Things No One Talks About Post IVF Failure

341b75e3605d7b1cfdca17c98453cfa7Just a warning, I am sure this will include TMI stuff. It will also contain depressing stuff. Read at your own risk.

So, there is tons of information out there about IVF, about pregnancy post IVF, medication side effects, etc. There doesn’t really seem to be much about what happens when IVF fails. At least, not without really digging it seems. And that shocks me, given it takes the average woman 2.6 rounds of IVF to have success. So without further ado, my list:

  • You will vacillate between extreme anger, sadness, and just plain exhaustion.
  • More then usual it will seem like every single person around you is pregnant.
  • You will question “Why me?” and feel even more broken.
  • Once your period comes, it will hit with a vengeance.
    • Prepare for extreme pain, clots, and bleeding for several days.
      • If you have endo, prepare to be in hell for several days, I was.
  • Once the period commences you will feel like you are being punished.
  • After it is all said and done you will be left feeling empty, broken, and hopeless.
  • Everyone will try and be super cheery and positive, and you will feel like throat punching them.
  • Feel free to grieve the loss. You have every right to. It was a loss.

2WW & Beta

So following the transfer, all you get to do is wait. At this point you are what we in the infertility sphere refer to as PUPO, or pregnant until proven otherwise. My beta was 9 days following my transfer, as if I had conceived naturally that would have been 14 days past ovulation, or the day my period would be due.

Because I am obsessive though, I started testing at home 6 days post 5 day transfer or 6DP5DT. I had already tested myself the day of transfer to verify that my trigger shot was out. Just like with my IUI, the trigger used to bring on ovulation is the same hormone that your body produces when you are pregnant called HCG. So you have to check to see if that is out of your system.

Sadly, I pee’d on sticks 6, 7, and 9dp5dt and they were all negative. So, going into my beta the morning of 9dp5dt I already knew the answer.

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My first IVF failed. I am not pregnant.

I would try to put into words how that feels, but it is truly impossible. I vacillate currently between hating myself and my body and just trying not to sit at home and cry all day.

The only good thing I have in this situation is the fact that we have 2 frozen embryo’s and I can immediately go back on medications to transfer those in about a month and a half. So I have started that process. In the meantime, I am trying my very best to not hate myself. I feel like the largest failure in the world currently, despite the fact that I have no control in this. Reality is I am grieving and it will simply take time. I leave you with 2 ecards that perfectly explain my current emotional state.

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Retrieval & Transfer

InstagramCapture_e6a732e0-bc26-46d2-bb2c-6442b8fd303aSo, 36 hours after my trigger shot Bill and I were sitting in the Syracuse office of CNY, signing all the paperwork and checks and preparing for retrieval. We both worked the 23rd, came home, saw the dogs and then got on the road. We ended up pulling into our hotel in Syracuse at around 1 am. All in all it was a pretty nice drive, despite being super uncomfortable for me.

We woke bright and early and got to CNY. We got there around 8:30 am, knowing we needed to fill out all of the paperwork still and do all of the financial stuff. The clinic itself is very, very nice. After waiting about 20 minutes, we signed everything, wrote the check, and then I got walked back to undress and prep for retrieval. The cool part about retrieval though was that after I was hooked up, Bill got to come in and sit next to me for the procedure. It was also amusing I guess, as when I am nervous/anxious I start to ramble alot, which I guess also translates to me fighting the anesthesia. Bill said I just kept talking past when he thought I should be out. When they started to bring me back out, 20 minutes later, he said I picked up, right where I had left off. The only thing I remember is talking about daydreams with the anesthetist and then waking up asking how many eggs they got.

They collected 17 eggs. Which was far more then I had thought they would get. After about 30-40 minutes of just hanging out, making sure I felt okay, I was cleared to get dressed and leave. From there, we got back on the road to head home. Downside to surgery though was that I hadn’t eaten, so we made a quick stop for lunch in downtown Syracuse at an amazing irish pub called Kitty Hoynes and we were back on the road.

The next day I got the call with my fertilization report. Out of 17 eggs, 10 were mature and 9 had been fertilized with ICSI. From there, the wait was on for day 5 when I would find out how many made it and for there transfer back.

 

For the transfer back we didn’t have the money for a hotel room so what we ended up doing was coming home on the 28th, we took a nap and woke up at 1 am and left to drive to Syracuse. We arrived back at CNY just in time for my 9 am transfer. Once I had been situated back in the transfer room, the Dr doing my transfer came in and gave me the piece of paper that showed how many embryo’s I still had that day. He said, well, there’s a problem, you have too many embryo’s! We looked over the sheet and all 9 were still hanging out. 2 or 3 obviously were not in great shape, but I looked to have at least 4-5 that would be okay.

After that he asked how many we wanted to transfer, 1 or 2, and without question we said 2. Bill and I had already discussed this at length and had decided that twins were a risk we were willing to take. The transfer itself while uncomfortable, wasn’t too bad. Once the 2 embryo’s were deposited back into my uterus I laid there for about 15 minutes and then we were back on the road. We both had to work the next day and were absolutely dead tired, so we hightailed it back home.

From there, all we could do is wait to find out the next day how many we had to freeze and for my test day, November 7th.

Trigger Time

InstagramCapture_ab04b806-ecf1-414f-ac01-b5862f25186cBased on my last post, my guess for trigger would be 9 days of stimming. I ended up being a bit off. In total I have stimmed for 11 days. I took my trigger shot last night. What this means is that my estrogen level is sufficiently high enough, and I have enough follicles for a retrieval. I took my trigger shot at 10pm last night, and will report to CNY at 9am Friday morning for a retrieval at 10am. What the trigger shot does is over the next 36 hours it artificially tells my body that it should prepare to ovulate. So it quickly matures any eggs within decent sized follicles (typically between 16mm and 22mm). Then, after that 36 hours it will have my body ovulate. Hence why timing on this part is very precise. When my body is ready to ovulate I will be under a general anesthesia and will have a doctor inserting a needle through my vaginal wall to aspirate the eggs from the follicles before they are released into my body.

Awesome visual, right?

At that point, Bill will also have deposited his sample and once my eggs are collected they will be whisked away to the lab where they will wash everything and then place sperm and eggs into petri dishes and see how many fertilize. If things don’t look good, they might even choose a sperm and place it directly into an egg through a process called intracytoplasmic sperm injection (ICSI). I will then receive a call on Saturday letting me know out of the number of eggs collected, how many have fertilized.

I should then also be scheduled for what is called a 5 day transfer on Wednesday, meaning I will be back in office and the embryo’s will be placed back into my uterus with the hopes that they will implant and grow.

All in all at this point I am at the most uncomfortable portion of this stage, as well as the most stressful. Tomorrow I will find out just how many eggs my body has produced and what quality they are. Saturday I will find out just how many fertilized embryo’s I have. Fingers crossed this part goes off without a hitch. They say it only takes one, but I’d really like 2 to transfer and 2 to freeze. Not getting my hopes up though.

And Then We Were Stimming

6tag_111014-213354The next step in the IVF process is called stimming. Once my body has been sufficiently suppressed, through the use of birth control and lupron, my doctors will then introduce drugs that will cause my ovaries to create multiple eggs. See, every month most women start the first few days of their period with several small follicles on each ovary. During this time one follicle (sometimes 2 or more, hence natural fraternal twins/triplets, etc) will pull ahead of all the rest. This follicle will go on to mature, then around day 14 of your cycle you will ovulate and release an egg. For IVF, we want more then 1 of these follicles to grow and mature, but NOT too many. We also want to control when we ovulate, so that the Dr may retrieve all of the eggs and they are not lost into the abyss.

Needless to say, this is where things get pretty serious. Based on your baseline results, your diagnosis, and your age, your Dr will prescribe you the dosages of these medications. You will then typically start taking the injections daily (stimming takes 8-12 days on average), with your first follow up ultrasound and bloodwork on day 3 or 4, and then every other day, or quite possibly every day up until your retrieval. There are numerous blood draws to watch and make your your estrogen levels don’t get to high too fast (estrogen indicates how many mature growing eggs you have), as well as LH and progesterone to make sure you don’t ovulate on your own. Timing for all of this is very critical. If you produce too many follicles and/or your estrogen gets to high you risk something called ovarian hyperstimulation syndrome. OHSS on the low end is just very uncomfortable, and on the extreme end is life threatening. So, kind of a big deal. You also don’t want to stim too quickly, as this can result in poor quality eggs. So it is a very delicate balance.

15494578012_df0c2a2849_oAt my baseline I had a very high antral follicle count (about 45-ish small follicles on each ovary) and an okay estrogen level (110). Because of these facts, combined with my age, and my mixed diagnosis of unexplained, suspected tubal factor, they have put me on a very, very low dose of stimulants. I am currently taking 75IU Gonal-F and 75IU Menopur, along with a lowered dose of 5IU Lupron.

Yesterday was stim day 5 for me, and also my first ultrasound and bloodwork. Currently I am responding well, with 8 measurable follicles, 4 on each ovary, and an estrogen level of 378, making me a high responder. Because of my high follicle counts, and my high response to low doses of meds, I get to continue on with the low dose of medications and I have a repeat ultrasound and bloodwork tomorrow to see how much further along I am.

InstagramCapture_81696fc1-6d5f-40d1-9a50-a355123fa353Today marks day 6 of meds and so far my side effects have been:

  • Bloating
  • Cramping
  • Mood Swings
  • Fatigue

Right now I am guessing I will stim for 9 days total. Making trigger Monday and retrieval Wednesday morning. That is just my current guess based on my research and current response to meds. Tomorrows scan and bloodwork will be alot more telling as far as how on target I am.