The Infertility Process

2nd and 3rd Egg Retrieval

After looking around at the other local IVF clinics, we decided to go back to California IVF.  A: Their statistics were at the national average or better and B. They knew us already. We also decided to add acupuncture which can be successful in helping with hormone regulation (read more about that experience here).  So, mid-July I started acupuncture and we had our appointment with Dr. Goud at California IVF.

For the clinic appointment, I made a packet of all of our information including a timeline of all of our procedures, treatments, medications and lab results at our previous clinic.  Dr. Goud looked over our information and we discussed our last IVF cycle in detail. He was surprised that the went ahead with the egg retrieval when my progesterone was so low (3.3 and they want it greater than 8).  We left the meeting hopeful because Dr. Goud seemed optimistic but also very frustrated that we did not listen to our instincts with our first IVF with regards to the progesterone level.

Dr. Goud wanted to do an ultrasound but felt like we didn’t need to repeat a saline ultrasound (WOO HOO).  He also wanted to repeat my hormone levels to see if anything had changed. Well they did change. My Anti-Mullerian Hormone (AMH) dramatically decreased.  AMH is secreted by developing egg sacs and is an indicator of ovarian reserve. Normal AMH is 1.0-4.0. My AMH in early 2017 was 1.6 but when it was tested again in July, it was 0.8.  It was such a dramatic drop that the doctor asked for it to be retested (the second was a tad lower). I was super bummed about the drop in my AMH but it motivated me to try to get the egg retrievals done as soon as possible before it dropped any lower.  

So, we got the first egg retrieval scheduled for the beginning of October 2017.  Like I’ve mentioned in a previous post, we decided to do not do PGS testing since it was more expensive than at the previous clinic. Instead, we decided to do two egg retrievals which would put us in a program they have where the embryo transfers would be free for one year.  With all the trouble we had this far, we thought this option was the best for us at the time.

We had to go to an IVF class where they go over medications, administering shots, what to expect for the procedure, etc.  There was also a class given by the embryologist discussing what they do in the lab, the growth of an embryo, and why timing is so important.  Both classes were super informative and put our mind at ease some – it also helped that we’d been through this before.

The hormones I was placed on for the first cycle were no joke.  My doctor was not messing around – plus, with my dramatic decline in AMH, I am sure he felt he needed to be aggressive.  And my emotions went on a roller coaster. I was very short and snappy with people (sorry to those people who came into the line of fire).  I spoke about the roller coaster later with a friend and she was honest with me saying I was quite the handful. My response, however, was that I was showing major restraint – if people only knew the chaos that was happening inside that I managed to filter.

The labs and ultrasounds looked good going into the egg retrieval and I started to get the full feeling from all the follicles growing.  The egg retrieval happened much in the same way it did at my previous clinic: the procedure room is connected to the lab, I am sedated, they retrieve the eggs, I recover and go home to await the results.  Because the stimulation medications were higher than the previous egg retrieval, my Ovarian HyperStimulation Syndrome symptoms were worse, as well. My abdomen was so distended and firm, I remember gaining four inches in my waste in 2 days.

They were able to retrieve 22 eggs, 13 eggs were mature, 10 fertilized.  In the end, we got 6 embryos – 1 Grade IV, 2 Grade III, 2 Grade II and 1 Grade I.  We were pretty thrilled with the results.

I am going to pause right here to talk about the post-hormone phase.  When people talk about follicle-stimulating hormones and all the influx of emotions, most don’t think about the time period when the hormones wear off.  It’s truly a rollercoaster – and not in a fun way (if you think rollercoasters are fun). There is this let down afterwards that is hard to describe but I am sure if you’ve ever been through it, you know what I mean (although, I had a friend go through IVF who said she didn’t feel any differently during or after the hormones).

Going into the 2nd egg retrieval, my infertility doctor conveyed his concern with doing the retrievals back-to-back.  The hormones and the retrieval procedure do a number on the body and, as you can imagine, he wanted to go into the second one with me as healthy as possible.  He stated we could move forward but only after another set of blood tests (progesterone, electrolytes, etc.) and an ultrasound. Everything looked good so we moved forward.

So, once again, there’s lots of hormones and the emotions and the discomfort of having numerous follicles growing at once.  The retrieval was another success: 18 eggs retrieved, 13 mature, and 11 fertilized. Of the 11 fertilized, 5 embryos made it blastocysts at Day 6 or 7 (2 embryos were Grade 2 and 3 Grade 3).

Again, we were excited.  We had 11 embryos total to transfer.  But, I had had enough. After the last egg retrieval, I looked at Andrew and told him that I can’t go through that again.  Even though it was hard for me to say out loud “no more”, the process was too hard. The hormones, the discomfort, the OHSS symptoms and, most of all, the emotions.  These 11 embryos were our last shot.

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