  Nothing really too terrible. I'm getting use to having the headaches at this point and I'll take the headaches over the other side effects.  Thankfully, I have not gained any weight as of yet. I was warned at the beginning of this process that I could gain 5-10 in water weight. Speaking of bad side effects, Greg should really be happy that I am not having emotional mood swings ; )

So, overall doing well!
Ultrasounds and possible more blood work Friday, Saturday and Sunday.  Hopefully follicles will continue to grow and I will have a retrieval date for early next week.


Another update possibly sometime this weekend!

Thanks for all the support!
Courtney

IVF Baseline and Start of Injections

I am a little late posting on this but my family was in town and then we went to Durango for the weekend.
But here is the IVF update:
Last Wednesday, the 11th, I went to the Dr. for my baseline appt.
The nurse did an ultrasound to check everything and to count how many follicles/eggs were in my ovaries.
At the time of ultrasound there were between 20-22 combined from both ovaries.  The nurse said that was a good number even slightly higher than normal. The number could change through out the next week but should stay around there. So we it would seem that we have a good chance to get some good eggs to be fertilized.
On Saturday the 14th, I started my injections. 2 a day for now.  One in the thigh and one the belly.
I am for sure not enjoying giving myself these injections.  Though the one in the thigh isn't so bad but the one in the belly is not fun and hurts more.  No crazy side effects yet, just some wicked headaches.  I'm trying to drink lots of gatorade and water to help keep the bloating down (i was warned that it would happen) and to help with the headaches.
Tomorrow the 17th I am going to the Dr. in the morning for my 1st ultrasound to the check to the growth of the eggs in the ovaries and the current count.  Also at this appt. they will decide if I need to change my injection dosages and when I need to start my 3rd daily injection. And they will decide when I need to start going in for daily ultrasounds and start getting daily blood work done. Yay more needles : (

More updates to come as I go to the Dr.

Goebel's riding the train from Silverton to Durango

Overdue Update and Starting IVF

I forgot that I had not posted on this blog in sooo long.
There hasn't been much that has been missed.  We have settled into our permanent lives here in ABQ.
We did get a new kitten.  His name is Zinc and we adopted him in April from the city animal shelter. He is absolutely adorable and quite the cuddler.  He has grown so much in the last 4 months.  When we got him he didn't even weigh 2 pounds and now at 6 months old he is just over 9 pounds.  Spice is still adjusting to having him around.  He likes to attack her when she least expects it.  I hope that once he grows out of his kitten playfulness that they will become better friends.

Over the summer I went on quite a few vacations and Greg came with me on one vacation.
In April, I went to Orlando, Fl to visit a friend that just relocated there.
In May, Greg and I went to Chicago, IL to visit our friends the Labuz's, that we met while we were all living in California and Amanda and I worked together.
In June, Greg and I went to AZ because my baby brother, Xander, got married!  We are so happy for him and our new sister-in-law Ashley.
In July, I went to New Orleans, LA with Amanda and her friends for a girls weekend.
In August, I went to Logan, UT with my mom, Xander and Ashley to the Utah Opera Festival.

That pretty much catches up what we have been up too.
Now with no more big vacations planned (except all the Goebel's are coming to ABQ for a few days and then we are going to Durango, CO for a few days, next week), Greg and I are starting our first IVF cycle.

*Medical details* Don't read below if you don't wanna know

Since most people are unaware of our situation and why we are going to be going through IVf, I will try a quick and non technical explanation,
Since 2011, I have had 3 unexplained miscarriages and 1 year where I was unable to even get pregnant.
After many exams and tests, I was diagnosed in PCOS or polycystic ovarian syndrome. Basically,  my hormones are not at the correct level and messes up my cycles. This also makes it more difficult for me get pregnant and then stay pregnant.  This diagnoses explains the year of not being able to get pregnant and one possible reason for my 1st miscarriage.  Now that I have been properly diagnosed and medicated, physically I have been able to get pregnant, 2 more times.But the reason the other 2 miscarriages had been unknown.
After a few more Drs. and no answers, I went to a fertility clinic to see a reproductive endocrinologist.
After talking over my history, the Dr immediately order more testing and not just on me but on Greg as well.
I had more hormone testing done, ultrasounds and Greg and I both had genetic testing done.  Greg also had his sperm tested.  All my hormones and such came back normal and good. Greg and I both had our genetic tests come back normal, no abnormalities detected.  However, Greg's sperm sample results were not perfect. All his numbers were good until they looked at the shape of the sperm. Only 2% were the normal shape.  This number was lower than it should be but now we had discovered another reason for miscarriages.  Abnormal shaped sperm can carry abnormal DNA and/or missing DNA.
This could be the reason why 2 out of 3 pregnancies had heartbeats and appeared normal until it got a stage where the DNA code was missing and then stopped growing.

So with all this new information, our Dr. recommended IVF (In-vitro fertilization).  This would give us the best chance for full term pregnancy.  We are not just doing traditional IVF either. We will be having the sperm that will fertilize any eggs hand picked, so the best shaped ones are used and then our resulting embryos will be frozen and genetically tested.  These processes should gives us the best odds for a normal healthy pregnancy and baby. We plan on only transferring one embryo, so there will be no risk of having multiples.  Our Dr. is confident that one embryo is all we will need and transferring more than one is a risk that we don't need to take a this time.
With all the technological advances that are involved in this whole process an added bonus is that if we have more than one good quality embryo, we will able to keep any extra frozen so that if/when we decided to have a second baby (or for some reason the first one doesn't take), we will only have to go through the transfer process and not the whole egg retrieval process too.  Another bonus is that if there is more than one good quality embryo we will get to choose which embryo will be transferred, and with having the embryos genetically tested we will know the sex of the baby at the time of transfer.

I think that about explains what we are doing and why.  Here is the breakdown of how long this process will take:
Week of Sept 9th-baseline appt (ultrasound to check ovaries and uterus)
                             beginning injection medications-stimulating hormones to make multiple eggs grow
Week of Sept 16th: daily/every other day ultrasound and blood test to monitor egg growth
Week of Sept 23rd: Egg retrieval, once eggs have reach the appropriate size
                               fertilization will occur the day eggs are retrieved

Once eggs are retrieved and have been fertilized, we will know how many embryos we have and then all will tested. After testing we will know how many good quality embryos we have and how many we will have to choose from and freeze.

Transfer of embryo is tentatively scheduled for Late Nov or Early Dec.
Once my body has been able to rid its self of all the stimulating hormones and testing has been completed.

I'll be trying my best to update on the progress of everything!  We are hopeful, excited and little nervous to be going through this process and that this all be worth the effort in the end.


Courtney