(In)Fertility Journey- 7. IVF Egg Retrieval

My egg retrieval was scheduled for 35 hours after my first injection of Lupron + Novarel, at 10:30am. Because I would be under ‘twilight’ anesthesia, I was told not to eat anything the night before after 9pm, and no liquids after midnight. I had trouble sleeping again, and was so ready for this to be over.

We checked in an hour before the procedure, and the medical staff started getting me ready. My husband and I were in a small curtained space with a hospital bed. I had an IV attached to a vein on the outside of my right hand, and was in a hospital gown when the embryologist, and then the doctor, came by for a quick check in.

We had previously had difficulty communicating in regards to ICSI and/or traditional fertilization, so we clarified that we were planning traditional fertilization for all eggs. The embryologist confirmed the plan, and my husband was present and ready to provide a fresh sample. We also told the embryologist that my husband had previously provided a sample for freezing, which was analyzed to be ‘good’ according to every criteria evaluated. And this is when we got a surprise:

The embryologist told us that they would need a fresh sample, because they only use frozen sperm for ICSI, not for traditional fertilization. After further questioning, she implied sperm that had been previously frozen are not as capable as fresh sperm to fertilize eggs by themselves. This was news to us. It didn’t even occur to me to research this, and when we had previously asked to freeze some sperm ‘just in case’ we were told that was a good idea.

I was irritated, because then I had more questions. Was freezing sperm more difficult than freezing embryos? Are sperm and embryos frozen using the same materials/procedures? If there is a clear decrease in functionality (quality?) of frozen sperm compared to fresh, what are the possible decreases in functionality between frozen vs. fresh embryos?! Now that I was thinking about it, of course freezing (and thawing) a biological sample would impact its subsequent function, but I didn’t have any time to discuss or consider this further. I was doubly upset to be in that position while not wearing underwear.

In the end, it likely made no difference, our doctor later assured us that my husband’s fresh sample was perfectly adequate (he told us via video conference, we did not get a report on the semen analysis).

It just seemed to be disjointed; every time we questioned our doctor, he assures us everything that takes place in the embryology lab is no problem; that biopsying the embryo has no negative consequences that he has seen. Meanwhile, the embryology lab is implying that frozen sperm is less competent than fresh sperm. It seems a case of the right hand not caring to know what the left hand is dealing with.

The embryologist was very nice, and was willing to talk to us, but it would have been much more helpful if we had a chance to speak with her before I’m in a gown and hooked up to an IV. To make it worse, the embryologist assured me that she was a ‘nerd’.

Rant:

In my experience, 99% of self proclaimed ‘nerds’ are idiots. The popularization of the term by silicon valley tech people has been used by some people to declare themselves of superior intelligence and or knowledge compared to everyone else.

The Oxford Languages definition of ‘nerd’ is “a foolish or contemptible person who lacks social skills or is boringly studious“. The self proclaimed nerds I have met are not studious- being studious takes time and effort and dedication, in short, hard work. It is much easier to simply declare oneself to be studious instead of actually being studious. The majority of the self proclaimed nerds I have met are disproportionately lazy.

I can agree that most self proclaimed nerds lack good social skills, because they lack modesty, appreciation of others, and the spirit of self improvement. Maybe from a different perspective, they have very effective social skills when it comes to an audience who will simply accept/believe a person who declares themselves superior to actually be superior. The majority of self proclaimed nerds I have met have been either narcissists or delusional in their perceived abilities. They are too busy announcing publicly, that they are a ‘nerd’ to actually learn or acknowledge the experience or knowledge of others, and therefore their untried, untested convictions continues to feed on itself.

I know that my default is to belittle myself, but even so, I cannot find a single positive/helpful instance where a person brags about being a nerd, especially when it comes to a topic of importance. Whether they intend to or not, they are declaring themselves ‘special’ and ‘better’ at the expense of everyone else.

Sometimes there are people using jargon that only they have any reason to be familiar with. I detest people who make others who are not in their specialty feel stupid for not knowing stuff that only someone in their job would know. Whenever I find myself in a position to share my experience or what I know, with someone who doesn’t have background in that area, I ask questions, explain things (and ask if my explanation is making sense) and be patient; I remember when I was learning things myself. No one is born with knowledge, it is gained, or earned. Approaching the unknown with curiosity and an open mind is so much more helpful to learning as opposed to being made to feel stupid or incapable. I know a number of amazing people who are experts in their field. They’ve never called themselves nerds, they’re too busy trying to have a discussion about something awesome.

The term ‘nerd’ is not a badge of honor for people to brag about. 99% of people I have met who are self-declared nerds are either engaged in delusional self propaganda, or are people with low self esteem. I have no problem with the word itself, but it has been heavily abused. I will decide for myself, based on available information and observations, whether someone is good at what they do. I have learned to be wary of such self proclamations. The typically mediocre reality of these people is even more depressing given their inflation of expectations.

In my situation, as this well-meaning embryologist is telling me that frozen sperm can only be used for ICSI, she doesn’t provide any additional information. People who are knowledgeable are capable of providing information to substantiate the use of any particular protocol. I asked her if frozen sperm has difficulty penetrating the zona pellucida, the protein shell that encloses the membrane of the egg, and she simply says ‘yes’, nothing further. Given that this is her job, and she just declared herself a nerd, I’d hoped (still) for more information, instead she was like every other self-professed nerd I’ve met; hyped up and lacking in delivery.

Regarding the question of fresh vs. frozen, this webpage provides some clarity, along with reference to an actual study.

If I sound angry here, it is because I am angry. I’m angry that I’m going through this stressful painful procedure, and paying people to do their jobs, and I don’t feel that I can trust these people to care about every detail of their job as much as I do. The embryologist may have been trying to reassure me by calling herself a ‘nerd’, instead she achieved the opposite.

After the embryologist left, our doctor came to talk to us for a bit; there really wasn’t much to say; we’d see how everything went afterwards. He mentioned that he would put in our prescription for antibiotics for endometriosis, and that we should start a day later, as I was already on so many drugs. We listened, but really what we were focused on were our 10 good-looking follicles.

My husband left for his part of the procedure, and I was left with the nurse and anesthesiologist, both of whom were excellent. They explained everything that they were going to do before, then told me of things to watch out for. Their calm, competence, complete information was so welcome. The nurse put a heat pad on me to help with my bloated stomach (why didn’t I think of that before?!). And then the anesthesiologist helped me carefully (IV attached) go empty my bladder first, and then settle in the operating room. The last thing I remember is the anesthesiologist telling me to lay farther back and then, nothing.

I woke up back in the curtained area. The anesthesiologist removed my IV. The nurse called my husband back, and perhaps about 45 mins had passed. I was given some water, and told that I would need to pee before I could leave.

And then, the nurse came back and asked me if I was ready to hear the results. She told us that they retrieved 6 eggs. I was a little confused why the embryologist didn’t tell us, and had the nurse tell us instead. My husband and I were disappointed. It made me really sad, but at the time I was also relieved it was over, and for the next 30 mins, I wasn’t feeling any pain, so it seemed okay. I know there was no point in being upset over a ‘good’ or ‘bad’ number, but it was certainly much lower than we had hoped.

I peed, and then the nurse and my husband helped me back to our car, as I was still a little unsteady (I was starting to feel like a slight hangover).

Egg retrieval was called Day 0 by the embryology lab, and we would get updates on Day 1 and Day 5, possibly on Day 6. In the following posts, this is what I mean when I refer to Day #.

We went home, and I was just so relieved to not have to take any more drugs, that I could be in recovery. Up to this point, things were confusing, scary, and upsetting at times. I started to feel more discomfort about an hour after getting home, I ate a good portion of my lunch. I wasn’t feel nausea so much, but my stomach was feeling very distended. After lunch I went to lay down and ended up sleeping for a couple of hours. I was excited that I was on the mend! I wasn’t really mentally prepared for worse.

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