WHO THIS POST IS FOR:
- Couples going through a round of IVF
- Women retrieving eggs to donate and freeze at a later time.
- Friends of infertile folks
Today was my first day of shots and thus, retrievals are on my mind. Friday I learned I was starting another round and will have another retrieval next week. I am quite excited because this means we are one step closer to getting some answers. Because I will have had 2 retrievals within one month, the info is fresh and ripe for the taking.
WHAT IS A RETRIEVAL?
If you are going through a cycle of IVF or freezing your eggs you need to have the eggs removed from your ovaries. Your doctor will devise a plan (according to your diagnosis) that will allow them to stimulate your follicles (the magical sacks inside of your ovaries that grow and house your eggs) so that they can remove as many eggs as possible. Your age plays a large part in the number and quality of eggs removed, however you can of course defy the odds. For example you can be young and have poor quality eggs or older with a bunch of eggs ready to go. The doctor will determine a course of action based on the stats that normally apply for your age.
You will begin your medication and stay on it for about 10-14 days. Your doctor will closely monitor you to figure out how your follicles are growing so that they can fix your medication dosages along the way. The entire process is incredibly calculated and is contingent upon time thus it requires a lot of oversight.
WHAT MEDS WILL I TAKE?
In order to get your follicles big and juicy (mmmmmmm) they will need to stimulate them. The doctor will use an injectable medication to help get the follicles to grow (I take a shot in the morning and a shot at night). The goal is to get the follicles to grow together. What I mean by this is, you don’t want one follicle thats huge, a few that are medium, and a bunch that are small. The ideal is to get a large group to grow around the same size at the same time. The reason for this is, around day 10 of shots your doctor is going to look at the size of the follicles and determine if you are ready to “trigger.” This means that within 2 days, your follicles will be at the magic size (for my doctor its about 20mm) and he/she will be able to get the most bang for their buck.
In addition to the two shots each day (or however many your doctor gives you), you will introduce a third shot late on in your cycle. Because you are growing all of these follicles, your body will say to itself, “HMMMM this is strange, shouldn’t I ovulate?” Since your body is so smart, your doctor will have you begin an additional injectable so that your ovaries will not ovulate and will wait to release any eggs. In my experience I started taking this particular shot around day 7 of my cycle.
Once your follicles are at a certain point (around 18 mm) your doctor will give you the go ahead to trigger. This is INCREDIBLY TIME SENSITIVE. Depending on when your procedure is, your doctor will give you an exact time to take your medication. This last shot lets the follicles know its go time. “The effect of the “trigger shot” is to send eggs into a reproductive division known as meiosis where the objective end point is a decrease in the number of chromosomes in the egg from 46 to 23 (half) prior to ovulation or egg retrieval.”(READ MORE SCIENCE-Y STUFF HERE). In laymen’s terms, the shot gives the follicles the go ahead to release the eggs from little sacks inside of the follicle. In the process they become mature eggs ready for the taking.
PREPPING FOR A RETRIVAL
Your doctors office will give you a time to show up for surgery. This is a surgery, you will not be awake for it. Most likely you have a procedure in early morning and will not eat prior to it because of the sedation.
Surgery (especially when new) can be scary. Do what you need to do for yourself to relax. Your partner (or sperm donation vile) will need to be present because you will need the sperm for your freshly retrieved eggs. Immediately following your retrieval the sperm and egg are introduced to one another in a petri dish.
*** Embryo fertilization and testing will be in a post in just a few short weeks, stay tuned!
You will most likely feel pretty crappy (crampy) and tired afterwards, do not make plans. Depending on overstimulation, etc. you may want to ensure you don’t have plans the following day either. Take each day as it comes and show kindness to yourself.
This past retrieval I had a list of TV shows I was waiting to watch so that I would be occupied while I was at home. I recommend you do the same.
Some women opt to get multiple eggs in the bank before transferring. Last year I did a retrieval (it failed), and then did another one. My second retrieval yielded 5 embryos. I defied all odds, after transferring 4 I still wasn’t pregnant. Statistically about half of the embryos should have been genetically sound.
My husband and I decided to search for answers and pursue genetic testing. This testing will help us figure out if it my eggs are my issue. Thus, it makes sense to get as many eggs as possible before testing. This process is called “batching.” Next week I will have a fourth retrieval and finally be done with retrievals forever 🙂
Many older women batch so that they can get a number of embryos to transfer all at once because statistically most of their eggs will have gone bad.
HOLY GUACAMOLE! YOUR OVARIES ARE THE SIZE OF AVOCADOS
A very small percentage of women over stimulate. What this means is, they produce an insane amount of follicles and the result is their ovaries get ridiculously big. In some cases fluid leaks from the ovaries which is quite dangerous. The fluid could leak throughout your body and cause some major damage. Additionally, because your ovaries are so big you can twist an ovary and cause a torsion.
I am one of the lucky women who are prone to this. If you are in this circumstance you will watched even more closely. If your doctor does not mention this, put him in line NOW.
Leading up to and after the retrieval is tough because you can literally feel your ovaries. They are big and heavy. Your stomach becomes huge and you feel super bloated and heavy. Once you get your period, your ovaries will chill out and you will feel better. Waiting around though is not fun, I cant pretend it is.
Some women will transfer their embryos after a retrieval while others must freeze and wait. If you are doing a fresh transfer, you will be given additional hormones to prep your body for the embryo implantation.
Managing your meds and feelings is a lot. Give yourself permission to be okay with the process. I have talked to so many women and each time I am reminded that its okay that our brains are consumed by this. It doesn’t make you a bad employee, friend, or partner. Its natural, this is intense. Be nice to yourself and try to laugh along the way.-
POSTS TO COME:
- Acupuncture before a procedure
- Make your partner give you shots
- Overstimulation, scary stuff
- Transfers, fresh and frozen
- Genetic testing
- Failed retrievals, whats next