Retrieval Results

The day started off ominously when we got in my Acadia at 6am and the car wouldn't start. Of all the steps in an IVF cycle, the timing of the trigger shot and the retrieval are the most crucial. After about 10 minutes working with my car, we ended up having to take DHs Subaru WRX STI, which is entirely uncomfortable with swollen ovaries, and we got there in a record 31 minutes going 85 mph to make sure we weren't late.

We walked into the building with the doctors and had a little chat in the elevator. I met the RE doing my retrieval and told him I only have 3, maybe 4, eggs and he needed to get them. He said not to worry, he's pretty greedy and he'll get everything he can. After doing paperwork we chatted with the RE for another 30 minutes just hanging out. We joked with the embryologist and told him to pick out a girly looking swimmer this time. Just to be clear, it was a joke. While it is possible to do full gender selection, we are not doing that. We did a lot of chatting with the docs before the procedure, it's a very different feel on a holiday when the staff is limited and just there for a few retrievals and transfers vs. other planned surgeries and a full days work.

A mystery was solved during my chat with the anesthesiologist. I'd mentioned before that the hysteroscopy surgeries were really kicking my butt and I was sleeping for 3-4 hours afterwards. Apparently that's because with those I have IV anesthesia along with gas (general anesthesia) and it takes a while for all the gas to work out of your system. For the retrieval, it's just IV anesthesia (sometimes called "twilight") and moves through your body faster. I felt pretty good after the surgery, napped for just an hour and was fully able to cook Thanksgiving dinner for DHs family.

But I'm getting ahead of myself. The retrieval. As I was moving into the OR and saying bye to my DH, I said "We're hoping for 3, 4, or maybe more." My first question in recovery of course was how many eggs. Oh yeah, we got 5! Now, we don't actually know if all the eggs are mature, if they will fertilize or survive the culture for the next 3 days, but for now we've got smiles on our faces with 5 eggs, which is more than we had expected.

I should be getting a call later this afternoon with the fertilization report. Come on, embies, fertilize, grow and come on back to me!

3rd Hystersoscopy - Check!

Just had another hysteroscopy on Thursday and the news was good - only minimal scar tissue grew back. The surgeon was able to remove all of it. I'm back on estrogen for a week to help keep the uterine walls from sticking together. The other piece of good news is that even if this first IVF fails, he doesn't think the tissue will grow back that quickly and I won't need to have a hysteroscopy before each and every cycle - whew!

I've got all my drugs in the house. I've got an appointment for my baseline bloodwork and ultrasound next Friday. I seriously never thought that I would be excited to see a needle again, but after 5 months of "preparing" to start trying for #2, the prospect of actually moving forward is very encouraging. If all goes well at my baseline, I'll be ready to stick a needle in my tummy next weekend!

Waiting until November

Based on my last consult, we realized that since the lab closes for 2-3 weeks each year in December, we can only get in one IVF. Rushing to get it done before we go to Jamaica and either getting a BFN, having a low Beta, or stressing about it wasn't going to do any good. So I'll remain on BCP, have my next hysteroscopy on 10/28, go on vacation and plan to start stims as soon as we get back.

The last day for stims based on the lab closing is 11/29. We should have 8 days of wiggle room in there to make sure we get done. Since I'm always a day 3 transfer, I probably have even 2 more days of wiggle room that they allow for day 5 transfers. What this means is I might be on bedrest during Thanksgiving and we're hosting some of DH's family. Oh well.

Now I need to get moving on working through all the additional drugs I need to order. The Bravelle, Menopur and Antagon are in the house. But I need Lovenox, Prednisone, HCG, Estrogen, antibiotics, valium, and the list goes on and on. I need to pull out my old notes on which pharmacy's had the best rates and get that ready to have all my Rx's called in. Be prepared for some additional venting on how I hate Rx companies over the next few weeks.

While we are definitely not pleased with the waiting game, it has been out of our control based on all the hysteroscopies. Even without the planned vacation, at this point we would only be able to do one IVF this year (I always need a month off after treatment due to ovarian cysts). Mentally, this helps us to feel better about where we are, as we were both frustrated with the fact that we've been trying to get started since May, always planning around this vacation, and the timing has hit this vacation right on the head.

4 lbs - Seriously?

On Thursday I was happily still just below my pre-pg weight. As of Friday post surgery, I had gained 4lbs and my clothes felt tight. I'm hoping some of it is the IV fluids still in my body, and not just the fact that I started high doses of estrogen again.

I'm expecting the usual weight gain from steriods and injections, but that's not until I'm actually starting my IVF cycle. This pre-cycle weight gain is annoying. Ah, welcome back to the world of fertility treatments...this blows.

I'm also still feeling extremely weak and get tired very easily. Sounds like time to lie on the couch and watch a movie.

Bye-bye Scar Tissue

I had another hysteroscopy yesterday, this time to cut out the scar tissue blocking the left side of my uterus. The doc said they had a plan to go after the scar tissue and cut out as much as they could, but they were not planning to be overly aggressive or heroic with removing all of it. I asked why. He said from the pictures, it didn't look promising to get it all and they didn't want to perforate my uterus. Good call. He said they would be doing ultrasound guidance to help determine where to cut and possibly it would be better than they expected.

They explained more about the balloon that they were going to put in to hold the sides of my uterus open while I heal. Apparently it would have a piece that hangs out of me and I would need to tape it to my leg or tuck it in my undies. Lovely. I also learned that the "few days to heal" is actually 21 days of estrogen therapy with progesterone added in the last 7 days. While I was hoping to start stims for IVF in a week, it's going to be another 3 week delay. I was quite disappointed at yet another setback, but realize that getting my uterus in the best possible shape is the most important thing.

And then they dropped the next bomb. I will most likely need to go back at the end of this 3 week period to have another hysteroscopy to get any additional scar tissue that grew back while I was healing. I had asked how quickly it grows back and the most crucial time is 2-3 weeks after it was removed. TTC#1 took 4 surgeries to get pg, and 2 surgeries for delivery. TTC#2 is starting off with 3 surgeries before I've even had my first retrieval.

Did all the pre-op paperwork, pee in a cup, vitals, and IV. I always say right away that I need lidocaine in my hand before they start digging for a vein for the IV, which always brings the anesthiologist right in. She started flicking my veins until they were tingling and said she could do it without lidocaine and wouldn't dig. I hesitantly said ok, and she got in right away. Score 1 for the anesthiologist. Off to the operating room. Got situated on the table, strapped down my arms, chatted with the scrub nurse and anesthiologist. Got some good oxygen and relaxy drugs. I never get enough time with the relaxy drugs before they put me to sleep, I mean at least let me enjoy the high for awhile, right?

Wake up in recovery. I immediately ask the nurse if I have a balloon in me. Nope. They tried putting the balloon in and apparently my body rejected it and it wouldn't stay in. So I'm just on the hormone therapy which is working on building a thick lining in my uterus. I also realized that I must have majorly chomped my lip because it is all puffy and hurts. My DH comes back to see me and then the doc comes in. It went better than expected and they got a good chunk of the scar tissue out. I think he said more, but I'll have to ask DH again, I'm still a bit fuzzy on the rest, but know I need to setup another consult with the RE to determine next steps based on the surgery results.

On the personal front, I'm not bouncing back from this one. I came home and slept for 2 1/2 hours, was exhausted from doing DSs evening routine, then went to bed at 9:30pm. Got up for work this morning and realized that I still have a ways to go for recovery. My blood pressue must be really low because I am extremely weak. It was an effort to carry DS this morning and while I've been working, I think I need a nap. I incorrectly think that just because there isn't an external scar that needs to heal and I'm not in pain (uncomfortable a bit, but no real pain) that I'm fine. I'm not. My body still needs time to rest. I need to remember that for the next surgery in a few weeks. Luckily the weekend will be here and I can chill for a few days.

Not the news I wanted to hear...more surgery

We aren't moving forward very quickly. I just had a consult with the RE today to review my hysteroscopy and MRI results. Apparently if you think of my uterine cavity as a triangle, 1/3 of it is blocked off. He assumes it's with scar tissue, which is bad. Scar tissue doesn't have any blood supply and it's blocking an entire wall of my uterus. This poses a number of problems.

1) I have bad eggs, I'm making the numbers up but it means only about 1 in 50 of my eggs is any good.
2) I don't stim well (I don't respond to the drugs). Typically, people doing IVF will have anywhere between 5 - 15 eggs retrieved which can then be fertilized into embryos. On my 3 previous IVFs, I had 1 egg, 3 eggs and 4 eggs that fertilized, although most were crappy eggs.
3) If there is no blood supply, there is nowhere for the embryo to implant. With my limited chances from #1 and #2 above, I don't want to decrease it by another 50% if the embryo decides to implant on the scar tissue side instead of the clean side.

All in all, this does not bode well. What to do? Apparently I need to have another HSG test (massive x-ray/ultrasound where they shoot dye up your hoo-ha) to see if there is any opening in my fallopian tube and to determine how massive the scar tissue is. Essentially, the RE is trying to figure out where/how he'll be able to cut the scar tissue out. Once that is decided...

I need to have another hysteroscopy, the same surgery I had three weeks ago. But this time, they'll be cutting the scar tissue out. My RE assured me that since scar tissue doesn't have any blood supply, I shouldn't have any issues with bleeding beyond a normal hysteroscopy. However, in order to prevent additional scar tissue from forming while my body recovers from surgery, they will insert a balloon into my uterus to keep the sides from touching each other. I'll keep it in for 3 days, then have it taken out at a normal office visit. It doesn't sound like any of this will be very pleasant.

Right after the surgery, I'll be put on massive doses of estrogen and progesterone for the next week or so. With the massive hormones and balloon shoved up me, don't be surprised if I complain of bloating. I don't quite recall the reason for all the estrogen and progesterone, but after that I should get another AF and be ready to start the IVF cycle.

On another venting side note about Rx issues, I had noted that my Bravelle finally shipped - yay! But that was a week ago and it has not arrived. It's coming via USPS Express International and requires a signature. I even paid the extra $89 for Speed Shipping which normally has it arrive in 3-4 days. I called about it last Friday, they said it was in the US. Tracking finally saw it in NY on Saturday. Sunday night it left Houston and was supposed to arrive today. I worked from home today in order to sign for it, but alas, it is still not here. I'm going to have to work from home again tomorrow to get the package, because going to the post office and waiting 30-45 minutes in line is probably worse, since they are only open during my work hours, or the time I have with my DS.

A regular theme throughout TTC#1 was...can I just catch a break? I'm starting to feel that way all over again. Why, oh why, doesn't *anything* just work smoothly?

Hysteroscopy today

Well, I had my hysteroscopy today and it wasn't the result I was looking for. Sounds like the right fallopian tube is clear. The left fallopian tube is either blocked, or embedded in so much scar tissue that the doc couldn't see the end of it. It might also be the reason why the doc said my uterus looked smaller than he would expect, too much scar tissue. So now I need to have an MRI to help figure out what's going on. Good news of course is that since we know we're doing IVF, my fallopian tubes aren't really needed anyway. Although this also pretty much rules out any "surprise pregnancies". Bad news, too much scar tissue, nowhere for a baby to grow. More to come.

I am wiped out. Normally I do pretty well after surgery and anesthesia (I had 6 surgeries to have DS, so I know what I'm talking about). I always get the post-anesthesia chills and I go to the hospital with a sweater and a blanket to use in the car. Today I got home, finally ate food for the first time at 1pm, then proceeded to sleep for 3 hours and I still feel groggy. I wonder if it's my old age....

Updates from my previous post. My prolactin level looks great. It's supposed to be between 3-30 and mine is at 4. I ordered the most expensive drugs from the UK and my Ganirelix and Menopur have arrived. However there is a shortage of Bravelle and they are waiting to get another shipment. I'm going to have to play the time game to either hunt some down in the US, or keep taking birth control until it arrives. Considering I now have to have an MRI and see what those results are, the Bravelle might get here in time.

Any my favorite, I've already gained 2 lbs after being on birth control for 2 weeks. Lovely.