Embryo Harvest -- The Ultimate Stay-cation

With the first phase of my board exam behind me just a few wee hours, I am ready for some blogging.

I thought I would start at the beginning of my IVF treatment. Some of these posts were written months ago, some are still unwritten, and others will be a little of both.

I wanted to delay my postings, partially for emotional reasons, partially for privacy, and partially for logistical reasons, like deciding when to tell work. Telling your boss you are hoping to have a baby can be awkward and a little scary.

* * *

Getting ready for some belly shots

After completing my residency at the end of June, I had a choice:

Vacation or IVF.

I had spent 5 years in residency. I felt I deserved a much needed break traveling somewhere lovely and tropical as a reward for my hard work before beginning my life of work at my new job a few weeks later. 

Or I could spend my two weeks off at home nursing my ovaries.

After much deliberation, I felt that as much as I hated the idea, ovary time it was.

I knew it would be the easiest and most stress free way to undergo the treatment which had the possibility of making me uncomfortable and would keep me at the beck-and-call of my doctors for almost daily ultrasounds, blood tests, and appointments.

So a few weeks before finishing residency I started the hormones. This was really great for our end of year banquet. Yes this means I cried.

Proof I was pretty hormonal

Before you get started they send you a medication calendar. This is because things get very overwhelming and confusing without it. You pick up your first of many bags at the pharmacy and have your first little heart attack when you get your pharmacy bill. Thank you insurance! You never quite get used to the receipts but it is more like chest pain than an actual heart attack with time.
 



Your medication timeline.
Just gets more tricky with time as you add more and more drugs into the mix!

Sadly this was a smaller receipt than many others!

The first bag of many bags-- feels like grocery shopping at the pharmacy

The first pharmacy shopping list. Overwhelming?

I give injections to patients all day every day, but I am a bit of a needle-phobe myself (with a history of fainting). So I was quite nervous to begin. Abe was on-call working nights when I had to start my injections so my friend Dr. B. was nice enough to assist me with my shots most days when he wasn't available. 

Friends don't let friends administer their own shots.
At least not at first!

During normal ovulation, usually only one follicle (containing the egg) grows. During IVF, the Docs are in control and they stimulate as many of your follicles to grow as possible. If you are like me (Polycystic Ovarian Syndrome), then you may grow A LOT of follicles. The clinic monitors this with ultrasounds every few days to check on the progress of the growing follicles.

Drugs Drugs Drugs

The follicles have to be over 1 cm in size before they can be collected. Once they reach adequate size, you are ready for the harvest. I was really hoping for a harvest on my birthday at the end of June so I would have plenty of time to have my transfer before starting work on the 7th. Unfortunately, mine were a bit behind schedule and this pushed my harvest and the subsequent transfer back to the 7th (A big day -- our anniversary, my first day at my first real job, and now our transfer). Bad timing and another issue for later.

By my last ultrasound I had almost 40 enlarged follicles about the size of those jumbo grapes you see at the grocery store. So, by my birthday I was feeling pretty uncomfortable and bloated, walking around with two huge bunches of grapes in my abdomen. Luckily I wasn't out and about too much or people would have wondered why I was walking like a 9 month pregnant lady.

Come early July, my follicles were finally ready for harvest. Abe met me after rounds for the procedure, performed under sedation. The doctors use a needle to collect as many follicles as they can from the swollen ovaries. Some people complain of pain after the procedure but I luckily didn't experience any immediate discomfort.

Ready to go!

After a short recovery time, you are allowed to go home and rest. You aren't supposed to do any vigorous physical activity, and need to monitor fluid intake and urine output, and watch for any symptoms of hyperstimulation (an uncommon but serious complication from all of the hormones).



Feeling groggy afterward.
 It was weird to be the patient this time instead of the one doing the sedation for someone else

I felt pretty good right after getting home, but by the end of the evening I felt very uncomfortable, super bloated, and I had gained 7 pounds in one afternoon. I felt nauseated and Abraham said I looked like I was already pregnant. After a few days of taking it easy I started to feel back to normal.

A few days later we got our report from the reproductive endocrinologist. I was very lucky as I had a great response!

They collected

33 follicles...

27 went on to fertilize...

25 fertilized normally ...

6 survived to day 5 growth (in a petri dish, not a test tube!)...
leaving us with 6 blastocysts (embryos) ready for transfer.