Recovery and The Deep Freeze

I didn’t anticipate how long it would take to recover from the egg retrieval process.  I keep reminding myself that I had a surgical procedure, and my body needs time to heal.  As someone who rarely takes any pain medication, I am discomfited by prolonged period of feeling “not myself”. Who wouldn’t, right?

Thankfully, I was able to work from home the two days after my procedure, and I rotated between the couch and the bed. My belly continued to feel distended and uncomfortable, as if imaginary weights were pulling it toward my feet.  My digestion was just as altered, which didn’t help my feelings of discomfort.  A close friend of mine had egg retrieval done the year before, and shortly thereafter we went on camping trip (which now seems absolutely absurd to me) and I remember that she was guzzling laxatives – I now empathize whole heartedly.

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The day following the retrieval we heard that, of the 18 eggs that were retrieved, 14 were able to be fertilized!  Daddy Graham and I couldn’t get over the fact that we were growing quite a brood in some nearby petri dishes.  My fertility clinic prefers to do frozen embryo transfers (FET), as it gives the body an opportunity to calm down from the trauma and stimulation of hormones and surgery.  That said, we knew that we would be waiting on pins and needles to find out how many of these 14 fertilized eggs would make it to the 5-day blastocyst stage (or blast) and subsequently cryopreserved.

Yesterday (a week after the retrieval) we learned that we had 8 blasts that were able to be frozen.  Going from 18 to 14 to 8 may seem like quite a decline, but I think that we are exceptionally lucky.  I did ask the embryologist for the “grades” of our embabies (I found this link extremely helpful), and we had 3 that were “good to great” and 5 that were “fair”. It’s hard not to get stuck on this grading system, but from what I understand, it isn’t necessarily a definitive indicator for successful implantation.

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I am now waiting for my period to start so that I can begin the uterine lining thickening protocol (more injections and suppositories, yay).  We are keeping our fingers crossed for a FET in August!

 

Lucky 18

Our egg retrieval today yielded 18 eggs! I’m writing this post from bed as I rest with a heating pad and lots of reading materials. Our cat the empath hasn’t left my side since we got back. 

I was equal parts nervous and excited for today’s procedure, as I’ve never had surgery before and I was more than ready to have my follicles aspirated (if only to alleviate the feelings of being 5 months pregnant!). Daddy Graham and I arrived at the clinic at 7, and he almost immediately was whisked away to do his part. Soon thereafter I was taken back to be prepped for surgery.

I was picturing one of those scratchy hospital gowns and an antisceptic room, but I was given a fluffy robe to wear (that was warm!!) and led to a spa-like room with a leather recliner! All of the staff – the nurses, surgeon, embryologist, and anesthesiologist – were extremely accommodating and helpful. The nurse joked that once the anesthesia was in the IV,  I would wake up and ask when we were about to start and it’d be all over, which is pretty much exactly how it happened! The last thing I remember was having an oxygen mask placed over my face, and the next I was blinking at the nurse. 

For the squeamish, you may want to skip to the next part as I want to write a little bit about what the surgery actually entailed.  Once under anesthesia, the surgeon inserts an ultrasound wand with a slender needle attached. This needle will then go through the vaginal wall and into the ovary where each follicle is aspirated through the needle and the eggs detach from the follicle wall and are sucked out of the ovary.  A few hours later the embryologist will insert the sperm into the egg, and then we wait! 

Before we left for home, I was told we had retrieved 18 eggs. It felt like an omen – 18 in Judaism is a lucky number that means ‘life’. While we won’t know until tomorrow how many of the eggs that we retrieved were viable for fertilization, we feel incredibly optimistic.  All we want is for one healthy embryo to stick! It’s amazing to think that in a Petri dish not that far away, our future Baby Graham is beginning his/her life. 

Trigger Happy

IMG_4622This morning’s appointment brought the welcome news that we are ready to trigger for our egg retrieval!  I’ve been really uncomfortable and nauseous the past few days and no wonder – today’s ultrasound revealed at least 20 follicles just on my right ovary.  The nurse actually stopped counting once she hit 12 on each side.  While I am pleased that my body has responded so well to the stimulating hormones, I do realize that it is quality over quantity, so I am really hoping that we are able to retrieve viable, healthy eggs that fertilize.  And, let’s be honest, I’m looking forward to not feeling like a Macy’s Thanksgiving Day Parade float.

I just had an opportunity to look at my lab results and, to my untrained eye, my estrogen levels look really high: slightly over 9,000 pg/mL.  As I understand it, each follicle will release between 150-200 pg/mL, so I get why my level is sky high but I worry that this could develop into ovarian hyperstimulation syndrome (OHSS) after egg retrieval and/or they will cancel this cycle.  I haven’t heard from my doctor’s office and they are usually really good about calling if there are any issues with my lab results.  Anxious, much?

Tonight I am scheduled to take my first trigger of Lupron.  Due to timing, I will have to give myself a Lupron shot at work tomorrow morning as well, which should be interesting to say the very least. Making IVF viable while I work has been a challenge, but thankfully I have a job with some flexibility and that is accommodating to the many doctor’s appointments that I’ve so far had.

Wednesday, first thing, Daddy Graham and I will head into the Fertility Clinic to have the eggs retrieved and for Daddy Graham to deliver some swimmers.  Fingers crossed that everything goes smoothly and that we are one step closer to Baby Graham!

Doing Battle with … Insurance

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As I had mentioned before, my insurance is covering my IVF (up to $50,000).  I am unbelievably lucky on this front, I know.  There are numerous women and couples who fork over their life savings for treatment which, as we all know, isn’t a guarantee that you will one day have a baby.  This doesn’t mean I don’t have to battle my insurance company for coverage of medicine …

As you all know, I’m currently in the middle of my first IVF cycle.  I was given a laundry list of prescriptions for the stimulating hormones which had to be fulfilled through a specialty pharmacy.  Four of the medicines required prior approval: the follistim (contains follicle-stimulating hormone (FSH) to help produce follicles/eggs), menopur (contains FSH and luteinizing hormone (LH) to help produce follicles/eggs), cetrotide (prevents premature ovulation by blocking the hormone that causes eggs to be released from the ovaries), and leuprolide (used as the trigger before IVF).  After much time spent on the phone with both the Fertility Clinic and Specialty Pharmacy through my insurance carrier, I was given the prior approval for three out of the four. Mind you, I was given approval after I had started the cycle – my Fertility Clinic was kind enough to “front” me the medicine that I needed with the understanding that, when my prescriptions came in, I would turn them over.   Leuprolide, however, was deemed “unnecessary” by my insurance carrier and denied.

Denied!  Even though it was a script written by my doctor for their IVF protocol.  Even though it was reviewed twice. Even though I am in the middle of my hormone therapy regimen and I need the medicine as soon as possible.  The specialty pharmacy said that my doctor could fax in a “letter of medical necessity”; the prior approval department at the doctor’s said they would be happy to do this but it could take up to two weeks to review.  TWO WEEKS?  Not the two week wait I am comfortable with … Instead, I am looking at paying out of pocket for the medicine, which is incredibly frustrating.

One more hurdle to clear. Deep breath in.