Saturday, November 5, 2011

Our First (and Last) Egg Retrieval

This post is being brought to you by Amber’s husband. For non-immediate family members who are unaware of the past 24-36 hours, you’ll understand why I’m writing this by the end of the post. I’ll start from where she left off...

Wednesday: Retrieval Day!

Amber came out of this feeling ok. The 90 minute ride home from Chattanooga went fine for the first hour, but she got very antsy to get out of the car the final half-our. She couldn’t get comfortable in the car, but we got her home and in bed and it started to look a bit better.

The egg retrieval procedure went well and everybody at the clinic was really excited! They were able to retrieve 27 eggs, which is a ton! 15 is considered to be about average, 20 would be great, so they were able to get way more than expected. Because of the high number of eggs she was likely having some ovarian hyperstimulation syndrome (OHSS) symptoms. That makes her really uncomfortable and feeling pretty terrible. We were hopeful that it would subside and that she would be feeling better in the next couple days
The embryologist at the clinic (I had no idea this was a career...) called us that night and again the next morning to give us an update on how the eggs looked and the fertilization process. Here is what we knew as of Thursday morning: They got 27 eggs total during the retrieval. Prior to retrieval, we chose to do an ICSI procedure on 50% of the eggs (Here is the Mayo Clinic definition on ICSI: Intracytoplasmic sperm injection (ICSI). This procedure consists of a microscopic technique (micromanipulation) in which a single sperm is injected directly into an egg to achieve fertilization in conjunction with the standard IVF procedure). So, they took 14 of the eggs for ICSI and after preparing them, found that only one of those was not mature enough to be used, which is a great percentage, and that takes our number down to 26 eggs. They did the ICSI on Wednesday and then the "regular" method on the other 13, where they just put everything in a dish and hope they fertilize on their own. The embryologist called Thursday morning with the best news we have gotten in a very long time. Of the 13 ICSI eggs, 12 fertilized (92%; the clinic said typical is 80%), and of the 13 from the "regular" method, 10 fertilized (77%; typical is 60%). That left us with 22 embryos growing in Chattanooga on Thursday morning! She said everything looked great and if it stayed that way, we should be on track for a transfer of 2 embryos on Monday (and we would be freezing however many are left).

It isn't often we have gotten great news throughout this process, so this had our spirits pretty high. Rightfully so!


As I said, the embryologist called in the morning and gave us the news listed above. Amber was feeling better, but still pretty sore. All was as expected and we were feeling pretty good about how everything was going. A pretty uneventful day looking back on it.


Uneventful Thursday took us into a more eventful, and unwelcome Friday.

Before we get to that...We did get another call from the embryologist and she at least had more good news. Of the 22 that made it through the fertilization process, 21 divided. All of them were between 2 and 6 cells, which is where we want to be for that first day. Each one is then graded on a scale of 1 to 5, with 1 being the best. 10 of the 21 were considered to be Grade 1 and the other 11 were either Grade 2 or 3. That is great news and we are still on schedule for a Monday transfer.

Back to the unwelcome part: Amber woke up feeling really pretty decent, all things considered, but after eating a full breakfast and taking the substantial amounts of medications she is on, things took a turn for the worse. She was still having some abdominal pain, but the worst part was the onset of nausea. She began vomiting a bit and got extremely uncomfortable. After I had several calls back and forth with the clinic in Chattanooga over the course of the morning they were concerned but we were all hopeful it would subside. She was able to rest a little more comfortably throughout the afternoon, so I kept an eye on her when I got home from work and thought we might be ok.

We had dinner last night and she was doing ok, relatively speaking. We went to bed and then it began....

Saturday (Today) - Rock Bottom? (lets hope...)

She started vomiting pretty regularly throughout the night. About every hour or two, she would wake me up to let me know that she had to go to the bathroom for another round. At about 6 AM, I noticed that her abdomen was getting very swollen and she was saying this was as bad as she has ever felt in her life, and I couldn’t disagree by looking at her gray coloring and obvious pain. We both new that the Ovarian Hyperstimulation Syndrome (OHSS) had fully set in, and was progressing rapidly. It wasn’t going to go away on its own, and we had to get her help. Now.

One of the nurses from Chattanooga had given us her personal cell phone number at the retrieval in case anything came up over the weekend (the staff there has been nothing short of exceptional through this whole thing!) and I took advantage of it. I texted the nurse at about 7AM this morning and she called back immediately. She said that Dr. Scotchie would be in about 7:30 and she would call back after talking to her. She called back and said that she probably had to have the fluid removed from her abdomen, but they were worried about us driving 90 minutes with Amber being so nauseated. They gave us the option of picking a hospital in Knoxville and then she would call to make sure they could accommodate us. We talked it over and decided that we just needed to go to Chattanooga, as awful as the drive would be, rather than try our luck here. I was worried about getting in, sitting in a waiting room, getting results sent to Chattanooga, having some resident or other doctor do the procedure if they hadn’t done it before, etc. As they were calling back, about 30 min later, to find out where we wanted to go, we were walking out the door to go to Chattanooga. Easily the best decision we could have made!

The car ride was just as terrible as you would involved Amber’s head being in a garbage can for half the ride. Talk about some interesting looks from people we passed. I don’t think there is anything further that needs to be said about that trip.

At 10AM this morning, we walked into the clinic and Dr Scotchie was walking past the front desk. She took one look at Amber and dropped everything and walked her right to the back and set up an IV. They had two transfers scheduled that they were just getting started, so we had to wait a bit, but they got her hydrated and on some pain and anti-nausea meds. She was resting as comfortably as could be expected within a few minutes of arrival. Again, a great decision not to go sit in an ER here in Knoxville, and huge thanks to the Chattanooga staff! By the time we got there her abdomen was even more swollen and there was a ton of fluid that had to be drained.

As soon as the two transfers were done, we were the only people in the clinic and they gave Amber their full attention and took here into the IVF clinic’s version of an Operating Room and started doing a paracentesis to remove the fluid.

While we were waiting, the embryologist came out and talked to us and gave our daily update. Of the 21 embryos we had from the previous day, ALL 21 are still dividing as well as they/we could hope. 11 are a Grade 1 (again, the best on a scale of 1-5), 6 are a Grade 2, and 4 are a Grade 3. No Grade 4 or 5. The embryologist is almost giddy when talking to us and has had nothing but great things to say, so we’ve enjoyed hearing from her these past few days. Again, this is really great news and lifted our spirits quite nicely amongst the obviously difficult day.

After the good news, it was back to the immediate worry. Amber was off to do the paracentesis and then I had 3 different people come out and tell me it was going well and that they were getting a great deal of fluid. When it was done, Dr. Scotchie came out and told me that they had drained 2.5 Liters of fluid! Yes, you read that right...LITERS! No wonder she was sick! After bringing her out of anesthesia, they brought her back out to recovery and she already had her color back, was feeling much better. They then said that if she was able to eat and keep down some crackers, we could go home today. If not, she would have to be admitted to a hospital in Chattanooga. Luckily, she was able to eat and they gave us the ok to go home.

We had already discussed with Dr. Scotchie that we did not feel comfortable with a Monday embryo transfer with how Amber was feeling and she said she was going to recommend the same thing. Because our embryos are doing well, we have decided that we will proceed with freezing all of the embryos on either Monday or Tuesday (depending on when the embryologist determines each individual one is ready to undergo the freezing process). She explained that typically about 80% of the embryos will survive the freezing/unfreezing process. We are very comfortable with this decision and this will give Amber the opportunity to get off all of the IVF-related meds, take some pain meds, and most importantly, get healthy. Once she gets back to feeling normal, or as normal as it gets these days, we will decide when to proceed with the embryo transfer. Dr. Scotchie said this would be a very sensible approach and that whenever we decide to do the transfer, it will seem like nothing compared to what we have been through the past six weeks! We are very thankful that our embryos are growing so well and that we even have this option to consider.

We loaded Amber back up in the car and she had plenty of pain meds to get her back home comfortably, which again was a welcome change. She has been up in bed since we got home and feeling much better (again, this is all relative). We can only hope this continues. There is a chance that we will have to go back one more time either Monday or Tuesday to do another paracentesis if there is further fluid build up. Hopefully we do not have to do this, but we will be proactive in making sure today’s events are not repeated.

Well, there you have it, folks. You are now up-to-date. Thank you to everyone who has written, called, texted, etc, to let Amber and I know you are thinking about us. Your continued support and prayers are very much appreciated. We thought we were prepared for the difficult road that this IVF process would be, but these past couple days have been more than we ever anticipated. With that said, we are very thankful that things did not turn out any worse than they have.

Hopefully Amber will be back on her feet soon and writing to provide her witty take on everything that has taken place this week. I’m not sure when that will be, but we know many people are following our journey and we will do our best to keep you updated with any new developments. Thanks again to everyone for your support!


MaryMargaret said...

I am so glad that you guys were watching for symptoms and have a great clinic that was on top on Amber's treatment! It sounds like a smart move to opt for an FET and let her recover a bit from the meds. Glad to hear that she's feeling better now! Congratulations on your amazing embryos!

Nichole said...

What wonderful news and such a scary experience all at the same time! Hope recovery goes well and you get to feeling better soon.

LC said...

Thanks for keeping us updated hubby! Hope Amber is starting to feel a lil better! Thinking of you guys.

SarahMayme said...

Wow- can't even imagine how you were feeling Amber! You told me a little about this but OMG! Congrats on the beautiful embryos! Please call if you ever need to chat or have some girl time! Hope you are feeling better each and every day!