From Egg to Embryo

The In-between Days

 

Sorry I’ve been rather quiet since the egg collection day,  I had been planning to give more regular updates throughout this period.

The afternoon and evening of the egg collection I was pretty sore particularly when walking, weeing or laughing, Paracetamol seemed to work quite well and just as long as I propped myself up comfortably on the sofa I wasn’t too uncomfortable.

   

On the morning after the egg collection – the Thursday - I was waiting for a phone call from the clinic to update me on how my little eggs were getting along, I didn’t have to wait too long as they phoned about 9.30.  The average fertilisation rate at my clinic is about 70% so since they go 12 eggs I was perhaps expecting about 7 or 8 to have fertilised, I felt that anything above 8 would be brilliant.  When they called however I couldn’t believe it, 11 of the 12 had fertilised! I was so amazed and all day kept going to my husband and my Mum, 11, I can’t believe there’s 11.  At this point they could say with a reasonable amount of confidence that they’d be able to get at least one of the embryos to blastocyst stage for transfer on Monday although they said there was still a small chance that the transfer might need to be Saturday.  They therefore said that they wouldn’t phone me again on Friday but would call me on Saturday morning to confirm that the transfer would be Monday and give me a time.

After the good news about the eggs – well actually embryos by that point, the day after the egg collection I had a very chilled day, my Mum came over and we spent most of the day chilling on the sofa with some knitting and a film.  I felt pretty much fine so felt a bit of a fraud doing virtually nothing but still seemed a good idea to take it easy and let everything settle.

 

Friday I didn’t do a lot, just passing the day with various activities to try and keep my mind occupied.  I was actually feeling more uncomfortable and bloated that day than the preceding day.  That night I didn’t sleep that well, tossing and turning for about an hour because of how bloated I felt.  

Saturday I was waiting for a phone call from the clinic, they phoned fairly early again which was good.  I wasn’t sure what to expect at this point, I knew that it was likely that some of the embryos had stopped developing so I was absolutely thrilled when they said that all 11 were still developing though one of them wasn’t developing at the rate that they’d expect meaning essentially I still had 10 good embryos available.   As I’ve said before this is all essentially irrelevant if in the end the embryo doesn’t implant but it does mean that they should have enough left to freeze some.  With NHS funded IVF in my area you get 2 cycles of IVF funded but if they have enough frozen embryos left over you can have an ‘extra’ frozen cycle in between each fresh cycle meaning that having some embryos spare essentially means I get twice as many tries. The clinic then gave me a time for transfer on Monday and informed me that they wouldn’t look at the embryos again until then.

 

The rest of Saturday and Sunday was spent trying to relax I had a night away with my cousins which just happened to coincide with the wait so that was a good distraction.  The main problem I had over the weekend was that I was extremely bloated and uncomfortable. Every time I ate something I felt uncomfortably bloated, full and a bit sick.  I was beginning to get a bit worried about ovarian hyperstimulation syndrome – which until I looked it up I didn’t realise generally starts around 4 days or so after egg collection.  Not wanting to go into too much detail however lets just say that I’ve come to the conclusion that it’s nothing that can’t be solved with a bit of prune juice!

Transfer Day

 

So after 5 long days of waiting, transfer day has finally arrived.  I’d been given a time of 1.30pm for the transfer and I had to be at the clinic for 1pm.  The morning did rather drag, especially as Matt was asleep after working a night so I didn’t have anybody to keep me company.  I filled the time watching a film and doing a bit or crochet to keep myself busy.   

"You can leave your socks on."

When we arrived at the clinic we went into the same place that we'd gone for the egg collection and got changed into a gown and Matt put on a  gown and overshoes over his clothes so that he could come with me.  They went through when to do a pregnancy test, what to do if it’s positive and what to do if it’s negative before the procedure.

 

When it was time to go down for the transfer we walked along to the same room where the egg collection was done but Matt was able to come with me this time.  The Dr talked me through the procedure, it did make me chuckle when he mentioned something about me getting into the ‘normal position’ because I don’t think there’s many people who’d consider laying on your back with your feet up in stirrups a normal position but it has become that over the last few weeks!

The embryologist then came in to tell me about the grades of the embryos – all 11 were still alive and the good news was that there was one very good one which was a 5BB, I wont go into the details of embryo classification as I don’t really understand in that well but all you really need to know is that the ‘5’ bit is very good and the ‘BB’ is OK.  The other part of the news wasn’t so good as all the other embryos aren’t looking great so they may not be able to freeze any but they’ll leave them to develop for another day and let me know.  This is disappointing because as I said earlier it would have been nice to have some spares in case this doesn’t work but what I tired to focus on is that the one that they put in is good, after all if they didn’t have that one good one then they’d have had to put one of the poorer quality ones in today.

For the procedure itself you don’t have any pain relief or sedation.  It’s rather uncomfortable but I wouldn’t say it was painful as such.  It's more all the preparation and getting everything in the right position that is uncomfortable whereas the procedure itself isn’t too bad.  Once I was in position they made sure I was able to see the screen and put a small catheter into my uterus, I could see this going in on the ultra sound.  The ultra sound itself wasn't very comfortable as you have to have a full bladder for the procedure and the ultrasound pushing on mystomach really makes you need to pee!  Once the catheter was in they squirted the fluid which contains the embryo down the tube into my uterus, we could see it going in as a little white squirt of fluid.  The catheter wass then removed but I had to stay in position while the embryolosit checked the tube under the microscope to make sure that the embryo had been carried in properly with the fluid and wasn’t stuck in the tube, apparently this can happen in 10% of cases and they then have to flush it through again.  Once they’d established that it’s all gone in ok everything was removed.

After the procedure we went back to the recovery room and I got dressed and had a much needed wee.  I automatically felt like I wanted to keep my legs crossed and walk like a penguin because I felt like  the embryo was just going to fall out, which of course is complete nonsense!  Once dressed that was it and we were free to go.

The 2 Week Wait

 

The 2 week wait isn’t actually a 2 week wait as it’s 15 days calculated from the time of the egg collection so it’s 10 days from now.  At the moment all I feel I want to do is chill out at

home and eat all the treats Matt has brought me from Waitrose – I’d asked for a chocolate orange but did rather well out of the fact that they didn’t have any as I got about 4 different treats instead, I will of course also be having a super healthy dinner.  There’s no evidence that laying down or bed rest helps at this stage otherwise I’d be up in bed right now, they just advise to take it easy, don’t lift anything heavy but carry on with life as normal, so that’s what I’ll be doing, trying to carry on life as normal even though I’ve never felt less normal in all my life!

Egg Collection Day

My egg collection is all done.  They managed to retrieve 12 eggs which apparently is a good number,  I can't help wishing it was even more seeing as I had 24 follicles but I think some of the follicles were pretty small so not big enough to get eggs from.

Before the egg collection I was feeling fairly relaxed and managed to sleep quite well last night much to my surprise. 

This is me before the egg collection, smiling for some bizarre reason!  The nurses were all really lovely and made me feel a relaxed.  Before the egg collection I had to get changed into a gown - they advise you to bring a dressing gown with you and I was very glad I did seeing as the gown was somewhat see through!  I wasn't able to eat from midnight onward and couldn't drink for 2 hours before the procedure, I was fairly lucky that my egg collection was early in the morning, though not the first as it happens, meaning I didn't have to sit around hungry for too long.  Once I was all changed they came and checked my details and attempted, unsuccessfully, to put a cannula in, so they left the cannula for somebody to do once I was in the room ready for the procedure.  I also had a pre medication tablet of temazepam and some paracetamol suppositories - I was in half a mind not to mention those in the blog since it's a bit embarrassing but since this is meant to be a candid account I can't really leave anything out, all I can say is the suppositories weren't as bad as I thought they would be.

Once the time was ready I walked through to the theatre where 3 people all together had to check my details again - of course there can't be any risk whatsoever of a mix up of eggs

as the implications would be unimaginable.  Despite the amnesic effects of the  sedation I can remember the theatre quite well.  There's obviously the undignified chair and stirrups to sit in though it really didn't feel that bad as they keep everything almost completely covered and only leave a little gap to get to where they need to go so I felt fairly relaxed from this perspective.  They got a cannula in no trouble the second time, the cannulation is a bit painful but not too bad, a kind of nasty stinging feeling I'd say. They were then able to give me a bit of fentanyl followed by the midazolam.  I wasn't knocked out at all just rather woozy and vague.  I'd like to be able to say that the procedure wasn't painful but that would be a lie, the first ovary, my left I think, wasn't too bad, painful but they'd got in, done it and got out before I really had much of a chance to think about it.  I'd been planning to watch on the screen but it all happened so quickly and I was so spaced out that I just didn't really get round to it.  The right ovary was more painful, they asked how I was feeling and whether I wanted more fenanyl and initially I said no but as they started to go in it was pretty painful for a few seconds and I automatically pulled back a bit and remember saying "I think you're going to have to give me some more pain relief," which they did without question.  All in all I'd sum up the experience by saying it was probably about what I expected, it was pretty painful but only for a very short period and the sedation helped to keep me relaxed and calm.  My one bit of advice would be to take something with you to squeeze on, a stress ball or something, as I find this really helpful to focus on when I'm in pain but I found the arms of the chair a bit difficult to hold onto to squeeze and I wasn't able to hold the nurses hand as she needed those to give me pain relief.

I was all quite a surreal experience because you have a Doctor doing the procedure, one nurse monitoring you and one giving the pain relief but then there's a door at the end that goes through to the lab and there were about 3 embryologists in there waiting to received my eggs and hopefully get them fertilised and into the incubator.  It really is quite an amazing and surreal experience.

Recovery Room

 

After the procedure they put me into wheelchair and wheeled me back to the recovery area where I just had to step across into a nice comfy reclining chair.  They put my dressing gown and a nice comfy fleece blanket over me and checked my blood pressure and other vital signs for a little while.  Matt appeared and got me some water to drink and once I'd had that and kept it's down I was allowed a cup of tea and some biscuits.  I was fortunate that I didn't feel sick at all though the lady in the cubicle next door did, every body's different in their response to the drugs. 

Here's a picture of me being monitored after the procedure and having a cup of tea.  I did manage to spill quite a bit of tea on the blanket, I'd like to say that's because I was under the effect of the drugs but knowing me I probably would have done that anyway!  I was feeling fairly comfortable and just a little bit spaced out at this time, though not as spaced out as I thought I would be, I guess it depends how much sedative they end up needing to give you, Matt commented he was surprised how 'with it' I was.


Once they were happy with everything they took off the monitoring, I was rather thirsty and had 2 cups of normal tea and a peppermint tea and some extremely nice orange chocolate biscuits. They then just needed to wait for me to have a wee before I was allowed to go, I hobbled over to the bathroom without too much trouble and managed to do a tiny little wee which was somewhat uncomfortable.  I had a little bit of bleeding which is normal but they gave me an advice sheet on what to do if this gets any more substantial.  I was then able to get dressed and walk to the car.

Relaxing at Home

 

We got home and I put on my lounge clothes and I've barely moved from the sofa since, apart from the hobble to the loo.  Matt has looked after me really well and as I wasn't feeling sick he made me a big plate of yummy pancakes with raspberries, blueberries, bananas and maple syrup and has been keeping me well supplied with hot drinks for the aftenoon.   I've felt rather sleepy and had a nap for about 1/2 hour but otherwise have just been chilling on the sofa with the telly on and some crochet.  The pain I'm experiencing at the moment is kind of like period pains combind with a sore cramping feeling as if somebody has put a needle into me and sucked my inards our, funny that...  It's not too bad though, definately ok when I'm sitting down though I made the mistake of watching something funny and laughing is painful as it pulls on my tummy muscles. Walking and going to the loo is a bit painful too but managable and paracetamol seems to help fairly well.  The pain got a bit worse initially as the IV pain killers they'd given me wore off but just as long as I take it easy I'm ok.  I would defnatley make sure you're able to take it easy for the rest of the egg collection day and have the next day off work. If your husband/partner isn't able to stay with you then get somebody else to come round and look after you if you can, I would have managed on my own but it's much nicer to be able to take it easy.

The Wait...

So now I just have to get my daily embryo update and see how they're developing, best case scenario is they can at least get one to a good blastocyst stage and put it in on Monday but we'll have to wait and see!

*sings* I Wanna Be Sedated

Egg collection tomorrow!  I’m having my egg collection under sedation and my husband is very helpfully singing this song to me and talking about how they’re going to harvest me.

The bit about the plane doesn't have any relevence but the rest is pretty accurate!

This may seem insensitive to some but my husband knows me well and knows I actually find this amusing and somewhat helpful; trying to keep everything relaxed and light helps to keep me calm.  I’m having mixed feelings about the awake sedation that my clinic uses for the egg collection.  For this they use 2 drugs – Fentanyl, a opioid, that is morphine like, pain killer and midazolam, a sedative that also has amnesic properties.  The idea is to keep you as comfortable and calm as possible without the risks of a general anaesthetic. I definitely want to have it and I want to be as comfortable as I can for the procedure, not least because it will help them to be able to get as many eggs as possible, but I don’t really like the fact that it has amnesic effects.  It’s difficult to explain, I feel like if this all works I want to be able to remember everything I’ve gone through to have a child, it won’t be a comfortable experience but that doesn’t mean it can’t be a positive one. Does that make sense?  I feel like this is part of my story, and part of the story of any child that is born from it, and as such I’d quite like to be able to remember it.  That doesn’t mean I’ll be turning down the midazolam but I just hope that it keeps me comfy but doesn’t completely wipe my memory of the whole experience. After all, I’ve gone to lots of effort to document this experience, I’d like to be able to remember this vital part of it, though I’d quite like to not be in a hideous amount of pain aswell so I’ll take the drugs!

If I'm feeling up to it I’ll try and write a post tomorrow afternoon to let you know how I’m getting on, until then I’ll spend the rest of today and tonight trying to relax and not thinking of the giant needle waiting for me tomorrow!

Gonal F Video

I'm a bit late posting this as I've now finished my Gonal F but here's my YouTube video for Gonal F injection technique.

Project Relax

It’s nearly my egg collection day, eek!  When I started I felt like the whole process would drag but it’s just flown by and I can’t believe I’m reaching the conclusion of this process.  I’ve managed to get nearly 2 weeks of work so my main priority now is to try and sit, relax and look after myself.

Last Scan 

 

I had my final and blood test today to check everything is ready for the egg collection on Wednesday.  The scan looked really good and I have 24 nice follicles sitting there hopefully ready to give up their little egg’s.  Apparently 24 is a very good number and higher than average but they didn’t seem concerned about ovarian hyper stimulation syndrome, which can be dangerous, so I was very pleased that I seem to have got the perfect balance.  As I keep reminding myself though this doesn’t mean that they’ll get 24 eggs, it doesn’t mean that they’ll develop into embryos and ultimately it doesn’t mean that I’ll get pregnant but at least we're starting from a good point,

Last Injection

At the moment I’m waiting for a phone call from my clinic to tell me what time my egg collection will be on Wednesday and this will determine when I give my trigger injection tonight.  The trigger injection is called Ovitrelle and it matures the eggs so they’re ready to be harvested – I hate that word but I’ll use it for want of a better one!    This has to be given exactly 36 hours prior to your egg collection presumably so that the eggs are mature but you don’t have time to actually ovulate so that the eggs remain in the follicles for them to get them out.  So this injection will be some time this evening up until around midnight.  I also have to give my final dose of Buserelin tonight which helps keeps everything in check and makes sure I don’t ovulate.  Then I’m done for injecting myself, perhaps until my next cycle of IVF or hopefully forever if it all works.

Anxieties 

I’m feeling fairly relaxed about everything at the moment.  I’m obviously really not looking forward to the egg collection but I’m not unduly anxious, I feel like if I can just try and keep myself calm take all the support and advice offered to me from the staff I’ll be ok. I know it’s going to be painful but it’s also over fairly quick and I’ll have plenty of sedation on board to help me through it.  If it works I’ll get everything I ever wanted and a bit of pain will be well worth it.

Getting Close Now

I’ve been a bit lax in writing over the past week, I've been so busy that I haven’t had time to sit down and update you on everything.

Tears

By the end of last week I was at a pretty low ebb. I would have still described myself as coping OK but I felt like I was pretty much on the edge of my energy and my sanity. I managed to function and get through my shifts at work but I felt constantly at risk of a meltdown.  Working night shifts didn’t help; I’m always more emotional when I’m tired so fertility drugs and nights was not a good combination.  I worked Saturday night so on Sunday I got up after 4 hours sleep (I had to be back the right way round for a day shift on Monday) and Matt had cooked me a lovely roast dinner.  Unfortunately I didn’t really get that much enjoyment out of the roast dinner as I spent the whole thing sobbing into my plate.  There wasn’t a particular reason for it but I just felt utterly physically and emotionally wiped out.

Over the last week however I’ve started to feel remarkably better now that my dose of Buserelin – the suppression medication - has been dropped down and I’m starting to get some of my hormones back.  My energy levels are a lot better, I feel more stable and not constantly like I'm going to fall off an emotional ledge!

Gonal F

The side effects of the Gonal F haven’t been too bad.  As I said I feel like I have a lot more energy than in the suppression stage of the treatment, last week the thought of getting to bed much past 9 o’clock made me panic about how I was going to make it through work the next day, now I feel remarkably chirpy all things considered.   The main side effect that I have noticed is feeling very bloated, as I knew I would.  I’ve got a proper little paunch going on.  If I stand sideways and look in the mirror I could easily imagine I was pregnant which is highly depressing considering that may be something I never get to experience.  I don’t feel too uncomfortable with the bloatedness though, just as long as don’t wear my tightest pair of jeans it doesn’t bother me too much.  I’ve got a few more days of the simulation left though so my little paunch is going to get rather more pronounced.

 

Monitoring Scans Number 1&2


After about a week of the Gonal F they started scanning me every couple of days or so, I’ve had scans this week on Wednesday and today (Friday) and I’ve got another on Monday.  These are the usual internal scans which are somewhat uncomfortable and occasionally painful, getting to my right ovary on Wednesday proved particularly painful for some reason.  They’re over fairly quick though, 5 or 10 minutes so not too bad.   They have a look at the lining of your womb, how many follicles you have on each ovary and they measure the follicles.  Once they’ve finished the scan the computer plots the size of the follicles onto a graph so show how big they are and how much bigger they need to be.  So far my treatment seems to be going well; I have something around 18 follicles, some bigger than others and they seem to be developing nice and steadily meaning I’m all on tract for my egg collection next Wednesday.   I’ve tried not to do too much research into how many is a good amount of follicles as it's more about how many eggs they get, the quality of the eggs and ultimately how many good quality embryos they get (but even all that is entirely irrelevent if they fail to implant).   I’m happy just to take the fact that they say I’m having a good response to the medications at the moment and try not to obsess about things too much.

So now I have a few days to relax (well after tomorrow when I’m at work)  before my next and probably final scan on Monday and then the egg collection on Wednesday, eek!