When we started the IVF process there were tons and tons of statistics thrown at us constantly to estimate response and success rates - age, AMH levels, FSH levels, antral follicle counts, estrogen, progesterone, clinical success, drop-offs through retrieval, fertilization, and ultimately blastocyst creation. So many numbers and so many statistical probabilities. I felt like my life and my body were being put into a calculator and out popped percentages for the likelihood of a happily ever after. It's a shame that all of this ultimately comes down to statistics and success rates, but I understand where they were coming from and why these are important particularly in the world of assisted reproduction and reproductive endocrinology.
One of my biggest traumas from the delivery disaster was feeling like I was asking for help and not receiving it. Through the IVF process, our RE was very careful to monitor everything to a T, for one because my percentage once computed through their statistical analysis showed a high probability of response to stimulation and also because she knew how terrified I was of having something overlooked again (and the potential disasters that can ensue.)
The entire process took approximately 4 weeks. We got insanely lucky that when my initial baseline bloodwork was done they seemed to catch my progesterone levels within 24 hours of an ovulation. Bloodwork a week later confirmed this for sure and I was able to proceed with the traditional long-lupron protocol. Two weeks of 20 mL lupron shots before adding stimulation medications of 75 mL Menopur and 225 mL Gonal-F and ultimately a trigger shot 36 hours before retrieval of Pregnyl. Not to mention daily Lovanox injections to prevent a blood clot.
I honestly didn't mind the shots. The needles were tiny, subcutaneous injections with the exception of the Pregnyl HCG trigger shot which was inter-muscular. On most days, I could hardly feel them other than the Lovanox ones that burned and always left bruises. Shots were to be taken 12 hours apart, with a Gonal-F in the morning along with Lovanox, and then the Menopur, another Gonal-F, and Lupron in the evening. We went down to a drive-in movie the day after I started my shots so I set my times as 5am in the morning and 5pm in the evening. My mother-in-law came down to help with our daughter so that I could make all the appointments and not have to do a lot of bending and lifting while on the stimulation meds.
My levels held steady throughout the entire process and I never had dosages adjusted. Daily instead of every other day ultrasounds and bloodwork monitored follicular growth and estrogen/progesterone levels and I responded the way we all hoped I would. I am so fortunate that a dear friend who is a nurse was willing to administer the HCG shot. The timing of the trigger shot is so critical (exactly 36 hours before the retrieval) and I was terrified I was going to mess it up. As it was, we had some difficulty mixing it and I'm eternally grateful for her expertise and calm in that moment as I panicked that I was going to screw up everything and god-forbid ovulate before they were able to do the procedure. For most people, if the IVF cycle is canceled and there aren't too many eggs to be released, people will be released to try to get pregnant the old fashioned way. In my case, I would lose all that hard work to the deep abdominal abyss and I was panicked at that thought of time and money literally evaporating.
We made it though to egg retrieval successfully. I was warned that I would need to take it easy that week so I had my parents come help with baby girl so that I could heal. I was given an information sheet on the symptoms of Overian Hyperstimulation Syndrome (OHSS) and what to look for in the event that the worst happened but two day after retrieval seemed to be feeling fine. We even walked through Costco. Fast forward to the end of that week though, and I started having a lot of pain in my abdomen above my belly button. Two trips to the ER over the course of the next week confirmed it - I had moderate OHSS. My ovary was 11 cm, basically the size of an orange, when normally they are to be the size of an almond. Fortunately my mother-in-law was able to come back down to help with baby girl because I was again not allowed to bend or pick up anything over 10 lbs and was put on modified bed rest for a week. I am grateful I never had the fluid in my abdomen and that I didn't need to be admitted to the hospital again.
I have been so defeated and frustrated with my body over all of this in regards to health and healing. I've always been super healthy, and never in my life have I had so many medical issues as I have in the past year. As of now, it's been two weeks since I first went to the ER for the OHSS and I'm feeling better, but still having some residual hormonal effects. The RE had said that once the next cycle kicks back in, it's sort of like flushing a toilet and starting again. The ER doctors though have said it can take a couple months to truly be back to normal after several "toilet flushes". Knowing me, I'll undoubtedly fall into the latter category as we add it to the "incredibly small statical chance" odds I continue to achieve. Lucky, lucky me.
After everything that has happened, I am just ready to get back to my normal life. I'm ready to enjoy going to the new trampoline park or getting back into Zumba. I don't want to worry that I am going to do damage to my incision or my ovary by bending over to pick up my daughter or getting on the floor to play with her. I want to be able to meet my girlfriends for cocktails or coffee and to eat spinach or kale whenever I want to. I know I need to be patient, but I can't help but feeling like I've missed out on some milestones with baby girl because of physical limitations I have never had before. If it weren't for amazing friends and family, I don't know where we'd be. I'm hoping this is the end of taking one step forward and two steps back, and maybe the final step to really healing and getting my life back on track. Onward and upward!
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