It’s been a while since I updated you on our infertility journey. Spring was a whirlwind I was happy to part with when summer made it’s appearance. After my attempted hydrosalpinx removal (more on that here), my surgeon and endocrinologist were on very different pages regarding the direction we should take with our treatments. Our surgeon felt it was not necessary to proceed with surgery again to remove the tube because he did not feel a hydrosalpinx existed, but rather just adhesions and abnormal anatomy. Our endocrinologist, however, felt we should have a specialist attempt to remove the tube because he very strongly felt there was a hydrosalpinx. We were torn and went back and forth with it for a while, but ultimately felt we should attempt removal again and if that was unsuccessful, we would then move forward with IVF. The good news is that we were able to have my tube successfully removed in June, but in the spring, I completed a round of IVF. I probably shouldn’t refer to it as a round because I did not have anything implanted, but I did have eggs retrieved, fertilized, and they are now frozen. So let me walk you through that leg of the journey and update you on where we are currently.
January through March was filled with doctors appointments and taking meds. After returning from our trip to Ethiopia, I was not menstruating, and we wanted to touch base with Shady Grove (fertility clinic) to figure out our steps moving forward. So after a few appointments and a “no menses panel,” a test to figure out why you’re not menstruating, my endocrinologist prescribed me cabergoline to start again to lower my prolactin levels, which in turn will allow me to menstruate/ovulate. Once I started ovulating, we scheduled another appointment and from there I received my calendar for IVF stimulation which would begin on March 9th by taking birth control pills.
Once March rolled around, I had a mock embryo transfer and an HSG. A mock embryo transfer is exactly as it sounds, a synthetic in vitro fertilization, performed as a way to increase IVF success rates. An HSG, otherwise referred to as a hysterosalpingogram, is performed to assess the structure and health of Fallopian tubes. The HSG continued to show what appeared to be a hydrosalpinx, but this would not negatively impact the steps required for egg retrieval. My endocrinologist therefore encouraged us to move forward with the initial steps of IVF and to retrieve eggs, revisiting the issue after egg retrieval.
Finally, on April 1st-Easter Sunday, we started IVF stims. This was quite a day. It started with Easter celebrations at our house with family and friends, and ended with Brian giving me my first IVF injections and us holding each other laughing and crying for the rest of the night. If you’ve experienced IVF or any sort of fertility treatments (or are married/in a relationship with someone who has) requiring hormone pills or injections, you know how trying this process can be. You get worked up with anticipation and anxiety, nerves and fear collide, eventually coming to a breaking point because you’ve been holding it together for so long. Tears are warranted and completely necessary for you and your spouses well being and sanity!
Things got easier after that first night and eventually I was giving myself injections! If you asked me in March if I’d be giving myself shots, the answer would be hell no! I did not think I was capable. Heck, I didn’t know if I’d be able to handle the shots with Brian injecting them without passing out. After a few days of giving myself injections, I was a pro and my numbers were looking fabulous! When you start IVF stims, you go in for bloodwork and ultrasounds every other day, then when they really kick in, every day. The goal is lots of growing follicles and I was on the right track. I had my routine down and honestly (although this will probably sound weird), I looked forward to it. It was one thing I had complete control over despite so many uncertainties in our lives at that time. It brought me solace because I knew I was doing something right.
Fast forward to day 7, and my nurse was unsure we’d make it to day 13 because I had lots of follies (follicles) and they were growing fast. This was a little concerning because we anticipated egg retrieval between days 13 and 15 and Brian had work travel scheduled for days 9-12. Talk about a nervous wreck! I was so anxious about how it would all play out, but Brian reassured me he would fly home if we got the word for egg retrieval (you usually get 24 hours notice) or cancel the trip altogether. Egg retrieval happened on day 12, so Brian traveled and flew home just a bit early, so it worked out, as it would have regardless of the day. My egg retrieval went smoothly and they were able to retrieve 15 eggs! That’s a great number especially considering it was only from one ovary. My right ovary was not doing anything, at least that they could do, probably a result of the hydrosalpinx. But lefty worked hard and it paid off!
This next stage of the process is excruciating! This is the process of fertilization, then embryo progression, when you wait anxiously for the daily call from your nurse telling you how many eggs fertilized and made it through the first night, then how many embryos survived each night thereafter. This lasts approximately 5-7 days, given the embryos continue to progress. This was more difficult then the stims because we went through so much to get to this point that to walk away with little or no embryos would have been devastating. Thankfully, we were left with 4 embryos.
At this point, we opted for PGS testing/pre-implantation genetic screening because chromosomal abnormalities are the leading cause of miscarriage and this process determines the chromosomal make-up of the embryos. Additionally, with my hydrosalpinx, our chances of successful implantation of the embryo/successful IVF were reduced to 25%, versus the ~50% success rate for anyone else. This does not mean life birth rates resulting from IVF, but successful implantation/pregnancy rates. Additionally, these are the numbers for women under the age of 35.
We sent out embryos off for PGS testing, which takes several weeks; another excruciating part of the process! By this point, you know not to get too excited or in your head about anything because you will lose your sanity. You have to take each day as it comes and know that their is a higher power, whatever you believe in, that has a plan or purpose in the whole process and in your life. By mid May, we had our results. Two eggs were normal and rated good, one abnormal, and one did not have any DNA detected, so we were left with two embryos to freeze. This was good news, but also the determining factor in moving forward with a second surgery in attempt to remove my hydrosalpinx. If we came out of it with 4 or more good embryos, our plan was to try implantation and if unsuccessful, we would move forward with surgery before trying implantation again. Alas, we had 2, so surgery it was.
June rolled around and I had my surgery, successful cauterization of my Fallopian tube to resolve the hydrosalpinx. And now, here we are mid-July anxiously waiting for August 2nd, the day of my baseline eval, and hopefully the start of the process of my frozen embryo transfer/FET currently scheduled for August 20th! Wish us luck and keep us in your thoughts!