(In)Fertility Journey- 8. IVF After Egg Retrieval

This entry is part [part not set] of 9 in the series IVF- In(Fertility) Journey

I was warned after the egg retrieval that I might be constipated and that bloating could last 4 to 5 days. I was recommended Colace to help with constipation, and that I could take Tylenol right away, or Advil a few hours after getting home.

I’m glad I loaded up on Advil (Tylenol doesn’t do much for me). I didn’t sleep well that night, but I also wanted to get up early in case the embryologist got back to us early. We were told only that the embryologist would call us on the morning after egg retrieval (Day 1) to tell us how many eggs were fertilized.

It’s hard to say when everything started to really go poorly, but a big turning point is when we got the call that morning on Day 1. We were told that of the 6 eggs retrieved, 5 were mature, and only 2 fertilized. We asked if the sperm even attached to the zona pellucida, and was told that some did, but likely not firm binding. We asked about how many sperms attached to the eggs, and was told that because eggs are 3D structures, and they are only looking at the 2D structure, they could not say. I felt like saying, ‘Have you considered moving the specimen stage of your microscope up and down to scan through the planes? That could give you at least a rough estimate of how many sperm cells attached!’ But I was so demoralized. I had lots of questions, but I really didn’t feel up to following up right then.

The person on the phone was a different embryologist from the one we spoke to the day before. She assured us that while the unfertilized eggs would remain in the incubator, they didn’t think anything would come of them. We thanked the embryologist for the call and after we hung up, I cried. I felt like such a failure. I kept hope alive this whole time, but this told me the chances of us getting a healthy embryo was very slight indeed, and it was most likely that we would not be making much progress in growing our family.

And because I’ve worked for years in a lab, some of it involving cell culture, I wondered if there was any issues with contamination in the lab. I worried that the embryologists wouldn’t take as good care of the unfertilized eggs as the fertilized ones. I worried about how careful every single staff member that came into contact with our eggs and sperm were. I worried that cutting an opening in the egg via assisted hatching to facilitate possible biopsy later was too much damage for the embryos. I worried that the stimulation/trigger protocol used did not produce mature eggs. I worried that all this artificial stuff just made my body confused and upset and it didn’t want to do what we tried to get it to do. I worried that the Novarel didn’t work as it should because the injection site developed a bruise and a lump that I could feel for a week and a half afterwards.

It didn’t help that I was physically feeling worse. I popped lots of Advil, but I was more distended and bloated than before the egg retrieval. I was more constipated. My breasts hurt more. And now I was also very, very sad. I felt frustrated after all the work that went into producing these eggs that I would never even get to see a picture, or get a written report on it; all we could rely on in terms of the progress of our eggs/embryos was a phone call.

When we started on this journey, we told ourselves that we would give this a try. At this point I was realizing that we may never be able to have our own kids. I was very sad.

We tried to keep our spirits up. It was close to Christmas, so we tried to do some holiday stuff, even if we were under quarantine for COVID. We sent family and friends holiday cards. We did Zoom meetings for fun. Meanwhile, I was totally miserable. The bloating and distension was worse. My breasts felt radioactive (they hurt all the time). My stomach skin/layer felt swollen. The last two bruises from injections took more than a week to go away. And most of all, I was horribly constipated.

On Day 2, despite the poor news we’d received so far, we went ahead and started taking the antibiotics for endometritis: 100mg Doxycycline Hyclate 2x/day, and 500mg Metronidazole 2x/day. I tried to tell myself that even if we don’t end up using my uterus, it’s probably good not to have an ongoing inflammation in there. The urge to just ignore the health my uncooperative/defective reproductive organs was strong. I reminded myself that they were a part of me, uncooperative/defective or not, and their status affects the rest of my well-being. So, onward with the antibiotics.

After the egg retrieval I felt as though I didn’t have any control/feeling of discrete parts in my stomach. I know that I did not feel like pooping at all, even though I tried. I had no poop, at all, nothing. I took Colace, which was supposed to produce a bowel movement in 12 to 72 hours. I waited another day.

On Day 3 I took more Colace. I was feeling miserable, because I hadn’t even caught up on pooping before egg retrieval, and after egg retrieval it was at a complete standstill. I was also getting random pains; my armpit where it swelled up after my flu shot hurt more. Some recent tendonitis in my hands started to hurt again. My overall torso was a mess; I had the worst breast tenderness ever, and my stomach was upset and distended. I was miserable.

On Day 4 I bit the bullet and got Senokot-S, which was purported to be more ‘effective’ of a treatment, and was supposed to produce a bowel movement in 6-12 hours. This stuff works. The maximum dose was for 4 tablets twice a day. I took the one dose at about 2pm, of 4 tablets. At almost exactly 12 hours later, I got up at 2am and felt like a cartoon character with a hose coming out of my back end. Then I did it again at 3am. Then again at 4-5am. Then went again perhaps 3 more times during the day. I felt so much better. Before, I had felt such an immense pressure in my abdomen that I couldn’t distinguish one pain from another. Now I can tell my stomach surface from my stomach, from my ovaries and uterus. I started to sleep better.

In hindsight, I should have taken it much earlier during stimulation, but I admit I had this horrible fear of having diarrhea at the egg retrieval.

On Day 5, we got another call from the same embryologist. Unfortunately the two fertilized eggs stopped developing at 20-something cells, and never made it to the 30-cell stage. Likely around day 3 or 4. The previously unfertilized cells looked like they might be spontaneously dividing, but they were not normal, and were unlikely to have been fertilized since the Day 1 update. They did not have any further information, but would keep the eggs and embryos for one more day, and follow up with us tomorrow. I cried some more.

On Day 6, we got a call from the embryology lab director. Not surprisingly, the two fertilized eggs had still made no improvement. The unfertilized cells were in the same state. There was no further information. The lab director told us they will be disposing of all the material that day. He also mentioned that the clinic would reach out to us in a few days to make a follow up appointment with our doctor. I asked if there was going to be any write up or if there was any additional information. There was none. I asked if there was at least a record of our eggs/embryo for this cycle, and was told that we could request it. So we requested it right away. I cried some more.

This was our IVF embryology report. It shows that there was about 11 follicles at the start of retrieval. I’m not sure if this is correct, but the start of retrieval was at 10:43 am and was completed at 10:48 am??? The sperm was fine, and that there was 6 oocytes retrieved. On Day 1, two had normal fertilization (2PN) and three did not fertilize (0PN), for a total of 5 mature eggs. On Day 3, the two fertilized embryos were developing, one a little slower than the other one, and assisted hatching was performed on both embryos. By Day 5, neither of the embryos had developed beyond the 30 cell stage when the ideal would be 60-100 cells. On Day 6, it was clear that no further development had occurred. The total number of embryos saved was zero. More discussion about this report in the next post.

On Day 8, my period started. I was surprised, I didn’t expect it for another week. It turns out that on Lupron, your period can start about a week after your dose. This was definitely the case for me. This period was definitely heavier than usual, but with lots of Advil, it was just a pretty normal period. Meanwhile, the antibiotics, for which I had another week to go, was making my tongue look furry, and I was getting indigestion.

A couple of days later the clinic called to say that they made an appointment for us to speak with our Doctor via phone or videoconference in two weeks. I would get sad, but basically just focused on resting and trying to enjoy the holidays. We stuffed our two sweet kitties into reindeer costumes (for two minutes!) and took pictures of them. I called my sister and cried and vented my frustration and sadness, and she listened- we even laughed a little while I was telling her about my constipation and the spectacular effects of Senokot-S. We made a special dinner for my husband, who’s birthday is on Christmas Eve. We couldn’t drink because of the antibiotics we were on, so we celebrated with fizzy blackberry soda.

We reminded each other how lucky we were to have each other and the life that we have. And in this manner, we put away 2020 and entered 2021.