The Infertility Process

Embryo Transfer #1 – Part 2

To recap…my first embryo transfer was on January 16 and we transferred 2 embryos. I had to continue the progesterone shots (the one in the butt) every night and my estrogen patches until I reach 12 weeks or the doctor says to stop.  

My first pregnancy test was on January 26 – let me clarify: my first blood test because I had peed on probably 10 sticks go into the blood draw.  They instructed me to arrive before 10am and we should have the results by the end of the day. I don’t remember the time they called but I do remember feeling like it took FOREVER.  

The nurse let us know the level was 21.  What does that mean exactly? Good question.  Anything over 20 is technically pregnant. SOOO, while 21 is greater than 20, it wasn’t a great indicator of pregnancy.  The nurse warned me that this was probably a chemical pregnancy but the doctor wanted to see me 3 days (it’s normally 2 days but it was a Friday and so I had to wait til Monday to repeat the test).

We were pretty disappointed and to make matters worse, I started to get a cold on the 25th.  More on that in a bit.

Monday comes and I go in for another pregnancy test.  This time, the level was 17. The nurse stated they were pretty sure it was not a viable pregnancy but they wanted me to come in for 1 more test in 2 days.  On Wednesday, the level was 38. While, the goal is to have the number double in 2 days, the level was still not promising. Friday, we had another test: 74.  Not quite doubled.

Throughout the week, I was absolutely miserable with the cold.  I am not big on taking cold medications because I don’t feel like they really help me but I usually take ibuprofen for my sore throat and nyquil to help me sleep.  Well, there was none of that. With the hopes that I might be pregnant, all I could take was tylenol and albuterol. So, I coughed and coughed and didn’t get any sleep (not that I would’ve gotten much sleep had I not been sick because we were anxious about the next lab results).

Moving on…

We arrived at another weekend and wondered all Saturday and Sunday what was going to be Monday’s level.  As I am sure you can imagine, there was little relaxing to be had.

Another Monday comes and my level was unfortunately 94.  It was apparent to my doctor that whatever was going on, the pregnancy was not viable and he told me to stop all medications.  By stopping the medications, it should’ve induced my period within a couple of days and the cycle would start over but my body didn’t get that memo – it has its own timeline.

Seven days later, I not only started my period, I was technically hemorrhaging and I started having severe pain on my left side.  To address the bleeding…most women don’t realize or don’t know or they just get used to a heavy flow but if you are soaking 2 pads within an hour, you should go to the ER.  That happened to me twice (2 hours in a row).

Now, to talk about the pain.  Because I have only one ovary and fallopian tube (on the left), I am super protective of it.  I was told by the nurse at the fertility clinic that a possibility for the wonky Hcg levels was I could be having an ectopic pregnancy.  And one of the many signs of an ectopic pregnancy is pain on the affected side. Well, the pain freaked me out more than the bleeding and is more of the reason I headed straight to the ER (I didn’t call or go to my fertility clinic because it was a Sunday).

The ER did some blood work and an ultrasound.  The ultrasound was normal. The labs came back and my red blood cells were low (no big surprise there with all the bleeding) but not enough for a blood transfusion.  My Hcg was 256. I was flabbergasted. I couldn’t understand why it would still go up. Also, while in the ER, the bleeding slowed to just spotting. The ER doc told me that it was probably still too early to see anything on ultrasound so an ectopic was still a possibility.  (Ugh!)

So, I went home and waited to call the fertility clinic first thing in the morning. They wanted to see me at the end of the week to do another ultrasound.  All week, I was so nervous constantly focusing on any pain or twinges of sensation in my abdomen. If I felt anything, I was heading back to the ER.

Friday, they repeated the ultrasound and the doctor was able to see a small sac but no fetus but a fairly healthy placenta.  Even though an ectopic pregnancy was possible (I did transfer 2 embryos), he was convinced that it was the placenta causing the rising levels of Hcg.  I was told to just keep waiting for my body to expel the pregnancy tissue. We were both surprised how relieved we were – it was bad news, sure, but it likely wasn’t an ectopic pregnancy which made us breathe a sigh of relief.

Meanwhile, I had a phone appointment with an OBGyn at my regular clinic (as a follow-up to my ER visit).  He reiterated what the ER and fertility doctor stated; however, he only wanted to wait a couple more days before scheduling a D&C.  So, we waited for 4 more days and still nothing – not even spotting – so we scheduled the D&C.

While we waited for the D&C to come, we got a letter/bill in the mail from a long-term storage facility for embryos.  Apparently, the clinic where we had our first round of IVF sent our genetically abnormal embryos to long-term storage.  (Click here for that post). (“He [the fertility doctor] also let us know that if any are genetically abnormal, he would not transfer them.  I thought it was strange that he would have to verbalize this but I guess some people have tried to transfer genetically abnormal embryos.”)

I was so stunned.  Why would they tell me they would not transfer genetically abnormal and then send them to a storage facility?  Why weren’t they discarded? AND WHY WAS I HAVING TO DEAL WITH THIS AS I WAIT FOR MY D&C????

I called the old fertility clinic and spoke with the director and she seemed genuinely upset that this was happening.  Because she had access to my chart, she could also see that I was in the middle of dealing with a miscarriage. She told me she would take care of all of the costs and that all we needed to do was sign paperwork that it was ok for the storage facility to dispose of the embryos.

For the D&C, it was pretty traumatic.  Every surgery I’ve ever had (D&C, polypectomy, hysteroscopy, etc.) I’ve always been sedated then they position me (basically it’s stirrups on steroids).  Well, not this time. They had me get in position and they started turning on all the machines. It was like they were going to start the procedure with me wide awake.  I think the nurse saw I was looking like a deer in headlights so she asked the doctor if it was ok to sedate me. She was like, “oh, yea. Go ahead.” Thankfully, the nurse pushed the medication pretty fast and I don’t remember anything after that (except waking up in recovery).

Lesson learned…ask for sedation before positioning.

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