Friday, May 9, 2014

IVF Cycle #1: An Embryo Transfer and a Funeral

Sunday morning I woke up early and could not sleep. I kept thinking about my grandpa and decided that I really wanted to write his obituary. Ideas and phrases kept popping into my head and I kept grabbing my phone off of my night stand to type little notes. Before I knew it I had written an entire obituary for him in the notepad app on my phone. At 7:00 am I texted my mom to ask if I could write it. I thought for sure she would be up-she never slept in. An hour later I had not heard from her so I confessed that I had actually already written it so I really hoped they would use it. She texted back saying that my grandma would love for me to do it. I called later that day and got information to fill in some blanks and then sent it to my dad to edit.

The rest of my Sunday was spent preparing for our embryo transfer in the morning. After the transfer I would be on bed rest/limited activity for three days. I had been recording movies on our DVR for weeks and also had "A Game of Thrones" to finish reading. I went to the store and bought fruits and veggies for smoothies and salads. I cut up a pineapple and put daily portions into zip lock bags so for breakfast I could just add a bag of pineapple, a banana, some orange juice, a scoop of yogurt and a handful of frozen strawberries to the blender to make a quick smoothie. I mixed lettuce, tomatoes and cucumber slices together and divided it into meal sized portions in zip lock bags, so for lunch I could take a bag of salad and top it with some steak or chicken strips (also prepared and in the fridge) and dressing for lunch. I figured I would leave dinners up to Ryan, since he would be home each night by that time. I made sure laundry was done and the house was clean so that I could truly relax for those three days.

By Monday morning I felt completely ready! We went to the doctor's office first thing in the morning to have our first little embryo put into my uterus. It sounds so cold and scientific, but really IVF is such a miraculous thing. I am so glad we have so many developments in modern medicine so that something like this can be an option! The doctor had me take some Valium to help me relax, then had us sign some papers and explained what was going to happen. Then we discussed the embryos. It used to be that more embryos meant a better chance of a pregnancy but our doctor said that current research shows an increase in twins when you transfer two embryos, but not necessarily pregnancy. With my age and good health he recommended one, but said it was up to us. We had though it over quite a bit (and I had looked up lots of information online) and decided to just transfer one embryo. Not all of our embryos had made it; we had eight embryos left and not all of those eight had reached the blastocyst stage they needed to before they could be frozen. They would transfer the best one of the eight embryos that day and freeze the other seven as they were ready. They even gave us a picture of two of our embryos to take home (which I still think is so cool! How many people get a picture of their baby at this early stage in development?!)

I keep this picture on my fridge.

The embryo transfer was a really neat thing to experience. As always, they had me laying down half naked and covered by a sheet. I was laying on a foam triangle shaped pillow to elevate my pelvic area. Ryan was sitting next to my head to my left. One of the nurses put jelly on my stomach for the ultrasound. On the wall behind the doctor they had a TV. The embryologist came in and had us verify that the name on a vial was mine then the he went into a room connected to ours and Dr. Moore told us to watch on the screen. He explained everything while we watched a little dot on a white screen grow larger as the microscope zoomed in until it looked just like the embryo in the picture. Then the embryologist zoomed out and we watched as a clear plastic tube appeared and sucked up the embryo. We could see the tiny little embryo move into the tube. Then the embryologist came back in holding the small catheter tube and handed it to the doctor. He inserted it into me and they watched on via ultrasound to make sure they got it in the right place then as they release the embryo a small white streak appeared. The embryo itself is too small to see on the ultrasound-the white streak was from the fluid that contained the embryo. After that the embryologist took the catheter back into the attached lab and put it under the microscope again. We watched on the screen as he zoomed in just to make sure the embryo had not gotten stuck in the tube. All was good and we were done!

Our ultrasound: notice the little white streak in the circle.

Dr. Moore said that for the next three days I should take it easy and limit my activity. He said I did not have to stay in bed all the time-we could go to dinner or a movie-but to try and stay off my feet as much as I could. I asked what he thought of me attending my grandpa's funeral. The viewing was being held Wednesday night and the funeral Thursday morning. I explained that it would mean packing and traveling since the funeral was in Idaho Falls. I really liked how my doctor handled this. He basically gave me permission to go, but then asked how I felt about it. I told him that I was worried about the stress of going on a trip, the emotional stress of seeing my mom and grandma cry and the physical standing and walking at the viewing and cemetery after the funeral. I explained that I felt like I had closure and really I wanted to be there for my family (who had told me to stay home) more than anything. I was actually pretty lucky: I got to say goodbye to my grandpa and make sure that my last meeting with him was meaningful. That is so much better closure and brings much more peace than a funeral could. After everything I had to say, he said that it would probably be a good idea for me to stay home, but to do what I felt I needed to do. I just appreciated the sensitive way he handled a tough question: he gave me his recommendation, but also made me feel like I should do what I thought was best.

They had me lay there for thirty minutes (I came prepared with a book) then a nurse came in and told me I could get dressed. I stood up and the Valium really hit me! I felt so dizzy and light that I couldn't help but giggle. Ryan had to help me get dressed then the nurse wheeled me down to the car in a wheelchair. I fell asleep before we were on the freeway and didn't wake up until we pulled into the driveway. I was starving so I went inside and had all the stuff out to make myself a salad before Ryan was even in the house. That was when I realized that I had forgotten to prep cheese...I pulled the one-pound block of cheese out of the fridge and grabbed a big knife. Ryan stopped me and told me that putting my body weight into a block of cheese was not bed rest and walked me downstairs and then fixed up my salad himself and brought it down to me-complete with tiny cubes of cheese sprinkled on top and the bottle of dressing on the side. I ate and then let the Valium take over again and I fell back asleep until I had to wake up for my progesterone shot. Ryan would have to give me these shots until my tenth week of pregnancy if we got a positive result! The shot was so much easier than I thought it would be. It was a pretty big needle and the shot had to go in my hip muscle (above my but cheek). We had the nurse draw circles on my back after egg retrieval so he would know where to aim. It did no hurt like I thought it would (yet...)

Later that day I cut my grandpa's obituary down to fit in the required word count and emailed it to my aunt so they could get it to the funeral home. It was printed in the the Idaho Falls Post Register on Wednesday that week (read it here: William Lynn Yorgesen Obituary). I don't really remember much about what I did during my three days of bed rest (but bed rest is not a very exciting way to spend your days). On the first day I went through all of my pictures and emailed some of the best ones of my grandpa to my aunt for a slide show they put together. I did not go to the funeral, but felt like I still was able to contribute. The funeral home would also provide a recording of the service so I knew that I would get to hear it all later. My mom told me that she knew my grandpa would've wanted me to do everything possible to bring a baby into the world and so she too thought that I should stay home. That made me feel better. Looking back now I have a little bit of regret because it would not have made a difference in the outcome if we had gone or not, but at the time I did not know that and we just did what we felt was best.

At this point I was still drinking a ton of Gatorade every day and it was really starting to make me feel sick-my stomach hurt all the time. On top of that I was nauseous off and on all the time-especially when I was hungry-likely from the HCG in my system from the Pregnyl shot. I still felt very bloated for a few days and was getting heartburn so bad that I couldn't sleep. Finally I decided that I could not take the Gatorade any more. I think all the sugar in it was irritating my stomach. I switched to coconut water and pedialyte to replace the electrolytes and broth for the sodium (I emailed the doctor for approval). After one day on the new fluids my stomach felt so much better. Two days later something magical happened: I lost two pounds and an inch and a half in one day! That meant everything was leveling out and I was probably no longer at risk for Ovarian Hyper Stimulation Syndrome. (I kept track of my weight, stomach circumference and fluid intake and output for another couple days just to be safe though.) I was finally starting to feel normal again...but normal was not necessarily what I was hoping for.

Later that week we found out we had lost another embryo, but we still ended up with six frozen ones. That meant we still had six more chances to try again, which is quite a few-more than a lot of couples come out with-so we still felt blessed. They scheduled our blood test to find out whether or not I was pregnant for March 8. For those who have experienced the "two-week-wait" you know that it feels like the longest two weeks of your life! I was fortunate enough that I only had to wait twelve days, but it was still a very long twelve days. The hardest part was knowing that according to the traditional pregnancy calendar I was technically already three weeks pregnant.

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