Day 4: Acupuncture and Patience

Today, I'm finding it difficult to be patient. We don't get an update on our embryos and I know they're in the most difficult phase of growth where many embryos are often lost. Last we heard, four were doing very well with 7-8 nice, even blastomeres (cells) and two were growing nicely but a little slower with only 6 nice, even blastomeres.

On day 4, we need those embryos to be in the Morula stage, the last phase before they grow into blastocysts, form the blastocoel (fluid filled cavity) and start differentiating cells. Today, and possibly tomorrow if they're slow growers, they should have between 10 and 30 cells.  They might even have begun compacting like the embryo below, which is where the cells start squishing together like the embryo below.

Nice quality Morula

Hopefully they'll make it through the morula stage and grow into nice blastocysts tomorrow. If they're not quite there yet it's still okay as long as they're progressing. They'll be allowed to grow to day 6 when plenty of embryos are frozen and I probably won't sleep until we get the call. As blastocysts, they should be dividing into the inner cell mass (ICM), the Trophectoderm (TE) and the blastocoel (fluid cavity), which gets bigger as the embryo expands.

Nice Blastocyst

We need good cell differentiation to get a clean biopsy of the embryos for PGD. They need to sneak some cells out of the TE on the side there, the cells that will become the placenta, so we can test the fetal DNA for abnormalities.

Since there's nothing I can do to help my embryos grow, my distraction for today was a much needed acupuncture appointment. I haven't been since my retrieval and it's supposed to really help with recovery and the symptoms of OHSS. I laid down on the table, S took one look at my belly and said "Oh boy, you're definitely hyper stimulated". Clearly other people think I look 6 months pregnant too.

I already knew that I probably had OHSS but it's still a bummer to have it confirmed by a nurse. I also woke up sore this morning, my hamstrings and back felt like I'd worked out, and S said it's because of all the fluid I'm retaining. The fluid is responsible for my bloat, my repeated peeing, the heart burn and now the muscle soreness. Oh the joys of IVF.

Dr. D's nurse also called today to ask us about aCGH testing for our embryos and to see how I'm doing. I told her we'd probably base our decision for chromosome testing on the number of embryos we get, our lab doesn't really need an answer until they have all of our biopsy samples but as long as we get a good amount from each cycle I think we'll probably go ahead and add it on. If we only end up with a couple of embryos from each cycle, I'm not sure if it's worth doing, but if we get six lovely frosties each time I'd say it's worth the extra $2500.

As for next cycle and the crazy bloating, she said Dr. D usually takes a "flush" cycle in between IVF cycles to allow all the hormones to flush out of your system. It would also give me a good amount of time to order my meds from IVFMeds.com so I wouldn't be doing things so last minute. She made a note for Dr. D to chat with me about it tomorrow when he calls with our embryo update, so I'll probably be holding my breath until the phone rings tomorrow morning. I so, so hope our six embryos are doing well, I worked so hard for them and I won't be able to relax until they're safely biopsied and frozen.

Day 3: Growth Report

We got our growth report this morning and our embryos are still dividing! We have 4 that look really good with nice, even cell division and 2 that look good but are growing a touch slower. We also have 1 that fertilized but is pretty far behind the others with only 2 cells so we're not sure if that little guy can catch up. E is calling it our runt, Wilbur, but I don't think there's any chance of him catching up.

Original Photo came from here

I talked to Dr. D about our next cycle and he thinks we're on track to start in about 6 weeks. I didn't get to really clarify what that means since I later realized it could mean taking a month off or not taking a month off. If I get my period in about 2 weeks, then go on birth control for about 2 weeks, then stim for about 2 weeks, that's 6 weeks right there. I was asking if we'd take 6 weeks off doing nothing before starting the next cycle but I don't think I got that across. I'll have to bring it up again another time.

I also asked about the crazy bloating which he said is probably from the HCG as well as the estrogen. He said I should expect it to stick around in my system for at least 10 days so I don't see this belly going down anytime soon. I have no illusions about the physical side effects of infertility and the IVF process but it would be nice if I could save some growth for a baby.

As far as recovery goes, I'm feeling a bit crappier today than yesterday. I'm still only mildly sore but I have a weird nauseous/imminent cold feeling that probably wasn't helped by the fact that I woke up every 2 hours to pee and didn't get great sleep. I'm not sure where I could have picked up a cold since I've been taking it pretty easy and not going anywhere but I can definitely feel it hovering at the edges of my throat. Hopefully it's just the hormones because I can not get sick right before our next cycle.

Day 2: Recovery

Thus far I think I've been pretty lucky with my recovery. I'm still good with just a couple Tylenol or Advil every 4-6 hours and if I don't take it, there's only a minor ache of discomfort. I never really had any bleeding, nausea, constipation, or serious pain. I know every egg retrieval is different and I don't want to jinx it for next cycle, but I hope I can get off this easy next time. Maybe it's my reward for having such a shot heavy stim cycle :)

The two symptoms I am experiencing at the moment are two I could definitely do without. For starters, I'm still super, super bloated and uncomfortable with a belly the size of a watermelon. Possibly even more bloated now than on retrieval day.  I haven't tried to wear my jeans yet but I doubt they'd button comfortably right now, even my loose jeans would cut right across my ovaries. This is probably still mild OHSS so I've just got to grin and bear it and hope it goes down.

In the same category, my grapefruit sized ovaries must be pushing on all sorts of things because I'm getting awful heart burn. No matter what I eat or how I sit, I have the worst acid indigestion. This is another one of those things you just have to wait out, so I'm popping Gaviscon like candy and hoping that it passes quickly. I just ran through my last bottle so getting more is first on my list of things to do tomorrow.

My secret weapon

For anyone else getting ready for an egg retrieval, I absolutely think that the crazy amount of water I've been drinking has played a big role in why I've felt okay. I drank 100-150oz the day before the retrieval and another 100-150oz the day of. I've been drinking at least 100oz a day since and despite the anesthesia, it's probably physically impossible to be constipated with that much water in your system. I know a lot of clinics push laxatives after a retrieval but I prefer to avoid that stuff if I can. In this case, I think the water is a pretty viable alternative. Plus, peeing every 10 minutes, while also tied to OHSS, helps clear the extra hormones out of your system which should mean less bloat and misery. I'm still sleeping with my feet up on a pile of pillows as well, which is supposed to help all the excess fluid drain.

The acupuncture has probably also played a roll. Even the regular treatments that just keep all your energy and such flowing normally can really help with clearing out your system. The surgery center was a little weird about herbs so I stopped drinking my herbs a couple days before the retrieval and I just started back up again today with my acupuncturist's blessing.

The embryologists try not to bother the embryos on days 2 and 4 so I sadly didn't get an update on my embies growth today. They should be growing and dividing with at least 4 cells so that they can reach 6-8 cells tomorrow. I'm on pins and needles waiting for tomorrows phone call and I'm hoping and praying that all six are still growing well.

 

Original Photo came from here

ETA: I totally forgot to talk about boobs! My boobs are SO SORE. They feel awful if I'm not wearing a bra, which luckily is almost never since they're on the gigantic side and I never go braless. This is probably from all the hormones too and just another thing I have to wait out :(

 

Day 1: Fertilization Report

Dr. D called this morning to give us the news that we now have SIX wonderful looking embryos. I was getting kind of starry eyed there for a bit, dreaming about having 11 embryos, but I'm very, very happy with our six.

Out of the eleven, 3 ended up being too immature/small to fertilize, leaving 8 good mature eggs, and 2 of those 8 don't look fabulous after fertilization, giving us the 6. The six all fertilized quickly and easily and are looking really good thus far. Dr. D said getting 80% of the mature eggs to fertilize is very good and I'm really excited for these six. Our next report will be on day 3 when we should be seeing 6-8 cells in each embryo. 

Original Photo came from here

As far as recovery goes, I'm doing better than I expected. I heard all sorts of horror stories about people being in terrible pain after a retrieval and I've been extremely lucky that that hasn't been my experience. I took two Tylenol around 1am and went to sleep with my feet on a big pile of pillows to try and help the bloat go down. Aside from getting up at 1:30, 2:30 and 5:00am to pee, I slept pretty well.

When I finally woke up, it was to the sensation of cramping and stabbing, but in my stomach not my ovaries. My first thought was:

"oh nooooo, is this the god awful constipation everyone talks about??? Noooo do not want!"

Ten seconds later I realized they weren't. Nope. Not even close. They were actually hunger pains! Apparently my body has not caught up to the fact that it's no longer feeding 11 protein leeching follicles and I'm still starving and craving soup. I did end up being a little constipated later but it wasn't anything like people had described, it did not make me feel like my ovaries were going to die and fall out, so clearly guzzling all this water is helping.  I'm averaging somewhere between 100-150 ounces a day of PH/electrolyte water, 2-3 of the big bottles from Whole Foods, and I have a couple more left to get me through today. 

I took two more Tylenol around 9am just in case and Dr. D told me to take it easy today. Since I inhaled all the Matzo ball soup E brought me yesterday, my first trip out of the house was to Factor's Deli to get two more Matzo ball soups. I'm pretty sure E thinks I'm a little crazy but it's nice to be craving the stuff I'm actually supposed to be eating. Clear, salty broth and protein is exactly what the doctor ordered, and as long as it continues to help, who am I to disagree??